UH Rainbow Chesterland Pediatrics Services

To help provide timely service to our patients, we prefer to schedule all visits. If you are later than 10 minutes for your appointment, we will try to work you back into the schedule. Out of courtesy to our other patients, we may be forced to ask you to reschedule your appointment. If you are more than 20 minutes late for your appointment time, we will unfortunately need to reschedule your appointment.

Please call the office to reschedule appointments you cannot attend at least 24 hours in advance.

Please allow 3 – 5 business days for medical forms (for school, sports or camp) to be completed. Forms must be dropped off at the front desk during normal business hours or faxed anytime. Your portion of the form should be filled out completely, including your child’s name and date of birth. If the form requires a doctor’s signature, the child must have had a physical within the last year or it cannot be signed. Please remember to schedule your child’s physical yearly.

Forms for School, Sports or Camp

1. Forms must be completely filled in by the parent, including exact name of medications on the bottle and form, ie: pill, liquid, and dosage.
2. If your child is seen by a specialist, please have the specialist sign the forms.

• Patient Registration Form
• Pediatric Health History
• Parent/Guardian Consent to Treat Minors
• UH General Consent Form
• Parent/Guardian Personal Health Record Account Request Form
• Authorization for Release of Medical Information
• Ohio High School Athletic Association Pre-Participation Physical Exam
• ADHD Vanderbilt Parent Form
• ADHD Vanderbilt Teacher Assessment Form

We know your kids don't always get sick on our schedule. If you have an urgent need after hours please call our main office number. UH Rainbow Babies & Children's Call Center will take your call. If their registered nurse cannot answer your questions, they will page a provider from Chesterland Pediatrics to call you back. Please save routine questions (mild illness, appointments, prescription refills, and test results) for the morning. We encourage you to refer to our website first, when practical, before calling the office.

If an emergency should arise, please call 9-1-1. Emergencies are considered to be those conditions that are life-threatening: loss of consciousness, severe bleeding, seizure, etc. In the case of minor emergencies (lacerations, cuts, mild fractures, sprains), please call our office first for instructions.

We will gladly schedule a prenatal visit with a provider to discuss our office and give you a prenatal visit and brief tour. We would like to see your newborn in our office within the first week of life, sooner if you have been advised to do so or have any concerns. Please call to schedule your newborn appointment as soon after delivery as you are able to. Congratulations!

We make every effort to schedule appointments for ill children on the day that you call us.

If you have a medical emergency during office hours, we will do our best to see your child immediately or refer you to the appropriate facility. Please call 9-1-1 for any life threatening condition: loss of consciousness, severe bleeding, seizure, etc.

Well child checks are a comprehensive visit to evaluate your child’s overall health. This includes a sports clearance evaluation. We will complete any sports physical form one year from the date your child was seen. We recommend that you call our office as much in advance as possible so you may choose the date that best fits your needs. The list below is our recommended schedule for Well Child Visits.

1 week of age, 1 month of age, 2 months, 4 months, 6 months, 9 months, 12 months, 15 months, 18 months, 24 months, 30 months, every year from 3 years – 18 years old.

Dr. Coutinho also provides travel advice and immunizations as per the CDC recommendations for both children and adults.

As a parent or legal guardian, you can manage your child’s online health information. Visit the MyChart for MyFamily section of our FAQs to learn more.

University Hospitals no longer accepts cash or check as in-person payment for services. You can pay by card (credit, debit, HSA, FSA, etc.), Apple Pay or Google Pay. You can also use UH MyChart to pay your bill online or before your appointment during eCheck-in. We accept checks for payment by mail.

You can now quickly and easily pay your provider bill online using our convenient online bill pay tool.

UH MyChart allows us to e-prescribe any prescriptions at your appointment within seconds. This will allow us to keep better track of all medications you are currently or have been taking, even if prescribed by another office. For prescription refills please try to give as much advance notice as possible; feel free to leave a message for the nurse, we ask that for most refills your child's physical is up-to-date.

Medications that are more closely regulated by the FDA have different requirements for prescribers. We are required by law to see your child regularly to monitor medication use and usefulness.

We accept most insurance carriers. Please have your card with you at the time of your visit. If we file your claim, you are responsible for only the co-pay at the time of visit. If we are not a provider for your insurance, if you are not insured or we do not file with your insurance company, you may be responsible for the entire charge at the time of service.