ACFB / Nelson Clinic Consent Form
A Change for Better (The ACFB Fund) has partnered with the Nelson Clinic to streamline the process of accessing medication services for adults newly diagnosed with Attention-Deficit/Hyperactivity Disorder. Clients who are diagnosed with ADHD through A Change for Better (The ACFB Fund) can get a direct referral for a medication consultation with the Nelson Clinic.
To streamline this process, A Change for Better collects consent from clients requesting an ADHD evaluation to forward their test results to the Nelson Clinic if the client is considering medication for their symptoms.
The fees you have paid for this assessment cover the evaluation through A Change for Better (The ACFB Fund) only. They do not cover serices through the Nelson Clinic. Should you choose to pursue medication services through the Nelson Clinic, you are responsible for all fees associated with those services. However, you will not have to receive a new ADHD assessment to receive medication management services with Nelson Clinic.
Information about the Nelson Clinic’s ADHD treatment services can be found here:
https://nelsonclinic.nz/services/adhd
By completing the form below, you acknowledge that you have read and agree to this document, and authorise A Change for Better (The ACFB Fund) and the Nelson Clinic to communicate about your treatment. The Nelson Clinic will receive a copy of your assessment report.