ARE YOU OK?

PENSACOLA POLICE DEPARTMENT
P.O. Box 1750
Pensacola, FL 32591

The Pensacola Police Department has joined a growing list of agencies nationwide participating in Are You O.K.?, a telephone reassurance system that takes the initiative in contacting its subscribers.

“We are excited at being able to offer this service to Pensacola residents, and hope it will help to reassure people who live alone that someone will check on them at least once a day,” said Chief John W. Mathis.

Once people register for Are You O.K.?, their confidential information is recorded in a computerized telephone calling system. At a designated time daily, the system calls participants. When they answer the telephone, a recorded message asks if they are OK and all they have to do is hang up.

If a participant does not answer the telephone, the system will call several more times over the next hour. If there is still no answer, the computer notifies dispatchers, who will try to reach designated emergency contacts. If that fails, an officer will be sent to check on the person.

Although participants can register to be called at any time of the day or night, it is suggested they request evening hours when they are more likely to be home.

Are You O.K.? is designed for older adults, people with disabilities, shut-ins, or anyone who lives alone and needs to be checked on daily. Registration is open to City of Pensacola residents; there is no charge to participate.

Participants are asked to notify the Pensacola Police Department at 435 – 1900 if they will be away from home during holidays, vacations or other times so that they will not activate the emergency alert system.

A waiver and registration form are included below. Please sign the waiver and mail it to Ashley Joyner at P.O. Box 1750, Pensacola, FL 32591.

The registration form can be completed and submitted online.

For more information, please call 435 – 1932 or 436 – 5416.
 

 

 

 

 

 

WAIVER FOR ARE YOU OK?

PENSACOLA POLICE DEPARTMENT
P.O. Box 1750
Pensacola, FL 32591

“WAIVER” – RELEASE AND HOLD HARMLESS THE PENSACOLA POLICE DEPARTMENT AGAINST ANY CLAIM IN RELATION TO SERVICE RECEIVED THROUGH THE ARE YOU OK? PROGRAM.

Subscriber acknowledges that the Pensacola Police Department is providing the service as a public service and for no compensation. Subscriber recognizes that the Pensacola Police Department may, at their discretion, terminate this service at any time. Subscriber also acknowledges that technical problems or human error may result in a failure of the service at any time. In consideration of these factors, SUBSCRIBER HEREBY WAIVES, RELEASES AND HOLDS HARMLESS THE PENSACOLA POLICE DEPARTMENT FROM ANY CLAIM ARISING FROM A FAILURE, FOR ANY REASON, TO PROVIDE THE SERVICES CONTEMPLATED BY THIS AGREEMENT, AND SUBSCRIBER FURTHER AGREES TO WAIVE, RELEASE AND HOLD HARMLESS THE PENSACOLA POLICE DEPARTMENT AGAINST ANY CLAIM FOR DIRECT, INCIDENTAL OR CONSEQUENTIAL DAMAGES ARISING FROM ANY ACTION OR OMISSION BY THE PENSACOLA POLICE DEPARTMENT, ITS VOLUNTEERS OR EMPLOYEES IN CONNECTION WITH THEIR PARTICIPATION IN THIS PROGRAM.
       
Date Participant Name (Printed)
     
  Participant Signature

 
Participant Address  
       
Date   Witness Name (Printed)  
       
    Witness Signature

 

  
Witness Address  
 
Please mail this Waiver to Ashley Joyner, Records Supervisor, at the above address after completing the form below.
 

The registration form below can be completed online and submitted electronically to our office. However, the waiver form must be sent via regular mail to complete registration.

Are You O.K.?® Field Interview Form
Phone: (xxx) xxx - xxxx
 		 Date of Birth:
 Time to Call: (hh:mm)
  AM    PM		 Answering Machine?
Yes   No		 Service Number: (official use only)
 Subscriber Name and Address:
          
Last Name                            First Name                           M.I.
Street Address
     
Apt Bldg Name                                                          Apt. #
          
City                                                State               Zip Code
Doctor and Clergy:
Doctor's Name
Doctor's Phone
Clergy's Name
Clergy's Phone
 In Case of Emergency, Notify:
      
Last Name                           First Name                        M.I.
Street Address
     
City                                                      State           Zip Code
    
Phone Number                     Cell Number
 
Last Name First Name M.I.
Street Address

City State Zip Code
Phone Number Cell Number
 Next of Kin:
      
Last Name                           First Name                         M.I.
Street Address
    
City                                                  State            Zip Code
   
Phone Number                    Cell Number
 
Last Name First Name M.I.
Street Address

City State Zip Code
Phone Number Cell Number
Key on Premises?
YES      NO  		Location:
 Key Holder:
          
Last Name                          First Name                             M.I.
Street Address
       
City                                                          State                Zip Code
        
Phone Number                             Cell Number
 
Last Name First Name M.I.
Street Address

City State Zip Code
Phone Number Cell Number
Pets?
YES      NO  		Type and Location:
Live Alone?
YES      NO  		Co-Residents:
Medical History
Able To Walk?
YES      NO  		List Physical Impairments:
Location of Medical History:

Remarks
Please include any additional information you believe we should have. Also, for officer safety, please indicate
if there are any weapons in the residence. If you do have a gun(s), please list where it is kept.

Do you give permission for your name, address and telephone number to be given to an organization so that you can be contacted before/after a natural disaster or other emergency to determine if you need assistance?
YES      NO 
 

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