Suicide Risk Assessment Form
Suicide Risk Assessment Form
Please complete this form to evaluate and identify potential risk factors for individuals experiencing suicidal thoughts or behaviors.
Full Name
Phone number
Are you currently experiencing emotional distress or depression?
Have you previously been diagnosed with a mental health disorder?
Have you ever had thoughts of harming yourself or suicide?
Have you made any previous suicide attempts?
If yes, please provide details of your previous suicide attempts.
Do you have a current plan to harm yourself or commit suicide?
Do you have access to lethal means such as firearms, medications, or other dangerous objects?
Are you currently receiving any professional help for your mental health?
Is there anything else you would like to share about your mental health or suicidal thoughts?
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