Grief Workshop

Grief Workshop

Registration Form
Name*

First NameLast Name
Address*

Street Address

Street Address 2

SuburbState

Post Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Gender

FemaleMaleTransgender Male (FTM)Transgender Female (MTF)Non-binaryOther
Your age*
Pronouns
Do you identify as Aboriginal or Torres Strait Islander?*

NoYES - Aboriginal AustralianYES - Torres Strait Islander AustralianBOTH Aboriginal & Torres Straight Islander Australian
Do you identify as Culturally and Linguistically Diverse (CALD)?*

YesNo
Emergency Contact Name:*
Emergency Contact Number:*
Please select the workshop date you wish to attend as well as a second preference in the event that we cannot enroll you into your preferred date. Dates are on our webpage.
First Preference
Second Preference
Your relationship to the person who passed*
How long ago?*
What do you aim to gain from attending the workshop?*

Better understand my griefUnderstanding different grieving styles within my familyLearn practical ways to copeFeel less alone with my griefIncrease a sense of hope for the futureUnderstand ways to honour my grief and my loved one
Please don't hesitate to provide a little more information

0/50
How did you hear about our Workshop?*

Web searchFamily / friendHealth care professionalCommunity Service / FSNCurrent / Previous ClientNewsletterSocial MediaOther
Thank you.

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