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Register a special needs person

Before you start

For each person with special needs or disabilities in your home, you will need to gather the following information prior to filling out the form:

  • Name
  • Home address
  • Work or school address
  • Phone number
  • Nature of disability or special need (clinical name)
  • Specialized equipment located on premises
  • Special circumstances emergency responders need to know
  • Emergency contacts

What to do

Fill out the registration form found at the bottom of this page and submit:

  • In-person at the Effingham Police Department
  • Call Billie Bales at 217-342-5327
  • Fill out the form and mail to Billie Bales
  • Submit the online form below

What's next

Data is kept on file for two years.  All registrations need to be resubmitted every two years to keep information current.

If any information changes, please contact us immediately.

Submit form

Get help

Billie Bales
Communications Manager

Office hours:
8:00 a.m. - 4:00 p.m.
Monday - Friday
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