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Eat Love Live Pre-assessment questionnaire

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Purpose

It is wonderful that you are considering engaging with a dietitian at Eat Love Live. This form is optional and you do not need to complete it if you would prefer not to.

This form has been designed with two purposes in mind:

Firstly, if you are unsure which dietitian would be the right fit for you Jo Money, Eat Love Live Clinical Director, will review the information you have provided and make a suggestion.

Or, this is an opportunity for you to provide some pre assessment information for the dietitian you are going to see.

There may be lots of information you wish to share with the dietitian and are worried it won't all be covered in the initial session. Or, you may be worried you might forget something.

Reflecting on your answers before the session may help you to develop a clearer understanding of the goals you would like to work on with your dietitian.

If you are worried that reflecting on your medical, dietary or mental health history may be distressing or triggering in any way then please know that it is ok not to fill in this form.

The information can all be gathered by your dietitian in the initial consultations in a supportive manner to avoid undue stress.

Privacy

This form will be stored in your medical record and viewed only by your dietitian. This form will only be viewed by Jo Money, clinical director for Eat Love Live, if necessary for the purposes of triage or allocation to the correct file.

You will complete a New client information form prior to your session which will gather all the relevant personal information, next of kin etc. This will be provided to you by reception and includes further information about privacy and confidentiality.