IN CASE OF AN EMERGENCY DIAL 9-1-1           NON-EMERGENCY LINE (352) 249-2790

Request for Assistance Form

If you have been affected by a disaster and require assistance, please complete this form.  Emergency Management will refer your request to an organization(s) that may be capable of helping you.

If you are requesting a well-being check, please contact the 9-1-1 Communications Center at 352-249-2790.

Information provided on this form may be considered a public record under Chapter 119, Florida Statutes, and may be subject to public disclosure.  Furthermore, by submitting this form, you authorize the Citrus County Sheriff’s Emergency Management Division to share your information with government, private, or not-for-profit organizations in an effort to provide requested assistance. 

How many people in household?