Special Notice Crisis Services If you or someone you know is in suicidal crisis, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255). Assistance is available 24/7 through this Lifeline number and their website www.suicidepreventionlifeline.org. please complete Please complete the following form, and someone from EDC will contact you. Email Email Confirm email Name First Last Title Workplace Work phone State State/Province - None -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Which of the following describe your role or affiliation? Behavioral health provider or organization Physical health provider or organization Integrated behavioral and physical health provider or organization State agency Researcher Suicide prevention advocate or organization School or college campus Suicide attempt survivor Suicide loss survivor Other Other, please describe Are you a current Garrett Lee Smith suicide prevention grantee? Yes No How did you hear about Zero Suicide? - None -Zero Suicide InstituteSocial mediaEmail list or contactNews articleWord of mouth Please share your reason for contacting us. (If you are reaching out about the CALM training, please specify). Math question 5 + 15 = Solve this simple math problem and enter the result. E.g. for 1+3, enter 4. Submit Leave this field blank