Interest Form for possible Zoom Interview Formulario de interés para posiblemente ser una entrevista de Zoom)
Please fill out this short form. This information will be collected for use in an upcoming book about the LatinX experience with ADHD. We appreciate your time and will send a follow up email if there are next steps to take.

(Por favor, rellene este breve formulario. Esta información se recopilará para su uso en un próximo libro sobre la experiencia de LatinX con el TDAH. Agradecemos su tiempo y le enviaremos un correo electrónico de seguimiento si hay pasos a seguir. Gracias, departe de Nicole y Andrea.)
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Last Name (Apellido) *
First Name (Nombre) *
Have you been formally diagnosed, by a physician, as having ADHD? (¿Ha sido diagnosticado formalmente, por un médico, con TDAH?) *
Email (Correo Electrónico) *
Phone Number (Número de Teléfono) *
What country were your parents born in?  (¿En qué país nacieron tus padres?)
What country were you born in?  (¿En qué país naciste?)
Would you be willing to have a 15 minute ZOOM interview with Nicole Biscotti or Andrea Aguirre regarding your experience with ADHD?      (¿Estaría dispuesto a tener una entrevista en la plataforma Zoom, de 15 minutos con Nicole Biscotti o Andrea Aguirre sobre su experiencia con el TDAH?) *
Would one or both of your parents be willing to interview with us regarding your experience with ADHD?  ¿Estarían uno o tus dos padres dispuestos a  entrevistar con nosotros sobre tu experiencia tu TDAH?
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Do you have any comments or questions?  (¿Tienes algún comentario o pregunta?)
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