Alzheimer's/Dementia Resources

The Alzheimer’s/Dementia Awareness Program is an initiative of the Norfolk Police Department to allow
members of our community to voluntarily identify those with Alzheimer’s/Dementia who live, work, or
go to school in our community. The purpose is to promote communication and give Norfolk Police quick
access to critical information about a person registered with the Alzheimer’s/Dementia Awareness
Program in a police emergency. The program will capture information about those with
Alzheimer’s/Dementia such as, a full description with photo, emergency contact information,
likes/dislikes, communication techniques, and other information tailored to each individual to assist in
interactions with law enforcement. The information voluntarily provided to NPD will be used by
dispatchers and officers in our response to calls for assistance that may involve those in our community
diagnosed with Alzheimer’s/Dementia. This may include a missing person, a medical emergency, a crisis
situation, or other interactions with our agency.

How It Works

The voluntary registration can be completed by following the steps below, which includes filling out a
form and including a current photograph of the person and submitting the requested documents.
Once received a member of Norfolk Police will contact the first Emergency Contact to verify receipt of
the registration. If we are unable to confirm with the first emergency contact the information will not be
entered.  Upon verification the information will be kept on file with Norfolk Police. The information will
then be provided to police personnel as needed in the performance of their duties. We encourage those
registered to update us periodically as important information changes such as an address change, or a
change in emergency contact information. We also ask if you can submit a new photo as the person
registered ages.

How to Register

Fill out the form below. Note that there are certain mandatory fields that must be completed for all
involved to successfully benefit from this program. Please confirm that the information is accurate
before submitting. * You MUST remember to include a current photograph of the person
when submitting the requested documents.

                  1. Email to:

                  2. Mail to or Drop off at:
                  Norfolk Police Department
                  Officer Michael Milano
                  14 Sharon Ave
                  Norfolk, MA 02056

Alzheimer's/Dementia Registration Form