Assessment Enquiries | Mind Evolution Centre

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Assessment Enquiries

14 Mortimer Street

Ipswich QLD, 4304

07 3413 9980

reception@mindevolutioncentre.com

Client's first name

Client's last name

Phone

Email

Which Assessment/s are you enquiring about?

Autsim

ADHD

Cognitive

Learning

Functional

Unsure

Other - please describe

Client's Date of Birth

Day

Month

Year

Do you have copies of school reports you could provide for the assessment?

Do you have healthcare reports you could provide for the assessment? i.e. any previous psychological testing

Do you have a referral / has anyone recommended this assessment?

Does the client have any existing diagnoses & when were they diagnosed?

Is the client verbal? (Able to speak in sentences?)

Are there any other details you'd like to provide?

Contact Name (if different to client)

Please upload any relevant documents

Mind Evolution Centre

Opening Hours

Monday - Friday

8:00am to 4:00pm

14 Mortimer Street Ipswich

reception@mindevolutioncentre.com

07 3413 9980

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