{"id":149,"date":"2020-11-07T01:04:10","date_gmt":"2020-11-07T01:04:10","guid":{"rendered":"https:\/\/www.stpaulallergy.com\/?page_id=149"},"modified":"2024-07-08T12:58:04","modified_gmt":"2024-07-08T12:58:04","slug":"forms","status":"publish","type":"page","link":"https:\/\/www.stpaulallergy.com\/?page_id=149","title":{"rendered":"Forms"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"149\" class=\"elementor elementor-149\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-3dd315f2 elementor-section-full_width elementor-section-height-default elementor-section-height-default\" data-id=\"3dd315f2\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-50df868f\" data-id=\"50df868f\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5e44456b elementor-widget elementor-widget-heading\" data-id=\"5e44456b\" 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-large\">Forms<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3aa123ba elementor-widget elementor-widget-text-editor\" data-id=\"3aa123ba\" 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>To help expedite the check-in process, please print and fill out any applicable forms below and bring the completed forms to your appointment. You will also need to bring your insurance card(s) and a photo ID.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-f3e7503\" data-id=\"f3e7503\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-3e34924f elementor-section-content-middle elementor-reverse-mobile elementor-section-full_width elementor-section-height-default elementor-section-height-default\" data-id=\"3e34924f\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-c231f77\" data-id=\"c231f77\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-37b9e536 elementor-widget elementor-widget-heading\" data-id=\"37b9e536\" 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<h3 class=\"elementor-heading-title elementor-size-large\">New Patient Forms<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-79d94843 elementor-widget elementor-widget-text-editor\" data-id=\"79d94843\" 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 style=\"text-align: left;\"><a href=\"http:\/\/www.stpaulallergy.com\/wp-content\/uploads\/2021\/06\/SPAA-Consent-Form-FINAL-2.pdf\" target=\"_blank\" rel=\"noopener\">Consent and Release Form<\/a><\/p><p style=\"text-align: left;\"><a href=\"http:\/\/www.stpaulallergy.com\/wp-content\/uploads\/2023\/04\/ROS-Form-under-age-5-NewPt-4.2023.docx\" target=\"_blank\" rel=\"noopener\">Intake Form for Patients Under Age 5<\/a><\/p><p style=\"text-align: left;\"><a href=\"http:\/\/www.stpaulallergy.com\/wp-content\/uploads\/2023\/04\/ROS-Form-5-NewPt-2.2022.docx\" target=\"_blank\" rel=\"noopener\">Intake Form for Patients Age 5+<\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-506c745\" data-id=\"506c745\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1574440 elementor-widget elementor-widget-heading\" data-id=\"1574440\" 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<h3 class=\"elementor-heading-title elementor-size-large\">Established Patient Forms<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1f03f7b elementor-widget elementor-widget-text-editor\" data-id=\"1f03f7b\" 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 style=\"text-align: left;\"><a href=\"http:\/\/www.stpaulallergy.com\/wp-content\/uploads\/2021\/06\/SPAA-Consent-Form-FINAL-2.pdf\" target=\"_blank\" rel=\"noopener\">Consent and Release Form<\/a><\/p><p style=\"text-align: left;\"><a href=\"http:\/\/www.stpaulallergy.com\/wp-content\/uploads\/2021\/06\/Pt-registration-form.pdf\" target=\"_blank\" rel=\"noopener\">Demographic Update Form<\/a><\/p><p style=\"font-size: 15px; font-style: normal; font-weight: 500; text-align: left;\"><a href=\"http:\/\/www.stpaulallergy.com\/wp-content\/uploads\/2023\/04\/ROS-Form-under-age-5-EstPt-4.2023.docx\" target=\"_blank\" rel=\"noopener\">Intake Form for Patients Under Age 5<\/a><\/p><p style=\"text-align: left;\"><a href=\"http:\/\/www.stpaulallergy.com\/wp-content\/uploads\/2023\/04\/ROS-Form-5-EstPt-2.2022.docx\" target=\"_blank\" rel=\"noopener\">Intake Form for Patients Age 5+<\/a><\/p><p style=\"text-align: left;\"><a href=\"http:\/\/www.stpaulallergy.com\/wp-content\/uploads\/2021\/06\/Minor-Consent-Form-4.12.21.pdf\" target=\"_blank\" rel=\"noopener\">Minor Consent Form<\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-5aeacf42\" data-id=\"5aeacf42\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-72159d8 elementor-widget elementor-widget-heading\" data-id=\"72159d8\" 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<h3 class=\"elementor-heading-title elementor-size-large\">Other Forms<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1f0386b elementor-widget elementor-widget-text-editor\" data-id=\"1f0386b\" 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 style=\"text-align: left;\"><a href=\"http:\/\/www.stpaulallergy.com\/wp-content\/uploads\/2024\/07\/Auth-for-Release-of-PHI.pdf\" target=\"_blank\" rel=\"noopener\">Medical Record Release Authorization<\/a><\/p><p style=\"text-align: left;\"><a href=\"http:\/\/www.stpaulallergy.com\/wp-content\/uploads\/2021\/09\/Notice-of-Privacy-Practices-December-2018b.pdf\" target=\"_blank\" rel=\"noopener\">Notice of Privacy Practices<\/a><\/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-5b391be6 elementor-widget elementor-widget-image\" data-id=\"5b391be6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"http:\/\/www.stpaulallergy.com\/wp-content\/uploads\/2020\/11\/library.jpg\" title=\"\" alt=\"\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Forms To help expedite the check-in process, please print and fill out any applicable forms below and bring the completed forms to your appointment. You will also need to bring your insurance card(s) and a photo ID. New Patient Forms Consent and Release Form Intake Form for Patients Under Age 5 Intake Form for Patients [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"site-sidebar-layout":"default","site-content-layout":"default","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"class_list":["post-149","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.stpaulallergy.com\/index.php?rest_route=\/wp\/v2\/pages\/149","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.stpaulallergy.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.stpaulallergy.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.stpaulallergy.com\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.stpaulallergy.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=149"}],"version-history":[{"count":0,"href":"https:\/\/www.stpaulallergy.com\/index.php?rest_route=\/wp\/v2\/pages\/149\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.stpaulallergy.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=149"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}