Submit Program Program Profile Program Name* Website Phone Number*Toll Free NumberFax NumberEmail Address Mailing Address Information*Summary description of the program*Available Languages* English French Mandarin Spanish Cree Other Other LanguagesIntervention Level* Mental Health Promotion (broadest category) Universal Prevention (suicide prevention for all children and/or youth) Selective Prevention (suicide prevention for those identified at risk) Indicated Prevention (suicide prevention for those who have exhibited signs/symptoms of suicide or suicide behaviours) Treatment Postvention Program Category* Awareness/Education (Programs that make students/youth more aware and knowledgeable about the signs and symptoms of suicide so that they can recognize these in themselves and in others) Screening (Tools which identify those at risk for suicide, suicide behaviours, suicidal ideation or other behavioural health problems.) Gatekeeper Training (Programs which improve knowledge and awareness of teachers or other adults who are working with children and youth so that they can assess risk and make referrals.) Peer Leadership (Programs which educate and engage youth in a range of roles to help and support other youth.) Skills Training (Programs which are designed to decrease risk factors and increase protective factors ( coping or general life skills) in youth.) Who is involved?* Certified instructors School staff Students Parents Trained volunteers Mental health professional Other professionals Who is the program for?* pre school JK K K to 12 1 2 3 4 5 6 7 8 9 10 11 12 0 - 4 years 5 - 12 years 13 - 21 years 21+ years Program Locations* Northern Health Region Prairie Mountain Health Interlake-Eastern Regional Health Authority Winnipeg Southern Health/Sante Sud Would you like to receive notification once the Regional toolkit and Program Directory are complete?YesNoNameThis field is for validation purposes and should be left unchanged.