Smiley Australia




My History:

My History is a series of 3 forms designed to record your health and lifestyle at three critical stages:

1. Health and Lifestyle Before the Illness

2. Health and Lifestyle when you First Became Ill

3. Health and Lifestyle Now

These records provide information that indicate changes in the areas of:

1. Social functioning
2. Occupational functioning
3. Physical Health
4. Mental Health

Each form consists of the same 77 questions and the answers are multiple choice. This information has the ability to provide a comparison to determine the of level of disruption that illness has caused in your life. It also highlights areas of current difficulties that could be addressed by specific treatment and/or support.

You will need to print a copy of your completed form before closing the page - once you close the page all the information is deleted and and you will not be able to retrieve it.

Alternatively you can print the form and tick it off with a pen, that way there is no risk of accidentally losing your work before completing and printing it.

Just click on the Link (underlined) above to go to that form.

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