• ADHD Career Coaching Questionnaire (ACCQ)

  • At Possibilities we offer ADHD Career Coaching for our clients. “Career” is a word with many meanings. What’s important is what that word means to you—now and in the future. Whether you’re doing short-term work while you figure things out, or beginning a new position at your dream job, ADHD Career Coaching can support you in moving forward and increasing your success.


    Please take a few minutes to complete this questionnaire prior to your first introductory coaching session. You will have the option to upload your resume before you submit this questionnaire.


    The coach will then review all your details and help identify your biggest career concerns, how ADHD symptoms are impacting your work and support your creation of smart goals. Through the sessions, you’ll check-in with your coach to see if deadlines were met etc. This step builds accountability throughout the coaching process. You don’t just set goals and receive guidance in coaching. You meet again with your coach and discuss what worked, what didn’t, and what strategies need to be changed to support success.

    • Our online forms use SSL encryption to maintain secure transmission of medical information. Forms must be submitted online. This document will be added to your chart in our electronic medical record system and cannot be deleted. Our electronic medical record system is mandated by the Ontario government, professional regulatory organizations, and privacy laws. 

    • Complete this form if you are interested in receiving Assistive Technology Academic Services. If you wish to receive Assessment and Diagnostic Services from our multi-expert team please complete our standard Clinic Intake Form for children and teens or adults instead.

    • Private therapists and coaches from various disciplines are available at Possibilities including Psychologists, Registered Psychotherapists, Social Workers, Occupational Therapists, Speech and Language Pathologists, Nurses, Certified Leadership Coachs and Teachers. Rates range from approximately $145 to $290 per session. Services from these providers are not covered by OHIP. Fees may be covered by private insurance plans. Please check with your insurer for potential coverage. 

    • Most services are delivered over secure video sessions. 

    • Yes, I understand that the Possibilities Team can only respond and book an appointment for me after I have filled out and submitted this intake form.
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  • Thank you for taking the time to complete this form. Please follow the following next steps:

     

    1. After clicking on the Review Button below, you will see a Print/Save button.

    2. Please print or save a copy of this document.

    3. Once printed or saved, you must then Submit your form.

    4. If you have any technical issues, please call our office at 833-482-5558.

     

    We look forward to supporting you through your important next steps. Our Care Team will contact you shortly to share details about your appointment options.

    Possibilities Clinic Team

  • Thank you for taking the time to begin our Intake form.

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    We wish you all the bet on your journey

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