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Intuitive Eating Group Application
Group for adults to learn about intuitive eating principles and apply them while receiving professional and peer support. Group facilitated by experienced eating disorder therapist, Jennifer Bullock, LPCC.
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Email
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Your email
How did you hear about this group?
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Friend recommendation
Doctor/therapist referral
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What would you like to get out of this group?
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Your answer
Are you familiar with intuitive eating?
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Yes
No
Do you have/have you had a diagnosed eating disorder?
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Yes
No
Other:
If your answer to the above question is yes, please give a brief description of where you are in the recovery process?
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Who is completing the survey?
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Provider (i.e. therapist, dietitian, doctor, etc)
Prospective Participant
Other:
Age of Prospective Participant
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Your name
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Your answer
Phone number
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E-mail
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Your answer
Are you currently working with an individual therapist?
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No
Questions and comments
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