ADHD Questionnaire

Name *

First Name

Last Name

Do you tend to avoid or delay getting started on a new important task? *

Never

Rarely

Sometimes

Often

Very Often

Do you find that the majority of your tasks (work/school assignments, etc.) are boring or repetitive, making them difficult to complete? *

Never

Rarely

Sometimes

Often

Very Often

Do you find yourself making careless mistakes when engaged in something you feel is boring, repetitive, or difficult? *

Never

Rarely

Sometimes

Often

Very Often

How often do you feel restless or fidgety? *

Never

Rarely

Sometimes

Often

Very Often

Do you regularly fail to remember important appointments or obligations? *

Never

Rarely

Sometimes

Often

Very Often

Do you have difficulty unwinding or feel often on the go? *

Never

Rarely

Sometimes

Often

Very Often

Do you have difficulty concentrating on people when they are speaking to you? *

Never

Rarely

Sometimes

Often

Very Often

Do you frequently misplace things (or have difficulty finding them)? *

Never

Rarely

Sometimes

Often

Very Often

Are you typically distracted (or find it hard to focus) when there is activity or noise around you? *

Never

Rarely

Sometimes

Often

Very Often

Do you find yourself avoiding situations like waiting your turn in line when waiting is expected and appropriate (i.e. at the grocery store)? *

Never

Rarely

Sometimes

Often

Very Often

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No, thank you.

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I agree

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