Pre-Assessment

These first questions look at focus, attention, and how you handle everyday things. There are no right or wrong answers, just go with how things have actually been for you. After this part, we'll ask a little about your medical history.

Personal Information

Tell us a little about yourself

First name (legal)

Last name

Preferred name Optional

Email Your email will only be used to respond to your submission with next steps. We do not share or sell your info. Privacy is respected.

Mobile phone number We'll text this number to verify it, and later with updates about your intake and your next steps.

Sex assigned at birth

Gender

Pronouns Optional

Age Verification

We need to confirm you're 18 or older.

Are you over the age of 18?

Yes

No

Date of birth

Pre-Assessment (1 of 2)

The next questions are about the past 6 months.

Answer based on how things have been for you recently — not your whole life.

Pre-Assessment (1 of 2)

For each one, rate how often it's bothered you.

🕐Thinking about the past 6 months

How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done?

Never
Rarely
Sometimes
Often
Very often

Pre-Assessment (1 of 2)

For each one, rate how often it's bothered you.

🕐Thinking about the past 6 months

How often do you have difficulty getting things in order when you have to do a task that requires organization?

Never
Rarely
Sometimes
Often
Very often

Pre-Assessment (1 of 2)

For each one, rate how often it's bothered you.

🕐Thinking about the past 6 months

How often do you have problems remembering appointments or obligations?

Never
Rarely
Sometimes
Often
Very often

Pre-Assessment (1 of 2)

For each one, rate how often it's bothered you.

🕐Thinking about the past 6 months

When you have a task that requires a lot of thought, how often do you avoid or delay getting started?

Never
Rarely
Sometimes
Often
Very often

Pre-Assessment (1 of 2)

For each one, rate how often it's bothered you.

🕐Thinking about the past 6 months

How often do you fidget or squirm with your hands or feet when you have to sit down for a long time?

Never
Rarely
Sometimes
Often
Very often

Pre-Assessment (1 of 2)

For each one, rate how often it's bothered you.

🕐Thinking about the past 6 months

How often do you feel overly active and compelled to do things, like you were driven by a motor?

Never
Rarely
Sometimes
Often
Very often

Pre-Assessment (2 of 2)

You're almost done with this part.

These next questions ask about everyday habits, still just thinking about the past 6 months.

Pre-Assessment (2 of 2)

First, a few questions about how you handle time

For each one, rate how often it's been a problem for you.

🕐Thinking about the past 6 months

Procrastinate or put off doing things until the last minute

Never or rarely
Sometimes
Often
Very often

Pre-Assessment (2 of 2)

First, a few questions about how you handle time

For each one, rate how often it's been a problem for you.

🕐Thinking about the past 6 months

Can't seem to hold in mind things I need to remember to do

Never or rarely
Sometimes
Often
Very often

Pre-Assessment (2 of 2)

First, a few questions about how you handle time

For each one, rate how often it's been a problem for you.

🕐Thinking about the past 6 months

Not motivated to prepare in advance for things I know I am supposed to do

Never or rarely
Sometimes
Often
Very often

Pre-Assessment (2 of 2)

First, a few questions about how you handle time

For each one, rate how often it's been a problem for you.

🕐Thinking about the past 6 months

Have trouble doing what I tell myself to do

Never or rarely
Sometimes
Often
Very often

Pre-Assessment (2 of 2)

Next, how you tackle organization and planning

For each one, rate how often it's been a problem for you.

🕐Thinking about the past 6 months

Have trouble learning new or complex activities as well as others

Never or rarely
Sometimes
Often
Very often

Pre-Assessment (2 of 2)

Next, how you tackle organization and planning

For each one, rate how often it's been a problem for you.

🕐Thinking about the past 6 months

Have difficulty explaining things in their proper order or sequence

Never or rarely
Sometimes
Often
Very often

Pre-Assessment (2 of 2)

Next, how you tackle organization and planning

For each one, rate how often it's been a problem for you.

🕐Thinking about the past 6 months

Unable to "think on my feet" or respond as effectively as others to unexpected events

Never or rarely
Sometimes
Often
Very often

Pre-Assessment (2 of 2)

Next, how you tackle organization and planning

For each one, rate how often it's been a problem for you.

🕐Thinking about the past 6 months

I don't seem to process information as quickly or as accurately as others

Never or rarely
Sometimes
Often
Very often

Pre-Assessment (2 of 2)

Now, a few about impulses and self-control

For each one, rate how often it's been a problem for you.

🕐Thinking about the past 6 months

Unable to inhibit my reactions or responses to events or others

Never or rarely
Sometimes
Often
Very often

Pre-Assessment (2 of 2)

Now, a few about impulses and self-control

For each one, rate how often it's been a problem for you.

🕐Thinking about the past 6 months

Make impulsive comments to others

Never or rarely
Sometimes
Often
Very often

Pre-Assessment (2 of 2)

Now, a few about impulses and self-control

For each one, rate how often it's been a problem for you.

🕐Thinking about the past 6 months

Likely to do things without considering the consequences for doing them

Never or rarely
Sometimes
Often
Very often

Pre-Assessment (2 of 2)

Now, a few about impulses and self-control

For each one, rate how often it's been a problem for you.

🕐Thinking about the past 6 months

Fail to consider past relevant events or past personal experiences before responding to situations (I act without thinking)

Never or rarely
Sometimes
Often
Very often

Pre-Assessment (2 of 2)

A few about how you stick with things

For each one, rate how often it's been a problem for you.

🕐Thinking about the past 6 months

Do not put as much effort into my work as I should or than others are able to do

Never or rarely
Sometimes
Often
Very often

Pre-Assessment (2 of 2)

A few about how you stick with things

For each one, rate how often it's been a problem for you.

🕐Thinking about the past 6 months

Others tell me I am lazy or unmotivated

Never or rarely
Sometimes
Often
Very often

Pre-Assessment (2 of 2)

A few about how you stick with things

For each one, rate how often it's been a problem for you.

🕐Thinking about the past 6 months

Inconsistent in the quality or quantity of my work performance

Never or rarely
Sometimes
Often
Very often

Pre-Assessment (2 of 2)

A few about how you stick with things

For each one, rate how often it's been a problem for you.

🕐Thinking about the past 6 months

Unable to work as well as others without supervision or frequent instruction

Never or rarely
Sometimes
Often
Very often

Pre-Assessment (2 of 2)

Last few, about emotions

For each one, rate how often it's been a problem for you.

🕐Thinking about the past 6 months

Have trouble calming myself down once I am emotionally upset

Never or rarely
Sometimes
Often
Very often

Pre-Assessment (2 of 2)

Last few, about emotions

For each one, rate how often it's been a problem for you.

🕐Thinking about the past 6 months

Cannot seem to regain emotional control and become more reasonable once I am emotional

Never or rarely
Sometimes
Often
Very often

Pre-Assessment (2 of 2)

Last few, about emotions

For each one, rate how often it's been a problem for you.

🕐Thinking about the past 6 months

Cannot seem to distract myself away from whatever is upsetting me emotionally to help calm me down. I can't refocus my mind to a more positive framework.

Never or rarely
Sometimes
Often
Very often

Pre-Assessment (2 of 2)

Last few, about emotions

For each one, rate how often it's been a problem for you.

🕐Thinking about the past 6 months

I remain emotional or upset longer than others

Never or rarely
Sometimes
Often
Very often

Submitting your responses…

Your results indicate that you show signs of common ADHD symptoms.

If you're curious about treatment, discussing your symptoms with an experienced clinician is your next step. But first, click continue below to share a little more about your medical history.

Continue: Medical History

Thanks for taking the time to complete the pre-assessment.

Based on your responses, your symptoms don't currently align with what we typically see in adult ADHD, but we don't want to leave you without direction.

This pre-assessment is a screening tool developed by the World Health Organization, not a diagnosis. It's common for people to feel like they may have ADHD when symptoms are actually stemming from another health condition or something going on in their personal or professional life. A more comprehensive evaluation can help sort that out.

Since we specialize specifically in adult ADHD, here are a few resources that may be a better fit:

Your primary care provider can help identify what might be contributing to your symptoms and connect you with the right specialist
ZocDoc lets you search providers by location and insurance: zocdoc.com
The Semel Institute at UCLA has a strong ADHD clinic with psychiatrists on staff: teams.semel.ucla.edu/adhd

Wishing you the best in your search.

— Millennium Medical Associates

Care match

We appreciate you taking the time to complete this.

Based on your responses, our practice may not be the best fit for your needs at this time. We want to make sure you receive the most appropriate care.

What this means: Our practice provides ADHD evaluation and treatment for adults aged 18 and older. For ADHD evaluation in children or adolescents, please speak with your pediatrician or a child/adolescent psychiatrist who can connect you with the right resources.

What we recommend: Please follow up with your primary care provider or a specialist who can better support your specific needs.

If you believe this was an error or have questions, please contact our office at (310) 734-8864.

It appears as if you have already submitted an assessment with us in the past.

If you believe you are seeing this message in error, please reach out to us at care@millenniummedicalassociates.com and we'll get everything squared away as soon as possible.