Lost/Missing Person Form
Oldham County Task Force
Agency Information
Revised Verion?
YES
NO
Revision Date
-
Month
-
Day
Year
Date
Revision Time
Hour Minutes
AM
PM
AM/PM Option
Date
-
Month
-
Day
Year
Date
Your Name
First Name
Last Name
Your Phone Number
Your Email
example@example.com
Your Agency
Reporting Person Information
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Relationship to MP:
NOTES:
Search Urgency Data
Number of Subjects Missing
*
Please Select
1
2
3 or more
Age
*
Please Select
Very Young
Other
Very Old
Medical Condition
*
Please Select
Known illness requiring medication
Suspected illness or injury
Healthy
Known fatality
Potential vision impairment
Time
*
Please Select
Reliable, punctual (being late is out of character)
Usually reliable, on time
Reliability, punctuality, questionable
Completely unreliable
Circumstances
*
Please Select
At risk for any reason
Adequate information, low risk
Questionable information
High probability not in the area
Experience Profile
*
Please Select
Not experienced, not familiar with the area
Not experienced, knows the area
Experienced, not familiar with the area
Experienced, knows the area
Physical Condition
*
Please Select
Unfit
Fit
Very Fit
Clothing Profile
*
Please Select
Inadequate or insufficient
Adequate
Very good for conditions
Weather Conditions
*
Please Select
Existing Hazardous Weather
Hazardous Forecast (8 hours or less)
Hazardous Forecast (more than 8 hours)
No hazardous weather forecast
Equipment Profile
*
Please Select
Inadequate for activity/environment
Questionable
Adequate
Very well equipped
Terrain & Hazardous Profile
*
Please Select
Known hazards
Difficult Terrain
Few Hazards
Easy Terrain, no known hazards
SEARCH URGENCY SCORE
Submit
Missing Person(s) Information
Subject (s) Name
First Name
Last Name
Subject (s) Name
First Name
Last Name
Subject (s) Name
First Name
Last Name
Height
Weight
Build
Eye Color
Hair Color
Hair Style/Other Hair Description
Facial Hair
Facial Features/Skin Color/Tone
Fingernail Color
Distinguishing Marks
Jewelry
Eyewear
Overall Appearance
Photos Available:
Yes
No
Upload Photos
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Clothing
Style
Color
Size
Other
Shirt/Sweater
Pants (belt/suspenders)
Outerware
Underwear/socks
Headwear
Rainwear
Glasses
Gloves
Neckwear
Footwear
Extra Clothing
Shoe Sole Type:
Shoe Sole Sample Available?
Yes
No
Scent Articles Available?
Yes
No
What Scent Article?
Sent Article Secured?
Yes
No
Number of Subjects Score
Age Score
Medical Condition Score
Time Score
Circumstances Score
Experience Profile Score
Physical Condition Score
Clothing Profile Score
Weather Conditions Score
Terrain and Hazardous Profile Score
Equipment Profile Score
Submit
Autism Questionnaire
Tracking Technology Device Work/Carried?
Yes
No
How are tracking measures initiated?
Attracted to Water
Yes
No
Which Body of Water?
Able to swim?
Yes
No
Attracted to Roadways/Highways?
Yes
No
Which Roadway/Highway?
Attracted to:
Trains
Heavy Equipment
Airplanes
Fire Trucks
Other
Other:
Wandered Before?
Yes
No
Where?
Siblings with Special Needs?
Yes
No
Sibling wandered before?
Yes
No
Where?
Favorite Places/Locations?
Communications is
Verbal
Non-verbal
Reaction when name called:
Responds to voice of:
Mother
Father
Other
Other:
Favorite Song:
Favorite Toy:
Favorite Character:
Knows Parents:
Names
Home Address
Phone #
Other Contact Information:
Likes:
Dislikes:
Fears:
Behavioral Triggers:
Reactions to:
Sirens
Aircraft
Canines/Search Dogs
People in Uniform
Response to Pain/Injury:
Response to being touched:
Wears Medical ID tag
Yes
No
Sensory, Medical, Dietary Issues/Requirements:
Methods Used to Calm once Upset:
Special Needs/Conditions:
Additional Notes/Comments
Submit
Runaway Questionnaire
Attracted to Water
Yes
No
Which Body of Water?
Able to swim?
Yes
No
Attracted to Wooded Area?
Yes
No
Which Wooded Area?
Runaway Before
Yes
No
Where Found?
Sibling Runaway Before?
Yes
No
Where Found?
Favorite Places/Locations:
Knows:
Home Address
Phone #
Other Contact Information:
Has Mobile Phone?
Yes
No
Mobile Phone Number
Password/PIN
Carrier
Social Media
Service
User Name
Password/PIN
1
2
3
4
5
On-Line Gaming
Game
Gamer Tag
Password/PIN
1
2
3
4
5
Likes:
Dislikes:
Fears:
Behavioral Triggers:
Wears Medical ID Tag?
Yes
No
Dietary Issues/Requirements:
Special-Needs Conditions
Other Notes/Comments
Submit
Should be Empty: