Appointment preparation worksheet
Short answer
This printable worksheet helps you gather what to say before an appointment about attention: your main concerns, when they started, where they show up, how they affect daily life, other things going on, and the questions you want to ask. Fill it in over a few days, bring it with you, and let the clinician decide what it means.
Print this page or copy the sections into a notebook. Write in short phrases; complete sentences are not needed. You can leave any section blank. The worksheet is for your own preparation and is not a test or a diagnostic tool.
How to use it
- Start a few days before the appointment, so examples have time to come to mind.
- Fill in Part A first. If you run out of time, that section matters most.
- Ask someone who knows you well whether they would add anything, if you are comfortable sharing it.
- Circle the few points you most want to cover, in case the visit is short.
- Bring the sheet and hand it over if talking feels hard.
Part A: What brings me in
| My concern, in my own words | Most recent example | How much it bothers me (a little, a lot) |
|---|---|---|
Part B: When it started
- When do I first remember noticing this? ______
- What was school like for me before my teens? ______
- Comments from teachers or report cards I remember: ______
- Family members who could share what they saw: ______
- Did anything change recently (new job, move, loss, baby, illness)? ______
Part C: Where it shows up
| Setting | Example of what happens | How often |
|---|---|---|
| Work or school | ||
| Home and money | ||
| Partner, family, friends | ||
| Driving, health habits, other |
Part D: Other things going on
- Sleep (hours, quality, snoring or waking at night): ______
- Stress, mood or worry lately: ______
- Health conditions I have: ______
- Medicines and supplements I take (bring the names): ______
- Alcohol, caffeine or other substances: ______
- Close relatives with attention or learning concerns, if known: ______
Part E: Questions I want to ask
- What could be causing what I am describing?
- What does an evaluation involve here, and who does it?
- Is there anything else you would want to check first?
- What information or records would be useful to bring next time?
- What are my options after the evaluation?
- My own question: ______
Part F: What to bring
- This worksheet
- Your screener result and answer grid, if you took a screener
- A list of medicines and supplements
- Old report cards or school records, if you have them
- Names and contact details of anyone willing to share observations
Part G: Notes during the appointment
| What the clinician said | Next steps and who does them | Follow-up date |
|---|---|---|
It is fine to ask the clinician to repeat something or to write it down for you. Many people forget part of what was said once they leave the room. Afterward, keep the sheet with your other notes, so you can build on it before any follow-up visit rather than starting over.
A starting point for your next step.
If you have not taken a screener yet, the free six-question ASRS adult screener gives you a result to add to Part F.Frequently asked questions
Do I need to fill in every section?
No. Fill in what you can. Even a few specific examples and questions make an appointment more productive.
Who should I bring this worksheet to?
Any healthcare provider you plan to talk with about attention, such as a primary care provider. Per CDC, that first provider can make the diagnosis or point you to a mental health specialist.
Will the worksheet tell me if I have ADHD?
No. It only organizes your own observations. A qualified clinician decides what they mean through an evaluation.
Sources
Source check: 2026-10-28. No medical review has occurred.
- NHS, Attention deficit hyperactivity disorder (ADHD) in adults
- NIMH, Attention-Deficit/Hyperactivity Disorder: What You Need to Know
- CDC, ADHD in Adults
Published 2026-10-28. Factual source check: ADHDFalcon editorial team, factual source check, 2026-10-28. No medical review has occurred.