Hi there! We are looking forward to getting to know you better — this form is the first step
What is your first name? *

Hi {{answer_44773317}}. What is your last name? *

What type of eating disorder do you have? *

What type of support do you think that you are most interested in right now?

Are you currently working with any other support {{answer_44773317}}?

If you are working with a treatment provider/dietician/doctor, we are happy to work alongside them too. If that is something you want, let us know and we can send more details on how that works

{{answer_44773317}}just to be sure, we want to check that you know AEDRA support is not therapy, and not a substitute for medical support, okay?

Okay, so how this works is that we will contact you (real soon!) and find you the perfect fit in terms of a coach and the type of service you want.

Is there anything else that you would like to tell us about you, or what it is that you really think you need in order to be successful in recovery?

Thanks for completing this typeform
Now create your own — it's free, easy, & beautiful
Create a <strong>typeform</strong>
Powered by Typeform