Assessment Intake Questions

ADHD Assessment Intake

Thank you for visiting our website to explore your options to

complete an Adult ADHD Assessment at CBT Niagara.

Please respond to the questions below to the best of your ability, as it

will allow our Assessment Intake Team the information they need

to best support you as you explore assessment options.

First name

Last name

Have you ever been diagnosed with ADD or ADHD?

Will you be working with your family doctor as you pursue this assessment?

Will you be using the results of your assessment for work or school accommodations?

Yes

Unsure

Other

Do you have an accessibility needs that we should be aware of, in order for our team to best support you in completing this assessment?

Yes

Once you click submit on this form, you will be redirected to a new page, to complete a standard Intake Form for new clients at CBT Niagara.

Please note that you will need to submit an Intake Form in order to provide our Intake Team with your contact information.