Bereavement Support Groups

Participant Information

Mobile Phone(Required)

Patient Information

Patient's Date of Birth(Required)

Patient's Date of Brain Tumor Diagnosis(Required)

Hospital Where Patient Received Treatment(Required)

Patient's Date of Death(Required)

Additional Information

Note: Please provide a little more detail about yourself and your child to help us better understand your current situation. Each question in this section requires at least two sentences (130 characters). Your answers will be reviewed by PBTF team members to ensure that this program is a good fit for you and meets your needs in the best way possible. You may receive a follow-up call from a PBTF team member for further clarification of your responses.

What challenges or stresses do you currently face at this stage in your grief journey?(Required)

Who is currently in your support system? Include friends, family members, church or other groups providing support.(Required)

Have you attended a bereavement support group previously? If so, please tell us a little bit about your experience.(Required)

Are there any specific topics you would like to see discussed in an online support group?(Required)

What do you hope to gain from participating in an online support group with the PBTF?(Required)

Virtual Support Group Commitment

The Pediatric Brain Tumor Foundation’s Virtual Support Groups run are held every other week through Zoom for 8 to 10 sessions. This program offers an online support group experience for parents and caregivers who have lost a child to a pediatric brain tumor by offering a safe space to connect with others who share their grief. The group offers participants the opportunity to share their stories and empower each other to manage the challenges presented by the loss of a child and all that follows. As a valued member of the group, we ask that you commit to attending each session. We understand from time to time circumstances will arise that may prevent you from attending. Please contact the facilitator and/or PBTF staff if you are unable to attend one of the scheduled sessions.

Email

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Support for Families

Participant Information

Patient Information

Additional Information

Virtual Support Group Commitment

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