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 an eating disorder? *
Have you ever had abnormal lab work? *
Did a therapist, doctor or dietitian recommend that you seek treatment? *
Have you ever gone to the emergency room or been hospitalized for conditions related to an eating disorder? *
Are you having any difficulties in the following areas? *
What are your treatment plans? *
If you or someone you know is having a psychiatric emergency or a suicide attempt is likely, please CALL 911 IMMEDIATELY.
