Question, Persuade, Refer Training Request

Please use this form to request Question, Persuade, Refer (QPR) Suicide Prevention Training for your organization or for a community event.

First Name *

Last Name *

Phone Number *

Primary Email Address *

Date & time you would like training conducted: *

Location (if online, please indicate which platform, i.e. Zoom, Teams, etc): *

Organization Name: *

Estimated attendance: *

Does your organization want specific demographic information covered? Please select any of the following: *

Any other comments or important considerations:

412 Lilly Rd. N.E., Olympia, Washington 98506-5132

(360) 867-2500 PHSS_MCH@co.thurtson.wa.us FAX (833) 499-1806 TTY/WA Relay 711