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   ADHD Questionnaire

You may answer for a child or for yourself.
Name
EMail


Attention:
 
1. I have problems paying close attention to details. yes   no
2. I frequently make careless mistakes. yes   no
3. I have difficulty maintaining attention. yes   no
4. I am often asked if I am listening to what is being said. yes   no
5. It is difficult for me to follow through with instructions. yes   no
6. I have difficulty with organizing tasks. yes   no
7. I avoid tasks that require sustained mental effort. yes   no
8. I am forgetful about daily activities. yes   no

Hyperactivity:
 
9. I am always restless. yes   no
10. I fidget with my hands and feet and squirm in my seat. yes   no
11. It is difficult to stay seated regardless of the surroundings. yes   no
12. I often talk excessively. yes   no
13. It is difficult to wait in lines and for my turn. yes   no
14. I often interrupt or intrude upon others. yes   no
  Send me periodic natural health information