FREE Eating Disorder Survey | Confidential Assessment

Alsana's FREE, confidential eating disorder assessment survey

Eating disorders impact people of all genders and body types. If you or a loved one are struggling, this survey can help determine if treatment may be right for you.

Step 1 of 13

Do you attempt to restrict calories or foods ? *

Do you make yourself sick because you feel uncomfortably full? *

Do you struggle with thoughts of killing yourself? *

Do you struggle with self harm behaviors? *

Do you consume alcohol? *

Do you use recreational drugs including cannabis products? *

Have you experienced trauma in the past that has contributed to behaviors or thoughts about food and your body? *

Do you have any medical complications related to your eating disorder? *

Have you ever had abnormal lab work? *

Are you currently working with an outpatient therapist or provider? *

Have you ever gone to the emergency room or been hospitalized for your eating disorder? *

Are you having any difficulties in the following areas? *

What are your treatment plans? *

Call 911 immediately

If you or someone you know is having a psychiatric emergency or a suicide attempt is likely, please CALL 911 IMMEDIATELY.

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