{"id":684,"date":"2025-03-15T13:22:32","date_gmt":"2025-03-15T13:22:32","guid":{"rendered":"https:\/\/dentalconsultants.pk\/?page_id=684"},"modified":"2025-03-15T13:22:32","modified_gmt":"2025-03-15T13:22:32","slug":"appointment-form","status":"publish","type":"page","link":"https:\/\/dentalconsultants.pk\/?page_id=684","title":{"rendered":"Appointment form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"684\" class=\"elementor elementor-684\">\n\t\t\t\t<div class=\"elementor-element elementor-element-02847cc e-flex e-con-boxed e-con e-parent\" data-id=\"02847cc\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-29ba14b elementor-widget elementor-widget-dt-reserve-appointment\" data-id=\"29ba14b\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;wdt_animation_effect&quot;:&quot;none&quot;}\" data-widget_type=\"dt-reserve-appointment.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"dt-sc-reserve-appointment type1 \">\n        <div class=\"column dt-sc-one-half first\">\n            <label>Available Services<\/label>\n            <div class=\"form-control\">\n                <select name=\"services\" class=\"dt-select-service\">\n                    <option value=\"\">Select Service<\/option><option value=\"2308\" >White Fillings ()<\/option><option value=\"2317\" >Skin Booster ()<\/option><option value=\"2300\" >Root Canal Treatment ()<\/option><option value=\"2312\" >Platelets Rich Plasma ()<\/option><option value=\"2325\" >PDO Thread lift ()<\/option><option value=\"2302\" >Laser Teeth Whitening ()<\/option><option value=\"2314\" >IV NUTRITIONAL THERAPY ()<\/option><option value=\"2321\" >Fat Loss Injections ()<\/option><option value=\"2319\" >Derma Fillers ()<\/option><option value=\"2298\" >Dental Implants ()<\/option><option value=\"2306\" >Crowns ()<\/option><option value=\"2323\" >Chemical Peels\/Mesotherapy ()<\/option><option value=\"2304\" >Braces ()<\/option><option value=\"2310\" >Anti-wrinkle treatment ()<\/option>                <\/select>\n            <\/div>\n        <\/div>\n\n        <div class=\"column dt-sc-one-half\">\n            <label>Staffs<\/label>\n            <div class=\"form-control dtstaff-drop-down\">\n                <select name=\"staff\" class=\"dt-select-staff\">\n                    <option value=\"\" style=\"background-image:url(https:\/\/via.placeholder.com\/60X60.jpg);\">Select Staff<\/option><option value=\"829\"  style=\"background-image:url('https:\/\/dentalconsultants.pk\/wp-content\/uploads\/2025\/04\/ChatGPT-Image-Sep-29-2026-10_26_04-AM-60x60.png');\">Dr. Bilal Javed Qureshi<\/option><option value=\"707\"  style=\"background-image:url('https:\/\/dentalconsultants.pk\/wp-content\/uploads\/2025\/03\/rrrrrrrrrrrrrrrr-60x60.jpg');\">Dr Nouman Waris<\/option><option value=\"706\"  style=\"background-image:url('https:\/\/dentalconsultants.pk\/wp-content\/uploads\/2025\/03\/surgi-staff-img-08-copy123-60x60.jpg');\">Dr Maimoona<\/option><option value=\"705\"  style=\"background-image:url('https:\/\/dentalconsultants.pk\/wp-content\/uploads\/2025\/03\/IMG_7619-683x1024-1-60x60.jpg');\">Dr Rabia<\/option><option value=\"703\"  style=\"background-image:url('https:\/\/dentalconsultants.pk\/wp-content\/uploads\/2025\/03\/surgi-staff-img-08-copyl-60x60.jpg');\">Dr Omer Ali Shah<\/option>                <\/select>\n            <\/div>\n        <\/div>\n\n        <div class=\"dt-sc-hr-invisible-small\"> <\/div>\n        <div class=\"dt-sc-clear\"> <\/div>\n        <div class=\"dt-sc-title\">\n            <h3>Time<\/h3>\n        <\/div>\n\n        <div class=\"column dt-sc-one-third first\">\n            <label>I am available on<\/label>\n            <div class=\"form-control form-calendar-icon\">\n                <input type=\"text\" id=\"datepicker\" name=\"date\" value=\"Select Date\" \/>\n            <\/div>\n        <\/div>\n\n        <div class=\"column dt-sc-one-third\">\n            <label>Start<\/label>\n            <div class=\"form-control\"><select name=\"start-time\" class='start-time'>\n                    <option value=\"00:00\"  selected='selected'>12:00 am<\/option><option value=\"01:00\" >1:00 am<\/option><option value=\"02:00\" >2:00 am<\/option><option value=\"03:00\" >3:00 am<\/option><option value=\"04:00\" >4:00 am<\/option><option value=\"05:00\" >5:00 am<\/option><option value=\"06:00\" >6:00 am<\/option><option value=\"07:00\" >7:00 am<\/option><option value=\"08:00\" >8:00 am<\/option><option value=\"09:00\" >9:00 am<\/option><option value=\"10:00\" >10:00 am<\/option><option value=\"11:00\" >11:00 am<\/option><option value=\"12:00\"  selected='selected'>12:00 am<\/option><option value=\"13:00\" >1:00 pm<\/option><option value=\"14:00\" >2:00 pm<\/option><option value=\"15:00\" >3:00 pm<\/option><option value=\"16:00\" >4:00 pm<\/option><option value=\"17:00\" >5:00 pm<\/option><option value=\"18:00\" >6:00 pm<\/option><option value=\"19:00\" >7:00 pm<\/option><option value=\"20:00\" >8:00 pm<\/option><option value=\"21:00\" >9:00 pm<\/option><option value=\"22:00\" >10:00 pm<\/option><option value=\"23:00\" >11:00 pm<\/option>                <\/select>\n            <\/div>\n        <\/div>\n\n        <div class=\"column dt-sc-one-third\">\n            <label>End<\/label>\n            <div class=\"form-control\"><select name=\"end-time\" class='end-time'>\n                    <option value=\"09:00\" >9:00 am<\/option><option value=\"10:00\" >10:00 am<\/option><option value=\"11:00\" >11:00 am<\/option><option value=\"12:00\"  selected='selected'>12:00 am<\/option><option value=\"13:00\" >1:00 pm<\/option><option value=\"14:00\" >2:00 pm<\/option><option value=\"15:00\" >3:00 pm<\/option><option value=\"16:00\" >4:00 pm<\/option><option value=\"17:00\" >5:00 pm<\/option><option value=\"18:00\" >6:00 pm<\/option><option value=\"19:00\" >7:00 pm<\/option><option value=\"20:00\" >8:00 pm<\/option><option value=\"21:00\" >9:00 pm<\/option><option value=\"22:00\" >10:00 pm<\/option><option value=\"23:00\" >11:00 pm<\/option><option value=\"23:59\"  selected='selected'>12:00 am<\/option>                <\/select><\/div>\n        <\/div>\n\n        <input type=\"hidden\" id=\"hidden-end-time\" name=\"hidden-end-time\" value=\"12:00 am\">\n\n        <div class=\"dt-sc-clear\"><\/div>\n\n        <div class=\"aligncenter\">\n            <a href=\"javascript:void(0);\" class=\"dt-sc-button medium bordered show-time\">Show Time<\/a>\n        <\/div>\n\n        <div class=\"dt-sc-hr-invisible-small\"> <\/div>\n        <div class=\"dt-sc-clear\"> <\/div>\n        <div class=\"available-times\"><\/div>\n\n        <div class=\"dt-sc-hr-invisible-medium\"><\/div>\n        <div class=\"dt-sc-clear\"><\/div>\n\n        <div class=\"dt-sc-complete-details\" style=\"display:none;\">\n\n            <div class=\"column dt-sc-one-third first\">\n\n                <div class=\"total-cost-info\">\n                    <div class=\"dt-sc-title\">\n                        <h3>Booking Details<\/h3>\n                    <\/div>\n                    <p class=\"total-cinfo-wrapper\">\n                        <span class=\"dt-sc-display-timing\">Date &amp; Time: <span><\/span><\/span>\n                        <span class=\"total-cinfo-service\">Service Price<\/span> +\n                        <span class=\"total-cinfo-staff\">Staff Cost<\/span>\n                        <span class=\"total-cinfo-price\">$ 00.00<\/span>\n                    <\/p>\n                <\/div>\n\n                <div class=\"aligncenter\">\n                    <a href=\"#\" class=\"dt-sc-button medium bordered dt-sc-update-details\">Update Details<\/a>\n                <\/div>\n\n            <\/div>\n\n            <div class=\"column dt-sc-two-third\">\n\n                <div id=\"personalinfo\" class=\"personal-info\">\n\n                                            <div class=\"ubpro-checkout-header-login\">\n                            <div class=\"ubpro-form-login-toggle\">\n                                <div class=\"ubpro-info\">Returning customer? <a href=\"#\" class=\"showlogin\">Click here to login<\/a><\/div>\n                            <\/div>\n\n                            <form name=\"reserveloginform\" id=\"reserveloginform\" action=\"https:\/\/dentalconsultants.pk\/wp-login.php\" method=\"post\"><p>If you have booked with us before, please enter your details below. If you are a new customer, please proceed to the Personal Info section.<\/p><p class=\"login-username\">\n\t\t\t\t<label for=\"user_login\">Username or Email Address<\/label>\n\t\t\t\t<input type=\"text\" name=\"log\" id=\"user_login\" autocomplete=\"username\" class=\"input\" value=\"\" size=\"20\" \/>\n\t\t\t<\/p><p class=\"login-password\">\n\t\t\t\t<label for=\"user_pass\">Password<\/label>\n\t\t\t\t<input type=\"password\" name=\"pwd\" id=\"user_pass\" autocomplete=\"current-password\" spellcheck=\"false\" class=\"input\" value=\"\" size=\"20\" \/>\n\t\t\t<\/p><p class=\"login-remember\"><label><input name=\"rememberme\" type=\"checkbox\" id=\"rememberme\" value=\"forever\" \/> Remember Me<\/label><\/p><p class=\"login-submit\">\n\t\t\t\t<input type=\"submit\" name=\"wp-submit\" id=\"wp-submit\" class=\"button button-primary\" value=\"Log In\" \/>\n\t\t\t\t<input type=\"hidden\" name=\"redirect_to\" value=\"https:\/\/dentalconsultants.pk\/?page_id=684\" \/>\n\t\t\t<\/p><p class=\"lost_password\"><a href=\"https:\/\/dentalconsultants.pk?lost-password&services&staff&date=2026-10-09\">Lost your password?<\/a><\/p><\/form>                        <\/div>\n                    \n                                    <\/div>\n\n            <\/div>\n\n        <\/div>\n\n    <\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Available Services Select ServiceWrinkle Treatment (30 mins)Tummy Tuck Surgery (30 mins)Skin Deep Aesthetics (30 mins)Plastic Surgery (30 mins)Nose Reshaping (30 mins)Lip Augmentation (30 mins)Laser Facial Treatment (30 mins)Cosmetic Surgery (30 mins)Cheek Augmentation (30 mins) Staffs Select StaffDalia OraNadav RafaelShira TziviaAryeh ShaniLihi RoniOsher AlonLiron AyalaAgam Arik Time I am available on Start Select Start Time12:00 am1:00 [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"_monsterinsights_skip_tracking":false,"footnotes":""},"class_list":["post-684","page","type-page","status-publish","hentry"],"aioseo_notices":[],"aioseo_head":"\n\t\t<!-- All in One SEO 5.0.2.1 - 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