Degree Subject:	-- None -- Architecture Art/Design Biological Science Biotechnical Science Business/Management Computer Science Economics Engineering English Environmental Science Geography History Languages Law Mathematical Science Media Medicine/Medical Science Music Performing Arts Philosophy Physical Science Planning/Surveying Politics Psychology Religious Studies Social Science Sport Science Other
If Other please specify:

What was the precise nature of your Autism Spectrum diagnosis?	-- Select -- Classic Autism High-functioning Autism Asperger Syndrome Atypical Autism Pervasive Developmental Disorder (PDD) PDD, Not Otherwise Specified (PDD-NOS) Other
If Other please specify:
Who diagnosed you?	-- Select -- psychiatrist psychologist neurologist paediatrician doctor
Where were you diagnosed (i.e. which clinic or hospital):
When were you diagnosed:

What was the precise nature of your Personality Disorder diagnosis?	-- Select -- Paranoid Personality Disorder Schizoid Personality Disorder Schizotypal Personality Disorder Antisocial Personality Disorder Borderline Personality Disorder Histrionic Personality Disorder Narcissistic Personality Disorder Avoidant Personality Disorder Dependent Personality Disorder Obsessive-Compulsive Personality Disorder Other
If Other please specify:

Which family member(s) was/were diagnosed with an Autism Spectrum Condition?	None Mother Father Brother Sister Maternal Grandmother Maternal Grandfather Paternal Grandmother Paternal Grandfather Maternal Aunt Maternal Uncle Paternal Aunt Paternal Uncle Cousin
	NOTE: click while holding down the Control key or Apple key to select more than one option.

Do any of your siblings have a diagnosis of Asperger Syndrome or High Functioning Autism?	No Yes

Do any of your children have a diagnosis on the autistic spectrum?

-- Select -- No Yes

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