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(513) 231-3345
Fax: (513) 231-6739

7502 State Road
Suite 3350
Anderson Township (
view map)

New for our families
Quick Clinics
7:30am-9:30am M-F
4pm-7pm M-Th
no appointment necessary

Appropriate illnesses: Any symptoms lasting less than a week; such as fever, UTI, sore throat, ear pain or minor injuries (no head injuries)

Immunization, Health, School Activity and Other Forms

New Patient Forms:

You may also want to print and complete the Standard Disclosure Form, the School/ Daycare Release Form, the Records Release Form as well as sign up for chart access through the Patient Portal.

Forms For Patients Over 18:

Authorization To Use/Disclose Protected Health Information:
Questions about which form is right for you? Contact our Medical Records department at (513) 231-3345, option 6.

Sports Forms:
The History page MUST be completed by the parent/ caregiver prior to dropping off the form.

School/Daycare Health Forms:
Please enter only your child’s name and date of birth

Vanderbilt Assessment Forms:
If your child has an upcoming ADHD evaluation appointment you may print the necessary forms here. You may also access these forms through the patient portal and invite your child’s teacher to complete their assessment online as well.


Call for more information if you reside in Eastgate, Amelia, Milford, Bethel or Anderson.


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