ADAM Questionnaire Scoring Tracker
Track and score responses for the ADAM Questionnaire with this structured, modern form.
Participant Initials
Date of Assessment
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
1. Do you feel that your energy level has decreased?
*
Never
Rarely
Sometimes
Often
Always
2. Have you noticed a decrease in your strength or endurance?
*
Never
Rarely
Sometimes
Often
Always
3. Do you feel less motivated or enthusiastic?
*
Never
Rarely
Sometimes
Often
Always
4. Have you experienced changes in your mood?
*
Never
Rarely
Sometimes
Often
Always
5. Do you find it more difficult to concentrate?
*
Never
Rarely
Sometimes
Often
Always
6. Overall assessment score (1 = lowest, 5 = highest)
*
1
2
3
4
5
Additional Notes
Submit
Should be Empty: