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ASH: Suicide Attempt Survivor Survey
The research questions in this survey are identical to those asked by Juliet Carr, founder of Attempted Suicide Help for her upcoming book.

NOTE: This survey makes no claims of psychological or emotional safety. It is intended for adults or those with parental/guardian approval.
Are you 18 years of age [in the USA], or above the age of legal consent in your country, or do you have the express approval of your parent/guardian to participate? *
First and Last Initials plus Month/Yr of Birth (example: MC11/1960) *
Your answer
Residence *
Your answer
Please check all that apply. *
Required
What were the emotions or feelings you had up to 24 hours prior to your attempt (s)?
Your answer
“Why?” is the biggest question loved ones have after an attempt. Can you describe why you attempted?
Your answer
Did you tell anyone how you were feeling or reach out for help before your attempt(s)?
Your answer
Did you reach out for help to save your life during your attempt(s) or did someone find you?
Your answer
If you did stop the attempt(s) what were some reasons or situations why?
Your answer
Did you have any experience during your attempt(s) that you would like to share?
Your answer
Did you leave a suicide note, and if so, does that note make sense to you as you look back now?
Your answer
Was there anything that could have changed in your life to make it so you would have not attempted?
Your answer
Was there anything that anyone in your life could have changed or done for you to make it so you would not attempt?
Your answer
What were the emotions or feelings you had when you realized your attempt was not completed?
Your answer
Are you now grateful you are alive and, if so, why?
Your answer
What are some things you have discovered since your attempt that have helped you?
Your answer
What are the biggest things you do now to stay healthy, supported and hopeful in life?
Your answer
Do you volunteer for any causes or organizations?
Your answer
Is there anything you would like to tell the people in your life about your attempt(s)?
Your answer
Is there anything else you would like to share with others?
Your answer
Way/s in which you attempted:
Your answer
Number of attempts:
Your answer
Time since your last attempt:
Your answer
If you would like your input data to be included in research projects resulting from this survey, please type your email below. NOTE: Email addresses will never be shared without express consent.
Your answer
Thank you for your input! The result of your input will be immediately viewable in chart form on the ASH website
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