Mutual Aid Mourning and Healing Request for Support
Dear friend,

If you are filling out this form, someone close to you has passed. With all the love in our hearts, we want to offer our deepest condolences and witness. There are no words to adequately comfort you. However, it is our humble and sincere hope that we might connect you with someone who can help facilitate some comfort and ease in your time of sorrow.

We are a group of Chicago-based organizers gathering a list of clergy members, death midwives/doulas, therapists, social workers, and healers who are here to offer some support by phone or video conferencing.

Please fill out the form below and tell us as much as you can about the support you are seeking. Within 24-hours, one of us will be in touch to connect you with someone or update you on the status of your request.

Please note that your information will not be shared outside this organizing team.
If you are a caregiver looking to volunteer your services, please email mutualaidmourning@gmail.com

In Solidarity,

Kelly Hayes, Tanuja Jagernauth, Heather Lynn, Nina D'Angier, Ashon Crawley, and Rabbi Brant Rosen.
Your name:
Email address: *
Phone number: (if you are seeking support via phone)
Your preferred method(s) of communication: (check all that apply) *
Required
With whom would you like to be connected? *
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Please tell us a little about the kind of support you are seeking: *
Is there anything else you would like us to know?
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