{"id":28420,"date":"2021-08-05T14:43:20","date_gmt":"2021-08-05T14:43:20","guid":{"rendered":"https:\/\/chiro.page\/demo5\/?page_id=28420"},"modified":"2026-11-02T15:54:48","modified_gmt":"2026-11-02T15:54:48","slug":"new-patient-information","status":"publish","type":"page","link":"https:\/\/chiro.page\/demo5\/new-patient-information\/","title":{"rendered":"New Patient Information"},"content":{"rendered":"\n<div class=\"et_pb_section_0 et_pb_section et_pb_fullwidth_section et_section_regular et_block_section landing\"><section class=\"et_pb_fullwidth_header_0 et_pb_fullwidth_header et_pb_bg_layout_dark et_pb_text_align_left et_pb_module et_flex_module\"><div class=\"et_pb_fullwidth_header_container left\"><div class=\"header-content-container center\"><div class=\"header-content et_flex_module\"><h1 class=\"et_pb_module_header\">New Patients<\/h1><span class=\"et_pb_fullwidth_header_subhead\">Forms, Insurance Policies, and First Day Procedures<\/span><div class=\"et_pb_header_button_wrapper\"><\/div><\/div><\/div><\/div><div class=\"et_pb_fullwidth_header_overlay\"><\/div><div class=\"et_pb_fullwidth_header_scroll\"><\/div><\/section><\/div><div class=\"et_pb_section_1 et_pb_section et_section_regular et_block_section hcta\"><div class=\"et_pb_row_0 et_pb_row et_block_row\"><div class=\"et_pb_column_0 et_pb_column et_pb_column_4_4 et-last-child et_block_column et_pb_css_mix_blend_mode_passthrough\"><div class=\"et_pb_cta_0 et_pb_promo et_pb_bg_layout_dark et_pb_module et_block_module\"><div class=\"et_pb_promo_description\"><h2 class=\"et_pb_module_header\">We are delighted you are here<\/h2><div class=\"et_pb_promo_content\"><p>Please access the first day forms and procedures below.<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><div class=\"et_pb_section_2 et_pb_section et_section_regular et_block_section lblocks\"><div class=\"et_pb_row_1 et_pb_row et_pb_equal_columns et_pb_gutters0 et_block_row et_pb_row_fullwidth\"><div class=\"et_pb_column_1 et_pb_column et_pb_column_1_3 et_block_column et_pb_css_mix_blend_mode_passthrough ltiles\"><div class=\"et_pb_image_0 et_pb_image et_animated et_pb_module et_block_module\"><span class=\"et_pb_image_wrap\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/chiro.page\/demo5\/wp-content\/uploads\/sites\/10\/2021\/07\/pexels-ryutaro-tsukata-5473182-scaled.jpg\" width=\"2560\" height=\"1707\" srcset=\"https:\/\/chiro.page\/demo5\/wp-content\/uploads\/sites\/10\/2021\/07\/pexels-ryutaro-tsukata-5473182-scaled.jpg 2560w, https:\/\/chiro.page\/demo5\/wp-content\/uploads\/sites\/10\/2021\/07\/pexels-ryutaro-tsukata-5473182-1280x854.jpg 1280w, https:\/\/chiro.page\/demo5\/wp-content\/uploads\/sites\/10\/2021\/07\/pexels-ryutaro-tsukata-5473182-980x653.jpg 980w, https:\/\/chiro.page\/demo5\/wp-content\/uploads\/sites\/10\/2021\/07\/pexels-ryutaro-tsukata-5473182-480x320.jpg 480w\" sizes=\"(min-width: 0px) and (max-width: 480px) 480px, (min-width: 481px) and (max-width: 980px) 980px, (min-width: 981px) and (max-width: 1280px) 1280px, (min-width: 1281px) 2560px, 100vw\" class=\"wp-image-28325\" title=\"pexels-ryutaro-tsukata-5473182\" \/><\/span><\/div><\/div><div class=\"et_pb_column_2 et_pb_column et_pb_column_2_3 et-last-child et_block_column et_pb_css_mix_blend_mode_passthrough ltiles\"><div class=\"et_pb_cta_1 et_pb_promo et_pb_bg_layout_dark et_clickable et_pb_module et_block_module lcta\"><div class=\"et_pb_promo_description\"><h2 class=\"et_pb_module_header\">Adult New Patient Paperwork<\/h2><\/div><div class=\"et_pb_button_wrapper\"><a class=\"et_pb_button et_pb_promo_button\" href=\"#\">Download Here<\/a><\/div><\/div><\/div><\/div><div class=\"et_pb_row_2 et_pb_row et_pb_equal_columns et_pb_gutters0 et_block_row swapcol et_pb_row_fullwidth\"><div class=\"et_pb_column_3 et_pb_column et_pb_column_2_3 et_block_column et_pb_css_mix_blend_mode_passthrough ltiles\"><div class=\"et_pb_cta_2 et_pb_promo et_pb_bg_layout_dark et_clickable et_pb_module et_block_module lcta\"><div class=\"et_pb_promo_description\"><h2 class=\"et_pb_module_header\">Pediatric Forms<\/h2><\/div><div class=\"et_pb_button_wrapper\"><a class=\"et_pb_button et_pb_promo_button\" href=\"#\">Download Here<\/a><\/div><\/div><\/div><div class=\"et_pb_column_4 et_pb_column et_pb_column_1_3 et-last-child et_block_column et_pb_css_mix_blend_mode_passthrough ltiles\"><div class=\"et_pb_image_1 et_pb_image et_animated et_pb_module et_block_module\"><span class=\"et_pb_image_wrap\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/chiro.page\/demo5\/wp-content\/uploads\/sites\/10\/2021\/08\/AdobeStock_300162264-scaled.jpeg\" width=\"2560\" height=\"1920\" srcset=\"https:\/\/chiro.page\/demo5\/wp-content\/uploads\/sites\/10\/2021\/08\/AdobeStock_300162264-scaled.jpeg 2560w, https:\/\/chiro.page\/demo5\/wp-content\/uploads\/sites\/10\/2021\/08\/AdobeStock_300162264-1280x960.jpeg 1280w, https:\/\/chiro.page\/demo5\/wp-content\/uploads\/sites\/10\/2021\/08\/AdobeStock_300162264-980x735.jpeg 980w, https:\/\/chiro.page\/demo5\/wp-content\/uploads\/sites\/10\/2021\/08\/AdobeStock_300162264-480x360.jpeg 480w\" sizes=\"(min-width: 0px) and (max-width: 480px) 480px, (min-width: 481px) and (max-width: 980px) 980px, (min-width: 981px) and (max-width: 1280px) 1280px, (min-width: 1281px) 2560px, 100vw\" class=\"wp-image-28434\" title=\"Osteopathy treatment for a child\" \/><\/span><\/div><\/div><\/div><\/div><div class=\"et_pb_section_3 et_pb_section et_section_regular et_block_section hcta\"><div class=\"et_pb_row_3 et_pb_row et_block_row\"><div class=\"et_pb_column_5 et_pb_column et_pb_column_4_4 et-last-child et_block_column et_pb_css_mix_blend_mode_passthrough\"><div class=\"et_pb_cta_3 et_pb_promo et_pb_bg_layout_dark et_clickable et_pb_module et_block_module\"><div class=\"et_pb_promo_description\"><h2 class=\"et_pb_module_header\">Insurance<\/h2><div class=\"et_pb_promo_content\"><p>We accept all major insurance, credit cards and Care Credit. If you have specific questions about your insurance benefits, please call us today.<\/p>\n<\/div><\/div><div class=\"et_pb_button_wrapper\"><a class=\"et_pb_button et_pb_promo_button\" href=\"https:\/\/chiro.page\/demo5\/appointments\/\">Schedule Now<\/a><\/div><\/div><\/div><\/div><\/div><div class=\"et_pb_section_4 et_pb_section et_section_regular et_block_section hcontact\"><div class=\"et_pb_row_4 et_pb_row et_pb_gutters1 et_block_row et_pb_row_fullwidth\"><div class=\"et_pb_column_6 et_pb_column et_pb_column_2_3 et_block_column et_pb_css_mix_blend_mode_passthrough cform\"><div class=\"et_pb_contact_form_0 et_pb_contact_form_container clearfix et_pb_module et_flex_module\" data-form_unique_num=\"0\" data-form_unique_id=\"7067d836e5cc6b8d0df5f1ee01accc26\" id=\"et_pb_contact_form_0\"><div class=\"et-pb-contact-message\"><\/div><div class=\"et_pb_contact\"><form class=\"et_pb_contact_form et_flex_module\" method=\"post\" action=\"https:\/\/chiro.page\/demo5\/wp-json\/wp\/v2\/pages\/28420\"><div class=\"et_pb_contact_field_0 et_pb_contact_field et_pb_module et_flex_module et_flex_column_12_24 et_flex_column_12_24_tablet et_flex_column_12_24_phone\" data-id=\"name\" data-type=\"input\"><label class=\"et_pb_contact_form_label\" for=\"et_pb_contact_0_name_0\">Name<\/label><input type=\"text\" name=\"et_pb_contact_0_name_0\" id=\"et_pb_contact_0_name_0\" class=\"input\" data-required_mark=\"required\" data-field_type=\"input\" data-original_id=\"name\" placeholder=\"Name\" title=\"\" value=\"\" \/><\/div><div class=\"et_pb_contact_field_1 et_pb_contact_field et_pb_module et_flex_module et_flex_column_12_24 et_flex_column_12_24_tablet et_flex_column_12_24_phone\" data-id=\"email\" data-type=\"email\"><label class=\"et_pb_contact_form_label\" for=\"et_pb_contact_0_email_1\">Email<\/label><input type=\"text\" name=\"et_pb_contact_0_email_1\" id=\"et_pb_contact_0_email_1\" class=\"input\" data-required_mark=\"required\" data-field_type=\"email\" data-original_id=\"email\" placeholder=\"Email\" title=\"\" value=\"\" \/><\/div><div class=\"et_pb_contact_field_2 et_pb_contact_field et_pb_module et_flex_module et_flex_column_24_24 et_flex_column_24_24_tablet et_flex_column_24_24_phone\" data-id=\"message\" data-type=\"text\"><label class=\"et_pb_contact_form_label\" for=\"et_pb_contact_0_message_2\">Message<\/label><textarea name=\"et_pb_contact_0_message_2\" id=\"et_pb_contact_0_message_2\" class=\"et_pb_contact_message input\" data-required_mark=\"required\" data-field_type=\"text\" data-original_id=\"message\" placeholder=\"Message\"><\/textarea><\/div><input type=\"hidden\" name=\"et_pb_contactform_submit_7067d836e5cc6b8d0df5f1ee01accc26\" value=\"et_contact_proccess\" \/><div class=\"et_contact_bottom_container\"><div class=\"et_pb_button_wrapper\"><button type=\"submit\" name=\"et_builder_submit_button\" class=\"et_pb_button et_pb_contact_submit\">Submit<\/button><\/div><\/div><input type=\"hidden\" id=\"_wpnonce-et-pb-contact-form-submitted-7067d836e5cc6b8d0df5f1ee01accc26\" name=\"_wpnonce-et-pb-contact-form-submitted-7067d836e5cc6b8d0df5f1ee01accc26\" value=\"f31b2f6e30\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/demo5\/wp-json\/wp\/v2\/pages\/28420\" \/><\/form><\/div><\/div><\/div><div class=\"et_pb_column_7 et_pb_column et_pb_column_1_3 et-last-child et_block_column et_pb_css_mix_blend_mode_passthrough ccdata\"><div class=\"et_pb_blurb_0 et_pb_blurb et_pb_bg_layout_dark et_pb_blurb_position_left et_pb_module et_block_module\"><div class=\"et_pb_blurb_content\"><div class=\"et_pb_main_blurb_image et_animated\"><span class=\"et_pb_image_wrap\"><span class=\"et-pb-icon\"><\/span><\/span><\/div><div class=\"et_pb_blurb_container\"><h4 class=\"et_pb_module_header\">Location<\/h4><div class=\"et_pb_blurb_description\"><p>1000 Main St.<br \/>Atlanta, GA<\/p>\n<\/div><\/div><\/div><\/div><div class=\"et_pb_blurb_1 et_pb_blurb et_pb_bg_layout_dark et_pb_blurb_position_left et_pb_module et_block_module\"><div class=\"et_pb_blurb_content\"><div class=\"et_pb_main_blurb_image et_animated\"><span class=\"et_pb_image_wrap\"><span class=\"et-pb-icon\"><\/span><\/span><\/div><div class=\"et_pb_blurb_container\"><h4 class=\"et_pb_module_header\">Telephone<\/h4><div class=\"et_pb_blurb_description\"><p><a href=\"tel:+14045557777\">(404) 555-7777<\/a><\/p>\n<\/div><\/div><\/div><\/div><div class=\"et_pb_blurb_2 et_pb_blurb et_pb_bg_layout_dark et_pb_blurb_position_left et_pb_module et_block_module\"><div class=\"et_pb_blurb_content\"><div class=\"et_pb_main_blurb_image et_animated\"><span class=\"et_pb_image_wrap\"><span class=\"et-pb-icon\"><\/span><\/span><\/div><div class=\"et_pb_blurb_container\"><h4 class=\"et_pb_module_header\">Hours of Operation<\/h4><div class=\"et_pb_blurb_description\"><p>Monday: 7am \u2013 5pm<br \/>Tuesday: 8am \u2013 4pm<br \/>Wednesday: 9am \u2013 4pm<br \/>Thursday: 8am \u2013 5pm<br \/>Friday: 9am \u2013 12pm<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><div class=\"et_pb_row_5 et_pb_row et_block_row\"><div class=\"et_pb_column_8 et_pb_column et_pb_column_4_4 et-last-child et_block_column et_pb_css_mix_blend_mode_passthrough\"><ul class=\"et_pb_social_media_follow_0 et_pb_social_media_follow clearfix et_pb_bg_layout_dark et_pb_module et_block_module\"><li class=\"et_pb_social_media_follow_network_0 et_pb_social_media_follow_network et_pb_social_icon et_pb_social_network_link et-social-facebook et_pb_module et_flex_module\"><a href=\"#\" class=\"icon\" title=\"Follow on Facebook\" target=\"_self\" rel=\"noopener\"><span class=\"et_pb_social_media_follow_network_name\">Follow<\/span><\/a><\/li><li class=\"et_pb_social_media_follow_network_1 et_pb_social_media_follow_network et_pb_social_icon et_pb_social_network_link et-social-twitter et_pb_module et_flex_module\"><a href=\"#\" class=\"icon\" title=\"Follow on X\" target=\"_self\" rel=\"noopener\"><span class=\"et_pb_social_media_follow_network_name\">Follow<\/span><\/a><\/li><li class=\"et_pb_social_media_follow_network_2 et_pb_social_media_follow_network et_pb_social_icon et_pb_social_network_link et-social-instagram et_pb_module et_flex_module\"><a href=\"#\" class=\"icon\" title=\"Follow on Instagram\" target=\"_self\" rel=\"noopener\"><span class=\"et_pb_social_media_follow_network_name\">Follow<\/span><\/a><\/li><li class=\"et_pb_social_media_follow_network_3 et_pb_social_media_follow_network et_pb_social_icon et_pb_social_network_link et-social-linkedin et_pb_module et_flex_module\"><a href=\"#\" class=\"icon\" title=\"Follow on LinkedIn\" target=\"_self\" rel=\"noopener\"><span class=\"et_pb_social_media_follow_network_name\">Follow<\/span><\/a><\/li><li class=\"et_pb_social_media_follow_network_4 et_pb_social_media_follow_network et_pb_social_icon et_pb_social_network_link et-social-google-plus et_pb_module et_flex_module\"><a href=\"#\" class=\"icon\" title=\"Follow on Google-plus\" target=\"_self\" rel=\"noopener\"><span class=\"et_pb_social_media_follow_network_name\">Follow<\/span><\/a><\/li><\/ul><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-28420","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/chiro.page\/demo5\/wp-json\/wp\/v2\/pages\/28420","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/chiro.page\/demo5\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/chiro.page\/demo5\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/chiro.page\/demo5\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/chiro.page\/demo5\/wp-json\/wp\/v2\/comments?post=28420"}],"version-history":[{"count":16,"href":"https:\/\/chiro.page\/demo5\/wp-json\/wp\/v2\/pages\/28420\/revisions"}],"predecessor-version":[{"id":28509,"href":"https:\/\/chiro.page\/demo5\/wp-json\/wp\/v2\/pages\/28420\/revisions\/28509"}],"wp:attachment":[{"href":"https:\/\/chiro.page\/demo5\/wp-json\/wp\/v2\/media?parent=28420"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}