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.

Elder ID Program - Online Form

  1. Elder ID Program
  2. The Roeland Park Police Department offers a program for at-risk residents in the city limits of Roeland Park. An identification database is maintained should an at-risk person be missing or is located. This program enables the Police Department to provide helpful information to patrol units and assist in locating a caregiver.

    To register an at-risk resident who resides in the city limits of Roeland Park, please complete this form. You may also print a paper copy of the Elder ID Program Form (PDF) . If printed, please return the form to:
    Roeland Park Police Department
    Attention: Records
    4600 W 51st Street
    Roeland Park, KS 66205

    For more information, contact the Roeland Park Police Department at 913-677-3363.
  3. Sex*
  4. Type "none" if there are no identifying characteristics.
  5. Color / Make / Model
  6. Contact Information
  7. A picture is required for this process.
  8. Leave This Blank:

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