Mama Bears to the Rescue Request Form
Serendipitydoah Mama Bears to the Rescue is a private Facebook group made up exclusively of moms of LGBTQ kids who love, support and affirm their own LGBTQ kids and want to share love and support with other LGBTQ people who don't have that kind of support from their own family.

The Mama Bears do things like attend same sex weddings as an affirming stand-in mom, visit an LGBTQ person in the hospital, include LGBTQ people in their holiday gatherings, send notes of encouragement, talk on the phone, text, get together for coffee or lunch etc.

The focus is on performing small acts of kindness, making connections and being a loving presence in the life of LGBTQ people who have lost support from friends and family members due to their LGBTQ status.

Fill out this form if you would like to request support for yourself or someone you know. By filling out this form you are giving permission for the information to be shared.

Name of LGBTQ person who needs support *
Your answer
Gender Identity and pronouns for person who needs support *
Your answer
Sexual Orientation *
Your answer
What kind of support is needed *
Your answer
Link to Facebook Account of person needing support (optional)
Your answer
Email Address of person needing support (optional)
Your answer
Phone Number of person needing support (optional)
Your answer
Mailing address of person needing support (optional)
Your answer
Preferred method of contact for person needing support *
Your answer
Name of person filling out this form *
Your answer
Email address of the person filling out this form *
Your answer
Any additional information you wish to share
Your answer
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