Skip to form

Lynchburg Police Dept.

905 Court Street Lynchburg, VA 24504

Our Marcus Alert Database gives individuals with a behavioral health illness, mental health illness, developmental or intellectual disability, or brain injury the opportunity to provide emergency response agencies with information regarding their special needs.

Parents of individuals under the age of 18 and legal guardians may also share this information with us. In the event of an emergency, first responders will be better equipped to serve them.

The information collected here will not be available to the public. It will only be shared with emergency response agencies to improve their ability to serve. By submitting your information, you agree that you voluntarily authorize its release to emergency responders.

Submitter's Information

Name of Submitter

MARCUS Alert Subject Information

Name of the individual to be added to database

Full Address of the individual to be added to database

Date of Birth


Emergency Contact Information

Full Name

By submitting this information, you agree to give local law enforcement personnel, Office of Emergency Management designees and responders permission to enter your home in the case of an emergency to assist in care and/or evacuation.

Be sure to verify that you are not a robot by using the Captcha tool at the below.
Having reCaptcha issues? Click here to reset the widget.