BLUE FAMILY First 52 Contact Form
I look forward to supporting law enforcement men and women and their BLUE families as they grieve. I just need a little information.

By completing this form, you are expressing interest in offering the BLUE FAMILY First 52 program at a 40% reduced price for your law enforcement community as an exclusive benefit. In order to improve accessibility to grief support. There is no cost for you as an organization to offer this benefit. Your commitment to the program includes:
- a link with a description on your organizations website
- communicate the benefit with your community

After you submit the completed form, you will receive an email to the address you provide with information about next steps. Please check for an email from Subject: Blue Family First 52 (You may need to check a spam or junk file). You will receive a phone call to confirm your request.

Please know your information with NOT be shared with any third-party entities.
Email address *
Type of Law Enforcement Organization *
Department, Agency or Organization Name *
Address (Street City, State Zip) *
Contact First & Last Name *
Contact Title *
Phone Number *
Most communication will be through Email. If necessary, when is the best time to reach you by phone? *
Website (ie. *
I understand that there is no cost to my department, agency or organization to offer the BLUE FAMILY First 52 exclusive benefit. My department, agency or organization agrees to communicate the benefit to our law enforcement families. I understand that our folks will be receiving a 40% discount on the full price ($65) of the First 52 program and will be asked to only pay $39 for the full program. *
Please include organization on Chartreuse Center's website and promotional materials regarding participating in BLUE FAMILY First 52. *
Thank you for your interest to participate in the First 52 Community Program.
You will receive an email from with the Subject: BLUE FAMILY First 52 Discount. Please watch for the email (you may want to check your junk or spam if you do not see it within the hour.) This email will have some important information for you about next steps. After verification of your department, agency or organization, you will receive another email that includes:
- welcome note to the program.
-description of the next steps in the validation process to confirm your organization.

After Validation, you will receive:
-a specific discount code to share within your organization.
- a couple sentences and a link to add to a resource page or share in your communications within your organization.
-an image to include on your website if you'd like to share that you are offering the program for your organization.
-a flier to copy, email or share with your organization..

If you have questions or need further information, feel free to call toll free at 800-484-5751 or email
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