FSW Psychology Adult Case Review Questionnaire

Thank you for returning to FSW Psychology for a follow-up review. We understand that sometimes a neurodivergent profile becomes clearer over time, or that new information may now be available that was not evident during the first assessment. This questionnaire is intended to help us understand any changes since the previous assessment, as well as gather any further background information that may now be relevant.

Name of the person requesting assessment review

Who is the review for

Preferred Pronouns

Date of birth

Address

Contact Number

Email Address

Have you remembered or discovered any additional information about your childhood or young adult life that you were not aware of during the first assessment?

Yes No

If you ticked yes, please provide more Information below:

Are there any areas that feel more noticeable, more concerning, or clearer now than they were at the time of the original assessment?

Have there been any significant life changes in the past 12 months that may be relevant?

Have you received any new support, intervention, or professional input since the first assessment?

Yes No Unsure

If you ticked yes, please provide more Information below:

Has any other new information become available since the first assessment that you would like us to consider as part of this review?

Yes No

If possible, please provide any relevant information below:

What do you see as your on-going strengths, interests, and positive qualities?

What are your main reasons for requesting a review at this stage?

What feels most important for us to understand now about you?

Are there particular questions you hope this review will help answer?

Please include any other relevant information in the text box below.

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