Grief Counseling Consent Form
Client Information
Full Name
Date of Birth
Contact Information
Counseling Information
Goals for Grief Counseling
Limitations of Confidentiality
Consent and Agreements
I agree to participate in grief counseling sessions.
I have read and understood the available information regarding counseling services.
I understand the limitations of confidentiality as explained.
Client Signature
Date
Counselor Signature (if applicable)