Saving Lives Together Consultant Notes

Consultant Name *

First Name

Last Name

Course/class type *

Concealed carry certification course

Concealed carry course (other)

Other firearm safety course

Class Date *

MM

DD

YYYY

Instructor Name *

First Name

Last Name

When during the overall training were the materials shared? *

Morning or early

Noon or middle

Later or afternoon

Presentation Details *

Select all that apply

Effective introduction/framing by instructor

Full video was shown

Powerpoint presentation was shown and discussed

Powerpoint slides were provided but not discussed

Other suicide prevention media or materials were shared

Rate the fidelity of the implementation. *

0= materials not shared at all or not shared during time when observer was present 1= materials shared with negative or counter-message introduction from instructor and/or negative or counter-message discussion from course attendees (negative or counter-message defined as stigmatizing language about certain individuals or communities, or about mental health, or about suicide or suicide prevention) 2= materials shared with no or minimal introduction from instructor and/or no or minimal discussion from course attendees 3 = materials shared with positive or on-message introduction from instructors and/or positive or on-message discussion from course attendees (positive or on-message defined as affirming importance of supporting mental health, promoting the role of firearm owners in responsible firearm storage and suicide prevention)

0 - no observed presentation of materials

1 - materials shared with negative talk

2 - materials shared with little/no talk

3 - materials shared with positive talk

Observed demographic representation in the class

Optional. Select any that apply.

Veterans

Person/people of color

Self-identified "new" firearm owners

Military family/caregivers