Forms

Due to COVID-19 safety restrictions, we apologize that we cannot accept school forms or medication forms by drop-off.
You must have had a physical that is current within the past year to complete school physical forms. Please fax the form to the number below or mail it to our office Attention: Medical Records Clerk.
HILLIARD: 614-529-2370
LEWIS CENTER: 740-657-8100
PICKERINGTON: 614-863-7388
WHITEHALL: 614-434-2701
Forms will be completed within 3-5 business days.
Please note we need to receive all pages of the document and you are required to complete the parent portion of the form in order for us to serve you better.
All completed forms will be mailed or faxed back to you as we cannot release protected health information via e-mail. If your child is in need of a physical, please call the office to schedule and you can bring your form with you to the appointment.