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About Us
Important Things To Know
Our Clinical Team
Our Support Team
Mission Vision Values
Our Environment
Careers
Assessments
Adults
Children
Teens
Psychotherapy
Adults
Teens
Children
Workshops
New Clients
Our Promise to You
Quick 1st Appointment
Our Clinical Approach
What to Expect
Virtual Services
Fees + Coverage
FAQs
Resources
Videos
Articles
Infographics
Questionnaire
Contact
Adult Inattention Questionnaire
Answer each question, then click submit to see your results.
Adult Inattention/Motor Restlessness Mini-Questionnaire
Feeling fidgety
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Difficulties with procrastination
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Difficulties with organization
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Impulsive behaviours (e.g., doing something without thinking of the potential consequences)
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Difficulties following conversations
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Forgetfulness
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Hyperfocusing (e.g., sustained, intense concentration on a single interest or project for an extended period of time)
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Difficulties completing tasks requiring sustained attention (e.g., paperwork, sitting through a 2-hour movie, etc.)
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Daydreaming
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Lack of attention to detail
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Unable to follow multi-step instructions
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Talking too much and/or interrupting others
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Difficulty waiting your turn (in lines, at traffic lights, etc.)
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Difficulties listening and understanding what is being said
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Consistently late for appointments
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Unable to multi-task
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Difficulties starting tasks and never finishing them
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Feeling sense of inner restlessness
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Difficulty “shutting your mind off” at night prior to bed
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Overreliance on caffeinated beverages (e.g., coffee, energy drinks, etc.) to help you focus/be productive
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
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