Forms + Links


On this page you'll find a variety of resources, forms, and links intended for our patients.

Patient Forms

New Patient Packet

Please complete the following forms and either fax or mail to our office along with a copy of your current insurance card.


Annual Demographic Information Update

Please print, complete and bring with you to your child's annual preventative exam.


Daycare Forms


Athletic Forms

Upon entering 7th grade most schools require annual completion of this form for all students participating in sports. Please print, complete the entire first page and then bring both pages with you to your child's annual preventative exam for the provider to review and complete.


Release Forms


Neuropsychology forms


Links to Online Resources

The following links to external web sites have been provided for informational purposes only and Rainbow Pediatrics is not responsible their availability or content.

ADOLESCENT HEALTH

  • The AWARE Foundation - AWARE (Adolescent Wellness through Access to Resources and Education) includes lists of support hotlines for teens to call for help with mental health, sexual abuse, eating disorders, suicide, STDs, emergency contraception, and more: http://www.awarefoundation.com/
  • I Wanna Know - This sites aims to teach kids about sexually-transmitted diseases before they learn the hard way: www.iwannaknow.org
  • Planned Parenthood: www.plannedparenthood.org/teens

BREASTFEEDING

BEHAVIOR & DEVELOPMENT

DENTAL HEALTH

DERMATOLOGY (SKIN)

GENERAL HEALTH

GOVERNMENT

HEART DISEASE

IMMUNIZATIONS / VACCINATIONS

MENTAL AND EMOTIONAL HEALTH

NUTRITION, FOOD SAFETY, & OBESITY

OPHTHALMOLOGY (EYE)

PREVENTION & SAFETY

PREGNANCY

PROCEDURES

PROFESSIONAL ORGANIZATIONS AND HOSPITALS

  • The American Academy of Pediatrics (AAP) – an organization of 60,000 pediatricians committed to the attainment of optimal physical, mental, and social health and well-being for all infants, children, adolescents and young adults. www.aap.org
  • Nationwide Children's Hospital: www.NationwideChildrens.com
  • Health Information Translations – A collaborative initiative to improve health education for limited English proficiency patients: www.healthinfotranslations.org
  • CAP4Kids Columbus - a free website sponsored by local Pediatricians and Nationwide Children's Hospital have that contains a wealth of information about helpful community resources for kids and families.: www.cap4kids.org/columbus
    Resource topics include:
    • Mental health resources
    • After school programs/camps
    • Daycare
    • Breastfeeding help
    • Free and discounted prescriptions
    • Low cost health care, travel clinics
    • Smoking cessation programs
    • Obesity resources
    • Teen resources
    • Resources for kids with special needs and much more!

SCHOOL

SPORTS MEDICINE

SPOTLIGHT ON SUMMER

SUBSTANCE ABUSE (Tobacco, Alcohol, Drug Abuse)

  • Netcare Access provides 24 hour mental health and substance abuse crisis intervention, stabilization and assessment for Franklin County, Ohio residents: www.netcareaccess.org
  • Tobacco Information and Prevention Source (TIPS): www.cdc.gov/tobacco/

TRAVEL

TOP