Family Support Registration

Family Information

Begin your healing journey today by filling out the family registration form. We see you. We care about your broken heart.

Parent's Name

Spouse Name

This address will receive a confirmation email

Phone

Address

Diocese + Parish

Red Bird Ministries collects the information below as data points to where families are coming from. This helps us to articulate the need in your community and advocate on your behalf when bringing in support to a new diocese/parish.

Diocese

Parish

Contact Information

Would you like someone to receive support information on your behalf? If so, please list their name, phone number, and email.

If you selected a referral to a Catholic Counselor, someone will be contacting you separately with that information.

Preferred Contact

Loss Information

The next set of questions will be specifically about your loss. We know this part is the hardest. We are wrapping our arms around you, sister/brother. We love you. We only want to help. Please let us know how we can serve you.

What is the name of your child? If you haven't given your baby a name yet, please just put "Baby" followed by your last name. Example: Baby Breaux

What is your child's date of birth? If pregnancy loss, you may put your date of delivery.

What is your child's date of death? If pregnancy loss, you may put your date of delivery or the date you found out your baby had died.

Child's Date of Death

How old was your child when he/she died? If pregnancy loss, please list the gestation week. Example: 11.5 weeks in utero, or 11.5 weeks.

Age at Death

Would you like your child to be included on the Memorial Wall on our website and in our End-of-the-Year Memorial video?

Yes No

Memorial Wall Photo

Upload (8MB)

Would like your child's name written on our memorial wall?

Yes No Already added my child's photo to the memorial wall.

If you selected yes to write your child's name on our memorial wall, please list how you would like your child's name to be displayed.

Support Services

Would you like to be notified when support is being offered both in-person and virtually. Please check all that applyI would like to:

Join Our Monthly/Quarterly Newsletter Join Our Email Support Updates as posted. I do not want to be emailed about support services.

Would you like to receive the following support offerings. Please check all that apply.

Spiritual Direction Appointment Virtual Comfort Call Recommended Support Offerings Information about bringing Red Bird Ministries to Your Parish No thank you

For counseling referrals, we will send a separate email to you with that information to connect with a Catholic provider in your area. For a conversation with clergy, we will share your request with the Nonnatus Foundation whose mission is pastoral accompaniment for families in crisis. They will reach out to schedule an appointment for you to talk with a priest. Please check all that apply.

Catholic Counselor Schedule a Call With Clergy No thank you.

What is your preferred method of communication from our Director of Family Support?

A phone call to my preferred contact. An email to my preferred contact. A packet of information to my home.

Check here if you would like to receive a personal call or email in the next 7 days. Phone Email

Siblings

The bond between siblings is truly irreplaceable, and we know that losing a sibling brings a profound heartache that aches deeply. We are here to offer our love and support to your children as they process their emotions and move through their grief year after year. We hope to provide comfort and hope during this incredibly difficult time in their lives with a Leo Lion. We know it can’t take the ache away, but Leo will be with you every day.

If you have a child or grandchild younger than 18 years old, Red Bird Ministries would be honored to mail you a Leo Lion.

Do you have living children or grandchildren?

Yes No

How old are they?

Would you like the team to mail a Leo Lion to your family?

Yes No

From all of us at Red Bird Ministries

Dear Family,

We want to extend our heartfelt gratitude to you for trusting Red Bird Ministries to support your family during this incredibly challenging time. It is our honor to walk alongside you as you navigate this season of profound suffering. After you complete this registration, you will receive an automated confirmation email from our team that outlines the various support services we offer. We know that finding the right resources can be overwhelming to families, so we have gathered a few things you can explore immediately.

We truly understand, as fellow parents of loss, and we want you to feel assured that our team is here to provide the support you need. Our Director of Family Support, Elizabeth Leon, will reach out to you personally using your preferred method of communication as soon as time permits.

Please remember that we operate on a standard weekday schedule, so any requests made over the weekend will be attended to at the beginning of the following week. Elizabeth is deeply committed to meeting with families, so there may be a slight delay in her follow-up communication as she balances comfort calls, support offerings, retreats, and grief events.

Also for further consideration, our team takes vacation for the first two weeks of July and for three weeks around Christmas. This allows us time for self-care as parents of loss to rest and renew our dedication to supporting you. Thank you for your understanding during this time. Please know that you are not alone, and we are here for you every step of the way.

Family Support Registration

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