Citrus Heights, CA · Sacramento County
Identification Registration – Special Needs Community Members
This Citrus Heights Police Department registration form lets people with special needs or their caregivers share information for emergency personnel.
What this form is
The form registers a community member with special needs on the police department’s special needs list for use during an emergency. It asks for personal and caregiver details, care requirements, allergies, emergency contacts, and a current photo. The individual and a caregiver or family member can print their names, sign, and date the form.
Who needs it
A person with special needs or their caregiver can complete this form to provide information for the police department’s emergency list.
How to submit it
The form identifies the Citrus Heights Police Department at 6315 Fountain Square Drive, Citrus Heights, CA 95621. It also lists the department phone number, (916) 727-5500.
About notarization
This form is signed without a notary; the individual and caregiver or family member sign and date it, and the form asks for a current photo.
How to submit this form
- 1
Download the Form
Download the Identification Registration – Special Needs Community Members form.
- 2
Complete the Form
Fill in the individual’s information, caregiver and other contacts, care requirements, allergies, and emergency contacts.
- 3
Add a Current Photo
The form says it is very important to have a current photo on file.
- 4
Sign and Date
The individual and caregiver or family member can print their names, sign, and date the form.
- 5
Contact the Police Department
The form lists the Citrus Heights Police Department address and phone number.
Frequently asked questions
- Do I need a notary for the special needs registration form?
- No. The individual and caregiver or family member sign and date the form; it also asks for a current photo.
- How do I submit the special needs registration form?
- The form lists the Citrus Heights Police Department at 6315 Fountain Square Drive, Citrus Heights, CA 95621, and provides its phone number.
- What information does the registration form request?
- It asks for personal and caregiver details, care requirements, allergies, emergency contacts, and a current photo.
Need something notarized?
This Identification Registration – Special Needs Community Members doesn’t need a notary — but if you have another Citrus Heights form that does, a commissioned online notary can help.