EATING DISORDERS SUPPORT SERVICE SCOTLAND

Scotland's Leading Private Service for Eating Disorders

EATING DISORDERS IN SCOTLAND
ABOUT US
ABOUT EATING DISORDERS
EATING QUESTIONNAIRE
OVER 18s SERVICES & SUPPORT
DIETITIAN & NUTRITION SERVICES
CARERS & SUPPORTERS
PROFESSIONALS & ORGANISATIONS
PROFESSIONAL NETWORKING GROUP
THERAPY ROOM HIRE
THERAPISTS & PRICE LIST
APPOINTMENT BOOKING FORM
MAKE A REFERRAL
NEWS & EVENTS BLOG
FAQ
CONTACT

Are you ready to book an appointment? Then complete the easy peasy Appointment Booking Form below. Thank you!

If you have decided that you would like to access some one-to-one help and support, such as therapy, counselling and psychotherapy etc., and you are ready to go ahead with making an appointment, please complete the online Appointment Booking Form below.

If you are looking to access Group Support (e.g. Support Groups) or Professional Services, want more information about anything or have any questions please get in touch via the Contact page here. If you are an organisation making a Make a Referral Form , please see the Referral Form here.

We will respond to emails within 2-3 working days (excluding weekends). We reply to ALL emails, so if you haven't received a reply within that time, please check your spam folder or re-send your email.

Appointment Booking Form

Please ensure you complete all sections marked * as the form will not send if these sections are not completed. A message will appear below when your form has been sent to us successfully. We will ALWAYS reply to your email, so if you don't get a reply within 2-3 working days, please check your spam folder or re-send your email. Thank you.

Subject *

First Name *

Surname *

Date of Birth *

Email *

Please re-enter your email address. *

Full Home Address and Postcode (we are unable to book an appointment unless we have a full home address) *

Contact Telephone Number *

Emergency Contact Name *

Emergency Contact Telephone Number *

Relationship to Emergency Contact (e.g. wife, son, mother, friend etc.) *

Have you previously had therapy or counselling? If you answered 'yes' please provide some details below **. Thank you. *

Yes

**Details

Have you previously accessed support with a dietitian (please only answer this question if you are seeking dietetic services).

Do you have any health problems for which you are currently receiving treatment? If you have answered 'yes' or 'awaiting treatment', please provide some details below **. Thank you *

Yes

Awaiting Treatment

** Details

Are you taking any medication at present? If so, please list these below, including dosage and what the medication is for**. Thank you *

Yes

** Medication Details

GP/Doctor's Details (please include GP name, address and telephone number). While we will not contact your GP/Doctor, we do require these details in the event of an emergency. We are unable to book an initial appointment without these details as we require these for safeguarding reasons. Thank you *

Please provide some brief details of what problems, concerns or issues you are seeking help and support with. *

What would you like to achieve from therapy, counselling or psychotherapy? *

If you are seeking support with a dietitian, please say a little bit about what would you like to achieve from dietetic and nutrition services (only complete this question if you are seeking dietetic support).

Please select which service(s) you would like to enquire about. If you are ready to make an appointment, please complete the BOOK APPOINTMENT FORM on this website instead. Thanks *

CBT (Cognitive Behavioural Psychotherapy)

Integrative Psychotherapy

CBT-T ED (10- session CBT programme for non-underweight eating disorders)

General/Humanistic/Person-Centred Counselling

Clinical Hypnotherapy

Solution Focused Brief Therapy

Guided CBT Self-Help (with a therapist)

Stress Management Therapy/Coaching

Life/Personal Coaching

Rewind Trauma Therapy Technique (3 session programme)

Grief and Bereavement Therapy and Counselling

Trauma Therapy

Couples Counselling and Relationship Therapy

Online Therapy and Counselling

Group Therapy (only available if we have 5-6 people attending every 2 weeks)

Dietitian and Nutrition Services (this service is only available if you are also working with a therapist here or elsewhere)

Carers and Supporters Therapy and Counselling

Any approach is suitable

Not Sure

Other (please specify below**)

** Other

Appointment Preference: when would you prefer appointments to take place? Appointments are subject to availability. *

Morning

Afternoon

Evening

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Any Day/Time

Other (please specify below**)

** Other

Do you have a therapist preference? Please tick all that apply (there are mini-bios of each therapist on the Price List page) *

Alexandra (Lead/Senior Accredited Psychotherapist and Clinical Director)

Amanda (Advanced Therapist and Counsellor)

Jackie (Therapist and Counsellor)

Liz (Advanced Therapist and Counsellor)

Jenny (Dietitian)

Natalia (Therapist, Counsellor and Coach)

Sue (Therapist and Counsellor)

I have no therapist preference and can work with any therapist

Appointment Format: please select your appointment preference. *

Face-to-face/In-Person

Online

I am happy to access either face-to-face or online appointments

Are appointments going to be funded by your insurance/EAP/rehabilitation/workplace company? These are more expensive due to additional work involved. We will require a formal letter from the funder declaring funding. *

Yes

Maybe (please specify below**)

** Details

If you would like to make us aware of any special/preferential needs/requirements in relation to your appointment, please use the space below. Thank you

Feel free to include any additional information or details you think are important for us to know. Please note that all information included in this form is confidential.

I want to join the Mailing List (to receive news, updates, events, offers etc.) *

Yes

How did you find out about us? *

Search Engine (e.g. Google, Yahoo etc.)

Word-of-Mouth

Beat Listing

Other professional (e.g. GP, therapist etc.)

Family/Friend

Workplace

Counselling Directory

Recommendation

Social Media (e.g. Facebook, Blogger, Twitter, Linkedin etc.)

Other (please specify below**)

** Other

How would you like us to respond to this initial email? (Please note that if you choose 'text', we will text you to let you know we have received your enquiry and then we will send you an info-email with all the relevant information you have requested). *

Text

Both

I understand that emails can go to the Spam folder and I will check the spam folder if I haven't received an email within 2-3 working days (not weekends). We will ALWAYS reply to your email). *

Yes

Thanks again for your enquiry and for getting in touch. We just want to double-check that we have permission to contact you via (please tick all that apply): *

Text

Both

Other (please specify**)

** Other

Message (please feel free to write any other information you wish to provide)

some-randome-random

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Address:

Talking EDs (Eating Disorders Support Service Scotland), Glasgow Therapy Rooms, Fitzgerald Room, Isherwood & Orwell Rooms, Regent Business Space, 2nd Floor, Left Wing, 180 West Regent Street, Glasgow, G2 4RW

support@eatingdisorderscotland.co.uk

Home

About Us

About Eating Disorders

Eating Questionnaire

Over 18s Services & Support

Dietitian & Nutrition Services

Carers & Supporters

Professionals & Organisations

Professional Networking Group

Staff Support Service
Therapy Room Hire

Price List

Appointment Booking Form