(2025) LoCSA Feedback Survey

  • Feedback Survey

    Level of Care Self-Assessment for an Eating Disorder (LoCSA)

  • Thank you for completing the Level of Care Self-assessment for an Eating Disorder (LoCSA). Now that you have reviewed your recommendations, we kindly ask that you complete the following feedback survey.

  • Consent- REMOVED

  • We would like to know how we can use your feedback. There are two ways your feedback can help us: 

    1. Program Evaluation or Research: Your responses will be de-identified (stripped of your personal information) and combined with others for analysis. 

    2. Promotional Use: Anonymous comments may be used in promotional materials and reports to help others learn about this tool. 

  • May we use your feedback in program evaluation or research efforts?
  • May we use your feedback in promotional materials, either online or in print?

  • Your Experience

  • How did you learn about the self-assessment?
  • Rows
  • When you reviewed your recommended level of care, did it feel accurate to you?
  • Overall, did you find the self-assessment helpful?
  • In what ways was the self-assessment helpful for you? (Select all that apply)
  • Do you plan on discussing your self-assessment results with a healthcare provider?
  • Has completing the self-assessment influenced your use of emergency services (e.g., emergency department) in any way?
  • Do you give us permission to use your feedback comments in our publication materials, either online or in print? All comments are anonymous and, if used, would be cited as "participant comment.”*
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