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  1. Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist Instructions. The questions on the back page are designed to stimulate dialogue between you and your patients and to help confirm if they may be suffering from the symptoms of attention-deficit/hyperactivity disorder (ADHD).

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  2. Adult ADHD Self-Report Scale (ASRS) Symptom Checklist. Please answer the questions below, rating yourself on each of the criteria shown using the scale on the right side of the page. As you answer each question, place an X in the box that best describes how you have felt and conducted yourself over the past 6 months. Never.

  3. The Adult ADHD Self-Report Scale (ASRS-v1.1) may be used as a tool to help screen for attention-deficit/hyperactivity disorder (ADHD) in adult patients. The checklist takes about 5 minutes to complete.

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  4. Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist. Description: The Symptom Checklist is an instrument consisting of the eighteen DSM-IV TR criteria. Six of the eighteen questions were found to be the most predictive of symptoms consistent with ADHD.

  5. ADULT ADHD SELF-REPORT SCALE (ASRS-V1.1) SYMPTOM CHECKLIST. Please answer the questions below, rating yourself on each of the criteria shown using the scale on the right side of the page.

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  6. The Adult ADHD Self-Report Scale (ASRS v1.1) and scoring system were developed in conjunction with the World Health Organization (WHO) and the Workgroup on Adult ADHD to help healthcare professionals to screen their patients for adult ADHD.

  7. Adult ADHD Self-Report Scale v1.1 (ASRS) Instructions: Please answer the questions below, rating yourself on each of the criteria shown. As you answer each question, select the box that best describes how you have felt and conducted yourself over the past 6 months. Never Rarely Sometimes Often Very Often 1 PART A -

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