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ADHD Assessment Form Template: Free Examples & Best Practices (2025)

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ADHD Assessment Form Template: Free Examples & Best Practices (2025)
ADHD Assessment Form Template: Free Examples & Best Practices (2025)
Quick Answer: ADHD Assessment Form Template

An ADHD assessment form template is a structured clinical tool used to systematically evaluate attention, hyperactivity, and impulsivity symptoms according to DSM-5 criteria. A comprehensive ADHD assessment includes developmental history, symptom rating scales (such as ASRS, Conners, or Vanderbilt), functional impairment evaluation, differential diagnosis screening, and collateral information gathering. Below you’ll find free templates for adult and pediatric ADHD evaluations, plus guidance on using AI-powered documentation to streamline your assessment workflow.


Introduction

ADHD assessment requires meticulous documentation to establish diagnosis, rule out alternative explanations, and support treatment planning. With ADHD prevalence estimates of 5-7% in children and 2.5-4% in adults worldwide, clinicians need efficient yet thorough evaluation frameworks.

This guide provides ready-to-use ADHD assessment templates for both adult and pediatric populations, reviews validated screening instruments, and explores how modern AI documentation tools can enhance your assessment efficiency while maintaining clinical rigor.


DSM-5 Diagnostic Criteria Overview

Before using assessment templates, clinicians should be familiar with DSM-5 criteria for ADHD diagnosis:

Core Symptom Domains

Inattention (6+ symptoms for children, 5+ for adults 17+): Fails to give close attention to details, difficulty sustaining attention, does not seem to listen when spoken to directly, fails to follow through on instructions, difficulty organizing tasks, avoids tasks requiring sustained mental effort, loses things necessary for tasks, easily distracted by extraneous stimuli, forgetful in daily activities.

Hyperactivity-Impulsivity (6+ symptoms for children, 5+ for adults 17+): Fidgets or squirms, leaves seat when remaining seated is expected, runs or climbs in inappropriate situations, unable to engage in leisure activities quietly, “on the go” or “driven by a motor,” talks excessively, blurts out answers, difficulty waiting turn, interrupts or intrudes on others.

Additional Diagnostic Requirements

Several symptoms present before age 12 years, symptoms present in two or more settings (home, school, work, social), clear evidence symptoms interfere with functioning, symptoms not better explained by another mental disorder.

ADHD Presentation Specifiers

Combined Presentation (314.01): Criteria met for both inattention and hyperactivity-impulsivity for past 6 months. Predominantly Inattentive Presentation (314.00): Inattention criteria met but not hyperactivity-impulsivity for past 6 months. Predominantly Hyperactive-Impulsive Presentation (314.01): Hyperactivity-impulsivity criteria met but not inattention for past 6 months.


Essential Components of ADHD Assessment

A comprehensive ADHD assessment should include the following elements:

Clinical Interview

Chief complaint and presenting concerns, detailed symptom history including onset, duration, and severity, developmental history (milestones, early childhood behavior), academic/occupational history and performance, social and relationship history, family psychiatric history (especially ADHD, mood, anxiety), medical history and current medications, substance use history, and previous evaluations and treatments.

Standardized Rating Scales

Self-report measures, parent/teacher/spouse collateral ratings, validated instruments with established norms, and multi-informant data collection.

Functional Impairment Assessment

Academic/occupational functioning, social relationships, home and family life, self-care and daily living, financial management, and driving and safety concerns.

Differential Diagnosis Screening

Mood disorders (depression, bipolar), anxiety disorders, learning disabilities, autism spectrum disorder, sleep disorders, substance use disorders, medical conditions affecting attention, and trauma-related disorders.


Template 1: Adult ADHD Comprehensive Assessment

Use for: Initial ADHD evaluations in adults (18+)

ADULT ADHD COMPREHENSIVE ASSESSMENT

Patient: [Name] | DOB: [Date] | Date of Evaluation: [Date] | Clinician: [Name, Credentials]

Referral Source: ___ | Reason for Referral: ___

PRESENTING CONCERNS: Chief complaint: ___. Duration of concerns: ___. Primary symptoms reported: ___. Impact on daily functioning: ___. Previous ADHD diagnosis: No / Yes – when, by whom: ___. Previous ADHD treatment: No / Yes – medications, response: ___.

DEVELOPMENTAL AND CHILDHOOD HISTORY: Pregnancy/birth complications: No / Yes: ___. Developmental milestones: Normal / Delayed: ___. Childhood behavior concerns: ___. Academic performance (elementary): Excellent / Good / Average / Below average / Failing. Childhood symptoms of inattention: ___. Childhood symptoms of hyperactivity: ___. School disciplinary issues: No / Yes: ___. Childhood diagnosis/treatment: ___. Report cards/records available: No / Yes – findings: ___.

EDUCATIONAL HISTORY: Highest education completed: ___. Academic difficulties: No / Yes: ___. Special education services: No / Yes: ___. Learning disability diagnosis: No / Yes: ___. Repeated grades: No / Yes: ___. Standardized test performance: ___.

OCCUPATIONAL HISTORY: Current employment: ___ | Duration: ___. Job performance concerns: ___. Jobs held in past 5 years: ___. Reason for job changes: ___. Workplace accommodations: No / Yes: ___. Organizational difficulties at work: ___. Time management issues: ___.

CURRENT SYMPTOM ASSESSMENT (DSM-5 CRITERIA):

Inattention Symptoms (Rate: 0=Never, 1=Rarely, 2=Sometimes, 3=Often, 4=Very Often):

SymptomRatingExamples/Context
Fails to give close attention to details / careless mistakes0 1 2 3 4___
Difficulty sustaining attention in tasks0 1 2 3 4___
Does not seem to listen when spoken to directly0 1 2 3 4___
Fails to follow through on instructions / finish tasks0 1 2 3 4___
Difficulty organizing tasks and activities0 1 2 3 4___
Avoids tasks requiring sustained mental effort0 1 2 3 4___
Loses things necessary for tasks0 1 2 3 4___
Easily distracted by extraneous stimuli0 1 2 3 4___
Forgetful in daily activities0 1 2 3 4___

Inattention Score: ___/36 | Symptoms rated 3-4: ___/9

Hyperactivity-Impulsivity Symptoms:

SymptomRatingExamples/Context
Fidgets or squirms in seat0 1 2 3 4___
Leaves seat when expected to remain seated0 1 2 3 4___
Feelings of restlessness0 1 2 3 4___
Difficulty engaging in leisure activities quietly0 1 2 3 4___
Feels “on the go” or “driven by a motor”0 1 2 3 4___
Talks excessively0 1 2 3 4___
Blurts out answers before questions completed0 1 2 3 4___
Difficulty waiting turn0 1 2 3 4___
Interrupts or intrudes on others0 1 2 3 4___

Hyperactivity-Impulsivity Score: ___/36 | Symptoms rated 3-4: ___/9

FUNCTIONAL IMPAIRMENT:

DomainImpairment LevelSpecific Impact
Work/CareerNone / Mild / Moderate / Severe___
EducationNone / Mild / Moderate / Severe___
RelationshipsNone / Mild / Moderate / Severe___
Home/FamilyNone / Mild / Moderate / Severe___
FinancesNone / Mild / Moderate / Severe___
Self-CareNone / Mild / Moderate / Severe___
DrivingNone / Mild / Moderate / Severe___

PSYCHIATRIC HISTORY: Previous psychiatric diagnoses: ___. Current psychiatric treatment: ___. Previous psychiatric medications: ___. Psychiatric hospitalizations: No / Yes: ___. Suicide attempts/self-harm: No / Yes: ___. Current suicidal ideation: No / Yes.

COMORBIDITY SCREENING: Depression symptoms: PHQ-9 score ___/27. Anxiety symptoms: GAD-7 score ___/21. Bipolar screening: MDQ positive / negative. Trauma history: No / Yes. Substance use: AUDIT-C ___; DAST ___. Sleep problems: No / Yes: ___. Autism spectrum traits: No / Yes.

MEDICAL HISTORY: Current medical conditions: ___. Current medications: ___. Allergies: ___. Head injury/TBI: No / Yes: ___. Seizure history: No / Yes. Cardiac history: No / Yes. Thyroid disorder: No / Yes. Sleep apnea: No / Yes. Recent physical exam: ___.

SUBSTANCE USE HISTORY: Alcohol: Frequency ___ | Amount ___. Cannabis: No / Yes – frequency: ___. Stimulants (non-prescribed): No / Yes: ___. Other substances: ___. History of substance use disorder: No / Yes: ___. Current recovery status: ___.

FAMILY HISTORY: ADHD in first-degree relatives: No / Yes – who: ___. Other psychiatric conditions in family: ___. Substance use disorders in family: ___.

STANDARDIZED ASSESSMENT RESULTS: ASRS v1.1 Screener: Part A ___/24 (≥14 suggests ADHD). ASRS v1.1 Full: Part B ___/48. WURS (retrospective): ___/100 (≥46 suggests childhood ADHD). CAARS Self-Report: Inattention T-score ___ | Hyperactivity T-score ___ | ADHD Index T-score ___. Collateral Rating (relationship: ___): ___.

COLLATERAL INFORMATION: Informant: ___ | Relationship: ___ | Years known: ___. Informant observations: ___. Childhood information from family: ___. Educational records reviewed: No / Yes – findings: ___. Employment records: No / Yes.

MENTAL STATUS EXAMINATION: Appearance: ___. Behavior: ___. Motor activity: WNL / Psychomotor agitation / Restlessness / Fidgeting. Speech: Rate ___ | Volume ___ | Coherence ___. Mood: ___. Affect: ___. Thought process: Linear / Circumstantial / Tangential. Thought content: ___. Attention/concentration: Intact / Impaired. Memory: Intact / Impaired. Insight: Good / Fair / Poor. Judgment: Good / Fair / Poor.

CLINICAL SUMMARY AND DIAGNOSTIC FORMULATION: ___.

DSM-5 DIAGNOSIS:

Primary: ___ (ICD-10: ___). Specify: Combined Presentation / Predominantly Inattentive / Predominantly Hyperactive-Impulsive. Severity: Mild / Moderate / Severe. Additional diagnoses: ___.

DIAGNOSTIC CRITERIA MET: ≥5 inattention symptoms (adults): Yes / No – count: ___. ≥5 hyperactivity-impulsivity symptoms (adults): Yes / No – count: ___. Symptoms present before age 12: Yes / No / Unclear. Symptoms present in 2+ settings: Yes / No. Clear functional impairment: Yes / No. Not better explained by another disorder: Yes / No.

TREATMENT RECOMMENDATIONS: Medication evaluation: Yes / No. Recommended medication class: Stimulant / Non-stimulant / Other. Psychotherapy: CBT / Coaching / Skills training. Accommodations recommended: Academic / Workplace. Referrals: Neuropsychological testing / Sleep study / Cardiology clearance / Other: ___. Follow-up: ___.

PATIENT EDUCATION PROVIDED: ADHD psychoeducation, treatment options discussed, medication risks/benefits reviewed, non-medication strategies discussed.

Clinician Signature: ___ | Credentials: ___ | Date: ___


Template 2: Child/Adolescent ADHD Assessment

Use for: ADHD evaluations in children and adolescents (ages 6-17)

CHILD/ADOLESCENT ADHD ASSESSMENT

Patient: [Name] | DOB: [Date] | Age: ___ | Grade: ___ | Date: [Date]

Parent/Guardian: ___ | Clinician: [Name, Credentials]

Referral Source: ___ | School: ___

PRESENTING CONCERNS: Primary concerns (parent): ___. Primary concerns (child): ___. Primary concerns (school): ___. Age concerns first noted: ___. Previous evaluations: No / Yes: ___.

DEVELOPMENTAL HISTORY: Pregnancy complications: No / Yes: ___. Delivery: Vaginal / C-section | Term / Preterm (___wks). Birth weight: ___ | APGAR: ___. NICU admission: No / Yes: ___. Motor milestones: Sat ___ | Crawled ___ | Walked ___. Language milestones: First words ___ | Sentences ___. Developmental concerns: ___. Early intervention services: No / Yes: ___.

MEDICAL HISTORY: Chronic conditions: ___. Current medications: ___. Allergies: ___. Head injury/concussion: No / Yes: ___. Seizures: No / Yes. Vision: Normal / Corrected / Concerns. Hearing: Normal / Concerns. Sleep: Hours/night ___ | Problems: ___. Last physical exam: ___.

EDUCATIONAL HISTORY: Current grade: ___ | School type: Public / Private / Charter / Homeschool. Academic performance: Above grade level / At grade level / Below grade level. Subjects of difficulty: ___. Current grades: ___. Retained a grade: No / Yes: ___. Special education services: No / Yes (IEP / 504): ___. Learning disability diagnosed: No / Yes: ___. Behavioral issues at school: No / Yes: ___. Suspensions/expulsions: No / Yes: ___.

BEHAVIORAL HISTORY: Behavior at home: ___. Behavior at school: ___. Peer relationships: ___. Extracurricular activities: ___. Screen time (daily): ___. Discipline strategies used: ___. Response to discipline: ___.

FAMILY HISTORY: ADHD: No / Yes – who: ___. Learning disabilities: No / Yes. Mood disorders: No / Yes. Anxiety disorders: No / Yes. Substance use disorders: No / Yes. Autism spectrum: No / Yes. Other psychiatric: ___.

SOCIAL HISTORY: Household members: ___. Parents: Married / Divorced / Separated / Single. Custody arrangement: ___. Siblings: ___. Recent stressors: ___. Trauma history: No / Yes. CPS involvement: No / Yes.

DSM-5 SYMPTOM ASSESSMENT:

Inattention Symptoms (Parent Report):

SymptomHomeSchoolExamples
Careless mistakes / poor attention to detail0 1 2 30 1 2 3___
Difficulty sustaining attention0 1 2 30 1 2 3___
Does not seem to listen0 1 2 30 1 2 3___
Fails to finish tasks0 1 2 30 1 2 3___
Difficulty organizing0 1 2 30 1 2 3___
Avoids mental effort tasks0 1 2 30 1 2 3___
Loses things0 1 2 30 1 2 3___
Easily distracted0 1 2 30 1 2 3___
Forgetful0 1 2 30 1 2 3___

Hyperactivity-Impulsivity Symptoms (Parent Report):

SymptomHomeSchoolExamples
Fidgets or squirms0 1 2 30 1 2 3___
Leaves seat0 1 2 30 1 2 3___
Runs/climbs excessively0 1 2 30 1 2 3___
Cannot play quietly0 1 2 30 1 2 3___
“On the go”0 1 2 30 1 2 3___
Talks excessively0 1 2 30 1 2 3___
Blurts out answers0 1 2 30 1 2 3___
Difficulty waiting turn0 1 2 30 1 2 3___
Interrupts others0 1 2 30 1 2 3___

STANDARDIZED RATING SCALES:

Parent ratings: Vanderbilt Parent: Inattention ___/27 | Hyperactivity ___/27 | ODD ___/24 | Conduct ___/42 | Anxiety/Depression ___/21. SNAP-IV Parent: Inattention ___ | Hyperactivity ___. Conners Parent (if used): Inattention T___ | Hyperactivity T___ | ADHD Index T___.

Teacher ratings: Vanderbilt Teacher: Inattention ___/27 | Hyperactivity ___/27 | ODD ___/24 | Conduct ___/42 | Anxiety/Depression ___/21. SNAP-IV Teacher: Inattention ___ | Hyperactivity ___. Conners Teacher (if used): Inattention T___ | Hyperactivity T___ | ADHD Index T___.

Performance ratings: Academic performance: ___ | Classroom behavior: ___ | Relationship with peers: ___ | Organizational skills: ___.

COMORBIDITY SCREENING: Oppositional behaviors: No / Subclinical / Clinical. Conduct problems: No / Subclinical / Clinical. Anxiety: No / Subclinical / Clinical. Depression: No / Subclinical / Clinical. Learning problems: No / Suspected / Diagnosed. Autism spectrum: No / Suspected / Diagnosed. Tic disorder: No / Yes. Sleep disorder: No / Yes.

CLINICAL OBSERVATION: Behavior in session: ___. Attention during interview: ___. Activity level: ___. Impulsivity observed: ___. Interaction with parent: ___. Mood/affect: ___. Cooperation: ___.

DIAGNOSTIC FORMULATION: ___.

DSM-5 DIAGNOSIS: Primary: ___ (ICD-10: ___). Presentation: Combined / Predominantly Inattentive / Predominantly Hyperactive-Impulsive. Severity: Mild / Moderate / Severe. Comorbid diagnoses: ___.

TREATMENT RECOMMENDATIONS: Parent training/education: ___. Behavioral interventions: ___. School accommodations (504/IEP): ___. Medication consideration: Yes / No / Deferred. Therapy referral: ___. Additional testing: Psychoeducational / Neuropsychological / Speech-language / OT. Follow-up: ___.

Clinician Signature: ___ | Date: ___


Template 3: ADHD Follow-Up/Medication Management

Use for: Ongoing medication monitoring and treatment follow-up

ADHD FOLLOW-UP VISIT

Patient: [Name] | DOB: [Date] | Date: [Date] | Clinician: [Name]

Current Medication(s): ___ | Dose: ___ | Frequency: ___

Last Visit: ___ | Time on Current Regimen: ___

SUBJECTIVE:

Medication compliance: Excellent / Good / Fair / Poor. Missed doses (past month): ___. Time of medication administration: ___.

Symptom Response: Overall symptom control: Much improved / Improved / Somewhat improved / No change / Worse. Attention/focus: ___. Hyperactivity: ___. Impulsivity: ___. Duration of effect: ___ hours. End-of-dose rebound: No / Yes.

Functional Status: Work/School performance: Improved / Same / Worse. Relationships: Improved / Same / Worse. Daily functioning: Improved / Same / Worse. Specific improvements: ___. Ongoing challenges: ___.

Side Effects Review:

Side EffectSeverity (0-3)Management
Decreased appetite0 1 2 3___
Weight change___lbs since last visit___
Sleep difficulties0 1 2 3___
Headache0 1 2 3___
Stomachache0 1 2 3___
Irritability0 1 2 3___
Mood changes0 1 2 3___
Tics0 1 2 3___
Heart racing/palpitations0 1 2 3___
Other: ___0 1 2 3___

Mood/Safety Screen: Depressed mood: No / Yes. Anxiety: No / Yes. Irritability: No / Yes. Suicidal ideation: No / Yes. Self-harm: No / Yes. Substance use: No / Yes.

OBJECTIVE:

Vital signs: BP ___/___ | HR ___ | Weight ___ (change: ___). Height: ___ (pediatric). BMI: ___ (percentile for age: ___). General appearance: ___. Behavior in session: ___. Cardiovascular: Regular rate and rhythm / Abnormal: ___.

Rating Scales (if obtained): ASRS: ___. Vanderbilt follow-up: ___. CGI-Severity: ___. CGI-Improvement: ___.

ASSESSMENT: ADHD: Well-controlled / Partially controlled / Poorly controlled. Medication response: Optimal / Suboptimal / Poor / Intolerable side effects. Comorbid conditions status: ___.

PLAN:

Medication changes: Continue current / Increase dose to ___ / Decrease dose to ___ / Change medication to ___ / Add ___ / Discontinue ___. Rationale: ___.

Non-pharmacological: Continue current strategies / Add: ___. Labs ordered: None / CBC / CMP / Thyroid / EKG / Other: ___. Referrals: ___. Follow-up: ___ weeks/months. Prescription provided: ___.

Clinician Signature: ___ | Date: ___


Validated ADHD Screening Tools Overview

Understanding available validated instruments helps clinicians select appropriate tools for their practice:

Adult Screening Tools

ASRS v1.1 (Adult ADHD Self-Report Scale): 18-item WHO-developed screener, Part A (6 items) for initial screening, free and widely validated, sensitivity 68.7%, specificity 99.5%.

CAARS (Conners’ Adult ADHD Rating Scales): Self-report and observer versions, provides T-scores with normative data, measures DSM symptoms plus additional domains, requires purchase.

WURS (Wender Utah Rating Scale): 61-item retrospective measure of childhood symptoms, helps establish childhood onset requirement, cutoff score of 46 suggests childhood ADHD.

Child/Adolescent Screening Tools

Vanderbilt Assessment Scales: Free, publicly available, parent and teacher versions, includes comorbidity screening (ODD, conduct, anxiety, depression), includes performance items.

Conners Rating Scales: Parent, teacher, and self-report versions, comprehensive with strong normative data, provides T-scores for clinical interpretation, requires purchase.

SNAP-IV: 90-item scale based on DSM criteria, free for clinical use, parent and teacher versions, includes ODD items.

NICHQ Vanderbilt: Developed by National Institute for Children’s Health Quality, comprehensive screening with functional assessment, widely used in primary care.


Documentation Best Practices

Supporting Diagnostic Validity

Document multiple sources of information (self-report, collateral, records), establish childhood onset with specific examples, demonstrate cross-setting impairment, rule out alternative explanations systematically, and use validated rating scales with documented scores.

Medication Documentation Requirements

For controlled substance prescribing, document diagnosis supporting treatment, informed consent discussion, baseline vital signs (BP, HR, weight), cardiovascular risk screening, PDMP check (where required), medication response and side effects, and periodic reassessment of continued need.

Common Documentation Errors

Avoid diagnosing without establishing childhood onset, relying solely on self-report without collateral information, failing to screen for comorbid conditions, inadequate documentation of functional impairment, missing differential diagnosis consideration, and insufficient medication monitoring documentation.


AI-Powered ADHD Assessment Documentation

ADHD assessments require extensive documentation across multiple domains. AI documentation tools can significantly reduce administrative burden while ensuring thorough capture of clinical information.

How AI Documentation Supports ADHD Assessment

AI ambient documentation captures your clinical interview in real-time, extracts relevant symptoms, history, and observations, organizes information according to diagnostic criteria, prompts for missing required elements, and generates structured notes for your review.

Benefits for ADHD Evaluations

FactorManual DocumentationAI Documentation
Initial assessment documentation30-45 minutes5-10 minutes review
Follow-up visit notes10-15 minutes2-3 minutes review
DSM criteria trackingManual checklistAutomated extraction
Symptom count accuracyVariableConsistent capture
Interview flowInterruptedNatural conversation

Learn more about how voice recognition technology and healthcare automation can transform your practice.


Frequently Asked Questions

Can ADHD be diagnosed in a single visit?

While screening can occur in one visit, comprehensive ADHD assessment typically requires gathering collateral information from multiple sources, which may take additional time. Some clinicians complete diagnosis in an extended initial visit (60-90 minutes) with pre-visit questionnaires, while others use a multi-visit approach.

What if I cannot establish childhood onset?

DSM-5 requires several symptoms present before age 12. If childhood history is unclear, gather information from family members, request school records, or use retrospective measures like the WURS. Document efforts to establish onset and clinical reasoning if history is limited.

How do I differentiate ADHD from anxiety?

Key distinguishing features include onset pattern (ADHD typically lifelong, anxiety may be episodic), nature of concentration problems (ADHD involves inability to sustain attention, anxiety involves distraction by worry), and whether symptoms improve in low-stress environments. Many patients have both conditions.

When should I refer for neuropsychological testing?

Consider referral when diagnosis is unclear despite thorough clinical assessment, learning disability is suspected, significant discrepancy exists between ability and performance, comorbid conditions complicate the picture, or objective documentation is needed for accommodations.

What documentation is needed for controlled substance prescribing?

Document thorough diagnostic assessment supporting ADHD diagnosis, informed consent discussion including risks and benefits, baseline and ongoing vital signs, PDMP verification (where required), medication response and side effect monitoring, and rationale for continued treatment at each visit.

How often should ADHD patients be reassessed?

During medication initiation, follow-up every 2-4 weeks until stable. Once stabilized, every 3-6 months for medication management. Annual comprehensive reassessment of diagnosis, symptoms, and functioning is recommended. More frequent visits if concerns arise.


Streamline Your ADHD Assessments

ADHD evaluations require thorough documentation across multiple domains—developmental history, symptom assessment, functional impairment, and differential diagnosis. AI documentation tools can capture this complexity while keeping you focused on the clinical interview.

NoteV’s AI ambient documentation listens to your assessment conversations and generates comprehensive, structured notes—automatically tracking DSM-5 criteria, symptom counts, and clinical observations.

Clinicians using NoteV for ADHD assessments report:

  • 60 percent reduction in documentation time
  • More thorough symptom capture
  • Improved diagnostic accuracy
  • Better patient rapport during interviews
  • Consistent documentation meeting prescribing requirements


Disclaimer: These templates are provided for educational purposes and should be adapted to meet your specific practice requirements, regulatory standards, and clinical judgment. ADHD diagnosis and treatment, particularly involving controlled substances, should follow applicable laws, regulations, and clinical guidelines. These templates do not constitute medical advice. Consult current DSM-5 criteria and clinical practice guidelines for diagnostic standards.

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