Client Profile Page 2

General Health

Temperament

Diagnosed with ADD?

When

If so, Do You Use Meds?

Others in Family w/ADD?

List Your ADD Support Team

Current or Previous Problems with

Current or Previous Problems with Alcohol or

Depression?

Drugs?

Any Family History of the Above?

Quality of Relationships with Family and Friends?

_____ Poor

_____Fair

_____Good

_____Excellent

Describe Your Workspace

Any Sleep Problems?

Describe Your To-Do List or Number of Projects in Process

Are You Always On Time or Always Late?

Are You Impulsive? When?

Have You Worked with a Counselor/Therapist?

How Do You Like to Learn? (visual – see the picture or color, tactile - touch, auditory - hear,

verbal – speak out loud and free-associate, kinesthetic – moving and doing, cerebral – think

about the big picture and make sense of the puzzle)

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Parent category: Business