Vanderbilt ADHD Assessment Screening
Asks about child's name, child's age, and grade level. Built for pediatric primary care ADHD evaluation and diagnosis.
- Questions
- 14
- Pages
- 2
- Time
- about 4 min
Your practice
Vanderbilt ADHD Assessment Screening
Page 1 of 2 · Your information
Live preview. Tap through it like a patient.
Who it is for
- Pediatric primary care ADHD evaluation and diagnosis
- Child psychiatry and developmental-behavioral pediatrics intake
- School-based ADHD assessment and IEP documentation
- Family medicine ADHD screening for school-age children
What's inside
Before you publish: Clinical review required: this worksheet does not calculate scores, diagnose, or recommend treatment. Confirm the questions and response options against your approved assessment protocol before use.
Page 1 · Your information
- Child's NameText
- Date of BirthDate
- Child's AgeNumber
- Grade LevelLong Text
- Parent/Guardian NameText
Page 2 · Additional details
- Easily distractedLong Text
- Fidgets with hands or feetLong Text
- Runs or climbs excessivelyLong Text
- Talks excessivelyLong Text
- Oppositional Behavior ItemsLong Text
From form to a ready patient

01
Make it yours
Reword, reorder, or add to the Vanderbilt ADHD Assessment Screening, and add your logo.

02
Patients finish it at home
A secure link by text or email, filled out on their phone before the visit. No app.

03
Your team sees who is ready
Each visit shows as ready once its forms are in. Answers land on the patient record.
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Questions
Send it before the visit, so patients arrive ready.
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