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How much is binge eating negatively affecting your quality of life?
Not at all
Somewhat
Very affected
Extremely affected
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Over the past 2 weeks, how often have you binged or felt out of control around food?
Not at all
Several days
More than half the days
Nearly every day
Multiple times a day
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Have you read our books or been on a program before?
Yes, I've read The Binge code
Yes, I've read The Bulimia Help Method
Yes, I've had coaching before
Not yet
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How would you like to communicate with your coach?
Mostly via email
Mostly via phone or video sessions
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