{"id":1197,"date":"2021-11-25T03:28:37","date_gmt":"2021-11-25T08:28:37","guid":{"rendered":"https:\/\/manhattananimalclinic.com\/?page_id=1197"},"modified":"2024-01-22T11:23:26","modified_gmt":"2024-01-22T16:23:26","slug":"book-appointment","status":"publish","type":"page","link":"https:\/\/manhattananimalclinic.com\/book-appointment\/","title":{"rendered":"Book Appointment"},"content":{"rendered":"<style>.kb-row-layout-wrap.wp-block-kadence-rowlayout.kb-row-layout-id1197_1329bd-de{margin-top:0px;margin-bottom:0px;}.kb-row-layout-id1197_1329bd-de > .kt-row-column-wrap{align-content:center;}:where(.kb-row-layout-id1197_1329bd-de > .kt-row-column-wrap) > .wp-block-kadence-column{justify-content:center;}.kb-row-layout-id1197_1329bd-de > .kt-row-column-wrap{column-gap:var(--global-kb-gap-md, 2rem);row-gap:var(--global-kb-gap-md, 2rem);max-width:var( --global-content-width, 1290px );padding-left:var(--global-content-edge-padding);padding-right:var(--global-content-edge-padding);padding-top:50px;padding-bottom:50px;min-height:400px;grid-template-columns:minmax(0, 1fr);}.kb-row-layout-id1197_1329bd-de{background-image:url('https:\/\/manhattananimalclinic.com\/wp-content\/uploads\/services-banner-image.png');background-size:cover;background-position:50% 65%;background-attachment:scroll;background-repeat:no-repeat;}.kb-row-layout-id1197_1329bd-de > .kt-row-layout-overlay{opacity:0.60;background-color:var(--global-palette4, #2D3748);}@media all and (max-width: 1024px){.kb-row-layout-id1197_1329bd-de > .kt-row-column-wrap{grid-template-columns:minmax(0, 1fr);}}@media all and (max-width: 767px){.kb-row-layout-id1197_1329bd-de > .kt-row-column-wrap{min-height:300px;grid-template-columns:minmax(0, 1fr);}}<\/style><div class=\"kb-row-layout-wrap kb-row-layout-id1197_1329bd-de aligncenter kt-row-has-bg wp-block-kadence-rowlayout\"><div class=\"kt-row-layout-overlay kt-row-overlay-normal\"><\/div><div class=\"kt-row-column-wrap kt-has-1-columns kt-row-layout-equal kt-tab-layout-inherit kt-mobile-layout-row kt-row-valign-middle kb-theme-content-width\">\n<style>.kadence-column1197_336253-8f > .kt-inside-inner-col,.kadence-column1197_336253-8f > .kt-inside-inner-col:before{border-top-left-radius:0px;border-top-right-radius:0px;border-bottom-right-radius:0px;border-bottom-left-radius:0px;}.kadence-column1197_336253-8f > .kt-inside-inner-col{column-gap:var(--global-kb-gap-sm, 1rem);}.kadence-column1197_336253-8f > .kt-inside-inner-col{flex-direction:column;}.kadence-column1197_336253-8f > .kt-inside-inner-col > .aligncenter{width:100%;}.kadence-column1197_336253-8f > .kt-inside-inner-col:before{opacity:0.3;}.kadence-column1197_336253-8f{position:relative;}@media all and (max-width: 1024px){.kadence-column1197_336253-8f > .kt-inside-inner-col{flex-direction:column;}}@media all and (max-width: 767px){.kadence-column1197_336253-8f > .kt-inside-inner-col{flex-direction:column;}}<\/style>\n<div class=\"wp-block-kadence-column kadence-column1197_336253-8f inner-column-1\"><div class=\"kt-inside-inner-col\"><style>.wp-block-kadence-advancedheading.kt-adv-heading1197_521af4-9b, .wp-block-kadence-advancedheading.kt-adv-heading1197_521af4-9b[data-kb-block=\"kb-adv-heading1197_521af4-9b\"]{padding-bottom:10px;margin-bottom:0px;text-align:center;font-style:normal;}.wp-block-kadence-advancedheading.kt-adv-heading1197_521af4-9b mark, .wp-block-kadence-advancedheading.kt-adv-heading1197_521af4-9b[data-kb-block=\"kb-adv-heading1197_521af4-9b\"] mark{font-style:normal;color:#f76a0c;padding-top:0px;padding-right:0px;padding-bottom:0px;padding-left:0px;}@media all and (max-width: 767px){.wp-block-kadence-advancedheading.kt-adv-heading1197_521af4-9b, .wp-block-kadence-advancedheading.kt-adv-heading1197_521af4-9b[data-kb-block=\"kb-adv-heading1197_521af4-9b\"]{font-size:42px;}}<\/style>\n<h1 class=\"kt-adv-heading1197_521af4-9b wp-block-kadence-advancedheading has-theme-palette-9-color has-text-color\" data-kb-block=\"kb-adv-heading1197_521af4-9b\">Pre-Visit Questionnaire<\/h1>\n<\/div><\/div>\n\n<\/div><\/div>\n\n<style>.kb-row-layout-wrap.wp-block-kadence-rowlayout.kb-row-layout-id1197_138460-08{margin-top:-100px;}.kb-row-layout-id1197_138460-08 > .kt-row-column-wrap{align-content:center;}:where(.kb-row-layout-id1197_138460-08 > .kt-row-column-wrap) > .wp-block-kadence-column{justify-content:center;}.kb-row-layout-id1197_138460-08 > .kt-row-column-wrap{column-gap:var(--global-kb-gap-md, 2rem);row-gap:var(--global-kb-gap-md, 2rem);max-width:var( --global-content-width, 1290px );padding-left:var(--global-content-edge-padding);padding-right:var(--global-content-edge-padding);padding-top:0px;padding-bottom:50px;grid-template-columns:minmax(0, 1fr) minmax(0, 2fr);}.kb-row-layout-id1197_138460-08 > .kt-row-layout-overlay{opacity:0.30;mix-blend-mode:overlay;}@media all and (max-width: 1024px){.kb-row-layout-wrap.wp-block-kadence-rowlayout.kb-row-layout-id1197_138460-08{margin-top:0px;margin-bottom:0px;}}@media all and (max-width: 1024px){.kb-row-layout-id1197_138460-08 > .kt-row-column-wrap{padding-top:50px;padding-right:20px;padding-bottom:50px;padding-left:20px;grid-template-columns:minmax(0, 1fr);}}@media all and (max-width: 767px){.kb-row-layout-id1197_138460-08 > .kt-row-column-wrap{padding-top:50px;grid-template-columns:minmax(0, 1fr);}}<\/style><div class=\"kb-row-layout-wrap kb-row-layout-id1197_138460-08 alignnone wp-block-kadence-rowlayout\"><div class=\"kt-row-column-wrap kt-has-2-columns kt-row-layout-right-golden kt-tab-layout-row kt-mobile-layout-row kt-row-valign-middle kb-theme-content-width\">\n<style>.kadence-column1197_23aaad-59 > .kt-inside-inner-col{padding-top:10px;padding-right:10px;padding-bottom:10px;padding-left:10px;}.kadence-column1197_23aaad-59 > .kt-inside-inner-col,.kadence-column1197_23aaad-59 > .kt-inside-inner-col:before{border-top-left-radius:15px;border-top-right-radius:15px;border-bottom-right-radius:15px;border-bottom-left-radius:15px;}.kadence-column1197_23aaad-59 > .kt-inside-inner-col{column-gap:var(--global-kb-gap-sm, 1rem);}.kadence-column1197_23aaad-59 > .kt-inside-inner-col{flex-direction:column;}.kadence-column1197_23aaad-59 > .kt-inside-inner-col > .aligncenter{width:100%;}.kadence-column1197_23aaad-59 > .kt-inside-inner-col:before{opacity:0.3;}.kadence-column1197_23aaad-59{position:relative;}@media all and (max-width: 1024px){.kadence-column1197_23aaad-59 > .kt-inside-inner-col{flex-direction:column;}}@media all and (max-width: 767px){.kadence-column1197_23aaad-59 > .kt-inside-inner-col{flex-direction:column;}}<\/style>\n<div class=\"wp-block-kadence-column kadence-column1197_23aaad-59 inner-column-1\"><div class=\"kt-inside-inner-col\">\n<p><\/p>\n\n\n\n<p><\/p>\n\n\n<style>.wp-block-kadence-advancedheading.kt-adv-heading1197_344090-50, .wp-block-kadence-advancedheading.kt-adv-heading1197_344090-50[data-kb-block=\"kb-adv-heading1197_344090-50\"]{font-size:30px;font-style:normal;}.wp-block-kadence-advancedheading.kt-adv-heading1197_344090-50 mark, .wp-block-kadence-advancedheading.kt-adv-heading1197_344090-50[data-kb-block=\"kb-adv-heading1197_344090-50\"] mark{font-style:normal;color:#f76a0c;padding-top:0px;padding-right:0px;padding-bottom:0px;padding-left:0px;}<\/style>\n<h4 class=\"kt-adv-heading1197_344090-50 wp-block-kadence-advancedheading\" data-kb-block=\"kb-adv-heading1197_344090-50\">Pre-Visit Questionnaire<\/h4>\n\n\n<style>.wp-block-kadence-advancedheading.kt-adv-heading1197_c5acd9-69, .wp-block-kadence-advancedheading.kt-adv-heading1197_c5acd9-69[data-kb-block=\"kb-adv-heading1197_c5acd9-69\"]{font-size:20px;font-style:normal;}.wp-block-kadence-advancedheading.kt-adv-heading1197_c5acd9-69 mark, .wp-block-kadence-advancedheading.kt-adv-heading1197_c5acd9-69[data-kb-block=\"kb-adv-heading1197_c5acd9-69\"] mark{font-style:normal;color:#f76a0c;padding-top:0px;padding-right:0px;padding-bottom:0px;padding-left:0px;}<\/style>\n<h6 class=\"kt-adv-heading1197_c5acd9-69 wp-block-kadence-advancedheading\" data-kb-block=\"kb-adv-heading1197_c5acd9-69\">Please complete the questionnaire below prior to your<strong>&nbsp;scheduled appointment<\/strong>. <\/h6>\n\n\n\n<h6 class=\"wp-block-heading\"><strong>If you have not scheduled your appointment,<\/strong> <strong>please contact us.<\/strong><\/h6>\n\n\n<style>#kt-modal1197_7060d2-06 .kt-blocks-modal-link{color:var(--global-palette1, #3182CE);background:transparent;border-color:var(--global-palette1, #3182CE);border-radius:4px;font-size:16px;line-height:24px;border-width:2px 2px 2px 2px;padding:4px 8px 4px 8px;margin:0px 0px 0px 0px;}#kt-modal1197_7060d2-06 .kt-blocks-modal-link:hover, #kt-modal1197_7060d2-06 .kt-blocks-modal-link:focus{color:#ffffff;background:var(--global-palette2, #2B6CB0);border-color:var(--global-palette2, 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tabindex=\"-1\" data-modal-close=\"true\"><div class=\"kt-modal-container kt-modal-height-fittocontent kt-close-position-inside\" role=\"dialog\" aria-modal=\"true\"><button class=\"kt-modal-close\" aria-label=\"Close Modal\" data-modal-close=\"true\"><svg viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" xmlns=\"https:\/\/www.w3.org\/2000\/svg\" stroke-width=\"2\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><line x1=\"18\" y1=\"6\" x2=\"6\" y2=\"18\"><\/line><line x1=\"6\" y1=\"6\" x2=\"18\" y2=\"18\"><\/line><\/svg><\/button><div id=\"kt-modal1197_7060d2-06-content\" class=\"kt-modal-content\"><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>\n                <div class='gf_browser_unknown gform_wrapper gravity-theme' id='gform_wrapper_4' style='display:none'>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Pre-Visit Questionnaire<\/h2>\n                            <span class='gform_description'><\/span>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_4'  action='\/wp-json\/wp\/v2\/pages\/1197' >\n                        <div class='gform_body gform-body'><div id='gform_fields_4' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_4_17\"  class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_17\"><label class='gfield_label' for='input_4_17' >State<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_17' id='input_4_17' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Choose Your State&#8230;<\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><\/select><\/div><\/div><div id=\"field_4_14\"  class=\"gfield gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_14\"><script type=\"text\/javascript\">\n gform.addFilter( 'gform_datepicker_options_pre_init', function( optionsObj, formId, fieldId ) {\n if ( formId == 4 && fieldId == 12 ) {\n optionsObj.minDate = '0';\n optionsObj.maxDate = '+10 Y';\n \n }\n return optionsObj;\n } );\n<\/script><\/div><div id=\"field_4_12\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_12\"><label class='gfield_label' for='input_4_12' >Scheduled Appointment Date<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_12' id='input_4_12' type='text' value='' class='datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_4_12_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_4_12_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_4_12' class='gform_hidden' value='https:\/\/manhattananimalclinic.com\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><fieldset id=\"field_4_13\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_13\"><legend class='gfield_label gfield_label_before_complex'  >Scheduled Appointment Time:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class=\"ginput_complex\">\n                        <div class='gfield_time_hour ginput_container ginput_container_time' id='input_4_13'>\n                            <input type='text' maxlength='2' name='input_13[]' id='input_4_13_1' value='Hour'    placeholder='HH' aria-required='true'   \/> \n                            <label class='hour_label screen-reader-text' for='input_4_13_1'>Hours<\/label>\n                        <\/div>\n                        <div class=\"below hour_minute_colon\">:<\/div>\n                        <div class='gfield_time_minute ginput_container ginput_container_time'>\n                            <input type='text' maxlength='2' name='input_13[]' id='input_4_13_2' value='Min'    placeholder='MM' aria-required='true'  \/>\n                            <label class='minute_label screen-reader-text' for='input_4_13_2'>Minutes<\/label>\n                        <\/div>\n                        <div class='gfield_time_ampm ginput_container ginput_container_time below' >\n                                \n                                <select name='input_13[]' id='input_4_13_3'  >\n                                    <option value='am' >AM<\/option>\n                                    <option value='pm' >PM<\/option>\n                                <\/select> \n                                <label class='am_pm_label screen-reader-text' for='input_4_13_3'>AM\/PM<\/label>                                \n                           <\/div>\n                    <\/div><\/fieldset><div id=\"field_4_18\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_18\"><label class='gfield_label' for='input_4_18' >Reason:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_18' id='input_4_18' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Choose Your Reason<\/option><option value='Pet Wellness' >Pet Wellness<\/option><option value='Boarding' >Boarding<\/option><option value='Spay &amp; Neuter' >Spay &amp; Neuter<\/option><option value='Vaccinations' >Vaccinations<\/option><option value='Surgery' >Surgery<\/option><option value='Micro-chipping' >Micro-chipping<\/option><option value='Grooming' >Grooming<\/option><option value='Dental Care' >Dental Care<\/option><option value='Laboratory' >Laboratory<\/option><option value='Radiology' >Radiology<\/option><option value='Nutrition' >Nutrition<\/option><option value='Others' >Others<\/option><\/select><\/div><\/div><fieldset id=\"field_4_19\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_19\"><legend class='gfield_label'  >Are you?<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_4_19'>\n\t\t\t<div class='gchoice gchoice_4_19_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='New Client'  id='choice_4_19_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_19_0' id='label_4_19_0'>New Client<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_19_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='Existing Client'  id='choice_4_19_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_19_1' id='label_4_19_1'>Existing Client<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_44\"  class=\"gfield gsection pre-titles field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_44\"><h3 class=\"gsection_title\">Client \/ Owner Information<\/h3><\/div><fieldset id=\"field_4_1\"  class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_1\"><legend class='gfield_label gfield_label_before_complex'  >Primary Owner Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name' id='input_4_1'>\n                            \n                            <span id='input_4_1_3_container' class='name_first' >\n                                                    <input type='text' name='input_1.3' id='input_4_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_4_1_3' >First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_4_1_6_container' class='name_last' >\n                                                    <input type='text' name='input_1.6' id='input_4_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_4_1_6' >Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_4_25\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_25\"><label class='gfield_label' for='input_4_25' >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_25' id='input_4_25' type='text' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_4_3\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_3\"><label class='gfield_label' for='input_4_3' >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_3' id='input_4_3' type='text' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_4_20\"  class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_20\"><legend class='gfield_label gfield_label_before_complex'  >Secondary Owner Name<\/legend><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name' id='input_4_20'>\n                            \n                            <span id='input_4_20_3_container' class='name_first' >\n                                                    <input type='text' name='input_20.3' id='input_4_20_3' value=''   aria-required='false'     \/>\n                                                    <label for='input_4_20_3' >First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_4_20_6_container' class='name_last' >\n                                                    <input type='text' name='input_20.6' id='input_4_20_6' value=''   aria-required='false'     \/>\n                                                    <label for='input_4_20_6' >Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_4_26\"  class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_26\"><label class='gfield_label' for='input_4_26' >Secondary Email<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_26' id='input_4_26' type='text' value='' class='large'     aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_4_22\"  class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_22\"><label class='gfield_label' for='input_4_22' >Secondary Phone Number<\/label><div class='ginput_container ginput_container_phone'><input name='input_22' id='input_4_22' type='text' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_4_21\"  class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_21\"><legend class='gfield_label gfield_label_before_complex'  >Address<\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address' id='input_4_21' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1' id='input_4_21_1_container' >\n                                        <input type='text' name='input_21.1' id='input_4_21_1' value=''    aria-required='false'    \/>\n                                        <label for='input_4_21_1' id='input_4_21_1_label' >Street Address<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city' id='input_4_21_3_container' >\n                                    <input type='text' name='input_21.3' id='input_4_21_3' value=''    aria-required='false'    \/>\n                                    <label for='input_4_21_3' id='input_4_21_3_label' >City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state' id='input_4_21_4_container' >\n                                        <select name='input_21.4' id='input_4_21_4'     aria-required='false'    ><option value='' selected='selected'><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_4_21_4' id='input_4_21_4_label' >State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip' id='input_4_21_5_container' >\n                                    <input type='text' name='input_21.5' id='input_4_21_5' value=''    aria-required='false'    \/>\n                                    <label for='input_4_21_5' id='input_4_21_5_label' >ZIP Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_21.6' id='input_4_21_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><fieldset id=\"field_4_29\"  class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_29\"><legend class='gfield_label'  >Reffered by one?<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_4_29'>\n\t\t\t<div class='gchoice gchoice_4_29_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='Hospital Sign'  id='choice_4_29_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_29_0' id='label_4_29_0'>Hospital Sign<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_29_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='Online'  id='choice_4_29_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_29_1' id='label_4_29_1'>Online<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_29_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='Client'  id='choice_4_29_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_29_2' id='label_4_29_2'>Client<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_29_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='Veterinarians'  id='choice_4_29_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_29_3' id='label_4_29_3'>Veterinarians<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_29_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='Humane Society\/ Pet Store'  id='choice_4_29_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_29_4' id='label_4_29_4'>Humane Society\/ Pet Store<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_29_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='gf_other_choice'  id='choice_4_29_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_29_5' id='label_4_29_5'>Other<\/label><br \/><input id='input_4_29_other' name='input_29_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_30\"  class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_30\"><label class='gfield_label' for='input_4_30' >Clinic 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_30' id='input_4_30' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_4_31\"  class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_31\"><label class='gfield_label' for='input_4_31' >Humane Society\/Pet Store 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_31' id='input_4_31' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_4_28\"  class=\"gfield gsection pre-titles field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_28\"><h3 class=\"gsection_title\">Patient \/ Pet Information<\/h3><\/div><div id=\"field_4_10\"  class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_10\"><label class='gfield_label' for='input_4_10' >Pet 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_10' id='input_4_10' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_4_32\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_32\"><legend class='gfield_label'  >Species<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_4_32'>\n\t\t\t<div class='gchoice gchoice_4_32_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='Canine'  id='choice_4_32_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_32_0' id='label_4_32_0'>Canine<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_32_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='Feline'  id='choice_4_32_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_32_1' id='label_4_32_1'>Feline<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_32_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='Avian'  id='choice_4_32_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_32_2' id='label_4_32_2'>Avian<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_32_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='Amphibian'  id='choice_4_32_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_32_3' id='label_4_32_3'>Amphibian<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_32_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='gf_other_choice'  id='choice_4_32_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_32_4' id='label_4_32_4'>Other<\/label><br \/><input id='input_4_32_other' name='input_32_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_34\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_34\"><legend class='gfield_label'  >Sex<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_4_34'>\n\t\t\t<div class='gchoice gchoice_4_34_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='Male'  id='choice_4_34_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_34_0' id='label_4_34_0'>Male<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_34_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='Male Neutered'  id='choice_4_34_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_34_1' id='label_4_34_1'>Male Neutered<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_34_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='Female'  id='choice_4_34_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_34_2' id='label_4_34_2'>Female<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_34_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='Female Neutered'  id='choice_4_34_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_34_3' id='label_4_34_3'>Female Neutered<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_7\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_7\"><label class='gfield_label' for='input_4_7' >Breed<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_7' id='input_4_7' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_4_33\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_33\"><label class='gfield_label' for='input_4_33' >Color<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_33' id='input_4_33' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_4_35\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_35\"><label class='gfield_label' for='input_4_35' >Pet 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_35' id='input_4_35' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_4_36\"  class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_36\"><legend class='gfield_label gfield_label_before_complex'  >Birth Date (if known)<\/legend><div id='input_4_36' class='ginput_container ginput_complex'><div class='gfield_date_month ginput_container ginput_container_date' id='input_4_36_1_container'>\n                                            <input type='text' maxlength='2' name='input_36[]' id='input_4_36_1' value=''   aria-required='false'   placeholder='MM' \/>\n                                            <label for='input_4_36_1' class='screen-reader-text'>Month<\/label>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date' id='input_4_36_2_container'>\n                                            <input type='text' maxlength='2' name='input_36[]' id='input_4_36_2' value=''   aria-required='false'   placeholder='DD' \/>\n                                            <label for='input_4_36_2' class='screen-reader-text'>Day<\/label>\n                                        <\/div><div class='gfield_date_year ginput_container ginput_container_date' id='input_4_36_3_container'>\n                                            <input type='text' maxlength='4' name='input_36[]' id='input_4_36_3' value=''   aria-required='false'   placeholder='YYYY'   \/>\n                                            <label for='input_4_36_3' class='screen-reader-text'>Year<\/label>\n                                       <\/div>\n                                   <\/div><\/fieldset><div id=\"field_4_37\"  class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_37\"><label class='gfield_label' for='input_4_37' >Microchip\/Tattoo#<\/label><div class='ginput_container ginput_container_text'><input name='input_37' id='input_4_37' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_4_39\"  class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_39\"><legend class='gfield_label'  >Do you have Pet Insurance?<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_4_39'>\n\t\t\t<div class='gchoice gchoice_4_39_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_39' type='radio' value='Yes'  id='choice_4_39_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_39_0' id='label_4_39_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_39_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_39' type='radio' value='No'  id='choice_4_39_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_39_1' id='label_4_39_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_42\"  class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_42\"><label class='gfield_label' for='input_4_42' >Insurance Company Name<\/label><div class='ginput_container ginput_container_text'><input name='input_42' id='input_4_42' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_4_43\"  class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_43\"><label class='gfield_label' for='input_4_43' >Policy Number<\/label><div class='ginput_container ginput_container_text'><input name='input_43' id='input_4_43' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_4_40\"  class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_4_40\"><label class='gfield_label' for='input_4_40' >Medications &amp; Diet<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_4_40'>Please name any medications or supplements (including flea, tick or heartworm prevention), this pet is currently taking. Include any information you might have i.e. strength, dosing frequency, date given. <\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_40' id='input_4_40' class='textarea small'  aria-describedby=\"gfield_description_4_40\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_4_41\"  class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_41\"><label class='gfield_label' for='input_4_41' >What type of food or treats do you give this pet? (product name, amount, frequency, etc.)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_41' id='input_4_41' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_4_45\"  class=\"gfield gfield--width-full field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_4_45\"><legend class='gfield_label gfield_label_before_complex'  >Is your pet experiencing any of the following symptoms? Select all that apply<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_4_45'><div class='gchoice gchoice_4_45_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.1' type='checkbox'  value='Bad Breath'  id='choice_4_45_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_45_1' id='label_4_45_1'>Bad Breath<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_45_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.2' type='checkbox'  value='Coughing'  id='choice_4_45_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_45_2' id='label_4_45_2'>Coughing<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_45_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.3' type='checkbox'  value='Sneezing'  id='choice_4_45_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_45_3' id='label_4_45_3'>Sneezing<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_45_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.4' type='checkbox'  value='Vomiting'  id='choice_4_45_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_45_4' id='label_4_45_4'>Vomiting<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_45_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.5' type='checkbox'  value='Diarrhea'  id='choice_4_45_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_45_5' id='label_4_45_5'>Diarrhea<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_45_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.6' type='checkbox'  value='Limping'  id='choice_4_45_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_45_6' id='label_4_45_6'>Limping<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_45_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.7' type='checkbox'  value='Masses'  id='choice_4_45_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_45_7' id='label_4_45_7'>Masses<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_45_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.8' type='checkbox'  value='Itching\/Scratching'  id='choice_4_45_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_45_8' id='label_4_45_8'>Itching\/Scratching<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_45_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.9' type='checkbox'  value='None'  id='choice_4_45_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_45_9' id='label_4_45_9'>None<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_47\"  class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_4_47\"><legend class='gfield_label gfield_label_before_complex'  >Have there been any changes in your pet&#039;s (select all that apply)<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_4_47'><div class='gchoice gchoice_4_47_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.1' type='checkbox'  value='Activity\/Exercise'  id='choice_4_47_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_47_1' id='label_4_47_1'>Activity\/Exercise<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_47_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.2' type='checkbox'  value='Appetite'  id='choice_4_47_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_47_2' id='label_4_47_2'>Appetite<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_47_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.3' type='checkbox'  value='Attitude'  id='choice_4_47_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_47_3' id='label_4_47_3'>Attitude<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_47_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.4' type='checkbox'  value='Behavior'  id='choice_4_47_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_47_4' id='label_4_47_4'>Behavior<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_47_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.5' type='checkbox'  value='Energy'  id='choice_4_47_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_47_5' id='label_4_47_5'>Energy<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_47_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.6' type='checkbox'  value='Environments (new pets\/people\/moving\/travel)'  id='choice_4_47_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_47_6' id='label_4_47_6'>Environments (new pets\/people\/moving\/travel)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_47_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.7' type='checkbox'  value='Urinary'  id='choice_4_47_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_47_7' id='label_4_47_7'>Urinary<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_47_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.8' type='checkbox'  value='Habits'  id='choice_4_47_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_47_8' id='label_4_47_8'>Habits<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_47_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.9' type='checkbox'  value='Water Consumption'  id='choice_4_47_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_47_9' id='label_4_47_9'>Water Consumption<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_47_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.11' type='checkbox'  value='None'  id='choice_4_47_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_47_11' id='label_4_47_11'>None<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_49\"  class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_49\"><legend class='gfield_label'  >Where does this pet spend time?<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_4_49'>\n\t\t\t<div class='gchoice gchoice_4_49_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='Indoor'  id='choice_4_49_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_49_0' id='label_4_49_0'>Indoor<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_49_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='Outdoor'  id='choice_4_49_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_49_1' id='label_4_49_1'>Outdoor<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_49_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='At daycare\/boarding\/dog park'  id='choice_4_49_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_49_2' id='label_4_49_2'>At daycare\/boarding\/dog park<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_49_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='Traveling'  id='choice_4_49_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_49_3' id='label_4_49_3'>Traveling<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_49_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='gf_other_choice'  id='choice_4_49_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_49_4' id='label_4_49_4'>Other<\/label><br \/><input id='input_4_49_other' name='input_49_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_50\"  class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_50\"><label class='gfield_label' for='input_4_50' >Is there anything else you want us to know about this pet (allergies, additional concerns, chronic conditions)?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_50' id='input_4_50' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_4_51\"  class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_51\"><label class='gfield_label' for='gform_browse_button_4_51' >Is there anything else you want us to know about this pet (allergies, additional concerns, chronic conditions)?<\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_4_51' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_4_51&quot;,&quot;container&quot;:&quot;gform_multifile_upload_4_51&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_4_51&quot;,&quot;filelist&quot;:&quot;gform_preview_4_51&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/manhattananimalclinic.com\\\/?gf_page=c708446c2fa1c05&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/manhattananimalclinic.com\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/manhattananimalclinic.com\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;104857600b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:4,&quot;field_id&quot;:51},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_4_51&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_4_51' class='gform_drop_area'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_4_51' class='button gform_button_select_files' aria-describedby=\"gfield_upload_rules_4_51\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gform_fileupload_rules' id='gfield_upload_rules_4_51'>Max. file size: 100 MB.<\/span><ul class='validation_message validation_message--hidden-on-empty gfield_validation_message gform-ul-reset' id='gform_multifile_messages_4_51'><\/ul> <!-- Leave <ul> empty to support CSS :empty selector. --><\/div><div id='gform_preview_4_51'><\/div><\/div><div id=\"field_4_52\"  class=\"gfield gfield--width-full field_sublabel_below field_description_below hidden_label gfield_visibility_visible\"  data-js-reload=\"field_4_52\"><label class='gfield_label' for='input_4_52' >CAPTCHA<\/label><div id='input_4_52' class='ginput_container ginput_recaptcha' data-sitekey='6LentV0dAAAAADO5Dw4ETF7O61I9cNQZqJXmpSYe'  data-theme='light' data-tabindex='0'  data-badge=''><\/div><\/div><div id=\"field_4_53\"  class=\"gfield gform_validation_container field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_4_53\"><label class='gfield_label' for='input_4_53' >Comments<\/label><div class='ginput_container'><input name='input_53' id='input_4_53' type='text' value='' \/><\/div><div class='gfield_description' id='gfield_description_4_53'>This field is for validation purposes and should be left unchanged.<\/div><\/div><\/div><\/div>\n        <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_4' class='gform_button button' value='Submit'  onclick='if(window[\"gf_submitting_4\"]){return false;}  window[\"gf_submitting_4\"]=true;  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_4\"]){return false;} window[\"gf_submitting_4\"]=true;  jQuery(\"#gform_4\").trigger(\"submit\",[true]); }' \/> \n            <input type='hidden' class='gform_hidden' name='is_submit_4' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='4' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_4' value='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' \/>\n            <input type='hidden' class='gform_hidden' name='gform_target_page_number_4' id='gform_target_page_number_4' value='0' \/>\n            <input type='hidden' class='gform_hidden' name='gform_source_page_number_4' id='gform_source_page_number_4' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            <input type='hidden' name='gform_uploaded_files' id='gform_uploaded_files_4' value='' \/>\n        <\/div>\n                        <\/form>\n                        <\/div><\/div><\/div><\/div><\/div><button class=\"kt-modal-label-show kt-blocks-modal-link\" data-modal-open=\"kt-target-modal1197_7060d2-06\"><span class=\"kt-blocks-modal-link-inner\">Questionnaires<\/span><\/button><\/div>\n\n\n<style>.wp-block-kadence-advancedheading.kt-adv-heading1197_3a5776-af, .wp-block-kadence-advancedheading.kt-adv-heading1197_3a5776-af[data-kb-block=\"kb-adv-heading1197_3a5776-af\"]{font-size:20px;font-style:normal;}.wp-block-kadence-advancedheading.kt-adv-heading1197_3a5776-af mark, .wp-block-kadence-advancedheading.kt-adv-heading1197_3a5776-af[data-kb-block=\"kb-adv-heading1197_3a5776-af\"] mark{font-style:normal;color:#f76a0c;padding-top:0px;padding-right:0px;padding-bottom:0px;padding-left:0px;}<\/style>\n<p class=\"kt-adv-heading1197_3a5776-af wp-block-kadence-advancedheading\" data-kb-block=\"kb-adv-heading1197_3a5776-af\">This questionnaire will only take a few minutes to complete the form and this information will allow us to provide the best care for your pet.<\/p>\n\n\n<style>.wp-block-kadence-advancedheading.kt-adv-heading1197_3e4541-3d, .wp-block-kadence-advancedheading.kt-adv-heading1197_3e4541-3d[data-kb-block=\"kb-adv-heading1197_3e4541-3d\"]{font-size:30px;font-style:normal;}.wp-block-kadence-advancedheading.kt-adv-heading1197_3e4541-3d mark, .wp-block-kadence-advancedheading.kt-adv-heading1197_3e4541-3d[data-kb-block=\"kb-adv-heading1197_3e4541-3d\"] mark{font-style:normal;color:#f76a0c;padding-top:0px;padding-right:0px;padding-bottom:0px;padding-left:0px;}<\/style>\n<h4 class=\"kt-adv-heading1197_3e4541-3d wp-block-kadence-advancedheading\" data-kb-block=\"kb-adv-heading1197_3e4541-3d\">In an Emergency<\/h4>\n\n\n<style>.wp-block-kadence-advancedheading.kt-adv-heading1197_87c134-f9, .wp-block-kadence-advancedheading.kt-adv-heading1197_87c134-f9[data-kb-block=\"kb-adv-heading1197_87c134-f9\"]{font-size:20px;font-style:normal;}.wp-block-kadence-advancedheading.kt-adv-heading1197_87c134-f9 mark, .wp-block-kadence-advancedheading.kt-adv-heading1197_87c134-f9[data-kb-block=\"kb-adv-heading1197_87c134-f9\"] mark{font-style:normal;color:#f76a0c;padding-top:0px;padding-right:0px;padding-bottom:0px;padding-left:0px;}<\/style>\n<p class=\"kt-adv-heading1197_87c134-f9 wp-block-kadence-advancedheading\" data-kb-block=\"kb-adv-heading1197_87c134-f9\">In the event of a pet emergency during normal business hours, please call us immediately. If you have a pet emergency after business hours, please contact:<\/p>\n\n\n<style>.wp-block-kadence-iconlist.kt-svg-icon-list-items1197_39157b-1d:not(.this-stops-third-party-issues){margin-top:0px;margin-bottom:0px;}.wp-block-kadence-iconlist.kt-svg-icon-list-items1197_39157b-1d ul.kt-svg-icon-list:not(.this-prevents-issues):not(.this-stops-third-party-issues):not(.tijsloc){margin-top:0px;margin-right:0px;margin-bottom:10px;margin-left:0px;}.wp-block-kadence-iconlist.kt-svg-icon-list-items1197_39157b-1d ul.kt-svg-icon-list{grid-row-gap:5px;}.wp-block-kadence-iconlist.kt-svg-icon-list-items1197_39157b-1d ul.kt-svg-icon-list .kt-svg-icon-list-item-wrap .kt-svg-icon-list-single{margin-right:10px;}.kt-svg-icon-list-items1197_39157b-1d ul.kt-svg-icon-list .kt-svg-icon-list-item-wrap, .kt-svg-icon-list-items1197_39157b-1d ul.kt-svg-icon-list .kt-svg-icon-list-item-wrap a{color:var(--global-palette3, #1A202C);font-size:20px;color:var(--global-palette3, #1A202C);}@media all and (max-width: 1024px){.kt-svg-icon-list-items1197_39157b-1d ul.kt-svg-icon-list .kt-svg-icon-list-item-wrap, .kt-svg-icon-list-items1197_39157b-1d ul.kt-svg-icon-list .kt-svg-icon-list-item-wrap a{font-size:25px;}}@media all and (max-width: 767px){.kt-svg-icon-list-items1197_39157b-1d ul.kt-svg-icon-list .kt-svg-icon-list-item-wrap, .kt-svg-icon-list-items1197_39157b-1d ul.kt-svg-icon-list .kt-svg-icon-list-item-wrap a{font-size:18px;}}<\/style>\n<div class=\"wp-block-kadence-iconlist kt-svg-icon-list-items kt-svg-icon-list-items1197_39157b-1d kt-svg-icon-list-columns-1 alignnone\"><ul class=\"kt-svg-icon-list\"><style>.kt-svg-icon-list-item-1197_5d0094-08 .kt-svg-icon-list-single{font-size:20px !important;color:var(--global-palette3, #1A202C) !important;}<\/style>\n<li class=\"wp-block-kadence-listitem kt-svg-icon-list-item-wrap kt-svg-icon-list-item-1197_5d0094-08 kt-svg-icon-list-style-default\"><span class=\"kb-svg-icon-wrap kb-svg-icon-fe_phoneCall kt-svg-icon-list-single\"><svg viewBox=\"0 0 24 24\"  fill=\"none\" stroke=\"currentColor\" stroke-width=\"2\" stroke-linecap=\"round\" stroke-linejoin=\"round\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"  aria-hidden=\"true\"><path d=\"M15.05 5A5 5 0 0 1 19 8.95M15.05 1A9 9 0 0 1 23 8.94m-1 7.98v3a2 2 0 0 1-2.18 2 19.79 19.79 0 0 1-8.63-3.07 19.5 19.5 0 0 1-6-6 19.79 19.79 0 0 1-3.07-8.67A2 2 0 0 1 4.11 2h3a2 2 0 0 1 2 1.72 12.84 12.84 0 0 0 .7 2.81 2 2 0 0 1-.45 2.11L8.09 9.91a16 16 0 0 0 6 6l1.27-1.27a2 2 0 0 1 2.11-.45 12.84 12.84 0 0 0 2.81.7A2 2 0 0 1 22 16.92z\"\/><\/svg><\/span><span class=\"kt-svg-icon-list-text\">Clinic:<span class=\"has-inline-color has-theme-palette-3-color\"> <\/span><a href=\"tel:(504) 362-1400\"><span class=\"has-inline-color has-theme-palette-3-color\">(504) 362-1400<\/span><\/a><\/span><\/li>\n\n\n<style>.kt-svg-icon-list-item-1197_9b06cf-39 .kt-svg-icon-list-single{font-size:20px !important;color:var(--global-palette3, #1A202C) !important;}<\/style>\n<li class=\"wp-block-kadence-listitem kt-svg-icon-list-item-wrap kt-svg-icon-list-item-1197_9b06cf-39 kt-svg-icon-list-style-default\"><span class=\"kb-svg-icon-wrap kb-svg-icon-fe_phoneCall kt-svg-icon-list-single\"><svg viewBox=\"0 0 24 24\"  fill=\"none\" stroke=\"currentColor\" stroke-width=\"2\" stroke-linecap=\"round\" stroke-linejoin=\"round\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"  aria-hidden=\"true\"><path d=\"M15.05 5A5 5 0 0 1 19 8.95M15.05 1A9 9 0 0 1 23 8.94m-1 7.98v3a2 2 0 0 1-2.18 2 19.79 19.79 0 0 1-8.63-3.07 19.5 19.5 0 0 1-6-6 19.79 19.79 0 0 1-3.07-8.67A2 2 0 0 1 4.11 2h3a2 2 0 0 1 2 1.72 12.84 12.84 0 0 0 .7 2.81 2 2 0 0 1-.45 2.11L8.09 9.91a16 16 0 0 0 6 6l1.27-1.27a2 2 0 0 1 2.11-.45 12.84 12.84 0 0 0 2.81.7A2 2 0 0 1 22 16.92z\"\/><\/svg><\/span><span class=\"kt-svg-icon-list-text\">Kennel (504) 362-1484<\/span><\/li>\n\n\n<style>.kt-svg-icon-list-item-1197_5c4232-6f .kt-svg-icon-list-single{font-size:20px !important;color:var(--global-palette3, #1A202C) !important;}<\/style>\n<li class=\"wp-block-kadence-listitem kt-svg-icon-list-item-wrap kt-svg-icon-list-item-1197_5c4232-6f kt-svg-icon-list-style-default\"><span class=\"kb-svg-icon-wrap kb-svg-icon-ic_phone kt-svg-icon-list-single\"><svg viewBox=\"0 0 8 8\"  fill=\"currentColor\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"  aria-hidden=\"true\"><path d=\"M.19 0c-.11 0-.19.08-.19.19v7.63c0 .11.08.19.19.19h4.63c.11 0 .19-.08.19-.19v-7.63c0-.11-.08-.19-.19-.19h-4.63zm.81 1h3v5h-3v-5zm1.5 5.5c.28 0 .5.22.5.5s-.22.5-.5.5-.5-.22-.5-.5.22-.5.5-.5z\" transform=\"translate(1)\"\/><\/svg><\/span><span class=\"kt-svg-icon-list-text\">Text: (504) 717-6821<\/span><\/li>\n<\/ul><\/div>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\n<\/div><\/div>\n\n\n<style>.kadence-column1197_279300-0d > .kt-inside-inner-col{padding-top:50px;padding-right:50px;padding-bottom:50px;padding-left:50px;}.kadence-column1197_279300-0d > .kt-inside-inner-col,.kadence-column1197_279300-0d > .kt-inside-inner-col:before{border-top-left-radius:15px;border-top-right-radius:15px;border-bottom-right-radius:15px;border-bottom-left-radius:15px;}.kadence-column1197_279300-0d > .kt-inside-inner-col{column-gap:var(--global-kb-gap-sm, 1rem);}.kadence-column1197_279300-0d > .kt-inside-inner-col{flex-direction:column;}.kadence-column1197_279300-0d > .kt-inside-inner-col > .aligncenter{width:100%;}.kadence-column1197_279300-0d > .kt-inside-inner-col{background-color:var(--global-palette7, #EDF2F7);}.kadence-column1197_279300-0d > .kt-inside-inner-col:before{opacity:0.3;}.kadence-column1197_279300-0d{position:relative;}@media all and (max-width: 1024px){.kadence-column1197_279300-0d > .kt-inside-inner-col{flex-direction:column;}}@media all and (max-width: 767px){.kadence-column1197_279300-0d > .kt-inside-inner-col{flex-direction:column;}}<\/style>\n<div class=\"wp-block-kadence-column kadence-column1197_279300-0d inner-column-2\"><div class=\"kt-inside-inner-col\">\n<h2 class=\"wp-block-heading\">Request An Appointment<\/h2>\n\n\n\n<p>*This contact form is just a request. YOUR APPOINTMENT MUST BE CONFIRMED BY OUR OFFICE &#8211; Please call us at (504) 362-1400 if you have not received confirmation via email. <\/p>\n\n\n\n                <div class='gf_browser_unknown gform_wrapper gravity-theme' id='gform_wrapper_3' >\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_3'  action='\/wp-json\/wp\/v2\/pages\/1197' >\n                        <div class='gform_body gform-body'><div id='gform_fields_3' class='gform_fields top_label form_sublabel_below description_below'><fieldset id=\"field_3_1\"  class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_1\"><legend class='gfield_label gfield_label_before_complex'  >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name' id='input_3_1'>\n                            \n                            <span id='input_3_1_3_container' class='name_first' >\n                                                    <input type='text' name='input_1.3' id='input_3_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_3_1_3' >First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_3_1_6_container' class='name_last' >\n                                                    <input type='text' name='input_1.6' id='input_3_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_3_1_6' >Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_3_2\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_2\"><label class='gfield_label' for='input_3_2' >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_2' id='input_3_2' type='text' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_3_3\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_3\"><label class='gfield_label' for='input_3_3' >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_3' id='input_3_3' type='text' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_10\"  class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_10\"><label class='gfield_label' for='input_3_10' >Pet 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_10' id='input_3_10' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_3_9\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_9\"><label class='gfield_label' for='input_3_9' >Pet Type:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_9' id='input_3_9' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select&#8230;<\/option><option value='Dog' >Dog<\/option><option value='Cat' >Cat<\/option><option value='Bird' >Bird<\/option><option value='Ferret' >Ferret<\/option><option value='Horse' >Horse<\/option><option value='Rabbit' >Rabbit<\/option><option value='Rodent' >Rodent<\/option><option value='Reptile' >Reptile<\/option><option value='Other' >Other<\/option><\/select><\/div><\/div><div id=\"field_3_7\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_7\"><label class='gfield_label' for='input_3_7' >Breed:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_7' id='input_3_7' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_3_14\"  class=\"gfield gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_14\"><script type=\"text\/javascript\">\n gform.addFilter( 'gform_datepicker_options_pre_init', function( optionsObj, formId, fieldId ) {\n if ( formId == 3 && fieldId == 12 ) {\n optionsObj.minDate = '0';\n optionsObj.maxDate = '+10 Y';\n \n }\n return optionsObj;\n } );\n<\/script><\/div><fieldset id=\"field_3_11\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_11\"><legend class='gfield_label gfield_label_before_complex'  >Appointment Reasons:<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_3_11'><div class='gchoice gchoice_3_11_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.1' type='checkbox'  value='Pet Wellness'  id='choice_3_11_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_11_1' id='label_3_11_1'>Pet Wellness<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_11_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.2' type='checkbox'  value='Boarding'  id='choice_3_11_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_11_2' id='label_3_11_2'>Boarding<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_11_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.3' type='checkbox'  value='Spay &amp; Neuter'  id='choice_3_11_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_11_3' id='label_3_11_3'>Spay &#038; Neuter<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_11_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.4' type='checkbox'  value='Vaccinations'  id='choice_3_11_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_11_4' id='label_3_11_4'>Vaccinations<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_11_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.5' type='checkbox'  value='Surgery'  id='choice_3_11_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_11_5' id='label_3_11_5'>Surgery<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_11_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.6' type='checkbox'  value='Micro-chipping'  id='choice_3_11_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_11_6' id='label_3_11_6'>Micro-chipping<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_11_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.7' type='checkbox'  value='Grooming'  id='choice_3_11_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_11_7' id='label_3_11_7'>Grooming<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_11_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.8' type='checkbox'  value='Dental Care'  id='choice_3_11_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_11_8' id='label_3_11_8'>Dental Care<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_11_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.9' type='checkbox'  value='Laboratory'  id='choice_3_11_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_11_9' id='label_3_11_9'>Laboratory<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_11_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.11' type='checkbox'  value='Radiology'  id='choice_3_11_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_11_11' id='label_3_11_11'>Radiology<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_11_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.12' type='checkbox'  value='Nutrition'  id='choice_3_11_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_11_12' id='label_3_11_12'>Nutrition<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_11_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.13' type='checkbox'  value='Others'  id='choice_3_11_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_11_13' id='label_3_11_13'>Others<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3_4\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_4\"><label class='gfield_label' for='input_3_4' >Note:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_4' id='input_3_4' class='textarea medium'    placeholder='Other appointment reasons? Queries? Just plain note? Leave it here.' aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_3_12\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_12\"><label class='gfield_label' for='input_3_12' >Desired Date:<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_12' id='input_3_12' type='text' value='' class='datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_3_12_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_3_12_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_3_12' class='gform_hidden' value='https:\/\/manhattananimalclinic.com\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><fieldset id=\"field_3_13\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_13\"><legend class='gfield_label gfield_label_before_complex'  >Desired Time:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class=\"ginput_complex\">\n                        <div class='gfield_time_hour ginput_container ginput_container_time' id='input_3_13'>\n                            <input type='text' maxlength='2' name='input_13[]' id='input_3_13_1' value='Hour'    placeholder='HH' aria-required='true'   \/> \n                            <label class='hour_label screen-reader-text' for='input_3_13_1'>Hours<\/label>\n                        <\/div>\n                        <div class=\"below hour_minute_colon\">:<\/div>\n                        <div class='gfield_time_minute ginput_container ginput_container_time'>\n                            <input type='text' maxlength='2' name='input_13[]' id='input_3_13_2' value='Min'    placeholder='MM' aria-required='true'  \/>\n                            <label class='minute_label screen-reader-text' for='input_3_13_2'>Minutes<\/label>\n                        <\/div>\n                        <div class='gfield_time_ampm ginput_container ginput_container_time below' >\n                                \n                                <select name='input_13[]' id='input_3_13_3'  >\n                                    <option value='am' >AM<\/option>\n                                    <option value='pm' >PM<\/option>\n                                <\/select> \n                                <label class='am_pm_label screen-reader-text' for='input_3_13_3'>AM\/PM<\/label>                                \n                           <\/div>\n                    <\/div><\/fieldset><div id=\"field_3_15\"  class=\"gfield gfield--width-full field_sublabel_below field_description_below hidden_label gfield_visibility_visible\"  data-js-reload=\"field_3_15\"><label class='gfield_label' for='input_3_15' >CAPTCHA<\/label><div id='input_3_15' class='ginput_container ginput_recaptcha' data-sitekey='6LentV0dAAAAADO5Dw4ETF7O61I9cNQZqJXmpSYe'  data-theme='light' data-tabindex='0'  data-badge=''><\/div><\/div><div id=\"field_3_16\"  class=\"gfield gform_validation_container field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_16\"><label class='gfield_label' for='input_3_16' >Comments<\/label><div class='ginput_container'><input name='input_16' id='input_3_16' type='text' value='' \/><\/div><div class='gfield_description' id='gfield_description_3_16'>This field is for validation purposes and should be left unchanged.<\/div><\/div><\/div><\/div>\n        <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_3' class='gform_button button' value='Submit'  onclick='if(window[\"gf_submitting_3\"]){return false;}  window[\"gf_submitting_3\"]=true;  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_3\"]){return false;} window[\"gf_submitting_3\"]=true;  jQuery(\"#gform_3\").trigger(\"submit\",[true]); }' \/> \n            <input type='hidden' class='gform_hidden' name='is_submit_3' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='3' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_3' value='WyJbXSIsImUxOTNhMGFkN2RkYzYyNTAwN2RiYmY3NDc0YzExNTg1Il0=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_target_page_number_3' id='gform_target_page_number_3' value='0' \/>\n            <input type='hidden' class='gform_hidden' name='gform_source_page_number_3' id='gform_source_page_number_3' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/form>\n                        <\/div>\n\n<style>.wp-block-kadence-advancedheading.kt-adv-heading1197_e8ed56-32, .wp-block-kadence-advancedheading.kt-adv-heading1197_e8ed56-32[data-kb-block=\"kb-adv-heading1197_e8ed56-32\"]{font-size:24px;font-style:normal;}.wp-block-kadence-advancedheading.kt-adv-heading1197_e8ed56-32 mark, .wp-block-kadence-advancedheading.kt-adv-heading1197_e8ed56-32[data-kb-block=\"kb-adv-heading1197_e8ed56-32\"] mark{font-style:normal;color:#f76a0c;padding-top:0px;padding-right:0px;padding-bottom:0px;padding-left:0px;}<\/style>\n<h3 class=\"kt-adv-heading1197_e8ed56-32 wp-block-kadence-advancedheading\" data-kb-block=\"kb-adv-heading1197_e8ed56-32\">YOUR APPOINTMENT MUST BE CONFIRMED BY OUR OFFICE &#8211; Please call us at (504) 362-1400 if you have not received confirmation via email. <\/h3>\n<\/div><\/div>\n\n<\/div><\/div>","protected":false},"excerpt":{"rendered":"<p>Pre-Visit Questionnaire Pre-Visit Questionnaire Please complete the questionnaire below prior to your&nbsp;scheduled appointment. If you have not scheduled your appointment, please contact us. This questionnaire will only take a few minutes to complete the form and this information will allow us to provide the best care for your pet. In an Emergency In the event&#8230;<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"ub_ctt_via":"","_kad_blocks_custom_css":"","_kad_blocks_head_custom_js":"","_kad_blocks_body_custom_js":"","_kad_blocks_footer_custom_js":"","_kadence_starter_templates_imported_post":true,"_kad_post_transparent":"","_kad_post_title":"hide","_kad_post_layout":"fullwidth","_kad_post_sidebar_id":"","_kad_post_content_style":"unboxed","_kad_post_vertical_padding":"hide","_kad_post_feature":"hide","_kad_post_feature_position":"","_kad_post_header":false,"_kad_post_footer":false,"footnotes":""},"featured_image_src":null,"taxonomy_info":[],"featured_image_src_large":false,"author_info":{"display_name":"FM Team","author_link":"https:\/\/manhattananimalclinic.com\/author\/anthony\/"},"comment_info":0,"_links":{"self":[{"href":"https:\/\/manhattananimalclinic.com\/wp-json\/wp\/v2\/pages\/1197"}],"collection":[{"href":"https:\/\/manhattananimalclinic.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/manhattananimalclinic.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/manhattananimalclinic.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/manhattananimalclinic.com\/wp-json\/wp\/v2\/comments?post=1197"}],"version-history":[{"count":39,"href":"https:\/\/manhattananimalclinic.com\/wp-json\/wp\/v2\/pages\/1197\/revisions"}],"predecessor-version":[{"id":1626,"href":"https:\/\/manhattananimalclinic.com\/wp-json\/wp\/v2\/pages\/1197\/revisions\/1626"}],"wp:attachment":[{"href":"https:\/\/manhattananimalclinic.com\/wp-json\/wp\/v2\/media?parent=1197"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}