Screening Measure

Name*

First NameLast Name

Email*

example@example.com

Date of Birth:*

DD/MM/YYYY

Phone Number*

Please enter a valid phone number.

I find most social interactions exhausting and will generally take time by myself to recharge afterwards.*

AgreeDisagree

I don't like when plans change and would get a bit stressed.*

AgreeDisagree

I find normal lighting, for example the main light in the living room very intense, I prefer dimmer light.*

AgreeDisagree

I prefer to have regular contact with my friends.*

AgreeDisagree

I feel like I have put a lot of effort into thinking about and worrying why I'm not more like other people.*

AgreeDisagree

I find speaking to strangers or acquaintances difficult and draining.*

AgreeDisagree

I do not fidget regularly.*

AgreeDisagree

When I get interested in something, I get completely lost in it and tend to zone in and forget about everything else.*

AgreeDisagree

In noisy environments, the background noise makes it difficult for me to focus on the conversation.*

AgreeDisagree

I find most small talk tedious and pointless.*

AgreeDisagree

Through observing others, I have learnt how to act and what to do in certain situations.*

AgreeDisagree

I have no problem with being spontaneous.*

AgreeDisagree

I'm good at reading people's true intentions.*

AgreeDisagree

Eye contact with others feels natural for me.*

AgreeDisagree

Some textures like wool or certain foods make me really uncomfortable.*

AgreeDisagree

I prefer communicating by email or text as things are clearer.*

AgreeDisagree

I find some smells like artificial scents overwhelming.*

AgreeDisagree

I find it difficult to make friends.*

AgreeDisagree

I notice I move my hands or other parts of my body almost constantly.*

AgreeDisagree

I often monitor and worry about the things I say in conversations.*

AgreeDisagree

I consent to Branchfield Clinic sending me an email (to the email address that I have provided above) with information relating to the outcome of this screening measure.*

Yes