Online Emergency Data Form

Dear Sherborn Resident,

In an effort to provide our best emergency services to you, we have partnered with the Disability Advisory Committee and your Council on Aging to develop an emergency database. The database is secure and can be viewed only by emergency responders. Some of the data will be transmitted to the Commonwealth’s 911 Enhanced DisAbility Telephone Service, which is also secure. When a call comes in from your home, or if your area of town is experiencing an emergency, we will be better able to assist you and your family.

Please complete this confidential form online and “Submit” when completed. The Police Department is available to assist if needed.  Please utilize our business line at 508-653-2424. We will need one form per household member with a special need or disability.

Thomas Galvin ChiefSherborn Police
Zachary Ward,Chief, Sherborn Fire

    Please check ALL that apply to the resident named below:

    Please provide the following information: