EmailMe Form - Unfiltered Grief

Name *

First Last

Name of Lost Loved One *

First Last

Relationship to Lost Loved One *

Do you wish to remain anonymous? *

Yes

No

Contact Phone (not required)

### - ### - ####

Contact Email *

Verify Email *

How would you describe your grief (how it looked/felt both emotionally and physically)? *

How did you cope/care for yourself? *

What has changed, from the initial shock up to now when time has passed? *

How has grief changed you? *

What is the best thing that someone did to help you in your grief? *

What was the worst thing someone did/said to you during your grief? (if there was something)

What advice would you give others starting their grief journey? *

Do you have any favourites quotes or advice that resonated with you during your grief journey? *

Do you authorize permission to share excerpts of your submission on our social media platforms?
*Please note: we will not use your full name, we will only use your first and last initial* *

Yes

No

If yes, would you like us to tag your social media?

Yes

No

Social media @ for tagging if confirmed: