Chat Registration:

Email:  
The following is used for conversational purposes only and is optional.
First Name
 
Last Name
 
 
 
City 
Postal code/Zip code *    

Should our chat session end unexpectedly, is there an email address or phone number we may reach you at?

Contact Info
How upset are you? [Scale of 1–5] * 
What is your main concern? * 
Other, please specify
Do you have thoughts of suicide? * 
Age *
Gender * 
How did you find out about Crisis Chat? * 
Other, please specify
Race – How do you identify yourself? * 
Ethnicity * 
Some visitors that use chat services may have thoughts of suicide.  If this is true for you, please complete the next six questions and then wait for the next available chat specialist.

If you are not having thoughts of suicide, please skip the next six questions and wait for the next available chat specialist. 
1. I am having thoughts about suicide, but I have…
2. I am having thoughts about suicide, but I have these thoughts...
3. I am having thoughts about suicide, but I am...
4. I am having thoughts about suicide, but I am...
5. I am having thoughts about suicide, but I am...
6. Is this the first time you have contacted this crisis chat line?

To enable Google Chat or SMS (text) communications please provide the following info:
Cellular Number:
 
Optional: Create a username & password for future use.
User name:  (6 - 12 characters)
Password  (6 - 12 characters)
Confirm Password 


(more)  

Verification: To complete the registration, solve the CAPTCHA and click "Start".
(this additional step helps prevent malicious and automated attempts to access the site)




 

 
Already Registered?
User name: 
Password 
Forgot Password






Why do we need Javascript enabled?

Javascript is a powerful programming language often used in web browsers to improve the user experience and enable dynamic functionality in web pages.

 Several key features and functionality within iCarol Messaging are facilitated by Javascript.

In order for us to provide the user with a rich Messaging experience, we rely on Javascript.

Please rest assured that we respect your privacy and security and will never use Javascript or any other technology to compromise  either.