MCSO MedicAlert Registration Form

Press Enter to show all options, press Tab go to next option

The Maricopa County Sheriff’s Office District 6 – Queen Creek is partnering with MedicAlert and Mercy Maricopa to help raise awareness of Alzheimer’s and autism.

MedicAlert is providing free MedicAlert bracelets for individuals with Alzheimer’s or autism.

The MedicAlert bracelet helps increase the likelihood that law enforcement will be able to successfully reunite individuals with family members in the event they go missing. 

To register for the free, voluntary program, complete the form below and submit via:

- Mail (print): MCSO, MedicAlert Program, 22308 S. Ellsworth Road, Queen Creek, 85142

- E-mail (MUST have Adobe Acrobat Pro - save the PDF and send as an attachment):

For specific questions regarding the MedicAlert program, contact Jillian MeGee,

For questions regarding the MCSO partnership with MedicAlert and Maricopa Mercy, contact Tina Brinkman

MedicAlert registration form

 Mercy_Maricopa_IC_logo_horiz_violet  MA_ logo_lg2