ADHD Patient PAQ

Patient PAQ - Adult ADHD (DSM-V)

This questionnaire asks you about your development from birth to help with the assessment process. You may wish to ask someone who knew you well as a child to assist with the first sections.

Please answer as fully as you can. This questionnaire also contains two standardised measures – the BAARS IV and the ASRS. Read all instructions and questions carefully, and select the most accurate answers.

Personal Details

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Informant Details

We require contact details for someone who knows you well as an adult to complete a short questionnaire about your recent behaviours and symptoms. If possible, please also provide details for someone who knew you as a child.

Reason for Referral

Personal History

Include details about your parents and siblings, their education and occupations, any major family moves, and significant life events.
Include length of pregnancy, any health issues, whether your mother smoked or drank alcohol, delivery details, feeding method, and any events considered important.
Describe when you reached key milestones such as walking and talking, how this compared with siblings or peers, and any notable personality traits or behaviours.
Summarise academic performance, handwriting and reading skills, friendships, behaviour in class, any incidents of bullying, and accidents or injuries.
Comment on academic strengths and weaknesses, friendships, discipline issues, any experiences with bullying, substance use, and relationships.
List subjects taken, grades achieved, and whether results met expectations compared with peers.
Outline romantic and family relationships, friendships, higher education, jobs held, and major career changes.
Describe your current living arrangements, work situation, relationships, hobbies, and personal goals.

DSM-V Self-Report (Childhood Symptoms): Inattention

DSM-V Self-Report (Childhood Symptoms): Hyperactivity

DSM-V Self-Report (Childhood Symptoms): Impulsivity

DSM-V Self-Report (Childhood Symptoms): Impact on Daily Life

DSM-V Self-Report (Current Symptoms): Inattention

DSM-V Self-Report (Current Symptoms): Hyperactivity

DSM-V Self-Report (Current Symptoms): Impulsivity

DSM-V Self-Report (Current Symptoms): Impact on Daily Life

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