{"id":498,"date":"2019-04-16T12:28:27","date_gmt":"2019-04-16T11:28:27","guid":{"rendered":"http:\/\/www.windpeds.com\/?page_id=498"},"modified":"2026-05-20T17:41:50","modified_gmt":"2026-05-20T17:41:50","slug":"forms-policies","status":"publish","type":"page","link":"https:\/\/www.windpeds.com\/es\/our-office\/forms-policies\/","title":{"rendered":"Forms &#038; Policies"},"content":{"rendered":"<div data-elementor-type=\"wp-page\" data-elementor-id=\"498\" class=\"elementor elementor-498\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c0e7f74 e-flex e-con-boxed e-con e-parent\" data-id=\"c0e7f74\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-9c43ea2 e-flex e-con-boxed e-con e-parent\" data-id=\"9c43ea2\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-8cd1a8c elementor-widget elementor-widget-heading\" data-id=\"8cd1a8c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Online forms<\/h2>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-4fef679 e-flex e-con-boxed e-con e-parent\" data-id=\"4fef679\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-b58fbbb e-con-full e-flex e-con e-child\" data-id=\"b58fbbb\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d717a10 elementor-widget elementor-widget-heading\" data-id=\"d717a10\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Solicitud de cita<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-523da5d elementor-widget elementor-widget-button\" data-id=\"523da5d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm elementor-animation-float\" href=\"https:\/\/form.jotform.com\/91271180832453\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-external-link-alt\" viewbox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M432,320H400a16,16,0,0,0-16,16V448H64V128H208a16,16,0,0,0,16-16V80a16,16,0,0,0-16-16H48A48,48,0,0,0,0,112V464a48,48,0,0,0,48,48H400a48,48,0,0,0,48-48V336A16,16,0,0,0,432,320ZM488,0h-128c-21.37,0-32.05,25.91-17,41l35.73,35.73L135,320.37a24,24,0,0,0,0,34L157.67,377a24,24,0,0,0,34,0L435.28,133.32,471,169c15,15,41,4.5,41-17V24A24,24,0,0,0,488,0Z\"><\/path><\/svg>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Visit Link<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-bdb72d5 e-con-full e-flex e-con e-child\" data-id=\"bdb72d5\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-aa2f54e elementor-widget elementor-widget-heading\" data-id=\"aa2f54e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Portal del paciente<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0e85ec4 elementor-widget elementor-widget-button\" data-id=\"0e85ec4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm elementor-animation-float\" href=\"https:\/\/wpfl.pcc.com\/portal\/session\/new\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-external-link-alt\" viewbox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M432,320H400a16,16,0,0,0-16,16V448H64V128H208a16,16,0,0,0,16-16V80a16,16,0,0,0-16-16H48A48,48,0,0,0,0,112V464a48,48,0,0,0,48,48H400a48,48,0,0,0,48-48V336A16,16,0,0,0,432,320ZM488,0h-128c-21.37,0-32.05,25.91-17,41l35.73,35.73L135,320.37a24,24,0,0,0,0,34L157.67,377a24,24,0,0,0,34,0L435.28,133.32,471,169c15,15,41,4.5,41-17V24A24,24,0,0,0,488,0Z\"><\/path><\/svg>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Visit Link<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-8b0fae1 e-con-full e-flex e-con e-child\" data-id=\"8b0fae1\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-81d8156 elementor-widget elementor-widget-heading\" data-id=\"81d8156\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Referral Request<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-859658e elementor-widget elementor-widget-button\" data-id=\"859658e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm elementor-animation-float\" href=\"https:\/\/form.jotform.com\/91264057572459\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-external-link-alt\" viewbox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M432,320H400a16,16,0,0,0-16,16V448H64V128H208a16,16,0,0,0,16-16V80a16,16,0,0,0-16-16H48A48,48,0,0,0,0,112V464a48,48,0,0,0,48,48H400a48,48,0,0,0,48-48V336A16,16,0,0,0,432,320ZM488,0h-128c-21.37,0-32.05,25.91-17,41l35.73,35.73L135,320.37a24,24,0,0,0,0,34L157.67,377a24,24,0,0,0,34,0L435.28,133.32,471,169c15,15,41,4.5,41-17V24A24,24,0,0,0,488,0Z\"><\/path><\/svg>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Visit Link<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-912f3eb e-flex e-con-boxed e-con e-parent\" data-id=\"912f3eb\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-8192d2d elementor-widget elementor-widget-heading\" data-id=\"8192d2d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Download forms<\/h2>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-2b840f4 e-flex e-con-boxed e-con e-parent\" data-id=\"2b840f4\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-68f6064 e-con-full e-flex e-con e-child\" data-id=\"68f6064\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-5a57ae4 elementor-widget elementor-widget-heading\" data-id=\"5a57ae4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">You may download and print any of the forms listed below before coming to our office. You may either bring them with you to your visit or fax them to us before your appointment. To view our forms, you will need Adobe Reader.<\/p>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-624207c e-con-full e-flex e-con e-child\" data-id=\"624207c\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f83c092 elementor-widget elementor-widget-heading\" data-id=\"f83c092\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">New Patient Packet [PDF]<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-026bf96 elementor-widget elementor-widget-button\" data-id=\"026bf96\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm elementor-animation-float\" href=\"https:\/\/www.windpeds.com\/wp-content\/uploads\/2025\/03\/New-Patient-Packet-1.pdf\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-cloud-download-alt\" viewbox=\"0 0 640 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M537.6 226.6c4.1-10.7 6.4-22.4 6.4-34.6 0-53-43-96-96-96-19.7 0-38.1 6-53.3 16.2C367 64.2 315.3 32 256 32c-88.4 0-160 71.6-160 160 0 2.7.1 5.4.2 8.1C40.2 219.8 0 273.2 0 336c0 79.5 64.5 144 144 144h368c70.7 0 128-57.3 128-128 0-61.9-44-113.6-102.4-125.4zm-132.9 88.7L299.3 420.7c-6.2 6.2-16.4 6.2-22.6 0L171.3 315.3c-10.1-10.1-2.9-27.3 11.3-27.3H248V176c0-8.8 7.2-16 16-16h48c8.8 0 16 7.2 16 16v112h65.4c14.2 0 21.4 17.2 11.3 27.3z\"><\/path><\/svg>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Download form<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-7113856 e-con-full e-flex e-con e-child\" data-id=\"7113856\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-715c705 elementor-widget elementor-widget-heading\" data-id=\"715c705\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Health Information Disclosure Statement [PDF]<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b4b331c elementor-widget elementor-widget-button\" data-id=\"b4b331c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm elementor-animation-float\" href=\"http:\/\/www.windpeds.com\/wp-content\/uploads\/2019\/04\/health-info-disclosure-statement.pdf\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-cloud-download-alt\" viewbox=\"0 0 640 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M537.6 226.6c4.1-10.7 6.4-22.4 6.4-34.6 0-53-43-96-96-96-19.7 0-38.1 6-53.3 16.2C367 64.2 315.3 32 256 32c-88.4 0-160 71.6-160 160 0 2.7.1 5.4.2 8.1C40.2 219.8 0 273.2 0 336c0 79.5 64.5 144 144 144h368c70.7 0 128-57.3 128-128 0-61.9-44-113.6-102.4-125.4zm-132.9 88.7L299.3 420.7c-6.2 6.2-16.4 6.2-22.6 0L171.3 315.3c-10.1-10.1-2.9-27.3 11.3-27.3H248V176c0-8.8 7.2-16 16-16h48c8.8 0 16 7.2 16 16v112h65.4c14.2 0 21.4 17.2 11.3 27.3z\"><\/path><\/svg>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Download form<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-94a6d8a e-flex e-con-boxed e-con e-parent\" data-id=\"94a6d8a\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1666363 elementor-widget elementor-widget-heading\" data-id=\"1666363\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Office Policies<\/h2>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-30db717 e-flex e-con-boxed e-con e-parent\" data-id=\"30db717\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-22b426f e-con-full e-flex e-con e-child\" data-id=\"22b426f\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-b218798 elementor-widget elementor-widget-heading\" data-id=\"b218798\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Office Policies<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b97266b elementor-widget elementor-widget-button\" data-id=\"b97266b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm elementor-animation-float\" href=\"https:\/\/www.windpeds.com\/wp-content\/uploads\/2026\/05\/Windermere_Pediatrics_Office_Policies_v2.pdf\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-cloud-download-alt\" viewbox=\"0 0 640 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M537.6 226.6c4.1-10.7 6.4-22.4 6.4-34.6 0-53-43-96-96-96-19.7 0-38.1 6-53.3 16.2C367 64.2 315.3 32 256 32c-88.4 0-160 71.6-160 160 0 2.7.1 5.4.2 8.1C40.2 219.8 0 273.2 0 336c0 79.5 64.5 144 144 144h368c70.7 0 128-57.3 128-128 0-61.9-44-113.6-102.4-125.4zm-132.9 88.7L299.3 420.7c-6.2 6.2-16.4 6.2-22.6 0L171.3 315.3c-10.1-10.1-2.9-27.3 11.3-27.3H248V176c0-8.8 7.2-16 16-16h48c8.8 0 16 7.2 16 16v112h65.4c14.2 0 21.4 17.2 11.3 27.3z\"><\/path><\/svg>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Download pdf<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-87b532f e-con-full e-flex e-con e-child\" data-id=\"87b532f\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-689670e elementor-widget elementor-widget-heading\" data-id=\"689670e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Notice of Privacy Practices [pdf]<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c8b6f3d elementor-widget elementor-widget-button\" data-id=\"c8b6f3d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm elementor-animation-float\" href=\"http:\/\/www.windpeds.com\/wp-content\/uploads\/2019\/04\/npp.pdf\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-external-link-alt\" viewbox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M432,320H400a16,16,0,0,0-16,16V448H64V128H208a16,16,0,0,0,16-16V80a16,16,0,0,0-16-16H48A48,48,0,0,0,0,112V464a48,48,0,0,0,48,48H400a48,48,0,0,0,48-48V336A16,16,0,0,0,432,320ZM488,0h-128c-21.37,0-32.05,25.91-17,41l35.73,35.73L135,320.37a24,24,0,0,0,0,34L157.67,377a24,24,0,0,0,34,0L435.28,133.32,471,169c15,15,41,4.5,41-17V24A24,24,0,0,0,488,0Z\"><\/path><\/svg>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Download pdf<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-e369eb0 e-con-full e-flex e-con e-child\" data-id=\"e369eb0\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-74114691 e-flex e-con-boxed e-con e-parent\" data-id=\"74114691\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-7fd04b27 elementor-widget elementor-widget-text-editor\" data-id=\"7fd04b27\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h2>En esta secci\u00f3n<\/h2><ul class=\"lst_of_left\"><li><span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.windpeds.com\/es\/our-office\/\">Our Location<\/a><\/span><\/li><li><span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.windpeds.com\/es\/our-office\/forms-policies\/\">Forms &amp; Policies<\/a><\/span><\/li><li><span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.windpeds.com\/es\/our-office\/billing-insurance\/\">Billing &amp; Insurance<\/a><\/span><\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Online forms Appointment Request Visit Link Patient Portal Visit Link Referral Request Visit Link Download forms You may download and print any of the forms listed below before coming to our office. You may either bring them with you to your visit or fax them to us before your appointment. 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