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General Life

All Information Kept Confidential

PLEASE READ:

Questions in this portion of the assessment are intended only to provide the coach with background information about current life habits and routines as they pertain to EFD & ADD/ADHD symptoms.


Diet, sleep and exercise, as well as other everyday life habits and routines, have profound effects on EFD & ADD/ADHD symptoms but we do not advise or advocate for any diet, sleep or exercise program.


Though these topics may be discusses and suggestions may be made, it is not implied that we will necessarily address these topics. Please answer as honestly as you can. This information is gathered to understand where an individual's current strengths and challenges may be.

Diet

2. How would you characterize your current diet and eating habits in terms of how it helps or exacerbates your EF & ADD/ADHD symptoms?

Exercise

1. Do you have a regular, consistent physical exercise routine?
2 How much do you think your exercise habits (or lack of) effect your energy, mood and EF or ADD/ADHD symptoms on a daily basis?
3. How many days in a typical week do you engage in at least 15-20 mins of moderate intensity exercise? (Anything from an intentionally hurried walk or moderate yoga program and up)
4. How would you characterize your current exercise habits (or lack thereof) in terms of how it helps or exacerbates your EF & ADD/ADHD symptoms?

Sleep

4. Is the amount you sleep each weeknight pretty consistent in terms of total sleep, within an hour?
5. Do you have difficulty falling asleep?
6. Do you wake up a lot during the night for any reason?
7. Is it particularly difficult to get up in the morning?
8. Do you oversleep and miss your alarm?
9. Are you commonly sleepy during the day?
10. Do you nap during weekdays?
12. How would you characterize your current sleep routine in terms of how it helps or exacerbates your EF & ADD/ADHD symptoms?

Mindfulness Practice

1. Do you practice any form of regular mindfulness practice? (eg. meditation, taichi, etc)
2. If you do have a mindfulness practice, do you feel it's particularly helpful for you EFD & ADD/ ADHD symptoms?

Digital Use

1. How much do you feel your digital device of choice makes procrastination and avoidance worse in your everyday life?
2. Do you use any kind of use-limiting software or hardware on any of your digital devices?
3. Do you use your phone or other screen device in the 1/2hr before bed?
4. Do you use phone/ calendar reminders?
5. Are they effective for you?

General

1. Do you keep a consistent calendar and/or planner?
2. Do you keep a written list of to-do's?
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