Your time is important to us. If you are a new patient or your address or insurance information has changed, please download, print and fill out the appropriate form and bring it to your next appointment.
- Pediatric Patient Registration Form (PDF)
- Internal Medicine History Form (PDF)
- Gyn Medicine History Form (PDF)
- IM or Gyn Patient Registration Form (PDF)
Medical and Billing Record Release Forms
Use this form when requesting transfer of your medical and billing records to TriHealth from another provider or when requesting TriHealth transfer your records.
- TriHealth (any entity) Authorization to Disclose PHI Form (PDF)
- TriHealth (any entity) Authorization to Disclose Billing Records Form (PDF)
If you have questions about your bill, you can do one of the following:
- Email TriHealth Patient Accounting
- Call our billing department at 513 569 6117 between 8:30 a.m. and 4:30 p.m. Monday through Friday.
We participate in most managed care plans. Please contact your physician's office if you have any questions.
- QCP follows the American Academy of Pediatrics guidelines and recommends infants are seen at: one month; two months; four months; six months; nine months; 12 months; 18 months; and 24 months.
- Checkups for toddlers and teens are recommended annually.
- Routine gynecology visits are recommended annually and should include an annual pap smear.
- Mammograms are recommended annually once a women reaches 40 years of age.
Walk-In Strep Clinics
Our Glenway and Western Ridge Pediatric offices offer walk-in strep clinics. QCP staff will perform a quick throat swab and initial results will be available while you wait. An appropriate antibiotic will be prescribed if the test is positive. See those practice pages for hours and information.