Take Me Home Registry

"Take Me Home" Registry

The Montclair Police Department offers a "Take Me Home" questionnaire designed to assist those who require special assistance in emergency situations. The information provided by you on this form will be held in the strictest confidence and will be shared only as necessary to ensure the safety of individuals in case of an emergency. Questionnaire information will be entered into the Montclair Police Department’s dispatch computer database so that, in the event of an emergency, the Police, Fire and Emergency Medical Services of the Township of Montclair can better serve you and your loved ones.

Download "Take Me Home" Registry questionnaire

Once completed, please hand deliver or mail the form to police headquarters (647 Bloomfield Avenue, Montclair, NJ 07042) marked "Attention: Officer Rusiniak."

If you have any questions regarding this form, please contact the Community Policing Bureau at 973-509-4775.