ARFID supplement info
Please take a moment to fill out this survey
Name
First Name
Last Name
IG Handle
Email
example@example.com
Phone Number
Please enter a valid phone number.
Please select what applies to your child:
Please Select
my child has ARFID
my child doesn't have a diagnosis, but I'm concerned about food intake
something else
Please share a little info about your child:
Rows
Strong ly Agree
Agree
Neutral
Disagree
Strongly Disagree
Eats plenty of proteins
Eats plenty of fruits & vegetables
Eats plenty of carbohydrates
Drinks plenty of water
Needs something for the nutritional gaps
Concerns with anxiety
Concerns with constipation
Concerns with immune system
Child's Age
2-5
6-10
11-14
15-18
18+
Anything else you would like to share with me about your child?
What about you? How are you feeling? Anything you need help with re: your health? Energy, sleep, stress, immune system, skincare, or overall wellness?
Submit
Should be Empty: