Support Group for Partners

This support group is a friendly space for partners to discuss the unique challenges of supporting and caregiving for a partner going through cancer, while also caring for small children.

Join us on the 4th Saturday of every month to talk about the fears, challenges, and successful coping strategies associated with supporting a partner and young children through a parent's cancer diagnosis.

Facilitated by Bright Spot Network's Director of Programs and Community Outreach, Carissa Hodgson, LCSW, OSW-C.

4th Saturday of the month 11am PST/1pm EST
Sign in to Google to save your progress. Learn more
First Name *
Last Name *
Email *
Phone *
Home Address (Street, City, State, Zip) *
Name of Emergency Contact *
Phone # of Emergency Contact *
Date of Birth *
MM
/
DD
/
YYYY
Gender
Race *
Type of Cancer *
Age of children at diagnosis? *
Anything else you want to let us know?
Please type your initials after every statement if you agree.
I understand that BSN support groups are NOT therapy. If I would like a referral to establish care with a mental health therapist, I will contact BSN who can assist in this process. *
I understand that BSN facilitators are mandated reporters. If information is shared relating to abuse/harm to a child, elder or vulnerable adult, or if someone indicates they are a danger to themself or others, BSN facilitators will report this information to the appropriate agency to provide support and follow-up. *
I understand that there are risks, benefits, and consequences associated with participating in a virtual support group including but not limited to, disruption of transmission by technology failures, interruption and/or breaches of confidentiality by unauthorized persons, and/or limited ability to respond to emergencies. *
Support Group Expectations
We know that making time commitments is hard, however, we also believe that in making the commitment fully, you will receive the most benefit and provide the most support to our community. To that end, we ask you to please:

• Join on time with the intention to stay the whole session.
• Come to the group solo: while sleeping babies are welcome, we would like the group session to be a respite from toddlers, older children, and partners—yours and everyone else’s.
• Concentrate fully on the support group. Please do not make us background to another task. For safety, please do not drive during group--if this is necessary, please turn off your camera so you can keep your eyes on the road. 
• Understand that this is a support group, not a happy hour. While social events could be a future offshoot of support group, the support group itself is not a place for drinking.

In support of everyone’s emotional needs, please remember that this is a group for cancer and parenting, which everyone handles differently. To that end, we ask that you please:

• Practice reserving judgement: listen openly, respect intentions, and appreciate the opinions and thoughts of everyone, including those you disagree with.
• Keep issues relating to politics and religion specific to how it is affecting your cancer experience. Please refrain from preaching our pushing your beliefs on anyone else in group.  
• Share your thoughts and share the space for others to do the same.
Please type your initials below to acknowledge you have read and agree to the above support group expectations. *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of brightspotnetwork.org.

Does this form look suspicious? Report