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Treatment Referral

ADHD Online Smart Assessment and Treatment Background

ADHD Online was created to help improve access to mental health care.   Our assessment is reviewed by our network of doctorate-level psychologists licensed in all 50 states.  Our psychologists can diagnose ADHD, anxiety and depression (19 different ICD-10 codes) in alignment with DSM-5 criteria, and they can also highlight indications of related conditions, including Binge Eating Disorder, Social Media Addiction, and Loneliness.  Patients get results within 3-5 business days, rather than waiting 9-12 months for a traditional in-person assessment.  

Many patients diagnosed by ADHD Online have chosen to stay with us for Telemedicine treatment. We currently offer Telemedicine Treatment in 40 states only to patients assessed and diagnosed by ADHD Online psychologists. Our patients are not required to stay with us for medical treatment, and we proudly partner with the rest of our patient’s care teams to ensure the best care possible.    

Our patients look to other care team members to facilitate optimal care coordination

Our patient has identified you as a vital member of their healthcare team, and they are requesting an in-person evaluation and a referral from you to help them continue their telemedicine treatment regimen from ADHD Online without interruption.

Telemedicine Referral Process

 Please complete the following steps to help ensure the proper oversight and care of our patient.

Complete an In-person exam to determine the suitability of stimulant treatment.

Complete the referral form to attest that the patient is cleared for the appropriate stimulant course for ADHD.  The form includes space for the clinician’s NPI and DEA numbers.   

Fax form (and, optionally, a recent AVS from the past 6 months detailing in-person exam) to ADHD Online at 616-210-3118.


We believe the mind and body are interconnected. We encourage our patients to get annual physical exams, and we seek to foster regular communication between our providers, our patients, and the rest of the patients’ care teams.  We strongly believe that the best care is possible only through a well-connected team of care providers.

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The system is experiencing technical issues scheduling new appointments.

We apologize for any inconvenience this may cause you. We understand the importance of making an appointment, and this issue is our top priority.

Please reach out to us via chat or call us at 888-493-ADHD (2343) and we will assist you. If we are not available, please leave us a message and we’ll get back to you as soon as possible.

The ADHD Online Team

Provide this form to your local practitioner. You could:

  • Send this link
  • Email the pdf
  • Print it out and bring it to your appointment

Ask your practitioner
to complete the form

In this form, your practitioner will request that ADHD Online continue to provide uninterrupted care

Return the form to us

You or your practitioner can return this form to us via email or fax it to 616-210-3118