UH Rainbow Chardon Pediatrics Services
As part of University Hospitals Rainbow Babies & Children’s Hospital – consistently ranked as one of America’s Best Children’s Hospital by U.S. News & World Report – our providers work closely with the finest pediatric specialists and surgeons in the region and the nation. As part of University Hospitals we have access to the most current diagnostic and treatment modalities, advanced technology and evidence-based care.
- Forms & Policies
Please allow 3-5 business days for medical forms (for school, sports or camp) to be completed. Forms must be dropped off at the front desk during normal business hours or faxed anytime. Your portion of the form should be filled out completely, including your child’s name and date of birth. If the form requires a doctor’s signature, the child must have had a physical within the last year or it cannot be signed. Please remember to schedule your child’s physical yearly.
Forms for School, Sports or Camp
- Forms must be completely filled in by the parent, including exact name of medications on the bottle and form, ie: pill, liquid, and dosage.
- If your child is seen by a specialist, please have the specialist sign the forms.
- Patient Registration Form
- Pediatric Health History
- Parent/Guardian Consent to Treat Minors
- UH General Consent Form
- Parent/Guardian Personal Health Record Account Request Form
- Authorization for Release of Medical Information
- Ohio High School Athletic Association Pre-Participation Physical Exam
- ADHD Vanderbilt Parent Form
- ADHD Vanderbilt Teacher Assessment Form
- Manage Your Child's Health Record
As a parent or legal guardian, you can manage your child’s online health information. Visit the MyChart for MyFamily section of our FAQs to learn more.
- Online Advice
You can ask your provider questions via the MyChart app. Message responses may take up to two business days. If this is an emergency, please call 9-1-1.
Login or register for MyChart.
UH MyChart allows us to e-prescribe any prescriptions at your appointment within seconds. This will allow us to keep better track of all medications you are currently or have been taking, even if prescribed by another office. For prescription refills please try to give as much advance notice as possible; feel free to leave a message for the nurse, we ask that for most refills your child's physical is up-to-date.
Medications that are more closely regulated by the FDA have different requirements for prescribers. We are required by law to see your child regularly to monitor medication use and usefulness.
- Pay Your Bill
You can now quickly and easily pay your provider bill online using our convenient online bill pay tool.
- Insurance Message
We accept most insurance carriers. Please have your card with you at the time of your visit. If we file your claim, you are responsible for only the co-pay at the time of visit. If we are not a provider for your insurance, if you are not insured or we do not file with your insurance company, you may be responsible for the entire charge at the time of service.