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New Client Information
Name
*
Best email:
*
Have you received an official diagnosis of ADHD?
*
Have you received an official diagnosis of ADHD?
A
yes
B
no
Are you taking any medication?
*
Are you taking any medication?
A
yes
B
no
If so, do you find it helpful?
*
In what areas does ADHD impact you the most? You can select more than one.
*
In what areas does ADHD impact you the most? You can select more than one.
family/relationships
work/school
initiating tasks
planning and organizing
procrastination
working memory
forgetfulness
time management
attention
emotional regulation
processing speed
inflexible thinking
What are your goals and expectations from ADHD coaching?
*
What else would you like to tell me?
*
Submit