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CCSW Intake Form

This field is for validation purposes and should be left unchanged.
DD slash MM slash YYYY
DD slash MM slash YYYY
The eating disorder my loved one struggles with currently, is best described as…?(Required)
I understand the Collaborative Care Skills Workshop is not a therapeutic program or a replacement for therapy, treatment or crisis intervention.(Required)
I confirm I can commit to a weekly 2-hour session for 5 consecutive weeks (from May 18), plus a follow-up session four weeks later.(Required)
Would you like to receive marketing and promotional emails from EDFA about our services, events, resources, campaigns, and news?

By submitting this form, you consent to EDFA storing your details securely for the purpose of contacting you about CCSW and creating a client file in our secure system.