Grief Your Way Assessment

Question Title

* 1. My most significant deaths were the loss of:

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:

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?

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?

1-4

5-8

9-12

13+

none

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* 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

Grief Your Way Assessment

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* 1. My most significant deaths were the loss of:

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* 2. The cause of the most significant death I’m dealing with was:

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* 3. How long has it been since the most significant death you are dealing with?

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* 4. If you have kids, how old is your youngest?

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* 5. If you are trying to solve a problem:

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* 6. First and Last Name

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* 7. Email Address to get a plan for YOU.