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Self‑Report ADHD Assessment – Conners
Assessment 1 of 121
Form Instructions & Things to Know
How to fill this form:
Read each question carefully before selecting an answer.
Select the most accurate option based on your observations.
Do not skip questions; every response helps in the assessment.
Things to know:
10-15 Mins
Estimated completion time.
Secure
Your data is fully encrypted.
Note:
This is a screening and assessment tool, not clinical (medical).
First, please provide your contact information.
Your Full Name
Email Address
Phone Number
Information about the individual being assessed.
Who are you filing for?
Choose relationship...
Self
Child
Partner
Family Member
Friend
Caretaker
Guardian
Teacher/Tutor
Name of Individual Being Assessed
Date of Birth
Age
Gender
*
Select Gender
Male
Female
School Grade (Optional)
Assessment Reasons / Reason for Assessment
1. I forget to do things.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
2. I have trouble knowing what to do even when it was just explained to me
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
3. I don't like doing things that make me think hard for a long time
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
4. I have trouble getting started on things I'm supposed to do.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
5. I am easily distracted.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
6. I get a headache when I have to pay attention for a long time.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
7. People don't think I'm listening to them.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
8. I don't finish things I start, like schoolwork, work, or other tasks.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
9. It's hard for me to get back to work after I've been interrupted.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
10. It's impossible for me to pay attention to things.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
11. I have trouble following instructions.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
12. It's hard for me to manage my time.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
13. I have trouble concentrating.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
14. I get so distracted that I can't get things done.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
15. I have trouble keeping my things organized.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
16. It's hard for me to pay attention to details.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
17. I make careless mistakes.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
18. I have trouble planning ahead.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
19. I accidentally skip questions in work or tests.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
20. There is nothing I can focus on for a long time.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
21. I lose things that I need.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
22. It's impossible for me to get my work done because I can't remember to do it.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
23. I avoid doing things that make me think hard for a long time.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
24. It's hard for me to figure out what to do first.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
25. It's hard for me to pay attention for a long time.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
26. I have trouble changing from one task to another.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
27. I have trouble focusing for a long time.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
28. I check my work for mistakes.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
29. I get out of my seat when I am not supposed to.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
30. I have too much energy to stay still.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
31. I feel like I need to be moving around.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
32. I don't know that I'm being loud until someone tells me.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
33. I talk too much.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
34. I run or climb even when I am not supposed to.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
35. I can't play or do things quietly.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
36. There's no way I can think unless I'm moving around.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
37. It's hard for me to sit still.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
38. I feel like I am driven by a motor.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
39. I fidget or squirm in my seat.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
40. I feel restless.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
41. I say the first thing that I think of.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
42. I forget to ask before using other people's things.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
43. I decide quickly without really thinking things through.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
44. I have trouble waiting for my turn.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
45. I interrupt people when they are talking or playing games.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
46. I do things before thinking about them.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
47. I talk when it's not my turn.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
48. I blurt out the answer before the question is finished.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
49. I'm impulsive.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
50. I lose my temper.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
51. It's hard for me to control my feelings.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
52. People make me angry.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
53. I have trouble calming down when I get upset.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
54. I am easily annoyed.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
55. I have no control over my behavior.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
56. I say or do things I don't mean because I'm angry.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
57. I get really angry all of a sudden
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
58. I overreact when I get upset.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
59. My mood changes quickly.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
60. It's hard for me to control how angry I get.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
61. I feel sad, gloomy, or irritable for many days at a time.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
62. I have hurt myself on purpose.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
63. The future seems hopeless to me.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
64. I feel worthless.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
65. I have thought about hurting myself.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
66. I have planned or tried to hurt myself.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
67. I am tired.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
68. I don't feel like doing things that I used to enjoy.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
69. Nothing makes me happy.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
70. I feel like things are not going well in my life, and I can't do anything about it.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
71. I have trouble sleeping because I worry about things.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
72. I have trouble falling or staying asleep.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
73. I have trouble controlling my worries.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
74. I get tired because I worry so much.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
75. I worry too much about a lot of things
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
76. I feel nervous or jumpy.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
77. I'm scared that people won't like me if they see how nervous I am
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
78. I don't know what my homework is or where I've put it.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
79. I forget to turn in completed work.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
80. I hand things in late.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
81. I skip classes.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
82. I get invited to play or go out with others.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
83. Other kids say I'm annoying.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
84. Other kids complain about the way I act.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
85. Making friends is hard for me.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
86. People don't want to be friends with me.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
87. I feel like I don't fit in.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
88. My family gets frustrated with me.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
89. My family gets frustrated with me.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
90. I make my family late for things.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
91. I argue with family members.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
92. I get along well with my family.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
93. I cause problems for my family.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
94. I hurt people by doing things like punching, kicking, or scratching.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
95. I steal from people by robbing them.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
96. I start fights with other people.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
97. I steal valuable things when no one is watching.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
98. I set things on fire to cause damage.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
99. I bully, threaten, or scare others.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
100. I've broken into houses, buildings, or cars.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
101. I stay out at night, even though it breaks the rules.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
102. I tell lies to get out of doing things or to get stuff.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
103. I do things to hurt animals.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
104. I destroy things on purpose that belong to others.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
105. I use a weapon to scare or hurt people.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
106. I made someone do something sexual against their will.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
107. I have run away from home for at least one night.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
108. I refuse to follow the rules.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
109. When I get mad at someone, I get even with them.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
110. I complain even when I'm having fun.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
111. I annoy people on purpose.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
112. I upset or offend others on purpose.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
113. I refuse to do what adults ask me to do.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
114. I blame others for my mistakes or bad behavior.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
115. I argue with adults.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
116. Describe how these behaviors cause serious problems for you at home, in school, at work, or with your friends.
117. Do you have any other problems?
118. What are your main strengths or skills?
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