| Show Hands downf Shire US Inc is the company to turn to for the information services and support you need to help your child with ADHD succeed IfflKIftlt' issfj siip cfjferi tfe AWfnffj) md i A mm the ADHD Support Company Shim US Ire ha clinician parents teachers and patients with ADHD Wa haw made spent yen working with physician It our mission I to provide products protrams and i aarvfcaa designed to Improve Ilia tnral undaratanrSng of ADHD and 1 i : to anhanoa the medical cam of those f whose lives am touched by ADHD We know how much of a difference access to updated Information can make to the srtfro famUr of a chid who is Mng with ADHD ovary day and wa would tea to work hand-in-han- with you d ®®to®®t'tEJE55SD3G)(i'CCprS3Mlti ADHDlGuTdeltor 1 ‘r r -- ' " r £ “t— if - - -- ' rf i & 888i7i74-3000 PNNTEOMUSA r 'it ' ) Hoi 6489640816 YES please send me ADHD: A Gukkfbr Families book and other information on treatment options for ADHD ' 1 Sipaturr (required) What is the patient's currently proscribed treatment? (please check all that apply) Behavioral Modification ("1 ocher O QW Mrrilt-artn- O n (plea specify) (please specify) 2 If medication how many times in a given day doea the patient taka the medication? Once More often O 3 If taking medication O-TWk- how satisfied O an youis the patient with ( the currant thedictrtion? O Extremely satisfied O Very satisfied O Saddled O Somewhat satisfied O Not at all satisfied (pin pill l nm&m wgn M eM fKnhJB l CTTY W I ' AJA 302-- 3 (Shire |
