Adult ADHD Quality of Life Assessment - AAQoL

Assessment 1 of 32

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.

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Note: This is a screening and assessment tool, not clinical (medical).

First, please provide your contact information.

Information about the individual being assessed.

1. How difficult has it been for you to Keep the house/apartment clean or neat.
2. How difficult has it been for you to manage your finances, such as cashing checks, mobile money deposit and withdrawal, balancing your checkbook, paying bills on time.
3. How difficult has it been for you to remember important things
4. How difficult has it been for you to get your shopping or buying items done (such as for food,clothes, or household items)
5. How often have you felt getting things done requires too much “effort.
6. How much of a problem has it been for you to complete projects or tasks (either at work or home).
7. How much of a problem has it been for you to get started with tasks you don’t find interesting.
8. How much of a problem has it been for you to balance multiple projects.
9. How much of a problem has it been for you to get things done on time
10. How much of a problem has it been for you to keep track of important items (such as keys, wallet, appointment, meeting).
11. How difficult has it been for you to pay attention when interacting with others.
12. How often have you felt overwhelmed.
13. How often have you felt anxious.
14. How often have you felt depressed
15. How often have you felt you have overreacted in difficult or stressful situations.
16. How troubled/bothered have you been by feeling fatigued.
17. How troubled/bothered have you been by fluctuations (ups and downs) in your emotions.
18. How often have you felt your energy is well spent (has positive results).
19. How often have you felt you can successfully manage your life.
20. How often have you felt as productive as you would like to be.
21. How often have you felt good about yourself.
22. How often have you felt people enjoy spending time with you.
23. How often have you felt your intimate relationship is going well emotionally.
24. How often have you felt able to enjoy time spent with other.
25. How often have you felt you have not been able to meet others’expectations of you (either at home or work).
26. How often have you felt you annoyed people.
27. How often have you felt people are frustrated with you.
28. How troubled/bothered have you been by tension in relationships.
29. How troubled/bothered have you been by not having quality time to spend with others.