Virtual Bereavement Groups Reporting Form Virtual Bereavement Groups Reporting Form Date MM slash DD slash YYYY Total Number of ParticipantsFacilitator 1 First Last Facilitator 2 First Last Themes or topics discussed in groupOptional Demographic InformationAge 18-2425-3435-4445-5455-6465+GenderFemaleMaleNon-BinaryIntersexTwo SpiritedOtherResiding LocationCity of Grande PrairieCounty of Grande PrairieMD of GreenviewGrimshawNorth PeaceOtherAdditional Comments/Notes
