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Screening Questionnaire

Your participation makes a difference

Crisis Support

If you are experiencing a crisis or medical emergency, immediately dial 911 and/or go to the nearest emergency room. If you are having suicidal thoughts or thinking of harming others, immediately dial 988 and/or go to the nearest emergency room.

Reading Requirements

1

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2

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Consent Document

Your Privacy

Protected & Secure: We will assign a code that is uniquely and privately tied to you. This protects your identity and ensures that your data stays safe.

Your Rights

Completely Optional: Your participation is completely voluntary, You can withdraw or contact us with concerns at any time.