1. 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
2. How often do you have difficulty getting things in order when you have to do a task that requires organization?
∠ Never
∠ Rarely
∠ Sometimes
∠ Often
∠ Very Often
3. How often do you have problems remembering appointments or obligations?
∠ Never
∠ Rarely
∠ Sometimes
∠ Often
∠ Very Often
4. When you have a task that requires a lot of thought, how often do you avoid or delay getting started?
∠ Never
∠ Rarely
∠ Sometimes
∠ Often
∠ Very Often
5. How often do you fidget or squirm with your hands or your feet when you have to sit down for a long time?
∠ Never
∠ Rarely
∠ Sometimes
∠ Often
∠ Very Often
6. How often do you feel overly active and compelled to do things, like you were driven by a motor?
∠ Never
∠ Rarely
∠ Sometimes
∠ Often
∠ Very Often
Please go ahead and print this page out to bring with you to your next appointment with us
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