safeTALK Request Form
safeTALK is a 3-4 hour alertness training that prepares anyone 15 or older--regardless of prior experience or training--to become a suicide-alert helper. Most people with thoughts of suicide don’t truly want to die but are struggling with the pain in their lives. Through their words and actions, they invite help to stay alive. safeTALK-trained helpers can recognize these invitations and take action by connecting them with life-saving intervention resources.
Email *
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Organization *
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Address / City / State / Zip *
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Contact Name *
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Contact Phone Number *
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Preferred date and time for safeTALK *
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Alternate date and time for safeTALK
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How many participants do you expect? *
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Does your organization have A/V equipment to support PowerPoint presentation? *
Additional questions, comments, or concerns:
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Thank you!
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