Application Healing for Grieving Hearts Program
Thank you for your interest in the Healing for Grieving Hearts program, a two months 1:1 program with Jacqueline Steudler, Creative Grief Coach and Art Therapist at JST Art and Therapy Inc.

Before we get on a free discovery call, I would like to know a little bit more about your situation. This will make it easier for us to decide if the Healing for Grieving Hearts program is a good fit for you. (All information will be kept private and not shared with anyone outside of JST Art and Therapy Inc.)

After our initial call, you will have time to decide if you want to step into your healing journey and work with me.

Thank you for trusting me with your grief story,
Email address *
First Name *
Last Name
Who did you lose? *
Tell me more...
What is the biggest challenge you face right now in regards to your loss?
Do you have any questions?
Would you be comfortable using an online platform for the coaching sessions? (Privacy and security are my priorities in choosing the online platform) *
A copy of your responses will be emailed to the address you provided.
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