{"id":103,"date":"2025-01-23T22:57:55","date_gmt":"2025-01-23T22:57:55","guid":{"rendered":"https:\/\/basekampdesignclient.com\/oms\/new-patient-forms\/"},"modified":"2025-04-04T20:06:24","modified_gmt":"2025-04-04T20:06:24","slug":"new-patient-forms","status":"publish","type":"page","link":"https:\/\/basekampdesignclient.com\/oms\/patient-info\/new-patient-forms\/","title":{"rendered":"New Patient Forms"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"103\" class=\"elementor elementor-103\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1525543e e-flex e-con-boxed e-con e-parent\" data-id=\"1525543e\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-2b338864 e-con-full e-flex e-con e-child\" data-id=\"2b338864\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-bdde506 elementor-widget elementor-widget-heading\" data-id=\"bdde506\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Online Patient Registration<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4a41f0df elementor-widget elementor-widget-text-editor\" data-id=\"4a41f0df\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Prior to your first visit, please complete these online registration forms. If you have any questions, give us a call.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4260ca59 elementor-mobile-align-center elementor-widget elementor-widget-button\" data-id=\"4260ca59\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"#\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Register Online<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-20a4a4d2 e-con-full e-flex e-con e-child\" data-id=\"20a4a4d2\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-1d249eb e-flex e-con-boxed e-con e-child\" data-id=\"1d249eb\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3b7c65c1 elementor-position-inline-start elementor-view-default elementor-mobile-position-block-start elementor-widget elementor-widget-icon-box\" data-id=\"3b7c65c1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-box-wrapper\">\n\n\t\t\t\t\t\t<div class=\"elementor-icon-box-icon\">\n\t\t\t\t<span  class=\"elementor-icon\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-far-file-pdf\" viewBox=\"0 0 384 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M369.9 97.9L286 14C277 5 264.8-.1 252.1-.1H48C21.5 0 0 21.5 0 48v416c0 26.5 21.5 48 48 48h288c26.5 0 48-21.5 48-48V131.9c0-12.7-5.1-25-14.1-34zM332.1 128H256V51.9l76.1 76.1zM48 464V48h160v104c0 13.3 10.7 24 24 24h104v288H48zm250.2-143.7c-12.2-12-47-8.7-64.4-6.5-17.2-10.5-28.7-25-36.8-46.3 3.9-16.1 10.1-40.6 5.4-56-4.2-26.2-37.8-23.6-42.6-5.9-4.4 16.1-.4 38.5 7 67.1-10 23.9-24.9 56-35.4 74.4-20 10.3-47 26.2-51 46.2-3.3 15.8 26 55.2 76.1-31.2 22.4-7.4 46.8-16.5 68.4-20.1 18.9 10.2 41 17 55.8 17 25.5 0 28-28.2 17.5-38.7zm-198.1 77.8c5.1-13.7 24.5-29.5 30.4-35-19 30.3-30.4 35.7-30.4 35zm81.6-190.6c7.4 0 6.7 32.1 1.8 40.8-4.4-13.9-4.3-40.8-1.8-40.8zm-24.4 136.6c9.7-16.9 18-37 24.7-54.7 8.3 15.1 18.9 27.2 30.1 35.5-20.8 4.3-38.9 13.1-54.8 19.2zm131.6-5s-5 6-37.3-7.8c35.1-2.6 40.9 5.4 37.3 7.8z\"><\/path><\/svg>\t\t\t\t<\/span>\n\t\t\t<\/div>\n\t\t\t\n\t\t\t\t\t\t<div class=\"elementor-icon-box-content\">\n\n\t\t\t\t\t\t\t\t\t<h3 class=\"elementor-icon-box-title\">\n\t\t\t\t\t\t<span  >\n\t\t\t\t\t\t\tPrintable Packet\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/h3>\n\t\t\t\t\n\t\t\t\t\t\t\t\t\t<p class=\"elementor-icon-box-description\">\n\t\t\t\t\t\tIf you prefer pen and  paper, you can download the forms here. Please write legibly and don't foget to bring them with you.\t\t\t\t\t<\/p>\n\t\t\t\t\n\t\t\t<\/div>\n\t\t\t\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-2ed9f934 e-flex e-con-boxed e-con e-child\" data-id=\"2ed9f934\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-7636160c elementor-position-inline-start elementor-view-default elementor-mobile-position-block-start elementor-widget elementor-widget-icon-box\" data-id=\"7636160c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-box-wrapper\">\n\n\t\t\t\t\t\t<div class=\"elementor-icon-box-icon\">\n\t\t\t\t<span  class=\"elementor-icon\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-user-lock\" viewBox=\"0 0 640 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M224 256A128 128 0 1 0 96 128a128 128 0 0 0 128 128zm96 64a63.08 63.08 0 0 1 8.1-30.5c-4.8-.5-9.5-1.5-14.5-1.5h-16.7a174.08 174.08 0 0 1-145.8 0h-16.7A134.43 134.43 0 0 0 0 422.4V464a48 48 0 0 0 48 48h280.9a63.54 63.54 0 0 1-8.9-32zm288-32h-32v-80a80 80 0 0 0-160 0v80h-32a32 32 0 0 0-32 32v160a32 32 0 0 0 32 32h224a32 32 0 0 0 32-32V320a32 32 0 0 0-32-32zM496 432a32 32 0 1 1 32-32 32 32 0 0 1-32 32zm32-144h-64v-80a32 32 0 0 1 64 0z\"><\/path><\/svg>\t\t\t\t<\/span>\n\t\t\t<\/div>\n\t\t\t\n\t\t\t\t\t\t<div class=\"elementor-icon-box-content\">\n\n\t\t\t\t\t\t\t\t\t<h3 class=\"elementor-icon-box-title\">\n\t\t\t\t\t\t<span  >\n\t\t\t\t\t\t\tHIPAA Notice\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/h3>\n\t\t\t\t\n\t\t\t\t\t\t\t\t\t<p class=\"elementor-icon-box-description\">\n\t\t\t\t\t\tYour privacy is important to us. Here's the notice that explains our responsibilities. You will be asked to sign an acknowledgment in the office.\t\t\t\t\t<\/p>\n\t\t\t\t\n\t\t\t<\/div>\n\t\t\t\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Online Patient Registration Prior to your first visit, please complete these online registration forms. If you have any questions, give us a call. Register Online Printable Packet If you prefer pen and paper, you can download the forms here. Please write legibly and don&#8217;t foget to bring them with you. HIPAA Notice Your privacy is [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":0,"parent":10,"menu_order":3,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-103","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/basekampdesignclient.com\/oms\/wp-json\/wp\/v2\/pages\/103","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/basekampdesignclient.com\/oms\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/basekampdesignclient.com\/oms\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/basekampdesignclient.com\/oms\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/basekampdesignclient.com\/oms\/wp-json\/wp\/v2\/comments?post=103"}],"version-history":[{"count":10,"href":"https:\/\/basekampdesignclient.com\/oms\/wp-json\/wp\/v2\/pages\/103\/revisions"}],"predecessor-version":[{"id":404,"href":"https:\/\/basekampdesignclient.com\/oms\/wp-json\/wp\/v2\/pages\/103\/revisions\/404"}],"up":[{"embeddable":true,"href":"https:\/\/basekampdesignclient.com\/oms\/wp-json\/wp\/v2\/pages\/10"}],"wp:attachment":[{"href":"https:\/\/basekampdesignclient.com\/oms\/wp-json\/wp\/v2\/media?parent=103"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}