Valerie’s House Graduation Form

We are honored that you have allowed us to walk alongside you for part of your grief journey. You will always be a part of the Valerie’s House family.

Please take a moment to complete this brief form to help us plan for your graduation and to help us better serve the needs of other grieving children and their families.

Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Please share something you have gained or learned from your experience and time at Valerie's House.

From your first experience at Valerie's House to the present, how do you feel your grief journey has changed?

Improved Significantly

Improved Moderately

Improved Slightly

Not Changed At All

Worsened

How do you think we could have made your experience at Valerie's House better?

Would you be interested in participating in a future Valerie's House support program offered on a monthly basis for families that are farther along in their grief journey?

Yes

What else should we know about your experience with Valerie's House?

OUR VISION IS THAT NO CHILD WILL GRIEVE ALONE.

The mission of Valerie’s House is to help children and families work through the loss of a loved one together and go on to live fulfilling lives.

Fort Myers Mailing Address:
PO Box 1955
Fort Myers, FL 33902

Naples Mailing Address:
819 Myrtle Terrace
Naples, Florida 34103

Punta Gorda Mailing Address:
233 East McKenzie Street
Punta Gorda, Florida 33950

Pensacola Mailing Address:
904 East Gadsden Street
Pensacola, Florida 32501

Valerie’s House has received the Guidestar Seal of Transparency.

VALERIE’S HOUSE, INC.
Fort Myers • Naples • Charlotte County • Pensacola
Phone 239-204-5804

Valerie’s House is a 501(c)3 charitable organization, registration # CH46827. A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE WITHIN THE STATE. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE. For more information, contact the Florida Department of Agriculture and Consumer Affairs at 1-800-HELP-FLA (435-7352) or visit www.freshfromflorida.com.

Graduation Form

Valerie's House

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OUR VISION IS THAT NO CHILD WILL GRIEVE ALONE.

The mission of Valerie’s House is to help children and families work through the loss of a loved one together and go on to live fulfilling lives.

Fort Myers Mailing Address:PO Box 1955Fort Myers, FL 33902

Naples Mailing Address:819 Myrtle TerraceNaples, Florida 34103

Punta Gorda Mailing Address:233 East McKenzie StreetPunta Gorda, Florida 33950

Pensacola Mailing Address:904 East Gadsden StreetPensacola, Florida 32501

Valerie’s House has received the Guidestar Seal of Transparency.

Fort Myers Mailing Address:
PO Box 1955
Fort Myers, FL 33902

Naples Mailing Address:
819 Myrtle Terrace
Naples, Florida 34103

Punta Gorda Mailing Address:
233 East McKenzie Street
Punta Gorda, Florida 33950

Pensacola Mailing Address:
904 East Gadsden Street
Pensacola, Florida 32501