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ADD/ADHD screening

hm_476x287_add3Are You concerned that you or someone you know may have ADD?

If so please read the following statements and answer yes or no:


1.  Often fail to give close attention to details or make careless mistakes in schoolwork, work or other activities?                            YES              NO

2. Have difficulty sustaining attention in tasks or play activities?        YES   NO

3. Not follow through on instructions and fail to finish work (not due to oppositional behavior or failure to understand instructions)     YES   NO

4. Not seem to listen when spoken to directly?    YES   NO

5. Have difficulty organizing tasks and activities?   YES   NO

6. Avoid, dislike, or are you reluctant to engage in tasks that require sustained mental effort?                     YES   NO

7. Lose things necessary for tasks or activities?     YES   NO

8. Get easily Distracted?                YES   NO

9.  Suffer from forgetfulness in daily activities?          YES   NO

10. Fidget with hands or feet or squirm in seat?      YES   NO

11. Run about or climb excessively in situations in which it is inappropriate (In adolescents or adults, may be limited to subjective feelings of restlessness)?     YES   NO

12. Have Difficulty playing or engaging in leisure activities quietly?      YES   NO

13. Constantly find yourself “on the go” or act as if “driven by a motor”?           YES   NO

14. Blurt out answers before questions have been completed?      YES   NO

15. Have difficulty awaiting your turn?      YES   NO

16. Interrupt or intrude on others?     YES   NO


If you (or someone you know) answered YES to three or more of the above questions You might be suffering from an attention problem. You can call our office (972) 480-0000 to see about being evaluated.



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ADHD Center, Inc.
5720 LBJ Freeway, Suite 660
Dallas, TX 75240
(On the 6th floor of the Bankers Commercial Life building)
Phone: 972-480-0000
Fax: 972-960-6097
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