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Private, consultant-led clinic. Not part of the NHS memory service. No GP referral needed.

Sheffield Memory Service & Geriatric Care Dr Pravin Jha · Consultant Geriatrician & Memory Specialist
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Relative or carer questionnaire

Recent Memory and Thinking Changes Questionnaire (AD-8)

Best completed by a family member or carer who knows the patient well. Eight questions about changes caused by difficulties with memory or thinking, rather than physical problems. It takes a couple of minutes.

This form is for your appointment with Dr Jha. It is not checked out of hours, so please don’t use it for anything urgent: call 999 in an emergency, or NHS 111 or your GP for other urgent problems.

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This should be best completed by a family member or carer who knows the patient well.

This short questionnaire helps us to understand if there have been any changes in memory or thinking.

It includes 8 simple questions and usually takes only a couple of minutes to complete. Please rate changes caused by difficulties with memory or thinking, rather than physical problems. Compare with the person’s previous abilities. There are no right or wrong answers.

Informant details

Patient detail

Your answers are stored securely on this website for Dr Jha. They are copied into your clinical record and deleted from the website within 90 days. Privacy notice

Back to the pre-consultation questionnaires