Adult ADHD - Information needed for GP

Page {{ paginatorProps.current }} of {{ paginatorProps.total }} ({{ paginatorProps.percentage }}% completed)

All questions marked with a * are mandatory

Processing
Personal Details
Processing
ADHD Questions
Is there any evidence of symptom onset in childhood (< 12 years old): *
Examples such as substance use, forensic history, relationship difficulties, failing in work/study
(including any diagnosis, past or current support from a local mental health team e.g. CMHT, IAPT)
(employment status, in education, independent living skills)

Privacy Consent

This form collects personal and medical information about you. We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage your submitted data.

Processing

There appears to be a problem loading the form, please refresh the page.
If the error persists please contact us.

Veteran Friendly Armed Forces veteran
friendly accredited
GP practice

Providing NHS Services

Contact

Thatcham Medical Practice
The Health Centre
Bath Road
Thatcham
Berkshire
RG18 3HD

Telephone: 01635 867171

The Practice

Quick Links

The Care Quality Commission Inspected and rated Good
-->