River Centre Clinic - Forms

In order to complete one of the assessment form packets, you will need a username and a password.

Phone 419-885-8800 or 1-877-212-5457 (toll free) or e-mail the Intake Department at info@river-centre.org.

The staff of the River Centre Clinic is committed to improving the services we offer to people who have eating disorders. We continually evaluate and update our treatment approach based on feedback from people who have received our services. Your completion of assessment form packages before admission, after discharge, and at follow-up is an essential part of the treatment process.


Forms
Click A, B or C below and enter your password:
Initial Information Form
Eat-26 Self Test

Assessment Forms:
The information from these forms pertains to your current situation, current eating problems, current medications, and various questions about your overall emotional and physical health. It is important to respond with your first thoughts and not worry about "looking good" or answering questions in a way that you think they "should" be answered. It is important that your answers reflect your real feelings, thoughts, and behaviors since the information gathered will be important in determining your initial treatment goals and response to treatment.

Confidentiality of Records:
The information obtained on this follow-up questionnaire package will be kept as part of your confidential clinical record and will only be released to an outside source if you give permission for the release of your medical information.

 
 
 
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