Pediatric Forms + Links

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

Pediatric 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.

  • Records Release: Please print, complete and forward to your child's previous physician prior to your first appointment in our office (if possible).

Annual Demographic Information Update

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

Daycare Forms

Student 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 for their availability or content.


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:

I Wanna Know - This sites aims to teach kids about sexually-transmitted diseases before they learn the hard way:

Planned Parenthood:


La leche league:


Potty Training Tips - A parent run site, with links to various potty-training pages:

Bedwetting Store for alarms:

Sleep Dry bedwetting alarms:

Development - Links to state, regional, and local early intervention and testing services:

Development focus on the first three years of life:

The Whole Child, a PBS website featuring articles, ideas for activities, reading lists, forums, etc.:


American Academy of Pediatric Dentistry:

Pediatric Dentistry – Drs Scott Nieman, Carolyn Barber, and Emily Baran at:


The National Pediculosis Association, Inc.:


Pediatrician's guide to your children's health and safety:

Kids Health:

Consult the medical resource doctors trust:


Columbus Health Department:

Franklin County Board of Health:

Ohio Department of Health:

Centers for Disease Control and Prevention:


The American Heart Association Children's Health Section:


American Academy of Pediatrics immunization site:

Healthy Children - Today, most children in the United States lead much healthier lives and parents live with much less anxiety and worry over infections during childhood. Immunizations are one of the success stories of modern medicine:

The Allied Vaccine Group - Dedicated to educating the public and caregivers exclusively through scientific information:

Autism and Vaccines Theory - Addresses the possible connection between autism and vaccination:

CDC's Vaccines and Immunizations Page - Designed to be the most comprehensive vaccine site on the internet:

CDC's Vaccine Safety Page:

Childhood Immunization Support Project (Run by the AAP):

The Vaccine Page provides links to web sites that provide valid information and news to parents about vaccines:

From, whose information is reviewed by MDs:


American Academy of Child & Adolescent Psychiatry –assisting parents and families in understanding developmental, behavioral, emotional and mental disorders affecting children and adolescents:

Kids Health for Parents:

American Association of Suicidology – Dedicated to the Understanding and Prevention of Suicide:



Nutrition – great ideas on games and activities to keep kids active:

Abbott Nutrition – information on products, education materials, clinical research:

American Obesity Society:

Let's Move - Program developed by First Lady Michelle Obama to solve the epidemic of childhood obesity within a generation.:

Nationwide Children's Hospital Center for Healthy Weight and Nutrition:


Conjunctivitis/ Pink Eye information:

The American Academy of Ophthalmology - Providing authoritative information about eye care for the public and members:


Prevent Blindness America - With sections on fireworks, sports, eyewear, and kids' safety measures:

National Poison Control Hotline:

Central Ohio Poison Center at Nationwide Children's Hospital:


National Safe Kids Campaign:

National Highway Traffic Safety Administration – for car seat information click "car seats" under "Browse Topics":

Car Safety Seats – National Child Passenger Safety Certification program offers a searchable link to inspection sites:

Bicycle Helmet Safety Institute:

U.S. Consumer Product Safety Commission:

American Society for Testing and Materials - All the fine print standards for toy safety specification:

Dr. Toy:


Ear Piercing – In-office medical piercing systems:


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.

Nationwide Children's Hospital:

Health Information Translations – A collaborative initiative to improve health education for limited English proficiency patients:

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.:
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!

Assistance locating quality preschool and day care programs: or


National Center for sports Safety:


Poison Ivy:

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:

Tobacco Information and Prevention Source (TIPS):


CDC website for up-to-date travel advisories and information: