La Porte, TX · Harris County

No notary required

Police Fire EMS Information for First Responders

This voluntary form lets individuals or their representatives share health, contact, and personal information to help La Porte emergency responders identify and assist them.

What this form is

Individuals living with a disability or health challenge, or their representatives, can use this form to share information that may help police, fire, or emergency response personnel during a call to their home. It asks for identifying details, relevant medical conditions, medications, emergency contacts, and information about communication and calming approaches. The document recommends updating and submitting the form every year to keep the information current.

Who needs it

An individual with a disability or health challenge, or their parent, guardian, foster family, or legal representative, may choose to complete and sign this form.

How to submit it

The form recommends submitting an update every year and lists La Porte Fire, EMS, and Police personnel to contact with questions or to update information. Their emails and phone numbers appear on the form.

About notarization

This document is signed without a notary; the person completing it signs and dates it, and the form identifies no notarized attachment or related step.

How to submit this form

  1. 1

    Download The Form

    Download the Police Fire EMS Information for First Responders form.

  2. 2

    Complete The Form

    Fill in the individual’s identifying, medical, medication, emergency contact, and personal information.

  3. 3

    Review And Sign

    Review the information and have the person completing the form sign and date it.

  4. 4

    Submit Or Update

    Submit the form and consider updating it yearly; use the listed personnel contacts for questions or to update information.

Frequently asked questions

Do I need a notary for the First Responder Information Form?
No. The form requires the person completing it to sign and date it, but it does not require a notary or identify a notarized attachment.
Who can complete the form?
The individual with the specified health challenge or disability may complete it, as may a parent or guardian for a minor, current foster family, legal representative, or legal guardian.
What information does the form ask for?
It asks for identifying and medical information, medications, emergency contacts, and details about the individual’s communication preferences, behaviors, and helpful de-escalation approaches.
How do I submit the form?
The form recommends submitting it yearly and lists La Porte Fire, EMS, and Police personnel to contact about questions or updating information. Their contact details are printed on the form.

Need something notarized?

This Police Fire EMS Information for First Responders doesn’t need a notary — but Texas residents can notarize other documents online with a commissioned online notary.