Caregivers of Grieving Children
Virtual Group Support Cove Program

If you are a parent/caregiver supporting a child(ren) grieving the death of a loved one, please consider joining our online support group through The Cove Center for Grieving Children. This support group is run by licensed clinical social worker Donna Nickdow. The support group will cover topics related to exploring the needs of grieving children. This group aims to provide a forum to talk about the challenges you are facing with your child(ren) and to support you in your own grief journey.

Timeframe
This group will meet 1x weekly for 6 weeks, with an option to continue group after the first 6 weeks. Groups will meet virtually via zoom.

Cohort 1: September-October (groups will meet on Wednesdays from 7:00pm-8:15pm)

Cohort 2: October-November (groups will meet on Wednesdays from 7:00pm-8:15pm)

Attendee Information

First name

Last name

Street Address

Street Address Line 2

City

State

Postal / Zip code

Phone

Best time to call

Morning

Afternoon

Night

Child's Information

We want to learn about the child(ren) who are grieving

Child's First Name

Child's Last Name

Birthday

Race

Is your child currently receiving counseling or therapy?

Yes

If other, please describe

Is your child currently enrolled in a Cove Program?

Yes

Death History

Please list all significant deaths (family members, friends, pets, etc.) in your child(ren)'s life along with the indicated information below.

Who died (full name and relationship to child(ren))

Cause(s) of death

How did you hear about the Cove?

Please share any other questions or concerns you may have:

I hereby give permission for The Cove Center for Grieving Children, Inc. to use my child’s artwork to promote the mission of The Cove, a program for grieving children and their families. This may include publication in their newsletter, social media, or on display in their coordinating office.

Yes

I hereby give permission for The Cove Center for Grieving Children, Inc. to use the photographic likeness of myself and/or my child(ren) in either photographs or film to promote the mission of The Cove, a program for grieving children and their families.

Yes

Once you submit your application you will be directed to our donation page. There is a recommended $25.00 one-time donation, which will help support our FREE Cove Virtual Programs and offset some of the costs of our organization, but you may contribute whatever is appropriate for your budget to support the services we provide. This process is optional. Thank you for your contribution.

Your application will be submitted to the site(s) of your choice and the site director will be following up with you to discuss your families needs and see if the program is an appropriate fit. Please allow 5-7 business days for this request to be processed. If you are filling out this application during June-August, please allow additional response time as we do not run our program during those months. If you have any questions please email us at info@covect.org or contact our Coordinating office to speak with someone at (203) 634-0500.

Thanks for submitting!

Caregivers of Grieving Children Virtual Group Support Cove Program