ADHD Diagnostic Documentation Requirements

Documentation Required for the Infirmary to Prescribe or Continue Stimulant Medication for ADHD

The Infirmary follows current national standards for the diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD), including the primarily inattentive presentation. ADHD is a clinical diagnosis made according to DSM-5-TR criteria. It is established through a comprehensive clinical evaluation and cannot be made on the basis of any single test.

Stimulant medications are controlled substances that can be misused or diverted. To prescribe or continue them, the Infirmary requires documentation of a properly conducted diagnostic evaluation by a qualified, licensed clinician (physician, psychiatrist, psychologist, or advanced practice provider). Students who received a diagnosis or prescription elsewhere may continue to obtain medication from that outside provider, but the Infirmary can write prescriptions only when the documentation below is on file. This reflects a cautious approach to a controlled medication and is not a judgment of any outside clinician.

Core documentation required (all four)

1. DSM-5-TR diagnosis of ADHD, specifying presentation type, with the clinician’s report confirming that criteria are met.
2. Clinical interview / mental status examination, including screening for conditions that mimic or co-occur with ADHD (anxiety, depression, sleep disorders, substance use, thyroid disease, prior head injury). Symptoms must not be better explained by another condition (Faraone et al., Nature Reviews Disease Primers, 2024).
3. Evidence of symptom onset before age 12 and impairment in two or more settings (e.g., academic and home/social/work), consistent with DSM-5-TR (Olagunju & Ghoddusi, American Family Physician, 2024).
4. Validated ADHD rating scales, ideally with collateral/informant input and historical records. Examples: Adult ADHD Self-Report Scale (ASRS), Conners Adult ADHD Rating Scales (CAARS), Wender Utah Rating Scale, or the BASC-3 (self/observer). Collateral sources may include childhood records, school transcripts, or a parent/partner report (Cortese et al., World Psychiatry, 2025).

Supporting records to include when available

• Childhood medical, psychological, or educational records documenting early symptoms.
• School transcripts, prior individualized education plans (IEPs), or 504 accommodation records.
• Prior prescriber records, current medication, dose, and response.

Formal psychological / neuropsychological testing — optional adjunct, not required

Neuropsychological and cognitive testing is neither necessary nor sufficient to diagnose ADHD and is not required by the Infirmary for most students (Mierau, Neurology Clinical Practice, 2025; Peterson et al., American Academy of Pediatrics, 2024). Continuous performance tests (e.g., TOVA, Conners CPT 3) and cognitive batteries have only modest accuracy and cannot, on their own, confirm or exclude ADHD (Arrondo et al., JAACAP, 2024).

Formal testing is most useful in specific situations — when there is no clear childhood or family history, when collateral information is lacking, when a confounding condition is suspected, or when a co-occurring learning disability or academic accommodations are being evaluated. When such testing is provided, current editions of the following are preferred:

• Attention / processing (adjunctive): Conners CPT 3, Test of Variables of Attention (TOVA), Stroop.
• Cognitive ability / aptitude: WAIS-5, Woodcock-Johnson IV Tests of Cognitive Abilities, KABC-II / KTEA.
• Academic achievement (for suspected learning disorder / accommodations): Woodcock-Johnson IV Tests of Achievement, WIAT-4.
• Social / emotional / personality: BASC-3, MMPI-3, PAI, or NEO-PI-3.

Additional information

The evaluating clinician should select the instruments most appropriate to each student’s clinical presentation and should assess for other areas of concern.

Stimulant medication is not indicated or necessary in every case of ADHD; management is individualized and may include non-stimulant medication and behavioral strategies.

Questions about these requirements or how to submit records may be directed to the Infirmary.

Documentation Required for the Infirmary to Prescribe or Continue Stimulant Medication for ADHD

The Infirmary follows current national standards for the diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD), including the primarily inattentive presentation. ADHD is a clinical diagnosis made according to DSM-5-TR criteria. It is established through a comprehensive clinical evaluation and cannot be made on the basis of any single test.

Stimulant medications are controlled substances that can be misused or diverted. To prescribe or continue them, the Infirmary requires documentation of a properly conducted diagnostic evaluation by a qualified, licensed clinician (physician, psychiatrist, psychologist, or advanced practice provider). Students who received a diagnosis or prescription elsewhere may continue to obtain medication from that outside provider, but the Infirmary can write prescriptions only when the documentation below is on file. This reflects a cautious approach to a controlled medication and is not a judgment of any outside clinician.

Core documentation required (all four)

1. DSM-5-TR diagnosis of ADHD, specifying presentation type, with the clinician’s report confirming that criteria are met.
2. Clinical interview / mental status examination, including screening for conditions that mimic or co-occur with ADHD (anxiety, depression, sleep disorders, substance use, thyroid disease, prior head injury). Symptoms must not be better explained by another condition (Faraone et al., Nature Reviews Disease Primers, 2024).
3. Evidence of symptom onset before age 12 and impairment in two or more settings (e.g., academic and home/social/work), consistent with DSM-5-TR (Olagunju & Ghoddusi, American Family Physician, 2024).
4. Validated ADHD rating scales, ideally with collateral/informant input and historical records. Examples: Adult ADHD Self-Report Scale (ASRS), Conners Adult ADHD Rating Scales (CAARS), Wender Utah Rating Scale, or the BASC-3 (self/observer). Collateral sources may include childhood records, school transcripts, or a parent/partner report (Cortese et al., World Psychiatry, 2025).

Supporting records to include when available

• Childhood medical, psychological, or educational records documenting early symptoms.
• School transcripts, prior individualized education plans (IEPs), or 504 accommodation records.
• Prior prescriber records, current medication, dose, and response.

Formal psychological / neuropsychological testing — optional adjunct, not required

Neuropsychological and cognitive testing is neither necessary nor sufficient to diagnose ADHD and is not required by the Infirmary for most students (Mierau, Neurology Clinical Practice, 2025; Peterson et al., American Academy of Pediatrics, 2024). Continuous performance tests (e.g., TOVA, Conners CPT 3) and cognitive batteries have only modest accuracy and cannot, on their own, confirm or exclude ADHD (Arrondo et al., JAACAP, 2024).

Formal testing is most useful in specific situations — when there is no clear childhood or family history, when collateral information is lacking, when a confounding condition is suspected, or when a co-occurring learning disability or academic accommodations are being evaluated. When such testing is provided, current editions of the following are preferred:

• Attention / processing (adjunctive): Conners CPT 3, Test of Variables of Attention (TOVA), Stroop.
• Cognitive ability / aptitude: WAIS-5, Woodcock-Johnson IV Tests of Cognitive Abilities, KABC-II / KTEA.
• Academic achievement (for suspected learning disorder / accommodations): Woodcock-Johnson IV Tests of Achievement, WIAT-4.
• Social / emotional / personality: BASC-3, MMPI-3, PAI, or NEO-PI-3.

Additional information

The evaluating clinician should select the instruments most appropriate to each student’s clinical presentation and should assess for other areas of concern.

Stimulant medication is not indicated or necessary in every case of ADHD; management is individualized and may include non-stimulant medication and behavioral strategies.

Questions about these requirements or how to submit records may be directed to the Infirmary.