Preventing Suicide Network-Online Survey/Questionnaire

Modified QUIS Parts 1,2,3 & 4

Your Age:

18-30

31-42

43-55

55-67

68 or older

Gender

Male

Female

Role Type
(choose one only, which you consider your PRIMARY role)

Family Member

Community Representative

Clinician

Unit Member/Active Duty

Policy Maker/Leader/ Senior Official

Your Service

Army

Navy

Air Force

Marines

Coast Guard

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