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

Symptom Checklist Instructions

This questionnaire is designed to help you and your doctor better understand your experiences with attention-deficit/hyperactivity disorder (ADHD). You may be completing it as part of your initial assessment, or as a way to review how your treatment is going. Your responses will help guide the discussion and support your care.

Please answer the following 18 questions by selecting the option that best reflects how you have felt and behaved over the past few weeks. If you are currently taking ADHD medication, please answer based on how things are going for you now—including the effects of your medication—not how you feel without it.

If you are unsure about a particular question, you can just choose the response that seems most accurate. There are no right or wrong answers—honesty will help ensure your care is tailored to your needs.

Today's Date *

First Name *

Last Name *

State *

Email *

1. How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done?* *

2. How often do you have difficulty getting things in order when you have to do a task that requires organization?* *

9. How often do you have difficulty concentrating on what people say to you, even when they are speaking to you directly?* *

12. How often do you leave your seat in meetings or other situations in which you are expected to remain seated?* *

16. 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?* *

Save and Complete Later