PTSD Checklist (PCL-5)

    For any questions please contact us at info@midispensary.com.au or call  1300 MI TIME (1300 648 463).

    Patient Details

    Please include the area code if you are inputting a home phone number.

    PTSD Questionnaire

    Instructions  Below is a list of problems that people sometimes have in response to a very stressful experience. Please read each problem and then select one of the options to indicate how much you have been bothered by that problem in the past week.

    In the past week, how much were you bothered by 


    Thank you for submitting your answers, our MiDispensary practitioners will discuss your answers with you in your next appointment.

    I declare all answers provided herein are true and accurate to the best of my knowledge and belief.

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