{"id":1293,"date":"2022-03-25T12:43:50","date_gmt":"2022-03-25T12:43:50","guid":{"rendered":"https:\/\/www.toplinemd.com\/medipath-pathology-services\/?page_id=1293"},"modified":"2022-03-25T13:15:38","modified_gmt":"2022-03-25T13:15:38","slug":"forms","status":"publish","type":"page","link":"https:\/\/www.toplinemd.com\/medipath-pathology-services\/forms\/","title":{"rendered":"Forms"},"content":{"rendered":"<p><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling fullwidth-padding-box\" style=\"--awb-background-position:left top;--awb-border-sizes-top:0px;--awb-border-sizes-bottom:0px;--awb-border-sizes-left:0px;--awb-border-sizes-right:0px;--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:5%;--awb-padding-bottom:5%;--awb-margin-bottom:0px;--awb-background-color:#f5f5f5;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-stretch fusion-flex-justify-content-center fusion-flex-content-wrap\" style=\"max-width:calc( 1170px + 0px );margin-left: calc(-0px \/ 2 );margin-right: calc(-0px \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_2_3 2_3 fusion-flex-column padding-wrapper\" style=\"--awb-padding-top:45px;--awb-padding-right:45px;--awb-padding-bottom:45px;--awb-padding-left:15px;--awb-bg-color:#ffffff;--awb-bg-color-hover:#ffffff;--awb-bg-size:cover;--awb-width-large:66.6666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:20px;--awb-spacing-left-large:0px;--awb-width-medium:100%;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-spacing-right-small:0px;--awb-spacing-left-small:0px;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-center fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1\" style=\"--awb-text-transform:none;--awb-margin-left:30px;\"><h2><i class=\"fas fa-file-pdf\"><\/i> Forms<\/h2>\n<\/div><div class=\"fusion-text fusion-text-2\" style=\"--awb-text-transform:none;\"><ul>\n<li><strong><a href=\"\/medipath-pathology-services\/wp-content\/uploads\/sites\/15\/2022\/03\/ABNEnglish2023v508.pdf\" target=\"_blank\" rel=\"noopener\">Advance Beneficiary Notice of Non-coverage (ABN)<\/a><\/strong><\/li>\n<li><strong><a href=\"\/medipath-pathology-services\/wp-content\/uploads\/sites\/15\/2022\/03\/ABNSpanish2023v50870820.pdf\" target=\"_blank\" rel=\"noopener\">Aviso anticipado de no cobertura al beneficiario (ABN)<\/a><\/strong><\/li>\n<li><strong><a href=\"\/medipath-pathology-services\/wp-content\/uploads\/sites\/15\/2022\/03\/MediPath-Collection-Devices-032122.pdf\" target=\"_blank\" rel=\"noopener\">MediPath Collection Devices<\/a><\/strong><\/li>\n<li><strong><a href=\"\/medipath-pathology-services\/wp-content\/uploads\/sites\/15\/2022\/03\/Laboratory-Financial-Consent-Form-03_21_2022_GS_MM_Final.pdf\" target=\"_blank\" rel=\"noopener\">Laboratory Financial Consent Form<\/a><\/strong><\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div><div class=\"fusion-bg-parallax\" data-bg-align=\"center center\" data-direction=\"up\" data-mute=\"false\" data-opacity=\"100\" data-velocity=\"-0.3\" data-mobile-enabled=\"false\" data-break_parents=\"0\" data-bg-image=\"https:\/\/www.toplinemd.com\/medipath-pathology-services\/wp-content\/uploads\/sites\/15\/2020\/02\/Request-an-appointmen-2.png\" data-bg-repeat=\"false\" data-bg-gradient-type=\"linear\" data-bg-gradient-angle=\"180\" data-bg-gradient-start-color=\"rgba(0,0,0,0.2)\" data-bg-gradient-start-position=\"0\" data-bg-gradient-end-color=\"rgba(255,255,255,0)\" data-bg-gradient-end-position=\"100\" data-bg-radial-direction=\"center center\" ><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2 fusion-parallax-up nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-sizes-top:0px;--awb-border-sizes-bottom:0px;--awb-border-sizes-left:0px;--awb-border-sizes-right:0px;--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:100px;--awb-padding-bottom:100px;--awb-background-image:linear-gradient(180deg, rgba(0,0,0,0.2) 0%,rgba(255,255,255,0) 100%),url(https:\/\/www.toplinemd.com\/medipath-pathology-services\/wp-content\/uploads\/sites\/15\/2020\/02\/Request-an-appointmen-2.png);;--awb-background-size:cover;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last fusion-column-no-min-height\" style=\"--awb-bg-blend:overlay;--awb-bg-size:cover;--awb-margin-bottom:0px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-3 fusion-text-no-margin\" style=\"--awb-margin-bottom:20px;\"><h2 class=\"entrust-health-title\">Entrust Your Health<br \/>\nTo Our Doctors<\/h2>\n<\/div><div class=\"fusion-aligncenter\"><a class=\"fusion-button button-flat button-large button-default fusion-button-default button-1 fusion-button-default-span \" style=\"--button_text_transform:uppercase;\" target=\"_self\" href=\"\/medipath-pathology-services\/contact-us\/\"><span class=\"fusion-button-text awb-button__text awb-button__text--default\">Contact Us<\/span><\/a><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div>\n<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-3 hundred-percent-fullwidth non-hundred-percent-height-scrolling fusion-equal-height-columns logos-footer\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:10px;--awb-padding-bottom:0px;--awb-padding-left:60px;--awb-background-color:#f0f3f6;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-first logo-footer\" style=\"--awb-padding-top:40px;--awb-bg-size:cover;width:50%;width:calc(50% - ( ( 0 ) * 0.5 ) );margin-right: 0px;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-image-element in-legacy-container\" style=\"--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><span class=\" fusion-imageframe imageframe-none imageframe-1 hover-type-none\"><a class=\"fusion-no-lightbox\" href=\"\/medipath-pathology-services\/\" target=\"_self\" aria-label=\"Medipath\"><img decoding=\"async\" width=\"270\" height=\"100\" alt=\"Medipath Topline logo\" src=\"https:\/\/www.toplinemd.com\/medipath-pathology-services\/wp-content\/uploads\/sites\/15\/2020\/06\/Medipath.png\" class=\"img-responsive wp-image-1230\" srcset=\"https:\/\/www.toplinemd.com\/medipath-pathology-services\/wp-content\/uploads\/sites\/15\/2020\/06\/Medipath-200x74.png 200w, https:\/\/www.toplinemd.com\/medipath-pathology-services\/wp-content\/uploads\/sites\/15\/2020\/06\/Medipath.png 270w\" sizes=\"(max-width: 850px) 100vw, 270px\" \/><\/a><\/span><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-3 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-last logo-footer\" style=\"--awb-padding-top:40px;--awb-bg-size:cover;width:50%;width:calc(50% - ( ( 0 ) * 0.5 ) );\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-image-element in-legacy-container\" style=\"--awb-max-width:270px;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><span class=\" fusion-imageframe imageframe-none imageframe-2 hover-type-none\"><a class=\"fusion-no-lightbox\" href=\"https:\/\/www.toplinemd.com\/\" target=\"_blank\" aria-label=\"TopLine MD-RegisterR_Stacked_Logo_rgb_color\" rel=\"noopener noreferrer\"><img decoding=\"async\" width=\"1576\" height=\"376\" src=\"https:\/\/www.toplinemd.com\/medipath-pathology-services\/wp-content\/uploads\/sites\/15\/2026\/03\/TopLine-MD-RegisterR_Stacked_Logo_rgb_color.png\" alt class=\"img-responsive wp-image-1387\" srcset=\"https:\/\/www.toplinemd.com\/medipath-pathology-services\/wp-content\/uploads\/sites\/15\/2026\/03\/TopLine-MD-RegisterR_Stacked_Logo_rgb_color-200x48.png 200w, https:\/\/www.toplinemd.com\/medipath-pathology-services\/wp-content\/uploads\/sites\/15\/2026\/03\/TopLine-MD-RegisterR_Stacked_Logo_rgb_color-400x95.png 400w, https:\/\/www.toplinemd.com\/medipath-pathology-services\/wp-content\/uploads\/sites\/15\/2026\/03\/TopLine-MD-RegisterR_Stacked_Logo_rgb_color-600x143.png 600w, https:\/\/www.toplinemd.com\/medipath-pathology-services\/wp-content\/uploads\/sites\/15\/2026\/03\/TopLine-MD-RegisterR_Stacked_Logo_rgb_color-800x191.png 800w, https:\/\/www.toplinemd.com\/medipath-pathology-services\/wp-content\/uploads\/sites\/15\/2026\/03\/TopLine-MD-RegisterR_Stacked_Logo_rgb_color-1200x286.png 1200w, https:\/\/www.toplinemd.com\/medipath-pathology-services\/wp-content\/uploads\/sites\/15\/2026\/03\/TopLine-MD-RegisterR_Stacked_Logo_rgb_color.png 1576w\" sizes=\"(max-width: 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class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div>\n<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":13,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"open","ping_status":"open","template":"100-width.php","meta":{"footnotes":"","_links_to":"","_links_to_target":""},"class_list":["post-1293","page","type-page","status-publish","hentry"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.toplinemd.com\/medipath-pathology-services\/wp-json\/wp\/v2\/pages\/1293","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.toplinemd.com\/medipath-pathology-services\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.toplinemd.com\/medipath-pathology-services\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.toplinemd.com\/medipath-pathology-services\/wp-json\/wp\/v2\/users\/13"}],"replies":[{"embeddable":true,"href":"https:\/\/www.toplinemd.com\/medipath-pathology-services\/wp-json\/wp\/v2\/comments?post=1293"}],"version-history":[{"count":0,"href":"https:\/\/www.toplinemd.com\/medipath-pathology-services\/wp-json\/wp\/v2\/pages\/1293\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.toplinemd.com\/medipath-pathology-services\/wp-json\/wp\/v2\/media?parent=1293"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}