Transcription of ADHD Management Plan/Sample 1
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1mgDose 2mgDose am/pmTimeam/pmDose 1mgDose 2mgDose 3mg Medication to be given on nonschool days Medication given fornumber of days School authorization signed by parent and MD Rx written for duplicate bottle for administration at school Side effects explained/information givenCommon Side Effects:decreased appetite, sleep problems, transient stomachache, transient headache, behavioral reboundCall your doctor immediately if any infrequent side effects occur:weight loss, increased heart rate and/or blood pressure,dizziness, growth suppression, hallucinations/mania, exacerbation of tics and Tourette syndrome (rare)ADHD Management Plan Sample 1 Date:To t h e f a m i l y o f, please refer to this plan between visits if you have questions about you are still unsure, call us at for s doctor isPager #Parent/GuardianRelationshipContact Number(s)School NameSchool Phone Teacher Contact Name Grade Teacher s E-mail AddressGoalsWhat improvements would you most like to see?
Explain all aspects of the Daily Report Card (DRC) to the child in a positive manner. 5. Establish a Home-based Reward System. Rewards must be selected by the child. Arrange awards so that: –Fewer or less preferred rewards can be earned for fewer yeses. –More desired rewards can be earned for better performance.
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