Referral Request
Certified GCU Graduate Grief Support Coaches
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please Phone support
Name
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First
Last
Is this request for a grief support for you, or someone else?
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It's for me
For someone else
If this request is for someone else, please give that person's name.
First
Last
Your Best Email Address
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Confirm Your Best Email Address
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City and State
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Country
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Phone with Area Code (If in the US or Canada and you'd like a phone call)
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What is the age of the person requesting grief coaching?
Gender: male / female
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Please briefly explain the nature / source of the grief in 2-3 sentences. The coach will gather more details if necessary.
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Do you have any special requests?
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Additional Comments (if any)
I understand that by submitting this request, I am requesting referral to a certified grief support coach. Grief Coach University certifies that each graduate has successfully completed our requirements for certification, however does not guarantee performance of the individual graduate. Grief Coach University, Beautiful Life International, LLC and staff will not be held liable for the actions or omissions of any grief support coach we refer. It is up to me, the person requesting a referral, to perform due dilligence with regard to hiring this person.
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Yes, I understand and Agree
I consent to collecting this data and processing it according to the Privacy Policy of this website.
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Yes, I am of majority age and consent to this.
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