{"id":2267,"date":"2023-10-13T19:07:55","date_gmt":"2023-10-13T19:07:55","guid":{"rendered":"https:\/\/nozcvcjb.elementor.cloud\/?page_id=2267"},"modified":"2025-07-14T23:37:41","modified_gmt":"2025-07-14T23:37:41","slug":"new-patient-forms","status":"publish","type":"page","link":"https:\/\/basekampdesignclient.com\/perio\/for-patients\/new-patient-forms\/","title":{"rendered":"New Patient Forms"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"2267\" class=\"elementor elementor-2267\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6ef3ffd e-flex e-con-boxed e-con e-parent\" data-id=\"6ef3ffd\" 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-3c8b3ba e-con-full e-flex e-con e-child\" data-id=\"3c8b3ba\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c6b93ce elementor-widget elementor-widget-text-editor\" data-id=\"c6b93ce\" 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-a7fcec2 elementor-mobile-align-center elementor-widget elementor-widget-button\" data-id=\"a7fcec2\" 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-b8e90a3 e-con-full e-flex e-con e-child\" data-id=\"b8e90a3\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-6583b15 e-flex e-con-boxed e-con e-child\" data-id=\"6583b15\" 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-2265ce2 elementor-position-inline-start elementor-view-default elementor-mobile-position-block-start elementor-widget elementor-widget-icon-box\" data-id=\"2265ce2\" 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>Prior to your first visit, please complete these online registration forms. If you have any questions, give us a call. Register Online HIPAA Notice Your privacy is important to us. Here&#8217;s the notice that explains our responsibilities. You will be asked to sign an acknowledgment in the office.<\/p>\n","protected":false},"author":7,"featured_media":0,"parent":4399,"menu_order":2,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-2267","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/basekampdesignclient.com\/perio\/wp-json\/wp\/v2\/pages\/2267","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/basekampdesignclient.com\/perio\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/basekampdesignclient.com\/perio\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/basekampdesignclient.com\/perio\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/basekampdesignclient.com\/perio\/wp-json\/wp\/v2\/comments?post=2267"}],"version-history":[{"count":10,"href":"https:\/\/basekampdesignclient.com\/perio\/wp-json\/wp\/v2\/pages\/2267\/revisions"}],"predecessor-version":[{"id":4548,"href":"https:\/\/basekampdesignclient.com\/perio\/wp-json\/wp\/v2\/pages\/2267\/revisions\/4548"}],"up":[{"embeddable":true,"href":"https:\/\/basekampdesignclient.com\/perio\/wp-json\/wp\/v2\/pages\/4399"}],"wp:attachment":[{"href":"https:\/\/basekampdesignclient.com\/perio\/wp-json\/wp\/v2\/media?parent=2267"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}