{"id":677,"date":"2026-05-12T09:48:38","date_gmt":"2026-05-12T09:48:38","guid":{"rendered":"https:\/\/webpro.us\/dev\/rdd\/?page_id=677"},"modified":"2026-05-29T19:34:55","modified_gmt":"2026-05-29T19:34:55","slug":"forms","status":"publish","type":"page","link":"https:\/\/webpro.us\/dev\/rdd\/new-patients\/forms\/","title":{"rendered":"New Patient Form"},"content":{"rendered":"<div class=\"et_pb_section_0 et_pb_section et_section_regular et_flex_section\">\n<div class=\"et_pb_row_0 et_pb_row et_flex_row\">\n<div class=\"et_pb_column_0 et_pb_column et-last-child et_flex_column et_pb_css_mix_blend_mode_passthrough et_flex_column_24_24 et_flex_column_24_24_tablet et_flex_column_24_24_phone et_flex_column_24_24_widescreen et_flex_column_24_24_ultraWide\">\n<div class=\"et_pb_heading_0 et_pb_heading et_pb_module et_flex_module\"><div class=\"et_pb_heading_container\"><h1 class=\"et_pb_module_header\">Request Your New Patient Forms<\/h1><\/div><\/div>\n<\/div>\n<\/div>\n<\/div>\n\n<div class=\"et_pb_section_1 et_pb_section et_section_regular et_flex_section et_animated\">\n<div class=\"et_pb_row_1 et_pb_row et_flex_row\">\n<div class=\"et_pb_column_1 et_pb_column et-last-child et_flex_column et_pb_css_mix_blend_mode_passthrough et_flex_column_24_24 et_flex_column_24_24_tablet et_flex_column_24_24_phone et_flex_column_24_24_widescreen et_flex_column_24_24_ultraWide\">\n<div class=\"et_pb_text_0 et_pb_text et_pb_bg_layout_light et_pb_module et_flex_module preset--group--divi-text--divi-font-body--default\"><div class=\"et_pb_text_inner\"><p>Welcome to Rainwater Drake Dental. Please enter your information below to request new patient paperwork. Alternatively, you can text us at <span><a href=\"sms:+15012245511\">(501) 224-5511<\/a> or email us at <a href=\"mailto:admin@rainwaterdrake.com\">admin@rainwaterdrake.com<\/a> to request the forms.<\/span><\/p>\n<\/div><\/div>\n<\/div>\n<\/div>\n\n<div class=\"et_pb_row_2 et_pb_row et_flex_row\">\n<div class=\"et_pb_column_2 et_pb_column et-last-child et_flex_column et_pb_css_mix_blend_mode_passthrough et_flex_column_24_24 et_flex_column_24_24_tablet et_flex_column_24_24_phone et_flex_column_24_24_widescreen et_flex_column_24_24_ultraWide\">\n<div class=\"et_pb_text_1 et_pb_text et_pb_bg_layout_light et_pb_module et_flex_module preset--group--divi-text--divi-font-body--default\"><div class=\"et_pb_text_inner\"><div class='fluentform ff-default fluentform_wrapper_5 ffs_default_wrap'><form data-form_id=\"5\" id=\"fluentform_5\" class=\"frm-fluent-form fluent_form_5 ff-el-form-top ff_form_instance_5_1 ff-form-loading ffs_default\" data-form_instance=\"ff_form_instance_5_1\" method=\"POST\" ><fieldset  style=\"border: none!important;margin: 0!important;padding: 0!important;background-color: transparent!important;box-shadow: none!important;outline: none!important; min-inline-size: 100%;\">\n                    <legend class=\"ff_screen_reader_title\" style=\"display: block; margin: 0!important;padding: 0!important;height: 0!important;text-indent: -999999px;width: 0!important;overflow:hidden;\">New Patient Forms Request<\/legend><input type='hidden' name='__fluent_form_embded_post_id' value='677' \/><input type=\"hidden\" id=\"_fluentform_5_fluentformnonce\" name=\"_fluentform_5_fluentformnonce\" value=\"de60357f8c\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/dev\/rdd\/wp-json\/wp\/v2\/pages\/677\" \/><div data-type=\"name-element\" data-name=\"names\" class=\" ff-field_container ff-name-field-wrapper\" ><div class='ff-t-container'><div class='ff-t-cell '><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label 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