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Suicide Risk Assessment Form Template

Essential Tool for Identifying Suicide Risk in Patients

Determining whether someone is at risk for suicide can be challenging, but having the right tools makes a difference. This suicide risk assessment form template helps mental health professionals effectively evaluate a patient's risk, ensuring timely and appropriate intervention. By utilizing this form, you can streamline the assessment process, enhance patient communication, and ultimately provide more effective support in crisis situations-all while maintaining compliance with industry standards like WCAG-aligned labels. Explore the live template to support your practice.

Use this Template (FREE) Live Preview
Is this an emergency requiring immediate help right now?
Yes
No
Who are you completing this form for?
Myself
Someone else (with their knowledge)
Someone else (concerned third party)
Prefer not to say
Do you consent to proceed and have this information used for risk assessment and follow-up?
Yes
No
Full name
Date of birth
Email address
Phone number
Emergency contact full name
Emergency contact phone number
In the past 2 weeks, how often have you had thoughts of killing yourself?
Never
Rarely
Sometimes
Often
Always
Are you having suicidal thoughts right now?
Yes
No
Do you have a specific plan for how you might attempt suicide?
Yes
No
Have you taken any steps to prepare (for example, gathering pills, writing notes, choosing a location)?
Yes
No
Do you intend to act on these thoughts?
Yes
No
If yes, what means are available?
Do you have access to a method or means right now?
Yes
No
Have you ever attempted suicide?
Yes
No
Have you engaged in self-harm without wanting to die?
Yes
No
Have you been diagnosed with any of the following? (Select all that apply)
Please Specify:
Which stressors are affecting you right now? (Select all that apply)
Please Specify:
I feel hopeless about the future.
Strongly disagree
Disagree
Neither agree nor disagree
Agree
Strongly agree
How connected do you feel to people who care about you?
Very disconnected
Disconnected
Neutral
Connected
Very connected
Who can you reach out to when you feel distressed?
What are your reasons for living or things worth staying for?
What coping strategies help you when you feel suicidal? (Select all that apply)
Please Specify:
Will you remove or secure any lethal means today?
Yes
No
Preferred follow-up method
Phone call
Text message
Email
Video appointment
In-person appointment
No follow-up requested
Do you consent to us contacting your emergency contact if we believe your safety is at risk?
Yes
No
Type your full name as signature
Date
I confirm the information provided is accurate to the best of my knowledge.
Strongly disagree
Disagree
Neither agree nor disagree
Agree
Strongly agree
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Paper art illustration related to a suicide risk assessment form template and form creation tools.

When to use this form

Use this form during intake, when a client discloses suicidal thoughts, after a crisis call, or at discharge planning to check current risk. You can document warning signs, gauge urgency, and decide on next steps such as safety planning, supervision level, or referral. Pair it with the Case conceptualisation form to link risk factors to history and treatment goals. For a quick snapshot of mood and stress, add the Saringan minda sihat (dass-21) form. Between sessions, invite clients to reflect on triggers and coping using the Mental health journal form. The outcome: clearer triage, consistent documentation, and faster coordination with family or supports when you need it most.

Must Ask Suicide Risk Assessment Questions

  1. In the past two weeks, have you had thoughts about ending your life or wishing you were dead?

    You learn whether thoughts are present now and how recent they are, which predicts near-term risk. Clear timing helps you choose the right level of monitoring and follow-up.

  2. Do you have a plan to harm yourself, and do you intend to act on it?

    Specific plans and intent raise risk and may require urgent safety steps. Details guide your decisions on means restriction, supervision, and care setting.

  3. Have you ever attempted to end your life or engaged in self-harm, and when did it occur?

    History of attempts is a strong predictor of future behavior. If loss is a factor, the Grief assessment form helps you explore its impact.

  4. Do you currently have access to the means you mentioned, such as medications, firearms, or other tools?

    Access to lethal means increases imminent risk. Knowing what is available lets you act quickly on means reduction with the client and their supports.

  5. What protective factors could keep you safe right now, and who can we contact in a crisis to support you?

    Naming supports and reasons for living protects against acting on urges. It anchors a practical safety plan for the next 24-72 hours and who to involve.

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