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PROVIDE BACKGROUND TO BETTER UNDERSTAND YOUR NEEDS.
Email address *
First Name *
Last Name *
Phone Number
Company, Organization or Affiliation (if applicable)
I Identify As: *
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Lifecycle: Which best fits where you are at? See more at unitesurvivors.org/lifecycle/ *
What motivated you to join our mailing list?
OPTIONAL: If you have been personally affected by suicide, have you told your story before? If yes, to who?
OPTIONAL: If personally affected by suicide: What if any, were/are the biggest challenges of sharing your story?
OPTIONAL: If you have told your story: What, if any, were the positive benefits of sharing your story publicly?
Have you visited/followed our YouTube (bit.ly/UniteSurvivorsYouTube) and Social Media (twitter.com/unitesurvivors and facebook.com/unitesurvivors and instagram.com/unitesurvivors)? *
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OPTIONAL: What should we be considering that you think is important or overlooked in the field of suicide prevention from moving forward?
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