Safe Watch Program – Medford Police Department

The Medford Police Department is committed to the safety of our residents who may have a disability or condition which would cause them to wander from their safe environment.

With this in mind, the Medford Police Department has initiated the Safe Watch Program designed to proactively gather pertinent and recent information on the individual so that if a person should go missing we are prepared immediately to begin an informed search, deploying resources constructively with the best chance of returning the individual to their safe environment as quickly as possible. By doing so, we can be prepared to conduct a well-informed search and deploy resources effectively if a person goes missing, with the goal of quickly returning them to a safe environment. It is designed for individuals with Autism Spectrum Disorder, Dementia, Alzheimer’s, Down Syndrome, Acquired or Traumatic Brain Injuries, and other conditions.

The information will be stored in a department database, allowing officers to access critical information from their cruiser laptop in the event of a disappearance. This information includes a summary of the individual’s name, nickname, age, address, height, weight, eye color, hair color, identifying marks, medical conditions, favorite places, and effective methods for approaching or calming the person. Family members, friends, or caregivers can fill out the SafeWatch form electronically or by printing a copy and returning it to the police station to ensure the most accurate information is available. This program is free, voluntary, and confidential, with the aim of better equipping emergency personnel to respond to crisis situations. The information is not for general release.

Family members/caregivers of at-risk individuals are encouraged to make use of this program by filling out the Safe Watch enrollment form below:

"*" indicates required fields

Date*

Name of Person Submitting Form*

Parent, Relative, Friend or Caregiver

First Last

Email of Person Submitting Form*

Phone Number of Person Submitting Form*

At Risk Person's Name*

First Last

Date of Birth*

Sex*

Race*

Ethnicity*

Address*

Street Address City State / Province / Region ZIP / Postal Code

Height*

Weight*

Hair Color*

Eye Color*

Identifying Marks (scars, tattoos, birthmarks, etc.)

Medical Condition

Yes

Medical Condition*

Medication

Yes

Medication Type

Allergies

Cell Phone Number of At Risk Person

Carrier Information

Vehicle Year/Make/Model

License Plate

Method of Communication

If non-verbal, sign language, picture boards, written words, etc.

Calming Techniques

Favorite song, interests to talk about, calming words, etc.

Habits/Preferences

How will the individual react to officers, sirens, K9s, helicopters?

Best methods of approach?

Favorite places to go or that they have wandered to before

Identification (jewelry, medical alert, ID card, tracker)

Any additional information you believe is important

Please be as detailed as possible

Emergency Contact 1 Name*

First Last

Emergency Contact 1 Address

Street Address City State / Province / Region ZIP / Postal Code

Emergency Contact 2 Phone Number*

Emergency Contact 2 Name*

First Last

Emergency Contact 2 Address

Street Address City State / Province / Region ZIP / Postal Code

Emergency Contact 2 Phone Number*

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