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Q.1
Do you have trouble getting started or initiating tasks?
Often
Not often
Q.2
Do you start tasks with enthusiasm but lose interest quickly?
Often
Not often
Q.3
Do you find it hard to do things that aren't necessary or highly stimulating?
Often
Not Often
Q.4
Are you easily distracted by things you see or hear?
Often
Not Often
Q.5
Do you become absorbed in things or tasks that interest you—sometimes to the point of forgetting about people around you or other obligations?
Often
Not Often
Q.6
Do you have trouble following conversations because you are distracted or because you are trying to remember what you wanted to say?
Often
Not often
Q.7
Do you forget things, even when they are important to you?
Often
Not often
Q.8
At least once a day do you lose or misplace items—for example, keys, wallet, purse, or a cell phone?
Often
Not Often
Q.9
Do you struggle to get a handle on clutter? Does your personal space get messy with piles of papers and miscellaneous items?
Often
Not Often
Q.10
Do you have difficulty figuring out what is most important or what you should start with given a list of things to do?
Often
Not Often
Q.11
Do you waste time trying to decide what to do first?
Often
Not often
Q.12
Do you become frustrated when things don’t go as planned and can you quickly become angry?
Often
Not often
Q.13
Do you let go of anger as quickly as it came?
Often
Not Often
Q.14
Do you have trouble completing multiple-step tasks and moving from one task to another?
Often
Not Often
Q.15
Do you say “I will do it later” and then forget all about it?
Often
Not often
Q.16
Do you forget appointments and do you typically run late?
Often
Not Often
Q.17
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