We are pleased to announce you can now complete your registration forms on-line ahead of your visit! Please click the links below to submit your child's forms. You will also need to log-in to your child's PATIENT PORTAL to complete your on-line registration.
- Child Registration Online Form
- Financial Policy Child Online Form
- West Side Pediatrics Patient Agreement Online Form
If you are transferring care to our facility from another practice, please complete the Medical Records Release form. Parents of newborns can complete this form to transfer your child's newborn summary from your birth hospital. You may also complete the on-line registration forms listed above before your first visit if you desire.
If you are transferring care, moving, aging out of the practice or need to send records to another specialist, please complete a medical release for us to send your records to another facility.
ADHD Vanderbilt Forms
If your doctor has requested Vanderbilt forms for your child's visit, you can print the forms here, complete them, and either fax to us ahead of time (513-347-2407) or bring them to your child's visit.
- Initial Teacher Vanderbilt
- Initial Parent Vanderbilt
- Follow Up Teacher Vanderbilt
- Follow Up Parent Vanderbilt
- ADHD Self Assessment
Questions about which forms you need? Please call our office (513-922-8200) and our courteous staff will assist you in preparing for your child's visit.
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it: