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ASERT Does Not Offer Crisis Services

If you or someone you love is experiencing mental health distress or thoughts of suicide please call or text 988 for support.

Premise History Form for Emergencies Social Story

Overview

This social story explains how filling out a premise history form can be helpful in emergency situations.

A cell phone, ambulance, and police car.

I can contact my local police or county dispatch and ask for a Premise History Form. If there is an emergency, I may need to call 911. They can send police, fire department, or an ambulance to me if I need it.

A man holding a cell phone up to his ear.

It is important for 911 staff to know as much as possible about me, my family and the situation.

A man holding a cell phone.

I may be scared or anxious and forget important information to share when I call 911.

A pencil, sheet of paper, and cell phone.

I can fill out a Premise History Form before I have an emergency.

A cell phone next to an arrow pointing to a police officer.

I can contact my local police or county dispatch and ask for a Premise History Form.

A computer screen.

If my county doesn’t have their own form, I can download a Premise History Form online.

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This information was developed by the Autism Services, Education, Resources, and Training Collaborative (ASERT). For more information, please contact ASERT at 877-231-4244 or info@PAautism.org. ASERT is funded by the Bureau of Supports for Autism and Special Populations, PA Department of Human Services.