questionnaires

• We ask our clients and/or their families to collect data before seeing us.
• This saves time and your costs and increases quality and   accuracy of the assessment we can provide.
• First please complete the online  referral form which will be sent directly to us by e mail and will start the process. 
• We will then contact you to let you know if we think can help or not and may offer an appointment.
• If we do not think we can help we will try to offer advice on who can.
• If an appointment has been offered please  complete additional questionnaires  and post them to Starfish Clinic, 215, Ponsonby Rd, Ponsonby, Auckland or bring them with you when you come to see us at the Auckland or Whangarei rooms. 
• If you have reports from previous assessments, therapies or treatments please have them copied for us and bring them along too.
• For children and young people at school COPIES of their reports will be very useful.

To be completed by anyone requesting services from Starfish

Please complete the online form for all referrals and requests for services at Starfish by clicking here; Referrals

The following questionnaires should also then be printed off, completed and posted or brought along with you for the appointment; 

Developmental questionnaire (MSWord.doc 282kb)
This is for parents/carers to complete about the child or young person on there early development. This is often also very useful for adult clients to get completed if possible.
 Consent form (MSWord.doc 157kb)
For access to past medical/psychological/educational information. 

To be completed for children and young people still at school or of school age

School Report Form (MSWord.doc 288kb)
This should be taken to the school and child/young persons teacher/head of year complete and return to us at Starfish. Required for all children and young people still at or recently at school.
Attentional difficulties questionnaire (MSWord.doc 178kb)
Where concentration and academic difficulties have been a problem.  
Strengths and difficulties questionnaire (link to another site)
For all children and teenagers. This is an online form on the YOUTHINMIND website in the UK. A report on the form will be sent to you immediately from the site. You can print this off and send to us at the address above.
Depression screening questionnaire.
For when there may be mood problems in children and young people. This is an online self scoring questionnaire.

For particular kinds of symptoms;

Adult ADHD Syndrome
Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist
Hamilton Anxiety Scale
This is an adult anxiety rating scale.
Social functionning questionnaire (MSWord.doc 167kb)
This form is for use if social skills or social functionning is a problem. 
AQ test is a measure of the extent of Autistic Traits in Adults

Screening Questionnaires for Asperger's Syndrome.
This takes you to Tony Attwood's Site. Go to home page then 'Diagnostic Scales' in the left hand menu. There are several  self or family completed questionnaires that can be completed here which are very useful . Once again, the more information you give us the better job we can do.
 Post Traumatic Stress Disorder check list
Check list for anxiety symptoms if you have been involved in a traumatic event.