Create an Account - Increase your productivity, customize your experience, and engage in information you care about.
The Guardian Program provides immediate access to critical information our first responders need when they encounter those in crisis. Often, those in crisis are not capable of effectively communicating and assisting the responding officer. The person may not be able to identify themselves, may appear lost/disoriented, or might act in a manner that could be misinterpreted by first responders.
Please provide the following information on the person participating in the program.
Provide the following medical information including the name of the condition causing mental impairment.
Notice: Documentation required to issue alert.
Please provide information for any vehicle the applicant has access to, regardless of current driving status.
Please provide the following information for other primary caregivers and emergency contacts.
I give the City of Midlothian, the Midlothian Police Department and its representatives permission to disseminate information included in this application, and/or acquired through the investigation of a missing person, as deemed necessary to locate the applicant in the event s/he is reported missing or endangered in any way that requires law enforcement assistance. I understand that personal information may be disseminated to other public safety agencies, media outlets, volunteer organizations and the general public and do not hold the City of Midlothian, the Midlothian Police Department or its representatives liable for any misuse of personal information.
This field is not part of the form submission.
* indicates a required field