Template library · Assessments & screeners
Body Image & Relationship with Food template
Explore the client's relationship with food, body image, and eating behaviors.
Qualitative assessment of body image and eating patterns
- 12 fields across 3 sections
- Included with MyWellOps
- Edit it, or save your own version
What’s in it
Assessment Details
- Client NameText
- Date of BirthDate
- Client ID / MRNText
- Date of AssessmentDate
- Clinician / CoachText
- Location / ModalityText
Assessment
- Client's description of relationship with foodText
- History of dieting or weight cyclingText
- Body image concernsText
- Impact on social and occupational functioningText
Signatures
- Clinician SignatureSignature
- Date signed (clinician)Date
When to use it
Use an assessment at the start of work to set a baseline, then repeat it at review points so you and the client can see what has changed.
How it works in MyWellOps
- Pick it from Documents.
- Send it to the client to complete, or fill it in together during a session.
- Each completed copy is kept on the client’s record, so earlier results are there to compare.
Spend less time on admin, more time with clients
Start free. Cancel anytime, and your data comes with you if you leave.
Would rather be shown? Book a 20-minute demo
- Free 1-on-1 onboarding
- 7-day free trial
- Cancel anytime