Vanderbilt ADHD Diagnostic Teacher Rating Scale. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. WebIn diagnosing ADHD, it is particularly important to address the following criteria: symptoms of hyperactivity/impulsivity or inattention that cause impairment that must have been present in childhood current symptoms that have been present for at least the past six months impairment from the symptoms present in two or more settings (for Proven falsifiability of commonly used diagnostic instruments is therefore of concern. European Psychiatry. You're likely to start by first talking to your primary care provider. The tool is meant to be completed after the clinician has finished an assessment of the young person including information obtained from a responsible family member or responsible adult who knows the youth well whenever possible. What, if anything, seems to improve your symptoms? This content does not have an English version. } The patient is very bright, and early school report cards do not describe problems with attention or behaviour. How does scoring work The scoring for ADHD rating scales varies according to the love of test and plan age of what person under consideration. As well as allowing 366 Adelaide St. E, suite 221, Toronto. Down Syndrome (DS) is a chromosomal alteration. What, if anything, appears to worsen your symptoms? Adult ADHD (attention deficit hyperactive disorder). WebView PDF. Copyright Attention Deficit Disorder Association 2015-2023. WebInterpreting ADHD Rating Scale Scores Adult Attention. National Institute of Mental Health. The patient felt a calming, focused sensation on a psychostimulant, energy drink, cannabis or cocaine. 3. You can try these assessments to determine if you may have some symptoms and experiences that are common in women with ADHD. stream In addition to traditional symptoms, the SASI also addresses challenges related to adult life such as parenting, workplace, and life maintenance (i.e. Conceptualization and Assessment of Quality of Life for Adults with Attention-Deficit/Hyperactivity Disorder. Make a donation. WebNext, it describes the five senses you are likely already familiar with. The reference standard was a clinical examination performed by a qualified professional using diagnostic criteria from the Diagnostic and Statistical Manual of Ask your health care team for more advice on resources. Please indicate the number of weeks or months you have been able to evaluate the behaviors: File Size: 661KBPage Count: 4. The patient was clearly hyperactive, impulsive and inattentive when younger, but currently has difficulty with only a few residual symptoms. WebADHD as a diagnosis in adults 5 General principles in assessing and managing adults with ADHD 6 Pre-referral recommendations 7 Referrals to mental health services 8 Assessment 11 Comorbidity 15 Specific patient groups 16 Management of ADHD 19 Service design 25 Training 27 References 28 Appendix 1: Transition guidance 32 Tips for managing your time and staying on scheduleTime management tips. Adults with attention deficit disorder often have a different perception of how time passes. Prioritization tips. Because adults with ADHD often struggle with impulse control and jump from one subject to another, completing tasks can be difficult and large projects can seem overwhelming.Learn to say no. 0?4YlP 6hPthAD|N8,&XhFnZ Xvjq PS:I O==}mv|k!xZ6Yt$|xwv eP {. A combination of these is often NICHQ is proud to have published the first edition in 2002 and has been at the forefront of supporting children and families affected by ADHD. What are the possible causes of my symptoms? Have your symptoms been continuous or occasional? The content of the questionnaire also reflects the importance that DSM-IV places on symptoms, impairments, and history for a correct diagnosis. 1926 0 obj <>/Filter/FlateDecode/ID[]/Index[1907 26]/Info 1906 0 R/Length 101/Prev 207174/Root 1908 0 R/Size 1933/Type/XRef/W[1 3 1]>>stream The symptoms of ADHD in women can look quite a bit different than in other genders. Self-assessment tools are often available in ADHD clinics but you can also find many of them online. This tool is more comprehensive in nature and is most commonly used to gather data in research studies. Lots of planning, imagination and a long-term commitment to serving patients, staff and the community. This article is free to access. After transition to adult services, adult healthcare professionals should carry out a comprehensive assessment of the person with ADHD that includes personal, educational, occupational and social functioning, and assessment of any coexisting conditions, especially drug misuse, personality disorders, emotional problems and This category only includes cookies that ensures basic functionalities and security features of the website. (There are many otherssee below.) Lets take a look at the different types of self-assessments for ADHD and where to find them. Accessed Jan. 26, 2019. 1. Attitudes, interests, abilities and performance. WebOPALK Assessment Guidelines for ADHD/ADD Page 2 Vanderbilt ADHD Diagnostic Rating Scales & Instructions for Parents & Teachers Page 37 OPALK ADHD/ADD Treatment Guidelines for Primary Care Clinicians Page 8 OPALK Medication Treatment Algorithm for ADHD/ADD Page 9 Every donation you make to CAMH enables us to directly help Canadians living with mental illness and countless more worldwidethrough the discoveries we share. There is no single tool for diagnosing ADHD. The associated symptoms of ADHD can be problematic for the person, but they are not part of the diagnostic criteria. For mental health services, a referral form needs to be completed by a healthcare provider. } Attention-deficit hyperactivity disorder (ADHD) can't be diagnosed with a physical test, like a blood test or an X-ray. Instead, a health professional uses an evaluation process to diagnose ADHD. During the evaluation, a professional gathers information about you or your child to determine if the criteria for ADHD are met. Do you drink alcohol or use recreational drugs? The tool does not make the diagnosis and does not have a threshold marker, but it helps you decide whether to consider ADHD if a patient answers yes to most of the questions. Necessary cookies are absolutely essential for the website to function properly. Which symptoms bother you most, and what problems do they seem to cause? In order to get a diagnosis of ADHD, you need to be assessed by a specialist in the field usually a psychologist or psychiatrist. No matter which self-assessment tool you use, the results can only provide general guidance. !*VG=EXg3w020m\&9Cc="L/aH;\YCdI ^+ We are in the grips of a crisis that ruins health, threatens lives and hurts economies. Part of the problem is that it can be difficult to diagnose, particularly in adults. In what settings have you noticed the symptoms: at home, at work or in other situations? Counseling for adult ADHD generally includes psychological counseling (psychotherapy), education about the disorder and learning skills to help you be successful. Accessed Jan. 26, 2019. ADHD. We also use third-party cookies that help us analyze and understand how you use this website. How do you replace an institution with an urban village? Sensory carts have been use WebAdult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist . Reilly MC, Zbrozek AS, Dukes EM. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. The following scales have been developed to screen, evaluate and monitor adults with ADHD. Associated symptoms in adults include: Do NOT use the following clinical observations to dismiss a diagnosis of ADHD: Consider ADHD if any of the following situations apply to the patient: If any of these situations apply, have the patient complete the Adult ADHD Self-Report Scale from the eToolkit that accompanies the Canadian ADHD Practice Guidelines developed by CADDRACanadian ADHD Resource Alliance (CADDRA; 2018, 2019). WebMany adults with ADHD do not realize they have the disorder. Participants respond to each item using scale from 1 (rarely/never) to 4 (almost always/always). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC or the Department of Health and Human Services (HHS). A single copy of these materials may be reprinted for noncommercial personal use only. text-decoration: none; 14 this version was designed to be filled out by parents and is commonly known as the madrs. If the child is found to have ADHD, after a treatment plan is developed and implemented, the clinician will employ similar tools to request feedback from parents and teachers. Are there any printed materials that I can have? other information we have about you. These can include the persons spouse, a close relative, employer and/or colleague. You are being assessed for Attention Deficit Hyperactivity Disorder (ADHD). WebADHD in Adults Fact or Fiction For many years we thought that most children grew out of ADHD, now we know that is a myth. Instructions . margin-bottom:10px; Self-assessments are frequently used in research studies, clinics, and even by health websites to screen for ADHD. Add the Vanderbilt adhd test for adults pdf for editing. letter-spacing: 2px; Many adults with undiagnosed ADHD will be managing their condition very successfully themselves and their lives may be going well without the need for a diagnosis or treatment. Counseling for adult ADHD generally includes psychological counseling (psychotherapy), education about the disorder and learning skills to help you be successful. health information, we will treat all of that information as protected health The CAARS report works best when combined with other sources of relevant information. We look forward to keeping you informed, inspired and involved in all things CAMH. %PDF-1.5 2014;16(3). With your support, CAMH researchers are revolutionizing the ways we diagnose, treat, and prevent mental illness. Text adapted from: "The adult patient with attention-deficit/ hyperactivity disorder," inPsychiatry in primary care byUmesh Jain(CAMH, 2019). So can classes to improve communication and develop conflict resolution and problem-solving skills. The checklist takes about 5 minutes to complete and can provide information that is critical to supplement the diagnostic process. 548 0 obj <>stream WebThe NICHQ Vanderbilt Assessment Scales are used by health care professionals to help diagnose ADHD in children between the ages of 6- and 12-years. 3 0 obj Our historyevolving from an asylum into a modern health facility with patients at the centre of careis the history of mental health care in Canada. Challenging the stigma associated with mental illness takes understanding, education and a closer look at our own attitudes toward health. .no-icon a.with-icon i {content: none!important;display: none!important} .nav_button { WebThe current provision in Adult ADHD Service is 0.5 whole time equivalent Consultant Psychiatrist offering new assessments and review appointments. If youre really feeling testy, heres a list of some other self-assessment screeners that can help you determine whether you might have symptoms of adult ADHD: Take an Adult ADHD Self-Assessment Screener, ADHD symptoms with the Structured Adult ADHD Self-Test. To prepare for your appointment, make a list of: Bring any past evaluations and results of formal testing with you, if you have them. endstream endobj 1908 0 obj <. min-width: 336px; Five are personal physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect. National Institute of Diabetes and Digestive and Kidney Diseases. Tell your doctor about any side effects. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2017. information highlighted below and resubmit the form. Using ADHD self-assessment tools is a quick and easy way to identify if you may have symptoms that are common in adult ADHD. Accessed Jan. 26, 2019. This sheet will describe: the common symptoms of ADHD in adults how professionals evaluate adults for possible ADHD Some adults very successfully learn to manage their lives with ADHD, some just get through knowing they are capable of more, too many struggle, fail and sadly do not get the help which will allow them to reach their potential. Train in a unique and welcoming learning environment with Canada's leading scientists in mental illness and addiction. WebThe Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist was developed in conjunction with the World Health Organization (WHO), and the Workgroup on Adult 2018;8:25. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. 2015;22:172. CHADD does not endorse products, services, publications, medications, or treatments, including those advertised in any CHADD publications, webinars or podcasts. Learn what drives our research agenda and priorities in the CAMH Research Plan for 2018-2023. 0 %PDF-1.6 % } 2019;56:14. %PDF-1.5 % It aims to improve recognition and diagnosis, as well as the quality of care and support for people with ADHD. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. The patient was diagnosed with ADHD as a child or adolescent. What ACEs do you have? WebDiagnosis of ADHD in adults is made clinically, with a focus on establishing impairment across multiple domains and excluding other causes of inattention and hyperactivity/impulsivity. The only way to get an actual diagnosis is through consultation and assessment with a professional. This tool is meant to be used with people 18 and over and assesses for the most common symptoms of ADHD. Getting a diagnosis for your ADHD is a crucial first step in finding an effective treatment. What websites do you recommend? These cookies do not store any personal information. The patient or a family member might say, I think I [they] have ADHD.. WebThe ASRS v1.1 has been validated for adults as well as adolescents ages 13 and up. Eligibility: Youth and adults age 18 Depending on the results of the initial evaluation, he or she may refer you to a specialist, such as a psychologist, psychiatrist or other mental health professional. You, and someone who knows you well (significant .next_btn{ WebCopeland Symptom List Adult Attention Deficit Disorder. American Thyroid Association. line-height: 60px; Therapists saw patients in both treatment groups; 14% of sessions were externally assessed to monitor for adherence and contamination. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/low-blood-glucose-hypoglycemia. x0Cc3~${7ImEY^Ub=?XOo_>]_}t? Put your skills and passion to work in a dynamic, supportive environmentand help transform lives and the future of mental health care. vertical-align: middle; Nor is it an alternative to ADHD diagnosis or treatment. 4 0 obj Clinicians evaluating a child for ADHD use a variety of assessment tools to gather information. Therapy that focuses on these issues and ways to better monitor your behavior can be very helpful. The symptoms must be present before age 12. As well as allowing for a thorough evaluation, two visits allows the clinician to assess motivation for follow up, persistence of symptoms and dysfunction, and likelihood for alternative diagnoses. Criterion validity and clinical usefulness of Psicothema. Webchildren and teens with ADHD stay organized and follow directions with tools such as keeping a routine and a schedule, organizing everyday items, using homework and 542 0 obj <>/Filter/FlateDecode/ID[<227CF97885E8A143BEED4D112D4DB281>]/Index[529 20]/Info 528 0 R/Length 73/Prev 35172/Root 530 0 R/Size 549/Type/XRef/W[1 2 1]>>stream To unsubscribe at any time click the link in our mailing or email: unsubscribe@camh.ca. Evaluation of adults presenting with ADHD symptoms typically requires at least two visits. Self-report, age 8-18 Scoring options: Manual scoring Other languages: Spanish Need help It might also help to have the patients partner complete the tool. Journal of Family Practice. Overlapping symptoms with other psychiatric disorders often lead to difficulties in diagnosis and although efficient By understanding diverse groups, we prevent, diagnose and care for each one with greater precision and personalization. The questions reflect the most common symptoms and usually ask you to rate them according to the severity of what you are experiencing. WebThe 6-question screener, the Adult ADHD Self-Report Scale (ASRS v1.1) Screener, is a subset of the 18-question scale, designed to screen for adult ADHD in community Overview of Possible Causes for Presenting Symptoms Similar to ADHD, ADHD Screeners and Quality of Life Assessments, Underdiagnosis of Attention Deficit/Hyperactivity Disorder in Adult Patients: A Review of the Literature, Conceptualization and Assessment of Quality of Life for Adults with Attention-Deficit/Hyperactivity Disorder, The Driving Behavior Survey: Scale Construction and Validation, The Validity and Reproducibility of a Work Productivity and Activity Impairment Instrument, Review and corroboration of current symptoms and dysfunction. Centralized information, intake and scheduling. Note: You must reset your password the first time you log into the website.New Member? .previous_btn_icon{ https://www.thyroid.org/hyperthyroidism/. These use questions adapted from the ASRS and even provide you with a little guidance at the end. Attention-deficit/hyperactivity disorder. include protected health information. CAMH believes in the principle of equity. Using evidence, we drive system and social change to optimize care and reduce the burden of mental illness, including addictions, across populations. Primary Psychiatry, 12(6), 58-64. WebMake these fast steps to change the PDF Vanderbilt adhd test for adults pdf online free of charge: Sign up and log in to your account. Evaluation for comorbid and /or mimicking psychiatric problems, medical disorders or substance abuse. Diagnosing ADHD is not a matter of simply recognizing certain symptoms; a thorough medical evaluation is necessary to rule out other possible causes for your symptoms. For more information, click here. American Psychiatric Association. endstream endobj startxref How can I best manage these conditions together? Inspired teaching fosters inspired learning CAMH improves the quality of care for all through excellence in professional education. Donate today. ASRS-v1.1 (Adult ADHD Self-Report Symptom Scale) The ASRS-v1.1 is the longer version of the ASRS and examines 18 symptoms of adult ADHD. endobj .previous_btn{ CADDRA has developed a form to support the transfer of patients to new healthcare professionals, including pediatric patients to adult services. Accessed Feb. 11, 2019. The ASRS was developed by the World Health Organization (WHO) and the Workgroup on Adult ADHD. height: 60px; display: inline-block; Underdiagnosis of Attention Deficit/Hyperactivity Disorder in Adult Patients: A Review of the Literature. vertical-align: middle; Some resources that may help you are listed below. The patient reports a great deal of problems with organization, time management and executive function, but is reliable in keeping appointments, filling out forms and paying for treatment. SIE News. background-repeat: no-repeat; WebAs a healthcare professional, you can use the ASRS v1.1 as a tool to help screen for ADHD in adult patients. Self-assessment tools can alert you (or someone else) to the fact that you have certain symptoms that are common in ADHD which would be a good reason to seek out a diagnostic assessment. <> display:inline-block; Note: there may be a fee associated with the use of some of these tools for you and/or the patient. color: white; Web Internet Addiction Assessment (Iaa) Sexual Addiction Screening Test (Sast) Adhd (2). Find out if Frida can help by taking our clinically proven 2-minute ADHD assessment. What treatments are available and which do you recommend? font-family: OpenSans, Sans-serif; Prim Care Companion CNS Disord. The Validity and Reproducibility of a Work Productivity and Activity Impairment Instrument. }>}_~s_+__~UuiFe|}wEw}p3\25^t o^LVE^^\_~+l7i$?gmMV_i:a_,'U:~42w|Q~oo&Jm(%rI7/7'b3_>Qv]mG-5\F+}]ZQn]Z9a?/1yG;):3OVKk_#Cy[ {S8_l=>wWw}vYQ%q.wJM?UZy;OO[?yc6%lK ri6 @X?YGm>xoXr1md]M5|mn*0mzR>+|?\HCZ08on^0_?$Jj{} vertical-align: middle; padding: 10px; To provide you with the most relevant and helpful information, and understand which Attitudes, interests, abilities and performance. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). } ;? The forms will provide him/her with information on how you function in different areas of life and must be reviewed by a trained medical professional as part of an overall ADHD assessment. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. The Driving Behavior Survey: Scale Construction and Validation. % https://www.aamft.org/Consumer_Updates/Adult_ADHD.aspx. You also have the option to opt-out of these cookies. Fields SA, et al. 14 this version was designed to be filled out by parents and is commonly known as the madrs. The DSM-5 refers to the fifth edition of this handbook, though the DSM-5 WebWe would like to show you a description here but the site wont allow us. Various websites have made them available to complete for free and even give you thoughtful results at the end. American Academy of Child and Adolescent Psychiatry, ADD-H: Comprehensive Teacher Rating Scale, Adult ADHD Self-Report Scale (ASRS v1.1) Screener, Adult ADHD Self-Report Screening Scale for DSM-5 (ASRS-5), Evaluating Your Child for ADHD and Evaluation Timeline (pdf), NICHQ Vanderbilt Assessment ScalePARENT Informant (pdf), NICHQ Vanderbilt Assessment Follow-upPARENT Informant (pdf), NICHQ Vanderbilt Assessment ScaleTEACHER Informant (pdf), NICHQ Vanderbilt Assessment Follow-upTEACHER Informant (pdf), Centers for Disease Control and Prevention, Barkley Home Situations Questionnaire (HSQ), Barkley School Situations Questionnaire (SSQ), An updated version of the 6-question screener which is validated for DSM-5, the. Please answer the questions below, rating yourself on each of the criteria shown using the scale on the right side of You are encouraged to share your results with WebApril 12th, 2019 - The Wender Utah ADHD Rating Scale WURS is a 61 item retrospective self report scale used to evaluate adults for ADHD The summary score is calculated by summing the responses to the twenty five ADHD questions Assessment of Fatigue in Older Adults The FACIT Fatigue April 21st, 2019 - Assessment of Fatigue in Older min-width: 336px; background-image: url("/-/media/images/professionals/dlt-test-photos/arrowleft_20px-svg.svg"); Without an assessment by a professional, these tools only provide information that you have symptoms that are common in adults with ADHD. float: right; There are no right or wrong answers. As a healthcare professional, you can use the ASRS v1.1 as a tool to help screen for ADHD in adult patients. transition-duration: 0.4s; ADDA delivers reliable information on ADHD. Return to ADHD Screening Tests Other tests include: Online ADHD Tests Response to Treatment Rating Scales Children and adults FREE Professional ADHD She has a masters degree in clinical psychology and a Ph.D. in developmental psychology. Discover the most common assessments used in adult ADHD, specialized assessments for women, and where to find free assessments online. background-image: url("/-/media/images/professionals/dlt-test-photos/arrowright_hover_20px-svg.svg")!important; The CAMH Store offers a wide array of mental illness and addiction resources for patients, families, students and professionals. Low blood glucose (hypoglycemia). As you answer each question in a way that best describes how you have felt and conducted yourself in the past 6 months. font-weight: 800; Easily distracted. 529 0 obj <> endobj https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/adult-adhd. amphetamine/dextroamphetamine (Adderall)dextroamphetamine (Dexedrine)lisdexamfetamine (Vyvanse) This website uses cookies to improve your experience. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Taking self-assessments can also be a way to self-monitor your symptoms over time as you engage in treatment protocols or even try positive lifestyle changes (i.e. The information provided by CHADDs National Resource Center on ADHD is supported by Cooperative Agreement Number NU38DD000002 funded by the Centers for Disease Control and Prevention (CDC). We have multiple locations. Accessed Jan. 26, 2019. WebThe WHO Adult ADHD Self Report Scale Reliability and. font-family: OpenSans, Sans-serif; (2005). Difficulty competing tasks. } Geffen J, et al. Choosing the Best Treatment Option for Adult ADHD, CanadaPhone: 587-844-6287Fax: 855-719-0483support@talkwithfrida.com. CAMH advocates for policies that are responsive to the needs of people with mental illness and addictions. letter-spacing: 2px; float: left; Basic questions to ask your doctor include: Don't hesitate to ask questions anytime you don't understand something. A good-quality assessment takes time and is ideally multidisciplinary, involving information gathered from a variety of sources https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml. Be prepared with all the info you need to make your inpatient experience at CAMH as comfortable as possible. Should I see a specialist such as a psychiatrist or psychologist? Ginsberg Y, Quintero J, Anand E, Casillas M, Upadhyaya HP. You can also view some of the screening and follow-up tools. American Association for Marriage and Family Therapy. This content does not have an Arabic version. height: 60px; Lisa Batten is a clinical scientist, therapist, and writer specializing in neuroscience and clinical pharmacology. Mayo Clinic, Rochester, Minn. June 13, 2019. Kooij JJS, et al. You can always review your results with a healthcare professional who specializes in ADHD or with your therapist. .next_btn:hover .next_btn_icon{ If you are unsure of an answer, provide an answer which best describes you a good deal of the time in that particular situation. Ontario, Canada M5A 3X9. The following components of a complete evaluation should be considered during both visits: View the Adult ADHD Assessment, Diagnosis and Treatment Approach Algorithm. Find directions. Planning on visiting CAMH? It asks you to rate yourself -- between never and very often -- on how often you experience common symptoms of adult ADHD. Cognitive and Behavioral Practice. The DSM-5 ADHD diagnostic criteria are of limited use in adults, as is neuropsychological testing. If you are in an emergency, in crisis or need someone to talk to, there is help. 5th ed. Testing tools for ADHD are quick, easy, and offer you valuable information about whether you might want to pursue getting a clinical assessment for ADHD. Copyright Attention Deficit Disorder Association 2015-2023. Other patients may, on further exploration, give a very convincing account of unusual coping strategies, such as excess time on homework or increased need for assistance. Accessed June 13, 2019. display:inline-block; WebAs attention-deficit/hyperactivity disorder (ADHD) is a feasible target for individuals aiming to procure stimulant medication or accommodations, there is a high clinical need for accurate assessment of adult ADHD. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. Since rating scales are based on self-reported perceptions, and are, therefore, subjective, it is recommended that significant persons in the adults life also complete the forms. Knowing the facts is the first step in creating hope. By accessing and using the website, you are indicating your acceptance to be bound by the terms and conditions of the user agreement as stated in full. By clicking Sign Up below, I consent to receive electronic communications (as selected above) from CAMH and CAMH Foundation. https://www.psychiatry.org/patients-families/adhd/what-is-adhd. Examples include: Standard treatments for ADHD in adults typically involve medication, education, skills training and psychological counseling. Proven falsifiability of commonly used diagnostic instruments is therefore of concern. If you want an interactive format, you can find adapted versions of the ASRS on several websites which you can complete electronically.

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