After completing this questionnaire, you'll be able to:
Email directly to Dr. Shah: click a button to open your email app with pre-filled details
Download and send yourself: download the results file and email it to: draanashah@protonmail.com
Important Notice:
This questionnaire is for information gathering purposes only and is not diagnostic. The responses you provide will be reviewed by your clinician as part of a comprehensive clinical assessment. Only a qualified healthcare professional can make diagnostic or treatment decisions. Please answer honestly based on your actual experiences.
Privacy: All data is processed locally on your device. Nothing is sent anywhere until you choose to download and share your results file with your clinician.
📝 Answering Questions: Try to answer every item. There are no right or wrong answers. If a statement doesn't quite fit, choose the option that comes closest to your experience. You may leave items blank if you genuinely cannot answer.
0 of 25 items answered (0%)
Your Information
Social Interactions
Instructions: Please read each statement below and choose the answer that best fits your experiences during social interactions. Use the 1–7 scale where 1 = Strongly Disagree and 7 = Strongly Agree.
Your responses have been saved. Please send your results to Dr. Shah using one of the options below.
Your clinician will review these results and discuss them with you during your assessment appointment.
Send Results to Dr. Shah:
Your results file is downloading now. Once it appears in your Downloads folder, attach it to the email that just opened and send.
Option 1: Click "Email Results" to open your email app with everything pre-filled. Attach the downloaded file and send. Option 2: Download the file and email it to draanashah@protonmail.com yourself.