Family Support Packet

Disclaimer: Please note that this form is only for mailed family support resources, and our team will not provide ongoing follow-up through this request. If you are seeking ongoing accompaniment, peer support, spiritual care, support groups, or fuller family support through Red Bird Ministries, please complete the Family Support Registration linked at the top of our Family Support page.

The information collected below is for the family who has experienced the loss of their child. This form may be completed by a family member, friend, parish staff member, healthcare provider, or another support person on behalf of the grieving family.

The information provided will be used to mail support materials and share future support by email for opportunities available through Red Bird Ministries. Please ensure the information entered is accurate so we can best serve and accompany the family during this season of grief.

Family of Loss Information

Parents Name

This address will receive a confirmation email

Phone

Address

Loss Information

Child's Name

Date of Death

Age of the Child

Family Information

Are there surviving siblings (4-17 years old) in the home?

Yes No

Parent's Marital Status:

Would you like information about: ☐ Virtual Support Groups ☐ Peer Support ☐ Spiritual Direction ☐ Counseling Referrals ☐ Sibling Support ☐ Retreats ☐ Resources for Fathers ☐ Pregnancy Loss Resources ☐ Suicide Loss Support ☐ Spanish Resources

Packet Preferences Which resources would be most helpful for your family right now? ☐ Books ☐ Prayer Resources ☐ Grief Education Materials ☐ Resources for Children/Teens ☐ Couple/Marriage Support ☐ Practical Guidance After Loss ☐ Funeral/Memorial Planning Resources ☐ Journaling Materials

Additional Information

Is there anything you would like us to know about your family or your loss?

Consent

I understand that Red Bird Ministries will email all families of loss support resources, grief programs, and future opportunities for accompaniment.

Yes, I understand

I understand that my information will remain confidential and only used to support the family of loss.

I understand.

Thank you for allowing us to walk alongside your family. You do not have to carry this grief alone.

— Red Bird Ministries

Description

We are deeply sorry for your loss.

Family Support Packet

Description

Please Fix the Following