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2. This form is for local law enforcement and Fire/Rescue/EMS personnel use only.

   
   

   Fire/Rescue/EMS personnel may require additional assistance from local law enforcement or other special equipment due to the nature of certain repeat calls. Law Enforcement may request officer safety information to be added along with other important responder information. This form allows first responders the opportunity to request automatic assistance on certain calls.

   
   

   Please fill out this form in its entirety. Feel free to contact the Audio & Data Entry Clerk, Mrs. Carolyn Morlock at 410-535-3169 if you have any questions.

4. Requesting Agency:*
6. Requester Name and Title:*
8. Requester Phone Number:*
10. Alert Address:
12. Address1*
14. Address2
16. City*
17. State*
18. Zip*
20. Response Requested: (Submit One)*

    1. Police
    2. Engine/EMS
    3. Misc.
22. Remarks/Reasoning:*
Leave This Blank:


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

    This field is not part of the form submission.

26. Submit

* indicates a required field