Screening Questionnaire

Options are presented below to enable you to fill out the questionnaire before meeting with us. You can download and print out the questionnaires in word format or request that we post out a copy to you. If you have any problems or queries with the screening questionnaires please contact us on 01506 825400 or via email admin@mlcscotland.com

• Download / Print - Child Screening Questionnaire
• Download / Print - Adult Screening Questionnaire

If you wish for us to post the Screening Questionnaires to you, then please fill out the form below.

Personal Details

1. Your Name
2. Address
3. Postcode
4. Telephone Number
5. Email
6. Mobile

Please send me the following Screening Questionnaire(s)

7. Child Screening Questionnaire
8. Adult Screening Questionnaire

The Screening Questionnaire originates from The British Journal of Occupational Therapy, Goddard S., Hyland D October 1988 and An organic basis for neuroses and educational difficulties.  Blythe P., McGlown D, 1979