Skip to content

Patient History and Registration Forms

We offer our paperwork online so you can complete it in the convenience of your own home. Simply download, complete, save as a PDF and attach in email to 48 hours before your first visit. Please make sure you have the most current version of Adobe Reader in order to fill-in / email the forms. If you do not have the ability to email the forms, please print and bring them in to our office completed to your visit 20 minutes beforehand, to allow Dr. Stephanie time to review them. You can also fax them to us 513-791-1351.

Adult Case History

small pdf icon Download Form

Pregnancy Questionnaire

Please complete this form along with Adult Case History if applicable.
small pdf icon Download Form

Pediatric Case History

small pdf icon Download Form

Free AdobeReader®

Get adobe readerEach form is a PDF document file. If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.