{"id":2303,"date":"2024-05-17T18:52:29","date_gmt":"2024-05-17T18:52:29","guid":{"rendered":"https:\/\/wellcaresolutions.al\/en\/?page_id=2303"},"modified":"2024-05-21T09:36:57","modified_gmt":"2024-05-21T09:36:57","slug":"formregistration","status":"publish","type":"page","link":"https:\/\/wellcaresolutions.al\/en\/formregistration\/","title":{"rendered":"Form Registration"},"content":{"rendered":"<section data-bb-version=\"4.9.1\" id=\"bt_bb_section6a72bf78eb1ca\" class=\"bt_bb_section bt_bb_layout_boxed_1200 bt_bb_vertical_align_top bt_bb_top_spacing_none bt_bb_bottom_spacing_none\"  data-bt-override-class=\"{&quot;bt_bb_top_spacing_&quot;:{&quot;current_class&quot;:&quot;bt_bb_top_spacing_none&quot;,&quot;xxl&quot;:&quot;none&quot;},&quot;bt_bb_bottom_spacing_&quot;:{&quot;current_class&quot;:&quot;bt_bb_bottom_spacing_none&quot;,&quot;xxl&quot;:&quot;none&quot;}}\"><div class=\"bt_bb_background_image_holder_wrapper\"><div class=\"bt_bb_background_image_holder btLazyLoadBackground\"  data-background_image_src=\"https:\/\/wellcaresolutions.al\/en\/wp-content\/uploads\/2024\/05\/close-up-smiley-patient-dentist-clinic-scaled.jpg\" data-parallax-zoom-start=\"1\" data-parallax-zoom-end=\"1\" data-parallax-blur-start=\"0\" data-parallax-blur-end=\"0\" data-parallax-opacity-start=\"1\" data-parallax-opacity-end=\"1\" style=\" background-image: url(&#039;https:\/\/wellcaresolutions.al\/en\/wp-content\/plugins\/bold-page-builder\/img\/blank.gif&#039;);\"><\/div><\/div><div class=\"bt_bb_port\"><div class=\"bt_bb_cell\"><div class=\"bt_bb_cell_inner\"><div class=\"bt_bb_row_wrapper\"><div  class=\"bt_bb_row\"  data-bt-override-class=\"{}\"><div data-bb-version=\"4.9.1\"  class=\"bt_bb_column col-xxl-12 col-xl-12 col-xs-12 col-sm-12 col-md-12 col-lg-12 bt_bb_vertical_align_top bt_bb_align_left bt_bb_padding_normal\"  data-width=\"12\" data-bt-override-class=\"{}\"><div class=\"bt_bb_column_content\"><div data-bb-version=\"4.9.1\" class=\"bt_bb_row_wrapper\"><div  class=\"bt_bb_row_inner\"  data-bt-override-class=\"{}\"><div data-bb-version=\"4.9.1\"  class=\"bt_bb_column_inner col-xxl-6 col-xl-6 col-xs-12 col-sm-6 col-md-6 col-lg-6 bt_bb_align_left bt_bb_vertical_align_top\"  data-width=\"6\" data-bt-override-class=\"{}\"><div class=\"bt_bb_column_inner_content\"><div data-bb-version=\"4.9.1\" class=\"bt_bb_separator bt_bb_border_style_none bt_bb_top_spacing_100 bt_bb_bottom_spacing_none\" data-bt-override-class=\"{&quot;bt_bb_top_spacing_&quot;:{&quot;current_class&quot;:&quot;bt_bb_top_spacing_100&quot;,&quot;xxl&quot;:&quot;100&quot;},&quot;bt_bb_bottom_spacing_&quot;:{&quot;current_class&quot;:&quot;bt_bb_bottom_spacing_none&quot;,&quot;xxl&quot;:&quot;none&quot;}}\"><\/div><div data-bb-version=\"4.9.1\" class=\"bt_bb_separator bt_bb_border_style_none bt_bb_top_spacing_100 bt_bb_bottom_spacing_none\" data-bt-override-class=\"{&quot;bt_bb_top_spacing_&quot;:{&quot;current_class&quot;:&quot;bt_bb_top_spacing_100&quot;,&quot;xxl&quot;:&quot;100&quot;},&quot;bt_bb_bottom_spacing_&quot;:{&quot;current_class&quot;:&quot;bt_bb_bottom_spacing_none&quot;,&quot;xxl&quot;:&quot;none&quot;}}\"><\/div><div class=\"bt_bb_raw_content\"><!DOCTYPE html>\n<html lang=\"en\">\n<head>\n  <meta charset=\"UTF-8\">\n  <meta name=\"viewport\" content=\"width=device-width, initial-scale=1.0\">\n  <title>Styled Paragraph<\/title>\n  <style>\n    .paragraph-container {\n      max-width: 600px; \/* Adjust the max-width to your preference *\/\n      margin: 0 auto; \/* Center the container horizontally *\/\n    }\n\n    .paragraph-container p {\n      color: white;\n      font-size: 40px; \/* Set the font size to 60px *\/\n      margin: 20px 0; \/* Adjust the top and bottom margin to add space around the paragraph *\/\n      line-height: 1; \/* Adjust the line-height to add space between lines *\/\n    }\n  <\/style>\n<\/head>\n<body>\n  <div class=\"paragraph-container\">\n    <p>Request a Free Quote! <br>\n<\/p>\n  <\/div>\n<\/body>\n<\/html><\/div><div class=\"bt_bb_raw_content\"><!DOCTYPE html>\n<html lang=\"en\">\n<head>\n  <meta charset=\"UTF-8\">\n  <meta name=\"viewport\" content=\"width=device-width, initial-scale=1.0\">\n  <title>Styled Paragraph<\/title>\n  <style>\n    .paragraph-container {\n      max-width: 600px; \/* Adjust the max-width to your preference *\/\n      margin: 0 auto; \/* Center the container horizontally *\/\n    }\n\n    .paragraph-container p {\n      color: white;\n      font-size: 30px; \/* Set the font size to 60px *\/\n      margin: 20px 0; \/* Adjust the top and bottom margin to add space around the paragraph *\/\n      line-height: 1; \/* Adjust the line-height to add space between lines *\/\n    }\n  <\/style>\n<\/head>\n<body>\n  <div class=\"paragraph-container\">\n    <p> <br>\nFill out the form below attaching your Overview. You can also request a quote by writing and attaching the Overview on Whatsapp.<\/p>\n  <\/div>\n<\/body>\n<\/html><\/div><div class=\"bt_bb_column_inner_highlight\"><\/div><\/div><\/div><div data-bb-version=\"4.9.1\"  class=\"bt_bb_column_inner col-xxl-6 col-xl-6 col-xs-12 col-sm-6 col-md-6 col-lg-6 bt_bb_align_left bt_bb_vertical_align_top\"  data-width=\"6\" data-bt-override-class=\"{}\"><div class=\"bt_bb_column_inner_content\"><div data-bb-version=\"4.9.1\" class=\"bt_bb_separator bt_bb_border_style_none bt_bb_top_spacing_100 bt_bb_bottom_spacing_none\" data-bt-override-class=\"{&quot;bt_bb_top_spacing_&quot;:{&quot;current_class&quot;:&quot;bt_bb_top_spacing_100&quot;,&quot;xxl&quot;:&quot;100&quot;},&quot;bt_bb_bottom_spacing_&quot;:{&quot;current_class&quot;:&quot;bt_bb_bottom_spacing_none&quot;,&quot;xxl&quot;:&quot;none&quot;}}\"><\/div><div data-bb-version=\"4.9.1\" class=\"bt_bb_separator bt_bb_border_style_none bt_bb_top_spacing_100 bt_bb_bottom_spacing_none\" data-bt-override-class=\"{&quot;bt_bb_top_spacing_&quot;:{&quot;current_class&quot;:&quot;bt_bb_top_spacing_100&quot;,&quot;xxl&quot;:&quot;100&quot;},&quot;bt_bb_bottom_spacing_&quot;:{&quot;current_class&quot;:&quot;bt_bb_bottom_spacing_none&quot;,&quot;xxl&quot;:&quot;none&quot;}}\"><\/div><div data-bb-version=\"4.9.1\" class=\"bt_bb_contact_form_7\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f905-o1\" lang=\"en-US\" dir=\"ltr\">\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\/2303#wpcf7-f905-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"905\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"5.9.5\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f905-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/div>\n<div class=\"bt_bb_cf7_form\">\n\t<div class=\"bt_bb_cf7_row\">\n\t\t<div class=\"bt_bb_cf7_element\">\n\t\t\t<p><label> <\/label>\n\t\t\t<\/p>\n\t\t\t<p style=\"text-color:black; color:white;\">Name & Last Name <span class=\"bt_bb_required\"><\/span>\n\t\t\t<\/p>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-name\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-name\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"bt_bb_cf7_row\">\n\t\t<div class=\"bt_bb_cf7_element\">\n\t\t\t<p><label> <\/label>\n\t\t\t<\/p>\n\t\t\t<p style=\"text-color:black; color:white;\">Your e-mail <span class=\"bt_bb_required\"><\/span>\n\t\t\t<\/p>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" 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>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"bt_bb_cf7_row\">\n\t\t<div class=\"bt_bb_cf7_element\">\n\t\t\t<p><label> <\/label>\n\t\t\t<\/p>\n\t\t\t<p style=\"text-color:black; color:white;\"> City <span class=\"bt_bb_required\"><\/span>\n\t\t\t<\/p>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"city\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"city\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"bt_bb_cf7_row\">\n\t\t<div class=\"bt_bb_cf7_element\">\n\t\t\t<p><label><\/label>\n\t\t\t<\/p>\n\t\t\t<p style=\"text-color:black; color:white;\"> Phone Number <span class=\"bt_bb_required\"><\/span>\n\t\t\t<\/p>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"phone-number\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"phone-number\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"bt_bb_cf7_row\">\n\t\t<div class=\"bt_bb_cf7_element\">\n\t\t\t<p><label><\/label>\n\t\t\t<\/p>\n\t\t\t<p style=\"text-color:black; color:white;\">\n\t\t\t<\/p>\n\t\t\t<p style=\"text-color:black;color:white;\"><b>ATTACH YOUR PANORAMIC DENTAL RADIOGRAPH<br \/>\n(Files allowed jpg, jpeg, png, pdf, doc) Maximum 10 MB. <\/b>\n\t\t\t<\/p>\n\t\t\t<p><span class=\"bt_bb_required\"><\/span>\n\t\t\t<\/p>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"file-cv\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file wpcf7-validates-as-required\" accept=\".pdf,.doc,.docx,.png,.jpg\" aria-required=\"true\" aria-invalid=\"false\" type=\"file\" name=\"file-cv\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"bt_bb_cf7_row\">\n\t\t<div class=\"bt_bb_cf7_element\">\n\t\t\t<p><label> <\/label>\n\t\t\t<\/p>\n\t\t\t<p style=\"text-color:black; color:white;\"> Message <span class=\"bt_bb_required\"><\/span>\n\t\t\t<\/p>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-message\"><textarea cols=\"40\" rows=\"4\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"your-message\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"bt_bb_cf7_row\">\n\t\t<div class=\"bt_bb_cf7_button bt_bb_cf7_element\">\n\t\t\t<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send your information\" \/>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n<\/div><p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"_wpcf7_ak_\"><label>&#916;<textarea name=\"_wpcf7_ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"_wpcf7_ak_js\" value=\"139\"\/><script>document.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );<\/script><\/p><input type='hidden' class='wpcf7-pum' value='{\"closepopup\":false,\"closedelay\":0,\"openpopup\":false,\"openpopup_id\":0}' \/><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<\/div><div class=\"bt_bb_column_inner_highlight\"><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><!-- cell_inner --><\/div><!-- cell --><\/div><!-- port --><\/section>","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"inline_featured_image":false,"footnotes":""},"class_list":["post-2303","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/wellcaresolutions.al\/en\/wp-json\/wp\/v2\/pages\/2303","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wellcaresolutions.al\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/wellcaresolutions.al\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/wellcaresolutions.al\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/wellcaresolutions.al\/en\/wp-json\/wp\/v2\/comments?post=2303"}],"version-history":[{"count":26,"href":"https:\/\/wellcaresolutions.al\/en\/wp-json\/wp\/v2\/pages\/2303\/revisions"}],"predecessor-version":[{"id":2401,"href":"https:\/\/wellcaresolutions.al\/en\/wp-json\/wp\/v2\/pages\/2303\/revisions\/2401"}],"wp:attachment":[{"href":"https:\/\/wellcaresolutions.al\/en\/wp-json\/wp\/v2\/media?parent=2303"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}