The Grounded Table
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Reason for care
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Appointment info
2
Prescreener
Reason for care
3
Contact information
What is the reason for seeking care?
Anorexia nervosa
ARFID
Binge eating disorder
Food addiction
Disordered Eating
PCOS
Diabetes
Substance abuse recovery
Weight and metabolism
Altered lipid labs
General nutrition
Other
What mental health concerns or treatment have occurred in the past?
In therapy now
In therapy in the past
I've seen a dietitian in the past
Taking psychiatric medication now
Hospitalized for mental health reasons now or recently
Hospitalized for mental health reasons in the past
Known neurologic or genetic disorder
Attempted suicide in the past
None of these apply
Additional information:
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If you or others are in immediate danger or experiencing a medical emergency, call 911 immediately.
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