Tanana Chiefs Conference - Coordinated Community Crisis Response Request Form

This form is NOT for individual patient crises-communities only

The TCC Crisis Response Committee will process this request within 24 hours. If submitted outside of business days, the request will be processed on the following business day. A staff member will reach out to follow up and coordinate a community crisis response.

If you are experiencing a mental health crisis and need immediate assistance, please reach out in one of the following ways:

TCC Behavioral Health
Call 907-459-3800
Available 24/7
Option 2 for After-Hours.

Alaska Careline
Call 1-877-266-4357 or
text 4help to 839863.
Available 24/7

Behavioral Health Crisis Line
Call or Text 988
Available 24/7

The 988 Suicide & Crisis Lifeline offers 24/7 call, text and chat access to trained crisis counselors who can help people experiencing suicidal, substance use, and/or mental health crisis, or any other kind of emotional distress. People can also call, text or chat 988 if they are worried about a loved one who may need crisis support.

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* 1. Please provide community requesting crisis response.

Community Name

Tribe

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* 2. Is this a formal request from the tribe?

Yes

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* 3. Who is the main point of contact for coordinating response?

First and Last Name

Email Address

Phone Number

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* 4. When did crisis event occur?

Date / Time

Date

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* 5. Who is involved in the incident? Please provide their names and roles.

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* 6. Please provide a summary of the incident.

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* 7. What other organizations have been contacted? (Law enforcement, public safety, tribal courts, OCS,.etc.)

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* 8. Are immediate services needed? If yes, please specify.

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* 9. What specific TCC service and/or technical assistance are being requested?

Behavioral Health Services

Wellness and Prevention Services

Tribal Government and Justice

Other