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Family Program
Pre-Registration Application 

Please be aware that we do not offer one-on-one therapy appointments. Our Family Program is a peer-based, mutual support group offered to children ages 5-17 who have experienced the death of an immediate family member (parent, sibling, or daily caregiver). 

We request that families allow at least 3 months to pass following the death of their loved one before participating in our programs. We have found that when families begin our programs too soon, they can feel overwhelmed and discouraged from returning.

If you have further questions, please feel free to contact us:


Phone: (203) 634-0500 

Pre-Registration Questions

Please answer the questions below so we can ensure that you qualify for our Family Program.


Would the children attending be between the ages of 5-17?

Our program and the activities provided are focused around the death of an immediate family member. If the deceased is not an immediate family member, it may be someone who was instrumental in the child's life (for example living with the child and/or helping raise them). 

With that said we are also willing to assess the family dynamic on a case-by-case basis to see if your family would be a good fit for our program. Please explain the relationship of the deceased to the child below. 

Thanks for submitting!

If you would prefer to have an application sent to your home address please call our main office at

(203) 634-0500.

**Please be aware the mailing process will take longer.**

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