Remember Participant Application

Dear Families,

We are deeply saddened to hear that you are experiencing the pain of losing a loved one to suicide. We want to take a moment to express our love and support for you. You are in our thoughts and prayers during this difficult time.

We appreciate your patience as we launch the Remember program groups. Remember leaders must complete the program and training before leading a group. The program requires two trained facilitators to guide each group and ensure a supportive environment for everyone involved. As we onboard new leaders, we will launch more Remember groups.

Since the Remember program is not intended to replace professional counseling, we need to gather information to assess readiness. Families who are ready for the program will be added to the next group's roster based on their availability.

As we gather important information to assess readiness, please be assured that this form will be kept confidential and viewed only by the Red Bird Ministries Remember Team Members. If therapy is a better solution right now, we will help you with a referral to someone in your diocese.

Family's Information

First & Last Name

This address will receive a confirmation email

Phone

Address

Diocese

Parish

Which cohort are you hoping to join?

Loved One's Information

Loved One's Name

Loved One's Date of Death

How old was your loved one who died?

What was your relationship with the deceased?

Impact of the Grief

Have you ever thought about seeking professional counseling?

Yes, I am currently in counseling. Yes, went but not currently in counseling. No, have thought about counseling, but have not atteded. Not interested.

If you are to enter you the Remember program you will be asked to list your counselor's information in case of an emergency, are you okay with providing that information to our team?

Yes No Maybe

Please describe how you have been experiencing your grief (e.g. crying, insomnia, emotional numbness, health issues, etc.)

Please describe how you have been coping with the loss of your loved one? (ex: taking medication, praying more, praying less, seeking therapy, overindulging in drink/food, self-harm, etc.)

What are you hoping to gain through your participation in Remember? Are there any particular emotional or spiritual goals that you have?

Is there anything else you would like us to know about you or your situation?

Optional

The development of this program has been made possible through the generosity of donors who believe families impacted by suicide deserve compassionate, faith-filled support. If you feel called to help us complete and sustain this work, we invite you to prayerfully consider becoming a monthly supporter. Even a modest monthly gift helps ensure that families are met with care, dignity, and hope when they need it most.

If you feel led to give, you may text any amount to (337) 216-1200 or visit our giving page here. This program would not be possible without the faithfulness of our monthly supporters, whose generosity allows us to reach and accompany so many hurting hearts.

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Remember Participant Application

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