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2. Owasso Special Needs Alert Program
   The Owasso Special Needs Alert Program (OSNAP) recognizes adults and children with special healthcare needs for Emergency Medical Services (EMS) providers. It is a pre-hospital notification program for any Owasso citizen who has special emergency care needs. First responders will be able to provide appropriate emergency care for the patient and reduce the level of stress usually experienced by the family when there is an emergency. Adults and children with disabilities, chronic conditions, and special healthcare needs are urged to enroll.
4. First Name
5. Last Name
7. Address1
9. Address/Apt Number
11. City
12. State
13. Zip
15. Phone Number
    Contact number for patient
16. Email Address
    Please add best email address for contact.
18. Alert Type
    -- Select One --Health/WelfareMental HealthSpecial Needs
20. Description
    Please describe the patient's condition and/or needs. Limit 500 characters
22. Access to Residence
    Please advise the best way for our Medics to access your residence in the event that someone cannot answer the door. (garage code, Knox Box, etc.)
24. Knox Box Info
    Knox Box Form
Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field