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How We Help
- Overview
- FAQs
- Resources
Get Involved
About Us
Request a Peer
News

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Request a Peer

Please use the contact form below to Request a Peer. We will try our best to respond back to you within 24 hours.

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Who are you requesting a peer mentor for? *

What is your relationship to the child? *

What is the name of the person requesting a peer mentor? *

What is the email address of the person requesting a peer mentor? *

What is the cell phone of the person requesting a peer mentor? *

What is your name? *

What is your email address? *

What is your cell phone or the best number to reach you? *

What organization do you work for? *

Child's name *

Child's diagnosis *

Child's current status *

Child's current age *

Where is the child currently being treated? *

Child's age at the time of their death *

Child's date of death *

Child's city and state of treatment *

How did you learn about Zach's Bridge? *

Google or other Internet search
A social worker or other medical professional
Instagram, Facebook or other social media
Someone else referred me
I don't recall or don't know
Other

What are the preferred methods of communication of the person seeking support? *

Text
Email
Phone Call
Any of the Above

Please share anything that might help us match with a peer, such as additional background about the family, child, or more details about the child’s cancer diagnosis.

Permission to Share *

I am authorized to share this information with Zach's Bridge.

Mia and family

My experience connecting with you has been amazing. I think hearing from someone that is in the same situation will always be superior to even the best counselor. This is a much, much needed resource.

– Leandro, father of Mia

Zach’s Bridge provides 1:1 peer support for advanced and bereaved pediatric cancer caregivers. Our goal is to ease the journey and give the entire family comfort and time to focus on what truly matters to them. Zach’s Bridge Inc is an IRS-certified 501(c)3 organization – Tax ID # 92-0768842.

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How We Help
- Overview
- FAQs
- Resources
Get Involved
About Us
Request a Peer
News

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