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Welcome to the ADHD Adult Screening - ASRSv1.1 Assessment

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Thank you for taking the time to complete this important assessment. This form is designed to help identify signs of Adult ADHD, providing valuable insights into your focus and behavior. Your honest responses will play a crucial role in understanding your experiences and guiding you toward the appropriate support and resources. We appreciate your participation and trust.

ADHD Adult Screening - ASRSv1.1 Assessment

Patient Health Questionnaire

Date of Birth

The Adult ADHD Self-Report Scale v1.1 (ASRSv1.1) is a self-report questionnaire designed to assess Attention Deficit Hyperactivity Disorder (ADHD) symptoms in adults.

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Please answer the questions below, rating yourself on each of the criteria shown. As you answer each question, select the option that best describes how you have felt and conducted yourself over the PAST 6 MONTHS.

1.) How often do you have trouble wrapping up the final details of a project once the challenging parts have been done? *
2.) How often do you have difficulty getting things in order when you have to do a task that requires organization? *
3.) How often do you have problems remembering appointments or obligations? *
4.) When you have a task that requires a lot of thought, how often do you avoid or delay getting started? *
5.) How often do you fidget or squirm with your hands or feet when you have to sit down for a long time? *
6.) How often do you make careless mistakes when you have to work on a boring or difficult project? *
7.) How often do you have difficulty keeping your attention when you are doing boring or repetitive work? *
8.) How often do you have difficulty concentrating on what people say to you, even when they are speaking to you directly? *
9.) How often do you misplace or have difficulty finding things at home or work? *
10.) How often are you distracted by activity or noise around you?*
11.) How often do you leave your seat in meetings or other situations in which you are expected to remain seated? *
12.) How often do you feel restless or fidgety? *
13.) How often do you have difficulty unwinding and relaxing when you have time to yourself? *
14.) How often do you find yourself talking too much when you are in social situations? *
15.) When you're in a conversation, how often do you find yourself finishing the sentences of the people you are talking to before they can finish them themselves? *
16.) How often do you have difficulty waiting your turn in situations when turn taking is required? *
17.) How often do you interrupt others when they are busy? *
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