The following is a comprehensive Eating Disorders questionnaire. The information collected in this document can greatly aid Adolescent Growth in conducting a comprehensive history of your child’s eating disorder. Your participation in this assessment gives us the information necessary to provide your loved one with the best diagnostic assessment possible. The process will require an hour or less of your time. Please answer as accurately and completely as possible.

Some of the questions will seem quite personal, but it is important that they be answered completely. No one has a perfect memory; but do the best you can in answering the questions accurately. It is especially important to have approximate dates for any previous treatment, for any psychiatric medication that has been taken, start and stop dates as well as dosages are needed. Month and year will do in most cases.

The form will be sent to our Admissions Specialists who will get back to you by the next business day.

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