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Run: Suicide Risk Assessment with SAFE-T and C-SSRS

Document suicide risk, protective factors, and next-step interventions in one SAFE-T and C-SSRS assessment form. Use it to standardize clinical documentation...

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Assessment Context and Consent

Assessment date (required)

Assessment time (required)

Assessment setting (required)

Reason for assessment (required)

Briefly document the presenting concern using minimum-necessary clinical detail.

Patient consented to this assessment (required)

PII and documentation disclosure acknowledged (required)

Confirm the patient was informed how clinical information will be used, shared, and stored according to policy.

Yes No N/A

SAFE-T Risk Factors

Current stressors (required)

Recent life events or triggers

Document only clinically relevant details.

Relevant psychiatric history

Access to lethal means (required)

Lethal means details

Document only the minimum necessary details for safety planning.

Recent alcohol or substance use (required)

Substance use details

C-SSRS Ideation and Behavior

Wish to be dead (required)

Active suicidal thoughts (required)

Ideation frequency

Ideation intensity

Suicide plan (required)

Plan details

Suicide intent (required)

Intent details

Past suicide attempts (required)

Past attempt details

Recent self-harm behavior (required)

Protective Factors and Supports

Protective factors

Support persons to involve

Add only contacts needed for the care plan; avoid unnecessary PII.

Coping strategies that have helped

Clinical Risk Level and Intervention Plan

Overall risk level (required)

Risk rationale (required)

Summarize the factors supporting the risk level, including risk and protective factors.

Intervention actions (required)

Safety plan details

Document warning signs, internal coping strategies, social supports, professional contacts, and emergency steps.

Disposition (required)

Follow-up date

Emergency escalation needed

Check if immediate emergency response procedures were initiated.

Yes No N/A

Submission and Audit Trail

Clinician name (required)

Clinician role (required)

Attestation (required)

I attest that this assessment was completed according to organizational policy and applicable clinical standards.

Yes No N/A

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