Getting to know you...

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Please fill out the following to the best of your ability. Your privacy is of the highest concern to Our Little Sparrows. We are here to support you in any way that we can, offering a safe space to share what is on your heart.

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First Name *

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Phone Number (please indicate if this is a work number) *

Please indicate your preferred method of communication. (Please select all that apply). *

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How did you hear about Our Little Sparrows?

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What Services Are you Interested in?

Please indicate at least one

Birth and Bereavement Doula Services (Online Only At This Time)

Grief Recovery Method (1On1) (Online Only Available At This time)

Grief Recovery Method (Group) (Not Available Due To Covid-19)

Grief Recovery Method (Children) (Not Available Due To Covid-19)

One-to-One Grief Support (Online only)

Please describe what has brought you to inquire about Grief Support (Grief Recovery Method® Programs or One-to-One Grief Support).

Please describe what has brought you to inquire about Birth and Bereavement Services.

What is the best day and time to connect with you? (Please offer three separate days and time of day (Morning, Afternoon, Etc. This phone call can last approximately 30 minutes). *

Please indicate below whether you are 18 years of age or older. Note: We are not licensed to work the persons under the age of 18. If you are a parent or work with minors, please inquire with us about The Grief Recovery Method's curriculum for adults, "Helping Children Grieve". *

Yes, I am 18 years old or older.

No, I am not yet 18 years old or older.

All rights reserved Our Little Sparrows © 2021. The copy and distribution of this form is strictly prohibited unless expressly permitted. Please contact info@ourlittlesparrows.org or call direct 1 (916) 572-6265.

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