Skip to site content
About Us
Contact Us
Patient Portal
Bill Pay
Careers
Schedule Appointment Now
Find a Provider
Services
Bariatric Medicine
Behavioral Health
Brain & Spine
Breast Center
Cancer Care
Digestive Health & Liver
Emergency Services
Express Care
Family Medicine
Fitness Center
Heart & Vascular
Home Care & Hospice
Imaging
Laboratory Services
Long-Term Care Facility
Nutrition & Wellness
Occupational Medicine
One Call - Patient Transfer Center
Orthopedics
Pediatrics
Pharmacy
Rehabilitation
Respiratory Medicine
Rheumatology
Sleep Medicine
Surgical Services
UP Regional Blood Center
Urology
Women's Health
Wound Care
Patients & Visitors
COVID-19 | Visitor Info
Patient Portal
Advance Directive
Classes & Events
Community Health Worker Program
Pay My Bill
Medical Records
Patient Feedback
Third Party Applications
Notice of Privacy Practices
Non-Discrimination Notice
Volunteer Services
Patient Rights & Responsibilities
Understanding Your Healthcare Costs
Patient Guidebook
Get Care Now
Locations
UP Health System - Bell
UP Health System - Marquette
UP Health System - Portage
Search
Pediatrics
Menu
Forms and Resources
Specialty Clinics
Safety Information for Parents
Kids Always Ride Safe (KARS)
Pediatrics Menu
Forms and Resources
Patient Forms
ROI (Release of Information) Form
UPHS - Pediatrics Referral Request Form
Health Appraisal Form
Minor Patient Consent Form
Adult Patient Consent Form
Consent to Treat Minor Without Parent Present Form
MHSAA Sports Physical Form
Resources for Parents
HealthyChildren.org
CDC.gov
VaccinateYourBaby.org
iVaccinate.org
