ADHD Initial Evaluation Form

ADHD CARING FOR CHILDREN WITH ADHD: A RESOURCE TOOLKIT FOR CLINICIANS, 2ND EDITION

Please correct the errors described below.

NICHQ Vanderbilt Assessment Scale: Parent Informant

Directions: Each rating should be considered In the context of what Is appropriate for the age of your child. When completing this form, please think about your child's behaviors in the past 6 months.

Symptoms

Never = 0 | Occasionally = 1 | Often = 2 | Very Often = 3

Performance

Other Conditions

Tic Behaviors: To the best of your knowledge, please indicate if this child displays the following behaviors:

Previous Diagnosis and Treatment: To the best of your knowledge, please answer the following questions:

For Office use only:

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