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Pre Consultation Questionnaire

Please choose a 'Pre-Consultation Questionnaire' relevant to your needs, from the list below (note that there is a separate questionnaire for adults and children).

Choose the 'HTML version' if you wish to complete and submit the questionnaire online. Choose the 'Adobe PDF version' if you want to print the questionnaire to paper, fill out by hand, and send by post. The PDF version requires PDF viewer, which you can download free using the link provided, if you do not already have it.

The 'Pre-Consultation Questionnaires' are not compulsory, but they do help Dr Sura get an overview of your personal, social and family situation. This can save on time and costs once consultations begin. The more informed Dr Sura is, the more helpful he can be.

Questionnaire 1
Please complete this questionnaire if you are an adult seeking consultation for yourself.

HTML
Abobe PDF


Questionnaire 2
Please complete this questionnaire if you are an adult seeking consultation for a child in your care.

HTML
Abobe PDF

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