Request a Rescue

IF your situation is a LIFE-THREATENING EMERGENCY (LIFE OR DEATH), please first call 911. We are doing our best, as a large group of volunteers, to help everyone we can. But please filter these life-threatening requests FIRST through official channels.

Please help us add your location to the public map or update your existing marker by filling out the information below! Thank you for your help!!

Status

Full Name

Street Address

Apartment Number

City

ZIP Code

Phone #

Alternate Emergency Phone #

Number of Adults

Number of Children

Ages

Physical Descriptions (clothing, scars, tattoos)

Number of Pets

Emergency Status

Life Threatening (LIFE OR DEATH)

Medical Evaluation Necessary (NOT LIFE OR DEATH)

Other (Flooding without necessary Medical Evaluation, etc.)

Special Considerations

Reporting Person's Contact Info

Reporting Person's Name (if different from above)

Reporting Person's Phone #

Reporting Person's Email

I agree, under oath and penalty of all applicable laws, this is known to me personally as AN EMERGENCY. I declare this to be true and factual and, by submitting this form, do hereby claim all responsiblity for information contained herein. It is understood by me that the submission of this form is a legal signature and agree releasing all others harmless in their attempts to relay my emergency rescue request. *

I Agree

Crowd Relief

Reporting Person's Contact Info