Back to Module Intro Sample Module 0% Complete 0/1 Steps Crisis Plan Form Sample Module Crisis Plan Form In Progress Lesson 1 of 1 In Progress Crisis Plan Form What is something I enjoy doing?What is one thing I am looking forward to doing?When I relapse or need to manage my risks, I will…notice warning signs that I am not doing well. These can be physical, emotional, or behavioral.As soon as I recognize these warning signs, I will go somewhere I feel safe and try to distract myself.have distractions I can use (list three).go somewhere I feel safe.What are some signs that I need help from others?Who is an important person in my life?Who can I reach out to for support? List their names and contact information.NameFirstLastPhone NumberNameFirstLastPhone NumberNameFirstLastPhone NumberHow would I like to be supported?Crisis Support: Alcohol & Drug Information & Referral Service 1 800 663 1441 Lower Mainland: 604 660 9382 Available to people needing help with any kind of substance abuse issues 24 hours a day. If I still need more help, I will go to the emergency room at the nearest hospital. If I can’t get to the hospital safely, I will call 911.Please note that your submission will not be saved. Export this form as a PDF to save your responses. Mac: Choose File > Print > Save as PDF | Windows: Press Ctrl + P > Save as PDF This field should be left blank
