Personal Emergency Plan for Eating Disorder Management

Important Contact Information

• Primary Mental Health Provider: _________________
  • Phone: _________________
• Emergency Contact Person: _________________
  • Phone: _________________
• Local Emergency Room: _________________
• National Eating Disorders Association Helpline: 1-800-931-2237

Warning Signs That Indicate Crisis

• Thoughts of self-harm or suicide
• Severe restriction of food intake for >24 hours
• Uncontrollable binge eating episodes
• Excessive exercise despite illness or injury
• Severe purging behaviors
• Physical symptoms:
  • Chest pain
  • Fainting or severe dizziness
  • Severe abdominal pain
  • Heart palpitations

Emergency Response Steps

Level 1 - Early Warning Signs

1. Use practiced coping skills
2. Contact support person
3. Follow meal plan strictly
4. Use distraction techniques
5. Journal thoughts and behaviors

Level 2 - Escalating Crisis

1. Call mental health provider
2. Activate support network
3. Cancel triggering commitments
4. Use crisis management skills
5. Consider urgent care visit

Level 3 - Emergency

1. Call emergency services (911)
2. Go to nearest emergency room
3. Contact primary mental health provider
4. Notify emergency contact person

Safety Plan Agreement

I agree to follow this plan and contact help when needed.

Patient Signature: _________________ Date: _________________

Provider Signature: _________________ Date: _________________