Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.
  1. The Palm Beach Police Department "Project Reunite"
    Project Reunite is a FREE service available for all residents of the Town of Palm Beach, for adults and children who may have difficulty communicating due to a developmental or cognitive disability. The database is maintained by the Palm Beach Police Department Communications Division. It is only accessible to law enforcement personnel and may include a photograph, disability information, physical description and emergency contact information. If a person in the Take Me Home program is encountered by a Palm Beach Police Officer, the Communications Division can access the database and quickly retrieve critical information that can help in communication with the individual and a safe return to the caregiver.
  2. Who Can Enroll?
    Any adult OR child who may have difficulty communicating due to a developmental or cognitive disability. These individuals tend to be at risk for wandering, and may include people with disabilities such as Alzheimer's, Autism Spectrum Disorder, Dementia, Down syndrome, etc.
    Information submitted using this form is sent directly to a designated person at the Palm Beach Police Department via regular email (not encrypted). The information is not maintained in a database at this website. While unlikely, it is technically possible for a third party to intercept your information. If you prefer, paper forms are available at the police department. Notice: Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing. Fla. Stat. 668.6076, History.-s, 1, ch. 2006-232.
  4. Subject Information
  5. Race*
  6. Sex*
  7. Please locate/upload a picture of the Subject
  8. Disability
  9. Emergency Contact Information
  10. Information Specific to the Individual
  11. By clicking "Yes", I constitute and affirm under oath that I am legally responsible for the person named above for whom I have provided information, and that I consent to have this information shared among law enforcement personnel for the enrollment in "Project Reunite" with the Palm Beach Police Department*
  12. Leave This Blank:

  13. This field is not part of the form submission.