Clay County Vulnerable Population Registry
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1. Introduction

Emergencies can occur at any time of the year, whether it is a fire, flood, tornado, or hazardous material spill. Clay County Public Health is currently identifying the needs of vulnerable populations in the County. The information gathered through this registry is protected under HIPAA and will only be used during an emergency by Clay County Public Health and Clay County Emergency Management. Please take a moment and complete the following survey to the best of your knowledge.

If you need assistance to complete the registry, please do not hesitate to contact us at Clay County Public Health at 218-299-5220 between 8:00 am and 4:30 pm, Monday through Friday.

Thank you for completing this survey.

1. Please check one of the following statements that identifies who is completing the Vulnerable Population Registry.

Please check one of the following statements that identifies who is completing the Vulnerable Population Registry. I am currently homebound and need assistance to evaucate my home during an emergency.

I am a family member of an individual who will need assistance to evacuate their home during an emergency.

I am employed by an agency providing assistance for vulnerable populations.

Other (please specify)

Clay County Vulnerable Population RegistryExit this survey

1. Introduction

1. Please check one of the following statements that identifies who is completing the Vulnerable Population Registry.

Clay County Vulnerable Population Registry
Exit this survey