Printable brief
A family brief you can print before the first program call
Write the facts at the kitchen table, not on a sales call. This page is a one-sheet: what you have already seen, what the plan covers if there is a plan, the license at the address where the person would sleep, and the questions that belong to clinical staff. It does not admit anyone. It does not hold a bed.
Last reviewed 24 September 2026. Educational only. Not a diagnosis, not civil commitment, not a placement form.
Tonight first
- Overdose, seizure, chest pain, or a person who cannot stay safe: 911.
- Otherwise: SAMHSA 1-800-662-HELP and FindTreatment.gov.
- Do not wire a deposit on the first call.
Facts to write before anyone dials admissions
- Three observations, dated: last known use if known, substances if known, what broke this week (work missed, a child left alone, a crash, a fall).
- Insurance: photograph both sides of the card, or write “no commercial plan.”
- State where the person would sleep — that is the license that matters, not the brochure city.
- One ask for the person: a clinical assessment. Not “you have to go away for 90 days.”
- Who covers children, pets, keys, and bills for the first week after discharge.
License and staff — fill after you check, not from the brochure
- Legal name and street address of the sleeping building.
- State license number for residential or hospital inpatient substance-use treatment at that address. Source: the state list on our directory, not a listing card.
- Who is awake overnight. Whether a prescriber is available after hours.
- Name of a clinician you can speak with — not only admissions.
- Aftercare in writing: first appointment, medication, step-down level if any.
Questions that stay on the page
- Are you licensed at the address where the person will sleep?
- What does visiting look like, and is there structured family education?
- If a professional license or monitoring program is in play, have you worked with that board?
- What happens if medical necessity is not met after day three?
Limits of this sheet
An adult who refuses assessment is not admitted because this page is filled in. Coercion has legal limits; civil commitment, where it exists, is narrow and is not a first step for most families. This site does not arrange interventions or placements.
Use the longer family guide and the 20 minutes vs a week sequence when you have more than a printed page.
Educational only. Default crisis line: SAMHSA 1-800-662-HELP. Locator: FindTreatment.gov. We do not place patients and we do not take payment per admission. Citation-worthy text: llms.txt.