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Woodlawn Park
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Police Department Welfare Check
First Name
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Please enter their first name.
Last Name
*
Please enter their last name.
Street Address
*
Please enter their street address.
Phone Number
*
Please enter their phone number.
Must contain a valid US phone number (e.g. 888-555-0123).
Cell Phone Number
*
Please enter their cell phone number.
Must contain a valid US phone number (e.g. 888-555-0123).
Date of Birth
*
Please enter their date of birth.
Date must be in YYYY-MM-DD or MM/DD/YYYY format.
Height
*
Feet
Inches
Feet must be a value from 1 to 10.
Inches must be a value from 0 to 11.
Please provide their height.
Weight
*
lbs
Please enter their weight.
Please enter a valid weight in lbs.
Hair Color
*
Please enter their hair color.
Eye Color
*
Please enter their eye color.
Emergency Contact Information #1
Name
*
Please enter the name of the emergency contact.
Phone number
*
Must contain a valid US phone number (e.g. 888-555-0123).
Please enter the phone number of the emergency contact.
Has Keys to House?
*
Yes
No
Please select whether or not the contact has keys to their house.
Emergency Contact Information #2
Name
Phone number
Must contain a valid US phone number (e.g. 888-555-0123).
Has Keys to House?
Yes
No
Please fill out all of the fields for the emergency contact.
Reason for requesting the welfare check
*
Please add the reason for requesting the welfare check.
Diagnosis/Illness & Known Medications
*
Please add information about any diagnosis/illness and known medications.
Person Making the Request
*
Please enter your full name.
Relationship
*
Please state your relationship to the person.
Cancel by Date/Time
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Date
Please provide a date.
The cancellation date entered cannot be in the past.
Time
Please provide a Time.
The time must be in 24 hour format
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