​​​​​​​​​​​​​​​​​​​​Brampton Fire and Emergency Services has a Vulnerable Persons Registry List that offers specialized assistance to residents who have disabilities, during an emergency.

To have your name or someone in your household added to the list, please complete the form below and return it to us. Once processed, the identified name(s) and address will be added to our Vulnerable Persons Registry List.

Please remember to:

  • Update your Vulnerable Persons Registry Form if there are any changes. Your form will be retained for a period of one (1) year from the date received.
  • Notify us if the “Vulnerable Person Resident” no longer resides at the address stated in the form.
  • If you live in a high-rise building, notify your building’s management office as well so that they can add you to the building’s list of occupants who require special assistance. Note: This information is provided only to Brampton Fire and Emergency Services.

Choose one of three ways to submit your Vulnerable Persons Registry Form:

  1. Complete online form below
  2. Mail completed form to:
    • Brampton Fire and Emergency Services
      Communications Division
      8 Rutherford Road South, Brampton, Ontario L6W 3J1
  3. Fax completed form​ to: 905.456.5710
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Please note: The fields marked * are mandatory.
Status
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Occupants
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Occupant One Age Range*





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Occupant Two Age Range





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Occupant Three Age Range





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Reason(s) for Special Assistance. Check all that apply.*
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Caregiver
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Emergency Contact
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Consent
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The personal information on this form is collected under authority of the Municipal Act, SO 2001, c. 25, and will be used by Brampton Fire and Emergency Services to provide assistance in the event of an emergency situation.

Always Dial 9-1-1 for Emergencies