AUTISM SAFETY AND AWARENESS
St. Cloud, Minnesota
Contact and Emergency Information For Carrying in the Pocket (Sample)
Gives name, address, and contact information about the person carrying it.
Designed for situations where the person is lost in a store or other public place.
Alter for your situation, print out, and place in his/her pocket.
DISABLED CHILD - PLEASE HELP ME
My name is ___________.
I have AUTISM. This is a brain disorder. I do not speak or understand or appreciate danger. I become lost very easily and do not know I am lost.
I may have outbursts or pinch or scream or shake my hands or arms or act in other unusual ways, particularly when I am under stress.
HOWEVER, I AM NOT DANGEROUS. I DO NOT HAVE ANY KIND OF WEAPON. I DO NOT USE WEAPONS. I NEVER INTEND TO HARM ANYONE.
My parents are ___________ and ___________
I live at ___________
My home phones are ___________
My mother works at ___________; phone ___________
My father works at ___________; phone ___________
My grandmother is ___________, address ___________; phone ___________
My doctor is ___________, address ___________; phone ___________
If you found me in a store or other building with a public address system, please have someone page my mother and father. Don’t leave me alone or let me wander off! If you cannot locate my parents, please call the police or have an ambulance take me to an emergency room.
I am on medications: ___________; and ___________.
REWARD FOR MY RETURN.