{"id":404,"date":"2025-06-27T11:31:46","date_gmt":"2025-06-27T11:31:46","guid":{"rendered":"https:\/\/novacareglobal.com\/?page_id=404"},"modified":"2025-07-07T11:35:19","modified_gmt":"2025-07-07T11:35:19","slug":"book-appointment","status":"publish","type":"page","link":"https:\/\/novacareglobal.com\/ar\/book-appointment\/","title":{"rendered":"\u0627\u062d\u062c\u0632 \u0645\u0648\u0639\u062f"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"404\" class=\"elementor elementor-404\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-4922f4c7 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"4922f4c7\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-20099c86\" data-id=\"20099c86\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7b376553 elementor-widget elementor-widget-heading\" data-id=\"7b376553\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Book Appointment<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-46391277 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"46391277\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Schedule your personalized in-home care visit with just a few clicks\u2014your health and comfort come first.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-35d00ab1 elementor-section-full_width elementor-section-height-default elementor-section-height-default\" data-id=\"35d00ab1\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-620b962c\" data-id=\"620b962c\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3f0de6ab elementor-widget elementor-widget-image\" data-id=\"3f0de6ab\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"713\" height=\"579\" src=\"https:\/\/novacareglobal.com\/wp-content\/uploads\/2025\/06\/7dbcced9d2243b361d7d12f32bdee3571636202441.jpg\" class=\"attachment-full size-full wp-image-276\" alt=\"\" srcset=\"https:\/\/novacareglobal.com\/wp-content\/uploads\/2025\/06\/7dbcced9d2243b361d7d12f32bdee3571636202441.jpg 713w, https:\/\/novacareglobal.com\/wp-content\/uploads\/2025\/06\/7dbcced9d2243b361d7d12f32bdee3571636202441-600x487.jpg 600w, https:\/\/novacareglobal.com\/wp-content\/uploads\/2025\/06\/7dbcced9d2243b361d7d12f32bdee3571636202441-300x244.jpg 300w\" sizes=\"(max-width: 713px) 100vw, 713px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-97edd3e elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"97edd3e\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-d53a423\" data-id=\"d53a423\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-077adc8 elementor-widget elementor-widget-heading\" data-id=\"077adc8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h6 class=\"elementor-heading-title elementor-size-default\">Visit Us<\/h6>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-34e9bbc elementor-widget elementor-widget-heading\" data-id=\"34e9bbc\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Need More Information?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b298090 elementor-widget elementor-widget-text-editor\" data-id=\"b298090\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Get in touch with us today and discover how Novacare can bring compassionate, expert care right to your doorstep.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-74affde elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"74affde\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-1e88abb\" data-id=\"1e88abb\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5c2c166 elementor-widget elementor-widget-eael-feature-list\" data-id=\"5c2c166\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"eael-feature-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"-icon-position-left -tablet-icon-position-left -mobile-icon-position-left\">\n\t\t\t<ul id=\"eael-feature-list-5c2c166\" class=\"eael-feature-list-items circle stacked  eael-feature-list-vertical\" data-layout-tablet=\"vertical\" data-layout-mobile=\"vertical\">\n\t\t\t                <li class=\"eael-feature-list-item elementor-repeater-item-e2825a1\">\n                    \n\t\t\t\t\t\t<div class=\"eael-feature-list-icon-box\">\n\t\t\t\t\t\t\t<div class=\"eael-feature-list-icon-inner\">\n\n\t\t\t\t\t\t\t\t<span class=\"eael-feature-list-icon fl-icon-0\">\n\n\t\t<i aria-hidden=\"true\" class=\"icon icon-phone-call\"><\/i>\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"eael-feature-list-content-box\">\n                            <h5 class=\"eael-feature-list-title\">Call Now<\/h5>\t\t\t\t\t\t<p class=\"eael-feature-list-content\">+973 38709910<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t<\/ul>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-d3b1b12\" data-id=\"d3b1b12\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-08dfa30 elementor-widget elementor-widget-eael-feature-list\" data-id=\"08dfa30\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"eael-feature-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"-icon-position-left -tablet-icon-position-left -mobile-icon-position-left\">\n\t\t\t<ul id=\"eael-feature-list-08dfa30\" class=\"eael-feature-list-items circle stacked  eael-feature-list-vertical\" data-layout-tablet=\"vertical\" data-layout-mobile=\"vertical\">\n\t\t\t                <li class=\"eael-feature-list-item elementor-repeater-item-e2825a1\">\n                    \n\t\t\t\t\t\t<div class=\"eael-feature-list-icon-box\">\n\t\t\t\t\t\t\t<div class=\"eael-feature-list-icon-inner\">\n\n\t\t\t\t\t\t\t\t<span class=\"eael-feature-list-icon fl-icon-0\">\n\n\t\t<i aria-hidden=\"true\" class=\"icon icon-envelope1\"><\/i>\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"eael-feature-list-content-box\">\n                            <h5 class=\"eael-feature-list-title\">Email Us<\/h5>\t\t\t\t\t\t<p class=\"eael-feature-list-content\">novacareglobal@gmail.com<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t<\/ul>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-13db839\" data-id=\"13db839\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-b02fd1b elementor-widget elementor-widget-metform\" data-id=\"b02fd1b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"metform.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div id=\"mf-response-props-id-450\" data-previous-steps-style=\"\" data-editswitchopen=\"\" data-response_type=\"alert\" data-erroricon=\"fas fa-exclamation-triangle\" data-successicon=\"fas fa-check\" data-messageposition=\"top\" class=\"   mf-scroll-top-no\">\n\t\t<div class=\"formpicker_warper formpicker_warper_editable\" data-metform-formpicker-key=\"450\" >\n\t\t\t\t\n\t\t\t<div class=\"mf-widget-container\">\n\t\t\t\t\r\n\t\t<div\r\n\t\t\tid=\"metform-wrap-b02fd1b-450\"\r\n\t\t\tclass=\"mf-form-wrapper\"\r\n\t\t\tdata-form-id=\"450\"\r\n\t\t\tdata-action=\"https:\/\/novacareglobal.com\/ar\/wp-json\/metform\/v1\/entries\/insert\/450\"\r\n\t\t\tdata-wp-nonce=\"9d29c31de8\"\r\n\t\t\tdata-form-nonce=\"b3ddbfb475\"\r\n\t\t\tdata-quiz-summery = \"false\"\r\n\t\t\tdata-save-progress = \"false\"\r\n\t\t\tdata-form-type=\"general-form\"\r\n\t\t\tdata-stop-vertical-effect=\"\"\r\n\t\t\tdata-payment-submit-before=\"0\"\r\n\t\t\t><\/div>\r\n\r\n\r\n\t\t<!----------------------------- \r\n\t\t\t* controls_data : find the the props passed indie of data attribute\r\n\t\t\t* props.SubmitResponseMarkup : contains the markup of error or success message\r\n\t\t\t* https:\/\/developer.mozilla.org\/en-US\/docs\/Web\/JavaScript\/Reference\/Template_literals\r\n\t\t--------------------------- -->\r\n\r\n\t\t\t\t<script type=\"text\/mf\" class=\"mf-template\">\r\n\t\t\tfunction controls_data (value){\r\n\t\t\t\tlet currentWrapper = \"mf-response-props-id-450\";\r\n\t\t\t\tlet currentEl = document.getElementById(currentWrapper);\r\n\t\t\t\t\r\n\t\t\t\treturn currentEl ? currentEl.dataset[value] : false\r\n\t\t\t}\r\n\r\n\r\n\t\t\tlet is_edit_mode = '' ? true : false;\r\n\t\t\tlet message_position = controls_data('messageposition') || 'top';\r\n\r\n\t\t\t\r\n\t\t\tlet message_successIcon = controls_data('successicon') || '';\r\n\t\t\tlet message_errorIcon = controls_data('erroricon') || '';\r\n\t\t\tlet message_editSwitch = controls_data('editswitchopen') === 'yes' ? true : false;\r\n\t\t\tlet message_proClass = controls_data('editswitchopen') === 'yes' ? 'mf_pro_activated' : '';\r\n\t\t\t\r\n\t\t\tlet is_dummy_markup = is_edit_mode && message_editSwitch ? true : false;\r\n\r\n\t\t\t\r\n\t\t\treturn html`\r\n\t\t\t\t<form\r\n\t\t\t\t\tclassName=\"metform-form-content\"\r\n\t\t\t\t\tref=${parent.formContainerRef}\r\n\t\t\t\t\tonSubmit=${ validation.handleSubmit( parent.handleFormSubmit ) }\r\n\t\t\t\t\r\n\t\t\t\t\t>\r\n\t\t\t\r\n\t\t\t\r\n\t\t\t\t\t${is_dummy_markup ? message_position === 'top' ?  props.ResponseDummyMarkup(message_successIcon, message_proClass) : '' : ''}\r\n\t\t\t\t\t${is_dummy_markup ? ' ' :  message_position === 'top' ? props.SubmitResponseMarkup`${parent}${state}${message_successIcon}${message_errorIcon}${message_proClass}` : ''}\r\n\r\n\t\t\t\t\t<!--------------------------------------------------------\r\n\t\t\t\t\t*** IMPORTANT \/ DANGEROUS ***\r\n\t\t\t\t\t${html``} must be used as in immediate child of \"metform-form-main-wrapper\"\r\n\t\t\t\t\tclass otherwise multistep form will not run at all\r\n\t\t\t\t\t---------------------------------------------------------->\r\n\r\n\t\t\t\t\t<div className=\"metform-form-main-wrapper\" key=${'hide-form-after-submit'} ref=${parent.formRef}>\r\n\t\t\t\t\t${html`\r\n\t\t\t\t\t\t<style key=\"1\">.elementor-450 .elementor-element.elementor-element-84c0545{--display:flex;--flex-direction:column;--container-widget-width:100%;--container-widget-height:initial;--container-widget-flex-grow:0;--container-widget-align-self:initial;--flex-wrap-mobile:wrap;--gap:0px 0px;--row-gap:0px;--column-gap:0px;}.elementor-450 .elementor-element.elementor-element-5ff1438{--display:flex;--flex-direction:row;--container-widget-width:initial;--container-widget-height:100%;--container-widget-flex-grow:1;--container-widget-align-self:stretch;--flex-wrap-mobile:wrap;--margin-top:0px;--margin-bottom:0px;--margin-left:0px;--margin-right:0px;--padding-top:0px;--padding-bottom:0px;--padding-left:0px;--padding-right:0px;}.elementor-450 .elementor-element.elementor-element-86c31dd{--display:flex;--flex-direction:column;--container-widget-width:100%;--container-widget-height:initial;--container-widget-flex-grow:0;--container-widget-align-self:initial;--flex-wrap-mobile:wrap;}.elementor-450 .elementor-element.elementor-element-55a9b3d .mf-input-label{display:block;color:#000000;}.elementor-450 .elementor-element.elementor-element-55a9b3d .mf-input-required-indicator{color:#f00;}.elementor-450 .elementor-element.elementor-element-55a9b3d .mf-input-wrapper .mf-input[aria-invalid=\"true\"], .elementor-450 .elementor-element.elementor-element-55a9b3d .mf-input-wrapper .mf-input.mf-invalid{border-color:#f00;}.elementor-450 .elementor-element.elementor-element-55a9b3d .mf-error-message{color:#f00;}.elementor-450 .elementor-element.elementor-element-55a9b3d .mf-input, .elementor-450 .elementor-element.elementor-element-55a9b3d .elementor-450 .elementor-element.elementor-element-55a9b3d .mf-input-wrapper .iti--separate-dial-code .iti__selected-flag, .elementor-450 .elementor-element.elementor-element-55a9b3d .mf-input-wrapper .iti--separate-dial-code .iti__selected-dial-code{color:#000000;}.elementor-450 .elementor-element.elementor-element-55a9b3d .irs--round .irs-bar, .elementor-450 .elementor-element.elementor-element-55a9b3d .irs--round .irs-from, .elementor-450 .elementor-element.elementor-element-55a9b3d .irs--round .irs-to, .elementor-450 .elementor-element.elementor-element-55a9b3d .irs--round .irs-single{background-color:#000000;}.elementor-450 .elementor-element.elementor-element-55a9b3d .irs--round .irs-handle{border-color:#000000;}.elementor-450 .elementor-element.elementor-element-55a9b3d .irs--round .irs-from:before, .elementor-450 .elementor-element.elementor-element-55a9b3d .irs--round .irs-to:before, .elementor-450 .elementor-element.elementor-element-55a9b3d .irs--round .irs-single:before{border-top-color:#000000;}.elementor-450 .elementor-element.elementor-element-55a9b3d .mf_select__single-value{color:#000000;}.elementor-450 .elementor-element.elementor-element-55a9b3d .mf-input-wrapper{border-color:#000000;}.elementor-450 .elementor-element.elementor-element-55a9b3d .mf-input-wrapper .input-range__track--active{background-color:#000000;}.elementor-450 .elementor-element.elementor-element-55a9b3d .mf-input-wrapper .asRange .asRange-pointer .asRange-tip{background-color:#000000;border-color:#000000;}.elementor-450 .elementor-element.elementor-element-55a9b3d .mf-input-file-upload-label, .elementor-450 .elementor-element.elementor-element-55a9b3d .mf-input-calculation-total{color:#000000;}.elementor-450 .elementor-element.elementor-element-55a9b3d .mf-input-file-upload-label svg path{stroke:#000000;fill:#000000;}.elementor-450 .elementor-element.elementor-element-55a9b3d .mf_multiselect__multi-value__label, .elementor-450 .elementor-element.elementor-element-55a9b3d .mf_multiselect__multi-value__remove,.elementor-450 .elementor-element.elementor-element-55a9b3d .mf_multiselect__menu-notice--no-options{color:#000000;}.elementor-450 .elementor-element.elementor-element-55a9b3d .mf-input:hover, .elementor-450 .elementor-element.elementor-element-55a9b3d .mf-input-wrapper:hover .iti--separate-dial-code .iti__selected-flag, .elementor-450 .elementor-element.elementor-element-55a9b3d .mf-input-wrapper:hover .iti--separate-dial-code .iti__selected-dial-code{color:#000000;}.elementor-450 .elementor-element.elementor-element-55a9b3d .irs--round 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span:before{color:#747474;top:2px;width:25px;}.elementor-450 .elementor-element.elementor-element-81864ee .mf-checkbox-option input[type=\"checkbox\"]:checked + span:before{color:#4285F4;}.elementor-450 .elementor-element.elementor-element-cb2a6a7{--display:flex;--flex-direction:row;--container-widget-width:initial;--container-widget-height:100%;--container-widget-flex-grow:1;--container-widget-align-self:stretch;--flex-wrap-mobile:wrap;--margin-top:0px;--margin-bottom:0px;--margin-left:0px;--margin-right:0px;--padding-top:0px;--padding-bottom:0px;--padding-left:0px;--padding-right:0px;}.elementor-450 .elementor-element.elementor-element-81a1f3a{--display:flex;--flex-direction:column;--container-widget-width:100%;--container-widget-height:initial;--container-widget-flex-grow:0;--container-widget-align-self:initial;--flex-wrap-mobile:wrap;--justify-content:center;}.elementor-450 .elementor-element.elementor-element-3ccae9a .mf-btn-wraper{text-align:left;}.elementor-450 .elementor-element.elementor-element-3ccae9a .metform-btn{padding:15px 40px 15px 40px;color:#ffffff;border-style:none;border-radius:5px 5px 5px 5px;}.elementor-450 .elementor-element.elementor-element-3ccae9a .metform-btn:hover{color:#FFFFFF;}.elementor-450 .elementor-element.elementor-element-3ccae9a .metform-btn:focus{color:#FFFFFF;}.elementor-450 .elementor-element.elementor-element-7d40243{--display:flex;--flex-direction:column;--container-widget-width:100%;--container-widget-height:initial;--container-widget-flex-grow:0;--container-widget-align-self:initial;--flex-wrap-mobile:wrap;--justify-content:center;}@media(min-width:768px){.elementor-450 .elementor-element.elementor-element-86c31dd{--width:50%;}.elementor-450 .elementor-element.elementor-element-0bca870{--width:50%;}.elementor-450 .elementor-element.elementor-element-369de30{--width:50%;}.elementor-450 .elementor-element.elementor-element-84ad213{--width:50%;}.elementor-450 .elementor-element.elementor-element-b360243{--width:50%;}.elementor-450 .elementor-element.elementor-element-5b63446{--width:50%;}.elementor-450 .elementor-element.elementor-element-e92493b{--width:50%;}.elementor-450 .elementor-element.elementor-element-2acca8b{--width:50%;}.elementor-450 .elementor-element.elementor-element-29a4f1a{--width:50%;}.elementor-450 .elementor-element.elementor-element-bab75a4{--width:50%;}.elementor-450 .elementor-element.elementor-element-12c19f1{--width:50%;}.elementor-450 .elementor-element.elementor-element-755fdb6{--width:50%;}.elementor-450 .elementor-element.elementor-element-0ab8bc1{--width:50%;}.elementor-450 .elementor-element.elementor-element-4689640{--width:50%;}.elementor-450 .elementor-element.elementor-element-01fed10{--width:50%;}.elementor-450 .elementor-element.elementor-element-5d54ba4{--width:50%;}.elementor-450 .elementor-element.elementor-element-fb56c40{--width:50%;}.elementor-450 .elementor-element.elementor-element-d9eb52c{--width:50%;}.elementor-450 .elementor-element.elementor-element-481acb5{--width:50%;}.elementor-450 .elementor-element.elementor-element-4903035{--width:50%;}.elementor-450 .elementor-element.elementor-element-0020842{--width:50%;}.elementor-450 .elementor-element.elementor-element-73087af{--width:50%;}.elementor-450 .elementor-element.elementor-element-7d19364{--width:50%;}.elementor-450 .elementor-element.elementor-element-45d9dbc{--width:50%;}.elementor-450 .elementor-element.elementor-element-27a5232{--width:100%;}.elementor-450 .elementor-element.elementor-element-81a1f3a{--width:50%;}.elementor-450 .elementor-element.elementor-element-7d40243{--width:50%;}}<\/style>\t\t<div data-elementor-type=\"wp-post\" key=\"2\" data-elementor-id=\"450\" className=\"elementor elementor-450\" data-elementor-post-type=\"metform-form\">\n\t\t\t\t<div className=\"elementor-element elementor-element-84c0545 e-flex e-con-boxed e-con e-parent\" data-id=\"84c0545\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div className=\"e-con-inner\">\n\t\t<div className=\"elementor-element elementor-element-5ff1438 e-con-full e-flex e-con e-child\" data-id=\"5ff1438\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div className=\"elementor-element elementor-element-86c31dd e-con-full e-flex e-con e-child\" data-id=\"86c31dd\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-55a9b3d elementor-widget elementor-widget-mf-listing-fname\" data-id=\"55a9b3d\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf-listing-fname&quot;}\" data-widget_type=\"mf-listing-fname.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\n\t\t<div className=\"mf-input-wrapper\">\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-text-55a9b3d\">\n\t\t\t\t\t${ parent.decodeEntities(`Full Name`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\n\t\t\t\t<\/label>\n\t\t\t\n\t\t\t<input type=\"text\" className=\"mf-input \" id=\"mf-input-text-55a9b3d\" \n\t\t\t\tname=\"mf-listing-fname\" \n\t\t\t\tplaceholder=\"${ parent.decodeEntities(`Full Name`) } \"\n\t\t\t\tonInput=${ parent.handleChange }\n\n\t\t\t\t\t\t\t\t\taria-invalid=\"${validation.errors['mf-listing-fname'] ? 'true' : 'false'}\"\n\t\t\t\t\tref=${ el => parent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true,\"expression\":\"null\"}, el) }\n\t\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\n\t\t\t\t\terrors=${validation.errors}\n\t\t\t\t\tname=\"mf-listing-fname\"\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\n\t\t\t\t\t\/>\n\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-0bca870 e-con-full e-flex e-con e-child\" data-id=\"0bca870\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-601fff6 elementor-widget elementor-widget-mf-date\" data-id=\"601fff6\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf-date&quot;}\" data-widget_type=\"mf-date.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-date-601fff6\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Date of Birth`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<${props.Flatpickr}\r\n\t\t\t\t\tname=\"mf-date\"\r\n\t\t\t\t\tclassName=\"mf-input mf-date-input mf-left-parent  \"\r\n\t\t\t\t\tplaceholder=\"${ parent.decodeEntities(`Date`) } \"\r\n\t\t\t\t\toptions=${{\"minDate\":\"\",\"maxDate\":\"\",\"dateFormat\":\"m-d-Y\",\"enableTime\":\"\",\"disable\":[],\"mode\":\"single\",\"static\":true,\"disableMobile\":true,\"time_24hr\":false}}\r\n\t\t\t\t\tvalue=${parent.getValue('mf-date')}\r\n\t\t\t\t\tonInput=${parent.handleDateTime}\r\n\t\t\t\t\taria-invalid=\"${validation.errors['mf-date'] ? 'true' : 'false'}\"\r\n\t\t\t\t\tonReady=${(dates, dateStr, instance) => props.DateWidget(\r\n\t\tinstance,\r\n\t\t'',\r\n\t\t{\"message\":\"This field is required.\",\"required\":false},\r\n\t\tregister,\r\n\t\tparent\r\n\t)}\r\n\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf-date\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t\t<\/div>\r\n\r\n\t\t\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-880814d e-con-full e-flex e-con e-child\" data-id=\"880814d\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div className=\"elementor-element elementor-element-369de30 e-con-full e-flex e-con e-child\" data-id=\"369de30\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-8de848d elementor-widget elementor-widget-mf-number\" data-id=\"8de848d\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf-National_ID___Iqama___Passport_No__&quot;}\" data-widget_type=\"mf-number.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-number-8de848d\">\r\n\t\t\t\t\t${ parent.decodeEntities(`National ID \/ Iqama \/ Passport No.:`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input\r\n\t\t\t\ttype=\"number\"\r\n\t\t\t\tstep=\"any\"\r\n\t\t\t\tclassName=\"mf-input \"\r\n\t\t\t\tid=\"mf-input-mobile-8de848d\"\r\n\t\t\t\t\t\t\t\tname=\"mf-National_ID___Iqama___Passport_No__\"\r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(`National ID \/ Iqama \/ Passport No.:`) } \"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\r\n\t\t\t\t\taria-invalid=\"${validation.errors['mf-National_ID___Iqama___Passport_No__'] ? 'true' : 'false'}\"\r\n\t\t\t\t\tref=${el => parent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":false,\"expression\":\"null\"}, el)}\r\n\t\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf-National_ID___Iqama___Passport_No__\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-84ad213 e-con-full e-flex e-con e-child\" data-id=\"84ad213\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-ffb3e02 elementor-widget elementor-widget-mf-radio\" data-id=\"ffb3e02\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf-Gender&quot;,&quot;mf_input_list&quot;:[{&quot;mf_input_option_text&quot;:&quot;Male&quot;,&quot;mf_input_option_value&quot;:&quot;Male&quot;,&quot;_id&quot;:&quot;c262636&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;Female&quot;,&quot;mf_input_option_value&quot;:&quot;Female&quot;,&quot;_id&quot;:&quot;e56a63b&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;}]}\" data-widget_type=\"mf-radio.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-radio-ffb3e02\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Gender`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<div className=\"mf-radio multi-option-input-type\" id=\"mf-input-radio-ffb3e02\">\r\n\t\t\t\t\t\t\t\t\t<div className=\"mf-radio-option \">\r\n\t\t\t\t\t\t<label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input\r\n\t\t\t\t\t\t\t\ttype=\"radio\"\r\n\t\t\t\t\t\t\t\tclassName=\"mf-input mf-radio-input \"\r\n\t\t\t\t\t\t\t\tname=\"mf-Gender\"\r\n\t\t\t\t\t\t\t\tvalue=\"Male\"\r\n\t\t\t\t\t\t\t\tdata-checked=\"\"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tonChange=${ parent.handleChange }\r\n\t\t\t\t\t\t\t\t\taria-invalid=\"${validation.errors['mf-Gender'] ? 'true' : 'false'}\"\r\n\t\t\t\t\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tparent.handleRadioDefault(el);\r\n\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"required\":false}, el)\r\n\t\t\t\t\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\tchecked=${'Male' === parent.getValue('mf-Gender')}\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t<span>\r\n\t\t\t\t\t\t\t\t${ parent.decodeEntities(`Male`) } \t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t<\/label>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t<div className=\"mf-radio-option \">\r\n\t\t\t\t\t\t<label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input\r\n\t\t\t\t\t\t\t\ttype=\"radio\"\r\n\t\t\t\t\t\t\t\tclassName=\"mf-input mf-radio-input \"\r\n\t\t\t\t\t\t\t\tname=\"mf-Gender\"\r\n\t\t\t\t\t\t\t\tvalue=\"Female\"\r\n\t\t\t\t\t\t\t\tdata-checked=\"\"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tonChange=${ parent.handleChange }\r\n\t\t\t\t\t\t\t\t\taria-invalid=\"${validation.errors['mf-Gender'] ? 'true' : 'false'}\"\r\n\t\t\t\t\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tparent.handleRadioDefault(el);\r\n\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"required\":false}, el)\r\n\t\t\t\t\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\tchecked=${'Female' === parent.getValue('mf-Gender')}\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t<span>\r\n\t\t\t\t\t\t\t\t${ parent.decodeEntities(`Female`) } \t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t<\/label>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf-Gender\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"mf-Gender\" value=\"\" \/>\r\n\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-1afa7e9 e-con-full e-flex e-con e-child\" data-id=\"1afa7e9\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div className=\"elementor-element elementor-element-b360243 e-con-full e-flex e-con e-child\" data-id=\"b360243\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-dcfaa8e elementor-widget elementor-widget-mf-number\" data-id=\"dcfaa8e\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf-Medical_Insurance_Provider__if_applicable__&quot;}\" data-widget_type=\"mf-number.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-number-dcfaa8e\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Medical Insurance Provider (if applicable):`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input\r\n\t\t\t\ttype=\"number\"\r\n\t\t\t\tstep=\"any\"\r\n\t\t\t\tclassName=\"mf-input \"\r\n\t\t\t\tid=\"mf-input-mobile-dcfaa8e\"\r\n\t\t\t\t\t\t\t\tname=\"mf-Medical_Insurance_Provider__if_applicable__\"\r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(`Medical Insurance Provider (if applicable):`) } \"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\r\n\t\t\t\t\taria-invalid=\"${validation.errors['mf-Medical_Insurance_Provider__if_applicable__'] ? 'true' : 'false'}\"\r\n\t\t\t\t\tref=${el => parent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":false,\"expression\":\"null\"}, el)}\r\n\t\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf-Medical_Insurance_Provider__if_applicable__\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-5b63446 e-con-full e-flex e-con e-child\" data-id=\"5b63446\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-54038b4 elementor-widget elementor-widget-mf-number\" data-id=\"54038b4\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf-Insurance_ID_Number_&quot;}\" data-widget_type=\"mf-number.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-number-54038b4\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Insurance ID Number:`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input\r\n\t\t\t\ttype=\"number\"\r\n\t\t\t\tstep=\"any\"\r\n\t\t\t\tclassName=\"mf-input \"\r\n\t\t\t\tid=\"mf-input-mobile-54038b4\"\r\n\t\t\t\t\t\t\t\tname=\"mf-Insurance_ID_Number_\"\r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(`Enter Insurance ID Number:`) } \"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\r\n\t\t\t\t\taria-invalid=\"${validation.errors['mf-Insurance_ID_Number_'] ? 'true' : 'false'}\"\r\n\t\t\t\t\tref=${el => parent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":false,\"expression\":\"null\"}, el)}\r\n\t\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf-Insurance_ID_Number_\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-aab0237 e-con-full e-flex e-con e-child\" data-id=\"aab0237\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div className=\"elementor-element elementor-element-e92493b e-con-full e-flex e-con e-child\" data-id=\"e92493b\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-83f5a65 elementor-widget elementor-widget-mf-number\" data-id=\"83f5a65\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf-MobileNumber&quot;}\" data-widget_type=\"mf-number.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-number-83f5a65\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Mobile Number:`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input\r\n\t\t\t\ttype=\"number\"\r\n\t\t\t\tstep=\"any\"\r\n\t\t\t\tclassName=\"mf-input \"\r\n\t\t\t\tid=\"mf-input-mobile-83f5a65\"\r\n\t\t\t\t\t\t\t\tname=\"mf-MobileNumber\"\r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(`Enter Mobile Number:`) } \"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\r\n\t\t\t\t\taria-invalid=\"${validation.errors['mf-MobileNumber'] ? 'true' : 'false'}\"\r\n\t\t\t\t\tref=${el => parent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true,\"expression\":\"null\"}, el)}\r\n\t\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf-MobileNumber\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-2acca8b e-con-full e-flex e-con e-child\" data-id=\"2acca8b\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-b760580 elementor-widget elementor-widget-mf-number\" data-id=\"b760580\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf-Alternate_Number__optional__&quot;}\" data-widget_type=\"mf-number.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-number-b760580\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Alternate Number (optional):`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input\r\n\t\t\t\ttype=\"number\"\r\n\t\t\t\tstep=\"any\"\r\n\t\t\t\tclassName=\"mf-input \"\r\n\t\t\t\tid=\"mf-input-mobile-b760580\"\r\n\t\t\t\t\t\t\t\tname=\"mf-Alternate_Number__optional__\"\r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(`Enter Alternate Number (optional):`) } \"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\r\n\t\t\t\t\taria-invalid=\"${validation.errors['mf-Alternate_Number__optional__'] ? 'true' : 'false'}\"\r\n\t\t\t\t\tref=${el => parent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":false,\"expression\":\"null\"}, el)}\r\n\t\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf-Alternate_Number__optional__\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-fbb6723 e-con-full e-flex e-con e-child\" data-id=\"fbb6723\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div className=\"elementor-element elementor-element-29a4f1a e-con-full e-flex e-con e-child\" data-id=\"29a4f1a\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-39b6461 elementor-widget elementor-widget-mf-email\" data-id=\"39b6461\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf-Email_Address__optional__&quot;}\" data-widget_type=\"mf-email.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-email-39b6461\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Email Address (optional):`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input \r\n\t\t\t\ttype=\"email\" \r\n\t\t\t\t \r\n\t\t\t\tdefaultValue=\"\" \r\n\t\t\t\tclassName=\"mf-input \" \r\n\t\t\t\tid=\"mf-input-email-39b6461\" \r\n\t\t\t\tname=\"mf-Email_Address__optional__\" \r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(`Enter Email Address:`) } \"\r\n\t\t\t\t \r\n\t\t\t\tonBlur=${parent.handleChange} onFocus=${parent.handleChange} aria-invalid=\"${validation.errors['mf-Email_Address__optional__'] ? 'true' : 'false' }\" \r\n\t\t\t\tref=${el=> parent.activateValidation({\"message\":\"This field is required.\",\"emailMessage\":\"Please enter a valid Email address\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":false,\"expression\":\"null\"}, el)}\r\n\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t<${validation.ErrorMessage} \r\n\t\t\t\terrors=${validation.errors} \r\n\t\t\t\tname=\"mf-Email_Address__optional__\" \r\n\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-bab75a4 e-con-full e-flex e-con e-child\" data-id=\"bab75a4\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-8e6875e elementor-widget elementor-widget-mf-radio\" data-id=\"8e6875e\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf-Preferred_Contact_Method__&quot;,&quot;mf_input_list&quot;:[{&quot;mf_input_option_text&quot;:&quot;Call&quot;,&quot;mf_input_option_value&quot;:&quot;Call&quot;,&quot;_id&quot;:&quot;696f550&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;SMS&quot;,&quot;mf_input_option_value&quot;:&quot;SMS&quot;,&quot;_id&quot;:&quot;6770cb0&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;Email&quot;,&quot;mf_input_option_value&quot;:&quot;Email&quot;,&quot;_id&quot;:&quot;cf19df8&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;WhatsApp&quot;,&quot;mf_input_option_value&quot;:&quot;WhatsApp&quot;,&quot;_id&quot;:&quot;557ed81&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;}]}\" data-widget_type=\"mf-radio.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-radio-8e6875e\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Preferred Contact Method: `) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<div className=\"mf-radio multi-option-input-type\" id=\"mf-input-radio-8e6875e\">\r\n\t\t\t\t\t\t\t\t\t<div className=\"mf-radio-option \">\r\n\t\t\t\t\t\t<label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input\r\n\t\t\t\t\t\t\t\ttype=\"radio\"\r\n\t\t\t\t\t\t\t\tclassName=\"mf-input mf-radio-input \"\r\n\t\t\t\t\t\t\t\tname=\"mf-Preferred_Contact_Method__\"\r\n\t\t\t\t\t\t\t\tvalue=\"Call\"\r\n\t\t\t\t\t\t\t\tdata-checked=\"\"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tonChange=${ parent.handleChange }\r\n\t\t\t\t\t\t\t\t\taria-invalid=\"${validation.errors['mf-Preferred_Contact_Method__'] ? 'true' : 'false'}\"\r\n\t\t\t\t\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tparent.handleRadioDefault(el);\r\n\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"required\":false}, el)\r\n\t\t\t\t\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\tchecked=${'Call' === parent.getValue('mf-Preferred_Contact_Method__')}\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t<span>\r\n\t\t\t\t\t\t\t\t${ parent.decodeEntities(`Call`) } \t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t<\/label>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t<div className=\"mf-radio-option \">\r\n\t\t\t\t\t\t<label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input\r\n\t\t\t\t\t\t\t\ttype=\"radio\"\r\n\t\t\t\t\t\t\t\tclassName=\"mf-input mf-radio-input \"\r\n\t\t\t\t\t\t\t\tname=\"mf-Preferred_Contact_Method__\"\r\n\t\t\t\t\t\t\t\tvalue=\"SMS\"\r\n\t\t\t\t\t\t\t\tdata-checked=\"\"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tonChange=${ parent.handleChange }\r\n\t\t\t\t\t\t\t\t\taria-invalid=\"${validation.errors['mf-Preferred_Contact_Method__'] ? 'true' : 'false'}\"\r\n\t\t\t\t\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tparent.handleRadioDefault(el);\r\n\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"required\":false}, el)\r\n\t\t\t\t\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\tchecked=${'SMS' === parent.getValue('mf-Preferred_Contact_Method__')}\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t<span>\r\n\t\t\t\t\t\t\t\t${ parent.decodeEntities(`SMS`) } \t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t<\/label>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t<div className=\"mf-radio-option \">\r\n\t\t\t\t\t\t<label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input\r\n\t\t\t\t\t\t\t\ttype=\"radio\"\r\n\t\t\t\t\t\t\t\tclassName=\"mf-input mf-radio-input \"\r\n\t\t\t\t\t\t\t\tname=\"mf-Preferred_Contact_Method__\"\r\n\t\t\t\t\t\t\t\tvalue=\"Email\"\r\n\t\t\t\t\t\t\t\tdata-checked=\"\"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tonChange=${ parent.handleChange }\r\n\t\t\t\t\t\t\t\t\taria-invalid=\"${validation.errors['mf-Preferred_Contact_Method__'] ? 'true' : 'false'}\"\r\n\t\t\t\t\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tparent.handleRadioDefault(el);\r\n\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"required\":false}, el)\r\n\t\t\t\t\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\tchecked=${'Email' === parent.getValue('mf-Preferred_Contact_Method__')}\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t<span>\r\n\t\t\t\t\t\t\t\t${ parent.decodeEntities(`Email`) } \t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t<\/label>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t<div className=\"mf-radio-option \">\r\n\t\t\t\t\t\t<label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input\r\n\t\t\t\t\t\t\t\ttype=\"radio\"\r\n\t\t\t\t\t\t\t\tclassName=\"mf-input mf-radio-input \"\r\n\t\t\t\t\t\t\t\tname=\"mf-Preferred_Contact_Method__\"\r\n\t\t\t\t\t\t\t\tvalue=\"WhatsApp\"\r\n\t\t\t\t\t\t\t\tdata-checked=\"\"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tonChange=${ parent.handleChange }\r\n\t\t\t\t\t\t\t\t\taria-invalid=\"${validation.errors['mf-Preferred_Contact_Method__'] ? 'true' : 'false'}\"\r\n\t\t\t\t\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tparent.handleRadioDefault(el);\r\n\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"required\":false}, el)\r\n\t\t\t\t\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\tchecked=${'WhatsApp' === parent.getValue('mf-Preferred_Contact_Method__')}\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t<span>\r\n\t\t\t\t\t\t\t\t${ parent.decodeEntities(`WhatsApp`) } \t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t<\/label>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf-Preferred_Contact_Method__\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"mf-Preferred_Contact_Method__\" value=\"\" \/>\r\n\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-9803399 e-con-full e-flex e-con e-child\" data-id=\"9803399\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div className=\"elementor-element elementor-element-12c19f1 e-con-full e-flex e-con e-child\" data-id=\"12c19f1\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-043bde6 elementor-widget elementor-widget-mf-text\" data-id=\"043bde6\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf-City&quot;}\" data-widget_type=\"mf-text.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-text-043bde6\">\r\n\t\t\t\t\t${ parent.decodeEntities(`City`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input\r\n\t\t\t\ttype=\"text\"\r\n\t\t\t\tclassName=\"mf-input \"\r\n\t\t\t\tid=\"mf-input-text-043bde6\"\r\n\t\t\t\tname=\"mf-City\"\r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(`Enter City`) } \"\r\n\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\r\n\t\t\t\t\tonBlur=${parent.handleChange}\r\n\t\t\t\t\taria-invalid=\"${validation.errors['mf-City'] ? 'true' : 'false'}\"\r\n\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":false,\"expression\":\"null\"}, el)\r\n\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf-City\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-755fdb6 e-con-full e-flex e-con e-child\" data-id=\"755fdb6\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-f8787ca elementor-widget elementor-widget-mf-text\" data-id=\"f8787ca\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf-District___Neighborhood_&quot;}\" data-widget_type=\"mf-text.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-text-f8787ca\">\r\n\t\t\t\t\t${ parent.decodeEntities(`District \/ Neighborhood:`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input\r\n\t\t\t\ttype=\"text\"\r\n\t\t\t\tclassName=\"mf-input \"\r\n\t\t\t\tid=\"mf-input-text-f8787ca\"\r\n\t\t\t\tname=\"mf-District___Neighborhood_\"\r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(`District \/ Neighborhood:`) } \"\r\n\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\r\n\t\t\t\t\tonBlur=${parent.handleChange}\r\n\t\t\t\t\taria-invalid=\"${validation.errors['mf-District___Neighborhood_'] ? 'true' : 'false'}\"\r\n\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":false,\"expression\":\"null\"}, el)\r\n\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf-District___Neighborhood_\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-0ab8bc1 e-con-full e-flex e-con e-child\" data-id=\"0ab8bc1\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-521c633 elementor-widget elementor-widget-mf-text\" data-id=\"521c633\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf-Street_Name_&quot;}\" data-widget_type=\"mf-text.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-text-521c633\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Street Name:`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input\r\n\t\t\t\ttype=\"text\"\r\n\t\t\t\tclassName=\"mf-input \"\r\n\t\t\t\tid=\"mf-input-text-521c633\"\r\n\t\t\t\tname=\"mf-Street_Name_\"\r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(`Street Name:`) } \"\r\n\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\r\n\t\t\t\t\tonBlur=${parent.handleChange}\r\n\t\t\t\t\taria-invalid=\"${validation.errors['mf-Street_Name_'] ? 'true' : 'false'}\"\r\n\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":false,\"expression\":\"null\"}, el)\r\n\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf-Street_Name_\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-de0c9d1 e-con-full e-flex e-con e-child\" data-id=\"de0c9d1\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div className=\"elementor-element elementor-element-4689640 e-con-full e-flex e-con e-child\" data-id=\"4689640\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-c19882b elementor-widget elementor-widget-mf-text\" data-id=\"c19882b\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf-Building_Villa_Number_&quot;}\" data-widget_type=\"mf-text.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-text-c19882b\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Building\/Villa Number:`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input\r\n\t\t\t\ttype=\"text\"\r\n\t\t\t\tclassName=\"mf-input \"\r\n\t\t\t\tid=\"mf-input-text-c19882b\"\r\n\t\t\t\tname=\"mf-Building_Villa_Number_\"\r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(`Enter Building\/Villa Number:`) } \"\r\n\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\r\n\t\t\t\t\tonBlur=${parent.handleChange}\r\n\t\t\t\t\taria-invalid=\"${validation.errors['mf-Building_Villa_Number_'] ? 'true' : 'false'}\"\r\n\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":false,\"expression\":\"null\"}, el)\r\n\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf-Building_Villa_Number_\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-01fed10 e-con-full e-flex e-con e-child\" data-id=\"01fed10\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-e8524c8 elementor-widget elementor-widget-mf-text\" data-id=\"e8524c8\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf-Landmark__optional__&quot;}\" data-widget_type=\"mf-text.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-text-e8524c8\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Landmark (optional):`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input\r\n\t\t\t\ttype=\"text\"\r\n\t\t\t\tclassName=\"mf-input \"\r\n\t\t\t\tid=\"mf-input-text-e8524c8\"\r\n\t\t\t\tname=\"mf-Landmark__optional__\"\r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(`Landmark (optional):`) } \"\r\n\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\r\n\t\t\t\t\tonBlur=${parent.handleChange}\r\n\t\t\t\t\taria-invalid=\"${validation.errors['mf-Landmark__optional__'] ? 'true' : 'false'}\"\r\n\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":false,\"expression\":\"null\"}, el)\r\n\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf-Landmark__optional__\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-5d54ba4 e-con-full e-flex e-con e-child\" data-id=\"5d54ba4\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-121e7dc elementor-widget elementor-widget-mf-text\" data-id=\"121e7dc\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf-Floor_Apartment_&quot;}\" data-widget_type=\"mf-text.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-text-121e7dc\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Floor\/Apartment:`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input\r\n\t\t\t\ttype=\"text\"\r\n\t\t\t\tclassName=\"mf-input \"\r\n\t\t\t\tid=\"mf-input-text-121e7dc\"\r\n\t\t\t\tname=\"mf-Floor_Apartment_\"\r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(`Floor\/Apartment:`) } \"\r\n\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\r\n\t\t\t\t\tonBlur=${parent.handleChange}\r\n\t\t\t\t\taria-invalid=\"${validation.errors['mf-Floor_Apartment_'] ? 'true' : 'false'}\"\r\n\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":false,\"expression\":\"null\"}, el)\r\n\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf-Floor_Apartment_\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-6276286 e-con-full e-flex e-con e-child\" data-id=\"6276286\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div className=\"elementor-element elementor-element-fb56c40 e-con-full e-flex e-con e-child\" data-id=\"fb56c40\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-94aef1a elementor-widget elementor-widget-mf-date\" data-id=\"94aef1a\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf-Preferred_Date_of_Appointment_&quot;}\" data-widget_type=\"mf-date.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-date-94aef1a\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Preferred Date of Appointment:`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<${props.Flatpickr}\r\n\t\t\t\t\tname=\"mf-Preferred_Date_of_Appointment_\"\r\n\t\t\t\t\tclassName=\"mf-input mf-date-input mf-left-parent  \"\r\n\t\t\t\t\tplaceholder=\"${ parent.decodeEntities(`Preferred Date of Appointment:`) } \"\r\n\t\t\t\t\toptions=${{\"minDate\":\"\",\"maxDate\":\"\",\"dateFormat\":\"m-d-Y\",\"enableTime\":\"\",\"disable\":[],\"mode\":\"single\",\"static\":true,\"disableMobile\":true,\"time_24hr\":false}}\r\n\t\t\t\t\tvalue=${parent.getValue('mf-Preferred_Date_of_Appointment_')}\r\n\t\t\t\t\tonInput=${parent.handleDateTime}\r\n\t\t\t\t\taria-invalid=\"${validation.errors['mf-Preferred_Date_of_Appointment_'] ? 'true' : 'false'}\"\r\n\t\t\t\t\tonReady=${(dates, dateStr, instance) => props.DateWidget(\r\n\t\tinstance,\r\n\t\t'',\r\n\t\t{\"message\":\"This field is required.\",\"required\":false},\r\n\t\tregister,\r\n\t\tparent\r\n\t)}\r\n\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf-Preferred_Date_of_Appointment_\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t\t<\/div>\r\n\r\n\t\t\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-d9eb52c e-con-full e-flex e-con e-child\" data-id=\"d9eb52c\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-de4aa42 elementor-widget elementor-widget-mf-radio\" data-id=\"de4aa42\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf-Preferred_Time_Slot_&quot;,&quot;mf_input_list&quot;:[{&quot;mf_input_option_text&quot;:&quot;Morning (8 AM \\u2013 12 PM)&quot;,&quot;mf_input_option_value&quot;:&quot;Morning (8 AM \\u2013 12 PM)&quot;,&quot;_id&quot;:&quot;2448bf0&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;Afternoon (12 PM \\u2013 4 PM)&quot;,&quot;mf_input_option_value&quot;:&quot;Afternoon (12 PM \\u2013 4 PM)&quot;,&quot;_id&quot;:&quot;b791109&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;Evening (4 PM \\u2013 8 PM)&quot;,&quot;mf_input_option_value&quot;:&quot;Evening (4 PM \\u2013 8 PM)&quot;,&quot;_id&quot;:&quot;40205fa&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;}]}\" data-widget_type=\"mf-radio.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-radio-de4aa42\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Preferred Time Slot:`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<div className=\"mf-radio multi-option-input-type\" id=\"mf-input-radio-de4aa42\">\r\n\t\t\t\t\t\t\t\t\t<div className=\"mf-radio-option \">\r\n\t\t\t\t\t\t<label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input\r\n\t\t\t\t\t\t\t\ttype=\"radio\"\r\n\t\t\t\t\t\t\t\tclassName=\"mf-input mf-radio-input \"\r\n\t\t\t\t\t\t\t\tname=\"mf-Preferred_Time_Slot_\"\r\n\t\t\t\t\t\t\t\tvalue=\"Morning (8 AM \u2013 12 PM)\"\r\n\t\t\t\t\t\t\t\tdata-checked=\"\"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tonChange=${ parent.handleChange }\r\n\t\t\t\t\t\t\t\t\taria-invalid=\"${validation.errors['mf-Preferred_Time_Slot_'] ? 'true' : 'false'}\"\r\n\t\t\t\t\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tparent.handleRadioDefault(el);\r\n\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"required\":false}, el)\r\n\t\t\t\t\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\tchecked=${'Morning (8 AM \u2013 12 PM)' === parent.getValue('mf-Preferred_Time_Slot_')}\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t<span>\r\n\t\t\t\t\t\t\t\t${ parent.decodeEntities(`Morning (8 AM \u2013 12 PM)`) } \t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t<\/label>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t<div className=\"mf-radio-option \">\r\n\t\t\t\t\t\t<label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input\r\n\t\t\t\t\t\t\t\ttype=\"radio\"\r\n\t\t\t\t\t\t\t\tclassName=\"mf-input mf-radio-input \"\r\n\t\t\t\t\t\t\t\tname=\"mf-Preferred_Time_Slot_\"\r\n\t\t\t\t\t\t\t\tvalue=\"Afternoon (12 PM \u2013 4 PM)\"\r\n\t\t\t\t\t\t\t\tdata-checked=\"\"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tonChange=${ parent.handleChange }\r\n\t\t\t\t\t\t\t\t\taria-invalid=\"${validation.errors['mf-Preferred_Time_Slot_'] ? 'true' : 'false'}\"\r\n\t\t\t\t\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tparent.handleRadioDefault(el);\r\n\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"required\":false}, el)\r\n\t\t\t\t\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\tchecked=${'Afternoon (12 PM \u2013 4 PM)' === parent.getValue('mf-Preferred_Time_Slot_')}\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t<span>\r\n\t\t\t\t\t\t\t\t${ parent.decodeEntities(`Afternoon (12 PM \u2013 4 PM)`) } \t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t<\/label>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t<div className=\"mf-radio-option \">\r\n\t\t\t\t\t\t<label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input\r\n\t\t\t\t\t\t\t\ttype=\"radio\"\r\n\t\t\t\t\t\t\t\tclassName=\"mf-input mf-radio-input \"\r\n\t\t\t\t\t\t\t\tname=\"mf-Preferred_Time_Slot_\"\r\n\t\t\t\t\t\t\t\tvalue=\"Evening (4 PM \u2013 8 PM)\"\r\n\t\t\t\t\t\t\t\tdata-checked=\"\"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tonChange=${ parent.handleChange }\r\n\t\t\t\t\t\t\t\t\taria-invalid=\"${validation.errors['mf-Preferred_Time_Slot_'] ? 'true' : 'false'}\"\r\n\t\t\t\t\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tparent.handleRadioDefault(el);\r\n\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"required\":false}, el)\r\n\t\t\t\t\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\tchecked=${'Evening (4 PM \u2013 8 PM)' === parent.getValue('mf-Preferred_Time_Slot_')}\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t<span>\r\n\t\t\t\t\t\t\t\t${ parent.decodeEntities(`Evening (4 PM \u2013 8 PM)`) } \t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t<\/label>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf-Preferred_Time_Slot_\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"mf-Preferred_Time_Slot_\" value=\"\" \/>\r\n\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-10da9f7 e-con-full e-flex e-con e-child\" data-id=\"10da9f7\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div className=\"elementor-element elementor-element-481acb5 e-con-full e-flex e-con e-child\" data-id=\"481acb5\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-128d45d elementor-widget elementor-widget-mf-radio\" data-id=\"128d45d\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf-Is_the_visit_urgent_&quot;,&quot;mf_input_list&quot;:[{&quot;mf_input_option_text&quot;:&quot;Yes&quot;,&quot;mf_input_option_value&quot;:&quot;Yes&quot;,&quot;_id&quot;:&quot;2448bf0&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;No&quot;,&quot;mf_input_option_value&quot;:&quot;No&quot;,&quot;_id&quot;:&quot;b791109&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;}]}\" data-widget_type=\"mf-radio.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-radio-128d45d\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Is the visit urgent?`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<div className=\"mf-radio multi-option-input-type\" id=\"mf-input-radio-128d45d\">\r\n\t\t\t\t\t\t\t\t\t<div className=\"mf-radio-option \">\r\n\t\t\t\t\t\t<label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input\r\n\t\t\t\t\t\t\t\ttype=\"radio\"\r\n\t\t\t\t\t\t\t\tclassName=\"mf-input mf-radio-input \"\r\n\t\t\t\t\t\t\t\tname=\"mf-Is_the_visit_urgent_\"\r\n\t\t\t\t\t\t\t\tvalue=\"Yes\"\r\n\t\t\t\t\t\t\t\tdata-checked=\"\"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tonChange=${ parent.handleChange }\r\n\t\t\t\t\t\t\t\t\taria-invalid=\"${validation.errors['mf-Is_the_visit_urgent_'] ? 'true' : 'false'}\"\r\n\t\t\t\t\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tparent.handleRadioDefault(el);\r\n\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"required\":false}, el)\r\n\t\t\t\t\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\tchecked=${'Yes' === parent.getValue('mf-Is_the_visit_urgent_')}\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t<span>\r\n\t\t\t\t\t\t\t\t${ parent.decodeEntities(`Yes`) } \t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t<\/label>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t<div className=\"mf-radio-option \">\r\n\t\t\t\t\t\t<label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input\r\n\t\t\t\t\t\t\t\ttype=\"radio\"\r\n\t\t\t\t\t\t\t\tclassName=\"mf-input mf-radio-input \"\r\n\t\t\t\t\t\t\t\tname=\"mf-Is_the_visit_urgent_\"\r\n\t\t\t\t\t\t\t\tvalue=\"No\"\r\n\t\t\t\t\t\t\t\tdata-checked=\"\"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tonChange=${ parent.handleChange }\r\n\t\t\t\t\t\t\t\t\taria-invalid=\"${validation.errors['mf-Is_the_visit_urgent_'] ? 'true' : 'false'}\"\r\n\t\t\t\t\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tparent.handleRadioDefault(el);\r\n\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"required\":false}, el)\r\n\t\t\t\t\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\tchecked=${'No' === parent.getValue('mf-Is_the_visit_urgent_')}\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t<span>\r\n\t\t\t\t\t\t\t\t${ parent.decodeEntities(`No`) } \t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t<\/label>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf-Is_the_visit_urgent_\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"mf-Is_the_visit_urgent_\" value=\"\" \/>\r\n\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-4903035 e-con-full e-flex e-con e-child\" data-id=\"4903035\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-94b04ce elementor-widget elementor-widget-mf-radio\" data-id=\"94b04ce\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf-Service_Requested_&quot;,&quot;mf_input_list&quot;:[{&quot;mf_input_option_text&quot;:&quot;Doctor Visit&quot;,&quot;mf_input_option_value&quot;:&quot;Doctor Visit&quot;,&quot;_id&quot;:&quot;2448bf0&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;Nurse Visit&quot;,&quot;mf_input_option_value&quot;:&quot;Nurse Visit&quot;,&quot;_id&quot;:&quot;b791109&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;Physiotherapy&quot;,&quot;mf_input_option_value&quot;:&quot;Physiotherapy&quot;,&quot;_id&quot;:&quot;40205fa&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;Lab Sample Collection&quot;,&quot;mf_input_option_value&quot;:&quot;Lab Sample Collection&quot;,&quot;_id&quot;:&quot;6b7df32&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;Injection \\\/ Wound Care&quot;,&quot;mf_input_option_value&quot;:&quot;Injection \\\/ Wound Care&quot;,&quot;_id&quot;:&quot;b18147e&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;Vital Checkup \\\/ Wellness&quot;,&quot;mf_input_option_value&quot;:&quot;Vital Checkup \\\/ Wellness&quot;,&quot;_id&quot;:&quot;c040363&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;Other&quot;,&quot;mf_input_option_value&quot;:&quot;Other&quot;,&quot;_id&quot;:&quot;277cfea&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;}]}\" data-widget_type=\"mf-radio.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-radio-94b04ce\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Service Requested:`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<div className=\"mf-radio multi-option-input-type\" id=\"mf-input-radio-94b04ce\">\r\n\t\t\t\t\t\t\t\t\t<div className=\"mf-radio-option \">\r\n\t\t\t\t\t\t<label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input\r\n\t\t\t\t\t\t\t\ttype=\"radio\"\r\n\t\t\t\t\t\t\t\tclassName=\"mf-input mf-radio-input \"\r\n\t\t\t\t\t\t\t\tname=\"mf-Service_Requested_\"\r\n\t\t\t\t\t\t\t\tvalue=\"Doctor Visit\"\r\n\t\t\t\t\t\t\t\tdata-checked=\"\"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tonChange=${ parent.handleChange }\r\n\t\t\t\t\t\t\t\t\taria-invalid=\"${validation.errors['mf-Service_Requested_'] ? 'true' : 'false'}\"\r\n\t\t\t\t\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tparent.handleRadioDefault(el);\r\n\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"required\":false}, el)\r\n\t\t\t\t\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\tchecked=${'Doctor Visit' === parent.getValue('mf-Service_Requested_')}\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t<span>\r\n\t\t\t\t\t\t\t\t${ parent.decodeEntities(`Doctor Visit`) } \t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t<\/label>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t<div className=\"mf-radio-option \">\r\n\t\t\t\t\t\t<label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input\r\n\t\t\t\t\t\t\t\ttype=\"radio\"\r\n\t\t\t\t\t\t\t\tclassName=\"mf-input mf-radio-input \"\r\n\t\t\t\t\t\t\t\tname=\"mf-Service_Requested_\"\r\n\t\t\t\t\t\t\t\tvalue=\"Nurse Visit\"\r\n\t\t\t\t\t\t\t\tdata-checked=\"\"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tonChange=${ parent.handleChange }\r\n\t\t\t\t\t\t\t\t\taria-invalid=\"${validation.errors['mf-Service_Requested_'] ? 'true' : 'false'}\"\r\n\t\t\t\t\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tparent.handleRadioDefault(el);\r\n\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"required\":false}, el)\r\n\t\t\t\t\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\tchecked=${'Nurse Visit' === parent.getValue('mf-Service_Requested_')}\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t<span>\r\n\t\t\t\t\t\t\t\t${ parent.decodeEntities(`Nurse Visit`) } \t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t<\/label>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t<div className=\"mf-radio-option \">\r\n\t\t\t\t\t\t<label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input\r\n\t\t\t\t\t\t\t\ttype=\"radio\"\r\n\t\t\t\t\t\t\t\tclassName=\"mf-input mf-radio-input \"\r\n\t\t\t\t\t\t\t\tname=\"mf-Service_Requested_\"\r\n\t\t\t\t\t\t\t\tvalue=\"Physiotherapy\"\r\n\t\t\t\t\t\t\t\tdata-checked=\"\"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tonChange=${ parent.handleChange }\r\n\t\t\t\t\t\t\t\t\taria-invalid=\"${validation.errors['mf-Service_Requested_'] ? 'true' : 'false'}\"\r\n\t\t\t\t\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tparent.handleRadioDefault(el);\r\n\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"required\":false}, el)\r\n\t\t\t\t\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\tchecked=${'Physiotherapy' === parent.getValue('mf-Service_Requested_')}\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t<span>\r\n\t\t\t\t\t\t\t\t${ parent.decodeEntities(`Physiotherapy`) } \t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t<\/label>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t<div className=\"mf-radio-option \">\r\n\t\t\t\t\t\t<label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input\r\n\t\t\t\t\t\t\t\ttype=\"radio\"\r\n\t\t\t\t\t\t\t\tclassName=\"mf-input mf-radio-input \"\r\n\t\t\t\t\t\t\t\tname=\"mf-Service_Requested_\"\r\n\t\t\t\t\t\t\t\tvalue=\"Lab Sample Collection\"\r\n\t\t\t\t\t\t\t\tdata-checked=\"\"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tonChange=${ parent.handleChange }\r\n\t\t\t\t\t\t\t\t\taria-invalid=\"${validation.errors['mf-Service_Requested_'] ? 'true' : 'false'}\"\r\n\t\t\t\t\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tparent.handleRadioDefault(el);\r\n\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"required\":false}, el)\r\n\t\t\t\t\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\tchecked=${'Lab Sample Collection' === parent.getValue('mf-Service_Requested_')}\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t<span>\r\n\t\t\t\t\t\t\t\t${ parent.decodeEntities(`Lab Sample Collection`) } \t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t<\/label>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t<div className=\"mf-radio-option \">\r\n\t\t\t\t\t\t<label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input\r\n\t\t\t\t\t\t\t\ttype=\"radio\"\r\n\t\t\t\t\t\t\t\tclassName=\"mf-input mf-radio-input \"\r\n\t\t\t\t\t\t\t\tname=\"mf-Service_Requested_\"\r\n\t\t\t\t\t\t\t\tvalue=\"Injection \/ Wound Care\"\r\n\t\t\t\t\t\t\t\tdata-checked=\"\"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tonChange=${ parent.handleChange }\r\n\t\t\t\t\t\t\t\t\taria-invalid=\"${validation.errors['mf-Service_Requested_'] ? 'true' : 'false'}\"\r\n\t\t\t\t\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tparent.handleRadioDefault(el);\r\n\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"required\":false}, el)\r\n\t\t\t\t\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\tchecked=${'Injection \/ Wound Care' === parent.getValue('mf-Service_Requested_')}\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t<span>\r\n\t\t\t\t\t\t\t\t${ parent.decodeEntities(`Injection \/ Wound Care`) } \t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t<\/label>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t<div className=\"mf-radio-option \">\r\n\t\t\t\t\t\t<label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input\r\n\t\t\t\t\t\t\t\ttype=\"radio\"\r\n\t\t\t\t\t\t\t\tclassName=\"mf-input mf-radio-input \"\r\n\t\t\t\t\t\t\t\tname=\"mf-Service_Requested_\"\r\n\t\t\t\t\t\t\t\tvalue=\"Vital Checkup \/ Wellness\"\r\n\t\t\t\t\t\t\t\tdata-checked=\"\"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tonChange=${ parent.handleChange }\r\n\t\t\t\t\t\t\t\t\taria-invalid=\"${validation.errors['mf-Service_Requested_'] ? 'true' : 'false'}\"\r\n\t\t\t\t\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tparent.handleRadioDefault(el);\r\n\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"required\":false}, el)\r\n\t\t\t\t\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\tchecked=${'Vital Checkup \/ Wellness' === parent.getValue('mf-Service_Requested_')}\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t<span>\r\n\t\t\t\t\t\t\t\t${ parent.decodeEntities(`Vital Checkup \/ Wellness`) } \t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t<\/label>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t<div className=\"mf-radio-option \">\r\n\t\t\t\t\t\t<label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input\r\n\t\t\t\t\t\t\t\ttype=\"radio\"\r\n\t\t\t\t\t\t\t\tclassName=\"mf-input mf-radio-input \"\r\n\t\t\t\t\t\t\t\tname=\"mf-Service_Requested_\"\r\n\t\t\t\t\t\t\t\tvalue=\"Other\"\r\n\t\t\t\t\t\t\t\tdata-checked=\"\"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tonChange=${ parent.handleChange }\r\n\t\t\t\t\t\t\t\t\taria-invalid=\"${validation.errors['mf-Service_Requested_'] ? 'true' : 'false'}\"\r\n\t\t\t\t\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tparent.handleRadioDefault(el);\r\n\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"required\":false}, el)\r\n\t\t\t\t\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\tchecked=${'Other' === parent.getValue('mf-Service_Requested_')}\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t<span>\r\n\t\t\t\t\t\t\t\t${ parent.decodeEntities(`Other`) } \t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t<\/label>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf-Service_Requested_\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"mf-Service_Requested_\" value=\"\" \/>\r\n\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-6a94ce6 e-con-full e-flex e-con e-child\" data-id=\"6a94ce6\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div className=\"elementor-element elementor-element-0020842 e-con-full e-flex e-con e-child\" data-id=\"0020842\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-eb4b516 elementor-widget elementor-widget-mf-text\" data-id=\"eb4b516\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf-Primary_Medical_Concern___Reason_for_Visit_&quot;}\" data-widget_type=\"mf-text.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-text-eb4b516\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Primary Medical Concern \/ Reason for Visit:`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input\r\n\t\t\t\ttype=\"text\"\r\n\t\t\t\tclassName=\"mf-input \"\r\n\t\t\t\tid=\"mf-input-text-eb4b516\"\r\n\t\t\t\tname=\"mf-Primary_Medical_Concern___Reason_for_Visit_\"\r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(`Enter Primary Medical Concern \/ Reason for Visit::`) } \"\r\n\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\r\n\t\t\t\t\tonBlur=${parent.handleChange}\r\n\t\t\t\t\taria-invalid=\"${validation.errors['mf-Primary_Medical_Concern___Reason_for_Visit_'] ? 'true' : 'false'}\"\r\n\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":false,\"expression\":\"null\"}, el)\r\n\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf-Primary_Medical_Concern___Reason_for_Visit_\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-73087af e-con-full e-flex e-con e-child\" data-id=\"73087af\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-612cb23 elementor-widget elementor-widget-mf-radio\" data-id=\"612cb23\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf-Any_existing_medical_conditions_&quot;,&quot;mf_input_list&quot;:[{&quot;mf_input_option_text&quot;:&quot;Diabetes &quot;,&quot;mf_input_option_value&quot;:&quot;Diabetes &quot;,&quot;_id&quot;:&quot;2448bf0&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;Hypertension &quot;,&quot;mf_input_option_value&quot;:&quot;Hypertension &quot;,&quot;_id&quot;:&quot;b791109&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;Asthma &quot;,&quot;mf_input_option_value&quot;:&quot;Asthma &quot;,&quot;_id&quot;:&quot;40205fa&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;Heart Disease&quot;,&quot;mf_input_option_value&quot;:&quot;Heart Disease&quot;,&quot;_id&quot;:&quot;6b7df32&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;Other&quot;,&quot;mf_input_option_value&quot;:&quot;Other&quot;,&quot;_id&quot;:&quot;277cfea&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;}]}\" data-widget_type=\"mf-radio.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-radio-612cb23\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Any existing medical conditions?`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<div className=\"mf-radio multi-option-input-type\" id=\"mf-input-radio-612cb23\">\r\n\t\t\t\t\t\t\t\t\t<div className=\"mf-radio-option \">\r\n\t\t\t\t\t\t<label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input\r\n\t\t\t\t\t\t\t\ttype=\"radio\"\r\n\t\t\t\t\t\t\t\tclassName=\"mf-input mf-radio-input \"\r\n\t\t\t\t\t\t\t\tname=\"mf-Any_existing_medical_conditions_\"\r\n\t\t\t\t\t\t\t\tvalue=\"Diabetes \"\r\n\t\t\t\t\t\t\t\tdata-checked=\"\"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tonChange=${ parent.handleChange }\r\n\t\t\t\t\t\t\t\t\taria-invalid=\"${validation.errors['mf-Any_existing_medical_conditions_'] ? 'true' : 'false'}\"\r\n\t\t\t\t\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tparent.handleRadioDefault(el);\r\n\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"required\":false}, el)\r\n\t\t\t\t\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\tchecked=${'Diabetes ' === parent.getValue('mf-Any_existing_medical_conditions_')}\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t<span>\r\n\t\t\t\t\t\t\t\t${ parent.decodeEntities(`Diabetes `) } \t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t<\/label>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t<div className=\"mf-radio-option \">\r\n\t\t\t\t\t\t<label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input\r\n\t\t\t\t\t\t\t\ttype=\"radio\"\r\n\t\t\t\t\t\t\t\tclassName=\"mf-input mf-radio-input \"\r\n\t\t\t\t\t\t\t\tname=\"mf-Any_existing_medical_conditions_\"\r\n\t\t\t\t\t\t\t\tvalue=\"Hypertension \"\r\n\t\t\t\t\t\t\t\tdata-checked=\"\"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tonChange=${ parent.handleChange }\r\n\t\t\t\t\t\t\t\t\taria-invalid=\"${validation.errors['mf-Any_existing_medical_conditions_'] ? 'true' : 'false'}\"\r\n\t\t\t\t\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tparent.handleRadioDefault(el);\r\n\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"required\":false}, el)\r\n\t\t\t\t\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\tchecked=${'Hypertension ' === parent.getValue('mf-Any_existing_medical_conditions_')}\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t<span>\r\n\t\t\t\t\t\t\t\t${ parent.decodeEntities(`Hypertension `) } \t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t<\/label>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t<div className=\"mf-radio-option \">\r\n\t\t\t\t\t\t<label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input\r\n\t\t\t\t\t\t\t\ttype=\"radio\"\r\n\t\t\t\t\t\t\t\tclassName=\"mf-input mf-radio-input \"\r\n\t\t\t\t\t\t\t\tname=\"mf-Any_existing_medical_conditions_\"\r\n\t\t\t\t\t\t\t\tvalue=\"Asthma \"\r\n\t\t\t\t\t\t\t\tdata-checked=\"\"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tonChange=${ parent.handleChange }\r\n\t\t\t\t\t\t\t\t\taria-invalid=\"${validation.errors['mf-Any_existing_medical_conditions_'] ? 'true' : 'false'}\"\r\n\t\t\t\t\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tparent.handleRadioDefault(el);\r\n\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"required\":false}, el)\r\n\t\t\t\t\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\tchecked=${'Asthma ' === parent.getValue('mf-Any_existing_medical_conditions_')}\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t<span>\r\n\t\t\t\t\t\t\t\t${ parent.decodeEntities(`Asthma `) } \t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t<\/label>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t<div className=\"mf-radio-option \">\r\n\t\t\t\t\t\t<label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input\r\n\t\t\t\t\t\t\t\ttype=\"radio\"\r\n\t\t\t\t\t\t\t\tclassName=\"mf-input mf-radio-input \"\r\n\t\t\t\t\t\t\t\tname=\"mf-Any_existing_medical_conditions_\"\r\n\t\t\t\t\t\t\t\tvalue=\"Heart Disease\"\r\n\t\t\t\t\t\t\t\tdata-checked=\"\"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tonChange=${ parent.handleChange }\r\n\t\t\t\t\t\t\t\t\taria-invalid=\"${validation.errors['mf-Any_existing_medical_conditions_'] ? 'true' : 'false'}\"\r\n\t\t\t\t\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tparent.handleRadioDefault(el);\r\n\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"required\":false}, el)\r\n\t\t\t\t\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\tchecked=${'Heart Disease' === parent.getValue('mf-Any_existing_medical_conditions_')}\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t<span>\r\n\t\t\t\t\t\t\t\t${ parent.decodeEntities(`Heart Disease`) } \t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t<\/label>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t<div className=\"mf-radio-option \">\r\n\t\t\t\t\t\t<label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input\r\n\t\t\t\t\t\t\t\ttype=\"radio\"\r\n\t\t\t\t\t\t\t\tclassName=\"mf-input mf-radio-input \"\r\n\t\t\t\t\t\t\t\tname=\"mf-Any_existing_medical_conditions_\"\r\n\t\t\t\t\t\t\t\tvalue=\"Other\"\r\n\t\t\t\t\t\t\t\tdata-checked=\"\"\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tonChange=${ parent.handleChange }\r\n\t\t\t\t\t\t\t\t\taria-invalid=\"${validation.errors['mf-Any_existing_medical_conditions_'] ? 'true' : 'false'}\"\r\n\t\t\t\t\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tparent.handleRadioDefault(el);\r\n\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"required\":false}, el)\r\n\t\t\t\t\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\tchecked=${'Other' === parent.getValue('mf-Any_existing_medical_conditions_')}\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t<span>\r\n\t\t\t\t\t\t\t\t${ parent.decodeEntities(`Other`) } \t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t<\/label>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf-Any_existing_medical_conditions_\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"mf-Any_existing_medical_conditions_\" value=\"\" \/>\r\n\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-0d8676c e-con-full e-flex e-con e-child\" data-id=\"0d8676c\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div className=\"elementor-element elementor-element-7d19364 e-con-full e-flex e-con e-child\" data-id=\"7d19364\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-da24655 elementor-widget elementor-widget-mf-text\" data-id=\"da24655\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf-Current_Medications__if_any__&quot;}\" data-widget_type=\"mf-text.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-text-da24655\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Current Medications (if any):`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input\r\n\t\t\t\ttype=\"text\"\r\n\t\t\t\tclassName=\"mf-input \"\r\n\t\t\t\tid=\"mf-input-text-da24655\"\r\n\t\t\t\tname=\"mf-Current_Medications__if_any__\"\r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(`Enter Current Medications (if any):`) } \"\r\n\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\r\n\t\t\t\t\tonBlur=${parent.handleChange}\r\n\t\t\t\t\taria-invalid=\"${validation.errors['mf-Current_Medications__if_any__'] ? 'true' : 'false'}\"\r\n\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":false,\"expression\":\"null\"}, el)\r\n\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf-Current_Medications__if_any__\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-45d9dbc e-con-full e-flex e-con e-child\" data-id=\"45d9dbc\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-0fb8dbd elementor-widget elementor-widget-mf-textarea\" data-id=\"0fb8dbd\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf-Additional_Notes__if_any__&quot;}\" data-widget_type=\"mf-textarea.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-text-area-0fb8dbd\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Additional Notes (if any):`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<textarea className=\"mf-input mf-textarea \" id=\"mf-input-text-area-0fb8dbd\"\r\n\t\t\t\tname=\"mf-Additional_Notes__if_any__\" \r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(`Enter message`) } \"\r\n\t\t\t\tcols=\"30\" rows=\"10\"\r\n\t\t\t\t\t\t\t\t\tonInput=${ parent.handleChange }\r\n\t\t\t\t\taria-invalid=\"${validation.errors['mf-Additional_Notes__if_any__'] ? 'true' : 'false'}\"\r\n\t\t\t\t\tref=${ el => parent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":false,\"expression\":\"null\"}, el)}\r\n\t\t\t\t\t\t\t\t><\/textarea>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf-Additional_Notes__if_any__\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-7391134 e-con-full e-flex e-con e-child\" data-id=\"7391134\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div className=\"elementor-element elementor-element-27a5232 e-con-full e-flex e-con e-child\" data-id=\"27a5232\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-81864ee elementor-widget elementor-widget-mf-gdpr-consent\" data-id=\"81864ee\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf-consent&quot;}\" data-widget_type=\"mf-gdpr-consent.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\n\t\t<div className=\"mf-input-wrapper\">\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-gdpr-81864ee\">\n\t\t\t\t\t${ parent.decodeEntities(``) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\n\t\t\t\t<\/label>\n\t\t\t\n\t\t\t<div className=\"mf-checkbox multi-option-input-type\" id=\"mf-input-gdpr-81864ee\">\n\t\t\t\t<div className=\"mf-checkbox-option\">\n\t\t\t\t\t<label>\n\t\t\t\t\t\t\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"checkbox\"\n\t\t\t\t\t\t\tclassName=\"mf-input mf-checkbox-input \"\n\t\t\t\t\t\t\tname=\"mf-consent\"\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tonInput=${ parent.handleOptin }\n\t\t\t\t\t\t\t\taria-invalid=\"${validation.errors['mf-consent'] ? 'true' : 'false'}\"\n\t\t\t\t\t\t\t\tref=${ el => parent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true,\"expression\":\"null\"}, el) }\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\n\t\t\t\t\t\t<span>\n\t\t\t\t\t\t\tI consent to sharing this information for the purpose of receiving medical home care services.\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\n\t\t\t\t\terrors=${validation.errors}\n\t\t\t\t\tname=\"mf-consent\"\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\n\t\t\t\t\t\/>\n\t\t\t\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-cb2a6a7 e-con-full e-flex e-con e-child\" data-id=\"cb2a6a7\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div className=\"elementor-element elementor-element-81a1f3a e-con-full e-flex e-con e-child\" data-id=\"81a1f3a\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-3ccae9a mf-btn--left elementor-widget elementor-widget-mf-button\" data-id=\"3ccae9a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"mf-button.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div className=\"mf-btn-wraper \" data-mf-form-conditional-logic-requirement=\"\">\r\n\t\t\t\t\t\t\t<button type=\"submit\" className=\"metform-btn metform-submit-btn \" id=\"\">\r\n\t\t\t\t\t<span>${ parent.decodeEntities(`Submit `) } <\/span>\r\n\t\t\t\t<\/button>\r\n\t\t\t        <\/div>\r\n        \t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-7d40243 e-con-full e-flex e-con e-child\" data-id=\"7d40243\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t`}\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t${is_dummy_markup ? message_position === 'bottom' ? props.ResponseDummyMarkup(message_successIcon, message_proClass) : '' : ''}\r\n\t\t\t\t\t${is_dummy_markup ? ' ' : message_position === 'bottom' ? props.SubmitResponseMarkup`${parent}${state}${message_successIcon}${message_errorIcon}${message_proClass}` : ''}\r\n\t\t\t\t\r\n\t\t\t\t<\/form>\r\n\t\t\t`\r\n\t\t<\/script>\r\n\r\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Schedule your personalized in-home care visit with just a few clicks\u2014your health and comfort come first. Visit Us Need More Information? Get in touch with us today and discover how Novacare can bring compassionate, expert care right to your doorstep. Call Now +973 38709910 Email Us novacareglobal@gmail.com<\/p>","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-404","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/novacareglobal.com\/ar\/wp-json\/wp\/v2\/pages\/404","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/novacareglobal.com\/ar\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/novacareglobal.com\/ar\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/novacareglobal.com\/ar\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/novacareglobal.com\/ar\/wp-json\/wp\/v2\/comments?post=404"}],"version-history":[{"count":52,"href":"https:\/\/novacareglobal.com\/ar\/wp-json\/wp\/v2\/pages\/404\/revisions"}],"predecessor-version":[{"id":639,"href":"https:\/\/novacareglobal.com\/ar\/wp-json\/wp\/v2\/pages\/404\/revisions\/639"}],"wp:attachment":[{"href":"https:\/\/novacareglobal.com\/ar\/wp-json\/wp\/v2\/media?parent=404"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}