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Pre-Psychology Appointment Form

This form helps your psychologist prepare for your upcoming appointment. It takes about 6 to 8 minutes to complete and your answers will be saved to your patient file. Anything sensitive can be discussed in session if you'd prefer not to write it here.

Medical context

A brief picture of your overall health helps us provide safe and appropriate care.

GP name

GP clinic

Relevant diagnoses or health conditions

Current medications

Allergies

GP health summary

All patients are asked to provide a current GP health summary so we can review relevant diagnoses, medications, allergies, and other important health information before care begins.

Have you uploaded a current GP health summary?

Have you uploaded a current GP health summary?
A
B
C
D

Do you authorise Continuum to request a brief health summary from your GP if needed?

Do you authorise Continuum to request a brief health summary from your GP if needed?
A
B

Psychology and emotional wellbeing

These questions help your psychologist understand what's going on for you and how to make the session feel safe and useful. You can skip anything you'd prefer to discuss in person.

Have you seen a psychologist before?

Have you seen a psychologist before?
A
B
C

Do you have a current Mental Health Care Plan?

Do you have a current Mental Health Care Plan?
A
B
C

What do you hope to get from working with us?

Current concerns

Current concerns

Are there any current safety concerns?

Are there any current safety concerns?
A
B
C

What helps you feel safe and supported during appointments?