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!
PA Offices |
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 |
| Privacy Practice Notice 2017 |
Privacy Practice Notice 2017 |
| Authorization Form |
Authorization Form |
| Insurance Verification Form |
Insurance Verification Form |
| Medical Information Releases |
Medical Information Release |
| VFC Eligibility Form |
VFC Eligibility Form |
| Steubenville Relocation Packet |
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