Personal Information
- Name: _________________
- Date of Birth: _________________
- Emergency Contact: _________________
- Contact Phone: _________________
- Psychiatrist: _________________
- Psychiatrist Phone: _________________
Warning Signs of Crisis
- Increased paranoid thoughts
- Hearing voices becoming louder or more frequent
- Difficulty distinguishing reality from delusions
- Severe agitation or restlessness
- Refusing to take medications
- Expressing thoughts of self-harm
Emergency Steps
1. Stay Safe
- Remove any dangerous objects from the immediate area
- If alone, move to a safe location or call a trusted person
- Keep distance if the person is agitated
2. Contact Help
In immediate danger, call 911
Otherwise contact:
- Primary psychiatrist: [Phone]
- Crisis hotline: 988
- Emergency contact: [Phone]
3. Medication Information
Current medications:
- Name: _________________ Dose: _________________
- Name: _________________ Dose: _________________
- Name: _________________ Dose: _________________
4. Hospital Preference
Preferred psychiatric facility: _________________
Address: _________________
Phone: _________________
Important Documents to Have Ready
- Insurance card
- List of current medications
- Medical history summary
- Legal documents (power of attorney, if applicable)
Post-Crisis Plan
- Schedule follow-up appointment with psychiatrist
- Review and adjust medication if needed
- Update emergency plan based on experience
- Attend support group meetings
Keep this plan in an easily accessible location and review it regularly with your care team.