Blue Butterfly School-Based Groups

Tidewell Grief Care’s Blue Butterfly Family Grief Program is offering grief support groups in Manatee County schools. Your school can apply now to participate in a six-week grief and loss program for students who are grieving the death of a special person in their lives.

To learn more, join us for an informational webinar! Email School Bereavement Advocate Jenna Lank at JLank@EmpathHealth.org to receive a link for the next scheduled webinar.

Program Application Form

Name of School*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Main Office Phone*
Name of Facilitator (Must be master's level mental health professional)*
Facilitator Cell Phone*
Facilitator Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Facilitator Email*
Name of Co-Facilitator (Must be school district employee)*
Co-Facilitator Cell Phone*
Co-Facilitator Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Co-Facilitator Email*
School Administrator Who Approved Program*
Session Information
Desired Day of Week*
Location in School (Must be private, closed-door location)*
Number of Grieving Students Identified*
Grades of Identified Students*
Is School Interested in 1 or 2 Sessions During School Year?*
Phone
This field is for validation purposes and should be left unchanged.

Program Application Form

Session Information