Department of Homeland Security & Emergency Operation Center 510 East Boston Street Covington, LA Phone: (985) 867-3787 Fax: (985) 898-3030

This Special Needs Survey Form will be used to collect information about people with special needs so that assistance can be provided to them during times of an emergency.

Please note that you need Adobe Acrobat to view and print the documents.

You may print the special needs survey and fill out by hand, or you may tab through the special needs survey, fill our online and print upon completion. Once you have completed the form, please send it to:

Office of Homeland Security & Emergency Preparedness
510 East Boston Street
Covington, LA 70433