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Bereaved by suicide: In this brief survey we are trying to understand how Covid-19 has impacted those bereaved by suicide.
1.
How would you describe your gender
Male (including transgender men)
Female (including transgender women)
Prefer to self-describe (please tell us below)
Prefer not to say
Prefer to self-describe
2.
Please tell us your age
18 and under
19-25
26-29
30-39
40-49
50-59
60-69
70+
3.
The person I lost to suicide was
Mother
Father
Daughter
Son
Sibling
Friend
Colleague
Partner
Other (please specify)
4.
Are you currently in receipt of bereavement support?
Yes
No
Previously
Other (please specify)
5.
Please tell us your email address (optional)