{"id":381,"date":"2020-09-15T17:27:47","date_gmt":"2020-09-15T21:27:47","guid":{"rendered":"https:\/\/carolinapinesent.fm1.dev\/resources\/patient-forms\/"},"modified":"2023-08-22T17:07:14","modified_gmt":"2023-08-22T21:07:14","slug":"patient-forms","status":"publish","type":"page","link":"https:\/\/carolinapinesent.com\/patient-forms\/","title":{"rendered":"Patient Forms"},"content":{"rendered":"\n<div class=\"wp-block-file\"><a id=\"wp-block-file--media-081e365f-4acb-47ae-852b-7b90ba7d714d\" href=\"https:\/\/carolinapinesent.com\/wp-content\/uploads\/2023\/08\/cpent_new-patient-paperwork_20230718.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">New Patient Intake Form<\/a><a href=\"https:\/\/carolinapinesent.com\/wp-content\/uploads\/2023\/08\/cpent_new-patient-paperwork_20230718.pdf\" class=\"wp-block-file__button wp-element-button\" download aria-describedby=\"wp-block-file--media-081e365f-4acb-47ae-852b-7b90ba7d714d\">Download<\/a><\/div>\n\n\n\n<div class=\"wp-block-file\"><a id=\"wp-block-file--media-f6a38ee6-8637-4f0e-9b6f-40c42773a79a\" href=\"https:\/\/carolinapinesent.com\/wp-content\/uploads\/2020\/12\/20201129_hipaa-acknowledgement-of-notice-of-privacy-practices-form-v2020.a.pdf\">Acknowledgment of Notice of Privacy Practices<\/a><a href=\"https:\/\/carolinapinesent.com\/wp-content\/uploads\/2020\/12\/20201129_hipaa-acknowledgement-of-notice-of-privacy-practices-form-v2020.a.pdf\" class=\"wp-block-file__button wp-element-button\" download aria-describedby=\"wp-block-file--media-f6a38ee6-8637-4f0e-9b6f-40c42773a79a\">Download<\/a><\/div>\n\n\n\n<div class=\"wp-block-file\"><a id=\"wp-block-file--media-9e76d654-8215-4655-aa58-051f1123df81\" href=\"https:\/\/carolinapinesent.com\/wp-content\/uploads\/2020\/12\/20201129_hipaa-protected-health-information-access-request-form-v2020.a.pdf\">PHI Access Request<\/a><a href=\"https:\/\/carolinapinesent.com\/wp-content\/uploads\/2020\/12\/20201129_hipaa-protected-health-information-access-request-form-v2020.a.pdf\" class=\"wp-block-file__button wp-element-button\" download aria-describedby=\"wp-block-file--media-9e76d654-8215-4655-aa58-051f1123df81\">Download<\/a><\/div>\n\n\n\n<div class=\"wp-block-file\"><a id=\"wp-block-file--media-93391c4e-0606-42bd-b3a2-460e716ce905\" href=\"https:\/\/carolinapinesent.com\/wp-content\/uploads\/2020\/12\/20201129_hipaa-authorization-for-release-of-protected-health-information-form-v2020.a.pdf\">Authorization for Release of PHI<\/a><a href=\"https:\/\/carolinapinesent.com\/wp-content\/uploads\/2020\/12\/20201129_hipaa-authorization-for-release-of-protected-health-information-form-v2020.a.pdf\" class=\"wp-block-file__button wp-element-button\" download aria-describedby=\"wp-block-file--media-93391c4e-0606-42bd-b3a2-460e716ce905\">Download<\/a><\/div>\n\n\n\n<div class=\"wp-block-file\"><a id=\"wp-block-file--media-00c65b5a-525c-4a5e-a668-870ff6bb302a\" href=\"https:\/\/carolinapinesent.com\/wp-content\/uploads\/2020\/12\/20201129_hipaa-protected-health-information-accounting-of-disclosures-request-form-v2020.a.pdf\">PHI Accounting of Disclosures Request<\/a><a href=\"https:\/\/carolinapinesent.com\/wp-content\/uploads\/2020\/12\/20201129_hipaa-protected-health-information-accounting-of-disclosures-request-form-v2020.a.pdf\" class=\"wp-block-file__button wp-element-button\" download aria-describedby=\"wp-block-file--media-00c65b5a-525c-4a5e-a668-870ff6bb302a\">Download<\/a><\/div>\n\n\n\n<div class=\"wp-block-file\"><a id=\"wp-block-file--media-909efe00-23ef-4c18-acc3-16df8a9a1487\" href=\"https:\/\/carolinapinesent.com\/wp-content\/uploads\/2020\/12\/20201129_hipaa-protected-health-information-alternative-communications-request-form-v2020.a.pdf\">PHI Alternative Communications Request<\/a><a href=\"https:\/\/carolinapinesent.com\/wp-content\/uploads\/2020\/12\/20201129_hipaa-protected-health-information-alternative-communications-request-form-v2020.a.pdf\" class=\"wp-block-file__button wp-element-button\" download aria-describedby=\"wp-block-file--media-909efe00-23ef-4c18-acc3-16df8a9a1487\">Download<\/a><\/div>\n\n\n\n<div class=\"wp-block-file\"><a id=\"wp-block-file--media-ce00760c-c692-41be-bd78-0b2cbb38304e\" href=\"https:\/\/carolinapinesent.com\/wp-content\/uploads\/2020\/12\/20201129_hipaa-protected-health-information-restriction-request-form-v2020.a.pdf\">PHI Restriction Request<\/a><a href=\"https:\/\/carolinapinesent.com\/wp-content\/uploads\/2020\/12\/20201129_hipaa-protected-health-information-restriction-request-form-v2020.a.pdf\" class=\"wp-block-file__button wp-element-button\" download aria-describedby=\"wp-block-file--media-ce00760c-c692-41be-bd78-0b2cbb38304e\">Download<\/a><\/div>\n\n\n\n<div class=\"wp-block-file\"><a id=\"wp-block-file--media-38c9ac51-6ea4-48ba-a3cc-c84b00752c13\" href=\"https:\/\/carolinapinesent.com\/wp-content\/uploads\/2020\/12\/20201129_hipaa-protected-health-information-accounting-of-disclosures-request-form-v2020.a.pdf\">PHI Accounting of Disclosures<\/a><a href=\"https:\/\/carolinapinesent.com\/wp-content\/uploads\/2020\/12\/20201129_hipaa-protected-health-information-accounting-of-disclosures-request-form-v2020.a.pdf\" class=\"wp-block-file__button wp-element-button\" download aria-describedby=\"wp-block-file--media-38c9ac51-6ea4-48ba-a3cc-c84b00752c13\">Download<\/a><\/div>\n\n\n\n<div class=\"wp-block-file\"><a id=\"wp-block-file--media-a37fbba9-707a-4f2c-abf8-70c97aa6a6c4\" href=\"https:\/\/carolinapinesent.com\/wp-content\/uploads\/2020\/12\/20201129_hipaa-protected-health-information-amendment-request-form-v2020.a.pdf\">PHI Amendment Request<\/a><a href=\"https:\/\/carolinapinesent.com\/wp-content\/uploads\/2020\/12\/20201129_hipaa-protected-health-information-amendment-request-form-v2020.a.pdf\" class=\"wp-block-file__button wp-element-button\" download aria-describedby=\"wp-block-file--media-a37fbba9-707a-4f2c-abf8-70c97aa6a6c4\">Download<\/a><\/div>\n\n\n\n<div class=\"wp-block-file\"><a id=\"wp-block-file--media-ce1e180a-0191-4789-93bf-783088fdcc2c\" href=\"https:\/\/carolinapinesent.com\/wp-content\/uploads\/2020\/12\/20201129_hipaa-hipaa-request-fulfillment-time-extension-form-v2020.a.pdf\">HIPAA Request Fulfillment Time Extension<\/a><a href=\"https:\/\/carolinapinesent.com\/wp-content\/uploads\/2020\/12\/20201129_hipaa-hipaa-request-fulfillment-time-extension-form-v2020.a.pdf\" class=\"wp-block-file__button wp-element-button\" download aria-describedby=\"wp-block-file--media-ce1e180a-0191-4789-93bf-783088fdcc2c\">Download<\/a><\/div>\n\n\n\n<div class=\"wp-block-file\"><a id=\"wp-block-file--media-f70c3a5d-a5c9-4eb3-9b3c-2f3297d65fb2\" href=\"https:\/\/carolinapinesent.com\/wp-content\/uploads\/2020\/12\/20201129_hipaa-hipaa-complaint-form-v2020.a.pdf\">HIPAA Complaint Form<\/a><a href=\"https:\/\/carolinapinesent.com\/wp-content\/uploads\/2020\/12\/20201129_hipaa-hipaa-complaint-form-v2020.a.pdf\" class=\"wp-block-file__button wp-element-button\" download aria-describedby=\"wp-block-file--media-f70c3a5d-a5c9-4eb3-9b3c-2f3297d65fb2\">Download<\/a><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":2,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_seopress_robots_primary_cat":"","_seopress_titles_title":"","_seopress_titles_desc":"","_seopress_robots_index":"","schema":"","fname":"","lname":"","position":"","credentials":"","placeID":"","no_match":false,"name":"","company":"","review":"","address":"","city":"","state":"","zip":"","lat":"","lng":"","phone1":"","phone2":"","fax":"","mon1":"","mon2":"","tue1":"","tue2":"","wed1":"","wed2":"","thu1":"","thu2":"","fri1":"","fri2":"","sat1":"","sat2":"","sun1":"","sun2":"","hours-note":"","footnotes":""},"service_tags":[],"class_list":["post-381","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/carolinapinesent.com\/wp-json\/wp\/v2\/pages\/381","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/carolinapinesent.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/carolinapinesent.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/carolinapinesent.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/carolinapinesent.com\/wp-json\/wp\/v2\/comments?post=381"}],"version-history":[{"count":14,"href":"https:\/\/carolinapinesent.com\/wp-json\/wp\/v2\/pages\/381\/revisions"}],"predecessor-version":[{"id":1729,"href":"https:\/\/carolinapinesent.com\/wp-json\/wp\/v2\/pages\/381\/revisions\/1729"}],"wp:attachment":[{"href":"https:\/\/carolinapinesent.com\/wp-json\/wp\/v2\/media?parent=381"}],"wp:term":[{"taxonomy":"service_tags","embeddable":true,"href":"https:\/\/carolinapinesent.com\/wp-json\/wp\/v2\/service_tags?post=381"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}