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Kids Plus Pediatrics
Kids Plus Pediatrics
  • Your Visit
    • New Patient Info
      • Getting Started
      • Kids + Family Guide
      • Behind the Scenes
    • Forms
    • Office Policies
      • Affordable Care Act Info
      • Financial Policy
      • Newborn Insurance Reminder
      • Non-Discrimination Policy
      • Screenings & Procedures
      • Split Family Policy
    • Patient Portal
    • Pre-Visit Questionnaires
    • Types of Visits
      • Well Visits
      • Walk-Ins
      • Virtual Visits
      • Fussy Baby
      • Dental Days
      • Adoption
      • Kids + Fit
      • Young Adult Care
    • Vaccinations
      • Vaccine Policy Statement
      • Vaccine Information Statements
      • COVID Vaccines
      • Flu Vaccines & Flu Clinics
      • HPV Vaccine: Cancer Prevention
  • Pediatrics +
    • Overview
    • Adoption
    • Behavioral Health
    • Breastfeeding
    • Concussions
    • Immunization
    • Infant Sleep
    • Nutrition & Fitness
  • Parent Resources
    • Overview
    • Blog
    • Classes
    • Doctors’ Notes
    • Podcast
    • Videos
  • Providers
  • About
    • Our Story
    • Our Mission & Vision
    • Advocacy
    • In the News
    • Kids + Jobs
    • Kids + Team
    • Kids + Teaching
    • Making Movies
    • Our Favorite Children’s Books
  • Offices
    • Overview
    • Cranberry/Seven Fields
    • Pleasant Hills
    • Squirrel Hill/Greenfield
  • Pre-Visit
  • Payments
    • Online Payments
    • Kids + Autopay
      • AutoPay Authorization
      • Kids + AutoPay FAQ
  • Patient Portal
Kids Plus Pediatrics
  • Pre-Visit
  • Payments
    • Online Payments
    • Kids + Autopay
      • AutoPay Authorization
      • Kids + AutoPay FAQ
  • Patient Portal
  • Your Visit
    • New Patient Info
      • Getting Started
      • Kids + Family Guide
      • Behind the Scenes
    • Forms
    • Office Policies
      • Affordable Care Act Info
      • Financial Policy
      • Newborn Insurance Reminder
      • Non-Discrimination Policy
      • Screenings & Procedures
      • Split Family Policy
    • Patient Portal
    • Pre-Visit Questionnaires
    • Types of Visits
      • Well Visits
      • Walk-Ins
      • Virtual Visits
      • Fussy Baby
      • Dental Days
      • Adoption
      • Kids + Fit
      • Young Adult Care
    • Vaccinations
      • Vaccine Policy Statement
      • Vaccine Information Statements
      • COVID Vaccines
      • Flu Vaccines & Flu Clinics
      • HPV Vaccine: Cancer Prevention
  • Pediatrics +
    • Overview
    • Adoption
    • Behavioral Health
    • Breastfeeding
    • Concussions
    • Immunization
    • Infant Sleep
    • Nutrition & Fitness
  • Parent Resources
    • Overview
    • Blog
    • Classes
    • Doctors’ Notes
    • Podcast
    • Videos
  • Providers
  • About
    • Our Story
    • Our Mission & Vision
    • Advocacy
    • In the News
    • Kids + Jobs
    • Kids + Team
    • Kids + Teaching
    • Making Movies
    • Our Favorite Children’s Books
  • Offices
    • Overview
    • Cranberry/Seven Fields
    • Pleasant Hills
    • Squirrel Hill/Greenfield

Forms

We’ll process 2 forms free of charge during your Well Visits. Just give them to a Family Care Coordinator at check-in, and we’ll complete them at your appointment.


Extra Forms

Additional forms, or forms provided at other times, are completed in 3-5 days for a $5 service fee.

24-Hour Service

Forms can be rush-completed in 24 hours for a $10 service fee.

Time-Frame Reminder

Your child’s Well Visit must have occurred in the time frame required for their age: the past 12 months for school-aged children; shorter intervals for younger children.

Your Visit

  • New Patient Info
    • Getting Started
    • Kids + Family Guide
    • Behind the Scenes
  • Forms
  • Office Policies
    • Affordable Care Act Info
    • Financial Policy
    • Late & Missed Appointments
    • Newborn Insurance Reminder
    • Non-Discrimination Policy
    • Screenings & Procedures
    • Split Family Policy
    • Weekend & Evening Code
  • Patient Portal
  • Types of Visits
    • Well Visits
    • Walk-Ins
    • Virtual Visits
    • Fussy Baby
    • Dental Days
    • Adoption
    • Kids + Fit
    • Young Adult Care
      • Consent & Confidentiality
      • Long Distance Care
  • Vaccinations
    • Vaccine Policy Statement
    • Vaccine Information Statements
    • COVID Vaccines
    • Flu Vaccines & Flu Clinics
    • HPV Vaccine: Cancer Prevention

Here are some forms used by Kids Plus patients and families.

Appointments

  • Consent for Treatment Without Parent or Guardian
  • Consent for Treatment of a Minor
  • Patient History

Sports

  • ImPACT Concussion Test Consent
  • PIAA Sports Physical Forms
  • Sports Participation Health History

Medical Records

  • Medical Records Release
    (get records FROM us)
  • Medical Records Request
    (get records FOR us)

Teens

  • Driver’s License/Learner’s Permit Form
  • Young Adult Release & Consent Form
  • Young Adult Long Distance Care Form

Work

  • Application for Work Permit

School & Child Care

  • Child Health Report
  • PA School Physical Form

Special Needs

  • Emergency Information for Children with Special Needs

Your Visit

  • New Patient Info
    • Getting Started
    • Kids + Family Guide
    • Behind the Scenes
  • Forms
  • Office Policies
    • Affordable Care Act Info
    • Financial Policy
    • Late & Missed Appointments
    • Newborn Insurance Reminder
    • Non-Discrimination Policy
    • Screenings & Procedures
    • Split Family Policy
    • Weekend & Evening Code
  • Patient Portal
  • Types of Visits
    • Well Visits
    • Walk-Ins
    • Virtual Visits
    • Fussy Baby
    • Dental Days
    • Adoption
    • Kids + Fit
    • Young Adult Care
      • Consent & Confidentiality
      • Long Distance Care
  • Vaccinations
    • Vaccine Policy Statement
    • Vaccine Information Statements
    • COVID Vaccines
    • Flu Vaccines & Flu Clinics
    • HPV Vaccine: Cancer Prevention

Contact or visit us.

Cranberry/Seven Fields
671 Castle Creek Drive
Seven Fields, PA 16046 USA

P: 724.761.2020

F: 724.778.8959

Pleasant Hills
810 Clairton Blvd.
Pittsburgh, PA 15236 USA

P: 412.466.5004

F: 412.466.7137

Squirrel Hill/Greenfield
4070 Beechwood Blvd.
Pittsburgh, PA 15217 USA

P: 412.521.6511

F: 412.521.6512

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