Introduction & Instructions

Thank you for contributing valuable data to help the Zero Suicide Partners of Pinellas (ZSPoP) track, monitor, and evaluate suicide prevention efforts throughout our community!

As a reminder, we will only report data in aggregate. This means that we will not share which partner(s) provided which data. We are interested in the collective efforts of the partnership, which is reflected in the how we share our data.


However, we ask you to provide your contact information during this survey. We do this to minimize the risk of duplicate reporting and to assess the overall level of membership engagement across the partnership. This also helps us follow-up with you if we have any questions or need clarification. 


We greatly appreciate your time, collaboration, and support. Please do not hesitate to reach out with any questions (kelliagrawal@suncoastcenter.org).


Instructions: 
If you participate in ZSPoP as an organizational partner, not an individual community, please click here to complete the organization data survey.

     
If a particular question does not apply to you, please enter “N/A” into the response box. Please do not leave any response boxes blank.


If a question does apply to you, but the answer for the month you are reporting for is none or zero, please enter “0” into the response box.

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* 1. Please provide your name and contact information.

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* 2. Please select the year for which you are reporting data.

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* 3. Please select the month for which you are reporting data. Please only report data for one specific month at a time.

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* 4. How many Safety Plans did you provided to community members this month?

Record the number of Safety Plans provided to community members during outreach events and community training. It will be aggregated with the rest of the Zero Suicide Partners of Pinellas data.

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* 5. How many Suicide Prevention Caring Contacts did you provide for individuals between treatment sessions or during transitions of care?

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* 6. How many suicide prevention community trainings, presentations, and/or workshops did you facilitate this month?

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* 7. How many suicide prevention workforce trainings, presentations, and/or workshops did you facilitate this month?

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* 8. If you conducted presentations or trainings on suicide awareness and prevention this month, how many people attended across all presentations and/or trainings?

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* 9. How many trainings on suicide awareness and prevention did you complete as a participant during the month being reported?

This can include training provided by ZSPoP. It can also include trainings provided by other groups and online.

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* 10. Please list the names of the trainings you completed as a participant this month.

This can include training provided by ZSPoP. It can also include trainings provided by other groups and online.

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* 11. How many support groups did you facilitate for survivors of suicide loss?

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* 12. How many support groups did you facilitate for survivors of suicide attempts?

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* 13. How many events or community meetings did you attend or provide support for on behalf of ZSPoP this month?

This includes tabling with ZSPoP during community events and also helping ZSPoP prepare for events.

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* 14. Do you have any additional information you would like to provide at this time?

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