Fathers Support Group Request Form

Fathers Support Group Request Form

Bellis offers expert-led, peer-based emotional support. Please answer a few questions so our team can point you in the right direction. We are committed to serving as a uniquely compassionate source of support. All information is confidential and will never be shared. We'll respond ASAP, but please know emails are not monitored 24 hours a day. If you need a listening ear before our next meeting, the Stronger Together Support Line is available for you. Feel free to call or text anytime at 833-4BELLIS (833-423-5547) - a trained team member will be ready to pick up the call or respond promptly.
Please select the description below that best describes your experience. (Feel free to pick more than one.)

You made an adoption plan for your child (to be parented by someone else) as an intentional, self-directed choiceYour parental rights were terminated by the courts after involvement by child protection services (whether voluntary or involuntary, you had little or no choice)You made an adoption plan for your child (to be parented by someone else) after involvement by child protection servicesYou transferred custody to another caretaker for your children after involvement by child protection servicesYou adopted a child (international, domestic, kinship, or foster care)You grew up as an adopted person (international, domestic, kinship, or foster care)You supported a close family member or friend through an adoption process, including open or closed adoptions with grandchildren and others
If you attend virtual meetings, can you participate in a private setting, where no one else can hear the meeting?
In what year(s) did your placement or termination take place?
Is there anything you want us to know about your story and the support you need?
If you are a social service professional seeking support for a client, please provide any helpful information so we can assist you.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Do you agree to opt-in to receive text messages about upcoming support meetings? You may opt-out at any time by replying "STOP."

I agree to opt-inI do not agree to opt-in
E-mail*
example@example.com
How did you learn about Bellis?
If you or someone you know is in immediate danger, please call 911.

If you are having thoughts of suicide or self-harm, please call or text the National Suicide Prevention Lifeline at 988. When you call, text, or chat 988, you will be connected to trained counselors who will listen, provide support, and connect you to resources, if necessary.

Please note: If your message to Bellis today describes that you are worried about your own safety due to thoughts of suicide or self-harm, Bellis may contact local emergency services to check on your welfare.

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