If my psychiatric symptoms return or worsen

 These are some warning signs that may precede a flare-up of symptoms.

1. __________________________________________
2. __________________________________________
3. __________________________________________
4. __________________________________________
5. __________________________________________

 If I should experience a flare-up I need to tell these people.

1. __________________________________________
2. __________________________________________
3. __________________________________________
4. __________________________________________
5. __________________________________________

 I need to do these things to cope in a positive way:

1. __________________________________________
2. __________________________________________
3. __________________________________________
4. __________________________________________
5. __________________________________________

 If I have a psychiatric emergency:

 I would like to see Doctor ___________________________

 I authorize ___________________________ to take care of

________________________________________________

 and ____________________________________________