{"id":107,"date":"2014-08-10T02:25:20","date_gmt":"2014-08-10T02:25:20","guid":{"rendered":"http:\/\/dehavenfamilydentistry.com\/?page_id=107"},"modified":"2014-08-10T20:58:54","modified_gmt":"2014-08-10T20:58:54","slug":"patient-forms","status":"publish","type":"page","link":"http:\/\/dehavenfamilydentistry.com\/?page_id=107","title":{"rendered":"Patient Forms"},"content":{"rendered":"<div class=\"et_pb_section et_section_regular\" style='background-color:#303749;'>\r\n\t\t\t\r\n\t\t\t\r\n\t\t\t\t\r\n\t\t\t\t<div class=\"et_pb_row\">\r\n\t\t\t<div class=\"et_pb_column et_pb_column_1_2\">\r\n\t\t\t<div class=\"et_pb_text et_pb_bg_layout_light et_pb_text_align_left\">\r\n\t\t\t<a href=\"http:\/\/dehavenfamilydentistry.com\/\"><img loading=\"lazy\" decoding=\"async\" id=\"tooth\" class=\"alignleft wp-image-43 size-medium\" src=\"http:\/\/www.dehaven.kelseyraczak.com\/wp-content\/uploads\/2014\/06\/dentistlogo-300x149.png\" alt=\"dentistlogo\" width=\"300\" height=\"149\" \/><\/a><\/p>\n<div id=\"header-text\">\n<h1>DeHaven Family Dentistry<\/h1>\n<h2>Dr. Todd<\/h2>\n<ul>\n<li>2206 E. 10th St. &#8211; Anderson, IN 46012<\/li>\n<li><i class=\"fa fa-phone fa-lg\"><\/i>\u00a0765.640.0262<\/li>\n<li>Monday &amp; Thursday: 8:00am &#8211; 5:00pm<\/li>\n<li>Tuesday &amp; Wednesday: 7:00am &#8211; 4:00pm<\/li>\n<\/ul>\n<\/div>\n\r\n\t\t<\/div> <!-- .et_pb_text -->\r\n\t\t<\/div> <!-- .et_pb_column --><div class=\"et_pb_column et_pb_column_1_2\">\r\n\t\t\t<div id=\"slider\" class=\"et_pb_slider et_pb_slider_fullwidth_off et_pb_slider_no_arrows et_pb_slider_no_pagination et_slider_auto et_slider_speed_7000\">\r\n\t\t\t<div class=\"et_pb_slides\">\r\n\t\t\t\t<div class=\"et_pb_slide et_pb_bg_layout_dark et_pb_media_alignment_center\" style='background-color:#ffffff;background-image:url(http:\/\/dehavenfamilydentistry.com\/wp-content\/uploads\/2014\/08\/outside.png);'>\r\n\t\t\t\r\n\t\t\t<div class=\"et_pb_container clearfix\">\r\n\t\t\t\t\r\n\t\t\t\t<div class=\"et_pb_slide_description\">\r\n\t\t\t\t\t\r\n\t\t\t\t\t<div class=\"et_pb_slide_content\"><\/div>\r\n\t\t\t\t\t\r\n\t\t\t\t<\/div> <!-- .et_pb_slide_description -->\r\n\t\t\t<\/div> <!-- .et_pb_container -->\r\n\t\t\t\r\n\t\t<\/div> <!-- .et_pb_slide -->\r\n\t\t<div class=\"et_pb_slide et_pb_bg_layout_dark et_pb_media_alignment_center\" style='background-color:#ffffff;background-image:url(http:\/\/dehavenfamilydentistry.com\/wp-content\/uploads\/2014\/08\/inside.png);'>\r\n\t\t\t\r\n\t\t\t<div class=\"et_pb_container clearfix\">\r\n\t\t\t\t\r\n\t\t\t\t<div class=\"et_pb_slide_description\">\r\n\t\t\t\t\t\r\n\t\t\t\t\t<div class=\"et_pb_slide_content\"><\/div>\r\n\t\t\t\t\t\r\n\t\t\t\t<\/div> <!-- .et_pb_slide_description -->\r\n\t\t\t<\/div> <!-- .et_pb_container -->\r\n\t\t\t\r\n\t\t<\/div> <!-- .et_pb_slide -->\r\n\t\t\r\n\t\t\t<\/div> <!-- .et_pb_slides -->\r\n\t\t<\/div> <!-- .et_pb_slider -->\r\n\t\t\r\n\t\t<\/div> <!-- .et_pb_column -->\r\n\t\t<\/div> <!-- .et_pb_row -->\r\n\t\t\t\r\n\t\t<\/div> <!-- .et_pb_section --><div class=\"et_pb_section et_section_regular\">\r\n\t\t\t\r\n\t\t\t\r\n\t\t\t\t\r\n\t\t\t\t<div class=\"et_pb_row\">\r\n\t\t\t<div class=\"et_pb_column et_pb_column_4_4\">\r\n\t\t\t<div class=\"et_pb_text et_pb_bg_layout_light et_pb_text_align_left\">\r\n\t\t\t\n<h1><span style=\"text-decoration: underline;\"><strong>Patient Forms &amp; Guidelines:<\/strong><\/span><\/h1>\n<p>\u00a0<\/p>\n<h2 class=\"h2Standard\">Appointment Guidelines:<\/h2>\n<p>Patients are seen by appointment only, so please call in advance so that our staff may reserve a time for you.<\/p>\n<p>It is our policy to confirm patients 24 hours in advance. Our staff makes every attempt to reach you a day or two before your appointment. We would greatly appreciate it if you call \u00a0us to confirm the day prior to your appointment if you know that we will have a difficult time reaching you.<\/p>\n<p>No charge will be made for missed appointments, provided at least 24 hours notice is given so that the time reserved for you may be made available for other patients. If you have a personal emergency, please let us know as soon as possible.<\/p>\n<p>\u00a0<\/p>\n<hr \/>\n<h2 class=\"h2Standard\">Forms (PDF Downloads):<\/h2>\n<p><a href=\"http:\/\/dehavenfamilydentistry.com\/wp-content\/uploads\/2014\/08\/PatientInformation.pdf\" target=\"_blank\"><strong>Patient Information Form (PDF)<\/strong><\/a><\/p>\n<p><strong><a href=\"http:\/\/dehavenfamilydentistry.com\/wp-content\/uploads\/2014\/08\/HealthHistory.pdf\" target=\"_blank\">Health History (PDF)<\/a><\/strong><\/p>\n<p><a href=\"http:\/\/dehavenfamilydentistry.com\/wp-content\/uploads\/2014\/08\/FinancialAgreement.pdf\" target=\"_blank\"><strong>Financial Agreement<\/strong><\/a><\/p>\n<p><a href=\"http:\/\/dehavenfamilydentistry.com\/wp-content\/uploads\/2014\/08\/HippaAuthorization.pdf\" target=\"_blank\"><strong>Hippa Authorization<\/strong><\/a><\/p>\n\r\n\t\t<\/div> <!-- .et_pb_text -->\r\n\t\t<\/div> <!-- .et_pb_column -->\r\n\t\t<\/div> <!-- .et_pb_row -->\r\n\t\t\t\r\n\t\t<\/div> <!-- .et_pb_section -->\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"open","ping_status":"open","template":"","meta":{"footnotes":""},"class_list":["post-107","page","type-page","status-publish","hentry","wpautop"],"_links":{"self":[{"href":"http:\/\/dehavenfamilydentistry.com\/index.php?rest_route=\/wp\/v2\/pages\/107","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/dehavenfamilydentistry.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/dehavenfamilydentistry.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/dehavenfamilydentistry.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/dehavenfamilydentistry.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=107"}],"version-history":[{"count":10,"href":"http:\/\/dehavenfamilydentistry.com\/index.php?rest_route=\/wp\/v2\/pages\/107\/revisions"}],"predecessor-version":[{"id":114,"href":"http:\/\/dehavenfamilydentistry.com\/index.php?rest_route=\/wp\/v2\/pages\/107\/revisions\/114"}],"wp:attachment":[{"href":"http:\/\/dehavenfamilydentistry.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=107"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}