BABY SPIRIT - Cremation Planning Form

We are so sorry for your loss. Please complete the form below to request support from the Baby Spirit Foundation.
Parent / Applicant Information

Please provide the best contact information for the parent or person completing this form.
Parent 1 Name

First NameLast Name
Parent 1 Phone Number
Format: (000) 000-0000.
Parent 1 Email Address
Parent 1 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent 2 / Other Parent’s Full Name

First NameLast Name
Age of Parent(s)
Parent(s) Race, Ethnicity, or Cultural Background
Applicant Relationship to Baby
If you are not the mother or father, are you completing this form with the family’s permission?

Baby's Information

Share as much as you feel comfortable. If a question does not apply, you may leave it blank unless marked required.
Baby's Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Date of Loss

MonthDayYear
Date
Where did the loss take place?
Hospital, medical center, home, etc.
City / Town Where the Loss Took Place
State Where the Loss Took Place

Tribute Page Information
Would you like Baby Spirit Foundation to create a free tribute page for your baby?
Are there additional family members you would like mentioned?
Parents, siblings, grandparents, or anyone else you would like included.
Is there anything special you would like shared about your baby or your family’s love for them?
This can be a memory, message, prayer, quote, nickname, or anything you would like people to know.
Would you like the tribute page to include a fundraising option?
Do you have a photo you would like included on the tribute page?

You may upload a baby photo, ultrasound, family photo, symbolic image, or leave this blank.
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Funeral Service Grant

We award up to $1,000 each month to selected families. Grants may help with funeral, cremation, burial or related expenses. We wish we could help every family, but funds are limited. Families selected for a grant will be notified by the 10th of the month.
Would you like to be considered for this month’s funeral service grant?
Optional Grant Video
After submitting this form, you may receive instructions for sending an optional video. The video does not need to be professional or polished. It can simply be a short message sharing who you are, who you are honoring, and how Baby Spirit Foundation’s support would help your family during this time.

Videos will remain private and will only be used for internal grant review, unless your family gives Baby Spirit Foundation separate permission to share it.

Consent & Permissions
Consent to Contact
Information Accuracy
Tribute Page Permission
Fundraising Permission
Emotional Support Email Permission
Would you be open to Baby Spirit Foundation sharing your family’s story, photo, video, or tribute page on our website, email updates, or social media to help raise awareness and support for other grieving families?
Should be Empty:

Parent / Applicant Information