BABY SPIRIT - Cremation Planning Form

We are so sorry for your loss. Please complete the form below to request support from the Baby Spirit Foundation.
Parent / Applicant Information

Please provide the best contact information for the parent or person completing this form.
Mother's Name

First NameLast Name
Mother's Phone Number
Format: (000) 000-0000.
Mother's Email Address
Mother's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent 2 / Other Parent’s Full Name

First NameLast Name
Applicant Relationship to Baby
If you are not the mother or father, are you completing this form with the family’s permission?

Baby's Information

Share as much as you feel comfortable. If a question does not apply, you may leave it blank unless marked required.
Baby's Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Date of Loss

MonthDayYear
Date
Where did the loss take place?
Hospital, medical center, home, etc.
City / Town Where the Loss Took Place
State Where the Loss Took Place

Memorial / Obituary Page Information
Would you like Baby Spirit Foundation to create a free memorial page for your baby?
Are there additional family members you would like mentioned?
Parents, siblings, grandparents, or anyone else you would like included.
Is there anything special you would like shared about your baby or your family’s love for them?
This can be a memory, message, prayer, quote, nickname, or anything you would like people to know.
Would you like the memorial page to include a fundraising option?
Do you have a photo you would like included on the memorial page?

You may upload a baby photo, ultrasound, family photo, symbolic image, or leave this blank.
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Monthly Funeral Service Grant
Would you like to be considered for this month’s funeral service grant?
Grant Video Requirement Acknowledgment
After submitting this form, you will receive an email with instructions for sending your video. The video does not need to be professional or polished. It can simply be a short message sharing who you are, who you are honoring, and how Baby Spirit Foundation’s support would help your family during this time.

Consent & Permissions
Consent to Contact
Information Accuracy
Memorial Page Permission
Fundraising Permission
Emotional Support Email Permission
Would you be open to Baby Spirit Foundation sharing your family’s story, photo, video, or memorial page on our website, email updates, or social media to help raise awareness and support for other grieving families?
Should be Empty:

Parent / Applicant Information