Request Prescription Adjustment

Let's Adjust Your Meds!

Please complete the below required fields so we can make this change for you.
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Please Enter Your Name:*

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Please indicate the change you would like to make, whether it's starting a new medication, changing existing medications, or switching to an alternative.
If we're making a change to your current medication, please select the medication you would like to change
Increase the doseDecrease the doseDiscontinue the medicationStart new medicationSwitch to an alternative medicationOther
Difficulties with focus and concentration(ADHD)Poor sleep(Insomnia)Worrying too much(Anxiety)Other
Not working well enoughNew problem that needs to be addressedToo many side effectsOther
If you would like to start a new medication. Please select that medication here:
I would like to start at the standard starting doseI would like to start at an equivalent dose to the l medication I am stoppingOther
Same as last timeOther
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Informed Consent:

Please tap here for immediate access to an evidence based, public resource to learn more about these medications. Including mechanisms of action, benefits, risks and potential side effects.
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Please sign below to verify you are in agreement to make the above medication changes, that you understand the risks and benefits of taking this medication, and that you agree to move forward today.
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Medication Adjustment

Service includes comprehensive chart review, adjusted prescription submission, with ongoing care and monitoring with the AutoPsych provider team.

$49.99 Quantity

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Let's Adjust Your Meds!

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