{"id":741,"date":"2018-11-02T23:44:08","date_gmt":"2018-11-02T23:44:08","guid":{"rendered":"http:\/\/theme.visualmodo.com\/medical\/?page_id=741"},"modified":"2019-01-11T20:44:20","modified_gmt":"2019-01-11T20:44:20","slug":"contact-alt","status":"publish","type":"page","link":"https:\/\/theme.visualmodo.com\/medical\/contact-alt\/","title":{"rendered":"Contact Alt"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row css=&#8221;.vc_custom_1541202231652{padding-top: 50px !important;}&#8221;][vc_column][vc_custom_heading text=&#8221;Contact Us&#8221; font_container=&#8221;tag:h3|font_size:2.5rem|text_align:center|line_height:1&#8243; use_theme_fonts=&#8221;yes&#8221;][vc_zigzag color=&#8221;custom&#8221; el_width=&#8221;20&#8243; el_border_width=&#8221;10&#8243; custom_color=&#8221;#0799ec&#8221;][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1541202007776{padding-top: 40px !important;padding-bottom: 50px !important;}&#8221;][vc_column width=&#8221;2\/3&#8243;]\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f456-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"456\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/medical\/wp-json\/wp\/v2\/pages\/741#wpcf7-f456-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"456\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f456-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<div class=\"row\">\n\t<p class=\"col-md-6\">SELECT DEPARTMENT\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"SelectDepartment\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"SelectDepartment\"><option value=\"Cardiac Clinic\">Cardiac Clinic<\/option><option value=\"Gynaecological Clinic\">Gynaecological Clinic<\/option><option value=\"Ophthalmology Clinic\">Ophthalmology Clinic<\/option><option value=\"Outpatient Surgery\">Outpatient Surgery<\/option><option value=\"Primary Health Care\">Primary Health Care<\/option><option value=\"Dental Clinic\">Dental Clinic<\/option><option value=\"Laryngological Clinic\">Laryngological Clinic<\/option><option value=\"Outpatient Rehabilitation\">Outpatient Rehabilitation<\/option><option value=\"Pediatric Clinic\">Pediatric Clinic<\/option><\/select><\/span>\n\t<\/p>\n\t<p class=\"col-md-6\">DATE OF BIRTH (mm\/dd\/yyyy)\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"date-321\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"date-321\" \/><\/span>\n\t<\/p>\n\t<p class=\"col-md-6\">FIRST NAME\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required textfield1\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Your First Name\" value=\"\" type=\"text\" name=\"your-name\" \/><\/span>\n\t<\/p>\n\t<p class=\"col-md-6\">LAST NAME\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required textfield2\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Your Last Name\" value=\"\" type=\"text\" name=\"your-name\" \/><\/span>\n\t<\/p>\n\t<p class=\"col-md-6\">EMAIL\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email emailfield1\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Your Email\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span>\n\t<\/p>\n\t<p class=\"col-md-6\">SOCIAL SECURITY NUMBER\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required textfield3\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Your SSN\" value=\"\" type=\"text\" name=\"your-name\" \/><\/span>\n\t<\/p>\n\t<p class=\"col-md-12\">REASON OF APPOINTMENT\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-message\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"Your Message\" name=\"your-message\"><\/textarea><\/span>\n\t<\/p>\n\t<p class=\"col-md-12\"><input 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\/>\nChicago, IL 60605[\/ve_infobox][vc_empty_space height=&#8221;45px&#8221;][ve_infobox style=&#8221;row&#8221; title=&#8221;Emails&#8221; icon=&#8221;linearicons-file-empty&#8221; icon_size=&#8221;3rem&#8221; icon_gap=&#8221;0 2em 0 0&#8243;]contact@site.com<br \/>\nmedical@theme.com[\/ve_infobox][\/vc_column][\/vc_row][vc_row][vc_column][vc_gmaps link=&#8221;#E-8_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&#8221; size=&#8221;500px&#8221;][vc_empty_space height=&#8221;50px&#8221;][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p class=\"card-text\">[vc_row css=&#8221;.vc_custom_1541202231652{padding-top: 50px 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