Tredyffrin Township
Chester County, Pennsylvania

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Special Needs/Reverse 9-1-1 Registration Form

Emergency Care for Residents in Need of Assistance

The Township maintains a list of residents who may need assistance in the event of an emergency (e.g. natural disaster). The Township also forwards this information onto Chester County, so that they may have complete information for the following programs:

Premise Information - this is a County program where citizens with unique conditions at their home (elderly person, chronic illness, mobility challenges, and/or language barriers) can add their information to the County's dispatch system so that it is immediately available to the 9-1-1 Telecommunicator when a 9-1-1 call is placed.

Reverse 9-1-1 - this is the County system that can place automated calls to residents, advising them of evolving situations, such as the need to shelter in place, missing persons, or localized flooding. The system picks up the numbers from the listed land line telephone book. Anyone with unlisted numbers, Voice over Internet Protocol (VoIP), or exclusive use of cell phones who would like to be included should complete the form below.

To register your information for these resources, please complete the following form.

Online Registration Form

All fields marked with an asterisk (*) are required.

General Information

*Name:
*Telephone:
*Address:
*Zip Code:

Emergency Contact Information

*Contact Name:
Relationship:
*Contact Home Phone:
Contact Work Phone:

Special Needs

I have the following special needs: (Check all that apply)

I require oxygen
I am unable to walk or have difficulty walking
I have a vision impairment
I have a hearing impairment
I can not speak/read English

Other special needs:

If you receive an error message while attempting to submit this information, please email the appropriate information to eoc@tredyffrin.org.

2009, Tredyffrin Township, Chester County, Pennsylvania. All rights reserved.

Administration
1100 Duportail Road
Berwyn, PA 19312-1079
Phone: (610) 644-1400,  Fax: (610) 993-9186
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