We provide free support to individuals and families who have experienced the death of a family member or friend, regardless of the cause of death.
Wave Riders
Free Grief Support for Children and Teens All services are free of charge. Please call for more information.
Individual Counseling: Free sessions available at our sites and schools. Camp Erin: A free weekend overnight camp the last weekend of September. Wave Riders: Support groups at our sites (evenings) and local schools (day). Locations: Albany
Please contact the site nearest you for more information:
Rensselaer Rotterdam Boys & Girls Club
The Community Hospice 445 New Karner Road Albany, NY 12205 Phone: 518-724-0200
The Community Hospice 246 Manny Corners Rd. Amsterdam, NY 12010 Phone: 518-843-5412
The Community Hospice 47 Liberty Street Catskill, NY 12414 Phone: 518-943-5402
The Community Hospice 295 Valley View Blvd. Rensselaer, NY 12144 Phone: 518-285-8100
Saratoga Springs Catskill
Wave Riders 2015 Fall Schedule:
Please Contact:
Oct. 27, Nov. 3,10, 24 , Dec.1, 8 Tuesdays, 5:30pm - 7:15pm Oct. 28, Nov. 4, 11,18, Dec. 2, 9 Wednesdays, 5:00pm - 6:30pm Oct. 19, 26, Nov. 2, 9, 16, 23 Mondays, 5:00pm - 6:30pm Oct. 28, Nov. 4, 11,18, Dec. 2, 9 Wednesdays, 5:30pm - 6:45 pm Monthly: Oct. 6, Nov. 3, Dec. 1 First Tuesday, 5:30pm - 7:15 pm
Mary Crea 518-724-0248 Julia Soto 518-285-8100 Amy Weinar 518-843-5412 Alycia Knowlton 518-581-0800 Joe Zanchelli 518-943-5402
Free Grief Support for Adults and Families All services are free of charge. Please call for more information.
Individual or Family Counseling: Free sessions are available at our sites. Support Groups: Schedule is subject to change. Please call to verify. Locations:
Dates/Time (some are monthly)
Please Contact:
Albany
Every 1st Tuesday, afternoons
Sue Emanuele 518-724-0200
rd
Albany
Every 3 Thursday, evenings
Sue Emanuele 518-724-0200
Rensselaer
Thursdays 5:30pm - 7:00pm
Julia Soto 518-285-8100
The Community Hospice 179 Lawrence Street Saratoga, NY 12866 Phone: 518-581-0800
Rensselaer
Tuesdays, 5:30pm - 7:00pm
Julia Soto 518-285-8100
Rensselaer
Wednesdays, 3:00pm - 4:30pm
Julia Soto 518-285-8100
Saratoga
Mondays, 6:30pm - 8:30pm
Maureen M 518-581-0800
Additional Services: -Memorial Services -Education & Outreach -Crisis Response
Saratoga
Wednesdays, 12:30-2:00pm
Maureen M 518-581-0800
Amsterdam
Tuesdays, 6:00pm - 7:30pm
Amy Weinar 518-843-5412
Catskill
Mondays, 2:00pm - 3:30pm
Joe Zanchelli 518-943-5402
Apply online today! For more information, please visit:
www.HospiceGriefServices.com
REQUEST FOR HOSPICE BEREAVEMENT SERVICES First and Last Name (of adult): Relationship to children below:
Todays Date: Ethnicity:
Parent / Legal Guardian / Other:
Mailing Address:
Phone Number:
City:
Zip Code:
Email Address:
Referred By:
Child’s First Name
Child’s Last Name
Age
M/F
Date of Birth
Name of the person who died:
Ethnicity
Grade
School
Date of death:
Cause of death: Relationship: The person who died is your:
□ □ □ □ □ □ □ □ □
Father Mother Son, age:___ Daughter, age:_ Brother, age:___ Sister, age: ___ Grandparent Aunt/Uncle Other:
Changes in behavior since the death?
Services you are requesting:
Preferred location:
□ □ □ □ □ □ □ □ □ □ □ □ □ □
□ □ □ □ □ □
□ □ □ □ □ □ □
Changes in sleep patterns Over or under eating Increased anxiousness Regression in children Physical or aggressive behavior Anger at self or others Difficulties with peers or family Risky or destructive behavior
Camp Erin Wave Riders Child Support Sessions Adult Support Sessions Adult Support Groups Other:
Albany Rensselaer Schenectady Amsterdam Saratoga Catskill
At School Any additional information you would like to share?
Ran away from home or school Refusal to talk about deceased Obsession with death Inappropriate sexual behavior Discussed or attempted suicide Other:
Did your love one receive any Hospice patient services? Is your household considered low income? <$34,575 Are there any allergies, medical or physical conditions? Are there any behavioral or mental health conditions?
Y Y Y Y
N County: N N N
I hereby give permission for all the individuals listed above to receive services from The Community Hospice. Please clearly PRINT Adult/Parent/Guardian’s Name: Today’s Date:
Signature:
Please return application to any site, fax to 518-729-4063, or complete online HospiceGriefServices.com
