National Alliance for Eating Disorders Psychological Services Intake Questionnaire
Welcome to the National Alliance for Eating Disorders' Psychological Services. Please complete this New Client Intake Form BEFORE your first therapy session.

Please note: the information you provide is protected as confidential information. It is important that your therapist receives accurate information, so please provide as much detail as possible. Please complete this information when you have the opportunity to do so in a comfortable, private space. This form may take approximately 30-45 minutes to complete in its entirety.

If you have any questions, please write them down and address them the next time you speak with a team member from The Alliance. You can also call 561-841-0900 or visit
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