Memorial Submission Form | Hospice Orillia

Garden of Remembrance Memorial Submission Form

Your Name (required)

Your Email (required)

Your Loved Ones Name

Will you be attending the in person ceremony on June 16th?

Would you like a special message displayed during the virtual ceremony that will be released after the ceremony?

Is your memorial for a baby or pregnancy?

If you would like a photo of your loved one to be included in the virtual program, which will be released one week following the live ceremony, please attach a photo. This photo may include your loved one (no group photos please). You can attach up to 1MB jpg, eps, png or pdf file

Would you like to order a copy of the Garden of Remembrance program?:
YesNo

If YES, please provide address for delivery:

By checking below:

You provide Hospice Orillia permission to share your loved ones name and/or photo during the Garden of Remembrance ceremony on the Hospice Orillia website, the Hospice Orillia Facebook page and the NSMHPCN YouTube channel.You provide Hospice Orillia permission to use your loved ones name and/or photo to increase awareness of the Garden of Remembrance.

Grief is a normal reaction to the loss of a loved one. It can also be a reaction to the loss of relationships, physical ability, opportunities or future hopes and dreams.

Bereavement is the state of having suffered the loss of a loved one. It is the time after a loss during which grief is experienced and mourning occurs.

Mourning is the external expression of grief. It includes rituals that mark someone’s death, such as funerals, wakes or memorial services. Mourning is strongly influenced by a person’s spiritual and cultural beliefs and practices.

Hospice Orillia is committed to creating and maintaining an environment free of discrimination. All individuals are treated with respect and dignity, and have equal opportunities. Our programs, services and opportunities will be accessible regardless of age, ancestry, colour, race, citizenship, ethnic origin, place of origin, creed, disability, family status, marital status, gender identity, gender expression, receipt of public assistance, record of offences, sex, or sexual orientation. We always provide a positive space to our clients, volunteers, and staff.