NICHQ ADHD Primary Care Initial Evaluation Form - depts washington 2026

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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