Eating Attitudes Self Assessment
Take this short, confidential questionnaire to help assess your relationship with eating habits.
Follow these simple steps:
Complete the Questionnaire
Answer each question honestly based on your recent eating habits and feelings about food and eating.
Submit Your Results
Save your results to your computer or print the completed form.
Email the form to me or upload to a link once I send you further instructions.
Next Steps
If your results indicate signs of disordered eating, I'll refer you to a specialist for tailored support.
If your results indicated that you DO NOT HAVE SIGNS of disordered eating, please follow the next steps:
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If you plan to use health insurance, fill out the insurance form for eligibility verification: INSURANCE FORM
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For out-of-pocket care, review the details by following this link: https://www.laureenrd.com/out-of-pocket-care
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Then complete the program pre-screening form: PROGRAM PRE-SCREENING FORM
Appointments will be scheduled after all documentation is received.