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* 1. What is your name?

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* 2. When the body stops working, it is permanent.

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* 3. It is okay to have different feelings about the death than other people.

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* 4. I am comfortable asking questions about the person who died.

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* 5. I am comfortable sharing my story with others.

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* 6. I have adults I trust that I can go to.

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* 7. I ask for help when I need it.

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* 8. When I am upset, I know what I can do to make myself feel better. (Coping skills)

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* 9. I have goals for the future.

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* 10. It is okay to feel upset.

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