Chat Registration:
Already Registered?
Click Here To Login!
User name: 
Password 
Forgot Password

 











Email:  
The following is used for conversational purposes only and is optional.
First Name *
 
Last Name
 
Country 
Region 
City 
Postal code/Zip code *  
 

Should our chat session end unexpectedly, is there a phone number we may reach you at?
Contact Info

Age - If you are under 13, please call 1-800-273-8255.
Age *
Gender * 
What is your main concern? * 
Other, please specify
Do you have thoughts of suicide? * 
How upset are you? [Scale of 1–5] * 
Origin of Chat
Ethnicity * 
How did you hear about Suicide Prevention and Crisis Services? * 

To enable Google Chat or SMS (text) communications please provide the following info:
Cellular Number:
 
Optional: Create a username & password for future use.
User name: 
(6 - 12 characters)
Password 
(6 - 12 characters)
Confirm Password 


(more details)  

Verification: To complete the registration, solve the CAPTCHA and click "Start".
(this additional step helps prevent malicious and automated attempts to access the site)