Young Adult Request for Support Form
Are you a young person in your 20s or 30s experiencing grief in the face of COVID-19 -- whether anticipatory grief about a loved one’s illness, or grief about the death of a loved one to COVID-19? We are here to support you.

The COVID Grief Network is a 100% volunteer-run mutual aid network, connecting young adults who are grieving the illness or death of someone to COVID-19 to grief support. We offer 3 kinds of support:

1) Individual Support: Up to 6 one-on-one sessions with a volunteer grief worker who is willing and able to offer supportive listening. After these sessions, your volunteer grief worker can refer you to local service agencies for long term support, if needed. All sessions will occur by phone or video-conference, and will be confidential. Your information will not be shared outside the Network. Note that volunteers with the Network do NOT provide therapy, mental health care or professional services, but can help you find longer term support if needed.

2) Group support: Crews of 8-12 young adults meet together weekly over 8 weeks, facilitated by a volunteer grief worker. If you select that you're interested in group support on this application, we'll follow up with next steps. Groups will occur by video-conference and will be confidential. Your information will not be shared outside the Network. To be clear, this offering is for guided and facilitated peer support and is not group therapy, nor does it substitute for licensed mental health care.

3) Joining our Facebook group: If you're interested in joining, just indicate that on your application.

You're welcome to request one or all of these kinds of support! In this application, you'll have a chance to indicate what you're interested in. If you have questions about whether you are eligible for the network, just go ahead and apply, and we'll let you know!

Please note that this is not a therapeutic network and is not a substitute for clinical mental health care. If you are currently in crisis, please go to the emergency room or call 911. If you are currently experiencing thoughts of suicide, please call 1-800-273-8255.
Email address *
First Name *
Last Name *
Gender Pronouns
Age *
Phone Number *
Where are you located? *
If "Other/Outside US", please specify:
Timezone *
What time of day are you usually available to receive support? (Check all that apply) *
In what language(s) would you prefer to receive grief support? (Check all that apply) *
What's your preferred form of contact? *
How did you hear about us? *
Within these categories, we would love to hear more specifics (for example: what’s the name of the Facebook group, organization, Twitter account, person, news publication, etc., where you heard about us?). We are committed to serving as many people as we can, and this will help us - thank you!
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