Get forms and information on supporting clients in the substance use commitment process. Last updated: November 21, 2024.
Forms for Substance Use Disorder (SUD) providers
| Name | File |
| IC Transition Planning Request |
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| Outpatient IC Provider Guide 2024 | |
| Outpatient Monthly IC Report |
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| Residential IC Provider Guide 2024 | |
| Residential Monthly IC Report |
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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. |
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| IC Withdrawal Management Readmission Form | |
| Physician Certificate |
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| SUD Patient Rights Form |
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| Withdrawal Management Provider Guide |
Forms for Law Enforcement Data Collection and Reporting Requirements
| Name | File |
| HB24-1079 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) |
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.