Family Crisis Plan Template With Instructions Page 4
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4The goal of this plan is:
I need to use this plan when:
Actions I can take:
Actions others can take to help me:
Some contacts and resources that
are helpful to me are:
Who I am
Name
Address
Telephone
Date of birth
Other important information about me:
I want this plan to be shared with:
*
*Note that if you want the provider to share this plan consent must be provided.
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