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Electrocardiogram (ECG / EKG) Consent & Questionnaire
ADHD EVALUATION
If your provider requests you complete ADHD Evaluation Forms, please complete the following:
1. ADHD Evaluative Questionnaire (Current Symptoms Self-Report)
2. Childhood Behaviour Scale (ADHD)
3. Weiss Functional Impairment Rating Scale – Self Report (WFIRS-S)
Please also request someone who knows you well complete the following (provide them with the link bit.ly/welladhdo):
- Anxiety
- Trauma & Dissociative Disorders
- Personality
- Sleep
- ADHD
- Eating Disorders
- Lifestyle / Quality of Life
- Substance Use Disorders