Here is my report, as an example, I took out identifying details, but it should give you the gist:

*****TW: contains an account of my suicide attempt******

As a short summary, before I begin the complete account, I wanted to lay out that I am filing this complaint because, during a therapy session, I presented to Dr. ______ with serious suicidal ideation, and we both acknowledged that I was a danger to myself and needed to be hospitalized urgently. She ended up letting me go home to wait for a call from the hospital alone, and when I was not able to be admitted to the hospital, i followed through on my plan to attempt suicide. I very nearly died, and spent 10 days in the ICU at ________ Hospital. Dr. ________ never saw me again after that day, and would not own up to any possible mistakes. I believe she was negligent and did not act in accordance with New York State Mental Hygiene Law (9.46, specifically). I have voicemails that she left on my phone that may help to prove this, and I will send them with this e-mail.

Now, I will go into further details. On the morning of _________ at 9am, I saw Dr. ___________ at her office at ___________ for a therapy appointment. This was my third appointment that week, and 6th within the short 2 weeks that I participated in therapy with her. At that point in time, I was in extreme psychological distress, having come to her directly after a hospitalization, my third in three months, at _____________ Hospital. On the morning of __________ I presented to her with very serious active suicidal ideation, and agreed to go back to the hospital to receive treatment. I had told her that I had a plan to commit suicide by overdose, had intentions of carrying out that plan, and had the means to do so. I also told her that I had written a suicide note. I came to that therapy session with my bags packed, expecting to go straight to the hospital from there. During the appointment, Dr. _________ and I both agreed that I was an imminent danger to myself, and that I needed to be hospitalized that day, for my safety. We called __________ Hospital from her office, and they did an intake with me. They told us they would call me back later and tell me if I was able to be admitted there. This was nearing the end of the appointment, so Dr. ___________ told me I had a choice: I could either wait in the waiting room there by myself until ____________ called me back, or I could go home, wait, and call her when I knew if, and when, I was going to the hospital. I chose the second option and went home. While I’m a strong believer in patient autonomy, I don’t believe Dr. __________ acted in accordance with the law or the standard of care by letting me leave by myself and be unsupervised, as she knew I was presently a danger to myself. When I was at home and called back ____________ for a status update, they informed me that they were unable to admit me at this time. I became extremely emotionally distraught and called Dr. ________ repeatedly and left messages. Her answering machine said to press 1 for emergency, and I did that, but to no avail, because I still got her voicemail. In my panicked and psychologically dysregulated state, I made the very regrettable decision to try to end my life. I overdosed on many different medications and then laid there waiting for the effects to set in for probably about an hour. At that point in time, I was discovered by my roommate and rushed to _________ Hospital ER, where I began declining. My oxygen levels started to fall, I became nonresponsive, had a seizure, and needed to be intubated. I spent about 7 days in a coma, and then 3 additional days recovering in the ICU. Luckily, I made a full recovery. I estimate that I placed those calls and left those voicemails for Dr. ________ around 11am, although I don’t know the exact time. I do know for certain that she returned my calls and left me voicemail messages at 12:44pm and 12:52pm. At this point in time, I was already in the ________ ER and not fully conscious. I will include the complete transcript of these voicemails after this synopsis of events (and I will attach them to the e-mail I send this in). There are a few notable quotes within them, though, that I would like to point to, as I believe they show that she knew that I was a danger to myself before I left her office, and therefore did not respond in the appropriate way according to professional standards and the law. In the first voicemail, she said: “…It does sound like you need to be hospitalized today and I’m concerned that this is the second time I’ve tried to call you and that you were not answering your phone. I am in my office right now, I have my phone ringer on and I hope to hear from you very shortly. If I do not hear from you by 1 o’clock I will probably need to call the police to come and do a welfare check and help facilitate your admission today…” This was followed up by several important quotes in her second voicemail: “…It's very important that you are working together with me today to help make sure that you are safe, in that we find a place to admit you to the hospital…” “…we have to work together in these high-risk situations where you are feeling very suicidal....” “…I cannot be your therapist if you disappear after telling me that you want to die, so we need to work together…” I believe that all of this clearly demonstrates that she was very aware of the danger I was in but did not act appropriately or promptly enough. This endangered my life, and I am very lucky to be alive today. The only reason I am alive to write this is that other people intervened. Given, while it was my choices and my actions that did this, I believe it was her responsibility as my provider to protect me and not allow me to have those choices in the first place. I was not of sound psychological mind at the time to make any decisions regarding my own care. She did eventually call for that welfare check, but the police only found an empty house, and then had to track my phone, and that’s how she figured out that I was in the Emergency Room at ___________ Hospital. The next day, a Saturday, Dr. _________ called ___________ to check on my condition. The staff at the ICU gave the phone to my mother, and they had a conversation. She denied any wrongdoing during that conversation, because she said she had another patient, and that’s why she couldn’t stay with me. I believe there were many ways that Dr. _________ could have ensured my safety in that moment, regardless. She had a professional and legal responsibility to protect me, as she knew I was an imminent danger to myself. I am filing this complaint because I could not let this negligence go, and I believe that she should be educated in some way so that this doesn’t happen to anyone else in the future.
I apologize for the long-winded nature of this complaint, but I wanted to spare no details to make my account complete. Below, I have included the full transcript of the voicemails. I have highlighted the relevant parts, but I have included the entire transcript for the sake of completeness and context.

Transcript of voicemails:
[Due to the very specific nature of these and in the interest of maintaining some level of anonymity, I’m not including them here on this forum, but I included them in my report.]