Report Suicide Concern
If you or any individual is struggling with suicide or suicidal thoughts please call the Suicide Prevention Hotline located below.

1-800-273-8255

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Date of Incident *
MM
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DD
/
YYYY
Date of Report *
MM
/
DD
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YYYY
Who is the person of concern? *
Grade of person in concern? *
Was suicide mentioned by the individual? *
Where did the incident take place? *
Required
Other location details: (Please explain the specific location details such as which hallway, where on the Internet, what restroom, etc.)
Describe what happened with as many details as possible.
 *
Person reporting the incident:(OPTIONAL). Please provide your full name and contact information.
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