New Clients [Self-referral or Professional referral]:

Both Forms can be completed online and then saved to your desktop as a pdf. They cannot be completed by using a phone.  Then either email as a pdf or print/fax to Deb before your appointment.

•   Grief Intake Form

•   Emergency Contact & Release Form

•    Deb's Grief Consult Brochure

Grief Intake Form & Release : Please complete on a computer, save as a pdf, then email Deb or print & fax or bring to your appointment, or if you don't have access to a printer, complete my hard copy form when you come for your face-to-face appointment. [Most appointments are Online Video sessions (I have limited face-to-face appts) - Forms will need to be emailed, faxed or mailed]

Your responses on the Grief Intake Form will give me a better understanding of the various factors that may be impacting your grief process.

If you choose to mail the forms please Mail to PO Box 54, Okemos, MI 48805.

 

 Professionals - If you would like to refer a client:

•   Professional Referral Form