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Adult ADHD Self-Report Scale (ASRS-v1.1)

This questionnaire may be used to help the clinician evaluate if you may be suffering from the symptoms of attention-deficit/hyperactivity disorder (ADHD). Please answer all questions as honestly and openly as possible and complete both Part A and Part B of the Symptom Checklist. If suggested, contact us as soon as you can.

Please note, this screening does not serve as a diagnosis tool but can aid your clinician in determining our recommended course of action.

HOW TO SCORE

Score: 0 – 3

Action – Speak with your physician regarding whether further evaluation is needed

Score: 4 – 6

Action – Your symptoms are highly consistent with ADHD in adults and further investigation is warranted

Sources
1. Schweitzer JB, et al. Med Clin North Am. 2001;85(3):10-11, 757-777.
2. Barkley RA. Attention Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment. 2nd ed. 1998.
3. Biederman J, et al. Am J Psychiatry.1993;150:1792-1798.
4. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision.
Washington, DC, American Psychiatric Association. 2000: 85-93.