Complete this questionnaire to the best of your ability, with as much detail as possible. Understand that not all questions will be relevant for each client and their respective medical concerns.
This form is designed for Custodial Caregivers to provide, in advance, certain information that will be useful to Search Teams, should the need ever arise. Providing the information in advance of the need will allow Search Management Personnel the necessary information for a more effective search response.
If you have questions, please email or call:
Describe facial hair, if any
Level of hearing ability WITHOUT aid
Level of vision ability WITHOUT aid
Please describe any tattoos, scars, or distinguishing marks
Briefly, please describe any additional medical comments
Please list any medications taken
Please describe the consequences without these medications
Please list and briefly describe any physical handicaps
Please list and briefly describe any psychological problems
If the caregiver is not present 24 hours each day, please describe who else is present, such as: secondary caregiver or the time gap when the primary is not present.
Just list previous full addresses
Branch, location(s), years
Name and relationship to patient
City, State, and County
After completing this application, the applicable individuals at Paulding County Sheriff’s Office will be notified and will contact you to schedule a time to provide the tracking bracelet. Additionally, there is a waiver that will need to be signed by the caregiver at this appointment.
It is included on the website “file title” for your review, but cannot be signed online. The list of instructions / requirements expected from the client is also attached, “file title” and a copy will be provided to you at the appointment.
If you have any further questions, please call 770-443-3010 and ask to speak with someone about Project Lifesaver.
This field is not part of the form submission.
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