---
title: Neonatal Bereavement Follow-Up Wellness Check Form Template | Paperform
description: Compassionate follow-up form for neonatal bereavement nurses conducting wellness checks, grief assessments, memory box delivery coordination, and subsequent pregnancy support for families experiencing loss.
url: "https://paperform.co/templates/neonatal-bereavement-follow-up-wellness-check"
type: static
generatedAt: "2026-04-04T00:44:41.758Z"
---

[← Back to free form templates](/templates/)    ![Neonatal Bereavement Follow-Up Wellness Check](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/neonatal-bereavement-follow-up-wellness-check.png)
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Losing a baby is one of the most profound losses a family can experience. Our **Neonatal Bereavement Follow-Up Wellness Check** template provides healthcare providers with a sensitive, structured approach to supporting families through their grief journey.

Designed specifically for bereavement nurses, midwives, and perinatal mental health teams, this template enables comprehensive follow-up care after neonatal loss. Whether you're conducting grief check-in calls, coordinating memory box delivery, arranging burial assistance, or providing subsequent pregnancy support, this form captures the information you need while maintaining the compassionate, person-centered approach families deserve.

The form guides healthcare professionals through wellness assessments, grief screening, practical support coordination, and ongoing care planning—all within a single, secure platform. Conditional logic ensures questions adapt to each family's unique situation, while integration capabilities mean submissions can flow directly into your patient management system or trigger follow-up workflows via [Stepper](https://stepper.io).

**Why healthcare providers trust Paperform for bereavement support:**

With Paperform, your bereavement follow-up process becomes more consistent, thorough, and compassionate. Submissions are securely stored with SOC 2 Type II compliance, and you can customize every aspect—from the language used to the support resources linked—ensuring the form reflects your organization's values and protocols.

For teams managing ongoing bereavement caseloads, [Stepper](https://stepper.io) can automate follow-up reminders, coordinate multi-disciplinary care teams, and ensure no family falls through the cracks during this critical time. You can also use [Papersign](https://papersign.com) for any consent forms related to ongoing care or subsequent pregnancy planning.

This template is ideal for hospital bereavement services, community midwifery teams, perinatal mental health services, hospice organizations, and any healthcare setting providing compassionate care after pregnancy or infant loss.
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