I understand that participation
in the Davie Police Department’s Special Needs At-Risk registry is
voluntary. The information I provide
including any medical history, diagnosis, medication and any other information that
is protected by HIPAA is of my choosing.
I further understand that the Davie Police Department will not disclose
this information and it is solely for the use of the program. This information will be used by responding
officer only in order to assist them in their duties. I further understand that I can withdraw this
information and from the program at any time.
If this is an emergency, please call 911