Medical Alert Response Plan

Medical Alert Response Plan is one of the many benefits of having a countywide enhanced 9-1-1, and Computer Aided Dispatch system, is the ability to enter into the system an emergency response plan for any location in the county.

As a 9-1-1 call is received from a specific location, the dispatcher is automatically made aware of the address information, along with any special response information. This information will expedite the response of Police, Fire or EMS personnel, while providing life-saving pre-arrival information.

To better serve those individuals with special medical needs, Gasconade County Central Communications can enter into the computer aided dispatch system, any information pertaining to special medical concerns, along with other emergency contact information. Click on the link below and a form will appear that can be printed, completed and then returned to Gasconade County Central Communications, or you can fill out the online form, and submit your information electronically.

This information will then be entered into the Computer Aided Dispatch system. This confidential information will become available for the dispatcher when a 9-1-1 call is made. Therefore, if the caller is unable to communicate with the dispatcher, the emergency alert information will provide valuable insight to expedite sending the appropriate public safety response.

Once a year a representative from Gasconade County E-911 Communications will call the listed contact/concerned person and verify that the information we have on record is up to date.

GASCONADE COUNTY E-911 COMMUNICATIONS
Medical Alert Information Database

A separate form should be completed for each individual member of the residence to whom conditions apply (i.e. one for husband, one for wife).

This information will be kept on file in the Gasconade County 911 center and will NOT be released to anyone without your consent.  Your electronic signature certifies that you have the conditions marked and/or authorizes entry into your residence in case of an emergency.

Name: 

Address:  City: 

Phone Number:  Birth date: 

Use a cane                                            Difficulty speaking                                 Using oxygen

Use a wheelchair                                  Unable to speak                                     Diabetic

Use a walker                                         Heart condition                                       Deaf

Blind                                                       Psychiatric/Emotional problems          Hard of hearing

Difficulty seeing                                    Asthma                                                    Seizures

Read lips                                               Breathing problems                               High blood pressure

Other:

Pets in the residence:

Allergies:

Location of a key to the residence:

In Case of an Emergency Please Contact: 

Relationship: Phone #1 
                                                                                   Phone #2

Notes or Comments: