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School Request Form

Please note: This form is not for specific student/patient information.

  • Schools: If medical forms are needed, please encourage the family to reach out directly to their CCHMC provider.
  • Parents/guardians: If you feel School Services support is needed, please talk to your CCHMC provider about a referral.
  • Providers outside CCHMC: If looking for School Services support for your patient, please either encourage the family to speak with their CCHMC provider about a referral or contact the CCHMC provider directly regarding placing a referral.

Cincinnati Children’s Hospital is committed to fostering collaboration, coordination, and care across education and healthcare systems.

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