How may I help?

Grief Circles

Please provide your information to join the Grief Circle.

I offer one-on-one coaching, workshops, lectures, in person and online circles.

This is not therapy, so please check in with your therapist, local support or authorities if that’s the nature of your need. May you be safe and well.

Grief Circles - Clients Contact Form

Name *

Name

First Name

Last Name

Email Address *

What is the nature of your grief and loss? *

Your relationship to the person you’re grieving *

How long ago was your loss?

Which state and country do you live in? *

What brings you here? *

Profession - What do you do for a living? *

How did you find out about this site? *

Please check what you're interested in: *

One-On-One Grief Coaching (please be as specific as possible answering the above questions and enter your address below)

Online Grief support groups (Requires registation and no drop-ins for each series)

Local events (Please state where you live to be put on the events list)

All of the options

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Available for talks, workshops. retreats and custom requests:

Grief Circles - Events Request Form

Requestor's Name *

Requestor's Name

First Name

Last Name

Subject *

Email *

Phone *

Phone

(###)

###

####

Organization's Name *

Organization's Address *

Organization's Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Organization's web page: *

http://

Organization's Mission *

Please desribe the audience *

Date of event *

Date of event

MM

DD

YYYY

Time of Event

Hour

Minute

Second

Type of event requested. If this is part of a larger event, please describe both *

Message *