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Adult ADHD Self-Report Scale

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Personal Details

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Part A

Please answer the following questions, rating yourself on each of the criteria shown

For each question, select the answer that best describes how you have felt and conducted yourself over the past 6 months.

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Next Step

Your score indicates symptoms highly consistent with ADHD, and further investigation is warranted.

If you would like to send this assessment to the surgery please continue to the next page

The previous questions are the most predictive of ADHD and are best for use as a screening instrument.

However, the frequency scores from the questions on the next page provide additional cues and can serve as further indications of symptoms.

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Part B

For each question, select the answer that best describes how you have felt and conducted yourself over the past 6 months.

This form collects personal and medical information about you and we use this information to allow the practice team to contact you.
Please read our Privacy Policy to discover how we protect and manage your submitted data.

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