[et_pb_section bb_built=”1″ admin_label=”section”][et_pb_row admin_label=”row” background_position=”top_left” background_repeat=”repeat” background_size=”initial”][et_pb_column type=”4_4″][et_pb_text background_position=”top_left” background_repeat=”repeat” background_size=”initial” _builder_version=”3.0.67″ background_layout=”light” text_orientation=”left” border_style=”solid”]<\/p>\n

Forms<\/h1>\n

[\/et_pb_text][et_pb_text _builder_version=”3.0.67″ background_layout=”light” text_orientation=”left” border_style=”solid”]<\/p>\n

Card on file Authorization Form<\/a><\/p>\n

Consent to treat a minor, if less than 18 yrs. of age<\/a><\/p>\n

HIPAA Signature Page<\/a><\/p>\n

HIPAA_Notice_of_Privacy_Practices<\/a><\/p>\n

Neck Disabilitiy (Given if neck pain)<\/a><\/p>\n

New Patient Questionaire<\/a><\/p>\n

Oswestry (Given if lower back pain)<\/a><\/p>\n

Pain Diagram<\/a><\/p>\n

Payment insurance sheet revised 5-16-2019<\/a><\/p>\n

[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"

Forms Card on file Authorization Form Consent to treat a minor, if less than 18 yrs. of age HIPAA Signature Page HIPAA_Notice_of_Privacy_Practices Neck Disabilitiy (Given if neck pain) New Patient Questionaire Oswestry (Given if lower back pain) Pain Diagram Payment insurance sheet revised 5-16-2019<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":8,"comment_status":"open","ping_status":"open","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"Consent to treat a Minor<\/a>\r\n\r\nHIPAA<\/a>\r\n\r\nNew Patient Information<\/a>\r\n\r\nPain Diagram Sheet<\/a>","_et_gb_content_width":"","footnotes":""},"_links":{"self":[{"href":"http:\/\/manchesternhchiropractor.com\/wp-json\/wp\/v2\/pages\/57"}],"collection":[{"href":"http:\/\/manchesternhchiropractor.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/manchesternhchiropractor.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/manchesternhchiropractor.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/manchesternhchiropractor.com\/wp-json\/wp\/v2\/comments?post=57"}],"version-history":[{"count":3,"href":"http:\/\/manchesternhchiropractor.com\/wp-json\/wp\/v2\/pages\/57\/revisions"}],"predecessor-version":[{"id":272,"href":"http:\/\/manchesternhchiropractor.com\/wp-json\/wp\/v2\/pages\/57\/revisions\/272"}],"wp:attachment":[{"href":"http:\/\/manchesternhchiropractor.com\/wp-json\/wp\/v2\/media?parent=57"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}