The information you enter into this form will be added to the Rappahannock-Rapidan Community Services (RRCS) Voluntary Database. The database is a requirement of a new law that was signed by the Governor of Virginia in November 2020—The Marcus-David-Peters Act. This database is a partnership between the RRCS, the Department of Behavioral Health and Developmental Services (DBHDS) and local law enforcement. The information that is voluntarily provided on this form will be shared with law enforcement and first-response agencies (police, fire, emergency services) in Rappahannock, Orange, Culpeper, Madison, and Fauquier counties to help ensure an appropriate emergency and/or crisis response. The information you provide will not be used for any other purpose, except to contact you to clarify data entered on this form if needed.