{"id":86,"date":"2012-07-31T02:17:58","date_gmt":"2012-07-31T02:17:58","guid":{"rendered":"http:\/\/theme-fusion.com\/avada\/?page_id=86"},"modified":"2026-09-01T20:34:42","modified_gmt":"2026-09-02T03:34:42","slug":"contact-2","status":"publish","type":"page","link":"https:\/\/wallachdermacenter.com\/?page_id=86","title":{"rendered":"Visit us Page"},"content":{"rendered":"<div class=\"title\"><h2><span style=\"color: #97b8b2;\">REGISTRATION FORMS <\/span><\/h2><div class=\"title-sep-container\"><div class=\"title-sep\"><\/div><\/div><\/div><div class=\"one_half\">Please complete, sign and bring the New Patient Information Form to your first appointment.<\/p>\n<ul>\n<li><a href=\"http:\/\/wallachdermacenter.com\/wp-content\/uploads\/2025\/01\/Jan-2025-WDC-FULL-REGISTRATION-FORMS4-2.pdf\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"text-decoration: underline;\">Registration Form<\/span> &#8211; PDF<\/a><\/li>\n<li><a title=\"HIPPA patient information\" href=\"http:\/\/wallachdermacenter.com\/wp-content\/uploads\/2014\/05\/npp_WALLACH-DERMA-CENTER.pdf\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"text-decoration: underline;\">HIPAA Notice of Privacy <\/span>&#8211; PDF<\/a><\/li>\n<\/ul>\n<h3 style=\"text-align: left;\"><strong>Before Your Visit<\/strong><\/h3>\n<p>To ensure a smooth check-in experience, please bring the following:<\/p>\n<ul>\n<li>Completed and signed Patient Registration Form<\/li>\n<li>Signed HIPAA Privacy Acknowledgment<\/li>\n<li>Valid government-issued photo ID<\/li>\n<li>Current insurance card(s)<\/li>\n<li>Copayment (due at the time of service)<\/li>\n<\/ul>\n<p>We kindly ask that you <strong>arrive 15 minutes before your scheduled appointment<\/strong> so we can complete your registration and begin your visit on time.<\/p>\n<\/div>\n<div class=\"one_half last\">\n<img decoding=\"async\" src=\"http:\/\/wallachdermacenter.com\/wp-content\/uploads\/2025\/02\/AdamWallach_300px_B.png\" alt=\"\" \/><\/div><div class=\"clearboth\"><\/div>\n<div class=\"clearboth\"><\/div><div class=\"demo-sep sep-shadow\" style=\"margin-top:10px;margin-bottom:10px;\"><\/div>\n<p><span style=\"color: #97b8b2;\">To schedule an appointment by email,<\/span> please provide the following information and we will contact you.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>To schedule an appointment by email, please provide the following information and we will contact you.<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"contact.php","meta":[],"_links":{"self":[{"href":"https:\/\/wallachdermacenter.com\/index.php?rest_route=\/wp\/v2\/pages\/86"}],"collection":[{"href":"https:\/\/wallachdermacenter.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/wallachdermacenter.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/wallachdermacenter.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/wallachdermacenter.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=86"}],"version-history":[{"count":27,"href":"https:\/\/wallachdermacenter.com\/index.php?rest_route=\/wp\/v2\/pages\/86\/revisions"}],"predecessor-version":[{"id":5667,"href":"https:\/\/wallachdermacenter.com\/index.php?rest_route=\/wp\/v2\/pages\/86\/revisions\/5667"}],"wp:attachment":[{"href":"https:\/\/wallachdermacenter.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=86"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}