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First Name ^*

Last Name ^*

Email ^*

Which country do you live in? ^*

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Which best describes you? ^*

Diagnosed ADHD

Undiagnosed ADHD

Parent/Carer of person with ADHD

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What best describes your current situation ^*

Using medication and happy with it

Using medication and unhappy

Not using medication

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What are you hoping to achieve by working with me? ^*

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How are you planning to fund your development?

Self funded

Peer funded

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