Pharmacists as Gatekeepers in Suicide Prevention (CDPH) Post Survey

Post Webinar Survey CAPE Continuing Education Credit

Thank you for attending the webinar 'Pharmacist as Gatekeepers in Suicide Prevention'. Please complete the following post-survey. Note if you are interested in receiving CAPE continuing education credits it is required. If you have questions or comments please reach out to Stephanie at Stephanie@yoursocialmarketer.com.

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* 1. First Name

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* 2. Last Name

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* 3. Email Address

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* 4. Are you Hispanic or Latino?

Yes

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* 5. What is your race?

White

Black

American Indian/Alaska Native

Asian

Native Hawaiian/Pacific Islander

Other (please specify):___________

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* 6. What is your current gender identity?

Male

Female

Genderqueer/Gender nonconforming

Transgender male

Transgender female

Questioning/unsure

Another gender identity

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* 7. Please select your age group:

18-24

25-44

45-64

65-84

85+

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* 8. Which of the following best describes your profession:

Pharmacist

Pharmacist in training

Other (please specify)

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* 9. What is your pharmacist license number? (If applicable, N/A if not applicable)

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* 10. What county do you practice in?

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* 11. Did you find the training effective in increasing your knowledge around pharmacists as gatekeepers in suicide prevention?

Yes

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* 12. Do you plan to utilize the information provide in the training in your work?

Yes

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* 13. Do you feel like you have the knowledge and skills to identify the warning signs of suicide risk?

Yes

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* 14. Do you feel like you have the knowledge and skills to provide referrals to services for those at risk of suicide?

Yes

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* 15. Which of the following explains why pharmacists are ideal gatekeepers for suicide prevention?

Pharmacists rarely interact with patients for monitoring

Pharmacists are easily accessible and trusted by patients

Pharmacists are not familiar with medications that have high toxicity

Pharmacists are not considered healthcare providers who can prevent suicide

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* 16. Which option provides the correct pairing of verbal and non-verbal warning signs for suicide?

Displaying anger: missing clinic visits

Signs of intoxication: overfilling medications

Being grateful for your services: talking about hopelessness

Talking about feeling isolated: talking about extreme guilt

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* 17. Which of the following medications presents a risk factor for suicide?

Buspirone

Naloxone

Amlodipine

Sertraline

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* 18. Which of the following are one of the first two suicide screening questions per the Columbia Suicide Severity Rating Scale?

Have you started to work out or worked out the details of how to kill yourself? Do you intend to carry out this plan?

Have you thought about how you might do this?

Have you wished you were dead or wished you could go to sleep and not wake up?

Have you done anything, started to do anything, or prepared to do anything to end your life?

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* 19. Which of the following is an appropriate community resource for those at risk of suicide?

National Suicide Prevention Lifeline or 988 Suicide & Crisis Line

SuicideIsPreventable.org

Crisis Text Line

All of the above

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* 20. Are you interested in receiving a Pharmacy Outreach Kit (1 Poster, Display Case & Display Insert, 400 Takeaway Cards, 50 Pens)?

Yes

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* 21. If you are interested in receiving a Pharmacy Outreach Kit please provide your full mailing address below (First and Last Name, Address, City, State, Zip Code). (while supplies last)