- Make a payment
- Contact [email protected] to set up dropbox.
- Submit completed questionnaires for report to Dropbox
- Please include the client’s birthdate on each form under “Age”
- Completed questionnaires must be submitted in excel format and fully completed, not missing any check boxes. Incomplete data will incur a $25 administrative fee.
As part of the Sadar evaluation process we routinely have clients/patients complete four questionnaires.
- Personal and Clinical Data- This allows patients to report in narrative form relevant information about their past and present functioning (e.g., issues around their birth, school, drugs/alcohol, sleep, etc.). This becomes a part of the generated report and serves to present clinical and historical information as a part of the report.
- Symptoms and Cortical Networks Questionnaire (developed by Dr. Amen)- the client/patient indicates frequency of experience of numerous items (e.g., difficulties concentrating; periods of heart pounding; etc.). Their pattern of responses is then correlated with possible stress/strain in five brain regions (basal ganglia, cingulate cortex, temporal lobes, prefrontal cortex and limbic system).
- van Deusen Questionnaire (developed by Peter van Deusen)- similar to the Amen questionnaire but the results are presented in a more geographical way depicting which cortical region (e.g., prefrontal, sensory motor, parietal, etc.) appear to be affected based on the client/patient’s pattern of responses.
- ADHD Questionnaire- this assesses for inattentiveness, hyperactivity/impulsiveness, over focusing and issues with emotional regulation.