Individual Grief Client Outcome Questionnaire (3 Month Update)

Grief Symptom Assessment

Please rate yourself in the following areas:
Selected Value: 0
0 = Low Stress ; 7 = High Distress
Selected Value: 0
0 = Low Distress ; 7 = High Distress
Selected Value: 0
0 = Low Ability ; 7= High Ability
Selected Value: 0
0 = Low Ability ; 7 = High Ability
Selected Value: 0
0 = Low Understanding ; 7 = High Understanding
Selected Value: 0
0 = Low Understanding ; 7 = High Understanding
Selected Value: 0
0 = Low Understanding ; 7 = High Understanding
Selected Value: 0
0 = Low Understanding ; 7 = High Understanding

Grief Counseling Feedback

How strongly would you agree with the following statements about your assigned therapist?
Selected Value: 0
0 = Strongly Disagree; 7 = Strongly Agree
Selected Value: 0
0 = Strongly Disagree; 7 = Strongly Agree
Selected Value: 0
0 = Strongly Disagree; 7 = Strongly Agree
Selected Value: 0
0 = Strongly Disagree; 7 = Strongly Agree
Selected Value: 0
0 = Strongly Disagree; 7 = Strongly Agree
Selected Value: 0
0 = Strongly Disagree; 7 = Strongly Agree