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(216) 412-2200

You don't have to journey alone...

Losing a spouse, partner, child, parent, sibling, or friend can deeply impact our lives. After experiencing the loss of a loved one, many people find hope and support by sharing their story in the safe atmosphere of a support group. Join us at Centering Space, a retreat center in Lakewood, Ohio, where you can explore your feelings surrounding your loss with a caring group of fellow grievers. Led by a licensed counselor, the group runs for 8 weeks.

An intake interview is required to join the group, and must be completed one week prior to the start of the group, continue with registration below…

Grief Support Group - Centering Space
Registration Information

Thank you for your interest in participating in our Grief Support Group at Centering Space, in partnership with Rockport Counseling. In the following pages you will be asked to provide some basic registration information, and also to choose a time for a screening phone call. The purpose of the screening call is to answer your questions about the group, and to understand where you currently are on your grief journey, to make sure that participating in the support group will be a positive and beneficial experience for you.

Our next start date is still being determined.

Registration
Contact Information

Name*

Name*

Email Address*

Email Address*

Phone Number*

Phone Number*

Registration
Loss Information

Name(s) of the person(s) you are grieving*

Name(s) of the person(s) you are grieving*

Relationship of person(s) to you*

Relationship of person(s) to you*

Cause of death (this can be as brief or detailed as you are comfortable providing)*

Cause of death (this can be as brief or detailed as you are comfortable providing)*

Date of death*

Date of death*

Do you feel emotionally able to share the story of your loss in a group setting?*

Do you feel emotionally able to share the story of your loss in a group setting?*

We understand that for various reasons, members of the group may not be able to attend every meeting, but it is our policy that members commit to attending the first two meetings, because this is when members of the group get to know one another and the story of one another's loss.

We understand that for various reasons, members of the group may not be able to attend every meeting, but it is our policy that members commit to attending the first two meetings, because this is when members of the group get to know one another and the story of one another's loss.

If the group reaches its maximum number of members, would you like to be placed on a waiting list for the next group?*

If the group reaches its maximum number of members, would you like to be placed on a waiting list for the next group?*

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  • Rockport Counseling, LLC

(216) 412-2200

14805 Detroit Avenue, Lakewood, Ohio

Serving the West Side of Cleveland, Lakewood, Rocky River, Fairview Park, Westlake, Bay Village, Avon, Avon Lake

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