Please feel free to either copy and paste the template below, or you can download it at the link below.
Let me know if you have any updates or corrections.
**Start of Template**
A/P
Patient has been diagnosed with ADHD for some time now
Reports a history of issues related to focus, concentration, and grades when in grade school
PDMP checked: No strange Prescribing
No concerning physical exam findings or symptoms today such as tachycardia, weight loss, or palpitations
Patient advised that this is not a long term solution, they are aware of the side effects of this medication including HTN, palpitations, agitation, anxiety, weight loss and appetite suppression
Patient wants to continue on current dose at this time
Functional assessment was completed. Pt reports that the medications are still helping and the benefits of the medication are still outweighing the risks.
-Provided patient with a 3 month supply of medications.
-Reminded patient that medications should be filled with a single provider, and at one pharmacy.
-No early refills
-Patient is responsible for keeping track of prescriptions, and lost or stolen prescriptions/medications will not be replaced with a new prescription.
-No sharing/redistribution in any way of the medication is allowed.
-Discussed with patient hat this would ideally this is not a long-term therapy as patient will eventually get to a place in life where they are able to manage symptoms without medications, and that the risk of HTN, MI, stroke will out-way the benefit of treatment for the medications
-Continue current stimulant
– F/U in 3 months for repeat evaluation
– No further questions from patient at this time
**End of Template**