Please note before completing this form: If there is evidence of immediate harm to self or others, call 9-1-1 and then call Security & Safety at 360-992-2133.

Information About BITA

Your Information

Person of Concern's Information

Incident Information

Time of Incident:

While writing your BITA referral, it is very important to only document observable behaviors and facts in the narrative. Avoid subjective feelings, diagnostic labels, and/or derogatory information. This information could be viewed by others so please avoid inflammatory language. Example descriptions are listed in the sample descriptions page.
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