Binge Eating Disorder Group Interest Survey
Thank you for helping us decide when to hold the DIET RIOT! goup. We appreciate your time!

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Email address *
How many clients (patients) do you have who may benefit from a BED treatment group?
First choice day/time combination
Please let us know when your clients (patients) might most like to attend a BED treatment group.
9am - 1pm
4pm - 8pm
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Second choice day/time combination
Please give us an alternate time your clients (patients) may be able to attend a BED treatment group.
9am - 1pm
4pm - 8pm
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
How soon would your clients (patients) wish to begin a BED treatment group?
Any info you'd like to add or questions you'd like us to answer?
Be sure to include your number if you want us to call you!
Your answer
Spam-Catcher Question
To ward off the robots!
In what city is Bright Road Recovery located?
Your answer
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