Circle of Support Form

Circle of Support

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Please complete these three sections. After you complete section 1, you can save this page as a text file, complete sections 2 and 3, then e-mail the results to "sidsnet1-at-sids-network-dot-org". Please use "Circle of Support form" as the subject line.

Section 1:

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	Name:
	E-mail address:
	My location is:
	Information about the baby who died (your relation to the baby, birthdate/deathdate/name):
	Numbers of surviving and numbers of subsequent siblings:
	Experience (please include a thumbnail sketch of why you are involved, any training you may have had, involvement in SIDS activities, etc.):

	My friend told me that if my baby were on a monitor, s/he would still be alive today.
	I feel that my spouse/significant other/friend does not feel the same way about my the baby's death that I do.
	My baby did not have any of the risk factors I read about. Why did my baby die?