Close
Home
Donate
Donate
Services
Counseling
Groups
About Us
History
Heartlinks Team
FAQs
Gallery
Media
Volunteer
Training Information
FAQs about Volunteering
Events
Monthly Group Night Registration
Addiction Loss Group Night Registration
Partner Loss+ Group Night Registration
Grief 101 Workshop
Uncharted Waters Workshop
Outreach Volunteering
Resources
Newsletter
Contact Us
Grief Reflections Blog
(618) 277-1800
•
support@myheartlinks.com
Services
About Us
Giving
Home
Events
Volunteer
Resources
Contact Us
Blog
“Open your arms to life! Let it strut into your heart in all its messy glory!”
–Deborah Wiles
Home
>
Events
>
Monthly Group Night Registration
Monthly Group Night Registration
Monday, May 2, 2022
Please fill out this form to register for our upcoming group night.
Group Night Registration
Monthly Group Night Registration
Yes, I have attended these groups before
I have already spoken with a Heartlinks Clinician about attending
I'm attending Aching Arms/Compassionate Friends group only
If you have not attended a monthly group night or spoken with one of our Clinicians about attending, you MUST call our office at (618) 277-1800 or fill out the new client form on our website before registering.
Today's Date
*
MM slash DD slash YYYY
What's your name? (First & Last)
*
Email
*
Which groups are you registering for this month?
*
Aching Arms / Compassionate Friends (Child Loss Group)
Partner Loss / Parenting Alone
Ducks / Teens
Rhap (Pre-Teens & Younger Teens)
Stars (Older Elementary age students)
Bears (Younger Kids-Early Elementary Age)
Include all groups your family will be attending.
Please list the names of all children attending and which group they will attend or type N/A
*
Hidden
COVID-19
I agree that I will not attend group if anyone in my party has been experiencing COVID-like symptoms or has received a positive COVID test in the last 14 days.
Hidden
Masks Required
I understand that masks are required at group night, regardless of vaccination status. I agree to wear a mask at group night, unless instructed otherwise by a Heartlinks counselor.
CAPTCHA