Supplements that May Help with ADHD symptoms -

Please enable JavaScript in your browser to complete this form.

Full Name *

First

Last

Date of Birth *

Phone Number *

Email Address *

Best Way to Reach You

Are You a Current Patient? *

List all of your current prescription medicines? *

List all of your current supplements?

List any medicine or food allergies? Type N/A if none. *

WHICH CONDITON ARE YOU REQUESTING SUPPLEMENTS FOR? *

Supplements for Chronic Fatigue

Probiotics 50 Billion CFU,
Glutathione
CoQ10 (Ubiquinol)
NAD+ / NMN Precursors
Acetyl-L-Carnitine (ALCAR)
D-Ribose
Alpha Lipoic Acid (R-ALA
Magnesium Malate
Magnesium Glycinate
Vitamin D3 + K2
Ashwagandha KSM-66
Rhodiola Rosea
DHEA (if deficient)
Phosphatidylserine
Pantothenic Acid (B5)
Vitamin C (high dose)
Methylated B-Complex
Zinc Bisglycinate
Omega-3 Fish Oil
Curcumin (bioavailable)
NAC (N-Acetyl Cysteine)

Supplements for Anxiety

Magnesium Glycinate
L-Theanine
GABA (Pharma-GABA
Passionflower Extract,
Ashwagandha KSM-66,
Rhodiola Rosea,
Phosphatidylserine
Vitamin D3 + K2
5-HTP
Inositol (Myo-Inositol)
B-Complex (Methylated)
Magnesium L-Threonate,
Omega-3 (EPA dominant)
Curcumin (bioavailable)
NAC (N-Acetyl Cysteine)
Probiotics 50 Billion CFU

Supplements for Depression

CoQ10 (Ubiquinol)
NAD+ / NMN Precursors
Acetyl-L-Carnitine (ALCAR)
D-Ribose
Alpha Lipoic Acid (R-ALA),
Magnesium Malate,
Ashwagandha KSM-66
Rhodiola Rosea
DHEA (if deficient)
Phosphatidylserine
Pantothenic Acid (B5)
Vitamin C (high dose)
Magnesium Glycinate
Vitamin D3 + K2
Methylated B-Complex
Iron (if ferritin low)
Zinc Bisglycinate
Omega-3 Fish Oil
Curcumin (bioavailable)
NAC (N-Acetyl Cysteine)
Probiotics 50 Billion CFU
Glutathione

Hormone Imbalance Supplements

DIM (Diindolylmethane)
Calcium D-Glucarate,
B-Complex (Methylated)
Magnesium Glycinate
Vitex (Chaste Tree Berry)
Vitamin D3 + K2
DHEA (if deficient)
Zinc Bisglycinate
Boron
Selenium
Iodine + Iodide
Myo-Inositol + D-Chiro (40:1)
Berberine
Black Cohosh
Evening Primrose Oil
Maca Root

Autoimmune Conditions Supplements

Vitamin D3 + K2
Omega-3 (EPA + DHA)
Magnesium Glycinate
Curcumin (bioavailable)
Boswellia Serrata (AKBA)
UC-II Collagen (Type II)
Probiotics 50 Billion CFU
L-Glutamine
Quercetin
NAC (N-Acetyl Cysteine)
Resveratrol
Alpha Lipoic Acid (R-ALA)
Selenium

Cognitive Decline and Brain Health Supplements

Lions Mane Mushroom
Bacopa Monnieri
Phosphatidylserine (PS)
Low-dose Lithium Orotate
Omega-3 DHA + EPA (DHA dominant),
Curcumin (bioavailable)
NAC (N-Acetyl Cysteine)
CoQ10 (Ubiquinol)
NAD+ / NMN Precursors
Magnesium L-Threonate
Ginkgo Biloba (EGb761)
Acetyl-L-Carnitine (ALCAR)
Vinpocetine
B-Complex (Methylated)
Ashwagandha KSM-66

Thyroid Disorders Supplements

Selenium
Zinc Bisglycinate
Magnesium Glycinate
Vitamin D3 + K2
Iron (if ferritin below 30)
Ashwagandha KSM-66
Methylcobalamin (B12)
NAC (N-Acetyl Cysteine)
Probiotics 50 Billion CFU
L-Glutamine
DIM (Diindolylmethane)
Curcumin (bioavailable)
Rhodiola Rosea

for / GLP-1

Adrenal and Stress Conditions Supplements

Ashwagandha KSM-66
Rhodiola Rosea
Eleuthero (Siberian Ginseng)
Holy Basil (Tulsi)
Phosphatidylserine
Vitamin C (high dose)
Licorice Root (DGL)
CoQ10 (Ubiquinol)
NAD+ / NMN Precursors
Magnesium Glycinate
Pantothenic Acid (B5)
DHEA (if deficient)
5-HTP
Omega-3 (EPA dominant)
Glycine

Gut Health Supplements

Broccoli Sprout Extract (Sulforaphane)
Peppermint Oil (enteric coated)
L-Glutamine
Bovine Colostrum
Probiotics 50 Billion CFU Multi-Strain
Zinc-Carnosine
DGL (Deglycyrrhizinated Licorice)
Betaine HCl + Pepsin
Slippery Elm Bark
Marshmallow Root
Aloe Vera (inner leaf)
Mastic Gum
Bismuth Subsalicylate
Quercetin
Psyllium Husk
Saccharomyces Boulardii
Berberine
Magnesium Citrate or Glycinate
Triphala
Digestive Enzyme Complex
Curcumin (bioavailable)
Vitamin D3 + K2
Omega-3 Fish Oil

Diabetes and Blood Sugar Supplements

Berberine
Magnesium Glycinate
Chromium Picolinate
Cinnamon Extract (Ceylon)
Myo-Inositol
Gymnema Sylvestre
Alpha Lipoic Acid (R-ALA)
Benfotiamine (fat-soluble B1)
CoQ10 (Ubiquinol)
Omega-3 EPA + DHA
Curcumin (bioavailable)
NAC (N-Acetyl Cysteine)
Vitamin D3 + K2
B-Complex (Methylated)
Probiotics 50 Billion CFU
Zinc Bisglycinate

Hypertension Supplements

Magnesium Glycinate
Ashwagandha KSM-66
Aged Garlic Extract
L-Citrulline
Hawthorn Berry Extract
CoQ10 (Ubiquinol)
Omega-3 EPA + DHA
Berberine
Resveratrol
Magnesium Taurate
Curcumin (bioavailable)
NAC (N-Acetyl Cysteine)
Vitamin D3 + K2,
B-Complex (Methylated)
Probiotics 50 Billion CFU

Hyperlipidemia Supplements

Berberine
Red Yeast Rice
Plant Sterols and Stanols
Psyllium Husk (soluble fiber)
Omega-3 EPA + DHA (high dose)
Niacin (flush-free or sustained release)
Resveratrol
Curcumin (bioavailable)
Vitamin C (high dose)
Tocotrienols (Vitamin E complex)
NAC (N-Acetyl Cysteine)
CoQ10 (Ubiquinol)
Magnesium Glycinate
Vitamin D3 + K2
B-Complex (Methylated)

ADHD and Focus Supplements

Zinc Bisglycinate
L-Tyrosine,
Rhodiola Rosea
Magnesium Glycinate
L-Theanine
GABA (Pharma-GABA)
Phosphatidylserine
CoQ10 (Ubiquinol)
NAD+ / NMN Precursors
Magnesium L-Threonate
Omega-3 EPA + DHA
Curcumin (bioavailable)
Vitamin D3 + K2
B-Complex (Methylated)
Probiotics 50 Billion CFU

Male Hormone Support Supplements

Zinc Bisglycinate
Magnesium Glycinate
Vitamin D3 + K2
Ashwagandha KSM-66
Boron
DIM (Diindolylmethane)
Calcium D-Glucarate,
Chrysin (with Piperine)
Maca Root
L-Citrulline
Pine Bark Extract (Pycnogenol)
DHEA (if deficient)
Phosphatidylserine
Omega-3 EPA + DHA
CoQ10 (Ubiquinol)
B-Complex (Methylated)

Weight Loss and GLP-1 Support Supplements

Whey or Plant Protein Powder
Creatine Monohydrate
HMB (Beta-Hydroxy Methylbutyrate)
Berberine
Myo-Inositol
Cinnamon Extract (Ceylon)
CoQ10 (Ubiquinol),
,Ginger Root Extract
Digestive Enzyme Complex
Probiotics 50 Billion CFU
Magnesium Glycinate
Vitamin D3 + K2
B-Complex (Methylated)
Omega-3 EPA + DHA
Curcumin (bioavailable),
NAC (N-Acetyl Cysteine)

Additional Supplements Not Listed?

Preferred Supply options

Pickup or Shipping options

Shipping Address (ALL new Patients must complete address information)

Address Line 1

Address Line 2

City

State

Zip Code

Additional Notes for Supplement Order Request

Acknowledgment

I understand this is a supplement request only and I agree to wait for confirmation from Dr. Thomas’s team before expecting my order to be fulfilled.

Signature (Type Name)

Date / Time

Date

Time

Supplement Request

ADHD and Focus
Supplement Request

Select the supplements you are interested in and submit your request. Dr. Thomas’s team will review your selections and follow up within one business day.

ⓘ All supplements are available at a patient discount through our Fullscript dispensary. Your selections will be reviewed by Dr. Thomas to ensure safety and compatibility with your current health plan. This form does not process payment — our team will contact you to confirm your order.

Your Information

Full name

Date of birth

Phone number

Email address

Best way to reach you

Are you a current patient?

Select Your Supplements

Check all supplements you are interested in ordering.

Dopamine and Focus

Zinc Bisglycinate Iron (if ferritin below 30) L-Tyrosine Rhodiola Rosea

Calm and Impulse Control

Magnesium Glycinate L-Theanine GABA (Pharma-GABA) Phosphatidylserine

Brain Energy

CoQ10 (Ubiquinol) NAD+ / NMN Precursors Magnesium L-Threonate

Inflammation

Omega-3 EPA + DHA Curcumin (bioavailable)

Foundations

Vitamin D3 + K2 B-Complex (Methylated) Probiotics 50 Billion CFU

Additional supplements or special requests

Order Details

Preferred supply

Pickup or shipping

Notes for Dr. Thomas

Acknowledgment

I understand this is a supplement request only and does not guarantee availability or constitute a purchase. I agree to wait for confirmation from Dr. Thomas’s team before expecting my order to be fulfilled.

✅

Request Received!

Your supplement request for ADHD and Focus has been sent to Dr. Thomas’s team. We will review your selections and contact you within one business day to confirm availability, pricing, and compatibility with your current health plan.

If you need to reach us sooner please call (317) 253-7795.

You can also browse and order directly through our Fullscript dispensary:

Shop Fullscript Dispensary

Supplements that May Help with ADHD symptoms

ADHD and FocusSupplement Request

Request Received!

ADHD and Focus
Supplement Request