ADHD Assessment

If you have been advised by the surgery to submit an attention deficit hyperactivity disorder (ADHD) assessment, please use this form.

ADHD Assessment

Please complete all the questions below. These are needed before your GP can refer you to the neurodevelopmental service, who carry out a thorough assessment.

We will contact you if we require more information, or let you know if we have completed a referral to the neurodevelopmental service. If you have not heard from us in the next two weeks, please contact us though the practice website.

The waiting times are particularly long for the neurodevelopmental clinic. You can read more about this, including details of the assessment process, waiting times and information about additional support on the Sussex Partnership NHS website.

We will refer you to the local Brighton & Sussex University Hospitals NHS Trust for your ADHD assessment. If you would like to be referred elsewhere, please let us know below.

Would you like to be referred elsewhere? *
Do you already have a diagnosis of Autistic Spectrum Condition, ADHD, Tourettes, Dyslexia or learning disability? *
Did you have any difficulties at school or attend a special school? *
Have you had any difficulties at work or University? *
Do you have any physical health conditions or high blood pressure? *
Do you take any medications? *
Do you take illicit drugs? *
Do you have a current or past history of mental health problems? *

Reason you are requesting an assessment

Please answer the questions below, rating yourself on each of the criteria shown using the scale based on which option best describes how you have felt and conducted yourself over the past 6 months.

Part A

How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done? *
How often do you have difficulty getting things in order when you have to do a task that requires organization? *
How often do you have problems remembering appointments or obligations? *
When you have a task that requires a lot of thought, how often do you avoid or delay getting started? *
How often do you fidget or squirm with your hands or feet when you have to sit down for a long time? *
How often do you feel overly active and compelled to do things, like you were driven by a motor? *

Part B

How often do you make careless mistakes when you have to work on a boring or difficult project? *
How often do you have difficulty keeping your attention when you are doing boring or repetitive work? *
How often do you have difficulty concentrating on what people say to you, even when they are speaking to you directly? *
How often do you misplace or have difficulty finding things at home or work? *
How often are you distracted by activity or noise around you? *
How often do you leave your seat in meetings or other situation in which you are expected to remain seated? *
How often do you feel restless or fidgety? *
How often do you have difficulty unwinding and relaxing when you have time to yourself? *
How often do you find yourself talking too much when you are in social situations? *
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? *
How often do you have difficulty waiting your turn in situations when turn taking is required? *
How often do you interrupt others when they are busy? *