Completed by the patient (or guardian) - Please complete all required fields and submit your form at least 72 hours prior to your appointment.
This form will be provided to the specialist doctor you have booked an appointment with.
If you have booked an appointment on behalf of someone else, please complete the form with the details of the patient

If you do not understand this form or require assistance we would recommend seeking assistance or calling Telecare on ph (03) 9052 4872.

Due to the limitation of tele-psychiatry services, most of our Psychiatrists are providing assessment and diagnostic services under Medicare item 291 and hand over the ongoing care to your referring GPs.

The management of patients with attention deficit hyperactivity disorder (ADHD) may involve the prescription of restricted (S8) psychostimulant medications (e.g. Lisdexamfetamine/Vyvanse or Ritalin/Methylphenidate). It is possible that your psychiatrist/paediatrician may recommend the prescription of these restricted drugs. Please be aware that while Telecare’s specialists may recommend treatment with such medications, they will in general not provide the prescription for these medications (unless exceptional circumstances apply). Our  psychiatrists/paediatricians  are able to provide a supporting letter to your GP, detailing their recommendation for the medication. Your GP may then be able to use that recommendation to apply for a permit to prescribe these recommended medications. In many states, GP prescription of these medications is permitted as long as they provide a letter from a specialist detailing this recommendation. We highly recommend that you discuss this arrangement with your GP prior to your appointment.

Please confirm with your referring GP that this is acknowledged and agreed upon,  prior to your telehealth appointment. 

ADHD assessment – what to expect?

• Diagnostic assessment for ADHD and development of a tailored management plan requires several sessions/attendance.

• For the first appointment bring a list of issues you believe need to be covered.

• Assessments typically require collection of information from other sources about childhood developmental history and current difficulties. Collateral information will be collected through sources such as: interview of a parent and/or partner, parent and partner questionnaires and school reports.

• Feel free to bring a family member, or a friend to provide supporting history.

• You will be sent out few questionnaires that will need to be filled out and sent back before your scheduled appointment. 

• You can obtain school reports, if not saved, by calling schools.

• NOTE WITHOUT HAVING ACCESS TO CHILDHOOD INFORMATION, THE DIAGNOSIS OF ADHD WILL REMAIN PROVISIONAL.

• If a diagnosis of ADHD was made by a previous or current health professional (e.g. pediatrician, psychiatrist, psychologist etc.) you will be expected to obtain the supporting documentation (e.g. reports, letters). Provision of such documents will expedite the assessment process.

• You would be asked to have blood tests, urine drug screens, physical health assessments, clearance from a cardiologist etc. before commencing treatment.

• Please note if there are comorbid psychiatric or physical conditions, they may need to be stabilized before specific medicine for ADHD is commenced.

Consent provided

Source: https://add.org

References:1. Schweitzer JB, et al. Med Clin North Am. 2001;85(3):10-11, 757-777.2. Barkley RA. Attention Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment. 2nd ed. 1998.3. Biederman J, et al. Am J Psychiatry.1993;150:1792-1798.4. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision.Washington, DC, American Psychiatric Association. 2000: 85-93.

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