Forms

Need a form? Look no further. All forms are available to download and print at your convenience. If you would like us to add a form to this Web page, please contact a physician liaison.

UPMC Children's Outpatient Specialty Care Services (PDF)
The UPMC Children's Outpatient Specialty Care Services provides access to all Ambulatory division phone and fax numbers.

Radiology Easy Script (PDF) 
Use this form to schedule radiology services at any UPMC Children's Hospital of Pittsburgh location. Directions to all facilities are included with the form.

Outpatient Easy Referral (PDF)
Provides an overview of all clinical divisions and phone numbers at UPMC Children's Hospital of Pittsburgh.

Request for Consultation, Pediatric General and Thoracic Surgery (PDF) 
Use this form to refer a patient for consultation with a pediatric surgeon at UPMC Children's Hospital of Pittsburgh.

Request for Pulmonary Function Testing (PDF)
Use this form to request pulmonary function testing at UPMC Children's Hospital of Pittsburgh.

Visit Navigation Services
Our Visit Navigation program helps families manage the complexities of scheduling multiple medical appointments.

Take advantage of free monthly CME via the Pediatric Insights Webinar Series. Our webinar series is designed to provide guidance for pediatricians, family practitioners, and other health care professionals. We’ll cover a wide range of topics about challenges you may face in your practice. If you’d like to recommend a topic, please send an email to MDrelations@chp.edu.