New Patient Forms

New Patient Forms

There are some information forms and symptom based questionnaires that I kindly ask all new speech therapy patients to complete before their initial appointment. The forms can be found below. The speech therapist will specify which forms you need to complete however the first two are for ALL patients. Please return the completed forms to Many thanks

All patients:

New patient form

New Patient GDPR form

Adult voice patients only – >16 years old:

Reflux Symptom Index

Voice Handicap Index

Paediatric patients only – can be complete by parent or carer:

Paediatric Voice Handicap Index

Cough patients only:

Leicester Cough Questionnaire