Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.How well are you coping with Thomas' death?I’m doing very wellI’m okThis is very hardI can’t seem to move onHow are you sleeping?NormallyI’m not sleeping wellMuch more or less than usualHow are you eating?NormallyMore than usualLess than usualHow are you spending your down time?I’m able to relaxWhen my mind is not busy, I am troubled.I cannot focus. All time is down time.Are you currently depressed?YesNoI’m not sureIn the last year, have you had thoughts of ending your life?Yes, I’ve seriously considered itYes, but I would never do it.NoIf you are depressed or have had suicidal thoughts, have you asked for help from anyone?Yes, I’ve spoken to my familyYes, I’ve spoken to my family am in counselingYes, I am in counselingNoName *FirstLastEmail *Submit
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