loader image

Mandatory

Important Questions We Must Ask

Once the form is completed and submitted, you will be contacted within the next 24 business hours for a short courtesy call (10 minutes or less) for consultation purposes. Please, fill in the data with the same reservation information: Your name and surname, email and contact number.

In case of doubts, you can consult the frequently asked questions or contact us:

FAQ
Contact

Important Questions We Must Ask
Full name
Full name
First Name
Last Name
Have you ever attempted to kill yourself?
Have you ever had thoughts of killing yourself?
How long ago you have been experiencing thoughts or have you attempted to kill or harm yourself?
Has anyone in your family or close to you died by suicide?
Have you ever felt you wanted to seriously harm or kill someone else?
Do you have weapons in your home or access to weapons?
Is there any history or presence of abuse or violence?
Save my progress to continue later

Let's work together

Greater time flexibility and comfort

Contact us!
wpChatIcon
wpChatIcon