Adult ADHD Intake – ADHD Medical Assessment
Medical and Work Assessment Tool for ADHD
Do you have heart disease?
Do you ever get chest pain on exertion?
Have you ever passed out or fainted whilst exercising?
Has any first degree relative died of sudden cardiac death before age 40?
Do you have uncontrolled high blood pressure?
Do you have hyper(overactive) thyroid eg. hyperthyroidism?
Do you have a heart murmur?
Do you have a congenital (from birth) heart disease or have previously had cardiac (heart) surgery?
Do you have palpatations that are rapid, regular, and stop and start suddenly that go on for more than a few beats at a time?
Do you have any history of alcohol abuse
Do you have any history of illegal drug use
Do you have any history of prescription medication abuse
Do you have any history of self harm or suicide attempts?
Have you currently or recently had thoughts about self harm?
Do you have any history of seizures
Do you have any history of lactose intolerance
Do you have any history of Raynaud’s phenomenon
Do you have any history of Glaucoma
Do you have any family history severe mental illness
Do you have any family history of ADHD
Have you previously seen a psychaitrist
Have you previously been prescribed psychotropic medication
Have you previously had any psychological interventions
Do you have any history of severe mental illness (psychosis, mania) or inpatient admissions.