CLINICIAN REGISTRATION FORM

Welcome to the ADHD Rating Scale registration page. Registration is free. Use of the site is free.

Please provide the information below to register as a Clinician. Your clients will be able to complete ADHD rating scales online and you will be able to view or download scored reports for your records.

ALL FIELDS ARE REQUIRED
Title
 Mr   Ms   Dr
First Name
Last Name
  First and Last Names may not contain numbers.
Discipline
Business Address 1
Business Address 2
City
Country
Province / State
Postal Code / Zip
Email Address
Required.
Too many characters.
Invalid email address.
Re-enter Email
Emails don't match.
  UserName and Password may contain only letters and numbers.
No special characters permitted.
Create UserName
 Must be at least four characters long.
Create Password
Required.
Exceeds 40 characters.
Re-enter Password

Passwords don't match.
How would you like to be notified that a rating scale has been completed under your name?
 
Email with password-protected PDF report attached (recommended)
Email only
No notification
NOTE:
Registration is not complete until you confirm your identity by clicking on a CONFIRMATION LINK which you will receive shortly by email.
(Please ensure our site is not being blocked by your email spam filter)