RAADS-R Questionnaire for Assessments

Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email*
Date*
MM slash DD slash YYYY
Your age in years*
Your gender:*
- Male
- Female
- Non-Binary
Have you ever been labeled as having Autism Spectrum Disorder, Asperger's Disorder, Pervasive Developmental Disorder, Dyslexia, Mental Retardation, Learning Disability or another psychiatric or neurological disorder? If so, please name the diagnosis or label, when it was given and by whom. Please use additional paper if necessary.*
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SCORE TOTAL
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SOCIAL RELATEDNESS Sub-Scale
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CIRCUMSCRIBED INTERESTS Sub-Scale
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LANGUAGE Sub-Scale
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SENSORY MOTOR Sub-Scale

The Essential Guide