Grief Coaching Assessment Information
This initial 25-minute assessment is a chance to meet on Zoom and see if grief coaching fits you. There is no cost for this consult and no obligation. Meetings are usually held on Zoom but we can use Whatsapp or Google meet if you prefer.
Sign in to Google to save your progress. Learn more
Email *
What is your name? *
What is your phone number to receive text messages? *
How would you prefer to be contacted? *
What loss are you struggling with in your life? *
How long have you been experiencing grief? *
What is your time zone? *
What days are you available? Check all that apply
What times are you available? Check all that apply
What would you like to get from grief coaching?
Do you have questions about grief coaching that you would like to ask prior to your assessment?
I am not set up for those who are considering self harm or having suicidal thoughts. If you are experiencing these, please get help immediately. 
You are so important. Call 988.
I agree that I am NOT considering self harm 
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy