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Alzheimer's and Related Illnesses
1. This address advisory form is designed to relay pertinent information regarding a resident within the jurisdiction of the Town of Prescott Valley to the Prescott Regional Communications Center (PRCC). All information received will be placed electronically into the Computer Aided Dispatch (CAD) system; linking it to the provided address.
2. The information received will be available to first responders dispatched to the address listed in Part I. The information may be helpful to the first responders in their initial response and contact at the specified location.
3. The information provided will stay attached to the provided address until the Primary Caregiver in Part II asks that it be removed or the current situation is no longer applicable.
4. Any information submitted will be used for the purposes of emergency response only with the goal of providing the best services possible to our community residents.
5. Please complete Part I through II and mail to:
216 S. Cortez Street, Prescott, AZ 86303
Include information on presenting problems, reason for call, significant agitation triggers and type, fears, safety concerns, suicidal ideation, issues of abuse, etc.
Emergency response program information, possible destinations, etc.
If you have any questions regarding this program, please contact:
7601 E Civic Circle, Prescott Valley, AZ 86314
Information contained in this packet is for the intended use of first responders to expedite the safety and care of the individual living with Alzheimer's. ID bracelets are solely for the purpose of helping first responders identify the individual and their caregiver information in an emergency.
This field is not part of the form submission.
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