Services for Seniors

Emergency contact information is vital to the safety of our Senior Citizens.

The Dover Police Department maintains an internal directory of contact and pertinent information of the Senior Citizens in our community, to be used in case of emergency. The form includes family contacts, key locations, and additional information that may help the Police assist Seniors.

Sergeant Woollard is the Elder Affairs Officer that acts as a liaison between the Dover Police Department and the Dover Council on Aging. The COA focuses on empowering seniors to live independently, promote well-being, maintain dignity, and enhance their quality of life. For more information on the COA their website can be found here

Please fill out the form below to have your information added to our Senior contact binder.

Senior Contact Information Form

Name of Senior*
Address*
City*
State*
Zip Code*
Phone Number*
Family Contact Information
Name of Family Contact Person #1*
Relationship*
Address*
City*
State*
Zip Code*
Phone Number*
Cell Phone*
Family Contact Person #2*
Relationship*
Address*
City*
State*
Zip Code*
Phone Number*
Cell Phone*
Additional Information and Keyholder Information
Please list any keyholders and additional information here such as "hard of hearing", "dementia", etc.

Leave This Blank:

1. Receive an email copy of this form.
Email address

This field is not part of the form submission.
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Services for Seniors

Senior Contact Information Form

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