{"id":63,"date":"2024-03-11T16:04:17","date_gmt":"2024-03-11T20:04:17","guid":{"rendered":"https:\/\/scsportsmedicine.com\/?page_id=63"},"modified":"2024-04-17T14:52:45","modified_gmt":"2024-04-17T18:52:45","slug":"patient-forms-and-registration","status":"publish","type":"page","link":"https:\/\/scsportsmedicine.com\/patient-information\/patient-forms-and-registration","title":{"rendered":"Patient Forms and Registration"},"content":{"rendered":"<section class=\"bde-section-63-101 bde-section\">\n              \n  \n\t\n\n\n\n<div class=\"section-container\"><h1 class=\"bde-heading-63-102 bde-heading\">\nPatient Forms & Registration\n<\/h1><\/div>\n<\/section><section class=\"bde-section-63-103 bde-section\">\n  \n\t\n\n\n\n<div class=\"section-container\"><div class=\"bde-columns-63-104 bde-columns\"><div class=\"bde-column-63-105 bde-column\">\n  \n\t\n\n\n\n<h2 class=\"bde-heading-63-109 bde-heading\">\nNew Patients\n<\/h2><div class=\"bde-rich-text-63-138 bde-rich-text breakdance-rich-text-styles\">\n<p>To expedite your visit when checking in to see a doctor, please download, print, and fill out the following forms before your appointment:<\/p>\n<\/div><div class=\"bde-icon-list-63-139 bde-icon-list\">\n<ul>\n  \n              \n    <li>\n                      \n            \n            \n\n    \n    \n    \n    \n    <a class=\"breakdance-link bde-icon-list__item-wrapper\" href=\"https:\/\/scsportsmedicine.com\/wp-content\/uploads\/2024\/03\/Patient-Information-Form-rev2b-1.pdf\" target=\"_blank\" data-type=\"url\"  >\n\n      \n      <span class='bde-icon-list__icon'>\n        <svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 384 512\"><!-- Font Awesome Free 5.15.1 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) --><path d=\"M369.9 97.9L286 14C277 5 264.8-.1 252.1-.1H48C21.5 0 0 21.5 0 48v416c0 26.5 21.5 48 48 48h288c26.5 0 48-21.5 48-48V131.9c0-12.7-5.1-25-14.1-34zM332.1 128H256V51.9l76.1 76.1zM48 464V48h160v104c0 13.3 10.7 24 24 24h104v288H48zm250.2-143.7c-12.2-12-47-8.7-64.4-6.5-17.2-10.5-28.7-25-36.8-46.3 3.9-16.1 10.1-40.6 5.4-56-4.2-26.2-37.8-23.6-42.6-5.9-4.4 16.1-.4 38.5 7 67.1-10 23.9-24.9 56-35.4 74.4-20 10.3-47 26.2-51 46.2-3.3 15.8 26 55.2 76.1-31.2 22.4-7.4 46.8-16.5 68.4-20.1 18.9 10.2 41 17 55.8 17 25.5 0 28-28.2 17.5-38.7zm-198.1 77.8c5.1-13.7 24.5-29.5 30.4-35-19 30.3-30.4 35.7-30.4 35zm81.6-190.6c7.4 0 6.7 32.1 1.8 40.8-4.4-13.9-4.3-40.8-1.8-40.8zm-24.4 136.6c9.7-16.9 18-37 24.7-54.7 8.3 15.1 18.9 27.2 30.1 35.5-20.8 4.3-38.9 13.1-54.8 19.2zm131.6-5s-5 6-37.3-7.8c35.1-2.6 40.9 5.4 37.3 7.8z\"\/><\/svg>\n      <\/span>\n      <span class='bde-icon-list__text' >\n      New Patient Information (PDF)\n      <\/span>\n                  <\/a>\n\n      \n    <\/li>\n\n  \n              \n    <li>\n                      \n            \n            \n\n    \n    \n    \n    \n    <a class=\"breakdance-link bde-icon-list__item-wrapper\" href=\"https:\/\/scsportsmedicine.com\/wp-content\/uploads\/2024\/03\/Patient-Health-History-Intake-Paperwork-updated-9-29-2021.pdf\" target=\"_blank\" data-type=\"url\"  >\n\n      \n      <span class='bde-icon-list__icon'>\n        <svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 384 512\"><!-- Font Awesome Free 5.15.1 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) --><path d=\"M369.9 97.9L286 14C277 5 264.8-.1 252.1-.1H48C21.5 0 0 21.5 0 48v416c0 26.5 21.5 48 48 48h288c26.5 0 48-21.5 48-48V131.9c0-12.7-5.1-25-14.1-34zM332.1 128H256V51.9l76.1 76.1zM48 464V48h160v104c0 13.3 10.7 24 24 24h104v288H48zm250.2-143.7c-12.2-12-47-8.7-64.4-6.5-17.2-10.5-28.7-25-36.8-46.3 3.9-16.1 10.1-40.6 5.4-56-4.2-26.2-37.8-23.6-42.6-5.9-4.4 16.1-.4 38.5 7 67.1-10 23.9-24.9 56-35.4 74.4-20 10.3-47 26.2-51 46.2-3.3 15.8 26 55.2 76.1-31.2 22.4-7.4 46.8-16.5 68.4-20.1 18.9 10.2 41 17 55.8 17 25.5 0 28-28.2 17.5-38.7zm-198.1 77.8c5.1-13.7 24.5-29.5 30.4-35-19 30.3-30.4 35.7-30.4 35zm81.6-190.6c7.4 0 6.7 32.1 1.8 40.8-4.4-13.9-4.3-40.8-1.8-40.8zm-24.4 136.6c9.7-16.9 18-37 24.7-54.7 8.3 15.1 18.9 27.2 30.1 35.5-20.8 4.3-38.9 13.1-54.8 19.2zm131.6-5s-5 6-37.3-7.8c35.1-2.6 40.9 5.4 37.3 7.8z\"\/><\/svg>\n      <\/span>\n      <span class='bde-icon-list__text' >\n      Patient Health History Intake Paperwork (PDF)\n      <\/span>\n                  <\/a>\n\n      \n    <\/li>\n\n  \n              \n    <li>\n                      \n            \n            \n\n    \n    \n    \n    \n    <a class=\"breakdance-link bde-icon-list__item-wrapper\" href=\"https:\/\/scsportsmedicine.com\/wp-content\/uploads\/2024\/03\/Privacy-Practices-Brochure.pdf\" target=\"_blank\" data-type=\"url\"  >\n\n      \n      <span class='bde-icon-list__icon'>\n        <svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 384 512\"><!-- Font Awesome Free 5.15.1 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) --><path d=\"M369.9 97.9L286 14C277 5 264.8-.1 252.1-.1H48C21.5 0 0 21.5 0 48v416c0 26.5 21.5 48 48 48h288c26.5 0 48-21.5 48-48V131.9c0-12.7-5.1-25-14.1-34zM332.1 128H256V51.9l76.1 76.1zM48 464V48h160v104c0 13.3 10.7 24 24 24h104v288H48zm250.2-143.7c-12.2-12-47-8.7-64.4-6.5-17.2-10.5-28.7-25-36.8-46.3 3.9-16.1 10.1-40.6 5.4-56-4.2-26.2-37.8-23.6-42.6-5.9-4.4 16.1-.4 38.5 7 67.1-10 23.9-24.9 56-35.4 74.4-20 10.3-47 26.2-51 46.2-3.3 15.8 26 55.2 76.1-31.2 22.4-7.4 46.8-16.5 68.4-20.1 18.9 10.2 41 17 55.8 17 25.5 0 28-28.2 17.5-38.7zm-198.1 77.8c5.1-13.7 24.5-29.5 30.4-35-19 30.3-30.4 35.7-30.4 35zm81.6-190.6c7.4 0 6.7 32.1 1.8 40.8-4.4-13.9-4.3-40.8-1.8-40.8zm-24.4 136.6c9.7-16.9 18-37 24.7-54.7 8.3 15.1 18.9 27.2 30.1 35.5-20.8 4.3-38.9 13.1-54.8 19.2zm131.6-5s-5 6-37.3-7.8c35.1-2.6 40.9 5.4 37.3 7.8z\"\/><\/svg>\n      <\/span>\n      <span class='bde-icon-list__text' >\n      Notice of Privacy Practices (PDF)\n      <\/span>\n                  <\/a>\n\n      \n    <\/li>\n\n  <\/ul>\n\n<\/div>\n<\/div><div class=\"bde-column-63-140 bde-column\">\n  \n\t\n\n\n\n<h2 class=\"bde-heading-63-141 bde-heading\">\nOther Forms\n<\/h2><div class=\"bde-icon-list-63-143 bde-icon-list\">\n<ul>\n  \n              \n    <li>\n                      \n            \n            \n\n    \n    \n    \n    \n    <a class=\"breakdance-link bde-icon-list__item-wrapper\" href=\"https:\/\/scsportsmedicine.com\/wp-content\/uploads\/2024\/03\/Request-for-Medical-Records-1.pdf\" target=\"_blank\" data-type=\"url\"  >\n\n      \n      <span class='bde-icon-list__icon'>\n        <svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 384 512\"><!-- Font Awesome Free 5.15.1 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) --><path d=\"M369.9 97.9L286 14C277 5 264.8-.1 252.1-.1H48C21.5 0 0 21.5 0 48v416c0 26.5 21.5 48 48 48h288c26.5 0 48-21.5 48-48V131.9c0-12.7-5.1-25-14.1-34zM332.1 128H256V51.9l76.1 76.1zM48 464V48h160v104c0 13.3 10.7 24 24 24h104v288H48zm250.2-143.7c-12.2-12-47-8.7-64.4-6.5-17.2-10.5-28.7-25-36.8-46.3 3.9-16.1 10.1-40.6 5.4-56-4.2-26.2-37.8-23.6-42.6-5.9-4.4 16.1-.4 38.5 7 67.1-10 23.9-24.9 56-35.4 74.4-20 10.3-47 26.2-51 46.2-3.3 15.8 26 55.2 76.1-31.2 22.4-7.4 46.8-16.5 68.4-20.1 18.9 10.2 41 17 55.8 17 25.5 0 28-28.2 17.5-38.7zm-198.1 77.8c5.1-13.7 24.5-29.5 30.4-35-19 30.3-30.4 35.7-30.4 35zm81.6-190.6c7.4 0 6.7 32.1 1.8 40.8-4.4-13.9-4.3-40.8-1.8-40.8zm-24.4 136.6c9.7-16.9 18-37 24.7-54.7 8.3 15.1 18.9 27.2 30.1 35.5-20.8 4.3-38.9 13.1-54.8 19.2zm131.6-5s-5 6-37.3-7.8c35.1-2.6 40.9 5.4 37.3 7.8z\"\/><\/svg>\n      <\/span>\n      <span class='bde-icon-list__text' >\n      Request of Medical Forms (PDF)\n      <\/span>\n                  <\/a>\n\n      \n    <\/li>\n\n  \n              \n    <li>\n                      \n            \n            \n\n    \n    \n    \n    \n    <a class=\"breakdance-link bde-icon-list__item-wrapper\" href=\"https:\/\/scsportsmedicine.com\/wp-content\/uploads\/2024\/03\/MEDICAL-RECORD-RELEASE-FORM.pdf\" target=\"_blank\" data-type=\"url\"  >\n\n      \n      <span class='bde-icon-list__icon'>\n        <svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 384 512\"><!-- Font Awesome Free 5.15.1 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) --><path d=\"M369.9 97.9L286 14C277 5 264.8-.1 252.1-.1H48C21.5 0 0 21.5 0 48v416c0 26.5 21.5 48 48 48h288c26.5 0 48-21.5 48-48V131.9c0-12.7-5.1-25-14.1-34zM332.1 128H256V51.9l76.1 76.1zM48 464V48h160v104c0 13.3 10.7 24 24 24h104v288H48zm250.2-143.7c-12.2-12-47-8.7-64.4-6.5-17.2-10.5-28.7-25-36.8-46.3 3.9-16.1 10.1-40.6 5.4-56-4.2-26.2-37.8-23.6-42.6-5.9-4.4 16.1-.4 38.5 7 67.1-10 23.9-24.9 56-35.4 74.4-20 10.3-47 26.2-51 46.2-3.3 15.8 26 55.2 76.1-31.2 22.4-7.4 46.8-16.5 68.4-20.1 18.9 10.2 41 17 55.8 17 25.5 0 28-28.2 17.5-38.7zm-198.1 77.8c5.1-13.7 24.5-29.5 30.4-35-19 30.3-30.4 35.7-30.4 35zm81.6-190.6c7.4 0 6.7 32.1 1.8 40.8-4.4-13.9-4.3-40.8-1.8-40.8zm-24.4 136.6c9.7-16.9 18-37 24.7-54.7 8.3 15.1 18.9 27.2 30.1 35.5-20.8 4.3-38.9 13.1-54.8 19.2zm131.6-5s-5 6-37.3-7.8c35.1-2.6 40.9 5.4 37.3 7.8z\"\/><\/svg>\n      <\/span>\n      <span class='bde-icon-list__text' >\n      Release of Medical Forms (PDF)\n      <\/span>\n                  <\/a>\n\n      \n    <\/li>\n\n  \n              \n    <li>\n                      \n            \n            \n\n    \n    \n    \n    \n    <a class=\"breakdance-link bde-icon-list__item-wrapper\" href=\"https:\/\/app.recordquest.com\/request\/scsm\" target=\"_blank\" data-type=\"url\" rel=\"noopener\">\n\n      \n      <span class='bde-icon-list__icon'>\n        <svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 448 512\"><!-- Font Awesome Free 5.15.1 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) --><path d=\"M448 80v352c0 26.51-21.49 48-48 48H48c-26.51 0-48-21.49-48-48V80c0-26.51 21.49-48 48-48h352c26.51 0 48 21.49 48 48zm-88 16H248.029c-21.313 0-32.08 25.861-16.971 40.971l31.984 31.987L67.515 364.485c-4.686 4.686-4.686 12.284 0 16.971l31.029 31.029c4.687 4.686 12.285 4.686 16.971 0l195.526-195.526 31.988 31.991C358.058 263.977 384 253.425 384 231.979V120c0-13.255-10.745-24-24-24z\"\/><\/svg>\n      <\/span>\n      <span class='bde-icon-list__text' >\n      Request for Patient Records\n      <\/span>\n                  <\/a>\n\n      \n    <\/li>\n\n  <\/ul>\n\n<\/div>\n<\/div><\/div><\/div>\n<\/section>","protected":false},"excerpt":{"rendered":"<p>Patient Forms &#038; Registration New Patients To expedite your visit when checking in to see a doctor, please download, print, and fill out the following forms before your appointment: New Patient Information (PDF) Patient Health History Intake Paperwork (PDF) Notice of Privacy Practices (PDF) Other Forms Request of Medical Forms (PDF) Release of Medical Forms [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":61,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_breakdance_hide_in_design_set":false,"_breakdance_tags":"","footnotes":""},"_links":{"self":[{"href":"https:\/\/scsportsmedicine.com\/wp-json\/wp\/v2\/pages\/63"}],"collection":[{"href":"https:\/\/scsportsmedicine.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/scsportsmedicine.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/scsportsmedicine.com\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/scsportsmedicine.com\/wp-json\/wp\/v2\/comments?post=63"}],"version-history":[{"count":9,"href":"https:\/\/scsportsmedicine.com\/wp-json\/wp\/v2\/pages\/63\/revisions"}],"predecessor-version":[{"id":924,"href":"https:\/\/scsportsmedicine.com\/wp-json\/wp\/v2\/pages\/63\/revisions\/924"}],"up":[{"embeddable":true,"href":"https:\/\/scsportsmedicine.com\/wp-json\/wp\/v2\/pages\/61"}],"wp:attachment":[{"href":"https:\/\/scsportsmedicine.com\/wp-json\/wp\/v2\/media?parent=63"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}