Virtual Grief Group Initial Questionnaire
Please complete this questionnaire to help us offer the best support to you in the group.

By completing this form, you are committing to doing your best to be present at ALL SIX sessions, to gain the most benefit.
Sign in to Google to save your progress. Learn more
Email *
Name *
Mailing Address: *
Who are you grieving right now or which deaths are you grieving? *
When did you loved one pass away? *
What is the most pressing question (s) you have about grief and loss? *
What do you hope to gain by participating in this support group? *
Disclaimer of service: Facilitators are trained in Grief Support and Adult Mental Health First Aid. This  virtual support group is not intended as or to be a substitute for formal clinical therapy or counselling by licensed personnel. *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms