{"id":1110,"date":"2023-06-09T21:45:05","date_gmt":"2023-06-09T21:45:05","guid":{"rendered":"https:\/\/innovadentallab.com\/?page_id=1110"},"modified":"2023-08-15T19:08:34","modified_gmt":"2023-08-15T19:08:34","slug":"form","status":"publish","type":"page","link":"https:\/\/innovadentallab.com\/form\/","title":{"rendered":"Form"},"content":{"rendered":"<div>\n<p>          <!--<img src = \"\/wp-content\/uploads\/2023\/08\/teethnum.png\" alt = \"HTML Map\" border = \"0\" usemap = \"#teeth\"\/>\n      \n      \n\n<map name = \"teeth\">\n         \n         \n\n<area shape = \"circle\" \n            coords = \"22,83,126,125\"\n            href = \"?diente-seleccionado=one\" \n            target = \"_self\"\n               \/>\n         \n         \n\n<area shape = \"circle\" \n            coords = \"73,168,32\"\n            href = \"?diente-seleccionado=two\"\n            target = \"_self\" \n\t\t\t\/>\n      <\/map>\n\n --><\/p>\n<p><img decoding=\"async\" src=\"\/wp-content\/uploads\/2023\/08\/teethnum.png\" usemap=\"#image_map\"><\/p>\n<map name=\"image_map\">\n<area alt=\"1\" title=\"1\" href=\"\/?diente=1\" coords=\"45,301,25\" shape=\"circle\">\n<area alt=\"8\" title=\"8\" href=\"\/?diente=8\" coords=\"224,47,21\" shape=\"circle\">\n<area alt=\"9\" title=\"9\" href=\"\/?diente=9\" coords=\"273,47,21\" shape=\"circle\">\n<area alt=\"13\" title=\"13\" href=\"\/?diente=13\" coords=\"414,163,18\" shape=\"circle\">\n<area alt=\"16\" title=\"16\" href=\"\/?diente=16\" coords=\"447,299,23\" shape=\"circle\">\n<area alt=\"20\" title=\"20\" href=\"\/?diente=20\" coords=\"415,526,24\" shape=\"circle\">\n<area alt=\"29\" title=\"29\" href=\"\/?diente=29\" coords=\"80,529,22\" shape=\"circle\">\n<\/map>\n<\/div>\n<div>\n<div class=\"forminator-ui forminator-custom-form forminator-custom-form-1102 forminator-design--flat  forminator_ajax\" data-forminator-render=\"0\" data-form=\"forminator-module-1102\" data-uid=\"660592fcd1139\"><br\/><\/div><form\r\n\t\t\t\tid=\"forminator-module-1102\"\r\n\t\t\t\tclass=\"forminator-ui forminator-custom-form forminator-custom-form-1102 forminator-design--flat  forminator_ajax\"\r\n\t\t\t\tmethod=\"post\"\r\n\t\t\t\tdata-forminator-render=\"0\"\r\n\t\t\t\tdata-form-id=\"1102\"\r\n\t\t\t\t\r\n\t\t\t\tdata-design=\"flat\"\r\n\t\t\t\t\r\n\t\t\t\t\r\n\t\t\t\t\r\n\t\t\t\tdata-grid=\"open\"\r\n\t\t\t\tenctype=\"multipart\/form-data\"\r\n\t\t\t\t\r\n\t\t\t\tstyle=\"display: none;\"\r\n\t\t\t\t\r\n\t\t\t\tdata-uid=\"660592fcd1139\"\r\n\t\t\t><div role=\"alert\" aria-live=\"polite\" class=\"forminator-response-message forminator-error\" aria-hidden=\"true\"><\/div><div class=\"forminator-row\"><div id=\"text-1\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-1_660592fcd1139\" id=\"forminator-field-text-1_660592fcd1139-label\" class=\"forminator-label\">Dental Office<\/label><input type=\"text\" name=\"text-1\" value=\"\" placeholder=\"E.g. text placeholder\" id=\"forminator-field-text-1_660592fcd1139\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"name-1\" class=\"forminator-field-name forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-1_660592fcd1139\" id=\"forminator-field-name-1_660592fcd1139-label\" class=\"forminator-label\">Dr.<\/label><input type=\"text\" name=\"name-1\" value=\"\" placeholder=\"E.g. 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class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Yes<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-1\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-1_660592fcd1139\" id=\"forminator-field-textarea-1_660592fcd1139-label\" class=\"forminator-label\">Specific Instructions:<\/label><textarea name=\"textarea-1\" placeholder=\"E.g. text placeholder\nYou can add new line\" id=\"forminator-field-textarea-1_660592fcd1139\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"upload-1\" class=\"forminator-field-upload forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-upload-1_660592fcd1139\" id=\"forminator-field-upload-1_660592fcd1139-label\" 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