THE TEST

Check only 1 box per question

                    
Rarely
Sometimes

Carelessness

Overlook or miss details? Submit inaccurate work?

RARELY
SOMETIMES
FREQUENTLY

Trouble staying focused

Trouble focusing throughout meetings or conversations?

RARELY
SOMETIMES
FREQUENTLY

Poor listening

Do you become distracted during conversations?

RARELY
SOMETIMES
FREQUENTLY

Easily sidetracked

Do you start tasks then lose focus?

RARELY
SOMETIMES
FREQUENTLY

Difficulty organizing work

Are you disorganized and messy? Do you miss deadlines?

RARELY
SOMETIMES
FREQUENTLY

Avoid lengthy mental tasks

Do you avoid paperwork or reviewing lengthy reports?

RARELY
SOMETIMES
FREQUENTLY

Losing everyday items

Like your keys, phone or glasses?

RARELY
SOMETIMES
FREQUENTLY

Easily distracted

Does your mind frequently wander?

RARELY
SOMETIMES
FREQUENTLY

Forgetfulness

Do you forget to return calls, keep appointments or pay bills on time?

RARELY
SOMETIMES
FREQUENTLY
Rarely
Sometimes

Fidgeting

Do you tap your hands, feet or squirm in your seat?

RARELY
SOMETIMES
FREQUENTLY

Can’t stay seated

Even when you’re expected to?

RARELY
SOMETIMES
FREQUENTLY

Feeling restless

Are you often on edge?

RARELY
SOMETIMES
FREQUENTLY

Difficulty with quiet activities

Like sitting through presentations or movies?

RARELY
SOMETIMES
FREQUENTLY

Always “on the go”

Uncomfortable being still for extended periods of time?

RARELY
SOMETIMES
FREQUENTLY

Talking excessively

Ignoring or missing social cues in the process?

RARELY
SOMETIMES
FREQUENTLY

Interrupting others

Do you cut others off, in traffic or conversation?

RARELY
SOMETIMES
FREQUENTLY

Have trouble waiting in line

In traffic, at the bank, etc.?

RARELY
SOMETIMES
FREQUENTLY

Intrusiveness

Do you butt into conversations or activities?

RARELY
SOMETIMES
FREQUENTLY

The number of checks under “sometimes” and “frequently” should be counted. If your score, in either column, is between 5-9, a full evaluation should be seriously considered.

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