People Helping People Alert Program

Please use this form to advise the police department of individuals with Autism, Alzheimer’s disease, dementia, special needs and elders.

The purpose of this form is to give us information and a photograph of a person who may become lost or missing PRIOR to an event. Having the information on hand will expedite the paperwork process so we can locate the person faster.

* indicates required field

Reporting Party or Care Taker

Autism, Alzheimer’s disease, dementia, special needs and elder information

Emergency Contacts

Please attach a photograph of a tight headshot (shoulders to top of head) and a full body picture if available

Acceptable file types: doc,docx,pdf,txt,gif,jpg,jpeg,png.
Maximum file size: 5mb.

After submitting this form you should be redirected to a submission confirmation page.  If not, please contact BPD Technical Services at 978-215-9636

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