Behavioral Health Crisis Center Patient Elopement Report

Secure Patient Elopement Reporting for Behavioral Health Facilities

When a patient leaves a behavioral health crisis center without authorization, every minute counts. This Patient Elopement Report template gives crisis centers, psychiatric hospitals, and mental health facilities a fast, structured way to document critical details, assess danger levels, and dispatch mobile crisis teams—all while maintaining compliance with legal and clinical protocols.

Built for the urgency of behavioral health crises

Patient elopements require immediate, coordinated response across clinical staff, security, crisis teams, and sometimes law enforcement. This template captures everything responders need in one clear submission:

• Patient identification and legal status including voluntary/involuntary holds and conservatorship details
• Comprehensive danger assessment covering suicide risk, violence potential, medical vulnerability, and environmental dangers
• Current medication schedule with missed doses and withdrawal risks clearly documented
• Physical descriptors and last known details to aid search and identification efforts
• Mobile crisis team dispatch information with priority routing and contact coordination

The form uses conditional logic to reveal relevant sections based on legal hold status and risk levels, ensuring staff complete only the fields that matter for each unique situation while capturing all legally required documentation.

Streamline crisis response with Stepper workflow automation

After a staff member submits an elopement report, time-sensitive actions need to happen immediately. Connect this form to Stepper to automate your crisis response protocol:

• Instantly alert mobile crisis teams, supervisors, and on-call clinicians via SMS and email
• Notify local law enforcement automatically when danger assessment scores reach critical thresholds
• Create incident tickets in your EHR or case management system with all documented details
• Generate timeline logs for regulatory compliance and legal documentation
• Update family contacts and legal representatives according to your facility's notification policies
• Trigger follow-up check-ins and debriefing workflows once the patient is located

This template is ideal for psychiatric hospitals, crisis stabilization units, residential treatment centers, and mobile crisis programs that need to balance urgent response with thorough documentation. Trusted by behavioral health providers who understand that clear reporting can mean the difference between a safe return and a tragic outcome, this form helps your team act fast while covering all clinical and legal bases.

Note: Paperform is not HIPAA compliant. Consult with your compliance team before collecting protected health information.