ADHD evaluation report template
A sanitized ADHD evaluation report skeleton in Word format, with adult and child variants in one document. It carries the structure a payer reviewer and a careful referrer both look for: a stated medical question, numbered sources across informants, DSM-5-TR criteria walked one at a time against your data, response style addressed before scores are interpreted, and functional impairment documented concretely enough to support medical necessity.
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Built for the diagnosis a reviewer will actually read
ADHD reports get reimbursed, questioned, and returned on the strength of two things: whether the diagnosis is mapped to criteria rather than asserted, and whether the functional impairment is documented well enough to justify the services recommended. The template is built around both. It opens with the referral question stated as a medical question and a numbered sources section that separates self-report, collateral report, records, and standardized instruments, each with dates.
The history sections prompt for exactly the evidence the criteria require: an age-of-onset trail with its source, cross-setting presence documented setting by setting, and a medical, psychiatric, and family history that forces the differential into the open. Sleep, thyroid, anxiety, depression, substance use, learning disorders, and medication effects are named as things to rule in or out, because they are the conditions ADHD is most often confused with. The instruments section is normed-value and informant-aware, with a response style and validity subsection that comes before interpretation, since self-reported attention symptoms are easy to over- or under-endorse.
The diagnostic core walks DSM-5-TR Criteria A through E individually, mapping your source data to each rather than restating the conclusion. A dedicated functional impact and medical necessity section documents the impairment in concrete terms and ties each recommendation back to it. A basis-and-limitations section and attestation close the report, with the diagnosis left where it belongs: with the clinician.
Every heading, table, and guidance note is editable. Placeholders are bracketed, and italic guidance notes explain what belongs in each section before you delete them. The adult and child paths live in the same file; delete the one you are not using.
About this template
Does it cover adults, children, or both?
Both, in one document. The history, onset, and setting prompts branch so that a child or adolescent evaluation captures school, grade, and guardian information while an adult evaluation captures work and occupational history. Delete the path you are not using.
Is it tied to a particular rating scale?
No. The instruments section is normed-value and informant-aware but instrument-agnostic, so it works with whatever adult and child ADHD rating scales and broadband behavior inventories your practice is normed on. You add one row per scale and informant.
Why does it walk the DSM criteria one at a time?
Because that is what separates a diagnosis from a screening, and it is what a payer reviewer checks. Mapping your source data to each criterion, including age of onset and cross-setting impairment, is also the cleanest defense if the diagnosis is ever questioned. The template prompts you to state each criterion in your own words rather than reproducing DSM text.
How does it help with payer documentation?
It forces the medical question to the top, keeps the differential explicit, and gives functional impairment and medical necessity their own section tied to the recommendations. Those are the parts reviewers weigh when authorizing testing reimbursement or treatment. The template does not make a coverage claim for you; it makes the clinical documentation legible.
Where does the template come from?
It is the sanitized skeleton of the ADHD evaluation template that ships inside Boreas Workflow, where it is populated from the case file: intake data, rating scale scores, interview records, and the clinician's signed diagnostic decisions.
Can I use it without Boreas?
Yes. It is a standard Word document with no macros and no lock-in. If you later want the version that fills itself from an audit-logged case file, that is what the software does.
What do you do with my email?
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The template is the skeleton. Boreas writes the first draft.
Boreas Workflow is a local-first desktop IDE for psychological assessment. Case data never leaves your machine, every diagnostic decision is rendered and signed by you before the writing assistant drafts a line, and rating scale scores and history flow into the report structure automatically. Reports come out in your voice, structured like this template, so you clear the backlog without cutting the documentation payers expect.