{"id":619,"date":"2018-12-15T03:11:43","date_gmt":"2018-12-15T03:11:43","guid":{"rendered":"http:\/\/advpainspecialists.com\/?page_id=619"},"modified":"2022-05-17T02:35:35","modified_gmt":"2022-05-17T02:35:35","slug":"new-patient","status":"publish","type":"page","link":"https:\/\/advpainspecialists.com\/es\/new-patient\/","title":{"rendered":"New Patient Forms"},"content":{"rendered":"\n<div class=\"row\">\n<div class=\"container-fluid\">\n<div class=\"row\">\n<h2 align=\"center\">New Patient Forms<\/h2>\n<p>&nbsp;<\/p>\n<p>This packet includes new patient forms that will need to be completed in order for us to assist with your care:<\/h1>\n<ul>\n<li><Strong>Consent for Treatment and Release of Information and Payment Authorization<\/li>\n<li>Controlled Substance (Narcotic) Agreement<\/strong> &nbsp; <strong  style=\"font-size:16px;\">(Maintained in file in the event controlled medications are prescribed by this office)<\/font><\/strong><\/li>\n<li><strong>Authorization to Release Medical Records &#038; Information <\/strong>&nbsp; <strong style=\"font-size:16px;\">(May determine facility name at time of office visit)<\/strong><\/li>\n<li><strong>Patient Information <\/strong> &nbsp;<strong  style=\"font-size:16px;\">(May omit the following sections if information not applicable or not readily available: Referral Information; Attorney, Insurance Information; and Work Comp, Personal Injury, Third Party, or Other Information)<\/strong><\/li>\n<\/ul>\n<div class=\"row\">\n<div class=\"col-sm-4\" align=\"center\"><a title=\"New Patient Form Download\" href=\"\/wp-content\/uploads\/2018\/12\/New-Patient-Packet-2015.pdf\" target=\"_blank\" rel=\"noopener\">New Patient Forms Download<br><img loading=\"lazy\" decoding=\"async\" src=\"\/wp-content\/uploads\/2018\/12\/PDF-icon.png\" alt=\"New Patient Forms Download\" width=\"42\" height=\"42\"><\/a><\/div>\n<div class=\"col-sm-4\" align=\"center\"><a title=\"Opioid Medication Notice\" href=\"\/wp-content\/uploads\/2019\/01\/Opioid-Medication-Notice.pdf\" target=\"_blank\" rel=\"noopener\">Opioid Medication Notice Download<br><img loading=\"lazy\" decoding=\"async\" src=\"\/wp-content\/uploads\/2018\/12\/PDF-icon.png\" alt=\"Opioid Medication Notice\" width=\"42\" height=\"42\"><\/a><\/div>\n<div class=\"col-sm-4\">&nbsp;<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>New Patient Forms &nbsp; This packet includes new patient forms that will need to be completed in order for us to assist with your care: Consent for Treatment and Release of Information and Payment Authorization Controlled Substance (Narcotic) Agreement &nbsp; (Maintained in file in the event controlled medications are prescribed by this office) Authorization to [&#8230;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>New Patient Forms - Advanced Pain Specialists of Southern California<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/advpainspecialists.com\/es\/new-patient\/\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:locale:alternate\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"New Patient Forms\" \/>\n<meta property=\"og:description\" content=\"New Patient Forms &nbsp; This packet includes new patient forms that will need to be completed in order for us to assist with your care: Consent for Treatment and Release of Information and Payment Authorization Controlled Substance (Narcotic) Agreement &nbsp; (Maintained in file in the event controlled medications are prescribed by this office) Authorization to [...]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/advpainspecialists.com\/es\/new-patient\/\" \/>\n<meta property=\"og:site_name\" content=\"Advanced Pain Specialists of Southern California\" \/>\n<meta property=\"article:modified_time\" content=\"2022-05-17T02:35:35+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Tiempo de lectura\" \/>\n\t<meta name=\"twitter:data1\" content=\"1 minuto\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/advpainspecialists.com\/new-patient\/\",\"url\":\"https:\/\/advpainspecialists.com\/new-patient\/\",\"name\":\"New Patient Forms\",\"isPartOf\":{\"@id\":\"https:\/\/advpainspecialists.com\/#website\"},\"datePublished\":\"2018-12-15T03:11:43+00:00\",\"dateModified\":\"2022-05-17T02:35:35+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/advpainspecialists.com\/new-patient\/#breadcrumb\"},\"inLanguage\":\"es-ES\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/advpainspecialists.com\/new-patient\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/advpainspecialists.com\/new-patient\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/advpainspecialists.com\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"New Patient Forms\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/advpainspecialists.com\/#website\",\"url\":\"https:\/\/advpainspecialists.com\/\",\"name\":\"Advanced Pain Specialists of Southern California\",\"description\":\"Relieving Pain And Restoring Possibilities\",\"publisher\":{\"@id\":\"https:\/\/advpainspecialists.com\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/advpainspecialists.com\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"es-ES\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/advpainspecialists.com\/#organization\",\"name\":\"Advance Pain Specialists of Southern California\",\"url\":\"https:\/\/advpainspecialists.com\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"es-ES\",\"@id\":\"https:\/\/advpainspecialists.com\/#\/schema\/logo\/image\/\",\"url\":\"http:\/\/advpainspecialists.com\/wp-content\/uploads\/2018\/07\/Advpain_logo.jpg\",\"contentUrl\":\"http:\/\/advpainspecialists.com\/wp-content\/uploads\/2018\/07\/Advpain_logo.jpg\",\"width\":296,\"height\":110,\"caption\":\"Advance Pain Specialists of Southern California\"},\"image\":{\"@id\":\"https:\/\/advpainspecialists.com\/#\/schema\/logo\/image\/\"}}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"New Patient Forms - Advanced Pain Specialists of Southern California","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/advpainspecialists.com\/es\/new-patient\/","og_locale":"es_ES","og_type":"article","og_title":"[:en]New Patient Forms[:] - Advanced Pain Specialists of Southern California","og_description":"New Patient Forms &nbsp; This packet includes new patient forms that will need to be completed in order for us to assist with your care: Consent for Treatment and Release of Information and Payment Authorization Controlled Substance (Narcotic) Agreement &nbsp; (Maintained in file in the event controlled medications are prescribed by this office) Authorization to [...]","og_url":"https:\/\/advpainspecialists.com\/es\/new-patient\/","og_site_name":"Advanced Pain Specialists of Southern California","article_modified_time":"2022-05-17T02:35:35+00:00","twitter_card":"summary_large_image","twitter_misc":{"Tiempo de lectura":"1 minuto"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/advpainspecialists.com\/new-patient\/","url":"https:\/\/advpainspecialists.com\/new-patient\/","name":"New Patient Forms","isPartOf":{"@id":"https:\/\/advpainspecialists.com\/#website"},"datePublished":"2018-12-15T03:11:43+00:00","dateModified":"2022-05-17T02:35:35+00:00","breadcrumb":{"@id":"https:\/\/advpainspecialists.com\/new-patient\/#breadcrumb"},"inLanguage":"es-ES","potentialAction":[{"@type":"ReadAction","target":["https:\/\/advpainspecialists.com\/new-patient\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/advpainspecialists.com\/new-patient\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/advpainspecialists.com\/"},{"@type":"ListItem","position":2,"name":"New Patient Forms"}]},{"@type":"WebSite","@id":"https:\/\/advpainspecialists.com\/#website","url":"https:\/\/advpainspecialists.com\/","name":"Advanced Pain Specialists of Southern California","description":"Relieving Pain And Restoring Possibilities","publisher":{"@id":"https:\/\/advpainspecialists.com\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/advpainspecialists.com\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"es-ES"},{"@type":"Organization","@id":"https:\/\/advpainspecialists.com\/#organization","name":"Advance Pain Specialists of Southern California","url":"https:\/\/advpainspecialists.com\/","logo":{"@type":"ImageObject","inLanguage":"es-ES","@id":"https:\/\/advpainspecialists.com\/#\/schema\/logo\/image\/","url":"http:\/\/advpainspecialists.com\/wp-content\/uploads\/2018\/07\/Advpain_logo.jpg","contentUrl":"http:\/\/advpainspecialists.com\/wp-content\/uploads\/2018\/07\/Advpain_logo.jpg","width":296,"height":110,"caption":"Advance Pain Specialists of Southern California"},"image":{"@id":"https:\/\/advpainspecialists.com\/#\/schema\/logo\/image\/"}}]}},"_links":{"self":[{"href":"https:\/\/advpainspecialists.com\/es\/wp-json\/wp\/v2\/pages\/619"}],"collection":[{"href":"https:\/\/advpainspecialists.com\/es\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/advpainspecialists.com\/es\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/advpainspecialists.com\/es\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/advpainspecialists.com\/es\/wp-json\/wp\/v2\/comments?post=619"}],"version-history":[{"count":39,"href":"https:\/\/advpainspecialists.com\/es\/wp-json\/wp\/v2\/pages\/619\/revisions"}],"predecessor-version":[{"id":871,"href":"https:\/\/advpainspecialists.com\/es\/wp-json\/wp\/v2\/pages\/619\/revisions\/871"}],"wp:attachment":[{"href":"https:\/\/advpainspecialists.com\/es\/wp-json\/wp\/v2\/media?parent=619"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}