Does every refill require a fresh check-in, or only periodic ones?

Not everytime! but during titration quite often. This is to check the safe responses to medication, give you oppertunity to explore and talk about your experiences. Its important to note that their is not just a physical adjustment to ADHD medication but a psychological one too. Our clincians spend time exploring both to give you a long term, sustainable and safe result. Once you are stable on a dose (and if nothing else is changing), every 3-6 months is normal for a check in.