Clinical Questionnaires


Complete a Form Online

notepad used for clinical questionnaires

If your clinician has asked you to complete one of the questionnaires below, you can do so securely online. Each form is sent directly to our clinic team, it is not stored anywhere else, and your responses will only be used to support your care.

IES-R

Impact of Event Scale – Revised

22 items measuring intrusion, avoidance and hyperarousal symptoms related to a specific stressful or traumatic event, over the past seven days.

ACE

Adverse Childhood Experience Questionnaire for Adults

10 categories of difficult childhood experiences. Your ACE score is simply the number of categories you experienced before age 18.

DASS-21

Depression, Anxiety & Stress Scales

21 items measuring symptoms of depression, anxiety and stress you've experienced over the past week.

PCL-5

PTSD Checklist for DSM-5

20 items measuring how much you've been bothered by PTSD symptoms, in relation to your worst stressful experience, over the past month.

DES-II

Dissociative Experiences Scale

28 items measuring how often you experience dissociation in everyday life, using a 0–100% slider for each item.

K10

Kessler Psychological Distress Scale

10 items measuring how often you've felt symptoms of anxiety and depression over the past 30 days.

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