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New Patient Pre-appointment Questionnaire

New Patient Pre-appointment Questionnaire

If you have an initial appointment with one of our Doctors or Allied Health Professionals below, you are required to complete a New Patient Pre-appointment Questionnaire. 

The questionnaires are in PDF format (unless specified), please complete the questionnaire electronnically or by hand, and upload the completed questionnaires in PDF format to your Patient Portal AT LEAST 7 DAYS prior to your initial appointment, otherwise your appointment will be cancelled by the clinic.

Doctor

Dr Charles Chan Mind Oasis Clinic

Consultant Psychiatrist
Dr Charles Chan

Adult ADHD Questionnaire (For patient)
(For Adult ADHD Patients to complete)

 

Adult ADHD Questionnaire (For Parents or Relatives)
(For Parents or Relatives to complete)

Dr Sukumar Rajendran Mind Oasis Clinic

Consultant Psychiatrist
Dr Sukumar Rajendran

Adult ADHD Questionnaire (For patient)
(For Adult ADHD Patients to complete)

 

Adult ADHD Questionnaire (For Parents or Relatives)
(For Parents or Relatives to complete)

Dr Clint Pistilli psychiatrist Mind Oasis Clinic Strathfield

Consultant Psychiatrist
Dr Clint Pistilli

(All of the below questionnaires are google documents, please complete it electronically and the results will be sent to Dr Pistilli directly.)

FOR INTELLECTUAL DISABILITY PATIENTS ONLY
(For Carer and Support Provider to complete)

Intellectual Disability – Pre-appointment Questionnaire

Intellectual Disability – Progress Report
(to complete FOLLOWING their first appointment)

 

 

FOR ADULT ADHD ASSESSMENT

Adult ADHD – Pre-appointment Questionnaire
(For Adult ADHD patients to complete)

Adult ADHD – Post-appopintment Questionnaire
(for patients and their carers to complete FOLLOWING their first appointment)

 

FOR AUTISM SPECTRUM (ASD) ASSESSMENT

ASD – Pre-appointment Questionnaire
(For ASD patients to complete)

ASD – Post-appopintment Questionnaire
(for patients and their carers to complete FOLLOWING their first appointment)

 

Dr Yu-Tang Shen Psychiatrist Mind Oasis Clinic Strathfield

Consultant Psychiatrist
Dr Yu-Tang Shen

Adult ADHD Questionnaire (For patient)
(For Adult ADHD Patients to complete)

 

Adult ADHD Questionnaire (For Parents or Relatives)
(For Parents or Relatives to complete)

Dr Sukumar Rajendran Mind Oasis Clinic

Consultant Psychiatrist
Dr Brandon Sullivan

Adult ADHD Questionnaire (For patient)
(For Adult ADHD Patients to complete)

 

Adult ADHD Questionnaire (For Parents or Relatives)
(For Parents or Relatives to complete)

Dr Namrata Shetty Mind Oasis Clinic

Consultant Psychiatrist
Dr Namrata Shetty

Adult ADHD Questionnaire (For patient)
(For Adult ADHD Patients to complete)

 

Adult ADHD Questionnaire (For Parents or Relatives)
(For Parents or Relatives to complete)

Dr Clint Pistilli psychiatrist Mind Oasis Clinic Strathfield

Pain Specialist
Dr Yi-Ching Lee

Pain Questionnaire

Allied Health Professionals

Keith Kong Mind Oasis Clinic

Clinical Psychologist
Keith Kong

DASS21 (English)

DASS21 (Chinese)

 

Olivia Brown Mind Oasis Clinic

Clinical Psychology Registrar
Olivia Brown

DASS21

Elizabeth (Lisa) Grauang - Mind Oasis Clinic

Registered Psychologist
Elizabeth Grauaug

DASS21

Adrian Brezniak Mind Oasis Clinic

Physiotherapist
Adrian Brezniak

PEG Pain Screening Tool

Pain S-E Questionnaire