{"id":50,"date":"2015-03-26T14:28:30","date_gmt":"2015-03-26T14:28:30","guid":{"rendered":"https:\/\/www.hillcrestdentalva.com\/staging\/?page_id=50"},"modified":"2021-02-08T14:15:33","modified_gmt":"2021-02-08T19:15:33","slug":"request-an-appointment","status":"publish","type":"page","link":"https:\/\/www.hillcrestdentalva.com\/patient-toolbox\/request-an-appointment\/","title":{"rendered":"Request an Appointment"},"content":{"rendered":"\t<div class=\"vc_row wpb_row vc_row-fluid\"  >\n\t<div class=\"vc_col-sm-6 wpb_column vc_column_container \">\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t\n\t<div class=\"wpb_text_column wpb_content_element \">\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t<h3>REQUEST YOUR FREE SMILE CONSULTATION TODAY<\/h3>\n<h4><a title=\"Privacy &amp; Terms\" href=\"https:\/\/www.hillcrestdentalva.com\/wp-content\/uploads\/2015\/05\/HIPAA.pdf\" target=\"_blank\" rel=\"noopener\"><i class=\"ico ico-tools\">D<\/i> Privacy &amp; Terms<\/a><\/h4>\n\n\t\t<\/div> \n\t<\/div> \n\t\t<\/div> \n\t<\/div> \n\n\t<div class=\"vc_col-sm-6 wpb_column vc_column_container \">\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t\n\t<div class=\"wpb_text_column wpb_content_element \">\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t\n                <div class='gf_browser_safari gform_wrapper form-contact-secondary_wrapper' id='gform_wrapper_3' ><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_3' id='gform_3' class='form-contact-secondary' action='\/wp-json\/wp\/v2\/pages\/50'>\n                        <div class='gform_body'><ul id='gform_fields_3' class='gform_fields top_label form_sublabel_below description_below'><li id='field_3_1'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible gfield-text gfield-medium' ><label class='gfield_label' for='input_3_1' >First Name<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_1' id='input_3_1' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_3_2'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible gfield-text gfield-medium' ><label class='gfield_label' for='input_3_2' >Last Name<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_2' id='input_3_2' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_3_8'  class='gfield field_sublabel_below field_description_below gfield_visibility_visible gfield-email gfield-medium' ><label class='gfield_label' for='input_3_8' >Email<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_8' id='input_3_8' type='text' value='' class='medium'     aria-invalid=\"false\" \/>\n                        <\/div><\/li><li id='field_3_7'  class='gfield field_sublabel_below field_description_below gfield_visibility_visible gfield-phone gfield-medium' ><label class='gfield_label' for='input_3_7' >Phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_7' id='input_3_7' type='text' value='' class='medium'    aria-invalid=\"false\"  \/><\/div><\/li><li id='field_3_6'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible gfield-textarea gfield-medium' ><label class='gfield_label' for='input_3_6' >Message<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_6' id='input_3_6' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id='field_3_9'  class='gfield field_sublabel_below field_description_below hidden_label gfield_visibility_visible gfield-captcha gfield-medium' ><label class='gfield_label' for='input_3_9' >CAPTCHA<\/label><div id='input_3_9' class='ginput_container ginput_recaptcha' data-sitekey='6LfHcVkaAAAAAH04mqAoLwQHIIhxFHeDOjY95zwj'  data-theme='light' data-tabindex='-1' data-size='invisible' data-badge='bottomright'><\/div><\/li>\n                            <\/ul><\/div>\n        <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_3' class='gform_button button' value='Submit' tabindex='1' onclick='if(window[\"gf_submitting_3\"]){return false;}  window[\"gf_submitting_3\"]=true; 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<\/script>\n\n\t\t<\/div> \n\t<\/div> \n\t\t<\/div> \n\t<\/div> \n<\/div>\n","protected":false},"excerpt":{"rendered":"REQUEST YOUR FREE SMILE CONSULTATION TODAY D Privacy &amp; Terms First Name*Last Name*Email PhoneMessage*CAPTCHA This iframe contains the logic required to handle Ajax powered Gravity Forms. jQuery(document).ready(function($){gformInitSpinner( 3, 'https:\/\/www.hillcrestdentalva.com\/wp-content\/plugins\/gravityforms\/images\/spinner.gif' );jQuery('#gform_ajax_frame_3').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_3');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_3').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > [...]","protected":false},"author":2,"featured_media":0,"parent":40,"menu_order":0,"comment_status":"open","ping_status":"open","template":"","meta":{"footnotes":""},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.hillcrestdentalva.com\/wp-json\/wp\/v2\/pages\/50"}],"collection":[{"href":"https:\/\/www.hillcrestdentalva.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.hillcrestdentalva.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.hillcrestdentalva.com\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hillcrestdentalva.com\/wp-json\/wp\/v2\/comments?post=50"}],"version-history":[{"count":0,"href":"https:\/\/www.hillcrestdentalva.com\/wp-json\/wp\/v2\/pages\/50\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/www.hillcrestdentalva.com\/wp-json\/wp\/v2\/pages\/40"}],"wp:attachment":[{"href":"https:\/\/www.hillcrestdentalva.com\/wp-json\/wp\/v2\/media?parent=50"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}