In Charge Eating Application

As this is group coaching and not 1:1 medical nutrition therapy, I really want to be thoughtful about making sure I am the best fit for what you are after - this is why I invite you to make an application.

There is absolutely no obligation for you to take your application any further than us just having a chat. Making an application is simply you, raising your hand to let me know that In Charge Eating resonates and you think it might be helpful for you.

You are not locked into joining and if after chatting you decide now is not the right time for you, I’m happy to share any other resources or point you in the direction of supports that might be a better fit for you right now - whether that is something that I offer within Feel Good Eating or with another clinician.

Please take a few minutes to complete the form below, sharing as much as you feel comfortable, so I can learn more about you.

What is your first name?

What is your last name?

What is your email address?

Tell me a bit about your current relationship with food and body, and what you are hoping to get out of working together for the next six months? How do you think In Charge Eating can help? (The more detailed the better)*

If you have an active eating disorder, please tell me more about your diagnosis, symptoms and treatment.

In Charge Eating will be a shaming, judgement, numbers, weight and diet-talk free zone. Will that work for you?*

A

Yes

B

No

Please select below your readiness for starting the In Charge Eating group program*

A

If we sound like a good fit, I am ready to get started and want to secure my spot ASAP. Please just send me details on how to do this.

B

I’m really interested but I’ve got some questions/want to chat with you first.

C

I know I want to have a better relationship with food but I’m not sure if this is right for me, can we talk?

If you’ve got questions or want to talk more, what’s your preferred method?

A

Hop on a Zoom call

B

Email

C

Direct Message

D

No questions - I'm all good!

Are you an existing In Charge Eating self-study student? If so, what email address did you use to join? (I want to make sure I get you set up with your discount!)