New Clients please note: You can opt to have your AEDRA Meal Support Coach share information with other treatment providers such as your dietitian by signing this Release of Information form and returning it to


Share Information With Your Coach Before Your Session


You are invited to share additional information with your coach before your session. 

This might be information such as:

  • The meal that you plan to eat
  • What you are working on and want to improve about your mealtime
  • Things that you are anxious about that you want support with while you are eating
  • Things that you would like to avoid conversation about
  • Any goals that you have for your meal support session. 

Please fill out the form below and submit. Please submit Share Information forms at least 8 hours before the start of your scheduled session. You are free to submit forms in less than 8 hours before your session, but AEDRA cannot gaurentee that your coach will recieve the information for late submissions. By submitting this form you are agreeing to allow AEDRA to share the information within this form with AEDRA coaches. 


Information to include with your message

Your Name

Your scheduled session time

Your scheduled coaches name

The message you would like your coach to receive before your session starts. 



Client Session Instructions for Coach

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