This is a screening measure to help you determine whether you might have an eating disorder that needs professional attention. Rate your agreement with each statement on the scale from “Always”, “Usually”, “Often”, “Sometimes”, “Rarely”, to “Never”. This screening measure is not designed to make a diagnosis of an eating disorder or take the place of a professional diagnosis or consultation. Please take the time to fill out the below form as accurately, honestly and completely as possible. All of your responses are confidential.