{"id":200,"date":"2020-08-12T14:22:47","date_gmt":"2020-08-12T18:22:47","guid":{"rendered":"https:\/\/chelmsfordhearinggroup.fm1.dev\/practice\/patient-forms\/"},"modified":"2022-09-28T18:55:40","modified_gmt":"2022-09-28T22:55:40","slug":"patient-forms","status":"publish","type":"page","link":"https:\/\/massachusettshearinggroup.com\/practice\/patient-forms\/","title":{"rendered":"Patient Forms"},"content":{"rendered":"\n<div class=\"wp-block-file\"><a id=\"wp-block-file--media-09c08748-0f17-4f21-9068-6289ba1da0e2\" href=\"https:\/\/massachusettshearinggroup.com\/wp-content\/uploads\/2020\/08\/chg_hearing_health_assessment_v12-2.pdf\">New Patient Hearing Health Assessment<\/a><a href=\"https:\/\/massachusettshearinggroup.com\/wp-content\/uploads\/2020\/08\/chg_hearing_health_assessment_v12-2.pdf\" class=\"wp-block-file__button\" download aria-describedby=\"wp-block-file--media-09c08748-0f17-4f21-9068-6289ba1da0e2\">Download<\/a><\/div>\n\n\n\n<div class=\"wp-block-file\"><a id=\"wp-block-file--media-618759ae-0bee-425e-9108-a8a4abd56841\" href=\"https:\/\/massachusettshearinggroup.com\/wp-content\/uploads\/2020\/08\/new-patient-companion-questionnaire.pdf\">New Patient Hearing Handicap Inventory<\/a><a href=\"https:\/\/massachusettshearinggroup.com\/wp-content\/uploads\/2020\/08\/new-patient-companion-questionnaire.pdf\" class=\"wp-block-file__button\" download aria-describedby=\"wp-block-file--media-618759ae-0bee-425e-9108-a8a4abd56841\">Download<\/a><\/div>\n\n\n\n<div class=\"wp-block-file\"><a id=\"wp-block-file--media-fece8c0a-2ac8-4746-a915-ccd0080aa6a5\" href=\"https:\/\/massachusettshearinggroup.com\/wp-content\/uploads\/2020\/08\/chg_july_hipaa_statement_letter_v7-1.pdf\">Practice Privacy Policy (HIPAA Statement)<\/a><a href=\"https:\/\/massachusettshearinggroup.com\/wp-content\/uploads\/2020\/08\/chg_july_hipaa_statement_letter_v7-1.pdf\" class=\"wp-block-file__button\" download aria-describedby=\"wp-block-file--media-fece8c0a-2ac8-4746-a915-ccd0080aa6a5\">Download<\/a><\/div>\n\n\n\n<div class=\"wp-block-file\"><a id=\"wp-block-file--media-8d4971ae-ea22-4032-abd7-a587523e5882\" href=\"https:\/\/massachusettshearinggroup.com\/wp-content\/uploads\/2020\/08\/practice-privacy-polica-acknowledgement-form.pdf\">Practice Privacy Policy Acknowledgment Form<\/a><a href=\"https:\/\/massachusettshearinggroup.com\/wp-content\/uploads\/2020\/08\/practice-privacy-polica-acknowledgement-form.pdf\" class=\"wp-block-file__button\" download aria-describedby=\"wp-block-file--media-8d4971ae-ea22-4032-abd7-a587523e5882\">Download<\/a><\/div>\n\n\n\n<div class=\"pf-link\">\n\t<a target=\"_blank\" class=\"download-link\" href=\"https:\/\/allegrocredit.com\/apply\/BEAA0053-E5C7-65E1-2A42C3F0B0C445DC\/\" rel=\"noopener noreferrer\">Better Hearing Plan application for Massachusetts patients<\/a>\n\t<a target=\"_blank\" class=\"download\" href=\"https:\/\/allegrocredit.com\/apply\/BEAA0053-E5C7-65E1-2A42C3F0B0C445DC\/\" rel=\"noopener noreferrer\">Click<\/a>\n<\/div>\n\n\n\n<div class=\"pf-link\">\n\t<a target=\"_blank\" class=\"download-link\" href=\"https:\/\/allegrocredit.com\/apply\/2FFFC873-E5C7-65E1-2A490AADCD5DCB44\/\" rel=\"noopener noreferrer\">Better Hearing Plan application for Nashua patients<\/a>\n\t<a target=\"_blank\" class=\"download\" href=\"https:\/\/allegrocredit.com\/apply\/2FFFC873-E5C7-65E1-2A490AADCD5DCB44\/\" rel=\"noopener noreferrer\">Click<\/a>\n<\/div>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" width=\"1280\" height=\"852\" src=\"https:\/\/massachusettshearinggroup.com\/wp-content\/uploads\/2020\/09\/iStock-1124735714_web.jpg\" alt=\"\" class=\"wp-image-357\" srcset=\"https:\/\/massachusettshearinggroup.com\/wp-content\/uploads\/2020\/09\/iStock-1124735714_web.jpg 1280w, https:\/\/massachusettshearinggroup.com\/wp-content\/uploads\/2020\/09\/iStock-1124735714_web-768x511.jpg 768w\" sizes=\"(max-width: 1280px) 100vw, 1280px\" \/><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>Better Hearing Plan application for Massachusetts patients Click Better Hearing Plan application for Nashua patients Click<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":111,"menu_order":6,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_seopress_robots_primary_cat":"","_seopress_titles_title":"","_seopress_titles_desc":"","_seopress_robots_index":"","schema":"","fname":"","lname":"","position":"","credentials":"","placeID":"","no_match":false,"name":"","company":"","review":"","address":"","city":"","state":"","zip":"","lat":"","lng":"","phone1":"","phone2":"","fax":"","mon1":"","mon2":"","tue1":"","tue2":"","wed1":"","wed2":"","thu1":"","thu2":"","fri1":"","fri2":"","sat1":"","sat2":"","sun1":"","sun2":"","hours-note":"","footnotes":""},"service_tags":[],"class_list":["post-200","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/massachusettshearinggroup.com\/wp-json\/wp\/v2\/pages\/200","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/massachusettshearinggroup.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/massachusettshearinggroup.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/massachusettshearinggroup.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/massachusettshearinggroup.com\/wp-json\/wp\/v2\/comments?post=200"}],"version-history":[{"count":2,"href":"https:\/\/massachusettshearinggroup.com\/wp-json\/wp\/v2\/pages\/200\/revisions"}],"predecessor-version":[{"id":2039,"href":"https:\/\/massachusettshearinggroup.com\/wp-json\/wp\/v2\/pages\/200\/revisions\/2039"}],"up":[{"embeddable":true,"href":"https:\/\/massachusettshearinggroup.com\/wp-json\/wp\/v2\/pages\/111"}],"wp:attachment":[{"href":"https:\/\/massachusettshearinggroup.com\/wp-json\/wp\/v2\/media?parent=200"}],"wp:term":[{"taxonomy":"service_tags","embeddable":true,"href":"https:\/\/massachusettshearinggroup.com\/wp-json\/wp\/v2\/service_tags?post=200"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}