Appointments at Pollokshaws Medical Centre

As you may have noticed the practice is continuing to work differently than it did pre-Covid. Due to increasing demands it is impossible to return to the appointment system we had prior to the pandemic.

Adult ADHD Self-Report Scale (ASRS v1.1)

You have contacted the practice looking to arrange an assessment for possible ADHD.

This assessment is carried out by the community mental health team (CMHT).

At present the waiting time for an ADHD assessment is about 12 months.

ADHD is neurodevelopmental condition that can impact your behaviour and the way you experience the world around you.

If you have ADHD your brain might work differently to other people. It means that the way your brain controls your concentration, activity levels and impulses is a bit different – this is a form of neurodiversity.

For example, you might act without thinking about the consequences or be very easily distracted.

Symptoms tend to start very early in life, before the age of six. Lots of people will get an ADHD diagnosis at this age, but you can be diagnosed at any stage in your life and you might not realise you have ADHD until you’re much older.

Symptoms for ADHD can be different for everyone and can depend on your age, sex, gender identity and whether you have any other neurodevelopmental conditions.

ADHD can run in families, but the cause is mostly unknown.

At present there is a huge demand for ADHD testing and often referral are rejected due to lack of information.

To help the CMHT assess your referral please complete the following form with as much information as possible. If you require a paper copy, please contact our reception team.

It would be helpful if you give specific examples of how you may be hyperactive, impulsive or inattentive and particularly explain with examples how this has affected you throughout your whole life.

Adult ADHD Self Report Scale (ASRS – v1.1)
Please use format day/month/year e.g. 12/05/1979

Please answer the questions below, rating yourself on each of the criteria shown using the scale from never to very often. As you answer each question, select the answer that best describes how you have felt and conducted yourself over the past 6 months.

Part A

1. How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done?
2. How often do you have difficulty getting things in order when you have to do a task that requires organisation?
3. How often do you have problems remembering appointments or obligations?
4. When you have a task that requires a lot of thought, how often do you avoid or delay getting started?
5. How often do you fidget or squirm with your hands or feet when you have to sit down for a long time?
6. How often do you feel overly active and compelled to do things, like you were driven by a motor?

Part B

7. How often do you make careless mistakes when you have to work on a boring or difficult project?
8. How often do you have difficulty keeping your attention when you are doing boring or repetitive work?
9. How often do you have difficulty concentrating on what people say, even when they are speaking to you directly?
10. How often do you misplace or have difficulty finding things at home or at work?
11. How often are you distracted by activity or noise around you?
12. How often do you leave your seat in meetings or other situations in which you are expected to remain seated?

Part C

13. How often do you feel restless or fidgety?
14. How often do you have difficulty unwinding and relaxing when you have time to yourself?
15. How often do you find yourself talking too much when you are in social situations?
16. When you’re in a conversation, how often do you find yourself finishing the sentences of the people you are talking to, before they can finish them themselves?
17. How often do you have difficulty waiting your turn in situations when turn-taking is required?
18. How often do you interrupt others when they are busy?

Please answer the following questions in your own words, providing examples about inattention, impulsivity and hyperactivity.

Privacy Policy

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data.