Provider resources for substance use commitment
Get forms and information on supporting clients in the substance use commitment process.
Last updated: June 23, 2025
Contents
- Forms for Substance Use Disorder (SUD) providers
- Forms for Withdrawal Management (WM) providers
- Forms for Law Enforcement Data Collection and Reporting Requirements
- Forms for Emergency Department Data Collection and Reporting Requirements
- Roles and responsibilities for IC cases
- Contact
- Request for training
Forms for Substance Use Disorder (SUD) providers
| Name | File |
| IC Transition Planning Request |
|
| Outpatient IC Provider Guide 2024 | |
| Outpatient Monthly IC Report |
|
| Residential IC Provider Guide 2024 | |
| Residential Monthly IC Report |
|
Forms for Withdrawal Management (WM) providers
| Name | File |
| EC Transfer Form |
|
Emergency Commitment Application Note: only service providers should fill out and submit this form. |
|
| IC Withdrawal Management Readmission Form | |
| Physician Certificate |
|
| SUD Patient Rights Form |
|
| Withdrawal Management Provider Guide | |
| IC Fact Sheet for Respondents |
Forms for Law Enforcement Data Collection and Reporting Requirements
| Name | File |
| Law Enforcement Data Collection and Reporting Requirements Memo | Law Enforcement Data Collection and Reporting Requirements Memo (PDF) |
| House Bill 24-1079 regarding Persons Detained in Jail on Emergency Commitment | HB24-1079 Persons Detained in Jail on Emergency Commitment (URL) |
| Data Submission Guide for HB24-1079 | Data Submission Guide for HB24-1079 (PDF) |
| Data Collection Template for HB24-1079 | Data Collection Template for HB24-1079 (Excel) |
Forms for Emergency Department Data Collection and Reporting Requirements
| Name | File |
| Emergency Department Data Collection and Reporting Requirements Memo | Emergency Department Data Collection and Reporting Requirements Memo (PDF) |
| House Bill 24-1079 regarding Persons Detained in Jail on Emergency Commitment | HB24-1079 Persons Detained in Jail on Emergency Commitment (URL) |
| Emergency Department Data Submission Guide for HB24-1079 | Emergency Department Data Submission Guide for HB24-1079 (PDF) |
| Emergency Department Data Collection Template for HB24-1079 | Emergency Department Data Collection Template for HB24-1079 (Excel) |
Roles and responsibilities for IC cases
Overview for IC cases: IC Agency Roles and Responsibilities
BHA contact and support
The BHA Substance Use Commitment Team is here to support service providers in this process. We’re available Monday–Friday, 8:00 AM–5:00 PM Mountain Time, and closed on holidays. Allow up to 24 hours for a return call.
- Phone: (303)-866-7502
- Email: cdhs_bha_ic@state.co.us
Request for training - EC/IC Substance Use
- Request a training for emergency commitment and involuntary commitment for substance use by filling out this form.