Sample Passive Consent Letter English signs of suicide 7th

7th GRADE -HEALTHFUL LIVING CLASSES- SIGNS OF SUICIDE
Dear Parent or Guardian:
The adolescent years are marked by a roller-coaster ride of emotions—difficult for youth, their parents, and educators. It is
easy to misread depression as normal adolescent turmoil; however, depression (among the most common of mental illnesses)
appears to be occurring at a much earlier age. Depression—which is treatable—is a leading risk factor for suicide. In addition,
self-injury has become a growing problem among youth.
To proactively address these issues, Rolesville Middle School is offering depression awareness and suicide prevention
training as part of the SOS Signs of Suicide® Prevention Program. The program has proven to be successful at increasing
help-seeking by students concerned about themselves or a friend and is the only school-based suicide prevention program
listed by SAMHSA for its National Registry of Evidence-Based Programs and Practices that addresses suicide risk and
depression, while reducing suicide attempts. In a randomized control study, the SOS high school program showed a reduction
in self-reported suicide attempts by 40% (BMC Public Health, July 2007).
Our goals in participating in this program are straightforward:
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To help our students understand that depression is a treatable illness
To explain that suicide is a preventable tragedy that often occurs as a result of untreated depression
To provide students training in how to identify serious depression and potential suicidality in themselves or a friend
To impress upon youth that they can help themselves or a friend by taking the simple step of talking to a responsible adult
about their concerns
To help students know whom in the school they can turn to for help, if they need it
During the weeks of September 28th-November 19th students will cover the SOS program during their Healthful
Living Class. Students will take a survey regarding the risk factors associated with suicide. Surveys will be viewed
by the school counselor after the presentation. Any student requesting to be seen by an adult will meet with the
school counselor before the end of the school day. Parents will be notified if their child is screened for depression or
suicide. This program is to help increase students awareness of the signs and symptoms related to depression, selfdestructive behaviors, and suicide.
We are enclosing a copy of the Parent Newsletter and Referral Resource List so that you have information and resources
about depression and its related risks.
If you do NOT want your child participating in the SOS Middle School program, please complete the form below and return
it to your child’s Healthful Living Teacher by Friday, August 21st (Tracks 1,3, and 4) . Track 2 needs to return the
form by Friday, September 11th. If we do not hear from you, we will assume your child has permission to participate in this
program.
Sincerely,
RMS Healthful Living Department
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Child’s Name___________________________________ Grade_________ Track________ Date_______________
Parent Name___________________________________ Parent Signature ________________________________
____ I do not want my child to participate in the Signs of Suicide Middle School Program.
SIGNS OF SUICIDE TRAINING DATES- 7th Grade
Team A: Brennan and Brodnick
Track 1: Brennan –7th Grade Tr. 1- October 7th and October 8th (Ms. DeRito)
Track 2: -Brodnick – 7th Grade Tr. 2- October 5th and 6th (Mrs. Hayes)
Track 3: No 7th Grade Track 3 classes
Track 4:Brennan-7th Grade Tr. 4- November 18th and November 19th (Mrs. Epps)
Brodnick-7th Grade Tr. 4-November 16th and November 17th (Mrs. Epps)
Team B: Averette, Komons, and Niebaum
Track 1: Komons- 7th Tr. 1- October 1st and October 2nd (Ms. DeRito)
Niebaum- 7th Tr. 1 – October 19th and October 20th (Ms. DeRito)
Track 2: Averette-7th Grade Track 2-September 30 and October 1st (Mrs. Hayes)
Track 3: Komons- September 30 and October 1st (Mrs. Hayes)
Track 4: Averette-7th Tr. 4 – September 28th and September 29th (Mrs. Epps)
Niebaum – 7th Tr. 4 – October 22nd and October 23rd (Mrs. Epps)
Team C: Hayes and Rossouw
Track 1: Rossouw-7th Grade Tr. 1 – November 2nd and November 3rd (Ms. DeRito)
Hayes – 7th Grade Tr. 1 – November 5th and November 6th (Ms. DeRito)
Track 2: No 7th Grade Track 2 classes
Track 3: Hayes-7th Grade Tr. 3 – October 15th and October 16th (Mrs. Hayes)
Rossouw-7th Grade Tr. 3 – October 12th and October 13th (Mrs. Hayes)
Track 4: No 7th Grade Track 4 classes