ADD/ADHD Screening Form

Assessments are currently being conducted via phone/video as the assessor is outside of New Zealand due to COVID-19 travel restrictions. 

If you are under 18, we recommend contacting Dr Garth Smith | Paediatrician to conduct the assessment face-to-face.


To ensure we provide you with the service that is most appropriate for your situation, and your needs,
we ask that you respond to the following questions:

Contact Details
ADD/ADHD Initial Screening Form
Has the person requiring assessment ever been diagnosed with, or been treated for, a mental health condition
Does the person requiring assessment have any history of developmental learning problems
Has the person requiring assessment had any behavioural difficulties at school or work
Is the person requiring assessment currently on any medications
Does the person requiring assessment have any family history of mental health
Does the person requiring assessment have a history of legal difficulties
Does the person requiring assessment have a history of substance abuse treatment
Does the person requiring assessment have a history of, or currently use recreational drugs
Does the person requiring assessment have a history of involvement with Oranga Tamariki or experienced out-of-home care
Does the person requiring assessment have a history of any head injuries requiring medical care
CAPTCHA
We'd like to prevent automated spam submissions. Please demonstrate that your are not a robot.