2. Business Emergency Contact Form
   For businesses physically located in Lincoln, MA only. Please fill out the below form to update your emergency contact(s) should the Lincoln Police/Fire Department need to contact you after your normal business hours. The Lincoln Police Department will call the business main phone number to verify all submitted information before updating our records. To remove an emergency contact from our records, please indicate which name(s) to remove in the 'Other Information' section.
4. Business Name*
5. Business Owner*
7. Business Address*
8. Apartment/Unit/Office
10. Business Phone Number*
11. Business Owner Email*
15. Emergency Contact (First and Last Name)*
16. Emergency Contact Title
18. Emergency Contact Number*
    Do not use store/office phone number
19. Emergency Contact Email*
21. Other Information
23. Acknowledgement*

    I acknowledge and authorize the above information may be kept by the Lincoln Police and Fire Department and may be used for contacting any listed parties in case of an emergency at the listed business. The emergency contact form is not an alarm system and should not be used in place of one. It is the responsibility of the business owner/manager to provide up to date information for any emergency contacts.

    1. I agree
Leave This Blank:


25. Submit

* indicates a required field