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ADHD Checklist

Do you experience any of the following?
Trouble paying attention to details or carelessness.
Yes
No
Touble sustaining attention.
Yes
No
Not seeming to listen.
Yes
No
Not following through well on tasks.
Yes
No
Having trouble organizing activities.
Yes
No
Disliking tasks requiring sustained mental effort.
Yes
No
Losing things needed for tasks.
Yes
No
Becoming easily distracted.
Yes
No
Becoming forgetful.
Yes
No
Fidgeting or squirming frequently.
Yes
No
Having trouble playing quietly.
Yes
No
Seeming to be always 'on the go'.
Yes
No
Talking excessively.
Yes
No
Acting without thinking.
Yes
No

If you have experienced several of these symptoms since childhood and the symptoms are disruptive to your life, you may have ADHD.

Summit Research Network is currently seeking individuals experiencing the above symptoms to participate in research studies.

You may contact Summit Research Network by calling (206) 292-CARE (2273) to learn more about current and pending studies.

All information you may provide is stored in a secure site, and cannot be released to any third party without your written and signed authorization.

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