{"id":155,"date":"2024-08-24T12:30:10","date_gmt":"2024-08-24T12:30:10","guid":{"rendered":"https:\/\/mywebdemo.company\/voc\/?page_id=155"},"modified":"2024-09-06T16:28:12","modified_gmt":"2024-09-06T16:28:12","slug":"new-client-form","status":"publish","type":"page","link":"https:\/\/mywebdemo.company\/voc\/new-client-form\/","title":{"rendered":"New Client Form"},"content":{"rendered":"<div class=\"wpb-content-wrapper\">[vc_row content_placement=&#8221;middle&#8221; column_spacing=&#8221;0px&#8221; equal_height=&#8221;yes&#8221; remove_bottom_col_margin=&#8221;true&#8221;][vc_column width=&#8221;1\/2&#8243; el_class=&#8221;grad-bg&#8221; css=&#8221;.vc_custom_1724861834616{padding-right: 50px !important;padding-left: 50px !important;background-image: url(https:\/\/mywebdemo.company\/voc\/wp-content\/uploads\/2024\/08\/crown-vets-gradient1.jpg?id=496) !important;background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;}&#8221; wpex_bg_position=&#8221;center center;&#8221; offset=&#8221;vc_col-sm-offset-0&#8243;]<style>.vcex-heading.vcex_6a406c069d84b{color:var(--wpex-palette-32-color);font-size:16px;font-weight:600;text-transform:uppercase;}.vcex-heading.vcex_6a406c069d84b .vcex-heading-side-border{border-color:var(--wpex-accent);}<\/style><h5 class=\"vcex-heading vcex-heading-side-border vcex-module wpex-heading wpex-text-2xl wpex-flex wpex-items-center wpex-mt-20 vcex_6a406c069d84b\"><span class=\"vcex-heading-inner wpex-inline-block\">Online Forms<\/span><span class=\"vcex-heading-side-border__border wpex-flex-grow wpex-h-0 wpex-border-solid wpex-ml-15 wpex-border-b-2\"><\/span><\/h5><style>.vcex-heading.vcex_6a406c069e6f9{color:var(--wpex-palette-32-color);font-size:48px;font-family:Montserrat;font-weight:700;}@media (max-width:1024px){.vcex-heading.vcex_6a406c069e6f9{font-size:24px;}}@media (max-width:959px){.vcex-heading.vcex_6a406c069e6f9{font-size:24px;}}@media (max-width:479px){.vcex-heading.vcex_6a406c069e6f9{font-size:28px;}}<\/style><h1 class=\"vcex-heading vcex-heading-plain vcex-module wpex-heading wpex-text-2xl wpex-mt-30 wpex-mb-20 vcex_6a406c069e6f9\"><span class=\"vcex-heading-inner wpex-inline-block\">New Client Form<\/span><\/h1>[vc_column_text css=&#8221;&#8221; color=&#8221;palette-32&#8243;]Save time during your next appointment! Complete your required forms online from any device at any time before your visit.[\/vc_column_text]<div class=\"vc_custom_1725384935411 wpex-clr\"><a href=\"#contact\" class=\"vcex-button theme-button minimal-border wpex-mb-20 inline wpex-flex-shrink-0 local-scroll-link\" style=\"color:var(--wpex-palette-32-color);border:2px solid #fff;width:250px;\" data-wpex-hover='{&quot;background&quot;:&quot;transparent&quot;,&quot;color&quot;:&quot;var(--wpex-palette-32-color)&quot;}'><span class=\"vcex-button-inner theme-button-inner\">Get Started<\/span><\/a><\/div> [\/vc_column][vc_column width=&#8221;1\/2&#8243;]<style>.vcex-image.vcex_6a406c06a2fa0 .vcex-image-img{height:530px;}<\/style><figure class=\"vcex-image vcex-module hero-bg vcex_6a406c06a2fa0\"><div class=\"vcex-image-inner wpex-relative wpex-inline-block\"><img width=\"1920\" height=\"1080\" src=\"https:\/\/mywebdemo.company\/voc\/wp-content\/uploads\/2024\/09\/New-Client-Form.jpg\" class=\"vcex-image-img wpex-align-middle wpex-object-cover\" alt=\"New-Client-Form\" loading=\"lazy\" decoding=\"async\" srcset=\"https:\/\/mywebdemo.company\/voc\/wp-content\/uploads\/2024\/09\/New-Client-Form.jpg 1920w, https:\/\/mywebdemo.company\/voc\/wp-content\/uploads\/2024\/09\/New-Client-Form-300x169.jpg 300w, https:\/\/mywebdemo.company\/voc\/wp-content\/uploads\/2024\/09\/New-Client-Form-1024x576.jpg 1024w, https:\/\/mywebdemo.company\/voc\/wp-content\/uploads\/2024\/09\/New-Client-Form-768x432.jpg 768w, https:\/\/mywebdemo.company\/voc\/wp-content\/uploads\/2024\/09\/New-Client-Form-1536x864.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\" \/><\/div><\/figure>[\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1725385158194{margin-top: 60px !important;}&#8221;][vc_column]<style>.vcex-heading.vcex_6a406c06a6627{color:var(--wpex-accent);font-size:16px;font-weight:700;text-transform:uppercase;}.vcex-heading.vcex_6a406c06a6627 .vcex-heading-side-border{border-color:var(--wpex-accent);}<\/style><h3 class=\"vcex-heading vcex-heading-side-border vcex-module wpex-heading wpex-text-2xl wpex-flex wpex-items-center wpex-mb-40 wpex-text-center vcex_6a406c06a6627\"><span class=\"vcex-heading-side-border__border wpex-flex-grow wpex-h-0 wpex-border-solid wpex-border-b-3 wpex-mr-15\"><\/span><span class=\"vcex-heading-inner wpex-inline-block\">Online Forms<\/span><span class=\"vcex-heading-side-border__border wpex-flex-grow wpex-h-0 wpex-border-solid wpex-ml-15 wpex-border-b-3\"><\/span><\/h3><style>.vcex-heading.vcex_6a406c06a6e8b{font-size:36px;font-weight:700;letter-spacing:var(--wpex-tracking-tight);}<\/style><h2 class=\"vcex-heading vcex-heading-plain vcex-module wpex-heading wpex-text-2xl wpex-mb-20 wpex-text-center vcex_6a406c06a6e8b\"><span class=\"vcex-heading-inner wpex-inline-block\">New Client Form<\/span><\/h2>[\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text css=&#8221;&#8221;]\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f812-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"812\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/voc\/wp-json\/wp\/v2\/pages\/155#wpcf7-f812-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=\"812\" \/>\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-f812-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;:812,&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<\/div>\n<div class=\"uacf7-form-wrapper-container uacf7-form-812  \"><label> <strong>Name<span class=\"red\">*<\/span><\/strong><\/label>\n<div class=\"form-one-half\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-name\" \/><\/span>\n<span style=\"font-size:13px; font-weight:400;\">First<\/span>\n<\/div>\n \n<div class=\"form-one-half last\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"last-name\" \/><\/span>\n<span style=\"font-size:13px; font-weight:400;\">Last<\/span>\n<\/div>\n<label><strong>Email<span class=\"red\">*<\/span><\/strong>\n    <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\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span> <\/label>\n\n<label> <strong>Primary Phone<span class=\"red\">*<\/span><\/strong>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"your-phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-phone\" \/><\/span> <\/label>\n\n<label> <strong>Secondary Phone<\/strong>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"secondary-phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"secondary-phone\" \/><\/span> <\/label>\n\n<label> <strong>Address<span class=\"red\">*<\/span><\/strong>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"address-one\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"address-one\" \/><\/span> <\/label>\n<span style=\"font-size:13px; font-weight:400;\">Address Line 1<\/span>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"address-two\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"address-two\" \/><\/span> \n<span style=\"font-size:13px; font-weight:400;\">Address Line 2<\/span>\n<br>\n<div class=\"form-one-half\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"city\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"city\" \/><\/span> \n<span style=\"font-size:13px; font-weight:400;\">City<\/span><\/div>\n\n<div class=\"form-one-half last\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"state\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"state\" \/><\/span>\n<span style=\"font-size:13px; font-weight:400;\">State \/ Province \/ Region<\/span><\/div>\n\n<div class=\"form-one-half\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"post-code\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"post-code\" \/><\/span> \n<span style=\"font-size:13px; font-weight:400;\">Postal Code<\/span><\/div>\n\n<div class=\"form-one-half last\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"Country\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"Country\"><option value=\"Australia\">Australia<\/option><\/select><\/span>\n<span style=\"font-size:13px; font-weight:400;\">Country<\/span><\/div>\n<p>&nbsp;<\/p>\n<label> <strong>Who else is authorized to make decisions about your pet's healthcare?<span class=\"red\">*<\/span><\/strong><\/label>\n\n<div class=\"form-one-half\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"auth\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"auth\" \/><\/span>\n<span style=\"font-size:13px; font-weight:400;\">First<\/span>\n<\/div>\n \n<div class=\"form-one-half last\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"auth-last-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"auth-last-name\" \/><\/span>\n<span style=\"font-size:13px; font-weight:400;\">Last<\/span>\n<\/div>\n\n<label> <strong>Phone<span class=\"red\">*<\/span><\/strong><span class=\"wpcf7-form-control-wrap\" data-name=\"auth-phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"auth-phone\" \/><\/span><\/label>\n\n<label> <strong>How did you find out about our hospital? If you were referred by someone, who should we thank?<span class=\"red\">*<\/span><\/strong><span class=\"wpcf7-form-control-wrap\" data-name=\"how-found-hospital\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"how-found-hospital\" \/><\/span><\/label>\n\n<label> <strong>Pet's Name?<span class=\"red\">*<\/span><\/strong><span class=\"wpcf7-form-control-wrap\" data-name=\"pet-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"pet-name\" \/><\/span><\/label>\n\n<label> <strong>Species (dog, cat, etc.)<span class=\"red\">*<\/span><\/strong><span class=\"wpcf7-form-control-wrap\" data-name=\"pet-species\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"pet-species\" \/><\/span><\/label>\n\n<label> <strong>Breed<span class=\"red\">*<\/span><\/strong><span class=\"wpcf7-form-control-wrap\" data-name=\"pet-breed\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"pet-breed\" \/><\/span><\/label>\n\n<label> <strong>Age\/Date of Birth<span class=\"red\">*<\/span><\/strong><span class=\"wpcf7-form-control-wrap\" data-name=\"pet-dob\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"pet-dob\" \/><\/span><\/label>\n\n<label> <strong>Sex<span class=\"red\">*<\/span><\/label>\n\n<span class=\"wpcf7-form-control-wrap\" data-name=\"Sex\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"Sex\" value=\"Male\" \/><span class=\"wpcf7-list-item-label\">Male<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"Sex\" value=\"Neutered Male\" \/><span class=\"wpcf7-list-item-label\">Neutered Male<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"Sex\" value=\"Female\" \/><span class=\"wpcf7-list-item-label\">Female<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"Sex\" value=\"Spayed Female\" \/><span class=\"wpcf7-list-item-label\">Spayed Female<\/span><\/label><\/span><\/span><\/span>\n\n<label> <strong>Does your pet have a microchip identification?<span class=\"red\">*<\/span><\/label>\n\n<span class=\"wpcf7-form-control-wrap\" data-name=\"microchip-id\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"microchip-id\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"microchip-id\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\n<input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Submit\" \/><\/div><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n[\/vc_column_text][\/vc_column][\/vc_row]\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row content_placement=&#8221;middle&#8221; column_spacing=&#8221;0px&#8221; equal_height=&#8221;yes&#8221; remove_bottom_col_margin=&#8221;true&#8221;][vc_column width=&#8221;1\/2&#8243; el_class=&#8221;grad-bg&#8221; css=&#8221;.vc_custom_1724861834616{padding-right: 50px !important;padding-left: 50px !important;background-image: url(https:\/\/mywebdemo.company\/voc\/wp-content\/uploads\/2024\/08\/crown-vets-gradient1.jpg?id=496) !important;background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;}&#8221; wpex_bg_position=&#8221;center center;&#8221; offset=&#8221;vc_col-sm-offset-0&#8243;][vc_column_text css=&#8221;&#8221; color=&#8221;palette-32&#8243;]Save time during your next appointment! Complete your required forms online from any device at any time before your visit.[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/2&#8243;][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1725385158194{margin-top: 60px !important;}&#8221;][vc_column][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text css=&#8221;&#8221;][\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-155","page","type-page","status-publish","hentry","entry","no-media"],"_links":{"self":[{"href":"https:\/\/mywebdemo.company\/voc\/wp-json\/wp\/v2\/pages\/155","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mywebdemo.company\/voc\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/mywebdemo.company\/voc\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/mywebdemo.company\/voc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/mywebdemo.company\/voc\/wp-json\/wp\/v2\/comments?post=155"}],"version-history":[{"count":4,"href":"https:\/\/mywebdemo.company\/voc\/wp-json\/wp\/v2\/pages\/155\/revisions"}],"predecessor-version":[{"id":845,"href":"https:\/\/mywebdemo.company\/voc\/wp-json\/wp\/v2\/pages\/155\/revisions\/845"}],"wp:attachment":[{"href":"https:\/\/mywebdemo.company\/voc\/wp-json\/wp\/v2\/media?parent=155"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}