{"id":8,"date":"2023-08-29T16:07:27","date_gmt":"2023-08-29T07:07:27","guid":{"rendered":"https:\/\/aiyu.dental\/en\/?page_id=8"},"modified":"2024-07-29T16:13:23","modified_gmt":"2024-07-29T07:13:23","slug":"appointment","status":"publish","type":"page","link":"https:\/\/aiyu.dental\/en\/appointment\/","title":{"rendered":"Appointment Request"},"content":{"rendered":"\n<div class=\"wp-block-contact-form-7-contact-form-selector\"><div role=\"form\" class=\"wpcf7\" id=\"wpcf7-f7-o1\" lang=\"ja\" 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\/8#wpcf7-f7-o1\" method=\"post\" class=\"wpcf7-form init\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"7\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"5.5.1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"ja\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f7-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;:7,&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<input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/div>\n<div class=\"font-color-size\">\n<div class=\"visit title-block\">\n<div>First Visit?<\/div>\n<p>\u3000\u3000\n<div><span class=\"wpcf7-form-control-wrap FristVisit\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"FristVisit\" value=\"Yes\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"FristVisit\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span><\/div>\n<\/div>\n<div class=\"name title-block\">\n<div>First Name<\/div>\n<div><span class=\"wpcf7-form-control-wrap First\"><input type=\"text\" name=\"First\" value=\"\" size=\"20\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required Name\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/div>\n<div>Last Name<\/div>\n<div><span class=\"wpcf7-form-control-wrap Last\"><input type=\"text\" name=\"Last\" value=\"\" size=\"20\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required Name\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/div>\n<\/div>\n<div class=\"birthday title-block\">\n<div>Birthday<\/div>\n<div class=\"birthday-wrap\">\n<div><span class=\"wpcf7-form-control-wrap Birthday-year\"><input type=\"number\" name=\"Birthday-year\" value=\"\" class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-required wpcf7-validates-as-number birthday-year\" min=\"1900\" max=\"3000\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/div>\n<div>Year<\/div>\n<\/div>\n<div class=\"birthday-wrap2\">\n<div><span class=\"wpcf7-form-control-wrap Birthday-month\"><input type=\"number\" name=\"Birthday-month\" value=\"\" class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-required wpcf7-validates-as-number birthday-month\" min=\"1\" max=\"12\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/div>\n<div>Month<\/div>\n<div><span class=\"wpcf7-form-control-wrap Birthday-day\"><input type=\"number\" name=\"Birthday-day\" value=\"\" class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-required wpcf7-validates-as-number birthday-day\" min=\"1\" max=\"31\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/div>\n<div>Day<\/div>\n<\/div>\n<\/div>\n<div class=\"sexual title-block\">\n<div>Sexal<\/div>\n<div><span class=\"wpcf7-form-control-wrap Sexal\"><span class=\"wpcf7-form-control wpcf7-radio sexal\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"Sexal\" value=\"Male\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Male<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"Sexal\" value=\"Female\" \/><span class=\"wpcf7-list-item-label\">Female<\/span><\/label><\/span><\/span><\/span><\/div>\n<\/div>\n<div class=\"number title-block\">\n<div>Phone Number<\/div>\n<div><span class=\"wpcf7-form-control-wrap Phonenumber\"><input type=\"tel\" name=\"Phonenumber\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-tel wpcf7-validates-as-required wpcf7-validates-as-tel phonenumber\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/div>\n<\/div>\n<div class=\"contens title-block\">\n<div>Contents<\/div>\n<div><span class=\"wpcf7-form-control-wrap Contens\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox contens\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"Contens\" value=\"\u6b6f\u306e\u6cbb\u7642\" \/><span class=\"wpcf7-list-item-label\">\u6b6f\u306e\u6cbb\u7642<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"Contens\" value=\"\u5c0f\u5150\u6b6f\u79d1\" \/><span class=\"wpcf7-list-item-label\">\u5c0f\u5150\u6b6f\u79d1<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"Contens\" value=\"\u6b6f\u5217\u77ef\u6b63\" \/><span class=\"wpcf7-list-item-label\">\u6b6f\u5217\u77ef\u6b63<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"Contens\" value=\"\u30db\u30ef\u30a4\u30c8\u30cb\u30f3\u30b0\" \/><span class=\"wpcf7-list-item-label\">\u30db\u30ef\u30a4\u30c8\u30cb\u30f3\u30b0<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"Contens\" value=\"\u30a4\u30f3\u30d7\u30e9\u30f3\u30c8\" \/><span class=\"wpcf7-list-item-label\">\u30a4\u30f3\u30d7\u30e9\u30f3\u30c8<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"Contens\" value=\"\u6b6f\u306e\u8a70\u3081\u7269\" \/><span class=\"wpcf7-list-item-label\">\u6b6f\u306e\u8a70\u3081\u7269<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"Contens\" value=\"\u30d8\u30eb\u30b9\u30b1\u30a2\" \/><span class=\"wpcf7-list-item-label\">\u30d8\u30eb\u30b9\u30b1\u30a2<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"Contens\" value=\"\u6b6f\u5468\u75c5\" \/><span class=\"wpcf7-list-item-label\">\u6b6f\u5468\u75c5<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"Contens\" value=\"\u7fa9\u6b6f\u306e\u8a2d\u8a08\" \/><span class=\"wpcf7-list-item-label\">\u7fa9\u6b6f\u306e\u8a2d\u8a08<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"Contens\" value=\"\u89aa\u77e5\u3089\u305a\" \/><span class=\"wpcf7-list-item-label\">\u89aa\u77e5\u3089\u305a<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"Contens\" value=\"\u8a2a\u554f\u6cbb\u7642\" \/><span class=\"wpcf7-list-item-label\">\u8a2a\u554f\u6cbb\u7642<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"Contens\" value=\"\u30de\u30bf\u30cb\u30c6\u30a3\u30fc\u6cbb\u7642\" \/><span class=\"wpcf7-list-item-label\">\u30de\u30bf\u30cb\u30c6\u30a3\u30fc\u6cbb\u7642<\/span><\/label><\/span><\/span><\/span><\/div>\n<\/div>\n<div class=\"appointment title-block\">\n<div>Appointment<\/div>\n<div><span class=\"wpcf7-form-control-wrap date\"><input type=\"date\" name=\"date\" value=\"\" class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/div>\n<div class=\"appointment-time-wrap\">\n<div><span class=\"wpcf7-form-control-wrap Start-Time\"><select name=\"Start-Time\" class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\"><option value=\"9:00(Weekend.Holiday)\">9:00(Weekend.Holiday)<\/option><option value=\"9:30(Weekend.Holiday)\">9:30(Weekend.Holiday)<\/option><option value=\"10:00\">10:00<\/option><option value=\"10:30\">10:30<\/option><option value=\"11:00\">11:00<\/option><option value=\"11:30\">11:30<\/option><option value=\"12:00\">12:00<\/option><option value=\"12:30\">12:30<\/option><option value=\"13:00\">13:00<\/option><option value=\"13:30\">13:30<\/option><option value=\"14:00\">14:00<\/option><option value=\"14:30\">14:30<\/option><option value=\"15:00\">15:00<\/option><option value=\"15:30\">15:30<\/option><option value=\"16:00\">16:00<\/option><option value=\"16:30\">16:30<\/option><option value=\"17:00\">17:00<\/option><option value=\"17:30\">17:30<\/option><option value=\"18:00(Weekday)\">18:00(Weekday)<\/option><option value=\"18:30(Weekday)\">18:30(Weekday)<\/option><\/select><\/span><\/div>\n<div>\uff5e<\/div>\n<div><span class=\"wpcf7-form-control-wrap Finish-Time\"><select name=\"Finish-Time\" class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\"><option value=\"9:30(Weekend.Holiday)\">9:30(Weekend.Holiday)<\/option><option value=\"10:00\">10:00<\/option><option value=\"10:30\">10:30<\/option><option value=\"11:00\">11:00<\/option><option value=\"11:30\">11:30<\/option><option value=\"12:00\">12:00<\/option><option value=\"12:30\">12:30<\/option><option value=\"13:00\">13:00<\/option><option value=\"13:30\">13:30<\/option><option value=\"14:00\">14:00<\/option><option value=\"14:30\">14:30<\/option><option value=\"15:00\">15:00<\/option><option value=\"15:30\">15:30<\/option><option value=\"16:00\">16:00<\/option><option value=\"16:30\">16:30<\/option><option value=\"17:00\">17:00<\/option><option value=\"17:30\">17:30<\/option><option value=\"18:00(Weekday)\">18:00(Weekday)<\/option><option value=\"18:30(Weekday)\">18:30(Weekday)<\/option><option value=\"19:00(Weekday\">19:00(Weekday<\/option><\/select><\/span><\/div>\n<\/div>\n<\/div>\n<div class=\"email title-block\">\n<div>E-mail<\/div>\n<div><span class=\"wpcf7-form-control-wrap E-mail\"><input type=\"email\" name=\"E-mail\" value=\"\" size=\"55\" class=\"wpcf7-form-control wpcf7-text wpcf7-email wpcf7-validates-as-required wpcf7-validates-as-email e-mail\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/div>\n<\/div>\n<div class=\"comment title-block\">\n<div>Comment<\/div>\n<div><span class=\"wpcf7-form-control-wrap Comment\"><textarea name=\"Comment\" cols=\"50\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea comment\" aria-invalid=\"false\"><\/textarea><\/span><\/div>\n<\/div>\n<\/div>\n<div class=\"spamcheck-font-size {<br \/>\n\">\n<div class=\"spamcheck title-block\">\n<div><span class=\"wpcf7-form-control-wrap SpamCheck\"><span class=\"wpcf7-form-control wpcf7-acceptance optional\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"SpamCheck\" value=\"1\" aria-invalid=\"false\" class=\"spamcheck-box\" \/><span class=\"wpcf7-list-item-label\">In order to prevent spam mail, please check this check box<\/span><\/label><\/span><\/span><\/span><\/div>\n<\/div>\n<\/div>\n<div class=\"submit\">\n<div><input type=\"submit\" value=\"Submit\" class=\"wpcf7-form-control has-spinner wpcf7-submit submit-button\" \/><\/div>\n<\/div>\n<div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div><\/form><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/aiyu.dental\/en\/wp-json\/wp\/v2\/pages\/8"}],"collection":[{"href":"https:\/\/aiyu.dental\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/aiyu.dental\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/aiyu.dental\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/aiyu.dental\/en\/wp-json\/wp\/v2\/comments?post=8"}],"version-history":[{"count":3,"href":"https:\/\/aiyu.dental\/en\/wp-json\/wp\/v2\/pages\/8\/revisions"}],"predecessor-version":[{"id":47,"href":"https:\/\/aiyu.dental\/en\/wp-json\/wp\/v2\/pages\/8\/revisions\/47"}],"wp:attachment":[{"href":"https:\/\/aiyu.dental\/en\/wp-json\/wp\/v2\/media?parent=8"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}