If you would like to complete your registration forms ahead of your visit, you can download them below. You will only need to complete these forms once, unless you change your contact or insurance information.
WSP Registration Form Child Version
WSP Registration Form Adult Version
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.
Medical Records Release TO West Side Pediatrics
Authorizes release of records TO West Side Pediatrics — this form can be printed, scanned, and emailed to [email protected] if needed.
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.
Medical Records Release FROM West Side Pediatrics
Authorizes release of records FROM West Side Pediatrics — this form can be printed, scanned, and emailed to [email protected] if needed.
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: