patient portal


To Schedule a Well Appointment

IF THIS IS AN EMERGENCY please call 911 or take your child to the nearest emergency room. If your child is a new patient to our practice, please call us to schedule an appointment by phone.

Our staff will check availability for these appointments during regular weekday hours and make every effort to respond to your request within 48 hours.

Dublin Office:
614.766.6321

Upper Arlington Office:
614.457.6461


Well Appointments
* Indicates required field

*Select the location for your appointment

Dublin
Upper Arlington

*Select the Physician you wish to see:

Dr. Jennifer Ricciardo
Dr. Charles Goddard
Dr. Wes Branstiter
Alicia Kuper, DO

*Please select preferred month:
*Please select preferred day:
*Please select preferred time:
Please enter a specific time if needed:
*Patient's First Name:
*Patient's Last Name:
*Patient's Phone Number:
*Email Address:
*Patient's Date of Birth:
*Please Select the Reason for Appointment:

Well Visit
Meet & Greet
Allergy Injections
Follow Up Visit
Conference
ADHD 3mo. Follow Up
Other

If you selected "Other" please elaborate:


© 2005 Northwest Pediatrics Inc.