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AGREEMENT FOR GRIEF GUIDANCE

Please read this agreement in its entirety, initial and check box to submit. If you are signing for a minor, please email lou@griefguider.com for the minor agreement form. 

Welcome to the grief guidance healing practice of Lou Bacon, M.Ed. This document contains important information about professional services offered and business policies. It also contains information about policies and practices to protect your privacy and information. Please read this document carefully and email lou@griefguider.com with any questions or concerns.

 

Grief Guide Professional Credentials: Lou Bacon has an Associate of Science degree from Quinnipiac University; a Bachelor of Arts degree from The University of New Hampshire, and a Master of Education in Counseling from the University of New Hampshire. Lou Bacon is not licensed by the state of NH or any other state. She has worked as a Volunteer, Public Speaker, Volunteer Trainer, and Bereavement Group Leader for Seacoast Hospice, Beacon Hospice, and Amedisys Hospice (NH) organizations for 28 years. Bacon has taught at the College and University level teaching Social Science courses, and Death & Dying, and Grief & Loss for 23 years.

 

Grief Guidance Services: Grief guidance varies based on the client and the client’s particular situation and goals. There are many different methods which may be used to address a particular event involving loss with a particular situation involving loss, including future goals, and objectives. For the best outcome, the client must choose to invest energy in the process and work actively on relevant topics both during and between sessions.

 

Based on normal grief reactions, guidance thought grief often brings up uncomfortable feelings such as sadness, guilt, anger, anxiety, or frustration when discussing aspects of the loss one is experiencing. Grief guidance has been shown to have benefits that can include better relationships, solutions to specific problems, increased life satisfaction, improved physical health, and significant reductions in feelings of distress. However, there are no guarantees as to what each client will experience.

 

What to Expect: The first session will involve an evaluation of your grief reaction and current process including needs, goals, and objectives to work toward. Navigating through the grief process can involve a significant investment of time, energy, and patience. It is important to select a guide with whom you are comfortable working. If at any time you have questions about guidance, please discuss them as they arise.

 

Sessions: Sessions are 45 minutes in length. Fees for sessions and package rates are listed on the Plans & Payments Page on the Grief Guide website. If you need to cancel a scheduled guidance session, you must do so at least 24 hours in advance. If you do not cancel a scheduled appointment with at least 24 hours’ notice or if you fail to attend a scheduled session, or are late by 15 minutes, you will not be reimbursed for that session,

 

Billing and Payments: Payment is expected in full for a session 24 hours prior to the beginning of each session. All payments will be accepted via Venmo or PayPal.

 

Insurance Reimbursement: The Grief Guide doesn’t accept or submit to any insurance companies.

 

Contacting Me: My preferred method of contact is email. Every effort will be made to return emails within one business day. If you are in an emergency situation, please call 911, 988 (the national suicide support line), or your physician.

 

Social Media Policy: I do not interact or accept “friend” requests via social media sites (Facebook, LinkedIn, etc.) because it has the potential to compromise privacy and complicate our therapeutic relationship.

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Confidentiality: All efforts will be made to keep your information secure. Notes may be taken during the session to refer to during a later session; no physical records of the zoom sessions will be saved once the session ends. Please be advised, it is:

  • The Grief Guide’s duty is to warn another in the case of potential suicide, homicide, or threat of imminent, serious harm to another individual.

  • The Grief Guide’s duty is to report suspicion of abuse or neglect of children or vulnerable adults.

  • The Grief Guide’s duty to report prenatal exposure to cocaine, heroin, phencyclidine, methamphetamine, amphetamine or their derivatives, THC, and excesses and habitual use of alcohol.

 

Changes in Services or Fees: Lou Bacon/Grief Guide reserves the right to change the policies, practices, procedures, and fees described in this document. You will be notified within 30 days of any such changes.

 

Minors: If you are under 18 years of age, please be aware that any sessions with The Grief Guide must be accompanied by a parent or legal guardian.

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Safety: All efforts will be made to provide a safe environment for all. Again, please contact 911 if you are in an emergency situation on any kind. You agree that if you engage in verbal, written, or physical behavior that is threatening in any way to the grief guide, or any other person, you may be identified to law enforcement, explaining that you are a client of The Grief Guide, and report the threatening behavior using your personal identifying information.
 

Summary of Agreement: I understand the basic goals, ideas, and methods of this guidance practice. I have no questions or concerns at this time. I understand that reaching the agreed upon grief guidance goal(s) is not guaranteed. I understand that grief management is successful for some people, moderately successful for others, and for some, not successful at all. I further understand that the initial symptoms or problems that are presented to Lou Bacon may initially become more intense.

 

Conclusion and Signatures: By initialing below and checking the box I indicate that I have received and read, and agree to the information in this agreement, have discussed the contents with the Grief Guide to my satisfaction, and agree to abide by its terms during sessions. I understand I may request a copy of this document.

If a minor will become a client of the grief guide, please email Lou Bacon directly at lou@griefguider.com for a form to fill out for the minor.

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