Smoke Alarm Request
Smoke Alarm Request
Henry County Department of Public Safety
Notice*
The only requirement for being eligable to receive smoke alarms is that you must live within Henry County. If you live outside of Henry County please contact the corresponding agency for your area.
Name
*
Address
Address
*
Street Address
Address Line 2
City
State / Province / Region
Select a State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Postal / Zip Code
Country
United States
Phone Number
Phone Number
*
-
###
-
###
####
Email
Type of heat in the home. (Select all that apply)
*
Type of heat in the home. (Select all that apply)
Electric (heat pump, baseboard heat, space heater, etc.)
Propane
Natural Gas
Oil Furnace
Kerosene
Wood
How many people live in the home?
*
How many people under the age of 17 live in the home?
*
How many people over the age of 65 live in the home?
*
Are there individuals with a disability, access, or funtional needs living in the home?
*
Are there individuals with a disability, access, or funtional needs living in the home?
Yes
No
How many pre-existing smoke alarms do you have in the home?
*
If you have alarms, how many are currently working?