The City of Jacksonville Emergency Preparedness Division maintains a registry of clients who have been identified as persons with Special Medical Needs. These individuals require assistance during evacuations and sheltering.

Who is a Special Needs Client?

A person qualifying for special needs is someone who is medically dependent on electricity (i.e. electricity needed for life-supporting equipment), oxygen, or individuals with physical, cognitive, or medical conditions who may require basic assistance from medical professionals. 

Registration Process

Please follow the web link below to register.

Special Needs Online Registration


To download the Special Needs Registration Form, please click on a form listed below.



Any person that meets the above criteria and plans to use a public shelter during an evacuation should register online by filling out the form below well in advance or by contacting the Emergency Preparedness Office by phone (904) 255-3110.

The registry is updated throughout the year. Each client must re-register every year on their birth month to remain in the system.

Special needs clients will receive notification by mail at the beginning of their birth month informing them of the need to re-register.

Each individual's registration form is reviewed by a Health Care Professional and categorized by the assistance required. They are then assigned to a shelter or hospital and to the appropriate transportation agency, if applicable.

Individuals will be notified by mail with information regarding what to bring to the shelter.

Tips For Filling Out Your Registration

Complete all medical questions.

If registering by mail, please write legibly. No cursive. Print, block style.

Remember to list if transportation is needed. Indicate “No” if it’s not. Please don’t leave that section blank.

Remember to list a contact number. We can't contact you in times of emergency if there isn't a number listed or if that number isn't accurate.

Yes, your medications are important! However, please list only prescription medications. We don’t need to document vitamins, supplements, or OTCs.

One form per individual.  (Note: If you and your spouse both need to register, please complete a form for each person.)

Don’t forget to add your apartment/unit number. A majority of our returned mail is because the apartment/unit number was not listed on the registration form.

A new form is needed ANNUALLY. We will notify you by mail when it is time to register.

Please don’t forget to inform us of the death of loved ones so we can remove them from the list.

What to expect at a special medical needs shelter:

Special needs shelter information

What happens during an evacuation?

Special Needs individuals requiring transportation will be contacted by phone to coordinate a pickup time. Please be ready when transportation arrives and make sure you have packed all essential items.

A caregivers or family member must accompany the Special Needs individual to the shelter.

Once the storm has passed, individuals are returned home by the same mode of transportation in which they arrived. Special Needs program officials will verify that the individual's residence is safe and habitable prior to their return.

These forms require Adobe Acrobat Reader, available for free from Adobe. If you do not have Acrobat Reader, click Adobe for a free download.