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Grief Intake Form - Deb Lee Gould, MEd

Grief Intake Form - Deb Lee Gould, MEd 2026

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Deb Lee Gould, MEd, is a Bereaved Parent and Grief Consultant offering support to parents and families coping with the death of a child. Her services focus on transforming grief into living with faith, hope, and love. She provides grief consultation through various means but emphasizes that her support is not a substitute for professional therapy. Confidentiality is maintained in her consultations, which are free of charge but accept donations. The document outlines terms and conditions for using her services, including the importance of seeking additional help if needed.

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Click ‘Get Form’ to open the Grief Intake Form in the editor.
Begin by filling in your personal details such as Name, Age, and Sex. This information helps tailor the support you receive.
Provide your contact information including Home Phone, Cell, and Email Address. Ensure these are accurate for effective communication.
Indicate if you are currently working with a therapist or medical professional regarding grief. If yes, provide their name and contact number.
List the names and birth/death dates of your deceased loved ones. This section is crucial for understanding your grief context.
Reflect on past losses and coping mechanisms learned from family. This insight can guide your healing process.
Detail any current difficulties you are experiencing related to grief. Be honest; this will help in providing appropriate support.
Finally, save the completed form as a PDF. You can then email it, print it to fax, or bring it to your appointment.

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Is grief counselling covered by Medicare?

Both Original Medicare and Medicare Advantage plans provide coverage for those requiring mental health services. Typically, grief counseling is an outpatient service covered by Medicare Part B. As long as the therapy is medically necessary, Medicare covers the costs for as long as someone needs it.

Does Medicare pay for grief counseling?

Do try talking about your feelings to a friend, family member, health professional or counsellor you could also contact a bereavement support organisation such as Cruse or call: 0808 808 1677. if youre struggling to sleep, get sleep tips from Every Mind Matters.

How many counseling sessions will Medicare pay for?

Yes, Medicare does limit the number of counseling sessions, specifically under Medicare Part B. Initially, youre allowed up to 20 outpatient individual or group therapy sessions per year. However, its important to note that further sessions may be authorized if deemed medically necessary by your healthcare provider.

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How to get free grief counselling?

For example, you could: Speak to your GP. Look into options for bereavement therapy or counselling. See if theres support available through your employer or place of study, if youre working or studying. Visit your local community centre or library. Seek support through your place of worship, if you have one.

How much does grief counseling cost?

The average cost of grief counseling typically ranges from $75 to $150 per session, though this can fluctuate based on the grief counselors experience, location, and the sessions length and type. The final price you pay for these types of mental health services will depend on many other things as well.

Grief Intake Form - Deb Lee Gould, MEd 2026

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Is grief counselling covered by Medicare?

Does Medicare pay for grief counseling?

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