{"id":4170,"date":"2020-10-15T13:06:25","date_gmt":"2020-10-15T20:06:25","guid":{"rendered":"https:\/\/upacifichearing.fm1.dev\/?page_id=4170"},"modified":"2024-04-18T15:49:05","modified_gmt":"2024-04-18T22:49:05","slug":"stockton-location-forms","status":"publish","type":"page","link":"https:\/\/hearingclinic.pacific.edu\/patient-forms\/stockton-location-forms\/","title":{"rendered":"Stockton Location Forms"},"content":{"rendered":"\n

Please download and print any of the forms required for your visit. Fill them out ahead of time and bring them to your scheduled appointment. This will help expedite the check-in process.<\/p>\n\n\n\n

New Patient Forms<\/summary>
\n
New Patient Packet<\/a>Download<\/a><\/div>\n\n\n\n
New Patient Intake Form (English)<\/a>Download<\/a><\/div>\n\n\n\n
New Patient Intake Form (Spanish)<\/a>Download<\/a><\/div>\n\n\n\n
Patient’s Financial Responsibility<\/a>Download<\/a><\/div>\n<\/div><\/details>\n\n\n\n
Privacy Practices<\/summary>
\n
Notice of Privacy Practices<\/a>Download<\/a><\/div>\n\n\n\n
Privacy Practices Acknowledgement<\/a>Download<\/a><\/div>\n<\/div><\/details>\n\n\n\n
Tinnitus Evaluation Forms<\/summary>
\n
Tinnitus Intake Form<\/a>Download<\/a><\/div>\n\n\n\n
Tinnitus Handicap Inventory<\/a>Download<\/a><\/div>\n<\/div><\/details>\n\n\n\n
Release of Information<\/summary>
\n
HIPAA Disclosure Authorization<\/a>Download<\/a><\/div>\n\n\n\n
HIPAA Release Request<\/a>Download<\/a><\/div>\n\n\n\n
Medical Clearance for Hearing Aid Use<\/a>Download<\/a><\/div>\n<\/div><\/details>\n\n\n\n
Telemedicine Consent<\/a>Download<\/a><\/div>\n","protected":false},"excerpt":{"rendered":"

Please download and print any of the forms required for your visit. Fill them out ahead of time and bring them to your scheduled appointment. This will help expedite the check-in process.<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":233,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_seopress_robots_primary_cat":"","_seopress_titles_title":"","_seopress_titles_desc":"","_seopress_robots_index":"","event_date":"","formatted_date":"","formatted_time":"","location":"","footnotes":""},"service_tags":[],"_links":{"self":[{"href":"https:\/\/hearingclinic.pacific.edu\/wp-json\/wp\/v2\/pages\/4170"}],"collection":[{"href":"https:\/\/hearingclinic.pacific.edu\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/hearingclinic.pacific.edu\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/hearingclinic.pacific.edu\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/hearingclinic.pacific.edu\/wp-json\/wp\/v2\/comments?post=4170"}],"version-history":[{"count":0,"href":"https:\/\/hearingclinic.pacific.edu\/wp-json\/wp\/v2\/pages\/4170\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/hearingclinic.pacific.edu\/wp-json\/wp\/v2\/pages\/233"}],"wp:attachment":[{"href":"https:\/\/hearingclinic.pacific.edu\/wp-json\/wp\/v2\/media?parent=4170"}],"wp:term":[{"taxonomy":"service_tags","embeddable":true,"href":"https:\/\/hearingclinic.pacific.edu\/wp-json\/wp\/v2\/service_tags?post=4170"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}