We are here to help. Threads of Life Family Support Request Form:
Threads of Life is not an organization any of us wanted to join.

Our "members" are workers and families who have been personally affected by a workplace tragedy. For this reason, we refer to our members as "family members". We know living with the outcome of a life altering injury, occupational disease, or death is so very difficult. Our programs offer compassion, understanding and hope in a supportive community with others who "get it."

In order for us to help guide you to our programs and services that may be most helpful, please take a few moments to introduce yourself here, and to briefly explain your individual/family's experience with workplace tragedy. All information provided will be kept confidential.

All of our support services, including programs are offered are free of charge to our family members.

If you have any questions please contact Karen Lapierre Pitts, Manager, Family Support kpitts@threadsoflife.ca or call 1-888- 567-9490.

 

Questions marked with an asterisk (*) are required.
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Email *
Your Name: *
Street Address: *
City: *
Province (Select): *
Postal Code *
Contact phone number: *
Please help us to understand how you've been personally affected by a workplace tragedy.                                   *
Required
Threads of Life’s programs and services are open to all family members affected by a workplace tragedy. If there are any additional members of your household who may wish to access Threads of Life’s services, please list their name(s) and relationship(s) to you below.                                                                                                                        *Please include a birthdate for anyone under the age of 18 (ex. Markus Smith, my son, Nov. 8, 2008.)
Full name of the worker involved in the tragedy: (yourself or loved one) *
Date of birth for the worker affected: *
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Your relationship to the worker: *
Date of tragedy (incident or diagnosis): *
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Date of death (if applicable):
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Briefly describe what happened. Please include type of industry & where it occured. *
How did you hear about Threads of Life? *
Do you have a question, or is there anything else you would like us to know? If so, feel free to include your thoughts below.  
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