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2. Lebanon Police Department created the C.A.R.E (Community Assistance Registry for the Exceptional) program to aid police officers during interactions with individuals with mental illness or diseases that affect their cognitive ability and communication. The registry uses voluntarily provided information and existing computer systems to improve the quality of police response to calls involving vulnerable populations.

4. Personal / Family Representative
6. First Name*
7. Last Name*
9. Email*
10. Phone Number*

    Please enter a valid phone number

12. Relationship To Person In Need*
13. Do You Reside In the Same Household?*
17. Handle With Care Person
19. First Name*
20. Last Name*
22. Address*
24. Apartment / Suite Number
26. City*
27. State / Province*
29. Date of Birth*
30. Race(s)*
32. Zip Code*
34. Gender*
36. Height*
37. Weight*
41. Information
43. School / Work*
44. If Vulnerable Person Operates A Vehicle
46. Triggers*

    Things to avoid

48. Calming Methods*

    Things that bring the individual joy

50. Photo
52. Brief Description of Special Needs

    i.e., dementia, substance abuse, etc.

54. Treating Physician (If Known)
55. Physician Phone Number

    Please enter a valid phone number

57. Anything Else We Should Know?
61. Emergency Contacts
63. Contact #1*
64. Phone Number*

    Please enter a valid phone number

66. Contact #2
67. Phone Number

    Please enter a valid phone number

Leave This Blank:


69. 1. Receive an email copy of this form.
70. Email address

    This field is not part of the form submission.

71. Submit

* indicates a required field