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FOLLOW-UP FORM: ADHD

How have you felt WITH your medication since the last time you had an office-visit?

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

How satisfied are you with your day-to-day ability to accomplish tasks, communicate effectively, and pay attention?

 
1=POOR 10=GREAT
 
1=POOR 10=GREAT
 
1=POOR 10=GREAT
 
1=POOR 10=GREAT
1= POOR 10=GREAT
 
 
If yes, please describe.

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