Special Needs Registry

Human Services Division

Please fill out the following information. Should you have any questions please feel free to call (856) 935-7510 ext. 8311 or 8316. All information will be kept strictly private and confidential.

Special Needs Registry Form

  • Emergency Contact Information

  • Other Information



Contact Us

Salem County Health Dept.
110 Fifth Street • Suite 500
Salem, NJ 08079

856.935.7510 (Phone)
856.935.8483 (Fax)
Report An Immediately Reportable Disease: 856-935-7510 ext. 8302

After Hours Contact


Have Concerns?

Report a Public Health Concern Here