Lewis and Clark Public Health QPR Pre-training Survey
SECTION I: Please provide the following information BEFORE the Gatekeeper Training. The anonymous information you provide will be used to assess the effectiveness of the QPR training.

Your email address will be kept confidential and will not be used in any reporting. We are asking for your email address in order to combine your pre-training survey and post-training survey results.
Email *
Age *
Gender *
Ethnicity *
Required
Have you or a family member ever served in the military? *
Are you attending this training for your role as a: *
How would you rate your knowledge of suicide in the following areas? *
Low
Medium
High
Facts concerning suicide prevention
Warning signs of suicide
How to ask someone about suicide
Persuading someone to get help
How to get help for someone
Information about local resources for help with suicide
*
Always
Sometimes
Never
Do you feel that asking someone about suicide is appropriate?
*
Always
Sometimes
Never
Do you feel likely to ask someone if they are thinking of suicide?
Before you take today's training, how would you rate your confidence in the following areas? *
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I feel confident in my level of understanding about suicide, suicide prevention and mental health.
I can recognize the signs a person may be dealing with a mental health problem, or suicidal crisis.
I feel prepared to help a person at-risk of suicide.
I can help a person who may be dealing with a mental health problem, or suicidal crisis by connecting them with resources.
I feel confident in my ability to recognize and correct mistaken beliefs about mental health, suicide, and mental illness as I come across them.
Since 2018, how many of the following training programs have you taken in Lewis and Clark County that are included in the following list: QPR (Question, Persuade, Refer); Youth Mental Health First Aid; Mental Health First Aid; Applied Suicide Intervention Skills Training (ASIST) *
A copy of your responses will be emailed to the address you provided.
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