Schedule an appointment for a memorial service in your baby's memory

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Three Little Birds, through its legacy project, Mama Bird Healing, offers families FREE information on how to plan and facilitate a memorial service for your baby. For a donation in your baby's name, we can handle everything for you that simply covers expenses/materials.

Please complete the attached form and we will be in contact with you to schedule your free consultation and create a meaningful public or private service through Kristen Samuelson, Intuitive Healer and Universal Life Minister.

Email *

You/partner's name(s) *

Town/State of residence *

Phone number that can receive/send texts *

Tell us about your baby *

Baby's date of birth *

YYYY

Is there a specific date or season you were hoping to have the service? *

Is there a specific location you were hoping to have the service? *

Do you imagine this service being private (immediate family) or more public (open to family and friends)? *

Please tell us any ideas/thoughts/suggestions you have or an overview of what you imagine would be right for you and your family. *

Please indicate what type of service may be of interest to you *

General memorial service

Ashes spreading ceremony (at a beach, park, private residence or other location)

Butterfly release ceremony (May-September only)

Sacred Tree/Memorial Garden Planting Ceremony

Birthday party celebration

Couple's vow renewal add-on

Photography/video of event

Do you have any signs and symbols that you connect to your baby? If so, please share! *

Are you interested in personalized items for purchase to be included (corsages, memorial garden stones, candles, etc.) *

Yes

Maybe

Send me a copy of my responses.

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