Pediatric Associates, Inc.
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Forms & Policies

Download Forms & Policies

Forms and Policies
We will send an e-mail 1-2 days ahead with all of the forms to be completed for registration prior to your appointment. Below are some other commonly used forms for your convenience.

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Download Patient Forms

  • Medical Records Request From Previous Physician
  • Medical Records Transfer Request
  • Boy Scout Class 1 & 2
  • Annual Health Medical Record
  • Work Permit
  • Behavioral Health Release of Confidential Information
  • Appointment of Personal Representative
  • Girl Scout Form
  • Child Care Statement
  • OHSAA FORM 2022 2023
  • Columbus City Schools Medication

Download Office Policies

  • NOTICE OF PRIVACY PRACTICES
  • Nondiscrimination and Interpreter Policy

Compliance

  • Ohio 2023 Minimum Wage
  • View Machine Readable Files
  • Employee Rights
In This Section
  • Parent Info
  • Is Your Child Sick?™
  • Dosage Charts
  • Immunization Schedule
  • Vaccine Information
  • ADHD
  • Asthma
  • Nutrition
  • Sports Tips
  • Behavioral Health and Behavior Disorders
  • Helping Hands
    • Diseases, Conditions & Surgeries
    • Procedures
    • Parental Guidance
  • Web Resources
  • Reading Material

Parent Resources

  • Get Directions Find one of our five locations.
  • Dosage Charts Track the dosage for your child.
  • Patient Forms Download the forms you need.
  • Mailing List Join our mailing list

Why Choose Us?

As a multi-physician, multi-office pediatric group we are committed to providing excellent health care to children in Central Ohio. Our focus is on preventive care: keeping your child healthy.

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Whitehall Office

(614) 501-7337

Monday – Friday: 8:00 AM – 5:00 PM

Hilliard Office

(614) 529-0771

Monday – Friday: 8:00 AM – 5:00 PM

Pickerington Office

(614) 864-3222

Monday – Friday: 8:00 AM – 5:00 PM

Lewis Center Office

(740) 657-8000

Monday – Friday: 8:00 AM – 5:00 PM

Canal Winchester Office

(614) 837-7337

Monday – Friday: 8:00 AM – 5:00 PM

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We are now offering self-scheduling appointments for established patients 3 years and older.

Schedule an Appointment Today!