The Gosforth Clinic
Welcome to The Gosforth Clinic. Completing this questionnaire will assist the clinicians involved in your care to better understand you and your personal history, helping to ensure a comprehensive assessment.
You may need to gather some information about your childhood from family members to complete all sections of the form. Understanding the various factors that have influenced you throughout your life is important, as brain development is shaped by a complex interaction of genetics, environment, personality, and experiences. We are committed to providing a safe and inclusive space for you to share sensitive information.
If any questions make you uncomfortable or if you would rather discuss with the doctor, please write “DISCUSS” as your answer.
If you are under 18 years of age, a parent, guardian, or adult support person is required to be present with you at the time of the Clinician’s assessment.
Please allow up to 20 minutes to complete your personal history.
Need some Help?
Gosforth Clinic is a referral-only, private adult psychiatric practice. Speak with your GP and ensure that you carefully follow the referral checklist.
If you need to contact the clinic, please reach out to us using the below methods:
Phone: (07) 5451 1800
Email: info@gosforthclinic.com.au
