Winter Springs Police Department Special Needs Registry

Winter Springs Police Department Special Needs Registry 

The Special Needs Registry is a way for the Winter Springs Police Department to better assist residents who have special needs and provide helpful information for emergency responders.  

The Special Needs Registry program is completely voluntary. None of the information requested on this form is mandatory. 

 Parents and caregivers may enroll any person of any age with any type of medical condition or disability, including but not limited to: Autism Spectrum Disorder, Alzheimer's or Dementia, Bipolar Disorder, and Down syndrome. Adults with special needs may also enroll themselves. To register applicants, their parents or guardians complete the Special Needs Registry Form and return the document to the Winter Springs Police Department. Forms can be dropped off at the Department, requested to be picked up by an officer or emailed to the Winter Springs Police Department at tballew [at] winterspringsfl.org (tballew[at]winterspringsfl[dot]org).


What happens once the person is registered? 
Participants will receive a Winter Springs Police Department vinyl decal to display on or near the front door of your home or on a vehicle 
When a Winter Springs Police Officer has contact with a person listed on the registry, our dispatchers can provide useful information to help the officer successfully interact and communicate with your loved one. The registry can also provide the parent or caregiver's emergency contact information. 

Who has access to my family member's profile? 
Winter Springs Police personnel who require this information in the performance of their official duties will have access to the information. This information may be shared with other police agencies during an emergency situation, or if the registered person is missing within another jurisdiction. There are strict regulations with respect to accessing and disseminating this information. 


Can I update my profile if there are changes? How do I do that? 
Information can be updated anytime it might bring a significant impact on our policing response. Some examples would include a change in address, or change in emergency contact information. 
Changes can be made by contacting the Winter Springs Police Department Community Relations unit at tballew [at] winterspringsfl.org (tballew[at]winterspringsfl[dot]org) or by submitting a new registration form. 
 

How will this registry help if my family member is missing? 
If the registered individual is reported missing by the parent/guardian, our responding police officers have easy access to their information through the Special Needs registry. Knowing an individual's special needs (including triggers, stimulants, and de-escalation techniques) greatly assists our officers in locating your loved one, and safely handling an encounter. 

If the individual is not reported missing, but otherwise is contacted by our police officers, a computer query of our Special Needs Registry may allow to quickly identify and reunite your loved one. 

Registration Procedures:

Parents and caregivers may enroll any person of any age with any type of medical condition or disability, including but not limited to: Autism Spectrum Disorder, Alzheimer's or Dementia, Bipolar Disorder, and Down syndrome. Adults with special needs may also enroll themselves.

What happens once the person is registered?

Participants will receive a Winter Springs Police Department vinyl decal to display on or near the front door of your home or on a vehicle When a Winter Springs Police Officer has contact with a person listed on the registry, our dispatchers can provide useful information to help the officer successfully interact and communicate with your loved one. The registry can also provide the parent or caregiver's emergency contact information.

Personal Information

Please input the personal information of the special needs individual below.
Name
Height
feet
inches
One file only.
256 MB limit.
Allowed types: gif jpg jpeg png.

Residential Information

Home Address

Parent or Guardian Information

Please input the personal information of a Parent and/or Guardian below.
Name

Additional Contact(s) Information:

Name

Regisrty Information: Disability/ Special Needs/Medical Needs

Please input the personal information of the special needs individual below
(Examples include sensory issues, certain behaviors, physical aggression, calming strategies, trigger mechanisms, audio or visual aids, or previous dealings with police.)
(Examples include words, pictures, electronic devices, etc.)

Liability and Release

Please carefully read this information before signing and submission.

RELEASE OF INFORMATION

I hereby give my permission for the Winter Springs Police Department to retain and distribute the information contained within this registration form to other first responder personnel, for the sole purpose of identification and protection of the person identified above in an emergency or crisis situation. Waiver: The undersigned understands that participation in this voluntary Special Needs Registry does not create any specific right, interest, or guarantee from the City of Winter Springs, its employees, elected officials, contractors, attorneys, or agents (collectively "the City"). The undersigned, on behalf of myself and on behalf of the Special Needs Individual identified on these forms, hereby release, waive, and discharge the City from any liability for personal injury, property damage, property theft, loss, or claims of any kind which may accrue to any person or any entity, including but not limited to the Special Needs Individual. Such waiver, release, and discharge include attorney's fees and litigation costs arising from, but not limited to, participation in this voluntary Special Needs Registry.
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