Family Emergency Communication Form

This form is designed to establish communication between estranged family members of Barry County residents during times of disaster within the county limits if normal communication is disrupted, or individuals evacutate their homes.

The information gathered using this form will be used to contact an individual and generate a reply in regards to the well-being of the resident. Please fill out this form as completely and accurately as possible

Your Name:
Your Address:
Your Phone No:
Your Email:
Resident Name:
Resident Address:
Resident Phone No:
Resident Email:
Brief Message:
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Barry County Emergency Management Department (BCEMD) - Information on emergency management, training and other events, links to various sites about emergency management, Emergency Coordinator and local Emergency Operations Center (EOC) contact information, emergency family communication form, and more to come.