Questions to ask at an ADHD assessment

What should I ask the evaluator about their training and approach?

Ask about their license type, how many adult ADHD assessments they conduct annually, and whether they use structured diagnostic tools. You want someone who sees adult presentations regularly—not someone whose caseload is mostly children or whose ADHD experience is incidental.

Useful questions: What's your professional license? How many adult ADHD evaluations do you complete in a typical year? Do you use rating scales or structured interviews, and which ones? How long is the full assessment, and does it include collateral information from family or old report cards?

If the evaluator seems annoyed by these questions, that's information. A clinician who routinely diagnoses ADHD in adults expects these questions and answers them plainly.

What other conditions will they rule out or screen for?

ADHD shares symptoms with anxiety, depression, sleep disorders, trauma responses, thyroid conditions, and several other diagnoses—so a responsible evaluation considers alternative explanations. Ask explicitly what else they'll be looking at.

Good evaluators will mention that they screen for mood and anxiety disorders, ask about sleep and medical history, and explore whether symptoms showed up in childhood or only in adulthood. If the assessment is a single fifteen-minute conversation with no mention of rule-outs, the quality is suspect.

You can ask: What other conditions can look like ADHD? Will you be screening for those? If my symptoms fit more than one diagnosis, how do you tease them apart? These questions signal that you're looking for accuracy, not just a label.

• Anxiety and depression (very common co-occurrences)
• Sleep disorders, including sleep apnea
• Trauma history and post-traumatic stress
• Thyroid or other metabolic conditions
• Substance use, past or current
• Learning disabilities or autism

A responsible evaluation considers alternative explanations, not just confirmation.

How much will the full assessment cost, and what's included?

Ask for the total out-of-pocket cost before the first appointment, including any follow-up visits to review results. If the practice bills insurance, ask what your plan typically reimburses and what you'll owe. If they don't know your plan's reimbursement rate, call your insurer directly with the CPT codes the office provides.

Many people are surprised by a second bill for the feedback session or written report. Ask up front: Is the cost you quoted for the full evaluation, including the follow-up and any written documentation? Are there separate charges for rating scales, the diagnostic report, or letters for work or school?

If cost is a barrier, ask whether the practice offers a sliding scale, payment plans, or knows of lower-cost options in the area. University training clinics and community mental health centers sometimes offer assessments at reduced fees.

What happens after the assessment?

Ask what format the results take—verbal feedback only, a written summary, a formal report—and how long it will take to receive them. If the evaluator diagnoses ADHD, ask whether they prescribe or refer, and to whom. If they don't diagnose ADHD, ask what they think is going on instead and what the next step should be.

You can also ask: If I'm diagnosed, will you provide a letter I can share with my primary care doctor or an employer if I need accommodations? If I'm not diagnosed, will the report explain what else might explain my symptoms?

Some evaluators do assessment only and refer elsewhere for treatment. Others assess and treat. Neither model is wrong, but you should know which you're walking into so you're not surprised when the evaluator says they don't prescribe.

Can I ask about the specific tools they'll use?

Yes. Structured tools add rigor. Common ones include the DIVA (Diagnostic Interview for ADHD in Adults), Conners' Adult ADHD Rating Scales, or the CAARS. Evaluators may also use broader screeners for mood and anxiety. Asking which tools they use shows you've done your homework.

If the clinician says they don't use any structured tools and rely solely on clinical judgment, that's not automatically disqualifying—but it's worth understanding why. Clinical judgment matters, but validated tools reduce bias and improve consistency, especially for presentations that don't fit the hyperactive-boy stereotype.

You might ask: Do you use any standardized rating scales or diagnostic interviews? How do those fit into your overall clinical judgment? A good answer will mention specific tools and explain how they integrate them with history and observation.

Is it okay to get a second opinion?

Yes. Second opinions are routine in medicine, and ADHD assessment is no exception. If the results don't match your lived experience, if the evaluator dismissed your concerns without explanation, or if you just want more confidence in the diagnosis, it's reasonable to consult someone else.

A second opinion is not an insult to the first clinician, and it's not doctor-shopping if you're genuinely uncertain. Many women receive an ADHD diagnosis only after an initial evaluator attributed everything to anxiety or depression and a second clinician took a fuller history. Advocacy for your own clarity is not pathological.

You don't need permission to seek a second evaluation. If cost is prohibitive, you can also ask a different clinician to review the first evaluator's report and give an opinion on whether the conclusions seem sound. That's often less expensive than a full repeat assessment.

A second opinion is not doctor-shopping if you're genuinely uncertain—it's normal medicine.