1. have you wished you were dead or you could go to sleep and not wake up? No Yes
2. have you had any actual thoughts of killing yourself? No Yes
3. have you been thinking about how you might do this? No Yes
4. have you had these thoughts and some intention of acting on them? No Yes
5. have you started to work out or worked out the details of how to kill yourself? Do you intend to carry out this plan? No Yes
6a. Have you ever done anything, started to do anything, or prepared to do anything to end your life? No Yes
6b. Was this within the past three months? No Yes