Students Facing Grief - Family Survey (Beaumont YSC) *To be completed by parent or guardian
Our Youth Service Center is applying for a grant to provide professional grief support services for our students and families. We need your help! Please complete the following questions (one survey PER CHILD).
Has your child lost an *important person during March 2020-present? *important person may include but is not limited to a parent, grandparent, relative, sibling, friend, neighbor
Before March 2020, has your child EVER lost an important person?
If you answered YES to the questions above, please let us know the reason for the loss. This will help us provide groups that will better serve your child's needs.
Long-term illness/Chronic health condition
If your child has lost an important person, did they receive any following kinds of help or support for grief? (check all that apply)
Individual counseling (1-3 sessions)
Family counseling (3+ sessions)
Small group counseling
Camp Hope (sponsored by Hospice)
Written materials/books about grief
None of the above
If our school received the grant to offer grief support groups for students, would be willing for your child to participate? (groups may be during the day or after-school)
If your child has experienced a loss during COVID-19 or any time before, please enter your child's name if you would like our student support staff to follow up.
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This form was created inside of Fayette County Public Schools.