Old Mill Park Homeowners Association, Inc.

Special Needs Residents List

What is special needs?

Special needs is considered anyone who could be listed in any of the following catagories:

1) elderly and/or live alone
2) on any type of machine that insures
their day to day living
3) physically or mentally challenged

Why the need for a Residents list?

A list of special needs residents will be helpful in the event of power outages, need for evacuations, etc., so that these residents can be checked on and assisted first, this list will also be used for the members of the Community Emergency Response Team to check on the elderly, or special needs on a regular basis.

Who has access to this list?

If a residents name and address are submitted, ONLY the officers of the Old Mill Park Homeowners Assoc., and the lead members of the Community Emergency Response Team will have access to this information, it will not be listed on the website, or given to any persons, (other than police and fire/rescue in the event of an emergency), without written authorization from 1) the resident themselves, or 2) the immediate caretaker of that resident, if resident is unable to give permission.
This is meant to be a help to the residents and their families, and any and all information will be closely monitored and secured.

List Submission

Please highlight, print, complete, and mail the following form to:
Old Mill Park Homeowners Assoc.
ATTEN: Special Needs Division
5620 Dollar Hide South Drive
Indianapolis, IN 46221



Residents Name:
_______________________________________

Residents Address:
_______________________________________
_______________________________________

Please List Special Needs:
_______________________________________

_______________________________________

_______________________________________

_______________________________________

_______________________________________

_______________________________________

_______________________________________

_______________________________________

_______________________________________

Please list Emergency Contact Information:

_______________________________________

_______________________________________

_______________________________________

_______________________________________

_______________________________________

_______________________________________

_______________________________________

_______________________________________

_______________________________________