Eating Disorder Screening Form
About this free form template

Screen for Eating Disorders with a Professional Assessment Form

Eating disorders affect millions of people worldwide and early detection is critical for effective treatment and recovery. This eating disorder screening form provides healthcare providers, counselors, and wellness professionals with a comprehensive assessment tool that combines validated screening instruments with practical questions about nutrition and body image concerns.

What's included in this template

This template incorporates the widely-used Eating Attitudes Test (EAT-26) questions along with body image assessment items and nutritional risk factors. The form helps identify warning signs across the spectrum of eating disorders, including anorexia nervosa, bulimia nervosa, binge eating disorder, and other specified feeding or eating disorders (OSFED).

The screening covers critical areas including:

  • Attitudes toward eating, food, and weight
  • Body image perception and satisfaction
  • Restrictive eating behaviors
  • Binge eating patterns
  • Compensatory behaviors
  • Physical symptoms and health impacts
  • Psychosocial functioning

Perfect for healthcare providers and wellness professionals

Whether you're a therapist, dietitian, primary care physician, school counselor, or wellness coach, this form helps you gather essential information before an initial consultation. The pre-visit format saves valuable appointment time and allows you to review responses beforehand to better prepare for the conversation.

Paperform makes it easy to collect sensitive health information securely while maintaining a supportive, non-judgmental tone. Customize the questions to match your practice needs, add your branding, and embed the form directly on your website or send via a private link.

Streamline your screening process with automation

Connect this screening form to your existing workflows using Stepper, Paperform's AI-native workflow builder. Automatically route high-risk responses to urgent follow-up lists, send personalized resource emails based on screening scores, update your EHR system, and schedule follow-up appointments—all without manual data entry.

For practices requiring signed consent or treatment agreements following screening, Papersign seamlessly converts form responses into professional documents ready for eSignature, keeping everything connected and compliant.

Paperform is SOC 2 Type II compliant and provides secure data handling for sensitive health information, though please note it is not HIPAA compliant. This template helps you deliver compassionate, evidence-based care while reducing administrative burden and ensuring no one falls through the cracks.

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