About this worksheet
A two-week structured reflection built for the appointment you're about to have with your psychiatrist, prescriber, or GP. Not medical advice — a communication aid. ADHD memory being what it is, most clients arrive at medication reviews saying 'I think it's working?' and leaving without a real dose adjustment. This worksheet fixes that. It captures the current medication and dose, rates nine functional domains over two weeks on a five-point scale (task initiation, sustained focus, emotional regulation, impulse control, sleep, appetite, anxiety, motivation, and sense-of-self), checks off common side effects, records when the medication seems to peak and wear off, and stages the specific questions the client wants to ask. Prescribers get more usable data in one page than they'll gather in a whole appointment on recall. Written in strictly non-prescriptive language — the worksheet describes, the prescriber decides.
When to use it
- Two weeks before a psychiatry or primary care ADHD medication review.
- When starting a new medication or adjusting a dose.
- Second opinions and cross-provider communication.
- Annual reviews or transfers of care.
- Not a substitute for medical evaluation. Do not adjust doses based on the worksheet.
How to use it
- 1
Fill daily, not from memory
Two-minute check at a consistent time. Retrospective ratings a week later carry all the ADHD memory bias the worksheet exists to correct.
- 2
Rate nine domains
The nine covered are the ones prescribers actually adjust on. Sense-of-self is the one clients most often want to raise but forget to.
- 3
Check side effects
Eight common ones. Rebound irritability and emotional blunting are underreported in appointments — the checklist prompts them.
- 4
Note peak and wear-off
Timing is often the adjustment, not the dose. 'It works until 2pm' is the sentence that shifts a decision.
- 5
Stage the questions
Write them down before the appointment. Prescriber time is short and ADHD working memory is shorter.
Frequently asked questions
Is this medical advice?+
No. It's a structured way to give your prescriber better data than 'I think it's working.' All medication decisions belong with the clinician who prescribes.
How long should I track before an appointment?+
Two weeks is the sweet spot — long enough to see patterns (peak/wear-off, weekend vs. weekday, sleep effects), short enough to complete without dropout.
Why does the worksheet ask about 'sense of self'?+
Emotional blunting and 'not feeling like me' are common on stimulants and non-stimulants and are underreported because clients don't know to raise them. Naming the domain gets it into the appointment.
Can I use this for my child's ADHD medication?+
The version here is written for adults and teens who track their own experience. For younger children, parents typically use a modified version — the Vanderbilt or SNAP-IV rating scales are the evidence-based pediatric analogs.
Is this worksheet free?+
Yes. Free printable PDF. Sign in to send as a secure client link.
Worksheet — ADHD Medication Reflection Worksheet — provided by TherapistAssist for clinical use. Not a substitute for assessment or treatment.
