Scheduling

Request an appointment

Tell us who your child is and roughly when suits you. Rosa calls back with real times, usually the same day and always by the end of the next business day.

Sample site. Try the form: it shows what parents see, and nothing you type leaves your browser.

About your child

Child's first name

Child's age

Reason for the visit

Have you been here before?

How we reach you

Your name

Phone

When suits you

Anything we should knowAccommodations, anxiety, a previous visit that went badly, a sibling who needs to come along. Please keep clinical detail brief and tell us the rest on the phone.

Submitting this form is a scheduling request, not a confirmed appointment. Nothing is booked until we speak.

In pain today?

Do not use this form. Call us and we will find you a time today.

(216) 555-0148

What happens next

Rosa reads your request and verifies your insurance benefits.
She calls you back with two or three actual times.
You get the health history forms by email so you are not filling them out with a toddler on your hip.

Where you are coming

1420 Alder Mill Road, Suite 200
Cedarfield, OH 44119

Free lot behind the building, entered from Alder Mill Road just past the credit union. The north entrance is level with the sidewalk and wide enough for a double stroller. The elevator to Suite 200 is immediately inside on the left; the stairwell is next to it if your child would rather climb.

What you type here goes to our practice management system and to nobody else. See our privacy policy andnotice of privacy practices.