{"id":106,"date":"2026-07-29T11:35:57","date_gmt":"2026-07-29T11:35:57","guid":{"rendered":"https:\/\/developer.devsigntech.com\/pimrip\/?page_id=106"},"modified":"2026-07-30T21:39:04","modified_gmt":"2026-07-30T21:39:04","slug":"new-patient-forms","status":"publish","type":"page","link":"https:\/\/developer.devsigntech.com\/pimrip\/new-patient-forms\/","title":{"rendered":"New Patient Forms"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"106\" class=\"elementor elementor-106\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-becc57f e-con e-atomic-element e-flexbox-base e-637f8ac \" data-id=\"becc57f\" data-element_type=\"e-flexbox\" data-e-type=\"e-flexbox\" data-interaction-id=\"becc57f\" data-e-type=\"e-flexbox\" data-id=\"becc57f\">\n    \t\t<div class=\"elementor-element elementor-element-f78a9bf elementor-widget elementor-widget-spacer\" data-id=\"f78a9bf\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0a58121 elementor-widget elementor-widget-html\" data-id=\"0a58121\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t\t<style>\n\n.intake-section{\n    max-width:1100px;\n    margin:auto;\n    font-family:Arial,Helvetica,sans-serif;\n}\n\n.intake-header{\n    text-align:center;\n    margin-bottom:40px;\n}\n\n.intake-header h2{\n    color:#B3CE58;\n    font-size:42px;\n    font-weight:700;\n    margin-bottom:15px;\n}\n\n.intake-header p{\n    color:#666;\n    font-size:18px;\n    line-height:1.8;\n}\n\n\n\/* Alert *\/\n\n.form-alert{\n    background:#FFF5E8;\n    border-left:6px solid #B3CE58;\n    padding:28px;\n    border-radius:18px;\n    margin-bottom:35px;\n    text-align:center;\n}\n\n.form-alert h3{\n    color:#333;\n    font-size:26px;\n    margin-bottom:12px;\n}\n\n.form-alert p{\n    color:#666;\n    line-height:1.8;\n    margin:0;\n}\n\n.phone-btn{\n    display:inline-block;\n    margin-top:18px;\n    background:#B3CE58;\n    color:#fff;\n    padding:14px 30px;\n    border-radius:50px;\n    text-decoration:none;\n    font-weight:bold;\n    font-size:18px;\n}\n\n\n\/* Information Card *\/\n\n.info-card{\n    background:#fff;\n    border-radius:20px;\n    padding:35px;\n    box-shadow:0 12px 35px rgba(0,0,0,.08);\n    margin-bottom:30px;\n}\n\n.info-card h3{\n    color:#B3CE58;\n    font-size:28px;\n    margin-bottom:25px;\n}\n\n\n\/* Checklist *\/\n\n.check-list{\n    display:grid;\n    grid-template-columns:repeat(auto-fit,minmax(300px,1fr));\n    gap:18px;\n}\n\n.check-item{\n    display:flex;\n    gap:15px;\n    align-items:flex-start;\n    background:#F8FBF0;\n    padding:18px;\n    border-radius:14px;\n    color:#555;\n    line-height:1.6;\n}\n\n.check-icon{\n    background:#B3CE58;\n    color:#fff;\n    width:32px;\n    height:32px;\n    min-width:32px;\n    border-radius:50%;\n    display:flex;\n    align-items:center;\n    justify-content:center;\n    font-weight:bold;\n}\n\n\n\/* Important Note *\/\n\n.warning-box{\n    background:#F7FAEE;\n    border:2px solid #B3CE58;\n    border-radius:18px;\n    padding:28px;\n    margin-top:30px;\n}\n\n.warning-box h3{\n    color:#444;\n    margin-bottom:15px;\n}\n\n.warning-box p{\n    color:#666;\n    line-height:1.8;\n}\n\n\n\/* Link Box *\/\n\n.link-box{\n    text-align:center;\n    background:linear-gradient(135deg,#B3CE58,#CBE083);\n    padding:35px;\n    border-radius:20px;\n    color:#fff;\n    margin-top:35px;\n}\n\n.link-box h3{\n    font-size:28px;\n    margin-bottom:15px;\n}\n\n.form-link{\n    background:#fff;\n    color:#7A9B22;\n    padding:14px 25px;\n    border-radius:50px;\n    display:inline-block;\n    font-weight:bold;\n    text-decoration:none;\n    margin-top:15px;\n    word-break:break-all;\n}\n\n\n\/* Contact Alternative *\/\n\n.contact-box{\n    margin-top:35px;\n    text-align:center;\n    padding:30px;\n    background:#fff;\n    border-radius:18px;\n    box-shadow:0 10px 30px rgba(0,0,0,.08);\n}\n\n.contact-box h3{\n    color:#B3CE58;\n    font-size:26px;\n}\n\n.contact-box p{\n    color:#666;\n    line-height:1.8;\n}\n\n\n@media(max-width:768px){\n\n.intake-header h2{\n    font-size:30px;\n}\n\n.info-card{\n    padding:25px;\n}\n\n.check-list{\n    grid-template-columns:1fr;\n}\n\n}\n\n<\/style>\n\n\n<div class=\"intake-section\">\n\n\n<div class=\"intake-header\">\n\n<h2>New Patient Forms & Intake Information<\/h2>\n\n<p>\nWe look forward to welcoming your family to Pimri Pediatrics.\nPlease review the information below before beginning the new patient intake process.\n<\/p>\n\n<\/div>\n\n\n<div class=\"form-alert\">\n\n<h3>\u26a0\ufe0f New Patient Forms Temporarily Unavailable<\/h3>\n\n<p>\nThe online new patient forms link is currently not working.\nOur team is working to resolve this issue.\nIn the meantime, please call our office and we will help you begin the process.\n<\/p>\n\n<a class=\"phone-btn\" href=\"tel:4804855166\">\n\ud83d\udcde Call 480-485-5166\n<\/a>\n\n<\/div>\n\n\n\n<div class=\"info-card\">\n\n<h3>\ud83d\udccb Please Have This Information Ready<\/h3>\n\n\n<div class=\"check-list\">\n\n\n<div class=\"check-item\">\n<div class=\"check-icon\">\u2713<\/div>\n<div>Birthdates for all children.<\/div>\n<\/div>\n\n\n<div class=\"check-item\">\n<div class=\"check-icon\">\u2713<\/div>\n<div>\nFor newborns and infants: birth weight, length, and head circumference (if known).\n<\/div>\n<\/div>\n\n\n<div class=\"check-item\">\n<div class=\"check-icon\">\u2713<\/div>\n<div>\nNames of all medications, supplements, and herbal treatments.\n<\/div>\n<\/div>\n\n\n<div class=\"check-item\">\n<div class=\"check-icon\">\u2713<\/div>\n<div>\nDates of procedures, surgeries, hospitalizations, broken bones, and other significant medical events.\n<\/div>\n<\/div>\n\n\n<div class=\"check-item\">\n<div class=\"check-icon\">\u2713<\/div>\n<div>\nInsurance ID number and policy\/group number if using insurance. Please include secondary insurance information if applicable.\n<\/div>\n<\/div>\n\n\n<div class=\"check-item\">\n<div class=\"check-icon\">\u2713<\/div>\n<div>\nPictures of the front and back of your insurance card. For newborns, please upload a parent's insurance card.\n<\/div>\n<\/div>\n\n\n<div class=\"check-item\">\n<div class=\"check-icon\">\u2713<\/div>\n<div>\nA list of questions and concerns you would like addressed during your first visit. This helps us schedule enough time for your appointment.\n<\/div>\n<\/div>\n\n\n<\/div>\n\n<\/div>\n\n\n\n<div class=\"warning-box\">\n\n<h3>\u23f0 Important: Complete Forms in One Sitting<\/h3>\n\n<p>\nThe intake forms must be completed in one session.\nYou may transfer certain information between children, such as address,\nphone number, and family medical history. However, once you begin,\nyou will <strong>not be able to save your progress and return later<\/strong>.\n<\/p>\n\n<\/div>\n\n\n\n<div class=\"link-box\">\n\n<h3>Start Your New Patient Forms<\/h3>\n\n<p>\nClick the button below to begin your intake forms.\n<\/p>\n\n<a class=\"form-link\" href=\"https:\/\/pimri.cypher01.com\/patients\/options\" target=\"_blank\">\nBegin New Patient Forms\n<\/a>\n\n<\/div>\n\n\n\n<div class=\"contact-box\">\n\n<h3>Not Sure If Pimri Pediatrics Is The Right Fit?<\/h3>\n\n<p>\nIf you are still deciding whether our approach is right for your family,\nplease do <strong>not<\/strong> complete the intake forms yet.\nInstead, send us a message through our Contact Us page so our staff can\nanswer your questions and discuss your concerns.\n<\/p>\n\n<\/div>\n\n\n<\/div>\t\t\t\t<\/div>\n\t\t\n<\/div>\n\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>New Patient Forms &#038; Intake Information We look forward to welcoming your family to Pimri Pediatrics. Please review the information below before beginning the new patient intake process. \u26a0\ufe0f New Patient Forms Temporarily Unavailable The online new patient forms link is currently not working. Our team is working to resolve this issue. In the meantime, [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"footnotes":""},"class_list":["post-106","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/developer.devsigntech.com\/pimrip\/wp-json\/wp\/v2\/pages\/106","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/developer.devsigntech.com\/pimrip\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/developer.devsigntech.com\/pimrip\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/developer.devsigntech.com\/pimrip\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/developer.devsigntech.com\/pimrip\/wp-json\/wp\/v2\/comments?post=106"}],"version-history":[{"count":4,"href":"https:\/\/developer.devsigntech.com\/pimrip\/wp-json\/wp\/v2\/pages\/106\/revisions"}],"predecessor-version":[{"id":336,"href":"https:\/\/developer.devsigntech.com\/pimrip\/wp-json\/wp\/v2\/pages\/106\/revisions\/336"}],"wp:attachment":[{"href":"https:\/\/developer.devsigntech.com\/pimrip\/wp-json\/wp\/v2\/media?parent=106"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}