Emergency Information: If you are in crisis, or at risk of harming yourself or others, please call us at (844) 317-1136 immediately. If this is an imminent emergency, please call 911 or proceed to the nearest ER.

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Who are you requesting help for?

Please note that you’re submitting a request for help on behalf of another individual.

We’ll follow up with you directly and explain the procedure for connecting with your friend or family member.If you’d prefer for your friend or family member to submit a request directly on their own behalf, they can do so by clicking “Self” on the first page of this form.

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What branch of the military did theyyou serve?

First, we need to collect some basic information. This process is completely confidential.

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First, we need to collect some basic information about you. This process is completely confidential.

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Now we need to know how to contact you. This process is completely confidential.

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Can you tell us more about why you’re reaching out for your friend or family member? Check all that apply. Can you tell us more about why you’re reaching out today? Check all that apply.

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Will you tell us more about what your friend or family member is feeling? Check all that apply. Will you tell us more about what you’re feeling? Check all that apply.

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Can you please give us some vital information on your friend or family member?

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One final question regarding your friend or family member’s safety and wellbeing. One final question concerning your safety and wellbeing.

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As a reminder, you can reach us by phone 24/7 at (844) 317-1136. If you’re having thoughts of killing yourself, we strongly urge you to call and speak with us immediately. Calling now is the fastest way to speak with an SSS team member.