Sensitive Practice Request forms

These forms are for patients who have experienced trauma or distressing events. The information shared can help the health care professional to provide health services in a sensitive way. The forms can be filled in online or printed, then given to the health care worker. The patient can choose how much information they want to share.

Choose the form below that is most suitable.

Sensitive Practice Request form (PDF)

Other versions

Sensitive Practice Request form - Simple English (PDF)
For people with English as a second language, or basic literacy

Sensitive Practice Request form - Easy Read (PDF)
For patients with cognitive impairment