Medical Information

Special Medical Information Forms Available

Two forms are available from the Tolland Fire Department to help residents who have special medical needs prepare a written record of critical information that can be easily available in an emergency.

Special Needs Registration Form

The Special Needs Registration Form is designed so that residents can list any special medical conditions which might become critical in the event of a prolonged loss of electricity or a mandatory evacuation. Residents who are hearing impaired, oxygen dependent, respirator dependent or confined to a wheelchair should consider completing this form. The completed form should be mailed to the Tolland Fire Department, P.O. Box 827, Tolland, CT 06084. The information will then be available to department and town Human Services personnel in case of an emergency event.

A copy of the Special Needs Registration Form appears in the Forms section of this website, and it can be downloaded as a PDF form and printed from your home computer. Copies of the form are also available at the Tolland Public Library, the Senior Center, the Department of Human Services in Town Hall, and the Tolland Fire Training Center, 191 Merrow Road. You may also request a copy of the form by calling the Tolland Fire Training Center at 871-3677. Please leave your name, mailing address and your phone number when you call. If you prefer to request a copy by mail, please send your request to the Tolland Fire Department, P.O. Box 827, Tolland, CT 06084. A form and a return envelope will be mailed to you.

Personal Emergency Medical Information Form

The Personal Emergency Medical Information form has been prepared to make it possible for residents to record a variety of information about their current medications and emergency contacts. The form is printed on bright yellow paper, and when it is filled out it should placed in a very conspicuous spot inside the home, such as on the front of the refrigerator, where it will be clearly visible to any emergency medical personnel who may be called for assistance.

Because the form is printed on special colored paper, it is not available for downloading on this website. However, copies of the form are available at the Tolland Public Library, the Senior Center, the Department of Human Services in the Town Hall, and at the Tolland Fire Training Center, 191 Merrow Road. You may also request a copy of the form by calling the Tolland Fire Training Center at 871-3677. Please leave your name, mailing address and your phone number when you call. If you prefer to request a copy by mail, please send your request to the Tolland Fire Department, P.O. Box 827, Tolland, CT 06084. A form and a return envelope will be mailed to you.