Home
What I Do
Introduction to What I Do
Counseling
Introduction to My Counseling Services
Private Sessions
Individuals and Families
Groups and Classes
Introduction to Groups/Classes
H.O.P.E. Perinatal Loss
Loss of Child
One Year Left
Consulting
Introduction to My Consulting Services
Organizational Matters
Personnel Matters
FAQs
Frequently Asked Fees and Payment Questions
Frequently Asked Counseling Questions
Frequently Asked Grief Questions
About Loss
Introduction to Loss
Losses
Death of Parents
Death of Spouse/Partner
Identity
Roles
Death of a Child
Dilemmas
Guilt
Parental Relationship
Perinatal Loss
Children's Special Considerations
Issues
Needs
Adolescents' Special Considerations
Bereavement
Grief
Introduction to Grief
Grief and Disease
Grief vs. Depression
Grief Reactions
Grief Factors
Disenfranchised Grief
Anticipatory Grief
Mourning
Introduction to Mourning
The Myth of Stages and Phases
The 5 Challenges of Mourning
Acknowledge the Reality of the Loss
Open Yourself to the Pain
Avoiding the Pain
Working Through the Pain
Revise Your Assumptive World
Your Assumptive World
Meaning Making
Restructure Your Relationship
Introduction to Restructuring Your Relationship
Extraordinary Experiences
Linking Objects
Reinvent Yourself
Styles
Complicated Mourning/Grief
When to Get Help
When to Get Help - Adults
When to Get Help - Children
Preparing For and Dealing With Loss
How to Support the Bereaved
About Dying
A Process
Introduction to Dying
Coping
Awareness
Stages, Phases, & Tasks
Stages and Phases of Dying
Stages of Life-threatening Illness
Tasks of Dying
Introduction to Tasks of Dying
Physical Tasks
Psychological Tasks
Social Tasks
Spiritual Tasks
Caregiving
Dimensions of Care
Physical Dimension
Psychological Dimension
Social Dimension
Spiritual Dimension
5 Themes of Caring
Resources
Books & Videos
Death and Dying
General Grief
Death of a Spouse/Partner
Death of a Parent
Death of a Child
Perinatal Loss
Grief and the Holidays
Children and Grief
ALS (Lou Gehrig's Disease)
Organ/Tissue Donation
Other Assorted Topics
Web Resources
To Articles
To Videos
Observations
Contact Information
Site Map
J. Worth Kilcrease, LPC, PLLC
No matter what accomplishments you achieve, somebody helps you.
Althea Gibson
Home
Informed Consent & Service Agreement
Next
Back
Next
Back
Next
NOTE:
*
indicates a required response.
I have read, understand, and agree to this Informed Consent and Service Agreement. I acknowledge that I am more than 17 years old and have the legal authority to bind myself, or others—such as a minor child—listed below, to this Agreement.
*
Yes
No
I give permission to have my sessions tape recorded. These recordings will be in lieu of physical note taking during the sessions.
*
Yes
No
I give permission for each of the following to be a means of communicating with me:
*
Telephone
Email
Text Message
Name
*
Name(s) of Additional Client(s)
Email
*
Verify Email
Date
Back
Reset
Submit
Thanks for completing and submitting the
Informed Consent and Service Agreement
. You will soon receive an email confirming I have received it.
By the way, be sure to complete and submit the
Counseling Client Intake Form
if you haven't already done so.
I look forward to meeting you at our first appointment,
Worth
Please turn on javascript to submit your data. Thank you!