Student QPR Enrollment & Request Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

QPR (Question-Persuade-Refer) Suicide Prevention Gatekeeper Training Program is a community-focused, nationally-recognized, empirically-based suicide prevention program. HPaW, CAPS, and other relevant departments have partnered to educate our community about suicide and the resources available for those needing professional help.

QPR is intended to teach individuals how to recognize the warning signs of suicide, and provides guidelines on how to:

Question a person about potential suicidal thoughts,

Persuade them to seek help, and

Refer them to appropriate professional services.

This form is only for students who wish to enroll in QPR. Staff/Faculty can sign up for QPR via myHRlearn. Reach out to hpaw@northwestern.edu with any questions.

Please use the form below to sign up for one of our open in person or virtual trainings or to request a training for up to 35 people.

Email *

Name: *

Student ID Number: *

Scheduled open trainings are listed below. Please select a training if you'd like to enroll individually in QPR- make sure the date, time, and location work for you before selecting the button.

Fall trainings have reached capacity. Sign up here to be the first to receive info about Winter quarter trainings.

Clear selection

If you're looking for a training for up to 35 people, please identify the following below:

1) Full name of group or organization

2) # of total participants expected (The max number of participants is 35. If you expect more than that, you may fill this out but please know that this might not be possible. If your group has less than 20 participants, you may be asked to join another group for this training.)

3) Preference for virtual or in-person

If in-person, what's your preferred location?

4 )List at least 3 preferred dates and times AT LEAST 3 WEEKS OUT. (We do not offer this program on weekends. Please only provide weekday and weeknight options starting no later than 7pm.)

Send me a copy of my responses.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of @u.northwestern.edu. Report Abuse

Forms