Your CAPS provider needs clear objective documentation of the testing done to diagnose your ADHD in order to prescribe the appropriate medication for you on a regular basis.
The following documentation must be included when requesting stimulant medication for ADHD.
A copy of the psychological evaluation report from the provider (psychologist or neuropsychologist) who diagnosed your ADHD. We have compiled a list of ADHD testing providers in the area for your convenience. This report must contain:
- Your name, date of birth, and the date of the psychoeducational evaluation
- Provider name (printed), office address and contact information, specialty, signature, and date of report
- Tests performed, which must include all of the following:
- Cognitive/intelligence test (WAIS-IV or Stanford-Binet 5, RIAS-2, Woodcock Johnson-IV)
- Achievement test (Woodcock-Johnson IV, WIAT)
- Test of sustained attention (TOVA or CPT)
- Self-report forms for ADHD (e.g., Brown or Conners)
- Collateral information from relevant individuals (may include Brown or Conners forms filled out by parents/caregivers/partners)
- Comprehensive diagnostic interview, which must include:
- Complete psychosocial and educational history
- Complete mental health and medical history, including current treatment regimen and medications (if applicable)
- Current symptoms
- Clinical evaluation, which must include:
- All test results and scores
- Interpretation of test results
- Diagnosis
- Summary and recommendations
How to Submit Documentation
Submit the above documentation in one of the following ways:
- Bring these documents to your initial visit at CAPS
- Fax documents to Campus Health at 919-966-4605, Attn: Health Information Management
- Email documents to [email protected]
Stimulant Medication Contract
Additionally, all students being prescribed stimulant medication must agree to and sign the stimulant medication contract.