About your ADHD Please rate what statements apply to you Never Rarely Sometimes Often Very Often I find it difficult to stay on task at work: I don’t follow through on instructions: I fail to finish work or chores: I have difficulty organising tasks and activities: I avoid, dislike, or am reluctant to engage with tasks that require sustained mental effort: Lose things necessary for tasks or activities: Am easily distracted: Forgetful in daily activities: Difficulty managing my money, bills or debts: My ADHD affects my ability to care for myself (dressing, bathing, hygiene, eating, sleeping): My ADHD affects my ability to maintain my health (exercise, nutrition, medical/dental care): My ADHD impacts my ability to perform Never Rarely Sometimes Often Very Often At Home: At Work/School: My relationships: Daily Responsibilities: Please select ADHD coping techniques that you use Never Rarely Sometimes Often Very Often Medication: Therapy/Support Groups: Reminders (post-its, lists, alarms, apps): Listen to music: Use a planner or organiser: Exercise: What strategies help you to manage disorganisation Never Rarely Sometimes Often Very Often Follow a routine: Journal: Use an app: Break big tasks into smaller ones: Set timers: Use alarms and reminders: Set goals: To-Do-Lists: Write everything down: Please select your top 3 goals for managing your ADHD Being able to finish projects and tasks Getting my household more organized Feel less irritable and upset Get personal finances more organised Improve personal relationships Feel calmer and feel less need to always be moving Get along better with others in social situations
