{"id":382,"date":"2016-11-15T11:58:25","date_gmt":"2016-11-15T15:58:25","guid":{"rendered":"http:\/\/saralaflamme.ca\/?page_id=382"},"modified":"2020-10-01T19:16:09","modified_gmt":"2020-10-01T23:16:09","slug":"appointment-request","status":"publish","type":"page","link":"https:\/\/inspiredentistes.ca\/en\/contact\/appointment-request\/","title":{"rendered":"Appointment Request"},"content":{"rendered":"<p><div class='content-column two_third'>\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f286-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"286\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/en\/wp-json\/wp\/v2\/pages\/382#wpcf7-f286-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"286\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.0.6\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f286-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<input type=\"hidden\" name=\"_wpcf7cf_hidden_group_fields\" value=\"[]\" \/>\n<input type=\"hidden\" name=\"_wpcf7cf_hidden_groups\" value=\"[]\" \/>\n<input type=\"hidden\" name=\"_wpcf7cf_visible_groups\" value=\"[]\" \/>\n<input type=\"hidden\" name=\"_wpcf7cf_repeaters\" value=\"[]\" \/>\n<input type=\"hidden\" name=\"_wpcf7cf_steps\" value=\"{}\" \/>\n<input type=\"hidden\" name=\"_wpcf7cf_options\" value=\"{&quot;form_id&quot;:286,&quot;conditions&quot;:[],&quot;settings&quot;:{&quot;animation&quot;:&quot;yes&quot;,&quot;animation_intime&quot;:200,&quot;animation_outtime&quot;:200,&quot;conditions_ui&quot;:&quot;normal&quot;,&quot;notice_dismissed&quot;:false}}\" \/>\n<input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/div>\n<p><label> Your name (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-name\"><input size=\"30\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-name\" \/><\/span> <\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-814\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"checkbox-814[]\" value=\"New Patient\" \/><span class=\"wpcf7-list-item-label\">New Patient<\/span><\/label><\/span><\/span><\/span><br \/>\n<label> Your email (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"30\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span> <\/label><br \/>\n<label> Confirm email<br \/>\n<span class=\"wpcf7-form-control-wrap confirm_email-507\"><input size=\"30\" class=\"wpcf7-form-control wpcf7-confirm_email wpcf7-validates-as-confirm_email\" aria-invalid=\"false\" value=\"\" type=\"confirm_email\" name=\"confirm_email-507\" \/><\/span> <\/label><br \/>\n<label> Your phone (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"tel-916\"><input size=\"30\" maxlength=\"400\" minlength=\"10\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"tel-916\" \/><\/span> <\/label><br \/>\nYour preferred time<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-21\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-21[]\" value=\"Morning\" \/><span class=\"wpcf7-list-item-label\">Morning<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-21[]\" value=\"Afternoon\" \/><span class=\"wpcf7-list-item-label\">Afternoon<\/span><\/label><\/span><\/span><\/span><br \/>\nService (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-452\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-452[]\" value=\"Emergency\" \/><span class=\"wpcf7-list-item-label\">Emergency<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"checkbox-452[]\" value=\"Exam &amp; cleaning\" \/><span class=\"wpcf7-list-item-label\">Exam &amp; cleaning<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-452[]\" value=\"other (specify below)\" \/><span class=\"wpcf7-list-item-label\">other (specify below)<\/span><\/label><\/span><\/span><\/span><br \/>\n<label> Note<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-note\"><textarea cols=\"40\" rows=\"2\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea callback\" aria-invalid=\"false\" name=\"your-note\"><\/textarea><\/span> <\/label><br \/>\n<span class=\"wpcf7-form-control-wrap recaptcha\" data-name=\"recaptcha\"><span data-sitekey=\"6Lfh1oEUAAAAANbTTZCBB-mfL_3Ii4fiZTrkij6F\" class=\"wpcf7-form-control wpcf7-recaptcha g-recaptcha\"><\/span>\r\n<noscript>\r\n\t<div class=\"grecaptcha-noscript\">\r\n\t\t<iframe loading=\"lazy\" src=\"https:\/\/www.google.com\/recaptcha\/api\/fallback?k=6Lfh1oEUAAAAANbTTZCBB-mfL_3Ii4fiZTrkij6F\" frameborder=\"0\" scrolling=\"no\" width=\"310\" height=\"430\">\r\n\t\t<\/iframe>\r\n\t\t<textarea name=\"g-recaptcha-response\" rows=\"3\" cols=\"40\" placeholder=\"reCaptcha Response Here\">\r\n\t\t<\/textarea>\r\n\t<\/div>\r\n<\/noscript>\r\n<\/span><br \/>\n<input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send\" \/>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<br \/><\/div><br \/>\n<div class='content-column one_third'><div class=\"fb-page\" data-href=\"https:\/\/www.facebook.com\/dresaralaflamme\/\" data-tabs=\"timeline\" data-width=\"\" data-height=\"600\" data-small-header=\"true\" data-adapt-container-width=\"true\" data-hide-cover=\"true\" data-show-facepile=\"false\">\n<blockquote class=\"fb-xfbml-parse-ignore\" cite=\"https:\/\/www.facebook.com\/dresaralaflamme\/\"><p><a href=\"https:\/\/www.facebook.com\/dresaralaflamme\/\">Dre Sara Laflamme<\/a><\/p><\/blockquote>\n<\/div><\/div><\/p>","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":18,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page-templates\/full-width.php","meta":{"footnotes":""},"class_list":["post-382","page","type-page","status-publish","h-entry","hentry","h-as-page"],"_links":{"self":[{"href":"https:\/\/inspiredentistes.ca\/en\/wp-json\/wp\/v2\/pages\/382","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/inspiredentistes.ca\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/inspiredentistes.ca\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/inspiredentistes.ca\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/inspiredentistes.ca\/en\/wp-json\/wp\/v2\/comments?post=382"}],"version-history":[{"count":2,"href":"https:\/\/inspiredentistes.ca\/en\/wp-json\/wp\/v2\/pages\/382\/revisions"}],"predecessor-version":[{"id":4692,"href":"https:\/\/inspiredentistes.ca\/en\/wp-json\/wp\/v2\/pages\/382\/revisions\/4692"}],"up":[{"embeddable":true,"href":"https:\/\/inspiredentistes.ca\/en\/wp-json\/wp\/v2\/pages\/18"}],"wp:attachment":[{"href":"https:\/\/inspiredentistes.ca\/en\/wp-json\/wp\/v2\/media?parent=382"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}