ADHD Testing Eligibility Pre-Screen
This brief pre-screen helps determine whether our Adult ADHD Testing service is appropriate for you.The screening takes about 1–2 minutes to complete.If eligible, you will receive instructions for the next step of the testing process. Some responses may indicate that ADHD testing may need to be postponed. If this occurs, guidance will appear explaining the reason.
Email Address
*
example@example.com
Full Name
*
First Name
Last Name
Are you 18 years or older?
*
Yes
No
If you answer No to the question 'Are you 18 years or older?', this form will end as the testing service is only available for adults.
Are you seeking immediate medication management through this testing service?
*
Yes
No
Are you currently experiencing any of the following?
*
Active suicidal thoughts
Recent psychiatric hospitalization (past 3 months)
Active psychosis or mania
Severe depression or anxiety currently untreated
None of the above
Are you currently taking any prescription medications for mood, attention, or mental health?
*
Yes
No
If yes, have any of these medications been started or had a dose change within the past 30 days?
*
Yes
No
Substance use in the past 30 days
*
Alcohol to intoxication more than 2 days a week
Daily Cannabis use
Benzodiazepines
Opioids
Stimulants
Illicit substances not prescribed to me
None of the above
I understand and acknowledge the following:
The QbTest is an objective data collection tool used to support a clinical assessment.
This testing does not guarantee a medication prescription.
Results must be interpreted by a clinician alongside other relevant clinical data.
I will follow all preparation instructions to ensure test validity.
I have read and acknowledge the statements above.
*
I have read and acknowledge the statements above.
Submit
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