Submit an First Responder

By submitting a first responder to our site, you are giving them a placeholder on the Honor Wall until their family is ready to put up a memorial. You are also assisting us as we collect information that helps to raise awareness and reduce the stigma associated with suicide.

View Criteria for Inclusion

Instructions

Please note that all fields marked with an asterisk (*) are required to provide relevant and accurate reporting. These fields are not confidential in that they will be used for aggregate reporting purposes. For instance, it will be reported the number of males and females who have died by suicide, the number of states with the highest suicide rates, etc.

Items without asterisks are not required. If provided, this information is strictly confidential and will not be disclosed without prior consent.

If you wish to report the name of the first responder you may, this will help with the vetting process but will be kept confidential. At no time will this piece of information be shared without your permission. This is not required for reporting purposes.

Note: Contact information for the person reporting is requested so that we may ensure the information is accurate and reliable. We will not contact you unless absolutely necessary.


Gender(Required)

MM slash DD slash YYYY
Military Veteran

Had the person sought help?
Was there a history of job related PTSD?
Were there prior suicide attempts?
Was this person under investigation at the time of death?

If available, and applicable, we appreciate any links to the death that can provide verification of the suicide or details about the firefighter. This includes a link to the obituary. All of this is kept confidential, no matter how public the suicide, unless the family provides permission to share.

On occasion, we send cards and small gifts, such as Christmas ornaments, to family members. Please add the mailing address, family relation type (parent, spouse...) and, any other information (names, ages and gender) below. Again, this information is not shared in any way and is solely used for support and remembrance.

Memorial Page
Max. file size: 15 MB.
By submitting your photo, you are giving Red H.E.L.P. explicit permission to use the photo on our website and facebook page. Red H.E.L.P. assumes that you have authority to grant permission to use the photo. If you have questions about photo use, please note that in the text field above and we will contact you via e-mail.

Your contact information

Can we contact you for more information if needed?
We will only contact you if there is something pressing that we feel we need to ask. For instance, if a future study requires more information. Otherwise, we will not contact you in any way.
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