COPEDS accepts patients who refer themselves for diagnosis and treatment, as well as patients referred by other physicians. You should be aware, however, that some insurance programs cover visits only when pre-approved or specifically referred by a primary care doctor.


For Primary Care Doctors:


If you have a child in your office that has an elevated glucose (who is otherwise clinically stable) that you suspect may be due to new onset diabetes, we can see your patient that same day at our office without the family having to go to the hospital. We will stabilize the child with intensive multiple daily insulin injection therapy upon arrival to our office. We will also start diabetes education over a 2 day period so that both the child and the family are empowered with information about diabetes. We are proud of the success and high primary care physician satisfaction that we have had with our New-Onset Diabetes Outpatient Management Program.



By completing the form below, you can immediately get your patient referred to our office. Within 48 hours we will call the patient, schedule an appointment, and fax to your office confirmation of the appointment. We hope this is a convenience to you that not only saves valuable time but also helps patients get scheduled sooner. Completed forms go directly to our Patient Services and Insurance Specialist's mailbox who will ensure that all information is maintained in a secure (confidential) location. Please inform us of any special scheduling needs or special circumstances unique to your patient in the section marked "Other pertinent information or comments."  Complete this ONLINE REFERRAL FORM (or click here for pdf form):

Patient Information
Patient Name *
Patient Name
Patient Date of Birth
Patient Date of Birth
Patient Address *
Patient Address
Patient Phone
Patient Phone
Doctor Information
Referring Doctor's Name *
Referring Doctor's Name
Practice Phone *
Practice Phone
Practice Fax
Practice Fax
Practice Address
Practice Address
Parent Information
Parent Name *
Parent Name
Primary Phone Number *
Primary Phone Number
Secondary Phone Number
Secondary Phone Number
Parent Address *
Parent Address
Insurance Information
Primary Insurance Claim Address *
Primary Insurance Claim Address
Primary Insurance Claim Phone Number *
Primary Insurance Claim Phone Number
Write 'none' if there is no secondary insurance carrier.
Secondary Insurance Claim Address
Secondary Insurance Claim Address
Secondary Insurance Claim Phone Number
Secondary Insurance Claim Phone Number
In case we need to contact you, your name *
In case we need to contact you, your name
In case we need to contact you, your phone number *
In case we need to contact you, your phone number

You may also print the COPEDS referral form here and send the completed form to our office via fax at (614) 839-3040 or via email to


COPEDS providers are available for general, emergency room, and nursery consultation at Nationwide Children’s Hospital, St. Ann’s Hospital, and Riverside Special Care nurseries. 


  • Office: (614) 839-3040
  • Answering service: (614) 839-3040
  • Children’s hospital [pager]: (614) 690-1077



  • Your patients should know the identity of physicians, nurses, and others at COPEDS involved in their care.
  • Every aspect of your patient’s care should be clearly explained to them.
  • Your patients should never feel "lost" or confused about what is happening.
  • You patients should always be able to receive adequate, high quality care in an emergency.
  • Our office should provide a comfortable, low stress, and safe environment.
  • Your patients should participate in the decision-making regarding their care.
  • Your patients should be cared for as a family, with respect for cultural/ethnic differences and freedom of choice
  • Your patients’ personal health information should be handled with utmost confidentiality.
  • Your patients should consent or decline to participate in any treatment that is considered experimental in nature (clinical trials), and to have those studies fully explained prior to consent. 
  • Our office should communicate with you in a timely manner about your patient’s plan of care.
  • We want to hear about problems or concerns sooner rather than later. It is important for us to be aware when we have failed to meet your expectations.