Good Grief Registration

Good Grief is a peer support group for teens offered as a joint initiative by Bereaved Families of Ontario – Midwestern Region (BFO-MR) and Hummingbird Centre for Hope (HCH). BFO-MR and HCH are peer-to-peer support organizations. We do not provide medical or professional psychological advice.

Once you submit the registration form, we will contact you to set up an intake.

The purpose of the intake is to gather any additional information needed in order for the facilitators to assess whether the group is appropriate and so they have a complete understanding of the dynamic in the group. The intake process also allows us to address any comments, questions or issues that you or the teen(s) may have before participating in the group.

Privacy and Confidentiality: The information that you share on this form will be kept private and confidential. It will be shared with your group facilitators for the purposes of conducting the intake, as further discussed in the consent below.

Confidentiality Exceptions
Staff and volunteers at BFO-MR and HCH have signed a confidentiality agreement. However, it should be noted that exceptions to the confidentiality rule are:
a) If a person has reasonable grounds to suspect that a child, under the age of sixteen, is or may be at risk of physical, sexual or emotional harm or neglect, the person must promptly report the suspicion and the information upon which it is based to a Children’s Aid Society. (Child and Family Services Act)
b) If a person suspects that a group member may be in danger of seriously harming themselves, or others, the person may seek advice or consultation that could result in breaching the confidentiality of a member. This could include: alerting the authorities and/or warning the person who is being threatened; and/or contacting a third party.
c) If called upon (subpoenaed) in court, if required to be disclosed to any regulatory body having jurisdiction, or if necessary, by reason of other legal requirements beyond the reasonable control of the recipient.

  • e.g. mother, father, aunt, legal guardian, etc.
  • Please include the street address, city and postal code
  • This is someone we can reach during the group in the event of an emergency.
  • e.g. mother, father, aunt, legal guardian, etc.
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • WE ARE ASKING THE FOLLOWING QUESTIONS SO THE FACILITATORS HAVE A COMPLETE UNDERSTANDING OF THE DYNAMIC IN THE ROOM.
  • INFORMATION ABOUT THE PERSON WHO DIED
  • Date Format: MM slash DD slash YYYY
  • e.g. work, social, family, other deaths, financial stress, etc.

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