{"id":9926,"date":"2021-04-28T14:33:32","date_gmt":"2021-04-28T18:33:32","guid":{"rendered":"https:\/\/amortho.com\/medical-questionnaire-for-patients\/"},"modified":"2021-06-10T11:07:26","modified_gmt":"2021-06-10T15:07:26","slug":"medical-quest","status":"publish","type":"page","link":"https:\/\/amortho.com\/en\/medical-quest\/","title":{"rendered":"Medical questionnaire for patients"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; admin_label=&#8221;COVID FORM HEADER&#8221; _builder_version=&#8221;4.4.3&#8243; custom_padding=&#8221;0px||0px|||&#8221; da_disable_devices=&#8221;off|off|off&#8221; saved_tabs=&#8221;all&#8221; da_is_popup=&#8221;off&#8221; da_exit_intent=&#8221;off&#8221; da_has_close=&#8221;on&#8221; da_alt_close=&#8221;off&#8221; da_dark_close=&#8221;off&#8221; da_not_modal=&#8221;on&#8221; da_is_singular=&#8221;off&#8221; da_with_loader=&#8221;off&#8221; da_has_shadow=&#8221;on&#8221;][et_pb_row column_structure=&#8221;1_2,1_2&#8243; make_equal=&#8221;on&#8221; custom_padding_last_edited=&#8221;on|phone&#8221; _builder_version=&#8221;4.4.7&#8243; background_color=&#8221;#ffffff&#8221; width=&#8221;100%&#8221; width_tablet=&#8221;&#8221; width_phone=&#8221;100%&#8221; width_last_edited=&#8221;on|desktop&#8221; max_width=&#8221;2560px&#8221; module_alignment=&#8221;center&#8221; custom_margin=&#8221;||||false|false&#8221; custom_padding=&#8221;0px||72px||false|false&#8221; custom_padding_tablet=&#8221;&#8221; custom_padding_phone=&#8221;0px||||false|false&#8221; border_color_all=&#8221;rgba(0,0,0,0)&#8221; locked=&#8221;off&#8221;][et_pb_column type=&#8221;1_2&#8243; module_class=&#8221;ds-vertical-align&#8221; _builder_version=&#8221;4.4.7&#8243; custom_padding=&#8221;0%|||6%|false|false&#8221; custom_padding_tablet=&#8221;0%|10%||10%&#8221; custom_padding_phone=&#8221;0%||0px||false|false&#8221; custom_padding_last_edited=&#8221;on|desktop&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_text _builder_version=&#8221;4.4.7&#8243; text_font=&#8221;||||||||&#8221; header_font=&#8221;||||||||&#8221; width=&#8221;100%&#8221; width_tablet=&#8221;100%&#8221; width_phone=&#8221;100%&#8221; width_last_edited=&#8221;on|phone&#8221; custom_margin=&#8221;0px||1%||false|false&#8221; custom_margin_tablet=&#8221;5%||||false|false&#8221; custom_margin_phone=&#8221;15%||2%||false|false&#8221; custom_margin_last_edited=&#8221;on|phone&#8221; custom_padding=&#8221;|||||&#8221; animation_style=&#8221;fade&#8221; header_font_size_phone=&#8221;30px&#8221; header_font_size_last_edited=&#8221;off|desktop&#8221; locked=&#8221;off&#8221; header_font_size__hover_enabled=&#8221;off|desktop&#8221;]<\/p>\n<h1>MEDICAL QUESTIONNAIRE <span style=\"color: #25a8ea;\">FOR NEW PATIENTS<\/span><\/h1>\n<p>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.4.7&#8243; header_3_font=&#8221;|||on|||||&#8221; max_width=&#8221;90%&#8221; max_width_tablet=&#8221;100%&#8221; max_width_phone=&#8221;100%&#8221; max_width_last_edited=&#8221;on|tablet&#8221; module_alignment=&#8221;left&#8221; custom_margin=&#8221;||12px||false|false&#8221; custom_padding=&#8221;|5%||0%|false|false&#8221; custom_padding_tablet=&#8221;|5%|0%|5%|false|false&#8221; custom_padding_phone=&#8221;|0%|0%|0%|false|false&#8221; custom_padding_last_edited=&#8221;on|desktop&#8221; animation_style=&#8221;fade&#8221; locked=&#8221;off&#8221;]<\/p>\n<h3>Welcome to our clinic<\/h3>\n<p>To become better acquainted and to be able to offer you the best possible care, we ask that you complete both sides of this Information Form. All information will be kept in the strictest confidence. <span style=\"text-decoration: underline;\">The responsible person for the orthodontic treatment decisions should be present at the first consultation.<\/span><\/p>\n<p>[\/et_pb_text][et_pb_button button_url=&#8221;#our-service&#8221; button_text=&#8221;FILL THE QUESTIONNAIRE NOW&#8221; _builder_version=&#8221;4.4.7&#8243; custom_button=&#8221;on&#8221; button_icon=&#8221;%%93%%&#8221; button_icon_color=&#8221;#ffffff&#8221; button_icon_placement=&#8221;left&#8221; button_on_hover=&#8221;off&#8221; custom_margin=&#8221;7px||14px||false|false&#8221; custom_padding=&#8221;|||31px|false|false&#8221; animation_style=&#8221;fade&#8221;][\/et_pb_button][\/et_pb_column][et_pb_column type=&#8221;1_2&#8243; module_class=&#8221;ds-vertical-align&#8221; _builder_version=&#8221;3.29.3&#8243; background_enable_image=&#8221;off&#8221; parallax=&#8221;on&#8221; custom_padding=&#8221;|||&#8221; custom_padding_tablet=&#8221;&#8221; custom_padding_phone=&#8221;||0px||false|false&#8221; custom_padding_last_edited=&#8221;on|desktop&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_image src=&#8221;https:\/\/amortho.com\/wp-content\/uploads\/2021\/04\/Archambault-Morton-Orthodontist-questionnaire-medical-2.jpg&#8221; alt=&#8221;Archambault-Morton-Orthodontist-questionnaire-medical-1&#8243; title_text=&#8221;Archambault-Morton-Orthodontist-questionnaire-medical-2&#8243; _builder_version=&#8221;4.4.7&#8243; custom_margin=&#8221;||-30px||false|false&#8221; custom_margin_tablet=&#8221;||0px||false|false&#8221; custom_margin_phone=&#8221;||0px||false|false&#8221; custom_margin_last_edited=&#8221;on|desktop&#8221; animation_style=&#8221;slide&#8221; animation_direction=&#8221;right&#8221; animation_duration=&#8221;1400ms&#8221; animation_intensity_slide=&#8221;3%&#8221; box_shadow_style=&#8221;preset2&#8243; box_shadow_horizontal=&#8221;-13px&#8221; box_shadow_vertical=&#8221;12px&#8221; box_shadow_blur=&#8221;35px&#8221; box_shadow_spread=&#8221;-8px&#8221; box_shadow_color=&#8221;rgba(0,0,0,0.43)&#8221;][\/et_pb_image][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>MEDICAL QUESTIONNAIRE FOR NEW PATIENTSWelcome to our clinic To become better acquainted and to be able to offer you the best possible care, we ask that you complete both sides of this Information Form. 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