Patient Forms

First Steps Pediatrics needs to maintain updated files on all our patients. The following documents help us to ensure that we have a complete understanding of our patients, their medical history, and how to best treat their needs. Please feel free to download these files and complete them in advance of your first visit with us. This will enable you to complete all the information necessary, while also making your initial visit a bit easier. Thank you!

Robinson, PA Office	Weirton, WV Office
You can download the complete patient package of documents or select from individual files from the links below.
Complete Patient Pack	Complete Patient Pack
New Patient Information	New Patient Information
Patient Registration Form	Patient Registration Form
Past Medical History	Past Medical History
Treatment Authorization Form	Treatment Authorization Form
First Steps' Financial Policy	First Steps' Financial Policy
HIPPA Regulations	HIPPA Regulations
Authorization Form	Authorization Form
Insurance Verification Form	Insurance Verification Form
Medical Information Releases	Medical Information Release
VFC Eligibility Form	VFC Eligibility Form