If you are in an emergency situation or feel like you want to harm yourself or others, do not complete this form, instead seek immediate attention by calling one of the numbers below.
- 211 for the local Crisis Center
- Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Disaster Distress Helpline: 1-800-985-5990 or text TalkWithUs to 66746. (TTY 1-800-846-8517)
Click here for additional emergency resources
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**Please note that BMH does not prescribe nor dispense psychotropic medications.