Do You Require Evacuation Assistance In An Emergency?

Homeland Security & Emergency Management utilizes this information to properly assist and evacuate individuals with disabilities, access, and functional needs in the area of the Seabrook Station Nuclear Power Plant in the event of an emergency.

In addition to the traditional annual calendar emergency assistance card, New Hampshire Homeland Security and Emergency Management is now offering the option to submit or change the same information online at any time. Even if you have submitted your information, we ask residents to submit their information each year.

This information will be kept strictly confidential for state and local emergency uses only.

Please read each option carefully so we can record the information to the best of our ability.

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Are you a local or state official submitting an entry or revision on behalf of a resident with access and/or functional needs?
Please check each box that applies to your assistance needs:
I require special transportation by:
Residence type
Do you have a service animal?

Contact Information

Name

Is your physical address the same as your mailing address?

Home Addres

Would you like to include contact information of a relative/person you would like us to notify to assist you in an emergency?*