{"id":1411,"date":"2020-07-01T12:38:08","date_gmt":"2020-07-01T12:38:08","guid":{"rendered":"https:\/\/barberpodiatry.com\/?page_id=1411"},"modified":"2020-07-01T12:38:43","modified_gmt":"2020-07-01T12:38:43","slug":"request-an-appointment","status":"publish","type":"page","link":"https:\/\/barberpodiatry.com\/request-an-appointment\/","title":{"rendered":"Request an Appointment"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1411\" class=\"elementor elementor-1411\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-c7ffe2c elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"c7ffe2c\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-558d8f1\" data-id=\"558d8f1\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2dd2ff7 elementor-widget elementor-widget-wp-widget-gform_widget\" data-id=\"2dd2ff7\" data-element_type=\"widget\" data-widget_type=\"wp-widget-gform_widget.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<link rel='stylesheet' id='gforms_reset_css-css' href='https:\/\/barberpodiatry.com\/wp-content\/plugins\/gravityforms\/legacy\/css\/formreset.min.css?ver=2.8.7' media='all' \/>\n<link rel='stylesheet' id='gforms_datepicker_css-css' href='https:\/\/barberpodiatry.com\/wp-content\/plugins\/gravityforms\/legacy\/css\/datepicker.min.css?ver=2.8.7' media='all' \/>\n<link rel='stylesheet' id='gforms_formsmain_css-css' href='https:\/\/barberpodiatry.com\/wp-content\/plugins\/gravityforms\/legacy\/css\/formsmain.min.css?ver=2.8.7' media='all' \/>\n<link rel='stylesheet' id='gforms_ready_class_css-css' href='https:\/\/barberpodiatry.com\/wp-content\/plugins\/gravityforms\/legacy\/css\/readyclass.min.css?ver=2.8.7' media='all' \/>\n<link rel='stylesheet' id='gforms_browsers_css-css' href='https:\/\/barberpodiatry.com\/wp-content\/plugins\/gravityforms\/legacy\/css\/browsers.min.css?ver=2.8.7' media='all' \/>\n<script src=\"https:\/\/barberpodiatry.com\/wp-includes\/js\/dist\/vendor\/wp-polyfill-inert.min.js?ver=3.1.2\" id=\"wp-polyfill-inert-js\"><\/script>\n<script src=\"https:\/\/barberpodiatry.com\/wp-includes\/js\/dist\/vendor\/regenerator-runtime.min.js?ver=0.14.0\" id=\"regenerator-runtime-js\"><\/script>\n<script src=\"https:\/\/barberpodiatry.com\/wp-includes\/js\/dist\/vendor\/wp-polyfill.min.js?ver=3.15.0\" id=\"wp-polyfill-js\"><\/script>\n<script src=\"https:\/\/barberpodiatry.com\/wp-includes\/js\/dist\/dom-ready.min.js?ver=392bdd43726760d1f3ca\" id=\"wp-dom-ready-js\"><\/script>\n<script src=\"https:\/\/barberpodiatry.com\/wp-includes\/js\/dist\/hooks.min.js?ver=c6aec9a8d4e5a5d543a1\" id=\"wp-hooks-js\"><\/script>\n<script src=\"https:\/\/barberpodiatry.com\/wp-includes\/js\/dist\/i18n.min.js?ver=7701b0c3857f914212ef\" id=\"wp-i18n-js\"><\/script>\n<script id=\"wp-i18n-js-after\">\nwp.i18n.setLocaleData( { 'text direction\\u0004ltr': [ 'ltr' ] } );\n<\/script>\n<script src=\"https:\/\/barberpodiatry.com\/wp-includes\/js\/dist\/a11y.min.js?ver=7032343a947cfccf5608\" id=\"wp-a11y-js\"><\/script>\n<script src=\"https:\/\/barberpodiatry.com\/wp-includes\/js\/jquery\/jquery.min.js?ver=3.7.1\" id=\"jquery-core-js\"><\/script>\n<script src=\"https:\/\/barberpodiatry.com\/wp-includes\/js\/jquery\/jquery-migrate.min.js?ver=3.4.1\" id=\"jquery-migrate-js\"><\/script>\n<script defer='defer' src=\"https:\/\/barberpodiatry.com\/wp-content\/plugins\/gravityforms\/js\/jquery.json.min.js?ver=2.8.7\" id=\"gform_json-js\"><\/script>\n<script id=\"gform_gravityforms-js-extra\">\nvar gf_global = {\"gf_currency_config\":{\"name\":\"U.S. Dollar\",\"symbol_left\":\"$\",\"symbol_right\":\"\",\"symbol_padding\":\"\",\"thousand_separator\":\",\",\"decimal_separator\":\".\",\"decimals\":2,\"code\":\"USD\"},\"base_url\":\"https:\\\/\\\/barberpodiatry.com\\\/wp-content\\\/plugins\\\/gravityforms\",\"number_formats\":[],\"spinnerUrl\":\"https:\\\/\\\/barberpodiatry.com\\\/wp-content\\\/plugins\\\/gravityforms\\\/images\\\/spinner.svg\",\"version_hash\":\"67a55d71f5ae966bbe459b6d72240c73\",\"strings\":{\"newRowAdded\":\"New row added.\",\"rowRemoved\":\"Row removed\",\"formSaved\":\"The form has been saved.  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gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_4' id='input_2_4' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_2_1\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_1\" ><label class='gfield_label gform-field-label' for='input_2_1'>Appointment Date<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_1' id='input_2_1' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_2_1_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_2_1_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_2_1' class='gform_hidden' value='https:\/\/barberpodiatry.com\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_2_5\" class=\"gfield gfield--type-time gf_right_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_5\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Time<\/label><div class=\"ginput_container ginput_complex gform-grid-row\"><div class=\"clear-multi\">\n                        <div class='gfield_time_hour ginput_container ginput_container_time gform-grid-col' id='input_2_5'>\n                            <input type='number' maxlength='2' name='input_5[]' id='input_2_5_1' value=''  min='0' max='12' step='1'  placeholder='HH' aria-required='false'   \/> <i>:<\/i>\n                            <label class='gform-field-label gform-field-label--type-sub hour_label screen-reader-text' for='input_2_5_1'>Hours<\/label>\n                        <\/div>\n                        \n                        <div class='gfield_time_minute ginput_container ginput_container_time gform-grid-col'>\n                            <input type='number' maxlength='2' name='input_5[]' id='input_2_5_2' value=''  min='0' max='59' step='1'  placeholder='MM' aria-required='false'  \/>\n                            <label class='gform-field-label gform-field-label--type-sub minute_label screen-reader-text' for='input_2_5_2'>Minutes<\/label>\n                        <\/div>\n                        <div class='gfield_time_ampm ginput_container ginput_container_time below gform-grid-col' >\n                                \n                                <select name='input_5[]' id='input_2_5_3'  >\n                                    <option value='am' >AM<\/option>\n                                    <option value='pm' >PM<\/option>\n                                <\/select> \n                                <label class='gform-field-label gform-field-label--type-sub am_pm_label screen-reader-text' for='input_2_5_3'>AM\/PM<\/label>                                \n                           <\/div>\n                    <\/div><\/div><\/li><\/ul><\/div>\n        <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_2' class='gform_button button' value='Submit'  onclick='if(window[\"gf_submitting_2\"]){return false;}  if( !jQuery(\"#gform_2\")[0].checkValidity || jQuery(\"#gform_2\")[0].checkValidity()){window[\"gf_submitting_2\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_2\"]){return false;} if( !jQuery(\"#gform_2\")[0].checkValidity || jQuery(\"#gform_2\")[0].checkValidity()){window[\"gf_submitting_2\"]=true;}  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