{"id":50,"date":"2021-09-20T09:56:29","date_gmt":"2021-09-20T09:56:29","guid":{"rendered":"http:\/\/34.82.184.65\/patients\/patient-forms\/"},"modified":"2023-12-12T17:48:32","modified_gmt":"2023-12-12T17:48:32","slug":"patient-forms","status":"publish","type":"page","link":"https:\/\/islanddermatology.net\/patients\/patient-forms\/","title":{"rendered":"Patient Forms"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"50\" class=\"elementor elementor-50\" data-elementor-settings=\"[]\">\n\t\t\t\t\t\t\t<div class=\"elementor-section-wrap\">\n\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-c847384 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"c847384\" data-element_type=\"section\">\n\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-100 elementor-top-column elementor-element elementor-element-4c5b385\" data-id=\"4c5b385\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-385e7d7 elementor-widget elementor-widget-heading\" data-id=\"385e7d7\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-large\">Downloadable patient forms you can print and fill out before your next visit to Island Dermatology!<\/h2>\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\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-c3cab5c elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"c3cab5c\" data-element_type=\"section\">\n\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-100 elementor-top-column elementor-element elementor-element-717e1651\" data-id=\"717e1651\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-531daad7 elementor-widget elementor-widget-text-editor\" data-id=\"531daad7\" data-element_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<div class=\"gap-y inline_widget_text-block\"><div class=\"type margin-top-none\"><p>Island Dermatology requests that all new patients provide us with basic health and general information, as well as any previous dermatologic history.<\/p><p>Please print and complete the following forms and bring them with you on your scheduled visit to our office. Thank you for your cooperation.<\/p><p><strong>New Patient Registration<\/strong><\/p><ul><li><a href=\"https:\/\/islanddermatology.net\/wp-content\/uploads\/2023\/12\/Island-Dermatology_Eng-Form-.pdf\" target=\"_blank\" rel=\"noopener\">Download here (English)<\/a><\/li><li><a href=\"https:\/\/islanddermatology.net\/wp-content\/uploads\/2023\/12\/Island-Dermatology_Esp-Form-.pdf\" target=\"_blank\" rel=\"noopener\">Descargar aqu\u00ed (Espa\u00f1ol)<\/a><\/li><\/ul><h6><em>Summary of Documentation: Financial Policy, Medical History, Patient Information \/ Primary Insurance \/ Additional Insurance, Acknowledgement of Receipt of Notice of Privacy Practices, Island Dermatology Inc. Notice of Privacy Practices, Patient Update Form<\/em><\/h6><\/div><\/div>\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\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-aa2b488 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"aa2b488\" data-element_type=\"section\">\n\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-100 elementor-top-column elementor-element elementor-element-f3c9e6c\" data-id=\"f3c9e6c\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-e953116 elementor-widget elementor-widget-text-editor\" data-id=\"e953116\" data-element_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<div class=\"gap-y inline_widget_text-block\"><div class=\"type margin-top-none\">\u00a0<\/div><\/div><div class=\"card card_size_lg card_theme_dark text-align-center inline_widget_cta\"><div class=\"card__body gap-y\"><div class=\"media__body\"><h3 class=\"card__title\"><a href=\"https:\/\/islanddermatology.net\/locations\/\"><strong>Request an Appointment<\/strong><\/a><\/h3><p>\u00a0<\/p><p><em>Request an appointment with us for all your dermatologic care needs.<\/em><\/p><div class=\"level margin-top-xs flex-justify-center\"><strong><a class=\"button button_color_primary\" href=\"https:\/\/islanddermatology.net\/locations\/\"> Find a Location\u00a0<\/a><\/strong> <a href=\"tel:949-720-1170\">949-720-1170<\/a><\/div><p><!-- .level --><\/p><\/div><p><!-- .media__body --><\/p><\/div><\/div>\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\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Downloadable patient forms you can print and fill out before your next visit to Island Dermatology! Island Dermatology requests that all new patients provide us with basic health and general information, as well as any previous dermatologic history. Please print and complete the following forms and bring them with you on your scheduled visit to [&hellip;]<\/p>\n","protected":false},"author":11,"featured_media":0,"parent":11,"menu_order":48,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"_links":{"self":[{"href":"https:\/\/islanddermatology.net\/wp-json\/wp\/v2\/pages\/50"}],"collection":[{"href":"https:\/\/islanddermatology.net\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/islanddermatology.net\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/islanddermatology.net\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/islanddermatology.net\/wp-json\/wp\/v2\/comments?post=50"}],"version-history":[{"count":35,"href":"https:\/\/islanddermatology.net\/wp-json\/wp\/v2\/pages\/50\/revisions"}],"predecessor-version":[{"id":4351,"href":"https:\/\/islanddermatology.net\/wp-json\/wp\/v2\/pages\/50\/revisions\/4351"}],"up":[{"embeddable":true,"href":"https:\/\/islanddermatology.net\/wp-json\/wp\/v2\/pages\/11"}],"wp:attachment":[{"href":"https:\/\/islanddermatology.net\/wp-json\/wp\/v2\/media?parent=50"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}