Declared Eating Difficulties (Eating Disorder/Disordered Eating)

Further Information

Thank you for declaring your eating difficulties (current or past) on your registration form. We would like to understand more about your eating difficulties to ensure we are offering you the best support we can.

Please complete this form even if you feel you have fully recovered from your eating difficulties.

Declared Eating Difficulties

Patient's Details

Eating Difficulty Questions

Eating Behaviours

Below are some examples of behaviours that people experiencing eating disorders and disordered eating may report. Please indicate below whether you have been affected by these behaviours, currently or in the past, and provide brief detail where possible.

Weight History

Please include an approximate date for any reported measures. Measures can be provided in imperial or metric units. If you are not sure exactly then please provide an estimate where possible.

Physical Symptoms

Please indicate below whether you are experiencing or have previously experienced any of the following physical symptoms. Please provide brief detail where possible. This helps us to understand how your eating difficulties may affect your physical health.

Thank you for sharing this information and for taking the time to complete this form. This will be reviewed by our clinicians who may invite you in for a physical health check and/or GP appointment. If you have or develop any concerns around your physical or mental health during your time at university, please book an appointment with a GP.