Austism screening Assessment

Please complete the following screening assessment. The information will be sent to our team of specialists who will be in touch shortly.

1. Lives somewhat in a world of his/her own with restricted idiosyncratic intellectual interests

Not At All Just A Little Quite A Lot

2. Has a deviant style of gaze

Not At All Just A Little Quite A Lot

3. Wishes to be sociable but fails to make relationships with peers

Not At All Just A Little Quite A Lot

4. Lives somewhat in a world of his/her own with restricted idiosyncratic intellectual interests

Not At All Just A Little Quite A Lot

5. Has special routines: insists on no change

Not At All Just A Little Quite A Lot

Patient Details First Name Last Name Email Age Phone Number