Universal Screening and Conversation Starters

The Affordable Care Act prohibits requiring data collection on firearm ownership; however, first amendment protections allow providers to have conversations with patients and their families about firearms and document these conversations as appropriate. Providers can perform screening and counseling regarding firearms, and if they choose to, can document those conversations. The information below provides sample questions and conversation starters to have with your patients around firearm safety.  

Regardless of if you have a screening survey, one technique for discussing firearm access with patients is a two-step approach, starting with a normalizing statement followed by open-ended questions to explore access and availability. When you are talking with patients about firearms, it is important to remember to use non-judgmental words and tone, and where able, use culturally appropriate language and correct firearm terminology. Some examples are listed here:

“I talk with all of my patients (parents) about home safety (things like pools, hot-water heaters, and medicines). Tell me a little about what firearms (firearm safety) look(s) like in your house/home…”

“Many of my patients have firearms in or around their home for hunting, target shooting, or home defense. Can you tell me a little bit about how you secure the firearms you have at home?”

“Last time we talked, you told me about the firearm you keep for self-defense. I’m curious, compared to a year ago, what does firearm safety/access look like for you now?”

“Some of my patients are concerned about their children spending time in homes with firearms that may not be secured, and having conversations with friends and family to ask about how they store their firearms. How do you have conversations with family and friends about this?”

“Firearms are important to many veterans (of my patients). I’m curious, how do you secure firearms in your home?”

Based on your patients’ initial responses, follow up probing questions can be used to get more information and help them identify areas and reasons for potential change. Some example language is listed below:

“In a typical day, what does firearm storage/safety look like for you? How often do you secure the firearm in that way? When might that not be the case? Tell me a little about that?”

“Which firearms do you secure in that way? Tell me a little bit about the firearms you don’t secure that way (in the firearm safe)?”

“Seems like keeping your family safe and reducing the risk of an unauthorized person gaining access to your firearms is important to you. I’m curious, what benefits might there be, if any, to keeping (all) the firearm(s) locked up in the gun safe?”

“What, if any, negative experiences might you have had by storing firearms that way? Any close calls?”


Storage Resources

There are multiple types of locked storage options that are available, and some forms may be more acceptable to a patient than others. Counseling has been shown to increase locked storage, with improved efficacy when messages balance household removal with storage options and when free locking or secure storage devices are physically provided during the visit. Patients should also be advised that, when possible, bullets should be stored separately from the firearm. Here are some printable handouts that you can provide to your patients and their families: 

If you are in immediate danger, please call 911.

If you are experiencing a crisis, please text or call 988.

The content of this website is not legal advice and is only intended for general informational purposes. If you need legal advice, please contact an attorney.