Brighter Days Assessment Form

Inquiry for Support
Please note: Brighter Days is not a crisis center; please call or text 988 if you need to talk to a trained professional right away.

Brighter Days Family Grief Center provides a variety of grief related services, including free short-term grief counseling, grief support groups, workshops, logistical guidance, and resource referrals. We support grievers ages 5+ and work with all family members, including extended family.

In order to help us better understand your specific situation, please fill out the form below. A member of our team will follow up within two business days to discuss how we can best support you during this difficult time.

If this is a confidential or media sensitive situation, please reach out to the Executive Director, Carolyn Kinzel, at carolyn@brighterdaysgriefcenter.org
Name*

First NameLast Name
Phone Number*
E-mail*
Who are you seeking information for?*

MyselfMy Adult Child (18+)My Child (under 18)My Family/Family MemberMy Colleague/FriendMy OrganizationMy SchoolOther
Are you experiencing grief due to the death or terminal diagnosis of your:

Child - 18+Child - Under 18Partner/SpouseParentSiblingOther
What services are you interested in learning about?*

Anticipatory Grief Support (for caregivers or patients facing a terminal diagnosis)Camp Erin - Youth and Family RetreatsGrief CounselingGrief Support GroupsLogistical Support (legal, financial, general)School or Organization Inquiry/TrainingsSoft Landings Bereaved Parent ProgramYoung Adult Support (ages 18-27)Youth SupportOther
For counseling or group services, what are your preferences: (pick all that apply)

Eden PrairieSt. PaulVirtual
Occasionally we have requests from support group participants to be placed with others closer to their own age. If this matters to you, please share your age.
Please share any details that you feel we should know prior to getting in touch with you. *
Would you like to be added to our newsletter for notification on groups/events?*

YesNo
Thank you for reaching out to Brighter Days; we understand this is a challenging time and we hope to provide you with the support and resources you and your family deserve.

One of our team members will reach out within 48 hours; please feel free to call the main line with any questions at 952-303-3873.
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Inquiry for Support