{"id":1384,"date":"2021-12-20T10:37:05","date_gmt":"2021-12-20T10:37:05","guid":{"rendered":"https:\/\/www.brightsmilesdentalstudio.com\/?page_id=1384"},"modified":"2021-12-20T10:37:06","modified_gmt":"2021-12-20T10:37:06","slug":"appointment-request","status":"publish","type":"page","link":"https:\/\/www.brightsmilesdentalstudio.com\/appointment-request\/","title":{"rendered":"Appointment Request"},"content":{"rendered":"\n\t<style>\n.appointment-form h2 {\n    margin-right: 0;\n    margin-left: 2%;\n    margin-bottom: 25px\n}\n\n.appointment-form form {\n    margin-left: 13px\n}\n\n.appointment-form form input[type=\"text\"],\n.appointment-form form input[type=\"email\"] {\n    display: block;\n    height: 30px;\n    width: 100%;\n    background: none;\n    border: 1px solid #e0e0e0;\n    padding-left: 2.1%;\n    word-spacing: 4px;\n    margin-bottom: 10px;    \n}\n.appointment-form form select {\n    display: block;\n    width: 100%;\n    height: 30px;\n    border: 1px solid #e0e0e0;\n    background: none;\n    padding-left: 1.2%;\n    margin-bottom: 10px;\n    -webkit-appearance: none;\n    -moz-appearance: none;\n    appearance: none;\n    background: url(https:\/\/www.brightsmilesdentalstudio.com\/wp-content\/themes\/ekwa\/images\/arrow.png) top right no-repeat\n}\n\n.appointment-form form textarea {\n    display: block;\n    width: 100%;\n    height: 66px;\n    background: none;\n    border: 1px solid #e0e0e0;\n    padding-left: 2.1%;\n    margin-bottom: 31px\n}\n\n.appointment-form form button {\n    padding-left: 37px;\n    padding-right: 37px;\n    line-height: 29px\n}\n@media screen and (max-width: 540px) {\n  .appointment-form form{\n      margin-left: 0;\n  }\n  .appointment-form form input[type=\"text\"],\n  .appointment-form form input[type=\"email\"] {      \n      height: 50px;  \n  }\n}\n<\/style>\n<div id=\"apprequest\" class=\"appointment-form text-center lazyload\" data-script=\"https:\/\/www.brightsmilesdentalstudio.com\/wp-content\/themes\/ekwa\/plugins\/datepicker\/datepicker.js\" data-link=\"https:\/\/www.brightsmilesdentalstudio.com\/wp-content\/themes\/ekwa\/plugins\/datepicker\/datepicker.css\" >\n    <h2>Appointment Request<\/h2>\n    <form onsubmit=\"return validateFormOnSubmit(this);\" method=\"post\" id=\"form266\" name=\"form266\"  action=\"https:\/\/www.ekwa.com\/ekwa-wufoo-handler\/without-captcha\/\">\n        <input aria-label=\"Appointment Date\" id=\"Field24\" name=\"Field24\" class=\"datetimepicker\" type=\"text\" value=\"Appointment Date *\" onblur=\"replaceText(this)\" onfocus=\"clearText(this)\">\n        <select aria-label=\"Select Preffered Time\" id=\"Field5\" name=\"Field5\" class=\"field select medium\">\n            <option value=\"Time\" selected=\"selected\">Time<\/option>\n            <option value=\"Morning\">Morning<\/option>\n            <option value=\"Lunch\">Lunch<\/option>\n            <option value=\"Evening\">Evening<\/option>\n        <\/select>\n        <input aria-label=\"Enter Your Name\" id=\"Field6\" name=\"Field6\"  type=\"text\" value=\"Your Name *\" onblur=\"replaceText(this)\" onfocus=\"clearText(this)\">\n        <input aria-label=\"Enter Email Address\" id=\"Field7\" name=\"Field7\"  type=\"text\" value=\"Email Address *\" onblur=\"replaceText(this)\" onfocus=\"clearText(this)\">\n        <input aria-label=\"Enter Your Contact Number\" maxlength=\"12\" id=\"Field127\" name=\"Field127\"  type=\"text\" value=\"Your Contact Number xxx-xxx-xxxx *\" onblur=\"replaceText(this)\" onfocus=\"clearText(this)\">\n        <textarea aria-label=\"Enter Comments\" id=\"Field10\" name=\"Field10\" onblur=\"replaceText(this)\" onfocus=\"clearText(this)\">Comments *<\/textarea>\n        <div class=\"input policy\">\n            <label for=\"Field26\">\n                <input aria-label=\"accept our Privacy Policy\" id=\"Field26\" name=\"Field26\" type=\"checkbox\">\n                By submitting the above form you agree and accept our <a href=\"https:\/\/www.brightsmilesdentalstudio.com\/privacy-policy\/\" style=\"color: #001233\" target=\"_parent\">Privacy Policy<\/a>.\n            <\/label>\n        <\/div>        \n        <br\/>\n        <button type=\"submit\" class=\"button\">Submit<\/button>\n        <input type=\"hidden\" name=\"custom-keywords\" value=\"info@jpstewartassociates.com,service\">\n        <input type=\"hidden\" name=\"url\" value=\"https:\/\/salesmanager.wufoo.com\/forms\/q1reds3g028kfsn\/#public\">\n        <input type=\"hidden\" id=\"idstamp\" name=\"idstamp\" value=\"8e0qB+cjVdwR4lqLGQNaKlMAzZ1O+M1q95GjLMAZvVk=\">\n    <\/form>\n<\/div>\n\n<script>\n    \/*============== Appointment Request Form Validation START =================*\/\nfunction validateFormOnSubmit(theForm) {\n    var reason = \"\";\n    reason += validateDate(theForm.Field24);\n    reason += validateTime(theForm.Field5);\n    reason += validateName(theForm.Field6);\n    reason += validateEmail(theForm.Field7);\n    reason += validateTel(theForm.Field127);\n    reason += validateMessage(theForm.Field10);\n    reason += validateConfirm(theForm.Field26);\n  \/\/  reason += validateQuestion(theForm.question);\n\n    if (reason != \"\") {\n        alert(\"Following field(s) need to be Filled:\\n\" + reason);\n        return false;\n    }\n    if(checkValue(theForm)) {\n        insitePost(theForm);\n    }\n    setTimeout(function(){theForm.submit();},500); \/\/ increase this value if it's not tracking properly\n    return true;\n}\n\nfunction validateConfirm(fld) {\n    var error = \"\";\n    if (fld.checked == \"\") {\n        fld.style.background = \"\";\n        error = \"- Please accept our privacy policy\\n\"\n    }\n    return error;\n}\n\nfunction validateDate(fld) {\n    var error = \"\";\n\n    if (fld.value == \"\") {\n        fld.style.background = \"\";\n        error = \"- Enter a date\\n\"\n    } else if (fld.value == \"Appointment Date *\") {\n        fld.style.background = \"\";\n        error = \"- Enter a date\\n\"\n    } else {\n        fld.style.background = \"\";\n    }\n    return error;\n}\n\nfunction validateTime(fld) {\n    var error = \"\";\n\n    if (fld.value == \"\") {\n        fld.style.background = \"\";\n        error = \"- Enter a date\\n\"\n    } else if (fld.value == \"Time\") {\n        fld.style.background = \"\";\n        error = \"- Select a Time\\n\"\n    } else {\n        fld.style.background = \"\";\n    }\n    return error;\n}\n\nfunction validateName(fld) {\n    var error = \"\";\n\n    if (fld.value == \"\") {\n        fld.style.background = \"\";\n        error = \"- Enter your name\\n\"\n    } else if (fld.value == \"Your Name *\") {\n        fld.style.background = \"\";\n        error = \"- Enter your name\\n\"\n    } else {\n        fld.style.background = \"\";\n    }\n    return error;\n}\n\nfunction trim(s)\n{\n    return s.replace(\/^\\s+|\\s+$\/, '');\n}\n\nfunction validateEmail(fld) {\n    var error=\"\";\n    var tfld = trim(fld.value); 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We ensure that we will get back to you as soon as possible during working hours.');\n         }, 2000);\n     }\n }\n showBackEndError('form-error', 'error-elm');\n\n function showBackEndError(uriSer, uriElm) {\n     if (getUrlParameter(uriSer)) {\n         var elemStr = getUrlParameter(uriElm);\n         var tempElem = null;\n         if (elemStr != \"\") {\n             tempElem = document.querySelector('#' + getUrlParameter(uriElm));\n         }\n         if (tempElem) {\n             tempElem.style.borderColor = 'red';\n             tempElem.style.borderWidth = '1px';\n             tempElem.style.borderStyle = 'solid';\n             tempElem.focus();\n         }\n         setTimeout(function () {\n             alert(getUrlParameter(uriSer));\n         }, 2000);\n         if (getUrlParameter('form-data')) {\n             var formDataObj = JSON.parse(atob(getUrlParameter('form-data')))\n             var formDataKeyArr = Object.keys(formDataObj);\n             for (var i = 0; i < formDataKeyArr.length; i++) {\n                 if (document.getElementById(formDataKeyArr[i])) {\n                     document.getElementById(formDataKeyArr[i]).value = formDataObj[formDataKeyArr[i]];\n                 }\n\n             }\n         }\n     }\n }\n\n function getUrlParameter(name) {\n     name = name.replace(\/[\\[]\/, '\\\\[').replace(\/[\\]]\/, '\\\\]');\n     var regex = new RegExp('[\\\\?&]' + name + '=([^&#]*)');\n     var results = regex.exec(location.search);\n     return results === null ? 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