Please find a list of our forms. Always make sure your Childs Name and Date of Birth are on all paperwork. You can send us forms by:
- Dropping them off at any of our clinics
- Securely fill and sign them directly online using links below
- Upload the fillable forms below to our secure portal at www.cardinalpediatrics.com/securesend
- Email them directly to This email address is being protected from spambots. You need JavaScript enabled to view it., however, please keep in mind email is NOT a secure form of communication
- Fax to 304-599-8003
- Text a picture to 304-599-8000.
Cardinal Forms
Securely Sign/Send Online Links | Download Fillable Forms |
New Patient Packet | New Patient Packet |
Release of Information to Cardinal Pediatrics | Release of Information to Cardinal Pediatrics |
Release of Information to Third Parties | Release of Information to Third Parties |
Patient Portal Signup through Follow My Health | Patient Portal Signup through Follow My Health |
* Patient portal signup form must be filled out prior to getting access to the patient portal. |
School Forms
Securely Sign/Send Online Links | Download Fillable Forms |
WV Sports Physical Form | WV Sports Physical Form |
Screeners