{"id":828,"date":"2019-04-17T11:35:02","date_gmt":"2019-04-17T15:35:02","guid":{"rendered":"https:\/\/augustaent.fm1.dev\/?page_id=828"},"modified":"2019-07-17T18:09:27","modified_gmt":"2019-07-17T22:09:27","slug":"request-an-appointment","status":"publish","type":"page","link":"https:\/\/augustaent.com\/request-an-appointment\/","title":{"rendered":"Request an Appointment"},"content":{"rendered":"\r\n<p>Please fill out the form below letting us know your preferred date and time or call us at <a href=\"tel:+17068685676\" class=\"phone \"> <span class=\"phNum\">(706) 868-5676<\/span><\/a>. We make every attempt to be as responsive to your scheduling needs as possible.<\/p>\r\n\r\n\r\n\r\n<p>Once we hear from you, one of our professionals\u00a0will contact you within 48 hours. <strong>Please call if your needs are more urgent.<\/strong><\/p>\r\n\r\n\r\n<p><script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script><\/p>\n<div class=\"fuel-gf-wrapper\">\n<div class='gf_browser_unknown gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_2' >\n<div id='gf_2' class='gform_anchor' tabindex='-1'><\/div>\n<form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_2' id='gform_2'  action='\/wp-json\/wp\/v2\/pages\/828\/#gf_2' data-formid='2' novalidate>\n<div class=\"fuel-gf-alert\" role=\"alert\"><\/div>\n<div class='gform-body gform_body'>\n<ul id='gform_fields_2' class='gform_fields top_label form_sublabel_below description_below validation_below'>\n<li id=\"field_2_19\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_19\" >\n<div class=\"field-section-title\">Patient Information<\/div>\n<\/li>\n<li id=\"field_2_1\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_1\" ><label class='gfield_label gform-field-label' for='input_2_1'>First Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>\n<div class='ginput_container ginput_container_text'><input name='input_1' id='input_2_1' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div>\n<\/li>\n<li id=\"field_2_2\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_2\" ><label class='gfield_label gform-field-label' for='input_2_2'>Last Name<\/label>\n<div class='ginput_container ginput_container_text'><input name='input_2' id='input_2_2' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div>\n<\/li>\n<li id=\"field_2_3\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_3\" ><label class='gfield_label gform-field-label' for='input_2_3'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>\n<div class='ginput_container ginput_container_text'><input name='input_3' id='input_2_3' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div>\n<\/li>\n<li id=\"field_2_5\" class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_5\" ><label class='gfield_label gform-field-label' for='input_2_5'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>\n<div class='ginput_container ginput_container_email'>\n                            <input name='input_5' id='input_2_5' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div>\n<\/li>\n<li id=\"field_2_4\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_4\" ><label class='gfield_label gform-field-label' for='input_2_4'>Date of Birth (mm\/dd\/yy)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>\n<div class='ginput_container ginput_container_text'><input name='input_4' id='input_2_4' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div>\n<\/li>\n<li id=\"field_2_12\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_12\" ><label class='gfield_label gform-field-label' for='input_2_12'>Street Address<\/label>\n<div class='ginput_container ginput_container_text'><input name='input_12' id='input_2_12' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div>\n<\/li>\n<li id=\"field_2_13\" class=\"gfield gfield--type-text field-city field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_13\" ><label class='gfield_label gform-field-label' for='input_2_13'>City<\/label>\n<div class='ginput_container ginput_container_text'><input name='input_13' id='input_2_13' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div>\n<\/li>\n<li id=\"field_2_14\" class=\"gfield gfield--type-text field-state field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_14\" ><label class='gfield_label gform-field-label' for='input_2_14'>State<\/label>\n<div class='ginput_container ginput_container_text'><input name='input_14' id='input_2_14' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div>\n<\/li>\n<li id=\"field_2_15\" class=\"gfield gfield--type-text field-zip field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_15\" ><label class='gfield_label gform-field-label' for='input_2_15'>Zip<\/label>\n<div class='ginput_container ginput_container_text'><input name='input_15' id='input_2_15' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div>\n<\/li>\n<li id=\"field_2_20\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_20\" >\n<div class=\"field-section-title\">Appointment Information<\/div>\n<\/li>\n<li id=\"field_2_8\" class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_8\" ><label class='gfield_label gform-field-label' for='input_2_8'>Location<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>\n<div class='ginput_container ginput_container_select'><select name='input_8' id='input_2_8' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Augusta Office' >Augusta Office<\/option><option value='Evans Office' >Evans Office<\/option><option value='Grovetown, GA' >Grovetown, GA<\/option><option value='Aiken Office' >Aiken Office<\/option><\/select><\/div>\n<\/li>\n<li id=\"field_2_9\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_9\" ><label class='gfield_label gform-field-label' for='input_2_9'>Appointment Date &amp; Time (mm\/dd hh:mm)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>\n<div class='ginput_container ginput_container_text'><input name='input_9' id='input_2_9' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div>\n<\/li>\n<li id=\"field_2_10\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_10\" ><label class='gfield_label gform-field-label' for='input_2_10'>Notes to Appointment Staff<\/label>\n<div class='ginput_container 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We make every attempt to be as responsive to your scheduling needs as possible. Once we hear from you, one of our professionals\u00a0will contact you within 48 hours. Please call if your needs are more urgent.<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":2,"comment_status":"closed","ping_status":"closed","template":"page_no-sidebar.php","meta":{"_seopress_robots_primary_cat":"","_seopress_titles_title":"","_seopress_titles_desc":"","_seopress_robots_index":"","schema":"","fname":"","lname":"","position":"","credentials":"","placeID":"","no_match":false,"name":"","company":"","review":"","address":"","city":"","state":"","zip":"","lat":"","lng":"","phone1":"","phone2":"","fax":"","mon1":"","mon2":"","tue1":"","tue2":"","wed1":"","wed2":"","thu1":"","thu2":"","fri1":"","fri2":"","sat1":"","sat2":"","sun1":"","sun2":"","hours-note":"","footnotes":""},"service_tags":[],"_links":{"self":[{"href":"https:\/\/augustaent.com\/wp-json\/wp\/v2\/pages\/828"}],"collection":[{"href":"https:\/\/augustaent.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/augustaent.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/augustaent.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/augustaent.com\/wp-json\/wp\/v2\/comments?post=828"}],"version-history":[{"count":0,"href":"https:\/\/augustaent.com\/wp-json\/wp\/v2\/pages\/828\/revisions"}],"wp:attachment":[{"href":"https:\/\/augustaent.com\/wp-json\/wp\/v2\/media?parent=828"}],"wp:term":[{"taxonomy":"service_tags","embeddable":true,"href":"https:\/\/augustaent.com\/wp-json\/wp\/v2\/service_tags?post=828"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}