NICHQ ADHD Primary Care Initial Evaluation Form - depts washington 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering the patient's name, date of birth, and evaluation date at the top of the form. Ensure accuracy as this information is crucial for identification.
  3. Fill in the parent(s) and teacher's details, including names and contact numbers. This section helps gather comprehensive insights from multiple sources.
  4. Complete the significant past medical history section. Provide detailed information on birth history, developmental milestones, health history, family medical history, current medications, prior ADHD diagnoses, and any stressors affecting the patient.
  5. In the physical examination section, input height, weight, blood pressure (BP), and findings from HEENT/NECK, CHEST/COR/LUNGS, ABDOMEN (ABD), GU, NEURO assessments.
  6. Proceed to fill out the ADHD diagnostic assessment. Indicate if a rating scale was used and specify which one. Complete both parent and teacher report sections regarding inattentive and hyperactive symptoms.
  7. Finally, review all entries for accuracy before saving or sharing your completed form. Utilize our platform’s features to sign or distribute as needed.

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You can visit Centric Mental Health, our dedicated website for Mental Health Services for more detailed information on Childrens ADHD Assessments, and book your appointment!
The NICHQ Vanderbilt Assessment includes informant forms for parents and teachers. The initial assessment scales have 2 components: symptom assessment and impairment in performance. The initial scales also have symptom screens for 3 other comorbiditiesoppositional-defiant, conduct, and anxiety/depression.
The diagnosis can be made by a mental health professional, like a psychologist or psychiatrist, or by a primary care provider, like a pediatrician.
Adult ADHD Self-Report Scale (ASRS-v1.1) Questionnaire - ADDA - Attention Deficit Disorder Association.
ADHD can be diagnosed by a number of different professionals, including pediatricians, psychiatrists, and clinical psychologists. There is no blood test or brain scan that can tell whether or not a child has ADHD.

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3. Tips to Get Insurance Coverage for ADHD Testing Confirm if your provider is in-network for ADHD testing. Obtain a referral from your primary care physician if needed. Provide medical documentation to support the necessity of ADHD testing.

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