{"id":11549,"date":"2023-05-20T21:17:32","date_gmt":"2023-05-20T18:17:32","guid":{"rendered":"https:\/\/acesaudi.org\/?page_id=11549"},"modified":"2023-05-21T18:44:47","modified_gmt":"2023-05-21T15:44:47","slug":"test3","status":"publish","type":"page","link":"https:\/\/acesaudi.org\/en\/test3\/","title":{"rendered":"test3"},"content":{"rendered":"<div class=\"frm_forms  with_frm_style frm_style_formidable-style frm_rtl\" id=\"frm_form_24_container\" data-token=\"f658017de31af10ccae15b3badef1028\">\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form  frm_pro_form \" id=\"form_6ja0x2\" data-token=\"f658017de31af10ccae15b3badef1028\">\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_screen_reader\">Previous beneficiary registration form<\/legend>\r\n\r\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"24\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_24\" id=\"frm_hide_fields_24\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"6ja0x2\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_24\" name=\"frm_submit_entry_24\" value=\"cadac0fdeb\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/en\/wp-json\/wp\/v2\/pages\/11549\" \/><div id=\"frm_field_454_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_ebb13\" id=\"field_ebb13_label\" class=\"frm_primary_label\">\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <input type=\"hidden\" value=\"s1\" name=\"item_meta[454]\"  id=\"field_ebb13\" \/>\t\t<select  disabled=\"disabled\"  data-frmval=\"s1\" data-invmsg=\"This field is invalid\" aria-invalid=\"false\"  >\n\t<option  value=\"s1\" selected='selected'>Single-disciplinary assessment<\/option><option  value=\"s2\">Multi -disciplinary assessment<\/option><option  value=\"s3\">Treat picky eating program<\/option><option  value=\"s4\">A package of treatment sessions in one specialty<\/option><option  value=\"s5\">Intensive rehabilitation programme<\/option><option  value=\"s6\">Intensive behavioral program<\/option><option  value=\"s7\">Individual treatment session<\/option>\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_439_container\" class=\"frm_form_field form-field  frm_top_container frm4 frm_first\">\r\n    <label for=\"field_ex4ti2\" id=\"field_ex4ti2_label\" class=\"frm_primary_label\">Can you please write the name of the treating specialist in the past? \r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_ex4ti2\" name=\"item_meta[439]\" value=\"\"  data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_441_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4\">\r\n    <label for=\"field_623w32\" id=\"field_623w32_label\" class=\"frm_primary_label\">First, second, and last name of the child's guardian \r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_623w32\" name=\"item_meta[441]\" value=\"\"  data-reqmsg=\"please fill this field\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_442_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4 frm_other_container\">\r\n    <label for=\"field_nmt52\" id=\"field_nmt52_label\" class=\"frm_primary_label\">The relationship of kinship between you and the child\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[442]\" id=\"field_nmt52\"  data-reqmsg=\"please fill this field\" aria-required=\"true\" data-invmsg=\"The relationship of kinship between you and the child is invalid\" aria-invalid=\"false\"  >\n\t\t<option  value=\"\" selected='selected'> <\/option><option  value=\"\u0623\u0645\">mother<\/option><option  value=\"\u0623\u0628\">father<\/option><option  value=\"\u0623\u062e\/\u0623\u062e\u062a\">brother\/sister<\/option><option  value=\"\u062e\u0627\u0644\/\u062e\u0627\u0644\u0629\">maternal uncle<\/option><option  value=\"\u0639\u0645\/\u0639\u0645\u0629\">paternal uncle<\/option><option  value=\"\u062c\u062f\/\u062c\u062f\u0629\">grand parent<\/option><option  value=\"\u0623\u062e\u0631\u0649\" class=\"frm_other_trigger\">other<\/option>\t<\/select>\n\t<label for=\"field_nmt52-otext\" class=\"frm_screen_reader frm_hidden\">The relationship of kinship between you and the child<\/label><input type=\"text\" id=\"field_nmt52-otext\" class=\"frm_other_input frm_pos_none\"  name=\"item_meta[other][442]\" value=\"\" \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_443_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label for=\"field_984um2\" id=\"field_984um2_label\" class=\"frm_primary_label\">Phone number\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_984um2\" name=\"item_meta[443]\" value=\"\"  data-reqmsg=\"please fill this field\" aria-required=\"true\" data-invmsg=\"Phone is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_444_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <label for=\"field_sgzda2\" id=\"field_sgzda2_label\" class=\"frm_primary_label\">Email\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_sgzda2\" name=\"item_meta[444]\" value=\"\"  data-reqmsg=\"please fill this field\" aria-required=\"true\" data-invmsg=\"Email is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_445_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm3 frm_first\">\r\n    <label for=\"field_os3gh2\" id=\"field_os3gh2_label\" class=\"frm_primary_label\">child full name\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_os3gh2\" name=\"item_meta[445]\" value=\"\"  data-reqmsg=\"please fill this field\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_446_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm3 frm_two_col\">\r\n    <div  id=\"field_2zd9d2_label\" class=\"frm_primary_label\">Gender\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_2zd9d2_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_446-0\">\t\t\t<label  for=\"field_2zd9d2-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[446]\" id=\"field_2zd9d2-0\" value=\"\u0630\u0643\u0631\"\n\t\t data-reqmsg=\"please fill this field\" data-invmsg=\"Gender is invalid\"   \/> Male<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_446-1\">\t\t\t<label  for=\"field_2zd9d2-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[446]\" id=\"field_2zd9d2-1\" value=\"\u0623\u0646\u062b\u0649\"\n\t\t data-reqmsg=\"please fill this field\" data-invmsg=\"Gender is invalid\"   \/> Female<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_447_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm3\">\r\n    <label for=\"field_t0okh2\" id=\"field_t0okh2_label\" class=\"frm_primary_label\">Date of birth\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_t0okh2\" name=\"item_meta[447]\" value=\"\"  maxlength=\"10\" data-reqmsg=\"please fill this field\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_448_container\" class=\"frm_form_field form-field  frm_top_container frm3\">\r\n    <label for=\"field_o3wfc2\" id=\"field_o3wfc2_label\" class=\"frm_primary_label\">Age\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_o3wfc2\" name=\"item_meta[448]\" value=\"\" readonly=\"readonly\"  data-invmsg=\"Number is invalid\" aria-invalid=\"false\"   min=\"0\" max=\"100\" step=\"any\" \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_449_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_36pt2\" id=\"field_36pt2_label\" class=\"frm_primary_label\">The current residence area\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_36pt2\" name=\"item_meta[449]\" value=\"\"  data-reqmsg=\"please fill this field\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_450_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n    <div  id=\"field_680k02_label\" class=\"frm_primary_label\">I agree to maintain the confidentiality of the information provided to me and the privacy of the service provider (specialist) by not filming or sharing the content of the program or photographing the specialist without obtaining prior consent\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_680k02_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_450-0\">\t\t\t<label  for=\"field_680k02-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[450]\" id=\"field_680k02-0\" value=\"\u0646\u0639\u0645\u060c \u0623\u0648\u0627\u0641\u0642\"\n\t\t data-reqmsg=\"please fill this field\" data-invmsg=\"I agree to maintain the confidentiality of the information provided to me and the privacy of the service provider (specialist) by not filming or sharing the content of the program or photographing the specialist without obtaining prior consent is invalid\"   \/> Yes, Agree<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_450-1\">\t\t\t<label  for=\"field_680k02-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[450]\" id=\"field_680k02-1\" value=\"\u0644\u0627\u060c \u0644\u0627 \u0623\u0648\u0627\u0641\u0642\"\n\t\t data-reqmsg=\"please fill this field\" data-invmsg=\"I agree to maintain the confidentiality of the information provided to me and the privacy of the service provider (specialist) by not filming or sharing the content of the program or photographing the specialist without obtaining prior consent is invalid\"   \/> No, Dont agree<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_451_container\" class=\"frm_form_field form-field  frm_none_container\">\r\n    <label for=\"g-recaptcha-response\" id=\"field_j1w1z2_label\" class=\"frm_primary_label\">Captcha\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <div  id=\"field_j1w1z2\" class=\"frm-g-recaptcha\" data-sitekey=\"6LdP4DskAAAAAFZyia5Ui8vMyskRu9ZiiDi_xBPh\" data-size=\"invisible\" data-theme=\"light\"><\/div>\r\n    \r\n    \r\n<\/div>\n<input type=\"hidden\" name=\"item_meta[452]\" id=\"field_r93w52\" value=\"\u0645\u0641\u062a\u0648\u062d\"  data-frmval=\"\u0645\u0641\u062a\u0648\u062d\"   \/>\n<input type=\"hidden\" name=\"item_meta[453]\" id=\"field_h2qfr2\" value=\"\" data-frmval=\"\"\/>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t\t\t<div id=\"frm_field_1535_container\">\n\t\t\t<label for=\"field_6g8nj\" >\n\t\t\t\tIf you are human, leave this field blank.\t\t\t<\/label>\n\t\t\t<input  id=\"field_6g8nj\" type=\"text\" class=\"frm_form_field form-field frm_verify\" name=\"item_meta[1535]\" value=\"\"  \/>\n\t\t<\/div>\n\t\t<input name=\"frm_state\" type=\"hidden\" value=\"aM3ZlaT18zmXkrpPr8OE4tYllD\/tUsYtYWdqhjaw7A2U88i+aZGzlMJ3TCToip8FazLp7j0WPHEyFt\/nLAKsMg==\" \/><div class=\"frm_submit\">\r\n\r\n<button class=\"frm_button_submit frm_final_submit\" type=\"submit\"   formnovalidate=\"formnovalidate\">Send<\/button>\r\n\r\n\r\n<\/div><\/div>\n<\/fieldset>\n<\/div>\n\n<\/form>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-11549","page","type-page","status-publish","hentry"],"acf":[],"meta_box":[],"_links":{"self":[{"href":"https:\/\/acesaudi.org\/en\/wp-json\/wp\/v2\/pages\/11549","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/acesaudi.org\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/acesaudi.org\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/acesaudi.org\/en\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/acesaudi.org\/en\/wp-json\/wp\/v2\/comments?post=11549"}],"version-history":[{"count":3,"href":"https:\/\/acesaudi.org\/en\/wp-json\/wp\/v2\/pages\/11549\/revisions"}],"predecessor-version":[{"id":86173,"href":"https:\/\/acesaudi.org\/en\/wp-json\/wp\/v2\/pages\/11549\/revisions\/86173"}],"wp:attachment":[{"href":"https:\/\/acesaudi.org\/en\/wp-json\/wp\/v2\/media?parent=11549"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}