CHAT Tool - Offender Health Research Network

Tick No or Yes as appropriate for each question and include additional notes No Yes
ATTENTION DEFICIT HYPERACTIVITY DISORDER
(symptoms should be present since childhood and pervasive across different settings)
Do you find it difficult to sustain attention or concentrate
Do you often feel restless, especially in situations where it is inappropriate
Do you interrupt people a lot so that they get upset with you
Do you find it hard to sit still or do people often tell you to stop fidgeting
Do you find it difficult to wait for your turn
ACTION FOR CARE PLAN
Surname:
DOB:
Forenames:
NHS Number:
CHAT Tool Secure Estate (Version 3 - June 2013)
76 | P age