Have a question?Contact UsContact Form I agree that my submitted data is being collected and stored. Address: 911 Fire-Rescue Drive London, KY 40741 Phone: (606) 864-2922 Emergency Services Disability Indicator FormThis form is utilized to assist emergency personnel within London's city limits in responding to an emergency at your address.Please enable JavaScript in your browser to complete this form.Name *FirstLastPhone Number *Address *Access InformationPlease provide any special code or access information to make entry on/in property.Please check all that apply to indicate that someone at the address:LSS Life Support System: has equipment required to sustain their lifeMI Mobility Impaired: is bedridden, wheelchair user or has another mobility impairmentB Blind: is legally blindDHH Deaf or Hard of Hearing: is deaf or hard of hearingTTY Communication via the phone may be TTYSI Speech Impaired: has a speech impairmentCI Cognitively Impaired: is cognitively impairedASD Autism Spectrum DisorderPlease fill this form out again if the status of the above disability indicator(s) change at any time. Location of Person in NeedIs there a place where an individual is located, for example, a specific room or floor of the home?How Many Reside at the Residence *Are You Interested in Additional Fire Department Programs?Smoke Detector InstallationHome Escape PlanFire Safety InspectionInfo About Fire Extinguisher UsePlease check all that apply.EmailEmailConfirm EmailNameSubmit