Town of Eden Emergency Notification Form
In the event of an emergency, if you or someone in your family is dependent on life support equipment or may be in need of special care, please fill out the following form. The Town of Eden Disaster Preparedness Committee will contact the person upon the receipt of the following information. If the Town's resident medical record has changed significantly, please fill out the form again. All information is strictly voluntary and will be kept confidential.
If you have any questions, please contact the Eden Disaster Preparedness Committee, or call 716 992-9211.
(* indicates required field)