Introductory Assessment

Client Assessment Form

Thank you for dedicating time to fill out this questionnaire. Your responses will guide our discussion, allowing us to delve deeper into your needs and determine the support required to help you achieve your goals.
Part B: Are You An Emotional Eater?
1. Do you eat more than you would like to when you have negative feelings, such as anxiety, depression, anger, or loneliness?
2. Do you have trouble controlling your eating when you have positive feelings – do you celebrate feeling good by eating?
3. When you have unpleasant interactions with others in your life, or after a difficult day at work, do you eat more than you would like?
Part C: Could It Be Binge Eating?
1. During the last 3 months, did you have any episodes of excessive overeating (i.e., eating significantly more than what most people would eat in a similar period of time)?
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