ADHD Stop and Redirect: Day 1 Intake

Page 1: Welcome and details
Full name

First NameLast Name
This form takes about 10 minutes. Your answers are what I use to write your audio, so be as honest and specific as you can.
Email address
example@example.com
Consent
Page 5: Your thought loops
Which thought loops show up for you most often?
If you ticked Other, write it here
What are the three hardest thoughts you get stuck on?
Can you share one recent example of a thought loop?
What feelings come up when the loop starts?
Does the loop usually start mostly from a thought inside your head, mostly something outside, or both equally?
Page 6: What you want instead
What feeling do you want more of?

Other
Describe that feeling in your own words
Choose your STOP signal
Only if you chose Other above: describe your own STOP signal
A word, a short phrase, or an image, for example Enough, Not now, a red light, a door closing. If you picked a STOP signal from the list above, type N/A here.
When the loop starts, what do you want to be able to say to yourself instead?
Write it the way you would actually say it. For example: I've done enough for today. Resting is part of the work. I can stop now and start again tomorrow. One thing at a time is still progress. Their silence isn't about me. Feedback is information, not a verdict. Pick one or write your own.
Anything else we should know before writing the audio?
Sender
Should be Empty: