ADHD

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ADHD

Please complete this form only if the purpose is related to ADHD.

This consultation is designed to help us understand your symptoms and provide the best possible care for your ADHD assessment or management. We will ask you a series of questions about your symptoms, medical history, and how ADHD may be affecting your daily life. Please answer as accurately as possible to help us offer appropriate advice and support.

2. You must agree to the following to continue your econsultation. *

I accept that I must complete this consultation in full and that I must click "FINISH" in order for this econsultation to be sent and reviewed by my surgery.

Please confirm that you agree to our privacy and data sharing policy. *

I agree to my data being stored, shared, and used for further communication in accordance with the privacy policy which can be found here for Bramley, Middleton, and Cottingley, here for Briercliffe GP Surgery, here for Gateshead Healthcare, here for Queens Medical Centre and Lynton, here for the Mayflower Group, and here for Coleridge.

4. We work with clinicians across the NHS. Your consultation may be reviewed by a suitably trained Clinical Pharmacist working for us or a local pharmacy who may contact you to carry out a telephone consultation if required. For more information, click here. *

I accept that my econsultation may be reviewed by a suitably trained Clinical Pharmacist working for my GP Surgery or a local pharmacy who may contact me to carry out a telephone consultation if required, or by another healthcare professional where clinically appropriate (eg a Doctor, Nurse Practitioner, or Paramedic).

5. All subsequent questions during the online consultation are directed at the person requiring the online consultation. You should only complete this consultation for: a) yourself, (b) for someone else where you have their permission to do so, (c) for someone else where you are permitted in law (for example, a parent or guardian, carer, someone with power of attorney). Please indicate who you are completing this online consultation for: *

Myself
Someone else (I have parental responsibility or I am a carer)
Another person (with their permission or allowed in law)

1. Econsultation reason: *

2. You must agree to the following to continue your econsultation. *

Please confirm that you agree to our privacy and data sharing policy. *

4. We work with clinicians across the NHS. Your consultation may be reviewed by a suitably trained Clinical Pharmacist working for us or a local pharmacy who may contact you to carry out a telephone consultation if required. For more information, click here. *