Adult Patient Paperwork

Please correct the errors described below.

Step 1: ADHD Adult Test

This test is not a comprehensive list of questions, but will give a good indication to the doctors whether further testing is needed to confirm ADD/ADHD symptoms.



The member ID is the unique ID your insurance company uses to identify your account. May also be called Member ID

The payor ID is generally a 5 digit number that is unique to each insurance company.

Have you had previous ADHD Treatment

If "Yes" above complete the following information.

Your information will be encrypted.