Registration for safeTALK & ASIST Suicide Prevention Trainings (sponsored by the Hawai'i Department of Health)
Please complete the following fields to register for one of the scheduled safeTALK or ASIST Trainings.
Thank you!

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* 1. First Name:

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* 2. Last Name:

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* 3. Position Title:

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* 4. Organization:

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* 5. Email Address:

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* 6. Phone number:

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* 7. Please select the suicide prevention training that you are registering for:

safeTALK

ASIST

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* 8. Desired Date:

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* 9. If you require ADA accommodation, please specify what type:

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* 10. Have you ever attended another suicide prevention training?

Yes

No

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* 11. If yes, which one?

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* 12. Are you a survivor? (either lost a loved one to suicide or survived an attempt yourself)

Yes

No

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