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City of Bridgeport
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Bridgeport Office of Emergency Management

Special Needs Voluntary Registration

Guidelines
Registry Form

This Special Needs Registry is entirely a voluntary program being offered to the citizens of Bridgeport through the Bridgeport Office of Emergency Management
in conjunction with Bridgeport's First Responders (police, fire, rescue, EMS personnel).

There are NO fees or obligations associated with this program. The purpose of the Special Needs Registry is to alert Bridgeport's First Responders of any health needs or limitations you may have during a disaster in which you require assistance.

The Special Needs Registry in NO means or conditions allows for participants in the registry to receive immediate or preferential treatment in an emergency situation. The registry will act as a guide and blueprint for Bridgeport's Emergency Response Community to develop an effective, safe and efficient emergency response plan. This information will be used to provide adequate sheltering, medical supplies and other emergency necessities.

The Bridgeport Office of Emergency Management will manage this information under the auspice of the Health Insurance Portability and Accountability Act (HIPAA). HIPAA was established in 1996 by the United States Government to establish standard security mechanisms by which health information is communicated via orally or written in any form or medium.

Protected Health Information (PHI) within the boundaries of HIPAA includes any individually identifiable health information; this information too will be managed with the same level of sensitivity and security.

The information provided in this registry will not be divulged under any circumstance to any individual or party except, that of Bridgeport's First Responders under the authorization of the Office of Emergency Management.

Your cooperation and participation in this matter will significantly contribute to the success of an efficient emergency evacuation operation if ever implemented.

Kind Regards,
Tammy Renzelli, MS
Director of Emergency Management
Victims Advocate
Bridgeport, WV 26330
304-842-8260 ext. 266
trenzelli@bridgeportwv.com

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