Helping suddenly bereaved people
Sudden Bereavement Help
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Online form if you have been bereaved, to get help from Sudden
Online form if you have been bereaved, to get help from Sudden
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Your details
First name
(Required)
Family name
(Required)
Your address
(Required)
Street Address
Address Line 2
City
County / State / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
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Bahrain
Bangladesh
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Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
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Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
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French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
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Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
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Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Réunion
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Phone number we can call you at
Email address we can email you at
Either a phone number or email address are required so we can contact you.
Contacting you
How would you prefer we contact you?
(Required)
by phone
by email
either
If by phone, what days are best for you?
Monday
Tuesday
Wednesday
Thursday
Friday
Select All
If by phone, what hours are best for you?
AM
PM
Select All
Your bereavement
When were you bereaved?
(Required)
Please choose
Today
Yesterday
This week
Last week
Two weeks ago
About a month ago
Two months ago
Longer than two months
What else do you want to tell us?
You can use this box to tell us anything you want about who has died, and how, or help you need (or leave blank).
Would you answer a few more easy questions?
(Required)
Just submit the form
I'm ok to answer a few more questions
The below questions help us understand a little bit more about who we are helping.
How old are you?
Please choose
18 – 24
25 – 34
35 – 44
45 – 54
55 – 64
65 – 74
75 – 84
85+
What is your ethnicity?
Please choose
White
- English / Welsh / Scottish / Northern Irish / British
- Irish
- Gypsy or Irish Traveller
- Any other White background
Mixed / Multiple ethnic groups
- White and Black Caribbean
- White and Black African
- White and Asian
- Any other Mixed / Multiple ethnic background
Asian / Asian British
- Indian
- Pakistani
- Bangladeshi
- Chinese
- Any other Asian background
Black / African / Caribbean / Black British
- African
- Caribbean
- Any other Black / African / Caribbean background
Other ethnic group
- Arab
- Any other ethnic group
What gender do you most identify with?
Female
Male
Prefer not to say
Other
Have you been bereaved before?
Please choose
Yes, including in a way that was sudden, or happened too soon in someone’s life
Yes, but not in a way that was sudden or too soon
No
How would you describe support you have from family or friends at this time?
I have good support
I have some support
I have no support
Email
This field is for validation purposes and should be left unchanged.
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