ESD Registration | www.emergencyservicesdirectory.org

1. New User Information

Requested Access Level:

Help?Registrant - Used to register as an individual or as the responsible party for maintaining/editing 1 or more organizations

Regional Access - Used by public safety organization administrators to request read only permission for all public safety organizations in the region of the administrator's organization including restricted info such as equipment availability, individuals' phone numbers, etc. (Granted only after verification of requester's stated role)

Full Access - Used by county or state officials to request read only permission for all public safety organizations in the state of the official's jurisdiction including restricted info such as equipment availability, individuals' phone numbers, etc. (Granted only after verification of requester's stated role)

Reasoning for higher access: *

(Registrant's personal information will not be viewed on the public site.)

First Name: *

Last Name: *

Your Phone: *

ext:

State *

County *

Your Email: *

Password *

Confirm password *

In case you forget your password

Challenge Answer:

Click to see the full list of supporters.

Organization Name *

Organzation Type

Add New Site

Site Type:

Address 1: *

Address 2:

City: *

County: *

State:

Zip: *

Latitude:

Longitude:

Phone:

Fax:

TTY Phone:

Add New Person

This information may only be viewable/searchable by officials with security clearance

Position:

First Name:

Last Name:

Personal Phone(optional):

Please use the xxx-xxx-xxxx format

Work Phone:

Please use the xxx-xxx-xxxx format

Fax:

Email:

Press the add person button to finalize this entry then press the OK button to return to the entry field

Add New Person

This information may only be viewable/searchable by officials with security clearance

Position:

First Name:

Last Name:

Personal Phone(optional):

Please use the xxx-xxx-xxxx format

Work Phone:

Please use the xxx-xxx-xxxx format

Fax:

Email:

Press the add person button to finalize this entry then press the OK button to return to the entry field

Add New Person

This information may only be viewable/searchable by officials with security clearance

Position:

First Name:

Last Name:

Personal Phone(optional):

Please use the xxx-xxx-xxxx format

Work Phone:

Please use the xxx-xxx-xxxx format

Fax:

Email:

Press the add person button to finalize this entry then press the OK button to return to the entry field

Add New Physician(s)

Instructions

Download a copy of the physicians template here
Fill out the excel document, but keep the headers the same(FIRST, MIDDLE, etc)
Save the file and click browse
Select the file and click ok, then click the "Save Data" button
Make sure the results are correct and click save again, if not click back and re-upload.

Choose File: *

Press the add physician button to finalize this entry then press the OK button to return to the entry field

First Name:

Middle Name:

Last Name:

Suffix:

Specialty:

License:

Contact:

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