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Grief Your Way Assessment
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1.
My most significant deaths were the loss of:
(Required.)
One parent
Multiple parents
Grandparent(s)
Child
Multiple children
Grandchild or grandchildren
Niece or nephew
Sibling or siblings
Aunt or Uncle
Spouse or multiple spouses
Romantic partner (not married)
Child’s parent
Friend or multiple friends
Other
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2.
The cause of the most significant death I’m dealing with was:
(Required.)
Natural anticipated
Natural sudden
Accident
Violent or traumatic
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3.
How long has it been since the most significant death you are dealing with?
(Required.)
0-3 months
4-6 months
7-12 months
1-2 years
2-5 years
6-10 years
11-20 years
20+ years
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4.
If you have kids, how old is your youngest?
(Required.)
1-4
5-8
9-12
13+
none
5.
If you are trying to solve a problem:
I don’t, I usually walk away instead.
Look it up online
Listen to a how-to podcast
Watch a how-to video
Print off or write down instructions
Talk to someone who might know the answer
6.
First and Last Name
7.
Email Address to get a plan for YOU.
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