EL DORADO COUNTY MULTI-DISCIPLINARY TEAM

The El Dorado County Sheriff’s Department in conjunction with other County and State agencies has provided the autism registration form to members of El Dorado County living with a child or adult with autism.
 
The information you provide will be utilized to identify your residence and the individual with autism. This information will be entered into the El Dorado County Sheriff’s Department dispatch computer system. This allows County dispatchers to access your provided information in the event we receive a call for service from your residence.

The El Dorado County Sheriff’s Department is committed to serving our communities with the highest level of service, compassion and understanding. Providing this information for our deputies will allow them to understand the situation thoroughly and provide the highest level of service during your time of need.

The El Dorado County Sheriff’s Department understands HIPAA regulations and your right to privacy. The information provided will be entered into the computer system and the form will be deleted. The information will be accessed under a right to know and need to know basis. The information is intended to serve the autistic community and their families in a positive manner, not in a manner to high light their condition.

The El Dorado County Sheriff’s Department encourages anyone with a member in their household to register and update the information on a yearly basis. This will allow the El Dorado County Sheriff’s Department the ability to maintain current records and continued service.  

Pursuant to HIPAA regulations 164.512(f) and 164.512(j)

Please complete the form linked below and mail or fax it to:

El Dorado County Sheriff's Office
ATTN: Sgt. Todd Hammitt
300 Fair Lane
Placerville, CA 95667

Fax: 530-626-8091

Autism Registration Form (PDF Format)

Autism Registration Form (Word Format)