NEW PATIENTS

All children are welcome at our practice, including new born babies, toddlers, school age children, and children with special needs. If you would like to join our practice but are unsure of the next step, please call us at 614.459.4200.


 
 

Becoming a New Patient

 
 
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INSURANCE

Please first send us your insurance card(s) for approval. We require copies or photos of all primary, secondary and/or Medicaid insurance cards (front and back). Please do not exclude any insurance information, as we cannot advise you if we are not fully informed. We cannot schedule any visits until we have completed forms on file. Please review our Insurance page for more information on our insurance policies.

If and when we approve your insurance, you may complete the corresponding patient forms provided below and send them to our office!

 
 
 
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COMPLETE NEW PATIENT REGISTRATION

Please complete the New Patient Registration paperwork that applies to you:

 
 
 
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SEND COMPLETED PAPERWORK TO OUR OFFICE

You can return the completed paperwork to our office in whichever manner is most convenient to you, using the following contact information:

  • Mail: Carine Pediatrics, 3300 Riverside Dr, #200, Upper Arlington, OH 43221

  • Email: mail@drcarine.com 

  • Fax: 614.459.1589

 
 
 
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TRANSFER MEDICAL RECORDS TO OUR OFFICE

To release records from your current office, specialist, or hospital to our office, please complete the Medical Release of Information Authorization form.  Please be sure to detail any specifics necessary on the form.

 
 
 
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AWAIT CONFIRMATION FROM OUR OFFICE

Once we receive your information in our office, we will register your child(ren), and then we will call you to schedule. While it may take 2-5 business days to get your paperwork reviewed and processed, you may also feel free to call and confirm we received the paperwork.

Thank you in advance for your cooperation!

 
 
 

Ready for a better healthcare experience?

We can’t wait to see you.