Virtual Support and Share Night, Tuesday June 6, 7:00 to 9:00 p.m.

Attendee Information

• * First Name:
• * Last Name:
• * Email Address:
• * Confirm Email Address:
• * Phone:
• * Address 1:
• * City:
• * ZIP Code:
• * Province:

• * Will you be joining our support and share groups after the presentation? --Choose-- Yes No

• We need this information to assign participants to a breakout room specific to their loss

• * Which support group would you like to join? --Choose-- Loss of spouse Loss of child Loss by suicide Loss of parent Loss of sibling Loss of relative Loss of friend
• * How did the person die? --Choose-- Suicide Substance use Accident Perinatal Cancer Long illness Sudden illness Sudden other By MAID Covid-19 Homicide Other
• *

  Have you attended our BFO-Ottawa groups before?

  • No. this is my first time
  • Yes. I've attended previously