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Suicide Risk Screen ASQ tool

SUICIDE RISK SCREENING TOOL - ASQ

Please answer the Questions Below -

I have read the above information and have had an opportunity to ask questions. I understand the benefits and risks of the flu vaccine as described. I request that the vaccine be given to me or to the person named below for who I am authorized to sign.

Resources

When people call, text, or chat 988 anywhere in the U.S., they will be connected to trained counselors that are part of the exisisting National Suicide Lifeline netowrk.

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