Police: Emergency Evacuation Form

South Kingstown Police Department

1790 Kingstown Road Wakefield, RI 02879
Phone: (401) 783-3321 Fax: (401) 788-9775

The South Kingstown Police Department has developed a registry of seniors and people with special needs who would like to receive evacuation and shelter assistance during natural disasters like hurricanes or severe flooding.

This is a free, voluntary registration. The information you provide will be confidential, in accordance with state law. It will be used by emergency personnel only to assure your safe and timely evacuation. Please fill out the questionnaire below and click submit at the bottom when complete.

A copy of your registration form will be automatically emailed to the South Kingstown Police Department.

Asterisk Fields Are Required

NAME
ADDRESS
NEXT OF KIN OR GUARDIAN
RESIDENCE
HEALTHCARE

(check all that apply)

Town of South Kingstown, Rhode Island
180 High Street | Wakefield, RI 02879
Tel. (401) 789-9331 | Fax. (401) 789-5280

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