{"id":110,"date":"2011-10-13T21:36:17","date_gmt":"2011-10-13T21:36:17","guid":{"rendered":"https:\/\/iowamercuryfreedentistry.com\/?page_id=110"},"modified":"2020-09-24T20:16:21","modified_gmt":"2020-09-24T20:16:21","slug":"new-patient-forms","status":"publish","type":"page","link":"https:\/\/iowamercuryfreedentistry.com\/?page_id=110","title":{"rendered":"New Patient Forms"},"content":{"rendered":"

\u00a0<\/strong>Please refrain from using scented body products on the day of your appointments (cologne\/perfume, hairspray, scented lotions, laundry products, essential oils, scented soaps). \u00a0This is very important to our chemically sensitive patients! \u00a0– Thank you. – Dr. Hanus<\/strong><\/p>\n

For your convenience\u00a0and to save your time upon arrival we have provided \u00a0attachments\u00a0of patient information documents needed for your appointment.<\/p>\n

Please print off all of \u00a0the documents and fill out all of the\u00a0information\u00a0to the best of your\u00a0ability prior to your arrival. \u00a0If you have an extensive history, complex or extenuating circumstances, please include additional information on a separate paper.<\/p>\n

This may include prescription medications being taken or treatments for specific issues in your past.<\/p>\n

These documents are required by law for your safety and privacy. Please bring all of the documents with you to your appointment. \u00a0If time allows, please mail or fax them prior to your appointment.\u00a0 \u00a0\u00a0<\/strong><\/p>\n

Patient Registration<\/a><\/p>\n

Medical History<\/a><\/p>\n

Dental History<\/a><\/p>\n

Financial policy<\/a><\/p>\n

HIPPA- Notice of Privacy Practice<\/a><\/p>\n

Receipt of HIPPA<\/a><\/p>\n

consent for use<\/a><\/p>\n

Med List<\/a><\/p>\n

Addendum<\/a><\/p>\n

TMJ Questionaire<\/a><\/p>\n

NP Summary<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

\u00a0Please refrain from using scented body products on the day of your appointments (cologne\/perfume, hairspray, scented lotions, laundry products, essential oils, scented soaps). \u00a0This is very important to our chemically sensitive patients! \u00a0– Thank you. – Dr. Hanus For your … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":292,"menu_order":1,"comment_status":"closed","ping_status":"open","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/iowamercuryfreedentistry.com\/index.php?rest_route=\/wp\/v2\/pages\/110"}],"collection":[{"href":"https:\/\/iowamercuryfreedentistry.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/iowamercuryfreedentistry.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/iowamercuryfreedentistry.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/iowamercuryfreedentistry.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=110"}],"version-history":[{"count":42,"href":"https:\/\/iowamercuryfreedentistry.com\/index.php?rest_route=\/wp\/v2\/pages\/110\/revisions"}],"predecessor-version":[{"id":1186,"href":"https:\/\/iowamercuryfreedentistry.com\/index.php?rest_route=\/wp\/v2\/pages\/110\/revisions\/1186"}],"up":[{"embeddable":true,"href":"https:\/\/iowamercuryfreedentistry.com\/index.php?rest_route=\/wp\/v2\/pages\/292"}],"wp:attachment":[{"href":"https:\/\/iowamercuryfreedentistry.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=110"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}