New Patients

Thank you for your interest in Ertel Medicine & Pediatrics. Our goal is to provide exceptional medical care with added conveniences and amenities that make it easier to heal. Some of these include: the onsite pharmacy, separate sick and well waiting areas and the ability to call the same day and get a FastTrack appointment. All of these extras have been developed to care especially with our patients in mind.

For your convenience the necessary paperwork is provided in PDF format below:

Adults (18+ years old)	Pediatric Patients (2 - 17 years)	Newborn (Under age 2 years)
History Page One History Page Two Registration Information Office Policies HIPAA Privacy Consent Form HIPAA Brochure -Pg 1 HIPAA Brochure -Pg 2	History Page One History Page Two Registration Information Office Policies HIPAA Privacy Consent Form HIPAA Brochure -Pg 1 HIPAA Brochure -Pg 2 Pediatric Reminder to bring Immunization Records	Newborn Parent Questionnaire Registration Information Office Policies HIPAA Privacy Consent Form HIPAA Brochure -Pg 1 HIPAA Brochure -Pg 2

If you have a question regarding your new appointment or you need to make an appointment, please call the office at 859.744.0067. We look forward to meeting you.

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