Business Emergency Contact Form

Business owners in Lawrence can now use this on-line form to register or update emergency contacts for their business. All information will be strictly confidential and used only for emergencies such as a burglary, damage to the business, an alarm, a fire or similar occurrences. Filling out this form will ensure that the Police and Fire Departments have the proper contact information for your business.

We recommend that you list at least two emergency contacts, those that have access to your building, and who can respond rapidly in the event of an emergency. Please include a second means of contact, such as cell phone or pager numbers. All information will be verified.

If you would rather fill out a paper form and mail or fax it back to us, you may download it here.

After you have completed filling in the required information, click on the SUBMIT button. You may update this form as often as you need to.

These fields are required in order to process.

  Business Information
Registering or Updating?
Business Name
Business Address
  Floor/Suite/Bldg
Business Telephone
Hours of Operation
Type of Business
    Contact First
Name
Title/Position
Phone Number
  Alternate Phone
    Contact Second
Name
Title/Position
Phone Number
  Alternate Phone
    Contact Third
  Name
  Title/Position
  Phone Number
  Alternate Phone
    Comments
  Please indicate any information which may be useful to any Police Officer or Firefighter responding, ie:guard dog, hazardous chemicals, etc.