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ADHD Questionnaire

A screening tool that helps clinicians spot signs consistent with ADHD across both younger patients and grown adults.

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Participant Name

First Name

Last Name

Date of Birth

How often do you have trouble wrapping up the final details of a project once the challenging parts have been done?

Never Rarely Sometimes Often Very often

How often do you have difficulty getting things in order when a task requires organization?

Never Rarely Sometimes Often Very often

How often do you have problems remembering appointments or obligations?

Never Rarely Sometimes Often Very often

How often do you avoid or delay starting a task that requires a lot of thought?

Never Rarely Sometimes Often Very often

How often do you fidget or squirm with your hands or feet when you have to sit for a long time?

Never Rarely Sometimes Often Very often

Are there specific situations or times when the symptoms are more noticeable?

Do these behaviors affect academic, occupational, or social functioning?

Completed By

The patient Parent Clinician

Full Name

First Name

Last Name

Date

Signature

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