SAFE Program

WCSO Safe Program Sticker
The Walton County Sheriff’s Office is committed to providing the best service possible to the citizens of Walton County. The newly launched SAFE program is designed to meet the needs of residents who may require special assistance during an emergency or non-emergency situation.

The Walton County Sheriff’s Office encourages Walton County residents to fill out a SAFE Program Resident Support Form for each member of their household with any kind of special physical, behavioral, and/or psychological needs.

Qualifications for the SAFE Program include, but are not limited to:

Autism
Asperger’s Syndrome
Behavioral Disorders
Cerebral Palsy
Cystic Fibrosis
Dementia
Developmental Delays
Down Syndrome
Hearing Impairment
Immobility
Mental Disorders
Neurological Disabilities
Seizure Disorders
Speech Impairment
Vision Impairment

Once the information on the SAFE Program Resident Form has been verified, an alert will be put into the Walton County Sheriff’s Office database. Any time WCSO receives a call related to the address or vehicle identification information listed on the SAFE Program Resident Form, the deputy or fire rescue crews responding to the call will receive an alert with a description of the member of the household who may require special attention or care. Members of the SAFE Program will also receive a custom decal to place on their vehicles or the windows of their home to alert first responders of loved ones with special needs.

Please complete the form below for each member of your household who requires any special needs or any attention or CLICK HERE to download the SAFE Program Form.

For more information about the SAFE Program, please call (850) 892-8111 or email [email protected].

* Indicates a required field.

Client Information

Name (required)AgeDate of Birth (required)

Address (required)City (required)State (required)Zip Code (required)

Home Phone (required)Cell PhoneRaceSexHeightWeight

Hair ColorEye ColorDL or ID #

Please list any physical, psychological, or diagnosed behavioral special needs that should serve as a reminder to first responders that special consideration or attention may be needed for the individual involved in a call for service. (Examples include autism, dementia, Down syndrome, hearing impaired, immobility, speech impaired, etc.) Additionally, please add any actions that may trigger the client. Also, include any calming strategies that can be used to help soothe the client. Please note any prior reactions to Law Enforcement and reactions they may have.

How does the client communicate? (words, pictures, device, etc.)

Special Needs

Miscellaneous Information

Miscellaneous Information: (stims, eye contact, frequently visited places, can they swim, etc.)

Emergency Contact Info

Name (required)AgeDate of Birth (required)Relationship (required)

Address (required)City (required)State (required)Zip Code (required)

Home Phone (required)Cell PhoneRaceSexHeightWeight

Hair ColorEye ColorDL or ID #

NameAgeDate of BirthRelationship

Address (required)CityStateZip Code

Home PhoneCell PhoneRaceSexHeightWeight

Hair ColorEye ColorDL or ID #

Vehicle Information

YearModelModelColorTag NumberTag State

Please allow three business days for contact by Sheriff's Office personnel. Walton County Sheriff's Office complies with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and it's amendments. All information received on this form will be kept private and not for public use. If you have any questions please call the Sheriff's Office at 850-892-8186.

Records Request