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(814) 266-8840

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Home About Us Services Testimonials Contact Us

JOHNSTOWNRICHLANDEBENSBURGSOMERSET

(814) 266-8840

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Phone:

Address:

(814) 266-8840

1322 Eisenhower Blvd.
Johnstown, PA 15904

Hours

Richland

Ebensburg

Johnstown

Somerset

Click a location to see its hours:

Forms

If you would like to cut down on the amount of paperwork that you will have to do when you arrive at our office, print out the forms you need below. You can fill them out at your convenience and then bring them with you to your appointment.

Click on a form to view and then download or print it. You may also right-click a form and select “save link as” or “save target as” to download it.

Patient Information Form

Use this form to provide us with information about yourself and/or your child(ren) prior to your first visit with us.

Record Release

Use this form to authorize the transfer of private health information from and to Pediatric Care Specialists.

School/Private Physical Form

Use this form when you have an appointment for a private or school physical.

PIAA Physical
Form

Use this form when you have an appointment for a sports physical.

Driver’s Permit Physical Form

Use this form when you have an appointment for a physical for a driver’s permit.

School Private Physical Form.pdf PIAA Form.pdf Drivers Physical Form.pdf Patient Info Form.pdf Record Release - 2016.pdf