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Q.1
You have something you want to ask your friend, but she is on the phone and you must wait a few minutes before asking. By the time she is finished, you completely forget what you wanted to ask.
*
Often
Not Often
Q.2
You plan to complete some work at home and pack up the items you need at the end of your workday. When you sit down to do the work, you realize that you forgot to bring home several critical items.
*
Often
Not Often
Q.3
You are having a conversation with a friend. You find it difficult to follow the conversation, forgetting what your friend said just moments before.
*
Often
Not Often
Q.4
You are completing a task with several steps, such as getting the trash, taking it outside, and then putting a new bag in the trash can. You usually forget the last step.
*
Often
Not Often
Q.5
When you read something, you usually end up going back to re-read the prior section because you can’t remember it.
*
Agree
Disagree
Q.6
You constantly misplace your cell phone. You feel like you waste time every day looking for your phone and other misplaced items like keys or glasses.
*
Agree
Disagree
Q.7
You are often accused of not listening because you don’t follow through on tasks you are asked to do.
*
Agree
Disagree
Q.8
You have a hard time remembering people’s names, even if you have met them multiple times.
*
Agree
Disagree
Q.9
In the morning, you usually rush around to get ready for work but still often end up being late.
*
Agree
Disagree
Q.10
You have a hard time managing large projects. Even when you break them down into steps, you find you miss steps or end up spending too much time on tasks that don’t have much importance.
*
Agree
Disagree
Q.11
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