Elderly & Special Needs Resident Signup

This webform is intended for those individuals that are elderly, have life-threatening health conditions, or have physical or cognitive disabilities, and would like a wellness check prior to and after a storm. Completing this form is a very personal choice. The Town keeps a running list of individuals we believe fall into this category,  submitting this completed webform will add you to this list. If you are elderly, have life-threatening health conditions that rely on continued power, or have physical or cognitive disabilities you may want to reach out to a family member to stay with you or to evacuate to a family member's home.  

Palm Beach County operates a Special Need shelter for qualifying individuals, you must apply in advance for placement at their shelter facility.  

Please note that the Town will reach out to any resident with significant damage to their property to ensure their safety regardless of this list.