7 days SMP Challenge - Initial Assessment
Name
*
Phone
*
Your Age
*
Occupation
*
1. Are you a Binge eater OR Emotional eater
*
2. What is it that leads you to binge eating / emotional eating
*
3. How long have you been facing the challenge of binge eating / emotional eating
*
4. What all have you tried till now to overcome binge eating / emotional eating
*
5. Why is it important for you to get over binge eating / emotional eating
*
6. What is the most important thing in your life right now
*
7. What do you want in your life 5 yrs from now
*
8. What time would you prefer for live event
*
3pm - 5pm
6pm - 8pm
Δ
>