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What We Do
Medical Care
Mental Health Therapy
Substance Use Disorder
Medication Assisted Treatment
LGBTQIA+ Medical Care
Gambling Addiction Treatment
Peer Recovery Coaching
Psychiatric Services
Suicide Awareness
Safe Plan
Medical CBD
Mobile Clinic
Safe Plan
Complete this Safe Plan to document how to keep you safe when you are having suicidal thoughts or feeling warning signs.
You can download a printable pdf or email your Safe Plan at the end of this form.
This is the suicide safe plan for:
Email:
My mobile phone:
Date of This Safety Plan:
Recognize Warning Signs
- Do you have any thoughts, feelings, or behaviors that might show you or friends/family that you are starting to struggle? List them here:
Coping Skills/Immediate Plan
- What can you do to keep yourself distracted and safe? Where will you be? Will there be any obstacles to any part of your plan?
Support
- Is there anyone you can turn to for help or call if your coping skills aren’t enough? If you can, list a few people and their mobile phone numbers:
Important Numbers
Counselor or Therapist:
Support person:
Local Hospital Name/Location: