New Pediatric Patients

The Pediatricians of Hyde Park welcomes new patients.  Choosing the right pediatrician for your child is one of the most important decisions you will make. By selecting Pediatricians of Hyde Park, you can feel confident and comfortable that you have made the right decision.There are specifics to when and how many patients we can accept at any given time. It is best to call the office for more information.

What to Expect

On the day of your child's first visit to our office, we recommend arriving a few minutes early. This allows extra time for finishing up any registration forms and ensures you have plenty of time to get acquainted with our staff and office. We look forward to meeting you and joining with you to help your child maintain optimal health.

Our Mission

Our practice is working together to build life-long relationships between our staff and our patients by consistently providing our patients with compassion, excellence and value. To fulfill this mission, we are committed to:

• Improving the lives of the children we serve by providing quality care in a child-centered environment.
• Listening to our young patients and their families who we are privileged to serve.
• Guiding our patients along a path of optimal health and wellness.
• Continually pursuing excellence at all levels through continuing education.

What to Bring to Your First Visit?

We work hard to ensure that your child receives prompt medical care in a comfortable, child-friendly office setting. To help expedite the first appointment, we ask that you please bring your child's immunization records as well as their previous medical records or a summation of their medical history.  Be prepared to complete paperwork regarding your family medical history, your child's medical history, and insurance information.

 

Patient Forms

We are also happy to offer you the option to download, print and complete our office forms IN ADVANCE to reduce paperwork time during your first appointment.

       Office Visit Forms   

• ASQ(9mo)
• ASQ (18mo)
• ASQ (24mo)
• ASQ (30mo)
• Authorization to Release 
• CRAFT (teenagers) 
• Divorce Policy  (if applicable)
• Edinburgh (post-partum)                                                                              
• Family Medial History  (needed for 1st visit)
• Financial Policy 2021  (needed for 1st visit)
• GAD-7 
• MCHAT
• Non-Covered Charges  (needed for 1st visit)
• Notice of Privacy Practices  (needed for 1st visit)              
• Patient Registration (needed for 1st visit)
• Portal Registration
• PHQ-2 (teenagers)  
• PHQ-9 (teenagers)
• Preventive + Sick Visit (needed for 1st visit)
• Teenage Consent (age 16+)
• Vaccine Policy  (needed for 1st visit)

       School Forms:

• Food Allergy Action Plan
• Kentucky Immunization Certificate Form
• Ohio Dept. of Job and Family Services (Child Medical Statement for Child Care)
• Ohio High School Athletic Association form 2021-2022 **Please note that the health history questions must be completed and sent over with the doctor portion or we will not be able to complete the form.**
• Kentucky High School Athletic Association form-**Please note that the health history questions must be completed and sent over with the doctor portion or we will not be able to complete the form.**
• Vanderbilt Parent
• Vanderbilt Parent Follow up
• Vanderbilt Teacher
• Vanderbilt Teacher Follow up

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.