For Patients

Massachusetts 911 Disability Indicator Form

Massachusetts 9-1-1 now gives the option for individuals with disabilities to register their cell phone number on the MA 911 Disability Indicator Form (previously only landlines could be registered). If someone who completes this form calls 9-1-1 from any location in Massachusetts, the disability code they select appears on the dispatcher’s screen and will alert first responders that someone may require additional assistance.

 After completing the form, drop it off at your local Police station for processing.

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