Recovery Day Application

How did you hear about us?

If no, please specify how you would prefer for us to communicate with you?* (e.g telephone, email, Whatsapp text, Whatsapp video, text message)

Are you happy to speak to us via Zoom to learn a bit more about you and answer any questions you have? (Yes / No)*

A recovery day includes in-person support with a specialist and a comprehensive plan following. Are you ready to invest in your recovery?

Are you interested in a recovery day, weekend experience or longer programme?* 

What makes you most excited about this experience?*

Are you currently receiving treatment for an eating disorder? If so please specify.*

Where is your approximate location? So we know if we can make it to you in-person* 

What would you like to gain from your recovery coaching day?*

Please share a little about where you are in your recovery journey.*

Email Address*

Phone Number*

Age*

Full Name*