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Montclair Township

Special Needs Questionnaire

The Montclair Police Department offers a Special Needs Questionnaire designed to assist those who require special assistance in emergency situations. The information provided by you on this form will be held in the strictest confidence and will be shared only as necessary to ensure your safety in case of an emergency.

Special Needs Questionnair information will be entered into the Montclair Police Department’s dispatch computer database so that in the event of an emergency, the Police, Fire and Emergency Medical Services of the Township of Montclair can better serve you. If you have any questions regarding this form, please contact the Community Policing Bureau at (973) 509-4740.

Download Special Needs Questionnaire