Maryborough Psychology & Health Clinic

Melinda Metaxas & Associates Pty Ltd

Online Parent/Carer Form

Why do I have to provide so much information?

The information that you provide assists with analysing the assessment results more accurately and ensures that the interpretation and recommendations are relevant to your situation. A diagnosis or conclusion cannot be reached until all factors have been considered. By providing information in this form, you are consenting for it to be included in your assessment report (unless you specify). Your information is confidential, and only you can decide who sees your information and report.

Not all of the questions will fit with your situation, so please just complete what you see as relevant. You can provide as much or as little information as you choose.

Commence Questionnaire

If you don't have time to complete the full questionnaire, you can come back later 

and click on the section below that you are up to!

SECTION A 

Personal Details

SECTION D

Education

SECTION B

Developmental History

SECTION E

Additional Skills  

SECTION C

Preschool History

SECTION F

Family