Intuitive Eating Virtual Small Group Questionnaire

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This is a 12-week small group coaching experience to help you heal your relationship with food and your body, ditch dieting for good, get back to trusting yourself around food AND enjoying the foods you actually like!

Group is held via pre-recorded modules & online live video sessions (recordings will be provided if you are unable to attend live). The next group begins Summer 2022.

Please provide your first and last name. *

Please provide your age *

How did you hear about this group? *

Have you heard of Intuitive Eating before? *

Yes

Have you read the book Intuitive Eating before? *

Yes

What inspired you to apply for this group? What are you hoping to gain from this group and learn about Intuitive Eating in a small group setting? *

Tell me about your previous experience with dieting. *

Have you been diagnosed with an Eating Disorder or do you currently exhibit symptoms of an ED such as purging or severe food restriction? *

Yes

If you answered Yes to the above Eating Disorder question, please explain.

In addition to the program fee ($674 - payment plans available), you commit to buying the Intuitive Eating book and reading ~1 chapter each week and attending the live group sessions as much as possible to create an engaging and supportive group experience. *

Yes

Do you understand this is not individualized nutrition coaching or counseling (although that is a service I provide and is an option for you to do separately from this group program)? *

Yes

Please note: This group coaching program is not appropriate for someone struggling with an active eating disorder (i.e. those who are engaging in behaviors such as purging, or those who are engaging in severe food restriction). If you have an active eating disorder, please see the National Eating Disorders Association for referrals instead.

Please share anything else that would be helpful for me to know about you! *

What is your email address? *

Thank You

Thank you. I will be in touch shortly.

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