IN CASE OF AN EMERGENCY. Emergency Reporting: Accident/Injury— Our facility has trained Responders. Request an employee to page “first aid responders” to your location and then call local emergency response. Dial 701 &702 separately. 701 to activate paging for offices and then dial 702 to activate a page in the factory. Emergency Response Dial 911
IN CASE OF AN EMERGENCY. If an emergency arises while you are using the building (fire, personal injury, etc.), call 911 and provide our physical address of 000 X. Xxxxx Xxxxxx Xxxx and then report the emergency to the Administrative Assistant 317.241.6163 or xxxxxxxxxxxxx@xxxxxxxxxxxxx.xxx as soon as possible. If the emergency arises after hours, please contact 000.000.0000.
IN CASE OF AN EMERGENCY. In the case of an emergency, always call your Gas Utility and/or your Electric Utility or other emergency personnel, and not us.
IN CASE OF AN EMERGENCY. A. For facility entry and or fob problems, please call .
IN CASE OF AN EMERGENCY. If you have a mental health emergency, we encourage you not to wait for a call back, but to do one or more of the following: Call Behavioral Health Link/GCAL: 000-000-0000 Call Lifeline at (000) 000-0000 (National Crisis Line) Call 911. Go to the local emergency room of your choice. If you & your therapist or psychologist decide to include Tele-Mental Health as part of your treatment, there are additional procedures that we need to have in place specific to Tele-Mental Health services. These are for your safety in case of an emergency and are as follows: You understand that if you are having suicidal or homicidal thoughts, experiencing psychotic symptoms, or in a crisis that we cannot solve remotely, we may determine that you need a higher level of care and Tele-Mental Health services are not appropriate. We require an Emergency Contact Person (ECP) who we may contact on your behalf in a life-threatening emergency only. Please write this person's name and contact information below. Either you or we will verify that your ECP is willing and able to go to your location in the event of an emergency. Additionally, if either you, your ECP, or we determine necessary, the ECP agrees take you to a hospital. Your signature at the end of this document indicates that you understand we will only contact this individual in the extreme circumstances stated above. Please list your ECP here: Name: Phone: You agree to inform your therapist of the address where you are at the beginning of every Tele-Mental Health session. You agree to inform your therapist of the nearest mental health hospital to your primary location that you prefer to go to in the event of a mental health emergency (usually located where you will typically be during a Tele-Mental Health session). Please list this hospital and contact number here: Hospital: Phone: Our Agreement to Enter into a Therapeutic Relationship Please print, date, and sign your name below indicating that you have read and understand the contents of this “Information, Authorization and Consent to Treatment” form as well as the Health Insurance Portability and Accountability Act (HIPAA) Notice of Privacy Practices” provided to you separately. Your signature also indicates that you agree to the policies of your relationship with your therapist and/or group leader, and you are authorizing your therapist and/or group leader to begin treatment with you. We are sincerely looking forward to facilitating you on your journey to...
IN CASE OF AN EMERGENCY. I Need Family Therapy/Xxxxx Xxxxxxx, MFT, LMFT is an outpatient facility, and we are set up to accommodate individuals who are reasonably safe and resourceful. We do not carry beepers nor are we available at all times. If at any time this does not feel like enough support, please inform your therapist, and he or she can discuss additional resources or transfer your case to a therapist or clinic with 24-hour availability. Generally, your therapist will return phone calls within 24-48 hours. If you have a mental health emergency, we encourage you not to wait for a call back, but to do one or more of the following: • Call 911. • Go to the emergency room of your choice • Call Behavioral Health Link/GCAL: 000-000-0000 • Call Lifeline at (000) 000-0000 (National Crisis Line) • Call Ridgeview Institute at 000.000.0000 • Call Peachford Hospital at 770.454.5589
IN CASE OF AN EMERGENCY. A. For facility entry and or key card problems, please call .
IN CASE OF AN EMERGENCY. If an emergency arises while you are using the building (fire, personal injury, etc.), call 911 and provide our physical address of 963 N. Girls School Road and then report the emergency to the Administrative Assistant 317.241.6163 or xxxxxxxxxxxxx@xxxxxxxxxxxxx.xxx as soon as possible. If the emergency arises after hours, please contact 000.000.0000.
IN CASE OF AN EMERGENCY involving the Minor Participant, I understand that efforts will be made to contact me. If I cannot be reached in a reasonable time period, I give permission to the Chapter and Activity Leader(s), and to emergency and medical personnel and institutions, to secure and provide appropriate medical treatment, in their best judgment, including hospitalization, anesthesia, surgery, and/or injections of medication to the Minor Participant. I authorize medical providers and record-keepers, in their best judgment, to disclose protected health information to Chapter and medical personnel who are involved in responding to the emergency.
IN CASE OF AN EMERGENCY. If an emergency arises while you are using the building (fire, personal injury, etc.), first call 911 and provide our physical address of 963 N. Girls School Road and then report the emergency to the Administrative Assistant 317.241.6163 or xxxxxxxxxxxxx@xxxxxxxxxxxxx.xxx as soon as possible. If the emergency arises after hours, please contact 000-000-0000. Sanctuary and Prayer Room The Sanctuary and Prayer Room are designated for religious use activities and shall not be considered available for other use except for weddings and funerals, without prior permission from the Chapel Hill Senior Pastor.
