Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Emergency Management

  1. To send a message to the Polk County Emergency Management, contact our staff or please fill out the following form.
  2. Jody Beauchane
    Emergency Management Director
    600 Bruce Street
    Crookston, MN 56716
    Phone: 218-470-8263
  3. Jill Potucek
    Support Staff
    600 Bruce Street
    Crookston, MN 56716
    Phone: 218-470-8290
  4. How would you like to be contacted?*
  5. Leave This Blank:

  6. This field is not part of the form submission.