Please click here to continue to the Questionnaire if you have been asked by your doctor to complete it.
There are no right or wrong answers. Do not spend too much time on any question.
Once you have completed the questionnaire, please show the results to the doctor.
This page is hosted externally (by the Western Australian Government). Your answers are not saved or transmitted anywhere, and you will not be asked to enter your personal details. However this page will save in your phone’s history, so you may wish to clear your browser history if you are concerned about other people seeing that you have accessed this website (click here for instructions).