Please complete this before the session starts
What has brought you here today? (3-4 sentences)
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Who else is in your “ ecosystem?”- Who else significant around you at home or somewhere else (such as the workplace)
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Is there or who is the doctor you are working with for your ADHD?
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Are you on medications at the moment? If so, what medications are you on?
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What effect is medication having?
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Rate (scale of 1-10) your current understanding of ADHD ?
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If you had to “define” ADHD to someone, what would you say?
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Rate (scale of 1-10) your current understanding of “Executive functions”
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What is your current understanding of “Executive functions”
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What has brought you to coaching- what are your expectations of coaching?
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What are your strengths?
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How are you in the following areas?
Focusing {"type":"radio","name":"__generic13","width":8,"value":"","size":"Small","validation":"","validationMessage":"Please make a selection for this item.","options":"0 \n1\n2\n3\n4\n5\n6\n7\n8\n9\n10"}
Pausing
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Procrastination
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Forgetfulness
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Punctuality
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Scheduling
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Time Awareness
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Time Management
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How would you describe yourself emotionally? tick all that apply{"type":"checkbox","name":"__generic21","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please check at least one item.","options":"Reacts quickly\nHas a “short fuse”\nFeelings easily hurt\nDisappointment felt deeply\nCool and calm most of the time\nBottles things up under stress"}
What would you most like to change?
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Thank you for completing this form!