{"id":2804,"date":"2015-01-29T06:39:51","date_gmt":"2015-01-29T06:39:51","guid":{"rendered":"http:\/\/raulcookdds.paulmillerhair.com\/?page_id=2804"},"modified":"2021-10-22T17:40:58","modified_gmt":"2021-10-22T21:40:58","slug":"schedule-appointment","status":"publish","type":"page","link":"https:\/\/www.raulcookdds.com\/schedule-appointment\/","title":{"rendered":"Request an Appointment"},"content":{"rendered":"<p>[vc_row][vc_column width=&#8221;2\/3&#8243;][vc_column_text]Please fill out the form below to request an appointment. \u00a0One of our staff members will confirm with you regarding the availability of the requested appointment.[\/vc_column_text]<script type=\"text\/javascript\">var 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id='gform_fields_2' class='gform_fields top_label form_sublabel_below description_below'><li id=\"field_2_9\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h2 class=\"gsection_title\">Hours<\/h2><div class='gsection_description' id='gfield_description_2_9'>Our open hours are: Monday - Thursday, between 8.00 AM - 11:AM  or 1:00 PM- 4:30 PM.<\/div><\/li><li id=\"field_2_10\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h2 class=\"gsection_title\">Your Information<\/h2><\/li><li id=\"field_2_1\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_2_1' >Please describe your dental situation:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_1' id='input_2_1' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_2_2\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label'  >Are you currently Dr. Cook&#039;s patient?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_2_2'>\n\t\t\t<li class='gchoice gchoice_2_2_0'>\n\t\t\t\t<input name='input_2' type='radio' value='Yes'  id='choice_2_2_0'    \/>\n\t\t\t\t<label for='choice_2_2_0' id='label_2_2_0'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_2_1'>\n\t\t\t\t<input name='input_2' type='radio' value='No'  id='choice_2_2_1'    \/>\n\t\t\t\t<label for='choice_2_2_1' id='label_2_2_1'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_2_3\" 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