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. 

  • 911
  • 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.

Telehealth is NOT the best option for you if you can answer yes to any of the following:
• You have thoughts of hurting yourself or others
• You are a minor or you are under the care of a legal guardian
• You are in an urgent crisis or an emergency situation
• You have been diagnosed with a severe mental illness, or if you have been advised to be in psychological supervision or psychiatric care
• You were required to undergo therapy or counseling either by a court order or by any other authority
• You do not have a device that can connect to the Internet or you do not have a reliable Internet connection