{"id":9023,"date":"2023-06-29T13:44:30","date_gmt":"2023-06-29T18:44:30","guid":{"rendered":"https:\/\/test.tulsa-health.org\/?page_id=9023"},"modified":"2023-12-20T17:38:29","modified_gmt":"2023-12-20T23:38:29","slug":"child-guidance-appointment-request","status":"publish","type":"page","link":"https:\/\/tulsa-health.org\/ar\/forms\/child-guidance-appointment-request\/","title":{"rendered":"\u0637\u0644\u0628 \u0645\u0648\u0639\u062f \u0625\u0631\u0634\u0627\u062f \u0627\u0644\u0637\u0641\u0644"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"9023\" class=\"elementor elementor-9023\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-bd818ef elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"bd818ef\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-40ea984\" data-id=\"40ea984\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-ea0c842 elementor-widget elementor-widget-heading\" data-id=\"ea0c842\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Child Guidance Appointment Request<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d4e9aca elementor-widget elementor-widget-text-editor\" data-id=\"d4e9aca\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Meet with a Child Guidance audiologist, behavioral health specialist, child development specialist, or speech and language pathologist.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-e2e13d7 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"e2e13d7\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-d468bbb\" data-id=\"d468bbb\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1a5b259 elementor-widget elementor-widget-shortcode\" data-id=\"1a5b259\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_12' >\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Child Guidance Appointment Request<\/h2>\n                            <p class='gform_description'><\/p>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; \u062a\u062d\u062f\u062f \u0627\u0644\u062d\u0642\u0648\u0644 \u0627\u0644\u0645\u0637\u0644\u0648\u0628\u0629<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_12'  action='\/ar\/wp-json\/wp\/v2\/pages\/9023' data-formid='12' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_12' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_12_13\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_13'>Instagram<\/label><div class='gfield_description' id='gfield_description_12_13'>\u0647\u0630\u0627 \u0627\u0644\u062d\u0642\u0644 \u0644\u0623\u063a\u0631\u0627\u0636 \u0627\u0644\u062a\u062d\u0642\u0642 \u0648\u064a\u062c\u0628 \u062a\u0631\u0643\u0647 \u062f\u0648\u0646 \u062a\u063a\u064a\u064a\u0631.<\/div><div class='ginput_container'><input name='input_13' id='input_12_13' type='text' value='' autocomplete='new-password'\/><\/div><\/div><div id=\"field_12_4\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_4'>If you are making a referral on behalf of a client, please provide your name, agency and phone number<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_4' id='input_12_4' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_12_1\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Child&#039;s Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_12_1'>\n                            \n                            <span id='input_12_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_12_1_3' class='gform-field-label gform-field-label--type-sub '>\u0627\u0644\u0627\u0648\u0644<\/label>\n                                                    <input type='text' name='input_1.3' id='input_12_1_3' value=''   aria-required='true'    autocomplete=\"given-name\" \/>\n                                                <\/span>\n                            \n                            <span id='input_12_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_12_1_6' class='gform-field-label gform-field-label--type-sub '>\u0627\u0644\u0627\u062e\u064a\u0631<\/label>\n                                                            <input type='text' name='input_1.6' id='input_12_1_6' value=''   aria-required='true'    autocomplete=\"family-name\" \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_12_5\" class=\"gfield gfield--type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Child&#039;s DOB<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div id='input_12_5' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_12_5_1_container'><label for='input_12_5_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_5[]' id='input_12_5_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_12_5_2_container'><label for='input_12_5_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_5[]' id='input_12_5_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_12_5_3_container'><label for='input_12_5_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_5[]' id='input_12_5_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><fieldset id=\"field_12_6\" class=\"gfield gfield--type-name gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Parent\/Guardian&#039;s Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_12_6'>\n                            \n                            <span id='input_12_6_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_12_6_3' class='gform-field-label gform-field-label--type-sub '>\u0627\u0644\u0627\u0648\u0644<\/label>\n                                                    <input type='text' name='input_6.3' id='input_12_6_3' value=''   aria-required='true'    autocomplete=\"given-name\" \/>\n                                                <\/span>\n                            \n                            <span id='input_12_6_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_12_6_6' class='gform-field-label gform-field-label--type-sub '>\u0627\u0644\u0627\u062e\u064a\u0631<\/label>\n                                                            <input type='text' name='input_6.6' id='input_12_6_6' value=''   aria-required='true'    autocomplete=\"family-name\" \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_12_12\" class=\"gfield gfield--type-email gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_12'>Parent\/Guardian&#039;s 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_12' id='input_12_12' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><fieldset id=\"field_12_7\" class=\"gfield gfield--type-address gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Family&#039;s Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_12_7' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_12_7_1_container' >\n                                        <label for='input_12_7_1' id='input_12_7_1_label' class='gform-field-label gform-field-label--type-sub '>\u0639\u0646\u0648\u0627\u0646 \u0627\u0644\u0634\u0627\u0631\u0639<\/label>\n                                        <input type='text' name='input_7.1' id='input_12_7_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_12_7_2_container' >\n                                        <label for='input_12_7_2' id='input_12_7_2_label' class='gform-field-label gform-field-label--type-sub '>\u0627\u0644\u0639\u0646\u0648\u0627\u0646: \u0627\u0644\u0633\u0637\u0631 \u0627\u0644\u062b\u0627\u0646\u064a<\/label>\n                                        <input type='text' name='input_7.2' id='input_12_7_2' value=''     aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_12_7_3_container' >\n                                    <label for='input_12_7_3' id='input_12_7_3_label' class='gform-field-label gform-field-label--type-sub '>\u0627\u0644\u0645\u062f\u064a\u0646\u0629<\/label>\n                                    <input type='text' name='input_7.3' id='input_12_7_3' value=''    aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_12_7_4_container' >\n                                        <label for='input_12_7_4' id='input_12_7_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                        <select name='input_7.4' id='input_12_7_4'     aria-required='true'    ><option value='' ><\/option><option value='\u0623\u0644\u0627\u0628\u0627\u0645\u0627' >\u0623\u0644\u0627\u0628\u0627\u0645\u0627<\/option><option value='\u0627\u0644\u0648\u0644\u0627\u064a\u0627\u062a \u0627\u0644\u0645\u062a\u062d\u062f\u0629\/\u0623\u0644\u0627\u0633\u0643\u0627' >\u0627\u0644\u0648\u0644\u0627\u064a\u0627\u062a \u0627\u0644\u0645\u062a\u062d\u062f\u0629\/\u0623\u0644\u0627\u0633\u0643\u0627<\/option><option value='\u0633\u0627\u0645\u0648\u0627 \u0627\u0644\u0623\u0645\u0631\u064a\u0643\u064a\u0629' >\u0633\u0627\u0645\u0648\u0627 \u0627\u0644\u0623\u0645\u0631\u064a\u0643\u064a\u0629<\/option><option value='\u0627\u0644\u0648\u0644\u0627\u064a\u0627\u062a \u0627\u0644\u0645\u062a\u062d\u062f\u0629\/\u0623\u0631\u064a\u0632\u0648\u0646\u0627' >\u0627\u0644\u0648\u0644\u0627\u064a\u0627\u062a \u0627\u0644\u0645\u062a\u062d\u062f\u0629\/\u0623\u0631\u064a\u0632\u0648\u0646\u0627<\/option><option value='\u0623\u0631\u0643\u0646\u0633\u0627\u0633' >\u0623\u0631\u0643\u0646\u0633\u0627\u0633<\/option><option value='\u0643\u0627\u0644\u064a\u0641\u0648\u0631\u0646\u064a\u0627' >\u0643\u0627\u0644\u064a\u0641\u0648\u0631\u0646\u064a\u0627<\/option><option value='\u0643\u0648\u0644\u0648\u0631\u0627\u062f\u0648' >\u0643\u0648\u0644\u0648\u0631\u0627\u062f\u0648<\/option><option value='\u0643\u0648\u0646\u064a\u062a\u064a\u0643\u062a' >\u0643\u0648\u0646\u064a\u062a\u064a\u0643\u062a<\/option><option value='\u062f\u064a\u0644\u0627\u0648\u064a\u0631' >\u062f\u064a\u0644\u0627\u0648\u064a\u0631<\/option><option value='\u0645\u0642\u0627\u0637\u0639\u0629 \u0643\u0648\u0644\u0648\u0645\u0628\u064a\u0627' >\u0645\u0642\u0627\u0637\u0639\u0629 \u0643\u0648\u0644\u0648\u0645\u0628\u064a\u0627<\/option><option value='\u0641\u0644\u0648\u0631\u064a\u062f\u0627' >\u0641\u0644\u0648\u0631\u064a\u062f\u0627<\/option><option value='\u062c\u0648\u0631\u062c\u064a\u0627' >\u062c\u0648\u0631\u062c\u064a\u0627<\/option><option value='\u063a\u0648\u0627\u0645' >\u063a\u0648\u0627\u0645<\/option><option value='\u0627\u0644\u0648\u0644\u0627\u064a\u0627\u062a \u0627\u0644\u0645\u062a\u062d\u062f\u0629\/\u0647\u0627\u0648\u0627\u064a' >\u0627\u0644\u0648\u0644\u0627\u064a\u0627\u062a \u0627\u0644\u0645\u062a\u062d\u062f\u0629\/\u0647\u0627\u0648\u0627\u064a<\/option><option value='\u0627\u064a\u062f\u0627\u0647\u0648' >\u0627\u064a\u062f\u0627\u0647\u0648<\/option><option value='\u0625\u0644\u064a\u0646\u0648\u064a' >\u0625\u0644\u064a\u0646\u0648\u064a<\/option><option value='\u0625\u0646\u062f\u064a\u0627\u0646\u0627' >\u0625\u0646\u062f\u064a\u0627\u0646\u0627<\/option><option value='\u0622\u064a\u0648\u0627' >\u0622\u064a\u0648\u0627<\/option><option value='\u0643\u0627\u0646\u0633\u0627\u0633' >\u0643\u0627\u0646\u0633\u0627\u0633<\/option><option value='\u0643\u0646\u062a\u0627\u0643\u064a' >\u0643\u0646\u062a\u0627\u0643\u064a<\/option><option value='\u0648\u0644\u0627\u064a\u0629 \u0644\u0648\u064a\u0632\u064a\u0627\u0646\u0627' >\u0648\u0644\u0627\u064a\u0629 \u0644\u0648\u064a\u0632\u064a\u0627\u0646\u0627<\/option><option value='\u0648\u0644\u0627\u064a\u0629 \u0645\u064a\u0646' >\u0648\u0644\u0627\u064a\u0629 \u0645\u064a\u0646<\/option><option value='\u0645\u064a\u0631\u064a\u0644\u0627\u0646\u062f' >\u0645\u064a\u0631\u064a\u0644\u0627\u0646\u062f<\/option><option value='\u0645\u0627\u0633\u0627\u062a\u0634\u0648\u0633\u062a\u0633' >\u0645\u0627\u0633\u0627\u062a\u0634\u0648\u0633\u062a\u0633<\/option><option value='\u0645\u064a\u0634\u064a\u063a\u0627\u0646' >\u0645\u064a\u0634\u064a\u063a\u0627\u0646<\/option><option value='\u0645\u064a\u0646\u064a\u0633\u0648\u062a\u0627' >\u0645\u064a\u0646\u064a\u0633\u0648\u062a\u0627<\/option><option value='\u0645\u064a\u0633\u064a\u0633\u064a\u0628\u064a' >\u0645\u064a\u0633\u064a\u0633\u064a\u0628\u064a<\/option><option value='\u0645\u064a\u0633\u0648\u0631\u064a' >\u0645\u064a\u0633\u0648\u0631\u064a<\/option><option value='\u0645\u0648\u0646\u062a\u0627\u0646\u0627' >\u0645\u0648\u0646\u062a\u0627\u0646\u0627<\/option><option value='\u0646\u0628\u0631\u0627\u0633\u0643\u0627' >\u0646\u0628\u0631\u0627\u0633\u0643\u0627<\/option><option value='\u0646\u064a\u0641\u0627\u062f\u0627' >\u0646\u064a\u0641\u0627\u062f\u0627<\/option><option value='\u0646\u064a\u0648 \u0647\u0627\u0645\u0628\u0634\u0627\u064a\u0631' >\u0646\u064a\u0648 \u0647\u0627\u0645\u0628\u0634\u0627\u064a\u0631<\/option><option value='\u0646\u064a\u0648 \u062c\u064a\u0631\u0633\u064a' >\u0646\u064a\u0648 \u062c\u064a\u0631\u0633\u064a<\/option><option value='\u0646\u064a\u0648 \u0645\u064a\u0643\u0633\u064a\u0643\u0648' >\u0646\u064a\u0648 \u0645\u064a\u0643\u0633\u064a\u0643\u0648<\/option><option value='\u0646\u064a\u0648\u064a\u0648\u0631\u0643' >\u0646\u064a\u0648\u064a\u0648\u0631\u0643<\/option><option value='\u0643\u0627\u0631\u0648\u0644\u0627\u064a\u0646\u0627 \u0627\u0644\u0634\u0645\u0627\u0644\u064a\u0629' >\u0643\u0627\u0631\u0648\u0644\u0627\u064a\u0646\u0627 \u0627\u0644\u0634\u0645\u0627\u0644\u064a\u0629<\/option><option value='\u062f\u0627\u0643\u0648\u062a\u0627 \u0627\u0644\u0634\u0645\u0627\u0644\u064a\u0629' >\u062f\u0627\u0643\u0648\u062a\u0627 \u0627\u0644\u0634\u0645\u0627\u0644\u064a\u0629<\/option><option value='\u062c\u0632\u0631 \u0645\u0627\u0631\u064a\u0627\u0646\u0627 \u0627\u0644\u0634\u0645\u0627\u0644\u064a\u0629' >\u062c\u0632\u0631 \u0645\u0627\u0631\u064a\u0627\u0646\u0627 \u0627\u0644\u0634\u0645\u0627\u0644\u064a\u0629<\/option><option value='\u0627\u0648\u0647\u0627\u064a\u0648' >\u0627\u0648\u0647\u0627\u064a\u0648<\/option><option value='\u0623\u0648\u0643\u0644\u0627\u0647\u0648\u0645\u0627' >\u0623\u0648\u0643\u0644\u0627\u0647\u0648\u0645\u0627<\/option><option value='\u0623\u0648\u0631\u064a\u062c\u0648\u0646' >\u0623\u0648\u0631\u064a\u062c\u0648\u0646<\/option><option value='\u0628\u0646\u0633\u0644\u0641\u0627\u0646\u064a\u0627' >\u0628\u0646\u0633\u0644\u0641\u0627\u0646\u064a\u0627<\/option><option value='\u0628\u0648\u0631\u062a\u0648\u0631\u064a\u0643\u0648' >\u0628\u0648\u0631\u062a\u0648\u0631\u064a\u0643\u0648<\/option><option value='\u0631\u0648\u062f \u0627\u064a\u0644\u0627\u0646\u062f' >\u0631\u0648\u062f \u0627\u064a\u0644\u0627\u0646\u062f<\/option><option value='\u0643\u0627\u0631\u0648\u0644\u064a\u0646\u0627 \u0627\u0644\u062c\u0646\u0648\u0628\u064a\u0629' >\u0643\u0627\u0631\u0648\u0644\u064a\u0646\u0627 \u0627\u0644\u062c\u0646\u0648\u0628\u064a\u0629<\/option><option value='\u062f\u0627\u0643\u0648\u062a\u0627 \u0627\u0644\u062c\u0646\u0648\u0628\u064a\u0629' >\u062f\u0627\u0643\u0648\u062a\u0627 \u0627\u0644\u062c\u0646\u0648\u0628\u064a\u0629<\/option><option value='\u062a\u064a\u0646\u064a\u0633\u064a' >\u062a\u064a\u0646\u064a\u0633\u064a<\/option><option value='\u062a\u0643\u0633\u0627\u0633' >\u062a\u0643\u0633\u0627\u0633<\/option><option value='\u064a\u0648\u062a\u0627' >\u064a\u0648\u062a\u0627<\/option><option value='\u062c\u0632\u0631 \u0641\u064a\u0631\u062c\u0646 \u0627\u0644\u0623\u0645\u0631\u064a\u0643\u064a\u0629' >\u062c\u0632\u0631 \u0641\u064a\u0631\u062c\u0646 \u0627\u0644\u0623\u0645\u0631\u064a\u0643\u064a\u0629<\/option><option value='\u0641\u064a\u0631\u0645\u0648\u0646\u062a' >\u0641\u064a\u0631\u0645\u0648\u0646\u062a<\/option><option value='\u0641\u0631\u062c\u064a\u0646\u064a\u0627' >\u0641\u0631\u062c\u064a\u0646\u064a\u0627<\/option><option value='\u0648\u0627\u0634\u0646\u0637\u0646' >\u0648\u0627\u0634\u0646\u0637\u0646<\/option><option value='\u0641\u0631\u062c\u064a\u0646\u064a\u0627 \u0627\u0644\u063a\u0631\u0628\u064a\u0629' >\u0641\u0631\u062c\u064a\u0646\u064a\u0627 \u0627\u0644\u063a\u0631\u0628\u064a\u0629<\/option><option value='\u0648\u064a\u0633\u0643\u0648\u0646\u0633\u0646' >\u0648\u064a\u0633\u0643\u0648\u0646\u0633\u0646<\/option><option value='\u0648\u0627\u064a\u0648\u0645\u0646\u063a' >\u0648\u0627\u064a\u0648\u0645\u0646\u063a<\/option><option value='\u0627\u0644\u0642\u0648\u0627\u062a \u0627\u0644\u0645\u0633\u0644\u062d\u0629 \u0627\u0644\u0623\u0645\u0631\u064a\u0643\u062a\u064a\u0646' >\u0627\u0644\u0642\u0648\u0627\u062a \u0627\u0644\u0645\u0633\u0644\u062d\u0629 \u0627\u0644\u0623\u0645\u0631\u064a\u0643\u062a\u064a\u0646<\/option><option value='\u0627\u0644\u0642\u0648\u0627\u062a \u0627\u0644\u0645\u0633\u0644\u062d\u0629 \u0627\u0644\u0623\u0648\u0631\u0648\u0628\u064a\u0629' >\u0627\u0644\u0642\u0648\u0627\u062a \u0627\u0644\u0645\u0633\u0644\u062d\u0629 \u0627\u0644\u0623\u0648\u0631\u0648\u0628\u064a\u0629<\/option><option value='\u0627\u0644\u0642\u0648\u0627\u062a \u0627\u0644\u0645\u0633\u0644\u062d\u0629 \u0641\u064a \u0627\u0644\u0645\u062d\u064a\u0637 \u0627\u0644\u0647\u0627\u062f\u0626' >\u0627\u0644\u0642\u0648\u0627\u062a \u0627\u0644\u0645\u0633\u0644\u062d\u0629 \u0641\u064a \u0627\u0644\u0645\u062d\u064a\u0637 \u0627\u0644\u0647\u0627\u062f\u0626<\/option><\/select>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_12_7_5_container' >\n                                    <label for='input_12_7_5' id='input_12_7_5_label' class='gform-field-label gform-field-label--type-sub '>\u0627\u0644\u0631\u0645\u0632 \u0627\u0644\u0628\u0631\u064a\u062f\u0649<\/label>\n                                    <input type='text' name='input_7.5' id='input_12_7_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_7.6' id='input_12_7_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_12_8\" class=\"gfield gfield--type-phone gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_8'>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_8' id='input_12_8' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_12_9\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Area of concern\/service requested<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_12_9'>Please check all that apply. \n<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_12_9'><div class='gchoice gchoice_12_9_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.1' type='checkbox'  value='Hearing'  id='choice_12_9_1'   aria-describedby=\"gfield_description_12_9\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_12_9_1' id='label_12_9_1' class='gform-field-label gform-field-label--type-inline'>Hearing<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_9_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.2' type='checkbox'  value='Speech\/Language'  id='choice_12_9_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_9_2' id='label_12_9_2' class='gform-field-label gform-field-label--type-inline'>Speech \/ Language<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_9_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.3' type='checkbox'  value='Autism'  id='choice_12_9_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_9_3' id='label_12_9_3' class='gform-field-label gform-field-label--type-inline'>Autism<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_9_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.4' type='checkbox'  value='Behavior'  id='choice_12_9_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_9_4' id='label_12_9_4' class='gform-field-label gform-field-label--type-inline'>Behavior<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_9_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.5' type='checkbox'  value='Sleep\/Toilet Training\/Eating'  id='choice_12_9_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_9_5' id='label_12_9_5' class='gform-field-label gform-field-label--type-inline'>Sleep \/ Toilet Training \/ Eating<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_9_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.6' type='checkbox'  value='Developmental Screening'  id='choice_12_9_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_9_6' id='label_12_9_6' class='gform-field-label gform-field-label--type-inline'>Developmental Screening<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_10\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Preferred location<\/legend><div class='gfield_description' id='gfield_description_12_10'>Not all services available at all locations. \n<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_10'>\n\t\t\t<div class='gchoice gchoice_12_10_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='Central Regional Health Center 315 S. Utica Ave.'  id='choice_12_10_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_12_10\"   \/>\n\t\t\t\t\t<label for='choice_12_10_0' id='label_12_10_0' class='gform-field-label gform-field-label--type-inline'>Central Regional Health Center 315 S. Utica Ave.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_10_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='North Regional Health and Wellness Center 5635 N. MLK Jr. Blvd.'  id='choice_12_10_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_10_1' id='label_12_10_1' class='gform-field-label gform-field-label--type-inline'>North Regional Health and Wellness Center 5635 N. MLK Jr. Blvd.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_10_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='James O. Goodwin Health Center 5051 S. 129th E. Ave.'  id='choice_12_10_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_10_2' id='label_12_10_2' class='gform-field-label gform-field-label--type-inline'>James O. Goodwin Health Center 5051 S. 129th E. 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);\n<\/script>\n<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-a501985 elementor-section-full_width elementor-section-height-default elementor-section-height-default\" data-id=\"a501985\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-557750c\" data-id=\"557750c\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7c2cd51 elementor-widget elementor-widget-shortcode\" data-id=\"7c2cd51\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\">\t\t<div data-elementor-type=\"section\" data-elementor-id=\"4934\" class=\"elementor elementor-4934\" data-elementor-post-type=\"elementor_library\">\n\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-4469b59d elementor-section-stretched elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"4469b59d\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;stretch_section&quot;:&quot;section-stretched&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-615ea353\" data-id=\"615ea353\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-bdb2691 elementor-widget elementor-widget-heading\" data-id=\"bdb2691\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">LOCATIONS<\/h5>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-00f74f9 elementor-widget elementor-widget-text-editor\" data-id=\"00f74f9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>We have 9 locations across Tulsa County that offer a variety of services to help you and your family stay healthy.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fd63501 elementor-align-center secondary elementor-widget elementor-widget-button\" data-id=\"fd63501\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"\/locations\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Find Yours<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>\u0637\u0644\u0628 \u0645\u0648\u0639\u062f \u0641\u064a \u0627\u0644\u0625\u0631\u0634\u0627\u062f \u0644\u0644\u0623\u0637\u0641\u0627\u0644 \u0645\u0642\u0627\u0628\u0644\u0629 \u0623\u062d\u062f \u0623\u062e\u0635\u0627\u0626\u064a\u064a \u0627\u0644\u0633\u0645\u0639 \u0641\u064a \u0627\u0644\u0625\u0631\u0634\u0627\u062f \u0644\u0644\u0623\u0637\u0641\u0627\u0644\u060c \u0623\u0648 \u0623\u062e\u0635\u0627\u0626\u064a \u0627\u0644\u0635\u062d\u0629 \u0627\u0644\u0633\u0644\u0648\u0643\u064a\u0629\u060c \u0623\u0648 \u0623\u062e\u0635\u0627\u0626\u064a \u0646\u0645\u0648 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