Lifeline Research Proposal Application

Welcome! Thank you for your interest in working with the National Suicide Prevention Lifeline. We are committed to furthering our understanding of crisis hotlines and their effectiveness among other suicide-related topics. Please complete the following questionnaire. A member of our evaluation team will assess the feasibility of this request and get back to you shortly.

Question Title

* 1. Please indicate the purpose of this request:

To obtain guidance on referring individuals who may experience a crisis to the Lifeline as part of a current research project

To collaborate with the Lifeline on a research project

To request data from the Lifeline for a research project

To obtain data/information for a media project

Other (please specify)

Question Title

* 2. Organization/Institution:

Question Title

* 3. Contact information:

First name

Last name

Prefix

Title

Phone number

Email address

Address

Address 2

State/Province

Zipcode

Country

Question Title

* 4. Please state the purpose of the research.

Question Title

* 5. What are the main outcomes of this research?

Question Title

* 6. What data will be requested from the Lifeline? If not applicable, please enter 'N/A'.

Question Title

* 7. What other resources, if any, are needed from the Lifeline to carry out this request? If not applicable, please enter 'N/A'

Question Title

* 8. Will your institution be able to perform an ethics review before the research commences?

Yes

N/A

Question Title

* 9. What is the expected social impact of this research?

Question Title

* 10. What is the proposed project timeline?

Please upload an overview of the timeline as an attachment (pdf, doc, or docx are accepted).

PDF, DOC, DOCX file types only.

Choose File

Question Title

* 11. Will you be requesting funding from the Lifeline to complete this project?

Yes (please specify the amount of the request in USD)

Question Title

* 12. Are there plans to disseminate the research findings?

Yes (please specify where the findings will be disseminated and/or the intended audience)

Question Title

* 13. Please upload any relevant attachments (pdf, doc, or docx are accepted).

(i.e., project proposal, recent publications on subject, etc.)

PDF, DOC, DOCX file types only.

Choose File

Thank you for completing this survey!

A member of our evaluation team will get back to you shortly.