This form will be provided to you at the time of prescription refill for ADD - ADHD medication(s). This states our policy regarding follow up and monitoring of your child's status, based on medical industry and health insurance quality care standards.

Form Form 1 of 2 Complete these forms only if your pediatrician requests them for a follow up visit.

Form Form 2 of 2 Complete these forms only if your pediatrician requests them for a follow up visit. (Updated 9/19/2012)

Form 1 of 2 Parents should print and complete this form prior to your child's appointment for evaluation of ADD/ADHD. Please bring both completed forms to your appointment.

Form 2 of 2 Parents should print and have your child's teacher complete this form prior to your child's appointment for evaluation of ADHD. Please bring both completed forms to your appointment.