{"id":758,"date":"2024-01-03T02:27:29","date_gmt":"2024-01-03T02:27:29","guid":{"rendered":"https:\/\/kristenherzel.com\/kmh\/?page_id=758"},"modified":"2024-11-01T19:57:32","modified_gmt":"2024-11-01T19:57:32","slug":"downloadable-forms","status":"publish","type":"page","link":"https:\/\/kristenherzel.com\/kmh\/downloadable-forms\/","title":{"rendered":"Downloadable Forms"},"content":{"rendered":"\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"731\" src=\"https:\/\/kristenherzel.com\/kmh\/wp-content\/uploads\/2024\/01\/Day-114-1024x731.jpg\" alt=\"\" class=\"wp-image-902\" srcset=\"https:\/\/kristenherzel.com\/kmh\/wp-content\/uploads\/2024\/01\/Day-114-1024x731.jpg 1024w, https:\/\/kristenherzel.com\/kmh\/wp-content\/uploads\/2024\/01\/Day-114-300x214.jpg 300w, https:\/\/kristenherzel.com\/kmh\/wp-content\/uploads\/2024\/01\/Day-114-768x549.jpg 768w, https:\/\/kristenherzel.com\/kmh\/wp-content\/uploads\/2024\/01\/Day-114-1536x1097.jpg 1536w, https:\/\/kristenherzel.com\/kmh\/wp-content\/uploads\/2024\/01\/Day-114-2048x1463.jpg 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<p><strong>Developmental History Questionnaire<\/strong>&nbsp;form.&nbsp;&nbsp;&nbsp;<a href=\"https:\/\/kristenherzel.com\/kmh\/forms\/Developmental%20History%20Questionaire%20-%20Dr.%20Kristen%20Herzel.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">PDF<\/a>&nbsp;&nbsp;&nbsp;<a href=\"https:\/\/kristenherzel.com\/kmh\/forms\/Developmental%20History%20Questionaire%20-%20Dr.%20Kristen%20Herzel.doc\" target=\"_blank\" rel=\"noreferrer noopener\">DOC<\/a><\/p>\n\n\n\n<p><strong>Assessment Consen<\/strong>t form. &nbsp;&nbsp;&nbsp;<a href=\"https:\/\/kristenherzel.com\/kmh\/forms\/Assessment%20Consent%20Form%20-%20Dr.%20Kristen%20Herzel.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">PDF<\/a><\/p>\n\n\n\n<p><strong>Confidential Authorization To Release Information<\/strong>\u00a0form.\u00a0\u00a0\u00a0<a href=\"https:\/\/kristenherzel.com\/kmh\/forms\/Confidential%20Authorization%20To%20Release%20Information%20Form%20-%20Dr.%20Kristen%20Herzel.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">PDF<\/a>    <a href=\"https:\/\/kristenherzel.com\/kmh\/forms\/Confidential%20Authorization%20To%20Release%20Information%20Form%20-%20Dr.%20Kristen%20Herzel.doc\" target=\"_blank\" rel=\"noreferrer noopener\">DOC<\/a><\/p>\n\n\n\n<p><strong>Email Agreement<\/strong> form. &nbsp;&nbsp;<a href=\"https:\/\/kristenherzel.com\/kmh\/forms\/Email%20Agreement%20Form%20-%20Dr.%20Kristen%20Herzel.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">PDF<\/a>&nbsp;<\/p>\n\n\n\n<p><strong>Your Rights to Privacy under HIPAA<\/strong>. &nbsp;&nbsp;&nbsp;<a href=\"\/kmh\/forms\/HIPAA_Form.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">PDF<\/a><\/p>\n\n\n\n<p><strong>Acknowledgement of Receipt of Dr. Kristen Herzel&#8217;s Notice of Privacy Practices<\/strong> form.&nbsp;&nbsp;&nbsp;<a href=\"https:\/\/kristenherzel.com\/kmh\/forms\/Acknowledgement%20of%20Receipt%20of%20Notice%20of%20Privacy%20Practices%20Form%20-%20Dr.%20Kristen%20Herzel.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">PDF<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Developmental History Questionnaire&nbsp;form.&nbsp;&nbsp;&nbsp;PDF&nbsp;&nbsp;&nbsp;DOC Assessment Consent form. &nbsp;&nbsp;&nbsp;PDF Confidential Authorization To Release Information\u00a0form.\u00a0\u00a0\u00a0PDF DOC Email Agreement form. &nbsp;&nbsp;PDF&nbsp; Your Rights to Privacy under HIPAA. &nbsp;&nbsp;&nbsp;PDF Acknowledgement of Receipt of Dr. Kristen Herzel&#8217;s Notice of Privacy Practices form.&nbsp;&nbsp;&nbsp;PDF<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_gspb_post_css":"","footnotes":""},"class_list":["post-758","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/kristenherzel.com\/kmh\/wp-json\/wp\/v2\/pages\/758","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kristenherzel.com\/kmh\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/kristenherzel.com\/kmh\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/kristenherzel.com\/kmh\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kristenherzel.com\/kmh\/wp-json\/wp\/v2\/comments?post=758"}],"version-history":[{"count":15,"href":"https:\/\/kristenherzel.com\/kmh\/wp-json\/wp\/v2\/pages\/758\/revisions"}],"predecessor-version":[{"id":976,"href":"https:\/\/kristenherzel.com\/kmh\/wp-json\/wp\/v2\/pages\/758\/revisions\/976"}],"wp:attachment":[{"href":"https:\/\/kristenherzel.com\/kmh\/wp-json\/wp\/v2\/media?parent=758"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}