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Rhode Island Special Needs Emergency Registry Intake Form


This is the intake tool that the Rhode Island Department of Health and the Rhode Island Emergency Management Agency use to register people with disabilities, chronic conditions, and special healthcare needs in advance of a disaster or other public health emergency.

Primary Toolkit:

EQUIPh Toolkit

Secondary Toolkits:

Health and Disability Toolkit

Keyword Area:

All-Hazards, Disability, Injury Prevention, Mental Health, Natural Disaster, Vulnerable Populations


Institutional Author:

Rhode Island Department of Health





The NACCHO Toolbox is a repository of available resources to help local public health practitioners. Tools are produced by local, state, and federal agencies, as well as academic institutions and other stakeholders. The contents of this Toolbox are solely the responsibility of the authors and do not necessarily reflect any official recommendations of NACCHO. NACCHO makes no express or implied warranty with respect to the contents and disclaims liability for any damages arising from or connected to the use of the material in this Toolbox.