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Welcome to the town of Sherborn, Massachusetts
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Official Webpage of the
Town of Sherborn

Town Hall
19 Washington Street
Sherborn, MA 01770
Phone & Fax Numbers
Residents' Emergency Data Form
Dear Sherborn Resident,

In an effort to provide our best emergency services to you, we have partnered with the Disability Advisory Committee and your Council on Aging to develop an emergency database.  The database is secure and can be viewed only by emergency responders.  Some of the data will be transmitted to the Commonwealth's 911 Enhanced DisAbility Telephone Service, which is also secure.  When a call comes in from your home, or if your area of town is experiencing an emergency, we will be better able to assist you and your family.

Please complete this confidential form online and "Submit" when completed.  The Police Department is available to assist if needed.  Please utilize our business line at 508-653-2424.  We will need one form per household member with a special need or disability.

Respectfully,
Richard Thompson, Chief of Police

Please Check ALL that apply to the resident named below:
CheckboxesCheckbox DescriptionCheckboxesCheckbox Description
Life Support System
Oxygen
Generator
Walker
Cane
Bed Ridden
Wheelchair
Deaf/Hard of Hearing
Speech Impairment
TTY
Blind
Autism
Cognitive Impairment (Dementia/Alzheimers)
Limited Vision
Diabetic
Service Dog
Please provide the following information:
Field DescriptionField DataRequired Field
required
required
required
required