ARFID (Avoidant Restrictive Food Intake) Intake
ARFID (Avoidant Restrictive Food Intake) Intake
Intake for Avoidant/Restrictive Food Intake Disorder evaluation in children and adults.
Patient Information
Patient name *
Your answer
Date of birth
Form completed by
Eating Pattern History
Age restrictive eating began
Primary reason for food avoidance
Sensory aversion (texture/smell/look)
Fear of choking/vomiting/allergic reaction
Lack of interest in food
Combination
Approximate number of foods regularly accepted
+ 11 more questions
About this template
Intake for Avoidant/Restrictive Food Intake Disorder evaluation in children and adults.
How does it work?
Click Use template. We'll drop a copy into your Formswrite workspace - no setup needed.
Tweak the questions, branding, and logic to fit your workflow. Add your logo, colors, and cover image.
Publish and share the link, embed it on your site, or drop it into a chatbot widget. Responses stream straight to your dashboard.