Database Inclusion Form
Are you a professional or business owner whose services could benefit our community? Join our database of resources by filling out this form. Let us know how you can contribute, whether you're a therapist, photographer, or offer other services that support our cause.
Full Name
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First Name
Last Name
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
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Format: (000) 000-0000.
E-mail
*
example@example.com
Please tell us what days of the week you are available to volunteer. Please check all that apply.
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Therapy/Counseling Services: Include therapists or counselors who specialize in grief counseling, trauma therapy, or other relevant mental health services.
Photography Services: Photographers who offer their services for memorial events, family portraits, or other occasions where capturing memories is important.
Legal Services: Lawyers or legal firms who provide pro bono or discounted legal assistance to individuals affected by violence, such as help with navigating the legal system or obtaining restraining orders.
Financial Services: Financial planners or advisors who offer guidance on managing finances after the loss of a parent, including assistance with budgeting, insurance claims, or accessing financial resources.
Support Groups: Organizations or individuals who facilitate support groups or peer-to-peer counseling for those who have lost a parent to violence.
Educational Workshops: Professionals who offer workshops or seminars on topics such as coping strategies, healing from trauma, or legal rights and resources for survivors of violence.
Art Therapy: Artists or art therapists who use creative expression as a form of therapy for individuals dealing with grief, trauma, or other emotional challenges.
Community Resources: Local organizations or community centers that offer additional support services, such as food assistance, housing resources, or job training programs.
Spiritual Support: Religious leaders or spiritual counselors who provide guidance and support to individuals coping with loss and trauma from a spiritual or faith-based perspective.
Medical Services: Healthcare professionals who specialize in treating physical injuries or addressing health concerns related to the trauma of losing a parent to violence.
Other
Brief Description of Services Offered
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How can your services benefit our organization or community?
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Any relevant qualifications or certifications?
*
Please tell us what days of the week you are available to provide your services. Please check all that apply.
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Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Additional comments or questions
Submit Form
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