Patient Onboarding Requirements

To begin treatment, all patients must provide the following:

1. Valid State ID
   • Must include current residential address (No P.O. Boxes accepted)
2. Second Federal ID
   • A clear copy of an additional form of federal identification (e.g., passport, Social Security card)
3. Medical Records
   • Records from the last 30 days from your prior prescribing, diagnosing, or treating physician
4. Signed HIPAA Authorization Form
   • Required to allow us to coordinate care and request records
5. Patient-Doctor Controlled Substance Contract
   • Signed agreement outlining responsibilities when being prescribed controlled substances

Ongoing Monitoring Requirements

To remain in good standing in the program, patients must agree to:

1. Random Urine Drug Screens
   • Conducted randomly throughout treatment
2. Random Virtual Pill Counts
   • 24-hour notice will be given; must be done on camera
3. Prescription Monitoring Program (PMP) Review
   • All patients are subject to PMP checks to ensure no duplicative prescriptions
4. Scheduled Urine Drug Screen
   • Completed at a LabCorp or Quest Diagnostics location nearest the patient

Prescription Fulfillment Policy

1. Contracted Pharmacies Only
   • All prescriptions will be filled through our licensed U.S.-based partner pharmacies (NY & NJ)
2. Electronic Prescribing Only
   • Prescriptions are transmitted directly through our secure EHR platform

Patient Responsibilities

1. Lost or Stolen Medication
   • A valid police report must be submitted to request any replacement or refill
2. No Early Refills
   • Early refill requests will be denied unless accompanied by an official police report

Virtual Consultation Policy

1. Consultation Frequency
   • Appointments are required every 28 days
2. Webcam Required
   • All visits must be completed on camera with a state-licensed physician
3. ADHD Questionnaire
   • A validated diagnostic checklist will be completed at each consult

Non-Compliance Policy

1. Program Termination
   • Failure to follow policies may result in removal from the program
2. High-Risk Monitoring
   • Non-compliant patients may be placed on high-risk list and require more frequent follow up.