SENHS – Help for Myself – Community Partners

I’m Seeking Help or Information for Myself

ARE YOU IN CRISIS? GET HELP NOW:

Call or Text 988 or Chat or call 833-710-6477 for 24/7 Support. Learn more: NH988.com

IF THIS IS AN EMERGENCY DIAL 911

Please complete the form below and a member of the SENHS team will contact you. The information you provide will help us understand how we can best assist you.

How old are you?(Required)

18 or older

Under 18

Are you currently using alcohol or other substances, or experiencing mental health concerns or symptoms?(Required)

Yes

No, but I would like to learn more about signs, symptoms, or treatment options.

How can we help?

Please briefly describe what you're looking for, any concerns you have, or any questions you'd like us to answer.

Name(Required)

First Last

Phone(Required)

Email(Required)

Preferred contact method:(Required)

Phone

Email

Either is fine