11. SCOFF Assessment

SCOFF Questionnaire

5 minute Eating Disorder Assessment Tool
Name

First NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate of birth
Email
example@example.com
Select your therapist
SCOFF Questionnaire

This is a screening tool that can be used to identify who may be at risk or have an eating disorder. Please answer all questions.

Rows	NO (0) points each	YES (1) point each
S. Do you make yourself Sick because you feel uncomfortably full?
C. Do you worry you have lost Control over how much you eat?
O. Have you recently lost more than One stone (14lbs) in a three-month period?
F. Do you believe yourself to be Fat when others say you are too thin?
F. Would you say that Food dominates your life?

SCOFF Questionnaire