Application

application

* Indicates required field

Name *

First

Last

Email *

Phone number *

Please tell me about your loss. What happened and when? Feel free to go into as much detail as you would like to share. *

How have you been managing your grief? What sort of coping strategies have you been utilizing? *

Have you received any formal/structured assistance for your grief? (Therapist, support group, etc.) *

How is your grief manifesting? What changes have you noticed in your mood or behavior? How does it feel in your body and where? *

Are there any other losses you are grieving or major life changes you are experiencing? *

Where are you on the religious/spiritual/atheist/agnostic end of things? *

Tell me about yourself. Who are you? Who were you before your loss? *

What are your goals for our work together? What would you like to accomplish? *

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