Navigating a loss

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Navigating a loss

WILD pre-consultation form

When did your loved one pass away?

Within the past 24 hours

Within the past week

Within the past month

Within the past year

Over a year ago

They haven't yet, I'm just preparing

Clear selection

Who Passed Away?

My partner/spouse

My parent

My child

My sibling

My grandparent

My friend

My family member

My pet

Other:

Clear selection

Were you anticipating this death?

Yes, my loved one was older or terminally ill

No, it was unexpected

I'm not sure

Clear selection

Which best represents your situation?

I'm NOT the primary person, but I want to help

I am one of a few primary people dealing with logistics after this loss

I am the only primary person dealing with logistics after this loss

Clear selection

Which aspects of dealing with a loss are most important to you? (Select all that apply)

Settling their will/estate

Funeral arrangements

Notifying friends and family

Honoring their legacy

Managing their finances

Handling their belongings

Closing their accounts

Coping with grief

Collecting benefits

Other:

Which communication method do you prefer?

Text

Phone

Zoom

Clear selection

Please provide the appropriate contact information: (Name, phone and/or email)

Submit

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