Page 1 of 1

Ambiguous Loss Questionnaire

What Is Ambiguous Loss?

Ambiguous loss is a type of grief that occurs when someone is physically or emotionally absent but still alive, or when there is no clear ending or closure. Unlike death, ambiguous loss leaves unanswered questions, making it difficult to know how—or even whether—to grieve.

I'm conducting this survey as part of the research for a book I'm writing about ambiguous loss, with the hope of helping others to feel understood, to find healing, and to know they are not alone.

Your participation is completely voluntary. You may skip any question you do not wish to answer.

Sincerely,
Shayla

1. What type of ambiguous loss have you experienced? (Select all that apply.)

A
B
C
D
E
F
G
H
I
J
K
L

2. Can you briefly tell me your story? Please share as much or as little as you're comfortable sharing. What happened, and what has this experience been like for you?

3. What has been the most difficult part of your experience with ambiguous loss? Choose up to 3.

A
B
C
D
E
F
G
H
I
J

4. Which chapter or stage best describes where you are today?

5. In what ways has ambiguous loss changed your daily life? Select all that apply.

6. Has anything helped you cope or begin healing?

7. What do you wish I had asked you about ambiguous loss? What else would you like for me to know?

8. Would you be interested in participating in this book as a case study? I'm looking for individuals who may be willing to share more of their story through a future interview. Participation is completely voluntary, and completing this survey does not obligate you in any way. You can also remain anonymous in the study.

If yes or maybe, type email address here:

If yes or maybe, type your name or pseudonym here: