Anorexia & Bulimia Care
We are hoping to pilot a nutritional guidance service. To gauge the likely demand for this service, we would appreciate your views by answering this survey.

The survey asks for your email address and a few details about you. Please be assured this information will be treated confidentially and your answers/personal information will not be shared with any third party. They are, however, helpful to our understanding of who is interested in this service.


Sign in to Google to save your progress. Learn more
Email *
How interested are you in a nutrition guidance service? *
Not very interested
Extremely interested
Please tell us more about your answer - are there particular issues or questions that affect the answer you gave?
Below are some elements/services that could be offered. Which interest you the most? Tick as many as apply.
Although we would have to make a charge for this service, it will be at a subsidised rate. Bearing in mind nutritionists normally charge £45-75 per hour or more and based on the examples below, please indicate what you'd be willing/able to pay for each.
£15
£25
£35
£45 or more
Food diary review, ONE video consultation & general recommendations by email only
Food diary review, TWO video consultations, detailed recommendations discussed on video call
Suggested meal plan based on my needs/circumstances
Additional check-ins/nutritional support (post-consultation)
Clear selection
Do you have any comments or suggestions you'd like to add?
About you
Do you currently live with disordered eating or a diagnosed eating disorder? If so, please indicate below.
How would you describe your gender?
Clear selection
Please indicate your age bracket
Clear selection
Thank you, we really appreciate your help!
Please click Submit below to send us your completed survey.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms