In an effort to provide the best possible service, Las Vegas Fire & Rescue, Clark County Fire Department and North Las Vegas Fire Department came together to bring you the First Responder Information Form. Henderson, Boulder City and Mesquite residents use different 911 system, in which this information will not be available.

If you or someone in your home has particular needs that emergency service workers should be aware of, you may request that the information be entered into the 911 Dispatch System. In the event of emergency, the information may assist the firefighters and paramedics to provide the highest quality service to you and your family. This information would be for your address only, and would not be shared with anyone outside the Fire Department.

If you wish for particular information to be entered into the 911 Dispatch System, please fill out this form and click the submit button. Asterisk * indicates a required field.

 
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Type of Residence: 



If other than house or duplex/fourplex:  Blgd or Space #:    Apt or Unit #:
Name of Complex: 
    * Address:     
* City:     
  * Zip Code:        
     Gate Code:     
* Emergency Contact Phone Number:   (ex. 702-999-9999)      
 * Emergency Contact Name:     
* Information you would like to enter to 911 System:     
Length of Time Requested: 


Your Email Address: