{"id":1754,"date":"2022-04-29T20:40:24","date_gmt":"2022-04-29T20:40:24","guid":{"rendered":"https:\/\/www.lowryortho.com\/?page_id=1754"},"modified":"2022-12-14T19:14:18","modified_gmt":"2022-12-14T19:14:18","slug":"dental-referral","status":"publish","type":"page","link":"https:\/\/www.lowryortho.com\/dental-referral\/","title":{"rendered":"Dental Referral"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row full_width=&#8221;stretch_row&#8221; gap=&#8221;35&#8243; equal_height=&#8221;yes&#8221; css=&#8221;.vc_custom_1651786761581{padding-top: 5% !important;padding-bottom: 5% !important;background-color: #f4f4f4 !important;}&#8221;][vc_column width=&#8221;1\/2&#8243;][vc_column_text css=&#8221;.vc_custom_1651782965241{margin-top: 0px !important;padding-top: 0px !important;}&#8221;]<\/p>\n<h1>Make a Referral<\/h1>\n<p>[\/vc_column_text][vc_separator][vc_column_text css=&#8221;.vc_custom_1651782993814{margin-top: 0px !important;padding-top: 0px !important;}&#8221;]<span style=\"color: #b2bf45;\"><strong>A successful practice doesn&#8217;t just happen; it is the result of a strong commitment to excellence in the professional community and in the relationships we build with our patients and colleagues. We appreciate the confidence you&#8217;ve placed in us to provide you with the complete care you need, and we thank you for recommending our practice to your friends and family.<\/strong><\/span><\/p>\n<p>If you are here to refer a friend to our practice, please provide us with the information below. Once you&#8217;ve completed the form, click on the SUBMIT button at the bottom of the page.[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/2&#8243;]\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f1825-o1\" lang=\"en-US\" dir=\"ltr\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/wp-json\/wp\/v2\/pages\/1754#wpcf7-f1825-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"1825\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"5.9.3\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f1825-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/div>\n<h2>Practice Information\n<\/h2>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"DoctorName\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Doctor Name\" value=\"\" type=\"text\" name=\"DoctorName\" \/><\/span>\n<\/p>\n<div class=\"one-half\">\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"PracticeName\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Practice Name\" value=\"\" type=\"text\" name=\"PracticeName\" \/><\/span>\n\t<\/p>\n<\/div>\n<div class=\"one-half last\">\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"YourEmail\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Your Email\" value=\"\" type=\"email\" name=\"YourEmail\" \/><\/span>\n\t<\/p>\n<\/div>\n<h2>Referral Information\n<\/h2>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"NameofPatient\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Name of Patient\" value=\"\" type=\"text\" name=\"NameofPatient\" \/><\/span>\n<\/p>\n<div class=\"one-half\">\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"PatientsPhone\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Patient&#039;s Phone\" value=\"\" type=\"tel\" name=\"PatientsPhone\" \/><\/span>\n\t<\/p>\n<\/div>\n<div class=\"one-half last\">\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"PatientEmail\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-email wpcf7-text wpcf7-validates-as-email\" aria-invalid=\"false\" placeholder=\"Patient&#039;s Email\" value=\"\" type=\"email\" name=\"PatientEmail\" \/><\/span>\n\t<\/p>\n<\/div>\n<p><label>Radiographs Sent?<\/label>\n<\/p>\n<div class=\"one-half\">\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"RadiographsSent\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"RadiographsSent\" value=\"Yes\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"RadiographsSent\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n\t<\/p>\n<\/div>\n<div class=\"one-half last\">\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"WhenWereTheySent\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"WhenWereTheySent\" \/><\/span>\n\t<\/p>\n<\/div>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"Comments\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"Comments\" name=\"Comments\"><\/textarea><\/span>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Submit Referral\" \/>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n[\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row full_width=&#8221;stretch_row&#8221; gap=&#8221;35&#8243; equal_height=&#8221;yes&#8221; css=&#8221;.vc_custom_1651786761581{padding-top: 5% !important;padding-bottom: 5% !important;background-color: #f4f4f4 !important;}&#8221;][vc_column width=&#8221;1\/2&#8243;][vc_column_text css=&#8221;.vc_custom_1651782965241{margin-top: 0px !important;padding-top: 0px !important;}&#8221;] Make a Referral [\/vc_column_text][vc_separator][vc_column_text css=&#8221;.vc_custom_1651782993814{margin-top: 0px !important;padding-top: 0px !important;}&#8221;]A successful practice doesn&#8217;t just happen; it is the result of a strong commitment to excellence in the professional community and in the relationships we build with our patients and&hellip;<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Dental Referral | Marcus Lowry Orthodontics of Idaho<\/title>\n<meta name=\"description\" content=\"We appreciate the confidence you&#039;ve placed in us to provide you with the complete care you need, and we thank you for recommending our practice to your friends and family.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, 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