{"id":10,"date":"2026-05-25T17:11:49","date_gmt":"2026-05-25T17:11:49","guid":{"rendered":"https:\/\/texasmedical.clients-demo-website.com\/?page_id=10"},"modified":"2026-05-25T18:08:50","modified_gmt":"2026-05-25T18:08:50","slug":"home","status":"publish","type":"page","link":"https:\/\/texasmedical.clients-demo-website.com\/","title":{"rendered":"Home"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"10\" class=\"elementor elementor-10\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-e3ad36a e-flex e-con-boxed e-con e-parent\" data-id=\"e3ad36a\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-276f4d2 elementor-button-align-stretch elementor-widget elementor-widget-form\" data-id=\"276f4d2\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;button_width&quot;:&quot;100&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t\t        <input type=\"hidden\" class=\"conditional_logic_data_js hidden\" data-form-id=\"Dale Sims\" value=\"{&quot;field_e230cfc&quot;:{&quot;display&quot;:&quot;show&quot;,&quot;trigger&quot;:&quot;ALL&quot;,&quot;datas&quot;:[{&quot;conditional_logic_id&quot;:&quot;field_06a5888&quot;,&quot;conditional_logic_operator&quot;:&quot;==&quot;,&quot;conditional_logic_value&quot;:&quot;Chronic Pain&quot;,&quot;_id&quot;:&quot;2b35725&quot;}]}}\" \/>\r\n\t\t<form class=\"elementor-form\" method=\"post\" name=\"Dale Sims\" aria-label=\"Dale Sims\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"10\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"276f4d2\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"\" \/>\n\n\t\t\t\t\t\t\t<input type=\"hidden\" name=\"queried_id\" value=\"10\"\/>\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_55ddd02 elementor-col-100\">\n\t\t\t\t\t<h2 class=spcl--head>1. Patient Information Section<\/h2>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-name elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-name\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tEnter Your Full Name\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[name]\" id=\"form-field-name\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Name\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-date elementor-field-group elementor-column elementor-field-group-field_755ecc8 elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_755ecc8\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDate of Birth\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[field_755ecc8]\" id=\"form-field-field_755ecc8\" class=\"elementor-field elementor-size-sm  elementor-field-textual elementor-date-field\" placeholder=\"YYY\/MM\/DD\" required=\"required\" pattern=\"[0-9]{4}-[0-9]{2}-[0-9]{2}\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-tel elementor-field-group elementor-column elementor-field-group-message elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-message\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPhone Number\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input size=\"1\" type=\"tel\" name=\"form_fields[message]\" id=\"form-field-message\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"123 456 789\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Only numbers and phone characters (#, -, *, etc) are accepted.\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-email elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-email\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tEmail Address\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[email]\" id=\"form-field-email\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"john@example.com\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group-field_4330e07 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_4330e07\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tResidency\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-eicon-caret-down\" viewBox=\"0 0 571.4 571.4\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M571 393Q571 407 561 418L311 668Q300 679 286 679T261 668L11 418Q0 407 0 393T11 368 36 357H536Q550 357 561 368T571 393Z\"><\/path><\/svg>\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[field_4330e07]\" id=\"form-field-field_4330e07\" class=\"elementor-field-textual elementor-size-sm\">\n\t\t\t\t\t\t\t\t\t<option value=\"\">Please Select<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Texan\">Texan<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Non-Texan\">Non-Texan<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_570127c elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_570127c\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tValid DL or ID\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_570127c]\" id=\"form-field-field_570127c\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Enter valid driver license or ID\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_cafd157 elementor-col-100\">\n\t\t\t\t\t<h2 class=spcl--head>2. Qualifying Condition Selection<\/h2>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_06a5888 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_06a5888\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tQualifying Conditions (Please upload valid documentation)\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Chronic Pain\" id=\"form-field-field_06a5888-0\" name=\"form_fields[field_06a5888][]\"> <label for=\"form-field-field_06a5888-0\">Chronic Pain<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"PTSD\" id=\"form-field-field_06a5888-1\" name=\"form_fields[field_06a5888][]\"> <label for=\"form-field-field_06a5888-1\">PTSD<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Cancer\" id=\"form-field-field_06a5888-2\" name=\"form_fields[field_06a5888][]\"> <label for=\"form-field-field_06a5888-2\">Cancer<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Seizures\" id=\"form-field-field_06a5888-3\" name=\"form_fields[field_06a5888][]\"> <label for=\"form-field-field_06a5888-3\">Seizures<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Arthritis\" id=\"form-field-field_06a5888-4\" name=\"form_fields[field_06a5888][]\"> <label for=\"form-field-field_06a5888-4\">Arthritis<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-upload elementor-field-group elementor-column elementor-field-group-field_e230cfc elementor-col-100\">\n\t\t\t\t\t\t\t<input type=\"file\" name=\"form_fields[field_e230cfc][]\" id=\"form-field-field_e230cfc\" class=\"elementor-field elementor-size-sm  elementor-upload-field\" multiple=\"multiple\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-sm\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Send<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t\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","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_canvas","meta":{"footnotes":""},"class_list":["post-10","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/texasmedical.clients-demo-website.com\/index.php\/wp-json\/wp\/v2\/pages\/10","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/texasmedical.clients-demo-website.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/texasmedical.clients-demo-website.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/texasmedical.clients-demo-website.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/texasmedical.clients-demo-website.com\/index.php\/wp-json\/wp\/v2\/comments?post=10"}],"version-history":[{"count":55,"href":"https:\/\/texasmedical.clients-demo-website.com\/index.php\/wp-json\/wp\/v2\/pages\/10\/revisions"}],"predecessor-version":[{"id":69,"href":"https:\/\/texasmedical.clients-demo-website.com\/index.php\/wp-json\/wp\/v2\/pages\/10\/revisions\/69"}],"wp:attachment":[{"href":"https:\/\/texasmedical.clients-demo-website.com\/index.php\/wp-json\/wp\/v2\/media?parent=10"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}