This comprehensive clinical intake questionnaire collects detailed behavioral, developmental, and functional history relevant to the evaluation of Attention-Deficit/Hyperactivity Disorder (ADHD) and related conditions. Information obtained through this questionnaire is used to support diagnostic clarification and treatment planning in conjunction with a clinical interview and review of relevant records.

Completion of this questionnaire does not constitute a diagnosis. Final diagnostic determinations are made by a licensed provider based on a comprehensive clinical evaluation.