Clinical Analysis Questionnaire


A clinical analysis questionnaire is one that is used by psychologists in order to identify psychological issues of individuals. This questionnaire helps to identify the various causes that are responsible for a certain psychological problem and thereby devise a strategy to reduce it. On the basis of this questionnaire the extent of depression that an individual is undergoing at present and the gravity of the issue can be easily identified by a psychologist. One can obtain more information about this questionnaire from the sample clinical analysis questionnaire provided here below.

Sample Clinical Analysis Questionnaire

Name of the individual                         —————————————————–

Address of the individual                    —————————————————–

Contact details of individual              —————————————————–

Marital status                                         —————————————————-

Age of the individual                             —————————————————-

Occupation of the individual              —————————————————-

Please answer the following questions in a truthful manner. The answers and personal information will be kept confidential.

1. Do you suffer from headaches frequently? If yes please specify the frequency and time period of the headache each time?

a. Yes _______________

b. No

2. Do you find it difficult to mingle and socialize with relatives and friends and avoid social gatherings?

a. Yes

b. No

3. Do you get a good sleep at night every day?

a. Yes

b. No

4. Do you end up fighting with others at home and work for small issues?

a. Yes

b. No

5. Do you find it difficult to concentrate on one thing or issues at a time in your life?

a. Yes

b. No

6. Do you lie to others in order to save yourself from a mistake committed earlier?

a. Yes

b. No

7. Do you find it difficult to remember important tasks that you need to complete on a regular basis?

a. Yes

b. No

8. Are you an emotionally stable person who can be calm even in worst of situations?

a. Yes

b. No

Category: Health Questionnaire

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