Admin only section
Client Section
This form is to collect basic information but not to identify you (your details will remain anonymous and excluded from invoices). This information is used to help provide a better service to clients by identifying key areas of need.
This is a short inventory to assess your general level of distress
Please read each statement and circle a number 0, 1, 2 or 3 which indicates how much the statement applied to you "over the past week". There are no right or wrong answers. Do not spend too much time on any statement.
The rating scale is as follows:
0 Did not apply to me at all
1 Applied to me to some degree, or some of the time
2 Applied to me to a considerable degree, or a good part of time
3 Applied to me very much, or most of the time