Specific Needs Disaster Voluntary Registry

Welcome

Welcome to the Los Angeles County Specific Needs Disaster Registry.

The purpose of this registry is to facilitate the planning and implementation of disaster response by first-responder agencies to Specific Needs persons living in the County of Los Angeles. The registry is a project of the Los Angeles County Office of Emergency Management in cooperation with other cities and agencies in the Los Angeles County disaster response operational area.

If you (or the person you are registering) live in Los Angeles County and have any of the following conditions which might impede with your abilities to evacuate a building, travel to or stay safely in an emergency evacuation center, or to securely shelter in place without assistance, then you may want to consider enrolling in the Registry.

Should a disaster strike in your area, this registry will be used to enhance the efficiency of those agencies called upon to respond. Enrollees are not prioritized for first consideration or evacuation. However the responding agencies will use this information to maximize their capacity to serve those with specific needs, both in the planning and preparation process, as well as in their actual post-disaster response.

	Physical disabilities Physical disabilities which limit walking or using stairs (such as those who use mobility devices - wheelchair, canes, crutches, walkers, etc or who experience extreme weakness or fatigue due to disabilities or age-related conditions).
	Cardiac and/or respiratory circumstances Cardiac and/or respiratory circumstances (heart conditions, breathing difficulties due to asthma, emphysema, or other symptoms triggered by stress, exertion, or exposure to dust or smoke etc.).
	Developmental disabilities Developmental disabilities , which create cognitive, thinking, or learning difficulties or Alzheimer’s or other age-related cognitive conditions  (people who could become confused during emergencies, or by unfamiliar surroundings, who may be prone to getting lost, or who would need simplified instructions during emergency response or evacuations).
	Emotional or psychiatric disabilities Emotional or psychiatric disabilities which cause disorientation, panic or impair other cognition or resopnse capabilities.
	Deafness or hearing loss Deafness or hearing loss which impairs the ability to communicate with emergency responders and other disaster personnel.
	Blindness or severe vision loss Blindness or severe vision loss that may result in the need for guidance, alternatively formatted materials, etc.
	Speech impairments Speech impairments which limit the ability to communicate with responders and/or emergency personnel.
	Short-term disabilities Short-term disabilities causing limitations that result from: Injuries Surgeries or illnesses Late or complicated pregnancies.
	Reliance on technologies that use electricity Reliance on technologies that use electricity or other power sources which may not be available during disasters (Ventilators, hearing aids, electric wheelchairs, electronic medication dispensers, kidney dialysis, etc).
	Using medications Using medications without which life-threatening health situations would rapidly develop.
	Participation in a home delivery program Participation in a home delivery program for meals that is your main food source.
	Need specialized paratransit vehicles Need specialized paratransit vehicles to travel in the event of an evacuation necessity.
	Experience seizures Experience seizures or other "attacks" which put your health or your abilities to evacuate safely at risk.
	Immune system deficiencies Immune system deficiencies which put you at risk.
	Communicable diseases Communicable diseases which put you and/or responders or others at risk (tuberculosis, hepatitis, HIV, etc.)
	Severe chemical or other allergies Severe chemical or other allergies which put you at risk and impede your ability to evacuate or shelter in place safely.

Enrollment in the Specific Needs Registry is completely voluntary. Please read and understand the following paragraphs before enrolling. If you choose to enroll, please fill out the forms as completely and accurately as possible. Please remember to keep your registry profile updated, especially if your circumstances change. The information you provide could help to save your life.

Confidentiality Statement

Information submitted on this registry form is for the purposes of planning and coordinating emergency responses. Your information will not be shared with unauthorized personnel or organizations. Release of this information to authorized agencies and personnel (which may include first responders such as local fire departments, police and/or sheriff's departments; shelter personnel; emergency operations managers, etc.) will occur only for the purpose of effecting the delivery of aid to enrollees.

	Notice of Disclaimer
The Specific Needs Disaster Registry is a voluntary program for those persons in Los Angeles County who may need specific disability-related assistance and/or accommodations in the event of a major disaster. Specific accommodations and assistance needs may include communicating through alternative means, requiring specialized paratransit services, life sustaining medications or equipment, etc.

Enrolling in the registry should never be considered as the only action necessary to prepare for disasters, nor does it ensure prompt and thorough response after a disaster strikes.