To expedite your first appointment, please arrive a few minutes early to complete registration forms so that we have all the necessary information to treat your child. You may also download and print the forms from this website, fill them out ahead of time, and bring them with you to the first appointment.
- Welcome Letter
- Patient Authorization Form
- Patient Registration Form
- Health History Form
- Financial Agreement
- Appointments, Cancellations, and No-Show Policy
- Authorization of Treatment of Minor
- Consent to Treat a Minor Without Parent/Guardian Present
- Medical Records Release
- Disclosure of Information
- Notice of Privacy Practices
- Vaccine Policy
- CDC Recommended Vaccine Schedule
- Work Permit Instructions and Form
- ADHD Treatment Instructions
- Ohio Sports Physical Form
- Immunization Certificate Kentucky
- Ohio Medical Statement for Child Care
- Is Your Child Too Sick for School?
- HIPAA Notice of Privacy Practice Acknowledgement
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.
