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treatment plan record for a child with adhd

overview

use this form to record information about your child's treatment plan for attention deficit hyperactivity disorder (adhd). review the plan with your doctor or other health professional often. together you can keep the plan up to date.

my child's main symptom of adhd is (inattention, impulsiveness, or hyperactivity) ______________________.

an example of this symptom is:

my child expresses the other symptoms of adhd in the following ways.

my child takes the following medicine for adhd at the listed times.

my child has the following learning disabilities or other medical conditions often associated with adhd. (if not applicable, cross out this statement.)

we are helping my child control the following behaviour.

we are using the following consequences or methods to help my child control behaviour.

my child is participating in a social skills training program to learn:

other things about my child's health:

related information

credits

current as of: june 24, 2023

author: healthwise staff
clinical review board
all healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

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this information does not replace the advice of a doctor. healthwise, incorporated, disclaims any warranty or liability for your use of this information. your use of this information means that you agree to the terms of use and privacy policy. to learn more about healthwise, visit healthwise.org. © 1995-2022 healthwise, incorporated. healthwise, healthwise for every health decision, and the healthwise logo are trademarks of healthwise, incorporated.

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