Crestview Hills, Kentucky
859-341-5400
513-820-2312 (after hours)
859-578-3172 Fax



Online Forms and Practice Resources for Pediatric Patient Families

This location contains practice forms and handouts. Please see "Well Child Checkups" for age specific handouts and forms.

ADHD

The following forms may be used as part of the initial evaluation of patients with Attention Deficit Hyperactivity Disorder.  We recommend an evaluation with a psychologist to confirm the diagnosis and exclude other problems. We use ratings scales for diagnosis and then to monitor treatment.


Cincinnati Childrens's Hospital Medical Center's parent information about ADHD and ADHD medications is at: www.cincinnatichildrens.org

Please review these materials before your first visit to our office for possible ADHD treatment!

Influenza (Flu) Vaccine Consent Form

Foster Care

Records Release

Sports Physical Forms

Medical Home Information for New Patients

Asthma

All families who have children with asthma are asked to complete the top portion of this form annually. The information on this form helps us to ensure our patients with asthma have good control of their symptoms. You may complete this form prior to your child's visits and bring it in with you.

Authorization to share medical information form

Warts

Constipation

Attached is a one page action plan and review for children with constipation, provided in collaboration with CCHMC.

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Pediatric Associates PSC - Crestview Hills | 2865 Chancellor Drive | Suites 225 (Upstairs) and 120 (Down Under) | Crestview Hills, KY 41017 | Phone: 859-341-5400 | Fax: 859-578-3172
Pediatric Associates PSC - Mt. Zion Road | 9920 Berberich Drive | Florence, KY 41042 | Phone: 859-341-5400 | Fax: 859-578-3172
Pediatric Associates PSC - Cold Spring | 175 French Street | Cold Spring, KY 41076 | Phone: 859-341-5400 | Fax: 859-578-3172
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