The Fire and Police Departments seek to serve all the residents of the community with the utmost respect and dignity. The Town of Hingham has created the Exceptional Needs Registry as a method to enable first responders who are called in to assist an individual with unique circumstances.

The two-sided form combines the Massachusetts 911 Disability Indicator form with the Town of Hingham Exceptional Needs form. The information on both sides will remain confidential and will only be accessed if a call to 911 is generated by a telephone number associated with the person listed on the form with a disability.

Complete the Form

Online - Complete the Online Exceptional Needs Registry Form

Download - Download the fillable Exceptional Needs Registry Form (PDF).

Hard Copy - The application can be picked up at the following locations:

• Central Fire Station- 339 Main Street
• Police Department - 35 Essington Drive
• Town Hall Main Office - 210 Central Street
• Hingham Public Library- 66 Leavitt Street
• Senior Center – 224 Central Street

Please return the completed form and a photograph to the Hingham Police Department:

Email  -  ExceptionalRegistry@hpd.org
In Person  -  35 Essington Drive
Fax - 781-741-1483

If you would like assistance completing the form, please contact the Commission on Disabilities cod@hingham-ma.gov.

All information is kept CONFIDENTIAL and can be removed per request of the resident.

Updates

Please update this form when any information changes. (i.e. phone #, Address, Diagnosis, Triggers). If you have previously filled out a form, we ask that you do it again so we can confirm our current records are up to date.