Functional Needs Registration


During an emergency it may be difficult to provide critical patient information to EMS and ER. By completing this form you can help optimize patient care by providing rapid and accurate patient information.

How to Register

To register, please complete the Function Needs Registration Form (PDF) and submit it to:
Onslow County Emergency Services
Attention: Functional Needs Registration Form
1180 Commons Drive North
Jacksonville, NC 28546

You may also fax forms to 910-455-6767. Please include the subject line Function Needs Registration on faxed forms.

For further information call 910-347-4270.