Application for Hospice Grief Services
The Community Hospice provides free grief support services to those who are grieving the death of a family member or friend. Services are provided at the following locations:

The Community Hospice, 445 New Karner Road, Albany, NY 12205
The Community Hospice, 295 Valley View Blvd, Rensselaer, NY 12144
The Community Hospice, 179 Lawrence Street, Saratoga Springs, NY 12866
The Community Hospice, 246 Manny's Corners Road, Amsterdam, NY 12010
The Community Hospice, 47 Liberty Street, Catskill, NY 12414
Sunnyview Rehabilitation Hospital,1270 Belmont Ave, Schenectady, NY 12308

More information on our services can be found on our website www.hospicegriefservices.com

A Bereavement Counselor will meet with you and your family to discuss the programs and services we have available. Services may include:

-Individual or Family grief counseling, for adults and children
-Support Groups, including Widow/Widowers, Daughters Group, Living with Loss etc.
-Camp Erin, a weekend camp for grieving children and teens, 6-17 years old
-Wave Riders, a six week program for grieving children and teens, 3-17 years old

These services are free of charge, and are available to everyone, regardless of whether the person who died was a Hospice patient. Additional supports are available for schools and organizations in our community, including training, support groups, memorial services, outreach and a crisis support team.

Once you have submitted your request, we will contact you within 5 business days.

Applications must be submitted by individuals requesting services and legal guardians.

Please call 518-724-0200 if you have any questions or concerns. Thank you for your interest.

Email address *
First Name *
If a minor, please enter the parent or legal guardian's first name.
Your answer
Last Name *
If a minor, please enter the parent or legal guardian's last name.
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Date of Birth
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Gender
With which gender do you identify?
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Phone Number *
Best number for contact during normal business hours. You may list more than one phone number. Please include area code.
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Mailing Address *
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City *
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State *
Zip Code *
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Ethnicity
For statistics.
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Marital Status
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Military Status
Is anyone in your household in the military? If yes, what branch?
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Low Income
For statistics. Is your household income less than $36,900 a year?
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