{"id":280,"date":"2019-03-30T16:11:11","date_gmt":"2019-03-30T16:11:11","guid":{"rendered":"http:\/\/eas-md.com\/?page_id=280"},"modified":"2022-04-25T23:49:33","modified_gmt":"2022-04-25T23:49:33","slug":"patient-forms","status":"publish","type":"page","link":"https:\/\/eas-md.com\/?page_id=280","title":{"rendered":"Patient Forms"},"content":{"rendered":"<div class=\"article-content\">\n<div class=\"RichTextElement\">\n<p class=\"paragraph_style\"><span class=\"style_1\">The following links are to printable forms that you may need to fill out for us.<br \/><\/span><\/p>\n<p class=\"paragraph_style\"><span class=\"style_1\">The New Patient Registration, \u00a0Medication Refill and the Patient Information Update Forms are .PDF&#8217;s that you fill out online and either save to your computer and then email back to me, or print out and bring with you to an appointment. If you know how to scan your signature and paste it into the appropriate signature boxes that would be fine\u2026otherwise you can sign the documents after they are printed out. \u00a0The Release of Information form would need to be printed and filled out by hand.\u00a0<\/span><\/p>\n<p class=\"paragraph_style\"><span class=\"style_1\">They are in .PDF format<br \/><\/span><\/p>\n<p><span style=\"color: #ff0000;\"><strong><a style=\"color: #ff0000;\" href=\"http:\/\/eas-md.com\/wp-content\/uploads\/2019\/03\/formswithcover_3_14_2017-4-1.pdf\">New Patient Registration<\/a><\/strong><\/span><\/p>\n<p><span style=\"color: #ff0000;\"><strong><a style=\"color: #ff0000;\" href=\"https:\/\/eas-md.com\/wp-content\/uploads\/2022\/04\/PT-UPDATE-FORM.pdf\">PT UPDATE FORM<\/a><\/strong><\/span><\/p>\n<p><a href=\"http:\/\/eas-md.com\/wp-content\/uploads\/2019\/03\/prescription-request-6-22-3.pdf\"><span style=\"color: #ff0000;\"><strong>Med Refill Request<\/strong><\/span><\/a><\/p>\n<p><a href=\"http:\/\/eas-md.com\/wp-content\/uploads\/2019\/03\/NVPG-release-of-info.pdf\"><span style=\"color: #ff0000;\"><strong>Release of Information<\/strong><\/span><\/a><\/p>\n<p><a href=\"https:\/\/eas-md.com\/wp-content\/uploads\/2019\/05\/telemedicine-payment-form.pdf\"><strong><span style=\"color: #ff0000;\">telemedicine payment form<\/span><\/strong><\/a><\/p>\n<\/div>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>The following links are to printable forms that you may need to fill out for us. The New Patient Registration, \u00a0Medication Refill and the Patient Information Update Forms are .PDF&#8217;s that you fill out online and either save to your computer and then email back to me, or print out and bring with you to an appointment. If you know how to scan your signature and paste it into the appropriate signature boxes that would be fine\u2026otherwise you can sign&#8230;<\/p>\n<p class=\"read-more\"><a class=\"btn btn-default\" href=\"https:\/\/eas-md.com\/?page_id=280\"> Read More<span class=\"screen-reader-text\">  Read More<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-280","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/eas-md.com\/index.php?rest_route=\/wp\/v2\/pages\/280","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/eas-md.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/eas-md.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/eas-md.com\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/eas-md.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=280"}],"version-history":[{"count":12,"href":"https:\/\/eas-md.com\/index.php?rest_route=\/wp\/v2\/pages\/280\/revisions"}],"predecessor-version":[{"id":612,"href":"https:\/\/eas-md.com\/index.php?rest_route=\/wp\/v2\/pages\/280\/revisions\/612"}],"wp:attachment":[{"href":"https:\/\/eas-md.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=280"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}