Skip to Main Content
Loading
Loading
County Offices
Know Your County
How Do I ... ?
Search
Home
Form Center
Form Center
Search Forms:
Search Forms
Select a Category
All Categories
Contact Us
Library
Public Information Requests
Verteran's Services
By
signing in or creating an account
, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.
Guardian Program
Sign in to Save Progress
This form has been modified since it was saved. Please review all fields before submitting.
PERSON BEING REGISTERED
Last Name
*
First Name
*
Middle Initial
Email Address
Phone Number
Cellular Carrier
Date of Birth
*
Date of Birth
Address
*
City
*
State
*
Zip Code
*
Sex
*
Height
Eye Color
Hair Color
Language
*
Race
*
African American
Asian
Hispanic
Indian
White
Complexion
Fair
Medium
Dark
Regularly Wears
Contacts
Glasses
Hearing Aids
Wig
Physical Identifiers
Beard
Birthmark
Moles
Mustache
Scar
Tattoo
Typical Clothing Worn
List favorite attractions or locations where the individual may be found in the space provided.
List favorite toys, topics of discussion, likes or dislikes.
Method of preferred communication (verbal, sign language, written words, songs, phrases s/he may respond to).
I.D./Medical Alert jewelry, GPS/Tracking Devices. If GPS is worn, provide manufacturer and transmitter number.
Public safety hazard information. If applicant may become combative if restrained, confronted, etc., provide information below
Medical Information
Primary Care Physician
Daytime Phone
After Hours Number
Physician documentation of mental impairment.
Notice: Documentation required to issue alert.
Current Medical Conditions
Current Medications
Allergies
Vehicle Information
Please provide information for any vehicle the applicant has access to, regardless of current driving status.
Year
Color
Make
Model
License Plate
Distinguishing marks, stickers, body damage
Year
Color
Make
Model
License Plate
Distinguishing marks, stickers, body damage
Photos of Person Being Registered
Front Photo
Side Photo
CARE GIVER OR EMERGENCY CONTACT PERSON
PRIMARY CONTACT PERSON
First Name
*
Last Name
*
Address
*
City
*
State
*
Zip Code
*
Email Address
*
Phone Number
*
SECONDARY CONTACT PERSON
First Name
Last Name
Email Address
Phone Number
ADDITIONAL USEFUL INFORMATION
Special Needs Identification Stickers
These stickers are to indicate that a special needs person are in your home or vehicle.
Home
Vehicle
Any additional information you think would be helpful for first responders in finding or interacting with the registered person.
To communicate this information to the Rockwall County Sheriff's Office, please click submit below.
Leave This Blank:
Receive an email copy of this form.
Email address
This field is not part of the form submission.
Submit
Submit and Print
* indicates a required field
Emergency Alert Signup
Employment
Financial Information
Listen to LIVE Commissioners Court Meetings
Open
Government
jury
Law
Enforcement
Library
Employment
Tax Office
Government Websites by
CivicPlus®
Arrow Left
Arrow Right
[]
Slideshow Left Arrow
Slideshow Right Arrow