JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Suicide Prevention Support Request Form
The purpose of this request form is to provide support to Wisconsin public or private K-12 schools to develop comprehensive systems for suicide prevention, intervention, and postvention. A
WISH Center
team member will follow up within a week by email to set up a time to meet with you.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Name
Your answer
School Building
Your answer
School District
Your answer
What area of suicide prevention would you like to receive support?
Selecting & implementing peer to peer suicide prevention
Review of policy
Crisis management and communication
Debriefing after a crisis
Suicide prevention
Suicide threat assessment
Family resources
K-12 Curriculum (specify level below)
Staff training options (SOS, QPR, YMHFA, eg.)
Safety Protocol
Other:
Other information that may be helpful:
Your answer
Thank You!
A WISH Center Team member will follow up within a week by email to set up a time to meet with you by phone or a virtual meeting.
Optional: Schedule a Google Meet to talk with Jenny Holle
Select a time that works for you to meet virtually:
https://calendar.app.google/bPfqLaq2Lr6onm6FA
Youth Suicide Prevention Resources from DPI
Please explore these additional Suicide Prevention resources available on the
DPI's Youth Suicide Prevention webpage.
School-based Suicide Prevention: Overview and Connections
(Module 1 of 3)
Suicide Prevention Curriculum in Health Education: Overview
(Module 1 of 3)
2023 Suicide Prevention Memo and Model Notice
Peer-to-Peer Suicide Prevention Grants
Peer-to-Peer Suicide Prevention Overview Video
An overview of Peer to Peer Suicide Prevention programs most often used in Wisconsin, along with information on funding sources.
https://youtu.be/5YAOyrpbjQc
Youth Mental Health First Aid Training Request Form - Mental Health Literacy Training for Adults
The Wisconsin Department of Public Instruction and the WISH Center can offer a limited number of YMHFA trainings at no cost to Wisconsin schools, organizations, and communities. You may be placed on a waiting list for the next fiscal year if the maximum number of trainings has been met.
Link to Inquiry Form:
https://goo.gl/forms/r0st2lslVkMLc3qr1
Learn More on the
WISH Center Website
.
Youth Suicide Prevention Resources from the WISH Center
Please explore additional Suicide Prevention resources available on the
WISH Website
.
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Cooperative Education Service Agency #4.
Report Abuse
Forms
