{"id":10,"date":"2011-08-09T12:01:48","date_gmt":"2011-08-09T12:01:48","guid":{"rendered":"http:\/\/new.northumberlanddental.com\/site\/?page_id=10"},"modified":"2024-09-27T12:21:58","modified_gmt":"2024-09-27T10:21:58","slug":"online-appointment-booking-request","status":"publish","type":"page","link":"https:\/\/northumberlanddental.com\/site\/online-appointment-booking-request\/","title":{"rendered":"Make a Booking"},"content":{"rendered":"<p>Please fill in the form below to submit your request for a booking. Please note that this is a request, NOT a confirmed booking. Feel free to send us a WhatsApp message on 0673463539 if that is your preferred method of communication.<\/p>\n<p>We will contact you to confirm your booking. If you haven&#8217;t heard from us, or you would prefer to call us or visit us at our Cape Town dental clinic first, please view our <a title=\"Contact Us\" href=\"\/site\/contact-northumberland-dental\/\">contact details<\/a>.<\/p>\n<p>Please note our operating hours when making your booking:<\/p>\n<div style=\"background-color: #f6f6f6; border: solid 1px #f3f3f3; border-left: solid 4px #65944A; padding: 5px;\">Monday to Friday: 8:30am &#8211; 1:00pm, 2:00pm &#8211; 5:30pm<\/div>\n<div style=\"background-color: #f6f6f6; border: solid 1px #f3f3f3; border-left: solid 4px #65944A; padding: 5px;\">Saturday: 8:30am &#8211; 12:30pm<\/div>\n<p>Fields marked with * are required.<\/p>\n<div style=\"border: solid 1px #ccc; background-color: #f6f6f6; padding-left: 5px;\">\n\n<!-- Fast Secure Contact Form plugin 4.0.52 - begin - FastSecureContactForm.com -->\r\n<div class=\"fscf-div-clear\"><\/div>\n\r\n<div id=\"FSContact1\" class=\"fscf-div-form\">\r\n<form action=\"https:\/\/northumberlanddental.com\/site\/wp-json\/wp\/v2\/pages\/10#FSContact1\" id=\"fscf_form1\" method=\"post\">\r\n\n<div id=\"fscf_div_clear1_0\" class=\"fscf-div-clear\">\n  <div id=\"fscf_div_field1_0\" class=\"fscf-div-field-left\">\r\n    <div class=\"fscf-div-label\">\n      <label class=\"fscf-label\" for=\"fscf_name1\">Name:<span class=\"fscf-required-indicator\">*<\/span><\/label>\n    <\/div>\r\n    <div class=\"fscf-div-field\">\r\n      <input class=\"fscf-input-text\" type=\"text\" id=\"fscf_name1\" name=\"full_name\" value=\"\"  \/>\r\n    <\/div>\r\n  <\/div>\n<\/div>\n\n<div id=\"fscf_div_clear1_4\" class=\"fscf-div-clear\">\n  <div id=\"fscf_div_field1_4\" class=\"fscf-div-field-left\">\n    <div  id=\"fscf_label1_4\" class=\"fscf-div-label\">\r\n      <label class=\"fscf-label\" for=\"fscf_field1_4\">Preferred appointment date<span class=\"fscf-required-indicator\">*<\/span><\/label>\n    <\/div>\n    <div class=\"fscf-div-field\">\n      <input class=\"fscf-input-text\" type=\"text\" id=\"fscf_field1_4\" name=\"preferred-appointment-date\" value=\"dd\/mm\/yyyy\"  size=\"15\"  \/>\n    <\/div>\n  <\/div>\n<\/div>\n\n<div id=\"fscf_div_clear1_5\" class=\"fscf-div-clear\">\n  <div id=\"fscf_div_field1_5\" class=\"fscf-div-field-left\">\n    <div  id=\"fscf_label1_5\" class=\"fscf-div-label\">\r\n      <label class=\"fscf-label\" for=\"fscf_field1_5\">Time<span class=\"fscf-required-indicator\">*<\/span><\/label>\n    <\/div>\n    <div class=\"fscf-div-field\">\n      <select class=\"fscf-input-select\" id=\"fscf_field1_5\" name=\"time[h]\">\n        <option value=\"\"><\/option>\n        <option value=\"00\">00<\/option>\n        <option value=\"01\">01<\/option>\n        <option value=\"02\">02<\/option>\n        <option value=\"03\">03<\/option>\n        <option value=\"04\">04<\/option>\n        <option value=\"05\">05<\/option>\n        <option value=\"06\">06<\/option>\n        <option value=\"07\">07<\/option>\n        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value=\"27\">27<\/option>\n        <option value=\"28\">28<\/option>\n        <option value=\"29\">29<\/option>\n        <option value=\"30\">30<\/option>\n        <option value=\"31\">31<\/option>\n        <option value=\"32\">32<\/option>\n        <option value=\"33\">33<\/option>\n        <option value=\"34\">34<\/option>\n        <option value=\"35\">35<\/option>\n        <option value=\"36\">36<\/option>\n        <option value=\"37\">37<\/option>\n        <option value=\"38\">38<\/option>\n        <option value=\"39\">39<\/option>\n        <option value=\"40\">40<\/option>\n        <option value=\"41\">41<\/option>\n        <option value=\"42\">42<\/option>\n        <option value=\"43\">43<\/option>\n        <option value=\"44\">44<\/option>\n        <option value=\"45\">45<\/option>\n        <option value=\"46\">46<\/option>\n        <option value=\"47\">47<\/option>\n        <option value=\"48\">48<\/option>\n        <option value=\"49\">49<\/option>\n        <option value=\"50\">50<\/option>\n        <option value=\"51\">51<\/option>\n        <option value=\"52\">52<\/option>\n        <option value=\"53\">53<\/option>\n        <option value=\"54\">54<\/option>\n        <option value=\"55\">55<\/option>\n        <option value=\"56\">56<\/option>\n        <option value=\"57\">57<\/option>\n        <option value=\"58\">58<\/option>\n        <option value=\"59\">59<\/option>\n      <\/select>\n    <\/div>\n  <\/div>\n<\/div>\n\n<div id=\"fscf_div_clear1_6\" class=\"fscf-div-clear\">\n  <div id=\"fscf_div_field1_6\" class=\"fscf-div-field-left\">\n    <div  id=\"fscf_label1_6\" class=\"fscf-div-label\">\r\n      <label class=\"fscf-label\" for=\"fscf_field1_6\">Alternate appointment date<\/label>\n    <\/div>\n    <div class=\"fscf-div-field\">\n      <input class=\"fscf-input-text\" type=\"text\" id=\"fscf_field1_6\" name=\"alternate-appointment-date\" value=\"dd\/mm\/yyyy\"  size=\"15\"  \/>\n    <\/div>\n  <\/div>\n<\/div>\n\n<div 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value=\"32\">32<\/option>\n        <option value=\"33\">33<\/option>\n        <option value=\"34\">34<\/option>\n        <option value=\"35\">35<\/option>\n        <option value=\"36\">36<\/option>\n        <option value=\"37\">37<\/option>\n        <option value=\"38\">38<\/option>\n        <option value=\"39\">39<\/option>\n        <option value=\"40\">40<\/option>\n        <option value=\"41\">41<\/option>\n        <option value=\"42\">42<\/option>\n        <option value=\"43\">43<\/option>\n        <option value=\"44\">44<\/option>\n        <option value=\"45\">45<\/option>\n        <option value=\"46\">46<\/option>\n        <option value=\"47\">47<\/option>\n        <option value=\"48\">48<\/option>\n        <option value=\"49\">49<\/option>\n        <option value=\"50\">50<\/option>\n        <option value=\"51\">51<\/option>\n        <option value=\"52\">52<\/option>\n        <option value=\"53\">53<\/option>\n        <option value=\"54\">54<\/option>\n        <option value=\"55\">55<\/option>\n        <option value=\"56\">56<\/option>\n        <option value=\"57\">57<\/option>\n        <option value=\"58\">58<\/option>\n        <option value=\"59\">59<\/option>\n      <\/select>\n    <\/div>\n  <\/div>\n<\/div>\n\n<div id=\"fscf_div_clear1_8\" class=\"fscf-div-clear\">\n  <div id=\"fscf_div_field1_8\" class=\"fscf-div-field-left\">\n    <div  id=\"fscf_label1_8\" class=\"fscf-div-label\">\r\n      <label class=\"fscf-label\" for=\"fscf_field1_8\">Reason for appointment<span class=\"fscf-required-indicator\">*<\/span><\/label>\n    <\/div>\n    <div class=\"fscf-div-field\">\n      <textarea class=\"fscf-input-textarea\" id=\"fscf_field1_8\" name=\"reason-for-appointment\" cols=\"30\" rows=\"10\" ><\/textarea>\n    <\/div>\n  <\/div>\n<\/div>\n\n<div id=\"fscf_div_clear1_1\" class=\"fscf-div-clear\">\n  <div id=\"fscf_div_field1_1\" class=\"fscf-div-field-left\">\n    <div class=\"fscf-div-label\">\n      <label class=\"fscf-label\" 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<\/div>\n    <div class=\"fscf-div-field\">\n      <input class=\"fscf-input-text\" type=\"text\" id=\"fscf_field1_11\" name=\"cellphone\" value=\"\"  \/>\n    <\/div>\n  <\/div>\n<\/div>\n\n<div id=\"fscf_div_clear1_12\" class=\"fscf-div-clear\">\n  <div id=\"fscf_div_field1_12\" class=\"fscf-div-field-left\">\n    <div  id=\"fscf_label1_12\" class=\"fscf-div-label\">\r\n      <label class=\"fscf-label\" for=\"fscf_field1_12\">I would prefer to be contacted by:<\/label>\n    <\/div>\n    <div class=\"fscf-div-field\">\n      <span><input type=\"radio\" class=\"fscf-input-radio\" id=\"fscf_field1_12_1\" name=\"i-would-prefer-to-be-contacted-by\" value=\"1\" \/> <label class=\"fscf-option-label\" for=\"fscf_field1_12_1\">Cellphone<\/label><\/span><br \/>\n      <span><input type=\"radio\" class=\"fscf-input-radio\" id=\"fscf_field1_12_2\" name=\"i-would-prefer-to-be-contacted-by\" value=\"2\" \/> <label class=\"fscf-option-label\" for=\"fscf_field1_12_2\">Email<\/label><\/span><br \/>\n      <span><input type=\"radio\" class=\"fscf-input-radio\" id=\"fscf_field1_12_3\" name=\"i-would-prefer-to-be-contacted-by\" value=\"3\" \/> <label class=\"fscf-option-label\" for=\"fscf_field1_12_3\">Telephone<\/label><\/span>\n    <\/div>\n  <\/div>\n<\/div>\n\n<div id=\"fscf_div_clear1_13\" class=\"fscf-div-clear\">\n  <div id=\"fscf_div_field1_13\" class=\"fscf-div-field-left\">\n    <div  id=\"fscf_label1_13\" class=\"fscf-div-label\">\r\n      <label class=\"fscf-label\" for=\"fscf_field1_13\">How did you hear about us?<\/label>\n    <\/div>\n    <div class=\"fscf-div-field\">\n      <span><input type=\"checkbox\" class=\"fscf-input-checkbox\" id=\"fscf_field1_13_1\" name=\"how-did-you-hear-about-us[1]\" value=\"1\" \/> <label class=\"fscf-option-label\" for=\"fscf_field1_13_1\">Search engine \/ Internet<\/label><\/span><br \/>\n      <span><input type=\"checkbox\" class=\"fscf-input-checkbox\" id=\"fscf_field1_13_2\" name=\"how-did-you-hear-about-us[2]\" value=\"2\" \/> <label 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class=\"fscf-div-clear\"><\/div>\n\n<!-- Fast Secure Contact Form plugin 4.0.52 - end - FastSecureContactForm.com -->\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Please fill in the form below to submit your request for a booking. Please note that this is a request, NOT a confirmed booking. Feel free to send us a WhatsApp message on 0673463539 if that is your preferred method &hellip; <a href=\"https:\/\/northumberlanddental.com\/site\/online-appointment-booking-request\/\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"open","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/northumberlanddental.com\/site\/wp-json\/wp\/v2\/pages\/10"}],"collection":[{"href":"https:\/\/northumberlanddental.com\/site\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/northumberlanddental.com\/site\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/northumberlanddental.com\/site\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/northumberlanddental.com\/site\/wp-json\/wp\/v2\/comments?post=10"}],"version-history":[{"count":53,"href":"https:\/\/northumberlanddental.com\/site\/wp-json\/wp\/v2\/pages\/10\/revisions"}],"predecessor-version":[{"id":1544,"href":"https:\/\/northumberlanddental.com\/site\/wp-json\/wp\/v2\/pages\/10\/revisions\/1544"}],"wp:attachment":[{"href":"https:\/\/northumberlanddental.com\/site\/wp-json\/wp\/v2\/media?parent=10"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}