ADHD Symptoms Screening Questionnaire
General Information
Full Name
Age
Symptom Checklist
1. Do you often have trouble finishing details or making careless mistakes?
Never
Rarely
Sometimes
Often
Very Often
2. Is it difficult to sustain attention on tasks or activities?
Never
Rarely
Sometimes
Often
Very Often
3. Do you often avoid or dislike tasks that require sustained mental effort?
Never
Rarely
Sometimes
Often
Very Often
4. Are you easily distracted by extraneous stimuli?
Never
Rarely
Sometimes
Often
Very Often
5. Do you fidget or feel restless when not moving?
Never
Rarely
Sometimes
Often
Very Often
6. Do you have difficulty waiting your turn?
Never
Rarely
Sometimes
Often
Very Often
7. Do you frequently interrupt or intrude on others?
Never
Rarely
Sometimes
Often
Very Often
Additional Notes