City of Seat Pleasant Police Department

Senior Safety Monitoring Program Application

As a duty of the COPS officer, the senior welfare checks are to engage with the elderly community. The officer assesses the needs of the individual and connects them to available community resources. The officer also engages in conversation regarding current events in the neighborhood with the individual. To request a senior welfare check, please fill out the form below.
For Emergencies: Call 9-1-1

Devan A. Martin Chief of Police  

Applicant Information

format: mm/dd/yyyy
*Please list any recent surgeries

Emergency Contacts Information

Authorization: The aforementioned applicant signs this application authorizing the City of Seat Pleasant Police Department to contact and visit the listed address of the registered senior weekly to check their well-being.

Format: mm/dd/yyyy