Neurodivergent Identification Survey
Help us understand your experiences and traits related to neurodivergence by completing this confidential survey.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Age
*
Gender
*
Female
Male
Non-binary
Prefer not to say
Other
Have you ever received a formal diagnosis of a neurodivergent condition?
*
Yes
No
Prefer not to say
Please rate how often you experience the following traits or behaviors:
*
Rows
Never
Rarely
Sometimes
Often
Always
Difficulty focusing or sustaining attention
1
2
3
4
5
Strong sensitivity to sensory input (e.g., sounds, lights, textures)
6
7
8
9
10
Preference for routines or predictability
11
12
13
14
15
Challenges with social communication or interpreting social cues
16
17
18
19
20
Highly focused interests or hobbies
21
22
23
24
25
Difficulty with organization or time management
26
27
28
29
30
How would you rate your comfort in social situations?
*
Very uncomfortable
1
2
3
4
5
6
7
8
9
Very comfortable
10
1 is Very uncomfortable, 10 is Very comfortable
How much do you agree with the statement: "I often feel different from others in the way I think or process information."
*
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
Do you use any coping strategies or supports to manage daily challenges related to neurodivergence? (Select all that apply)
Professional therapy/counseling
Medication
Support groups or communities
Personal coping strategies (e.g., routines, reminders)
None
Other
Is there anything else you would like to share about your experiences related to neurodivergence?
Submit Survey
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