{"id":45,"date":"2026-04-29T10:44:27","date_gmt":"2026-04-29T14:44:27","guid":{"rendered":"https:\/\/fabricegarnierorthodontiste.com\/formulaires\/?page_id=45"},"modified":"2026-04-29T10:45:14","modified_gmt":"2026-04-29T14:45:14","slug":"appointment","status":"publish","type":"page","link":"https:\/\/fabricegarnierorthodontiste.com\/formulaires\/appointment\/","title":{"rendered":"Appointment"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-41\" src=\"https:\/\/fabricegarnierorthodontiste.com\/formulaires\/wp-content\/uploads\/2026\/04\/logo.png\" alt=\"\" width=\"144\" height=\"124\" \/><\/p>\n<h3><span style=\"color: #afc44b;\">Make an appointment<\/span><\/h3>\n<p><span style=\"color: #333333;\">To request an initial consultation appointment, please complete the form below. A staff member will be happy to contact you to schedule a date and time slot.<\/span><\/p>\n<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform-theme gform-theme--foundation gform-theme--framework gform-theme--orbital' data-form-theme='orbital' data-form-index='0' id='gform_wrapper_8' style='display:none'><style>#gform_wrapper_8[data-form-index=\"0\"].gform-theme,[data-parent-form=\"8_0\"]{--gf-color-primary: #204ce5;--gf-color-primary-rgb: 32, 76, 229;--gf-color-primary-contrast: #fff;--gf-color-primary-contrast-rgb: 255, 255, 255;--gf-color-primary-darker: #001AB3;--gf-color-primary-lighter: #527EFF;--gf-color-secondary: #fff;--gf-color-secondary-rgb: 255, 255, 255;--gf-color-secondary-contrast: #112337;--gf-color-secondary-contrast-rgb: 17, 35, 55;--gf-color-secondary-darker: #F5F5F5;--gf-color-secondary-lighter: #FFFFFF;--gf-color-out-ctrl-light: rgba(17, 35, 55, 0.1);--gf-color-out-ctrl-light-rgb: 17, 35, 55;--gf-color-out-ctrl-light-darker: rgba(104, 110, 119, 0.35);--gf-color-out-ctrl-light-lighter: #F5F5F5;--gf-color-out-ctrl-dark: #585e6a;--gf-color-out-ctrl-dark-rgb: 88, 94, 106;--gf-color-out-ctrl-dark-darker: #112337;--gf-color-out-ctrl-dark-lighter: rgba(17, 35, 55, 0.65);--gf-color-in-ctrl: #fff;--gf-color-in-ctrl-rgb: 255, 255, 255;--gf-color-in-ctrl-contrast: #112337;--gf-color-in-ctrl-contrast-rgb: 17, 35, 55;--gf-color-in-ctrl-darker: #F5F5F5;--gf-color-in-ctrl-lighter: #FFFFFF;--gf-color-in-ctrl-primary: #204ce5;--gf-color-in-ctrl-primary-rgb: 32, 76, 229;--gf-color-in-ctrl-primary-contrast: #fff;--gf-color-in-ctrl-primary-contrast-rgb: 255, 255, 255;--gf-color-in-ctrl-primary-darker: #001AB3;--gf-color-in-ctrl-primary-lighter: #527EFF;--gf-color-in-ctrl-light: rgba(17, 35, 55, 0.1);--gf-color-in-ctrl-light-rgb: 17, 35, 55;--gf-color-in-ctrl-light-darker: rgba(104, 110, 119, 0.35);--gf-color-in-ctrl-light-lighter: #F5F5F5;--gf-color-in-ctrl-dark: #585e6a;--gf-color-in-ctrl-dark-rgb: 88, 94, 106;--gf-color-in-ctrl-dark-darker: #112337;--gf-color-in-ctrl-dark-lighter: rgba(17, 35, 55, 0.65);--gf-radius: 3px;--gf-font-size-secondary: 14px;--gf-font-size-tertiary: 13px;--gf-icon-ctrl-number: url(\"data:image\/svg+xml,%3Csvg width='8' height='14' viewBox='0 0 8 14' fill='none' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath fill-rule='evenodd' clip-rule='evenodd' d='M4 0C4.26522 5.96046e-08 4.51957 0.105357 4.70711 0.292893L7.70711 3.29289C8.09763 3.68342 8.09763 4.31658 7.70711 4.70711C7.31658 5.09763 6.68342 5.09763 6.29289 4.70711L4 2.41421L1.70711 4.70711C1.31658 5.09763 0.683417 5.09763 0.292893 4.70711C-0.0976311 4.31658 -0.097631 3.68342 0.292893 3.29289L3.29289 0.292893C3.48043 0.105357 3.73478 0 4 0ZM0.292893 9.29289C0.683417 8.90237 1.31658 8.90237 1.70711 9.29289L4 11.5858L6.29289 9.29289C6.68342 8.90237 7.31658 8.90237 7.70711 9.29289C8.09763 9.68342 8.09763 10.3166 7.70711 10.7071L4.70711 13.7071C4.31658 14.0976 3.68342 14.0976 3.29289 13.7071L0.292893 10.7071C-0.0976311 10.3166 -0.0976311 9.68342 0.292893 9.29289Z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-icon-ctrl-select: url(\"data:image\/svg+xml,%3Csvg width='10' height='6' viewBox='0 0 10 6' fill='none' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath fill-rule='evenodd' clip-rule='evenodd' d='M0.292893 0.292893C0.683417 -0.097631 1.31658 -0.097631 1.70711 0.292893L5 3.58579L8.29289 0.292893C8.68342 -0.0976311 9.31658 -0.0976311 9.70711 0.292893C10.0976 0.683417 10.0976 1.31658 9.70711 1.70711L5.70711 5.70711C5.31658 6.09763 4.68342 6.09763 4.29289 5.70711L0.292893 1.70711C-0.0976311 1.31658 -0.0976311 0.683418 0.292893 0.292893Z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-icon-ctrl-search: url(\"data:image\/svg+xml,%3Csvg width='640' height='640' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath d='M256 128c-70.692 0-128 57.308-128 128 0 70.691 57.308 128 128 128 70.691 0 128-57.309 128-128 0-70.692-57.309-128-128-128zM64 256c0-106.039 85.961-192 192-192s192 85.961 192 192c0 41.466-13.146 79.863-35.498 111.248l154.125 154.125c12.496 12.496 12.496 32.758 0 45.254s-32.758 12.496-45.254 0L367.248 412.502C335.862 434.854 297.467 448 256 448c-106.039 0-192-85.962-192-192z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-label-space-y-secondary: var(--gf-label-space-y-md-secondary);--gf-ctrl-border-color: #686e77;--gf-ctrl-size: var(--gf-ctrl-size-md);--gf-ctrl-label-color-primary: #112337;--gf-ctrl-label-color-secondary: #112337;--gf-ctrl-choice-size: var(--gf-ctrl-choice-size-md);--gf-ctrl-checkbox-check-size: var(--gf-ctrl-checkbox-check-size-md);--gf-ctrl-radio-check-size: var(--gf-ctrl-radio-check-size-md);--gf-ctrl-btn-font-size: var(--gf-ctrl-btn-font-size-md);--gf-ctrl-btn-padding-x: var(--gf-ctrl-btn-padding-x-md);--gf-ctrl-btn-size: var(--gf-ctrl-btn-size-md);--gf-ctrl-btn-border-color-secondary: #686e77;--gf-ctrl-file-btn-bg-color-hover: #EBEBEB;--gf-field-img-choice-size: var(--gf-field-img-choice-size-md);--gf-field-img-choice-card-space: var(--gf-field-img-choice-card-space-md);--gf-field-img-choice-check-ind-size: var(--gf-field-img-choice-check-ind-size-md);--gf-field-img-choice-check-ind-icon-size: var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style>\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>\u00ab\u00a0<span class=\"gfield_required gfield_required_asterisk\">*<\/span>\u00a0\u00bb indique les champs n\u00e9cessaires<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_8'  action='\/formulaires\/wp-json\/wp\/v2\/pages\/45' data-formid='8' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_8' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_8_9\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >IMPORTANT NOTICE<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description gfield_consent_description' id='gfield_consent_description_8_9' tabindex='0'>This form is intended exclusively for new patients seeking an initial orthodontic consultation. Please note that we do not provide care for retention appliances (lingual wire or retainer trays) when the initial treatment was not completed at our clinic. If you were treated at our clinic, we invite you to contact our team directly by phone at (450) 378-2365.<\/div><div class='ginput_container ginput_container_consent'><input name='input_9.1' id='input_8_9_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_8_9\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_8_9_1' >I understand<\/label><input type='hidden' name='input_9.2' value='I understand' class='gform_hidden' \/><input type='hidden' name='input_9.3' value='9' class='gform_hidden' \/><\/div><\/fieldset><fieldset id=\"field_8_10\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >PLEASE NOTE<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description gfield_consent_description' id='gfield_consent_description_8_10' tabindex='0'>Please note that we are not registered with the Canadian Dental Care Plan.<\/div><div class='ginput_container ginput_container_consent'><input name='input_10.1' id='input_8_10_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_8_10\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_8_10_1' >I understand<\/label><input type='hidden' name='input_10.2' value='I understand' class='gform_hidden' \/><input type='hidden' name='input_10.3' value='9' class='gform_hidden' \/><\/div><\/fieldset><div id=\"field_8_11\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style=\"background-color:#9cb03a;padding:20px;color:#ffffff;font-weight:bold;font-size:22px;\">Patient information<\/a><\/div><\/div><div id=\"field_8_1\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_1'>First Name and Last Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_1' id='input_8_1' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_12\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_12'>Gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_12' id='input_8_12' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Male' >Male<\/option><option value='Female' >Female<\/option><option value='Non-binary' >Non-binary<\/option><\/select><\/div><\/div><div id=\"field_8_14\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_14'>Age<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_14' id='input_8_14' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_16\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_16'>Date of birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_16' id='input_8_16' type='text' value='' class='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon'   placeholder='dd\/mm\/yyyy' aria-describedby=\"input_8_16_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_8_16_date_format' class='screen-reader-text'>DD slash MM slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_8_16' class='gform_hidden' value='https:\/\/fabricegarnierorthodontiste.com\/formulaires\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_8_13\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_13'>Language<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_13' id='input_8_13' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='French' >French<\/option><option value='English' >English<\/option><\/select><\/div><\/div><fieldset id=\"field_8_15\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Complete Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_8_15' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_8_15_1_container' >\n                                        <input type='text' name='input_15.1' id='input_8_15_1' value=''    aria-required='true'    \/>\n                                        <label for='input_8_15_1' id='input_8_15_1_label' class='gform-field-label gform-field-label--type-sub '>Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_8_15_2_container' >\n                                        <input type='text' name='input_15.2' id='input_8_15_2' value=''     aria-required='false'   \/>\n                                        <label for='input_8_15_2' id='input_8_15_2_label' class='gform-field-label gform-field-label--type-sub '>Apartment<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_8_15_3_container' >\n                                    <input type='text' name='input_15.3' id='input_8_15_3' value=''    aria-required='true'    \/>\n                                    <label for='input_8_15_3' id='input_8_15_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_8_15_4_container' >\n                                        <select name='input_15.4' id='input_8_15_4'     aria-required='true'    ><option value='' ><\/option><option value='Alberta' >Alberta<\/option><option value='Colombie-Britannique' >Colombie-Britannique<\/option><option value='Manitoba' >Manitoba<\/option><option value='Nouveau-Brunswick' >Nouveau-Brunswick<\/option><option value='Terre-Neuve-et-Labrador' >Terre-Neuve-et-Labrador<\/option><option value='Territoires du Nord-Ouest' >Territoires du Nord-Ouest<\/option><option value='Nouvelle-\u00c9cosse' >Nouvelle-\u00c9cosse<\/option><option value='Nunavut' >Nunavut<\/option><option value='Ontario' >Ontario<\/option><option value='\u00cele du Prince-\u00c9douard' >\u00cele du Prince-\u00c9douard<\/option><option value='Qu\u00e9bec' selected='selected'>Qu\u00e9bec<\/option><option value='Saskatchewan' >Saskatchewan<\/option><option value='Yukon' >Yukon<\/option><\/select>\n                                        <label for='input_8_15_4' id='input_8_15_4_label' class='gform-field-label gform-field-label--type-sub '>Province<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_8_15_5_container' >\n                                    <input type='text' name='input_15.5' id='input_8_15_5' value=''    aria-required='true'    \/>\n                                    <label for='input_8_15_5' id='input_8_15_5_label' class='gform-field-label gform-field-label--type-sub '>Postal Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_15.6' id='input_8_15_6' value='Canada' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_8_3\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_3'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_3' id='input_8_3' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_8_4\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_4'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_4' id='input_8_4' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_17\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_17'>First name and last name of the first parent<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_17' id='input_8_17' type='text' value='' class='large'  aria-describedby=\"gfield_description_8_17\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_8_17'>(If the patient is under 18 years old)<\/div><\/div><div id=\"field_8_18\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_18'>First and last name of the second parent<\/label><div class='ginput_container ginput_container_text'><input name='input_18' id='input_8_18' type='text' value='' class='large'  aria-describedby=\"gfield_description_8_18\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_8_18'>(If the patient is under 18 years old)<\/div><\/div><div id=\"field_8_19\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_19'>Name of the person to contact to schedule an appointment<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_8_19' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_20\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_20'>Contact person&#039;s phone number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_20' id='input_8_20' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_8_21\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Would you prefer to receive appointment confirmations by:<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_8_21'>\n\t\t\t<div class='gchoice gchoice_8_21_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Email'  id='choice_8_21_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_21_0' id='label_8_21_0' class='gform-field-label gform-field-label--type-inline'>Email<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_21_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Text Message'  id='choice_8_21_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_21_1' id='label_8_21_1' class='gform-field-label gform-field-label--type-inline'>Text Message<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_8_22\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_22'>Please specify the phone number for the text message:<\/label><div class='ginput_container ginput_container_phone'><input name='input_22' id='input_8_22' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_8_23\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you already have a file at our clinic with another member of your family?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_8_23'>\n\t\t\t<div class='gchoice gchoice_8_23_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='Yes'  id='choice_8_23_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_23_0' id='label_8_23_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_23_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='No'  id='choice_8_23_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_23_1' id='label_8_23_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_8_24\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_24'>If yes, please provide the patient&#039;s name:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_24' id='input_8_24' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_25\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style=\"background-color:#9cb03a;padding:20px;color:#ffffff;font-weight:bold;font-size:22px;\">Specific information<\/a><\/div><\/div><div id=\"field_8_26\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_26'>First and last name of your dentist<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_26' id='input_8_26' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_8_40\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Reason(s) for the appointment<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_8_40'><div class='gchoice gchoice_8_40_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.1' type='checkbox'  value='Lack of space'  id='choice_8_40_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_40_1' id='label_8_40_1' class='gform-field-label gform-field-label--type-inline'>Lack of space<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_40_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.2' type='checkbox'  value='Crowding'  id='choice_8_40_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_40_2' id='label_8_40_2' class='gform-field-label gform-field-label--type-inline'>Crowding<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_40_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.3' type='checkbox'  value='Treatment requiring jaw surgery'  id='choice_8_40_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_40_3' id='label_8_40_3' class='gform-field-label gform-field-label--type-inline'>Treatment requiring jaw surgery<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_40_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.4' type='checkbox'  value='Impacted canine'  id='choice_8_40_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_40_4' id='label_8_40_4' class='gform-field-label gform-field-label--type-inline'>Impacted canine<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_40_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.5' type='checkbox'  value='Aesthetics'  id='choice_8_40_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_40_5' id='label_8_40_5' class='gform-field-label gform-field-label--type-inline'>Aesthetics<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_40_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.6' type='checkbox'  value='Recommended by the dentist'  id='choice_8_40_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_40_6' id='label_8_40_6' class='gform-field-label gform-field-label--type-inline'>Recommended by the dentist<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_40_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.7' type='checkbox'  value='I would like a second opinion'  id='choice_8_40_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_40_7' id='label_8_40_7' class='gform-field-label gform-field-label--type-inline'>I would like a second opinion<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_40_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.8' type='checkbox'  value='Other'  id='choice_8_40_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_40_8' id='label_8_40_8' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_8_28\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_28'>Additional information<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_28' id='input_8_28' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_8_29\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you ever received orthodontic treatment?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_8_29'>\n\t\t\t<div class='gchoice gchoice_8_29_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='Yes'  id='choice_8_29_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_29_0' id='label_8_29_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_29_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='No'  id='choice_8_29_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_29_1' id='label_8_29_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_8_30\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >If so, what orthodontic treatment have you already received?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_8_30'><div class='gchoice gchoice_8_30_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.1' type='checkbox'  value='Braces'  id='choice_8_30_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_30_1' id='label_8_30_1' class='gform-field-label gform-field-label--type-inline'>Braces<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_30_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.2' type='checkbox'  value='Invisalign aligners'  id='choice_8_30_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_30_2' id='label_8_30_2' class='gform-field-label gform-field-label--type-inline'>Invisalign aligners<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_30_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.3' type='checkbox'  value='Expansion appliance'  id='choice_8_30_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_30_3' id='label_8_30_3' class='gform-field-label gform-field-label--type-inline'>Expansion appliance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_30_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.4' type='checkbox'  value='Other'  id='choice_8_30_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_30_4' id='label_8_30_4' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_8_31\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_31'>If Other, please specify:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_31' id='input_8_31' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_32\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_32'>Are you currently undergoing treatment with appliances in your mouth (braces, expansion devices, aligners (Invisalign)...)?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_32' id='input_8_32' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/div><div id=\"field_8_39\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_39'>Additional information<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_39' id='input_8_39' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_8_33\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_33'>Will the patient be living in the Granby area for the next 2 years (planned move for studies or work, planned trip of more than 6 months...)?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_33' id='input_8_33' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/div><fieldset id=\"field_8_34\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >How did you hear about the clinic?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_8_34'><div class='gchoice gchoice_8_34_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.1' type='checkbox'  value='Dentist'  id='choice_8_34_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_34_1' id='label_8_34_1' class='gform-field-label gform-field-label--type-inline'>Dentist<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_34_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.2' type='checkbox'  value='Internet search'  id='choice_8_34_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_34_2' id='label_8_34_2' class='gform-field-label gform-field-label--type-inline'>Internet search<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_34_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.3' type='checkbox'  value='Clinique Poster'  id='choice_8_34_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_34_3' id='label_8_34_3' class='gform-field-label gform-field-label--type-inline'>Clinique Poster<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_34_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.4' type='checkbox'  value='Friends\/family'  id='choice_8_34_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_34_4' id='label_8_34_4' class='gform-field-label gform-field-label--type-inline'>Friends\/family<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_34_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.5' type='checkbox'  value='Other'  id='choice_8_34_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_34_5' id='label_8_34_5' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_8_36\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Accuracy of information<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description gfield_consent_description' id='gfield_consent_description_8_36' tabindex='0'>I certify that the information provided is accurate. I have been informed that if the patient\u2019s primary residence is not located in the Granby region over the next two years, it is highly likely that no orthodontic treatment can be initiated and that consultation fees will remain payable.<\/div><div class='ginput_container ginput_container_consent'><input name='input_36.1' id='input_8_36_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_8_36\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_8_36_1' >I certify<\/label><input type='hidden' name='input_36.2' value='I certify' class='gform_hidden' \/><input type='hidden' name='input_36.3' value='9' class='gform_hidden' \/><\/div><\/fieldset><div id=\"field_8_6\" class=\"gfield gfield--type-turnstile gfield--input-type-turnstile gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_6'>Security<\/label><div class='ginput_container ginput_container_turnstile'><div class='cf-turnstile' data-sitekey='0x4AAAAAACHZxtgHc4H_NPpb' data-timeout-callback='SS88TurnstileCallback' data-theme='light' data-size='normal'><\/div><\/div><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_8' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Send your information'  \/> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_8' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_8' id='gform_theme_8' value='orbital' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_8' id='gform_style_settings_8' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_8' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='8' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='CAD' value='3+jlurKgS0NcxyaO5gbMOg9De6xYnnRnnO4IjBi76\/DPU4G5mUbc+XOFsS8NTHZksN1kimsbpwm2Y5SZ24FtnSCJvC9iSW1JueOchbDtaFHbhaE=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_8' value='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' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_8' id='gform_target_page_number_8' value='0' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_8' id='gform_source_page_number_8' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/form>\n                        <\/div><script>\ngform.initializeOnLoaded( function() {gformInitSpinner( 8, 'https:\/\/fabricegarnierorthodontiste.com\/formulaires\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', false );jQuery('#gform_ajax_frame_8').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_8');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_8').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){form_content.find('form').css('opacity', 0);jQuery('#gform_wrapper_8').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_8').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_8').removeClass('gform_validation_error');}setTimeout( function() { \/* delay the scroll by 50 milliseconds to fix a bug in chrome *\/  }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_8').val();gformInitSpinner( 8, 'https:\/\/fabricegarnierorthodontiste.com\/formulaires\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', false );jQuery(document).trigger('gform_page_loaded', [8, current_page]);window['gf_submitting_8'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}jQuery('#gform_wrapper_8').replaceWith(confirmation_content);jQuery(document).trigger('gform_confirmation_loaded', [8]);window['gf_submitting_8'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_8').text());}else{jQuery('#gform_8').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger(\"gform_pre_post_render\", [{ formId: \"8\", currentPage: \"current_page\", abort: function() { this.preventDefault(); } }]);        if (event && event.defaultPrevented) {                return;        }        const gformWrapperDiv = document.getElementById( \"gform_wrapper_8\" );        if ( gformWrapperDiv ) {            const visibilitySpan = document.createElement( \"span\" );            visibilitySpan.id = \"gform_visibility_test_8\";            gformWrapperDiv.insertAdjacentElement( \"afterend\", visibilitySpan );        }        const visibilityTestDiv = document.getElementById( \"gform_visibility_test_8\" );        let postRenderFired = false;        function triggerPostRender() {            if ( postRenderFired ) {                return;            }            postRenderFired = true;            gform.core.triggerPostRenderEvents( 8, current_page );            if ( visibilityTestDiv ) {                visibilityTestDiv.parentNode.removeChild( visibilityTestDiv );            }        }        function debounce( func, wait, immediate ) {            var timeout;            return function() {                var context = this, args = arguments;                var later = function() {                    timeout = null;                    if ( !immediate ) func.apply( context, args );                };                var callNow = immediate && !timeout;                clearTimeout( timeout );                timeout = setTimeout( later, wait );                if ( callNow ) func.apply( context, args );            };        }        const debouncedTriggerPostRender = debounce( function() {            triggerPostRender();        }, 200 );        if ( visibilityTestDiv && visibilityTestDiv.offsetParent === null ) {            const observer = new MutationObserver( ( mutations ) => {                mutations.forEach( ( mutation ) => {                    if ( mutation.type === 'attributes' && visibilityTestDiv.offsetParent !== null ) {                        debouncedTriggerPostRender();                        observer.disconnect();                    }                });            });            observer.observe( document.body, {                attributes: true,                childList: false,                subtree: true,                attributeFilter: [ 'style', 'class' ],            });        } else {            triggerPostRender();        }    } );} );\n<\/script>\n\n","protected":false},"excerpt":{"rendered":"<p>Make an appointment To request an initial consultation appointment, please complete the form below. A staff member will be happy to contact you to schedule a date and time slot.<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"blank","meta":{"footnotes":""},"class_list":["post-45","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/fabricegarnierorthodontiste.com\/formulaires\/wp-json\/wp\/v2\/pages\/45","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/fabricegarnierorthodontiste.com\/formulaires\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/fabricegarnierorthodontiste.com\/formulaires\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/fabricegarnierorthodontiste.com\/formulaires\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/fabricegarnierorthodontiste.com\/formulaires\/wp-json\/wp\/v2\/comments?post=45"}],"version-history":[{"count":2,"href":"https:\/\/fabricegarnierorthodontiste.com\/formulaires\/wp-json\/wp\/v2\/pages\/45\/revisions"}],"predecessor-version":[{"id":47,"href":"https:\/\/fabricegarnierorthodontiste.com\/formulaires\/wp-json\/wp\/v2\/pages\/45\/revisions\/47"}],"wp:attachment":[{"href":"https:\/\/fabricegarnierorthodontiste.com\/formulaires\/wp-json\/wp\/v2\/media?parent=45"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}