{"id":505,"date":"2020-03-13T09:13:39","date_gmt":"2020-03-13T09:13:39","guid":{"rendered":"https:\/\/salute.vamtam.com\/?page_id=505"},"modified":"2020-03-13T09:13:39","modified_gmt":"2020-03-13T09:13:39","slug":"online-forms","status":"publish","type":"page","link":"https:\/\/drpritysharma.com\/?page_id=505","title":{"rendered":"Online Forms"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"505\" class=\"elementor elementor-505\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-79a87f6a elementor-section-height-min-height elementor-section-items-stretch elementor-section-boxed elementor-section-height-default\" data-id=\"79a87f6a\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-4ec79dcf\" data-id=\"4ec79dcf\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;background_motion_fx_motion_fx_scrolling&quot;:&quot;yes&quot;,&quot;background_motion_fx_scale_effect&quot;:&quot;yes&quot;,&quot;background_motion_fx_scale_speed&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:2,&quot;sizes&quot;:[]},&quot;background_motion_fx_scale_range&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:{&quot;start&quot;:66,&quot;end&quot;:93}},&quot;background_motion_fx_devices&quot;:[&quot;desktop&quot;],&quot;background_motion_fx_scale_direction&quot;:&quot;out-in&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-3cb0de28 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"3cb0de28\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-44bb7a1a\" data-id=\"44bb7a1a\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-29d17767\" data-id=\"29d17767\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7c55d6fd elementor-shape-circle e-grid-align-right elementor-widget__width-auto vamtam-layout-horizontal elementor-grid-0 elementor-widget elementor-widget-social-icons\" data-id=\"7c55d6fd\" data-element_type=\"widget\" data-widget_type=\"social-icons.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-social-icons-wrapper elementor-grid\">\n\t\t\t\t\t\t\t<span class=\"elementor-grid-item\">\n\t\t\t\t\t<a class=\"elementor-icon elementor-social-icon elementor-social-icon-print elementor-repeater-item-f0b87d5 vamtam-trigger-print\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-screen-only\">Print<\/span>\n\t\t\t\t\t\t<svg class=\"e-font-icon-svg e-fas-print\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M448 192V77.25c0-8.49-3.37-16.62-9.37-22.63L393.37 9.37c-6-6-14.14-9.37-22.63-9.37H96C78.33 0 64 14.33 64 32v160c-35.35 0-64 28.65-64 64v112c0 8.84 7.16 16 16 16h48v96c0 17.67 14.33 32 32 32h320c17.67 0 32-14.33 32-32v-96h48c8.84 0 16-7.16 16-16V256c0-35.35-28.65-64-64-64zm-64 256H128v-96h256v96zm0-224H128V64h192v48c0 8.84 7.16 16 16 16h48v96zm48 72c-13.25 0-24-10.75-24-24 0-13.26 10.75-24 24-24s24 10.74 24 24c0 13.25-10.75 24-24 24z\"><\/path><\/svg>\t\t\t\t\t<\/a>\n\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<span class=\"elementor-grid-item\">\n\t\t\t\t\t<a class=\"elementor-icon elementor-social-icon elementor-social-icon-envelope elementor-repeater-item-220d436\" href=\"mailto:info@salute.com\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-screen-only\">Envelope<\/span>\n\t\t\t\t\t\t<svg class=\"e-font-icon-svg e-fas-envelope\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M502.3 190.8c3.9-3.1 9.7-.2 9.7 4.7V400c0 26.5-21.5 48-48 48H48c-26.5 0-48-21.5-48-48V195.6c0-5 5.7-7.8 9.7-4.7 22.4 17.4 52.1 39.5 154.1 113.6 21.1 15.4 56.7 47.8 92.2 47.6 35.7.3 72-32.8 92.3-47.6 102-74.1 131.6-96.3 154-113.7zM256 320c23.2.4 56.6-29.2 73.4-41.4 132.7-96.3 142.8-104.7 173.4-128.7 5.8-4.5 9.2-11.5 9.2-18.9v-19c0-26.5-21.5-48-48-48H48C21.5 64 0 85.5 0 112v19c0 7.4 3.4 14.3 9.2 18.9 30.6 23.9 40.7 32.4 173.4 128.7 16.8 12.2 50.2 41.8 73.4 41.4z\"><\/path><\/svg>\t\t\t\t\t<\/a>\n\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<span class=\"elementor-grid-item\">\n\t\t\t\t\t<a class=\"elementor-icon elementor-social-icon elementor-social-icon-share-alt elementor-repeater-item-fe46285\" href=\"#elementor-action%3Aaction%3Dpopup%3Aopen%26settings%3DeyJpZCI6IjI3NDIiLCJ0b2dnbGUiOmZhbHNlLCJhbGlnbl93aXRoX3BhcmVudCI6IiJ9\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-screen-only\">Share-alt<\/span>\n\t\t\t\t\t\t<svg class=\"e-font-icon-svg e-fas-share-alt\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M352 320c-22.608 0-43.387 7.819-59.79 20.895l-102.486-64.054a96.551 96.551 0 0 0 0-41.683l102.486-64.054C308.613 184.181 329.392 192 352 192c53.019 0 96-42.981 96-96S405.019 0 352 0s-96 42.981-96 96c0 7.158.79 14.13 2.276 20.841L155.79 180.895C139.387 167.819 118.608 160 96 160c-53.019 0-96 42.981-96 96s42.981 96 96 96c22.608 0 43.387-7.819 59.79-20.895l102.486 64.054A96.301 96.301 0 0 0 256 416c0 53.019 42.981 96 96 96s96-42.981 96-96-42.981-96-96-96z\"><\/path><\/svg>\t\t\t\t\t<\/a>\n\t\t\t\t<\/span>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-58f9e312 elementor-section-height-min-height elementor-section-items-stretch elementor-section-boxed elementor-section-height-default\" data-id=\"58f9e312\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-473f948d\" data-id=\"473f948d\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-7cb2f4ce elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"7cb2f4ce\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-43ef344c\" data-id=\"43ef344c\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1eb8384b elementor-widget-mobile__width-auto elementor-widget elementor-widget-heading\" data-id=\"1eb8384b\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">Information<\/h5>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-5ee68e4e elementor-hidden-desktop elementor-hidden-tablet\" data-id=\"5ee68e4e\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-32ab345b elementor-widget__width-auto elementor-view-default elementor-widget elementor-widget-icon\" data-id=\"32ab345b\" data-element_type=\"widget\" data-widget_type=\"icon.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-icon-wrapper\">\n\t\t\t<div class=\"elementor-icon\">\n\t\t\t<i aria-hidden=\"true\" class=\"vamtamtheme- vamtam-theme-emergency-phone\"><\/i>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-193bdbba elementor-widget__width-auto elementor-widget elementor-widget-heading\" data-id=\"193bdbba\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\"><a href=\"tel:+%201%20541-754-3010\">+ 1 541-754-3010<\/a><\/h5>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-c8a0972 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"c8a0972\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-29c26a07\" data-id=\"29c26a07\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-233aa397 elementor-widget elementor-widget-heading\" data-id=\"233aa397\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Online Forms <\/h1>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-4c22f500 elementor-section-height-min-height elementor-section-items-stretch elementor-section-boxed elementor-section-height-default\" data-id=\"4c22f500\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-33b53cfa\" data-id=\"33b53cfa\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-277f53a8 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"277f53a8\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-7e5c0d7a\" data-id=\"7e5c0d7a\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-442dab8a elementor-align-left elementor-mobile-align-left elementor-widget-mobile__width-auto elementor-widget elementor-widget-button\" data-id=\"442dab8a\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"\/book-an-appointment\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Request Appointment ><\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-717584fc elementor-hidden-phone\" data-id=\"717584fc\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7a155a83 elementor-widget__width-auto elementor-view-default elementor-widget elementor-widget-icon\" data-id=\"7a155a83\" data-element_type=\"widget\" data-widget_type=\"icon.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-icon-wrapper\">\n\t\t\t<div class=\"elementor-icon\">\n\t\t\t<i aria-hidden=\"true\" class=\"vamtamtheme- vamtam-theme-emergency-phone\"><\/i>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4ca43cd2 elementor-widget__width-auto elementor-widget elementor-widget-heading\" data-id=\"4ca43cd2\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\"><a href=\"tel:+%201%20541-754-3010\">+ 1 541-754-3010<\/a><\/h5>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-b8be30d elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"b8be30d\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-cca827f\" data-id=\"cca827f\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-f563970 elementor-widget__width-auto elementor-widget elementor-widget-heading\" data-id=\"f563970\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Online Forms <\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d3fc45d elementor-widget elementor-widget-text-editor\" data-id=\"d3fc45d\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>Here are some important forms you to review and complete prior to your appointment with one of our physicians or provider.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4aa1716 elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"4aa1716\" data-element_type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/salute.vamtam.com\/wp-content\/uploads\/2020\/04\/Patient-Information-Form.pdf\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-far-file-pdf\" viewBox=\"0 0 384 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><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\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Screening Checklist for Visitors<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/salute.vamtam.com\/wp-content\/uploads\/2020\/04\/Patient-Information-Form.pdf\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-far-file-pdf\" viewBox=\"0 0 384 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><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\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">New Patient Enrollment Form<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/salute.vamtam.com\/wp-content\/uploads\/2020\/04\/Patient-Information-Form.pdf\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-far-file-pdf\" viewBox=\"0 0 384 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><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\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Medical History Form <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/salute.vamtam.com\/wp-content\/uploads\/2020\/04\/Patient-Information-Form.pdf\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-far-file-pdf\" viewBox=\"0 0 384 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><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\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Online Doctor Appointment Form<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/salute.vamtam.com\/wp-content\/uploads\/2020\/04\/Patient-Information-Form.pdf\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-far-file-pdf\" viewBox=\"0 0 384 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><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\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Psychiatric Evaluation Form<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/salute.vamtam.com\/wp-content\/uploads\/2020\/04\/Patient-Information-Form.pdf\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-far-file-pdf\" viewBox=\"0 0 384 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><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\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Quick Emergency Contact Form<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/salute.vamtam.com\/wp-content\/uploads\/2020\/04\/Patient-Information-Form.pdf\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-far-file-pdf\" viewBox=\"0 0 384 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><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\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Blood Donation Form<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/salute.vamtam.com\/wp-content\/uploads\/2020\/04\/Patient-Information-Form.pdf\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-far-file-pdf\" viewBox=\"0 0 384 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><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\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">HIPAA Privacy Restriction Questionnaire<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/salute.vamtam.com\/wp-content\/uploads\/2020\/04\/Patient-Information-Form.pdf\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-far-file-pdf\" viewBox=\"0 0 384 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><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\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Medical Release Form<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Print Envelope Share-alt Information + 1 541-754-3010 Online Forms Request Appointment > + 1 541-754-3010 Online Forms Here are some important forms you to review and complete prior to your appointment with one of our physicians or provider. Screening Checklist for Visitors New Patient Enrollment Form Medical History Form Online Doctor Appointment Form Psychiatric Evaluation&#8230;<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"inline_featured_image":false,"footnotes":""},"class_list":["post-505","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Online Forms - Dr Prity Sharma<\/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:\/\/drpritysharma.com\/?page_id=505\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Online Forms - Dr Prity Sharma\" \/>\n<meta property=\"og:description\" content=\"Print Envelope Share-alt Information + 1 541-754-3010 Online Forms Request Appointment &gt; + 1 541-754-3010 Online Forms Here are some important forms you to review and complete prior to your appointment with one of our physicians or provider. 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