{"id":9063,"date":"2023-06-29T14:16:16","date_gmt":"2023-06-29T19:16:16","guid":{"rendered":"https:\/\/test.tulsa-health.org\/?page_id=9063"},"modified":"2023-12-20T17:43:39","modified_gmt":"2023-12-20T23:43:39","slug":"healthy-start-referral","status":"publish","type":"page","link":"https:\/\/tulsa-health.org\/my\/forms\/healthy-start-referral\/","title":{"rendered":"\u1000\u103b\u1014\u103a\u1038\u1019\u102c\u101e\u1031\u102c \u1005\u1010\u1004\u103a\u101b\u100a\u103a\u100a\u103d\u1014\u103a\u1038\u1015\u102b\u104b"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"9063\" class=\"elementor elementor-9063\" 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\">Healthy Start Referral<\/h1>\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 InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return 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_13' >\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Healthy Start Referral<\/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; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_13'  action='\/my\/wp-json\/wp\/v2\/pages\/9063' data-formid='13' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_13' class='gform_fields top_label form_sublabel_above description_below validation_below'><div id=\"field_13_32\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_32'>URL<\/label><div class='ginput_container'><input name='input_32' id='input_13_32' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_13_32'>This field is for validation purposes and should be left unchanged.<\/div><\/div><div id=\"field_13_7\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Mother&#039;s Contact Information<\/h3><\/div><fieldset id=\"field_13_1\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Mother&#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_13_1'>\n                            \n                            <span id='input_13_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_13_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_1.3' id='input_13_1_3' value=''   aria-required='true'    autocomplete=\"given-name\" \/>\n                                                <\/span>\n                            \n                            <span id='input_13_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_13_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_1.6' id='input_13_1_6' value=''   aria-required='true'    autocomplete=\"family-name\" \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_13_4\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Mother&#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_country ginput_container_address gform-grid-row' id='input_13_4' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_13_4_1_container' >\n                                        <label for='input_13_4_1' id='input_13_4_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_4.1' id='input_13_4_1' value=''    aria-required='true'   autocomplete=\"address-line1\" \/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_13_4_2_container' >\n                                        <label for='input_13_4_2' id='input_13_4_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                        <input type='text' name='input_4.2' id='input_13_4_2' value=''    autocomplete=\"address-line2\" aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_13_4_3_container' >\n                                    <label for='input_13_4_3' id='input_13_4_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_4.3' id='input_13_4_3' value=''    aria-required='true'   autocomplete=\"address-level2\" \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_13_4_4_container' >\n                                        <label for='input_13_4_4' id='input_13_4_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                        <select name='input_4.4' id='input_13_4_4'     aria-required='true'   autocomplete=\"address-level1\" ><option value='' ><\/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' selected='selected'>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                                      <\/span><input type='hidden' class='gform_hidden' name='input_4.6' id='input_13_4_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_13_31\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_31'>Zip Code<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_31' id='input_13_31' class='large gfield_select'  aria-describedby=\"gfield_description_13_31\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='74011' >74011<\/option><option value='74012' >74012<\/option><option value='74063' >74063<\/option><option value='74106' >74106<\/option><option value='74110' >74110<\/option><option value='74115' >74115<\/option><option value='74116' >74116<\/option><option value='74117' >74117<\/option><option value='74126' >74126<\/option><option value='74127' >74127<\/option><option value='74130' >74130<\/option><\/select><\/div><div class='gfield_description' id='gfield_description_13_31'>Client must be pregnant and reside in one of the following 11 Tulsa County zip codes: 74011, 74012, 74063, 74106, 74110, 74115, 74116, 74117, 74126, 74127 or 74130.\n<\/div><\/div><div id=\"field_13_16\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_16'>Mother&#039;s Age<\/label><div class='ginput_container ginput_container_number'><input name='input_16' id='input_13_16' type='number' step='any'   value='' class='small'      aria-invalid=\"false\"  \/><\/div><\/div><fieldset id=\"field_13_17\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-half field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Mother&#039;s DOB<\/legend><div id='input_13_17' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_13_17_1_container'><label for='input_13_17_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_17[]' id='input_13_17_1'   aria-required='false'  ><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_13_17_2_container'><label for='input_13_17_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_17[]' id='input_13_17_2'   aria-required='false'  ><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_13_17_3_container'><label for='input_13_17_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_17[]' id='input_13_17_3'   aria-required='false'  ><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_13_2\" class=\"gfield gfield--type-email gfield--input-type-email field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Mother&#039;s Email Address<\/legend><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_13_2_container'>\n                                <span id='input_13_2_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <label for='input_13_2' class='gform-field-label gform-field-label--type-sub '>Email Address<\/label>\n                                    <input class='' type='email' name='input_2' id='input_13_2' value=''     aria-invalid=\"false\"  autocomplete=\"email\"\/>\n                                <\/span>\n                                <span id='input_13_2_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <label for='input_13_2_2' class='gform-field-label gform-field-label--type-sub '>Confirm Email Address<\/label>\n                                    <input class='' type='email' name='input_2_2' id='input_13_2_2' value=''     aria-invalid=\"false\"  autocomplete=\"email\"\/>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><div id=\"field_13_5\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_5'>Mother&#039;s Phone Number<\/label><div class='ginput_container ginput_container_phone'><input name='input_5' id='input_13_5' type='tel' value='' class='medium'    aria-invalid=\"false\"  autocomplete=\"tel\" \/><\/div><\/div><div id=\"field_13_18\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_18'>Alternative Phone Number<\/label><div class='ginput_container ginput_container_phone'><input name='input_18' id='input_13_18' type='tel' value='' class='medium'    aria-invalid=\"false\"  autocomplete=\"tel\" \/><\/div><\/div><fieldset id=\"field_13_19\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Languages Spoken<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_13_19'><div class='gchoice gchoice_13_19_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.1' type='checkbox'  value='English'  id='choice_13_19_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_19_1' id='label_13_19_1' class='gform-field-label gform-field-label--type-inline'>English<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_19_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.2' type='checkbox'  value='Spanish'  id='choice_13_19_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_19_2' id='label_13_19_2' class='gform-field-label gform-field-label--type-inline'>Spanish<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_19_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.3' type='checkbox'  value='American Sign Language'  id='choice_13_19_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_19_3' id='label_13_19_3' class='gform-field-label gform-field-label--type-inline'>American Sign Language<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_19_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.4' type='checkbox'  value='Other'  id='choice_13_19_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_19_4' id='label_13_19_4' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_20\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_20'>Week Pregnant<\/label><div class='ginput_container ginput_container_number'><input name='input_20' id='input_13_20' type='number' step='any'  max='52' value='' class='small'      aria-invalid=\"false\" aria-describedby=\"gfield_instruction_13_20 gfield_description_13_20\" \/><div class='gfield_description instruction ' id='gfield_instruction_13_20'>Please enter a number less than or equal to <strong>52<\/strong>.<\/div><\/div><div class='gfield_description' id='gfield_description_13_20'>When appropriate\n<\/div><\/div><fieldset id=\"field_13_21\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-third field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Mother&#039;s Estimated Due Date<\/legend><div id='input_13_21' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_13_21_1_container'><label for='input_13_21_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_21[]' id='input_13_21_1'   aria-required='false'  ><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_13_21_2_container'><label for='input_13_21_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_21[]' id='input_13_21_2'   aria-required='false'  ><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_13_21_3_container'><label for='input_13_21_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_21[]' id='input_13_21_3'   aria-required='false'  ><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_13_22\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >First-time Pregnancy?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_22'>\n\t\t\t<div class='gchoice gchoice_13_22_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='Yes'  id='choice_13_22_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_22_0' id='label_13_22_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_22_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='No'  id='choice_13_22_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_22_1' id='label_13_22_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_24\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Parent\/Guardian&#039;s Name<\/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_13_24'>\n                            \n                            <span id='input_13_24_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_13_24_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_24.3' id='input_13_24_3' value=''   aria-required='false'     \/>\n                                                <\/span>\n                            \n                            <span id='input_13_24_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_13_24_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_24.6' id='input_13_24_6' value=''   aria-required='false'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_13_25\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-full field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_25'>Parent\/Guardian&#039;s Phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_25' id='input_13_25' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_26\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Reason for Referral (mark 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_13_26'><div class='gchoice gchoice_13_26_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.1' type='checkbox'  value='Non-pregnant\/ICC'  id='choice_13_26_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_26_1' id='label_13_26_1' class='gform-field-label gform-field-label--type-inline'>Non-pregnant\/ICC<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_26_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.2' type='checkbox'  value='Pregnant'  id='choice_13_26_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_26_2' id='label_13_26_2' class='gform-field-label gform-field-label--type-inline'>Pregnant<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_26_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.3' type='checkbox'  value='Postpartum'  id='choice_13_26_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_26_3' id='label_13_26_3' class='gform-field-label gform-field-label--type-inline'>Postpartum<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_26_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.4' type='checkbox'  value='Parenting\/Child (under 18 months)'  id='choice_13_26_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_26_4' id='label_13_26_4' class='gform-field-label gform-field-label--type-inline'>Parenting\/Child (under 18 months)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_26_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.5' type='checkbox'  value='Previous Infant Death'  id='choice_13_26_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_26_5' id='label_13_26_5' class='gform-field-label gform-field-label--type-inline'>Previous Infant Death<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_26_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.6' type='checkbox'  value='Received late\/no prenatal care during current or previous pregnancy'  id='choice_13_26_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_26_6' id='label_13_26_6' class='gform-field-label gform-field-label--type-inline'>Received late\/no prenatal care during current or previous pregnancy<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_26_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.7' type='checkbox'  value='Previous pre-term or LBW birth'  id='choice_13_26_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_26_7' id='label_13_26_7' class='gform-field-label gform-field-label--type-inline'>Previous pre-term or LBW birth<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_26_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.8' type='checkbox'  value='Previous complicated pregnancy or maternal health complication'  id='choice_13_26_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_26_8' id='label_13_26_8' class='gform-field-label gform-field-label--type-inline'>Previous complicated pregnancy or maternal health complication<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_26_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.9' type='checkbox'  value='First time Mom\/Dad'  id='choice_13_26_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_26_9' id='label_13_26_9' class='gform-field-label gform-field-label--type-inline'>First time Mom\/Dad<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_26_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.11' type='checkbox'  value='Pregnant\/Parenting Teen'  id='choice_13_26_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_26_11' id='label_13_26_11' class='gform-field-label gform-field-label--type-inline'>Pregnant\/Parenting Teen<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_26_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.12' type='checkbox'  value='Mental Health'  id='choice_13_26_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_26_12' id='label_13_26_12' class='gform-field-label gform-field-label--type-inline'>Mental Health<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_26_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.13' type='checkbox'  value='Family Violence'  id='choice_13_26_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_26_13' id='label_13_26_13' class='gform-field-label gform-field-label--type-inline'>Family Violence<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_26_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.14' type='checkbox'  value='Tobacco Use'  id='choice_13_26_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_26_14' id='label_13_26_14' class='gform-field-label gform-field-label--type-inline'>Tobacco Use<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_26_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.15' type='checkbox'  value='Housing'  id='choice_13_26_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_26_15' id='label_13_26_15' class='gform-field-label gform-field-label--type-inline'>Housing<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_26_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.16' type='checkbox'  value='Lack of Basic Needs'  id='choice_13_26_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_26_16' id='label_13_26_16' class='gform-field-label gform-field-label--type-inline'>Lack of Basic Needs<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_26_17'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.17' type='checkbox'  value='Substance\/Alcohol Use'  id='choice_13_26_17'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_26_17' id='label_13_26_17' class='gform-field-label gform-field-label--type-inline'>Substance\/Alcohol Use<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_26_18'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.18' type='checkbox'  value='Other'  id='choice_13_26_18'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_26_18' id='label_13_26_18' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_27\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_27'>Prenatal Physician<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_27' id='input_13_27' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_23\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_23'>Referring Agency<\/label><div class='ginput_container ginput_container_text'><input name='input_23' id='input_13_23' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_28\" class=\"gfield gfield--type-text 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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>\u1000\u103b\u1014\u103a\u1038\u1019\u102c\u101e\u1031\u102c \u1005\u1010\u1004\u103a\u101b\u100a\u103a\u100a\u103d\u1014\u103a\u1038\u1015\u102b\u104b<\/p>","protected":false},"author":1,"featured_media":9699,"parent":8843,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-9063","page","type-page","status-publish","has-post-thumbnail","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Healthy Start Referral - 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