Patient Forms and Information

Hospitals & Locations > Queen City Physicians > Patient Forms and Information


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.

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.


If you have questions about your bill, you can do one of the following:


We participate in most managed care plans. Please contact your physician's office if you have any questions.

Check-Up Schedule

  • 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; 15 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.

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