ADHD Assessment for Adults PDF: Free Editable Evaluation Form

What You Need to Know About the ADHD Assessment for Adults PDF

• An ADHD assessment for adults PDF is a printable form for a full attention-deficit/hyperactivity disorder (ADHD) evaluation.
• More than half of US adults with ADHD, 55.9%, received their diagnosis at age 18 or older.¹
• Pair the form with a free or licensed screener, and let the full workup guide the diagnosis.

Download the ADHD Assessment for Adults PDF

The form comes as an editable DOCX and a printable PDF with the same 15 sections.

Note: This template is for informational purposes only and does not constitute legal or medical advice. Have your compliance officer review it before clinical use.

• Download the Adult ADHD Assessment Form (DOCX)
• Download the ADHD Assessment for Adults PDF

What Should an Adult ADHD Assessment Cover Beyond a Screener?

An adult ADHD assessment should check a positive screen against childhood history, daily life, and other conditions. The screen shows who needs a closer look. The rest of the workup shows whether symptoms began early and still cause problems. When the workup points to other conditions, a full psychiatric evaluation template covers psychiatric, medical, social, and family history in the sections American Psychiatric Association guidelines define.

A 2024 National Academies workshop report states there were "no United States guidelines for diagnosing and treating adults with ADHD."²

The form puts the workup in a set order and holds no licensed test items. The evaluating clinician records the findings and makes the diagnosis.

What Does This ADHD Assessment for Adults PDF Include?

The ADHD assessment for adults PDF has 15 sections in the order of a full evaluation. Fields use bracket placeholders, such as [Patient Name], in place of patient data.

• Patient and visit. Fill in [Patient Name], [Date of Birth], and [Medical Record Number]. Add the date of service, session length, service type, and clinician license number.
• Reason for assessment. Write the concern in the patient's own words next to the referral question.
• Consent and privacy. Check that treatment consent is on file. A printed notice keeps psychotherapy notes out of this record.
• Screening results. Record the date, scoring method, and result of the Adult ADHD Self-Report Scale (ASRS) screener.
• Current symptoms. Enter counts from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). According to the American Psychiatric Association (APA), adults over age 17 need five from either symptom group.³
• Childhood onset. Mark whether several symptoms began before age 12, and name the source.
• Impairment by setting. Describe problems at work, at home, and with others. The APA describes a pattern "present in multiple settings."³
• Collateral informant. Record input from someone who knows the patient well and note whether a release is on file.
• Other conditions. Review depression, anxiety, substance use, bipolar disorder, and autism. The APA notes that DSM-5 has no autism exclusion.³
• Substance use. Record use history and flag substance use disorder (SUD) records covered by federal Part 2 rules.
• Risk and safety. Check for suicidal thoughts, homicidal thoughts, and self-harm, and note any safety plan.
• Impression and plan. Enter the DSM-5 diagnosis and a current-year ICD-10-CM code. Set measurable goals with a review date for the mental health treatment plan.
• Addendum and signature. Date any late entry with a reason, then sign with credentials and date.

Which Adult ADHD Screening Tools Are Free to Use, and Which Need Permission?

Of the ASRS scales, the ASRS v1.1 six-question screener is free to use without formal permission.⁴ The owner asks users to cite the 2005 paper on the scale and to include its copyright notice.⁴ The longer checklist and the newer ASRS-5 each need a permission request.⁴

For a licensed tool, use the validated instrument with appropriate licensing. Depression and anxiety screens, such as the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), can support rule-outs. Both appear in this guide to the mental health questionnaire.

How Accurate Is the ASRS Screener, and What Does a Positive Screen Mean?

The ASRS v1.1 screener closely matched clinician diagnoses in a study of 668 US health plan members.⁷ Its accuracy score, the area under the curve (AUC), was 0.90 on a scale where 1.0 is perfect.⁷

The owner's 2024 scoring update lists two scoring rules.⁸

• Original rule. One point per item above a set threshold gives a 0 to 6 total, and 4 or more screens positive.⁸
• Alternative rule. Answers score 0 for "never" up to 4 for "very often," and a 0 to 24 total of 14 or more screens positive.⁸

The owner reports that the 0 to 6 rule gave high or uneven prevalence estimates.⁸

The ASRS-5 is a separate screener built for DSM-5.⁹ In general population data, it caught 91.4% of true cases.⁹ It also cleared 96.0% of people without ADHD.⁹

In a clinical sample where 57.7% met criteria, that second figure fell to 74.0%.⁹ More people without ADHD screen positive in that setting.

A positive screen starts the evaluation. CAMH, a Canadian mental health center, states, "The tool does not make the diagnosis."¹⁰

How Do You Complete an Adult ADHD Evaluation Step by Step?

Follow the order of the form, from the screen to a plan.

1. Log the screen. Enter the screener date, scoring method, and result.
2. Interview the patient. A 2024 National Academies workshop summary says the interview "should inquire about symptoms, impairments, and comorbid conditions."²
3. Confirm childhood onset. Check early examples against school records or family reports.
4. Map daily impact. Give one concrete example per setting.
5. Get outside history. CAMH suggests having the patient's partner complete the screening tool too.¹⁰ Get a signed release first.
6. Rule out other causes. Review mood, anxiety, substance use, and bipolar symptoms.
7. Record the impression and plan. List pending items, goals, and the follow-up date.

The same workshop reported that more than 70% of adults with ADHD have at least one other psychiatric disorder.² Its figures put depression near 55% and anxiety near 47%.² Workshop figures also list substance use disorders at 41% and bipolar disorder at 35%.²

How Should You Document and Protect an Adult ADHD Assessment?

File the completed form in the medical record and protect it as PHI under the HIPAA Privacy Rule. Psychotherapy notes kept apart from that record generally need a separate patient authorization before you share them (45 CFR 164.508(a)(2)). Keep this form out of any file you hold for psychotherapy notes.

• 42 CFR Part 2. These federal rules apply to "any federally assisted program that provides SUD diagnosis, treatment, or referral for treatment."¹¹ Compliance with the 2024 final rule "was required by February 16, 2026."¹¹
• State law. Mental health privacy requirements vary by state and can be stricter than HIPAA. Ask your compliance officer to review the form.
• Telehealth prescribing. A temporary Drug Enforcement Administration (DEA) extension lets practitioners "remotely prescribe Schedule II-V controlled medications via audio-video telemedicine encounters."¹² The extension runs "through December 31, 2026," so check the DEA site before you prescribe.¹²
• Instrument copyright. Keep the owner's notice with any ASRS v1.1 screener you use: "Copyright © New York University and President and Fellows of Harvard College. All rights reserved."⁴

A full adult evaluation produces a long interview record for the clinician to turn into these fields. Practices that plan to audio-record the interview can compare AI scribes for psychiatry on mental status exam (MSE) structure, risk documentation, and 42 CFR Part 2 handling.

How Can Commure Scribe Help Document an Adult ADHD Evaluation?

Record the adult ADHD interview with Commure Scribe, and the evaluating clinician can stay present in the room. Commure Scribe supports in-person and telehealth visits and recognizes multiple speakers, including a partner giving collateral history.

Within seconds of ending the recording, a structured SOAP note appears with suggested ICD-10 and CPT codes. The clinician reviews and edits the note, then carries the history and impression details into this form. Specialty templates and a custom template builder help match the note to the form's sections.

Commure Scribe is HIPAA compliant and SOC 2 certified, with onshore data storage. Before committing, review how AI medical scribes work and what to evaluate, then run a one-week trial on real evaluations.

Keep your focus on the ADHD interview

A full ADHD evaluation leaves a long interview to write up, and Commure Scribe can draft that note for your review. Start a 7-day trial, no credit card required, or see current Commure Scribe plans.

This article is for informational and educational purposes only, does not constitute legal, medical, or professional advice, and does not guarantee regulatory compliance or diagnostic accuracy.

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