Premise Alert Program
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Premise Alert Program Notification Form
The
Illinois Premise Alert Program (Public Act 96-0788)
provides for Public Safety Agencies in the State of
Illinois to allow people with special needs to provide
information to police, fire and EMS personnel to be kept
in a database. The information can then be provided to
responders dealing with situations involving the special
needs individuals. The information provided by you will
be kept confidential and used only to provide Police,
Fire and EMS personnel with the information needed to
deal with situations or emergencies involving a special
needs person. The notification expires 2 (two) years
after the date it was submitted. You may update or renew
the information at any time by submitting the Premise
Alert Form.
Information shall be entered into
the Premise Alert Program or verified by:
(A)
the individual,
(B) family members,
(C) friends,
(D) caregivers, or
(E) medical personnel
familiar with the individual.
Individuals
must understand that the information provided to the
Premise Alert Program will not result in any type of
preferential treatment to the individual and that the
Village of Spring Grove nor any other responding
agencies will not be held liable for duties relating to
the reporting of special needs individuals.
For
the purposes of the Premise Alert program "disability"
and "special needs individual" are defined as:
•
"Disability" means an individual's physical or mental
impairment substantially limits one or more of the major
life activities; a record of such impairment; or when
the individual is regarded as having such an impairment.
• "Special needs individuals" means those
individuals who have or are at increased risk for a
chronic physical, developmental, behavioral, or
emotional condition and who also require health and
related services of a type or amount beyond that
required by individuals generally.
Click
here
to access application. Please forward completed forms
to:
Spring Grove Police
7401 Meyer Road
Spring Grove, IL 60081
