QPR Training Inquiry Form 

Thanks for your interest in holding a QPR (Question, Persuade, Refer) Suicide Prevention Training! Please take a moment to fill out the QPR Training Inquiry Form.

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* 1. Name

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* 2. Telephone

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* 3. Email 

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* 4. Date or dates of specific training request.  (The more specific, the more helpful for our cadre of trainers.)

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* 5. Time of Training (is applicable)

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* 6. Business/School/Civic Organization/Church/Group Name (if applicable)

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* 7. Number of Anticipated Audience Members

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* 8. Training Location (if applicable) (e.g. Faith Church, XXX Street, XXXX City)

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* 9. Type of Audio/Technology Available at your desired location listed above

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* 10. Comments

Thanks for your interest in having a QPR (Question, Persuade, Refer) Suicide Prevention Training! Please allow for 10 business days (or sooner) to receive a response as we reach out to the HSC 2020 cadre of certified QPR trainers. Thank you for being a mental health champion!

If you have questions or do not hear back during 10 business days, please call MHA Sheboygan at (920) 458-3951 or email info@mhasheboygan.org.

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