Behavioral Services Intake Form

Behavioral Services New Form

Basic Client Information:


Adult Rehabilitative Mental Health Services (ARMHS)


Mental Health Support:


Crime Prevention:


Drug Abuse Prevention:


Additional Information (Optional)


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WHO CAN CALL?


This crisis helpline is for anyone who is experiencing emotional distress, personal crisis, or urgent mental health support needs.

You can call if you are:

• Feeling overwhelmed, anxious, or unable to cope
• Experiencing emotional pain, panic, or severe stress
• Facing a personal or family crisis
• Feeling hopeless, alone, or in need of immediate support
• Worried about your safety or the safety of someone else
• Supporting a loved one who is in crisis and need guidance

Note:
This hotline is strictly for crisis support and emotional assistance.
It is not for food assistance, shelter requests, or general service inquiries.