Form – ADHD Assessment Short – Well Health Counselling

What’s your age group?

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Under 18

18-24

25-34

35-44

55+

How long have you noticed ADHD-related challenges?

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Less than 6 months

6 months – 1 year

1–3 years

More than 3 years

Have you previously undergone an ADHD assessment?

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Yes

No

Not sure

Have you received therapy, coaching, or support for ADHD issues before?

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Yes

No

What’s the best way to contact you?

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Phone

Email

Via text