Sinnergy Wellness Group
R · E · S · T · O · R · E    MNT
Family Agreement · Pediatric
Weekly Check-in — Family Guide
For families with a child or teen in eating disorder treatment
Kristine Sinner, MS, RDN/LDN, CEDS-C · NPI 1073918116 · (480) 382-6109
Please read carefully before signing
A weekly check-in is something Kristine may recommend during your child’s care, not a universal requirement. This document explains what a check-in involves and the family commitment it asks of you, so that if she recommends one, you can make an informed decision together. After reading, indicate your response below — accept, defer, decline, or ask for more discussion in session. Every path notifies Kristine. If you accept, both parents or guardians must sign.
How the Weekly Check-In works
This page is your family’s consent to the Weekly Check-In — not the check-in itself. If Kristine and your family decide it’s part of your child’s care, her team will upload a fillable check-in to your Healthie portal each Monday. You fill it in together during the week and return it through Healthie, email, or bring it to the next session before you meet.
1
A letter to your family
This isn’t something your child does alone

One of the things I most want families to know, coming in, is that your child’s recovery is a family project, not a solo one they’re supposed to work out on their own. The research on this is remarkably clear: kids and teens whose families are in it with them recover faster, more completely, and with fewer relapses than kids left to carry it alone. That’s not a comment on any child’s strength. Food is one of the most basic ways a family loves each other, day in and day out — it makes sense that healing it takes all of you.

If I suggest a weekly check-in for your child at some point, it’s one of the ways we stay connected to what’s really happening between sessions — how meals went, how they felt, how their body’s answering back, what the eating disorder tried to do. When I can see the real picture, I can catch small things before they grow, adjust quickly, and spend our time on what matters most for your child.

2
Why your child needs you in this
This isn’t about willpower or maturity

Here’s something I want to say gently but clearly: a child or teen with an eating disorder isn’t in a position to run their own recovery, and that isn’t a character flaw. Most kids won’t fill out a check-in reliably on their own, and some will avoid it entirely. Please know: that is expected. It’s not your child being defiant or lazy or unmotivated. It’s the eating disorder doing what eating disorders do — hiding, quieting, minimizing. Your child is not the problem.

So your job here isn’t to force compliance or turn into the food police. Your job is to hold the structure so the check-in gets done. That can look like sitting next to your child while they fill it in. It can look like doing it together, based on what you observed that day. It can look like you filling it in yourselves on the days your child just can’t. All three are completely fine. An honest check-in from you is far more useful to me than a blank or softened one from a child too sick to tell me the truth.

3
Day-to-day
What this looks like at home
  • Find the same quiet window each day — often right after dinner — for a 3–5 minute check-in. It doesn’t need to be long. Just consistent.
  • Sit together. Walk through the day’s meals and snacks. What was eaten, how much, how it went.
  • Write down what you observed as the parent. If your child refused a meal, minimized a symptom, or had a hard moment, please write it honestly. I need the real picture, not the tidy one. You aren’t getting them in trouble — you’re helping me help them.
  • Leave the reflection page to your child to fill in privately. That page is their space. Please don’t pressure it, read over their shoulder, or ask them to justify what they wrote.
  • Send the check-in to me at kristine@sinnergywellness.com before your child’s next appointment.
4
If the family has two homes
Both households, one direction
Why I ask both households to be part of this

One of the hardest truths about eating disorder recovery is that your child needs the adults in their life rowing in the same direction, even when the adults aren’t under the same roof. When one household is holding the recovery structure and the other isn’t, the eating disorder finds exactly the inconsistency it needs to keep going — even when both of you love your child deeply and want them well.

I know this chapter of family life can be painful, especially if the separation itself is still raw or if things between the two of you are tender. I’m not going to pretend that’s simple. I’m not asking you to agree on parenting philosophy, or on anything else between you. I’m just asking you to agree on this one thing: during recovery, your child needs both homes holding the same rhythms around food — check-in included, in whichever home your child is in that week.

If that kind of cooperation genuinely isn’t possible right now, please tell me. We’ll find a way forward together. Both parents signing below just means you’ve heard this, you understand the why, and you’re willing to work within it for your child — whatever your relationship with each other looks like.

5
A note just for you
If you’re the young person reading this

Hey. If you’re the person this is all about, I want to say a few things to you directly.

Your parents are involved in this because they love you, and because I asked them to be. It’s not because you’re a little kid, and it’s not because I don’t trust you. It’s because eating disorders work really, really hard to isolate the person who has them — to make you feel like you’re alone with it, like no one else sees it, like it’s just yours to carry. We’re not going to let yours do that. Your team — your parents, your therapist, your doctor, and me — we’re all on the same side. Yours. The check-in is one of the ways we stay in touch with each other between our sessions.

You don’t have to do the check-in alone. You don’t have to do it perfectly. What you do need to do is pretty simple: don’t lie on it, don’t hide it, and don’t let the ED erase things from it. That part matters. Everything else, we can work with.

The reflection page is yours. Seriously. Write whatever you want there — your parents don’t need to read it, and I won’t share it with them without asking you first. That’s your space. You can use it for anything — stuff you’re proud of, stuff you’re scared of, questions you want to bring to our next session. Or just a sentence. You don’t have to make it good.

Your response to this recommendation
A check-in is not required for every client — We will discuss whether it’s right in this phase of care. Please indicate our response below. Kristine will be notified of our choice either way.
✓ Yes — let’s do this together
We’ve read through, it sits right with us, and we’re ready to check the boxes below and sign.
⏸ Not yet — we’d like to wait a little
Something in our family isn’t ready for this step right now. We’d like to come back to it later, when things feel more settled or when we and Kristine agree the timing is right.
✗ Not right now — we’d rather not start a check-in
We’ve read this through and it’s not the right fit for our family at the moment. We’d like to keep working with Kristine in other ways, and she can reach out so we can talk.
💬 We have questions — let’s talk about it first
We’re not ready to say yes or no yet. We’d like to bring this to our next session and hear more.
What we’re agreeing to together
If your family is saying yes to the check-in, tap each one below to let me know you’ve read it and it sits right with you. All five before you send.
✓
We’ve read through the sections above, and we have a sense of how the check-in will be used, why family is part of it, and what that means for us.
✓
We’ll hold a consistent daily check-in to complete the check-in with or for our child, and send it to Kristine before each session.
✓
We’ll record honest observations, including the days our child refused a meal or minimized something. We understand the real story helps more than the tidy one.
✓
If our family has two homes, we’ll have both households completing the check-in consistently during the weeks our child is with each parent — regardless of what’s between us as parents.
✓
We’ll respect our child’s private reflection space and won’t pressure them to share what they write there.
Parent / Guardian 1 — your signature
Whichever of you is filling this out first.
Co-habitating parent
Non-custodial parent
Legal guardian
Other
Sign below with your finger (on phone) or mouse (on desktop). If you mess up, just tap “Clear” and try again.
Parent / Guardian 2 Signature *
Both parents must sign — including if separated or divorced. If truly single-parent and no second guardian exists, type “N/A” in the fields and leave the signature blank; we will discuss in session.
Your child’s signature
If your child is willing, they sign here to show they’ve heard the section written to them. If they’re not ready to sign, that’s okay — we can leave this blank and it won’t stop anything.
If the client is unable or unwilling to sign, leave blank — this is not a requirement to proceed.
This stays in your child’s chart with the rest of our work together.
R.E.S.T.O.R.E. MNT · Sinnergy Wellness Group
8700 E. Vista Bonita Suite 236 · Scottsdale, AZ 85255 · (480) 382-6109