{"id":169,"date":"2019-10-21T12:25:27","date_gmt":"2019-10-21T12:25:27","guid":{"rendered":"https:\/\/www.winslettwalls.com\/?page_id=169"},"modified":"2020-08-31T18:29:13","modified_gmt":"2020-08-31T18:29:13","slug":"appointments","status":"publish","type":"page","link":"https:\/\/www.winslettwalls.com\/appointments\/","title":{"rendered":"Patient Information"},"content":{"rendered":"<p>[et_pb_section bb_built=&#8221;1&#8243; _builder_version=&#8221;3.29.3&#8243; max_width=&#8221;1200px&#8221; max_width_last_edited=&#8221;off|&#8221; module_alignment=&#8221;center&#8221; box_shadow_horizontal_tablet=&#8221;0px&#8221; box_shadow_vertical_tablet=&#8221;0px&#8221; box_shadow_blur_tablet=&#8221;40px&#8221; box_shadow_spread_tablet=&#8221;0px&#8221; z_index_tablet=&#8221;500&#8243; next_background_color=&#8221;#000000&#8243; custom_margin=&#8221;||0px|&#8221; custom_padding=&#8221;||0px|&#8221;][et_pb_row][et_pb_column type=&#8221;4_4&#8243; custom_padding__hover=&#8221;|||&#8221; custom_padding=&#8221;|||&#8221;][et_pb_text admin_label=&#8221;Header Text&#8221; 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Appointment with Winslett &#038; Walls<\/h3>\n<p><!-- [et_pb_line_break_holder] --><div class=\"frm_forms  with_frm_style frm_style_formidable-style\" id=\"frm_form_2_container\" >\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form  frm_js_validate  frm_ajax_submit  frm_pro_form \" id=\"form_appointment-request-form\"  >\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_screen_reader\">Appointment Request Form<\/legend>\r\n\r\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"2\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_2\" id=\"frm_hide_fields_2\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"appointment-request-form\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_2\" name=\"frm_submit_entry_2\" value=\"5af098b11d\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/wp-json\/wp\/v2\/pages\/169\" \/><div id=\"frm_field_6_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_first frm_half\">\r\n    <label for=\"field_qh4icy2\" id=\"field_qh4icy2_label\" class=\"frm_primary_label\">Name\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_qh4icy2\" name=\"item_meta[6]\" value=\"\"  data-reqmsg=\"This field cannot be blank.\" aria-required=\"true\" data-invmsg=\"Name is invalid\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_qh4icy2\"\/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_qh4icy2\">First<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_7_container\" class=\"frm_form_field form-field  frm_required_field frm_hidden_container frm_half\">\r\n    <label for=\"field_ocfup12\" id=\"field_ocfup12_label\" class=\"frm_primary_label\">Last\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_ocfup12\" name=\"item_meta[7]\" value=\"\"  data-reqmsg=\"This field cannot be blank.\" aria-required=\"true\" data-invmsg=\"Last is invalid\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_ocfup12\"\/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_ocfup12\">Last<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_8_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_full\">\r\n    <label for=\"field_29yf4d2\" id=\"field_29yf4d2_label\" class=\"frm_primary_label\">Email\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_29yf4d2\" name=\"item_meta[8]\" value=\"\"  data-reqmsg=\"This field cannot be blank.\" aria-required=\"true\" data-invmsg=\"Please enter a valid email address\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_10_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_full\">\r\n    <label for=\"field_9jv0r12\" id=\"field_9jv0r12_label\" class=\"frm_primary_label\">Message\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[10]\" id=\"field_9jv0r12\" rows=\"5\"  data-reqmsg=\"This field cannot be blank.\" aria-required=\"true\" data-invmsg=\"Message is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_11_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_1t7sb\" id=\"field_1t7sb_label\" class=\"frm_primary_label\">Phone\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"tel\" id=\"field_1t7sb\" name=\"item_meta[11]\" value=\"\"  data-invmsg=\"Phone is invalid\" aria-invalid=\"false\" pattern=\"((\\+\\d{1,3}(-|.| )?\\(?\\d\\)?(-| |.)?\\d{1,5})|(\\(?\\d{2,6}\\)?))(-|.| )?(\\d{3,4})(-|.| )?(\\d{4})(( x| ext)\\d{1,5}){0,1}$\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_xy8p6\" id=\"field_xy8p6_label\" class=\"frm_primary_label\">Date\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_xy8p6\" name=\"item_meta[12]\" value=\"\"  maxlength=\"10\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_13_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <div  id=\"field_x7jcq_label\" class=\"frm_primary_label\">Time\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_time_wrap\"><span dir=\"ltr\">\r\n<select aria-label=\"Time ... hour\"name=\"item_meta[13][H]\" id=\"field_x7jcq_H\"  data-frmval=\"{&quot;H&quot;:&quot;&quot;,&quot;m&quot;:&quot;&quot;,&quot;A&quot;:&quot;&quot;}\" data-invmsg=\"Time is invalid\" class=\"auto_width frm_time_select\" aria-invalid=\"false\"  ><option value=\"\"  selected='selected'><\/option><option value=\"12\" >12<\/option><option value=\"1\" >1<\/option><option value=\"2\" >2<\/option><option value=\"3\" >3<\/option><option value=\"4\" >4<\/option><option value=\"5\" >5<\/option><option value=\"6\" >6<\/option><option value=\"7\" >7<\/option><option value=\"8\" >8<\/option><option value=\"9\" >9<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><\/select>\r\n<span class=\"frm_time_sep\" aria-hidden=\"true\">:<\/span>\r\n<select aria-label=\"Time ... minute\"name=\"item_meta[13][m]\" id=\"field_x7jcq_m\"  data-frmval=\"{&quot;H&quot;:&quot;&quot;,&quot;m&quot;:&quot;&quot;,&quot;A&quot;:&quot;&quot;}\" data-invmsg=\"Time is invalid\" class=\"auto_width frm_time_select auto_width frm_time_select\" aria-invalid=\"false\"  ><option value=\"\"  selected='selected'><\/option><option value=\"00\" >00<\/option><option value=\"30\" >30<\/option><\/select>\r\n<\/span>\r\n<select aria-label=\"Time\"name=\"item_meta[13][A]\" id=\"field_x7jcq_A\"  data-frmval=\"{&quot;H&quot;:&quot;&quot;,&quot;m&quot;:&quot;&quot;,&quot;A&quot;:&quot;&quot;}\" data-invmsg=\"Time is invalid\" class=\"auto_width frm_time_select auto_width frm_time_select auto_width frm_time_select\" aria-invalid=\"false\"  ><option value=\"AM\" >AM<\/option><option value=\"PM\" >PM<\/option><\/select>\r\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_14_container\" class=\"frm_form_field form-field  frm_none_container\">\r\n    <div  id=\"field_yjj43_label\" class=\"frm_primary_label\">reCAPTCHA\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div id=\"field_yjj43\" class=\"frm-g-recaptcha\" data-sitekey=\"6LdE08YUAAAAAEJ55pXP_zJ5v_aVc2aFdntxVYIv\" data-size=\"invisible\" data-theme=\"light\"><\/div>\r\n    \r\n    \r\n<\/div>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t\t\t\t<div class=\"frm_verify\" 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Find everything you need for your next appointment at Winslett &amp; Walls Dental Excellence here.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.winslettwalls.com\/appointments\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Appointments | Winslett &amp; Walls Dental Excellence | Wilmington NC Dentist\" \/>\n<meta property=\"og:description\" content=\"Download all of the forms you need and schedule your dentist appointment online! 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