* 1. Impact on condition of children with ADHD - reason for prescribing Intuniv: What symptoms or impairments remained
after conventional ADHD medication treatment that needed to be better managed and lead to your child being prescribed Intuniv (please check all that apply)

* 2. Child's experience with current therapy: Other than Intuniv, what medication has your child tried? (please check all that apply)

* 3. Did your child experience adverse effects on other medication that prevented their continued use?

* 4. Based on your child's experience with Intuniv: Which of your child's symptoms or impairments did Intuniv decrease? (please check all that apply)

* 5. What was your child able to do, complete, be involved in etc. when taking Intuniv that they were not able to do when they were on other medications or on medications without Intuniv? (please check all that apply)

* 6. Have there been negative effects while taking Intuniv that did not abate in a few weeks? (please check all that apply)

* 7. Does your child take Intuniv with a stimulant, or non-stimulant medication, or alone?

* 8. Has your child stopped taking or decreased the dose of other ADHD medications since being on Intuniv?

* 9. Do you have any additional information that you would like to add about your child’s experience on Intuniv?

* 10. Would you be willing to speak about your child’s experiences on Intuniv with a CADDAC representative to further support our work?

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