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Get Cghq-1734.pdf. Suicide-related Behavior Report Form

Pt or Suicide Completion of CG members. After completing form, submit to CG-1111, EAP Manager. The purpose of the Privacy Act is to ensure that proper notification is given regarding the legal implications and purposes for collecting personal information. The individual who is the subject of the report must be made aware of the Privacy Act statement below before completing and submitting the information, unless he/she is deceased. PRIVACY ACT STATEMENT * Authority: 14 U.S.C. 93(a)(17); 10 U.

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