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Request for support

To receive support services from the Pregnancy and Infant Loss Network at Sunnybrook, please fill out our intake form below.

To learn more about the support services we offer, visit our support programs page.

PAIL Network provides support to any family in Ontario who has experienced the loss of their pregnancy or the death of their baby up to 12 months of age, including:

Request form

In order for us to provide you with the best possible match for peer support, please provide as much information as you are comfortable sharing. Please note, we are unable to offer support outside of the province of Ontario. The form below can not be submitted if the fields marked with an *asterisk* are incomplete.

* indicates a required field.

Date of birth
Address

Contact information

I grant my consent to be contacted via the methods listed above.
I would like to be contacted about my accessibility needs.

Support type

Please review the available peer support options below and check off any that you may be interested in. Our Referral Coordinator will review each type of support with you and help you to determine which type you would like to proceed with.

Preferred method of support is

PAIL Network will contact families by phone to further discuss support needs. For other correspondence, please let us know how you would prefer to communicate with us.

Contact preference
How did you hear about PAIL?

Please share the details of your loss

Date of loss

Category of loss

 

We understand that this loss reaches into all aspects of your life, and can also offer peer support during your pregnancy after loss, support as you are parenting through loss, and a dedicated group for the non-birthing partner in grief.