First Name
*
Last Name
*
How often do you have difficulty concentrating on what people say to you, even when they are speaking to you directly?
*
Never
Rarely
Sometimes
Often
Very often
How often do you leave your seat in meetings or other situations in which you are expected to remain seated?
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Never
Rarely
Sometimes
Often
Very often
How often do you have difficulty unwinding and relaxing when you have time to yourself?
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Never
Rarely
Sometimes
Often
Very often
When you are 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?
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Never
Rarely
Sometimes
Often
Very often
How often do you put things off until the last minute?
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Never
Rarely
Sometimes
Often
Very often
How often do you depend on others to keep your life in order and attend to details?
*
Never
Rarely
Sometimes
Often
Very often
Total Score
*
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