PANDA - Adult ADHD Self-Report Scale

Adult ADHD Self-Report Scale

(ASRS-v1.1) Symptom Checklist
Name:*

FirstLast
Date of Birth:*

MonthDayYear
Date
DIRECTIONS: Please answer the questions below, rating yourself on each of the criteria shown using the scale on the right side of the page. As you answer each question, place an X in the box that best describes how you have felt and conducted yourself over the past 6 months.
How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done?*

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

NeverRarelySometimesOftenVery Often
How often do you have problems remembering appointments or obligations?*

NeverRarelySometimesOftenVery Often
When you have a task that requires a lot of thought, how often do you avoid or delay getting started?*

NeverRarelySometimesOftenVery Often
How often do you fidget or squirm with your hands or feet when you have to sit down for a long time?*

NeverRarelySometimesOftenVery Often
How often do you feel overly active and compelled to do things, like you were driven by a motor?*

NeverRarelySometimesOftenVery Often
How often do you make careless mistakes when you have to work on a boring or difficult project?*

NeverRarelySometimesOftenVery Often
How often do you have difficulty keeping your attention when you are doing boring or repetitive work?*

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

NeverRarelySometimesOftenVery Often
How often do you misplace or have difficulty finding things at home or at work?*

NeverRarelySometimesOftenVery Often
How often are you distracted by activity or noise around you?*

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

NeverRarelySometimesOftenVery Often
How often do you feel restless or fidgety?*

NeverRarelySometimesOftenVery Often
How often do you have difficulty unwinding and relaxing when you have time to yourself?*

NeverRarelySometimesOftenVery Often
How often do you find yourself talking too much when you are in social situations?*

NeverRarelySometimesOftenVery Often
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?*

NeverRarelySometimesOftenVery Often
How often do you have difficulty waiting your turn in situations when turn taking is required?*

NeverRarelySometimesOftenVery Often
How often do you interrupt others when they are busy?*

NeverRarelySometimesOftenVery Often
Should be Empty: