WOOD COUNTY CRISIS INTERVENTION STAT FORM

In Programs by NAMI Wood County

[[[["field63","equal_to","BOWLING GREEN POLICE DEPARTMENT"]],[["email_to",null,"sfrank@bgohio.org, skleiber@bgohio.org"]],"and"],[[["field63","equal_to","BOWLING GREEN STATE UNIVERSITY POLICE DEPARTMENT"]],[["email_to",null,"jbetori@bgsu.edu, kuhlmeg@bgsu.edu, campbem@bgsu.edu, mblank@bgsu.edu"]],"and"],[[["field63","equal_to","NORTH BALTIMORE POLICE DEPARTMENT"]],[["email_to",null,"allandbaer@yahoo.com"]],"and"],[[["field63","equal_to","NORTHWOOD POLICE DEPARTMENT"]],[["email_to",null,"dhubaker@northwoodpolice.com"]],"and"],[[["field63","equal_to","OWENS POLICE DEPARTMENT"]],[["email_to",null,"gary_stewart3@owens.edu"]],"and"],[[["field63","equal_to","ROSSFORD POLICE DEPARTMENT"]],[["email_to",null,"jjohnson@rossfordohio.com"]],"and"],[[["field63","equal_to","WOOD COUNTY PARK DISTRICT"]],[["email_to",null,"tbateson@wcparks.org"]],"and"],[[["field63","equal_to","WOOD COUNTY SHERIFF'S OFFICE"]],[["email_to",null,"lwolf-baker@co.wood.oh.us"]],"and"]]
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WOOD COUNTY CRISIS INTERVENTION STAT FORM
TO BE COMPLETED ANY TIME A CRISIS SITUATION IS ENCOUNTERED.

Agencies participating in the Crisis Intervention process strive to keep this information accurate based on the views, opinions, and observations effected solely on this incident and is intended to provide general information and should not be used as a substitute for a professional evaluation. Furthermore, the above named department and the Wood County Sheriff’s Office take no responsibility for the accuracy or validity of any contents and make no representation about any information provided and disclaim all liability.

Starting time of call:
access_time
Ending time of call:
access_time
SUBJECT INFORMATION
SUBJECT CRISIS
Type of crisis:
Involvement of Drugs/Alcohol:
MENTAL HEALTH AGENCY INVOLVEMENT
Time Agency was Contacted:
access_time
Time Agency Arrived:
access_time
LAW ENFORCEMENT
COMPLETED BY
FOLLOW UP
Requesting follow up with the individual by a mental health professional:If yes, please fill out the contact information for the individual.
Officer SatisfactionWas the officer satisfied with the outcome?
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