{"id":1334,"date":"2025-05-13T10:09:00","date_gmt":"2025-05-13T10:09:00","guid":{"rendered":"https:\/\/softwavetherapycanada.com\/arc\/?page_id=1334"},"modified":"2025-05-13T10:55:12","modified_gmt":"2025-05-13T10:55:12","slug":"new-patient-registration-form","status":"publish","type":"page","link":"https:\/\/softwavetherapycanada.com\/arc\/new-patient-registration-form\/","title":{"rendered":"New Patient Registration Form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1334\" class=\"elementor elementor-1334\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-216ba9c e-flex e-con-boxed e-con e-parent\" data-id=\"216ba9c\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-25a8cc4 elementor-widget elementor-widget-heading\" data-id=\"25a8cc4\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">New Patient Registration <br>Form<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-1087c0c e-flex e-con-boxed e-con e-parent\" data-id=\"1087c0c\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-aae8723 e-flex e-con-boxed e-con e-child\" data-id=\"aae8723\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-37beb41 elementor-widget elementor-widget-heading\" data-id=\"37beb41\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">Patient<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b612de3 elementor-widget elementor-widget-heading\" data-id=\"b612de3\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Registration Form<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b0aaf56 contact-form elementor-widget elementor-widget-shortcode\" data-id=\"b0aaf56\" data-element_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\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f1333-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"1333\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/arc\/wp-json\/wp\/v2\/pages\/1334#wpcf7-f1333-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"1333\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f1333-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<div class=\"row\">\n  <div class=\"form-group col-12 col-md-6 mb-3\">\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"first-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"First Name\" value=\"\" type=\"text\" name=\"first-name\" \/><\/span>\n  <\/div>\n  <div class=\"form-group col-12 col-md-6 mb-3\">\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"last-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Last Name\" value=\"\" type=\"text\" name=\"last-name\" \/><\/span>\n  <\/div>\n\n  <div class=\"form-group col-12 col-md-6 mb-3\">\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"birth-date\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date form-control\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"mm\/dd\/yyyy\" value=\"\" type=\"date\" name=\"birth-date\" \/><\/span>\n  <\/div>\n\n  <div class=\"form-group col-12 col-md-6 mb-3\">\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"sex\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" name=\"sex\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Male\">Male<\/option><option value=\"Female\">Female<\/option><option value=\"Other\">Other<\/option><\/select><\/span>\n  <\/div>\n\n  <div class=\"form-group col-12 mb-3\">\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"country\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" name=\"country\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Canada\">Canada<\/option><option value=\"USA\">USA<\/option><option value=\"Other\">Other<\/option><\/select><\/span>\n  <\/div>\n\n  <div class=\"form-group col-12 mb-3\">\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"address-line-1\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Address Line 1\" value=\"\" type=\"text\" name=\"address-line-1\" \/><\/span>\n  <\/div>\n  <div class=\"form-group col-12 mb-3\">\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"address-line-2\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" aria-invalid=\"false\" placeholder=\"Address Line 2\" value=\"\" type=\"text\" name=\"address-line-2\" \/><\/span>\n  <\/div>\n\n  <div class=\"form-group col-12 col-md-4 mb-3\">\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"city\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"City\" value=\"\" type=\"text\" name=\"city\" \/><\/span>\n  <\/div>\n  <div class=\"form-group col-12 col-md-4 mb-3\">\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"province\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Province\" value=\"\" type=\"text\" name=\"province\" \/><\/span>\n  <\/div>\n  <div class=\"form-group col-12 col-md-4 mb-3\">\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"postal-code\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Postal Code\" value=\"\" type=\"text\" name=\"postal-code\" \/><\/span>\n  <\/div>\n\n  <div class=\"form-group col-12 col-md-6 mb-3\">\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"phone-primary\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel form-control\" aria-invalid=\"false\" placeholder=\"Phone (Primary)\" value=\"\" type=\"tel\" name=\"phone-primary\" \/><\/span>\n  <\/div>\n  <div class=\"form-group col-12 col-md-6 mb-3\">\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"phone-secondary\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel form-control\" aria-invalid=\"false\" placeholder=\"Phone (Secondary)\" value=\"\" type=\"tel\" name=\"phone-secondary\" \/><\/span>\n  <\/div>\n\n  <div class=\"form-group col-12 mb-3\">\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email form-control\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Email\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span>\n  <\/div>\n\n  <div class=\"form-group col-12 col-md-4 mb-3\">\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"height\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" aria-invalid=\"false\" placeholder=\"Height (cm, ft, etc.)\" value=\"\" type=\"text\" name=\"height\" \/><\/span>\n  <\/div>\n  <div class=\"form-group col-12 col-md-4 mb-3\">\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"weight\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" aria-invalid=\"false\" placeholder=\"Weight (Kg, Lbs, etc.)\" value=\"\" type=\"text\" name=\"weight\" \/><\/span>\n  <\/div>\n  <div class=\"form-group col-12 col-md-4 mb-3\">\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"shoe-size\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" aria-invalid=\"false\" placeholder=\"Shoe Size\" value=\"\" type=\"text\" name=\"shoe-size\" \/><\/span>\n  <\/div>\n\n  <div class=\"form-group col-12 mb-3\">\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"family-doctor\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea form-control\" aria-invalid=\"false\" placeholder=\"Family Doctor Information\" name=\"family-doctor\"><\/textarea><\/span>\n  <\/div>\n\n  <div class=\"form-group col-12 mb-3\">\n    <strong>Why did you choose us? (Referred by):<\/strong><br>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"referral\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"referral[]\" value=\"Convenient Location\" \/><span class=\"wpcf7-list-item-label\">Convenient Location<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"referral[]\" value=\"Flyer\" \/><span class=\"wpcf7-list-item-label\">Flyer<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"referral[]\" value=\"Family\" \/><span class=\"wpcf7-list-item-label\">Family<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"referral[]\" value=\"Friend\" \/><span class=\"wpcf7-list-item-label\">Friend<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"referral[]\" value=\"Doctor\" \/><span class=\"wpcf7-list-item-label\">Doctor<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"referral[]\" value=\"Online result\" \/><span class=\"wpcf7-list-item-label\">Online result<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"referral[]\" value=\"Other\" \/><span class=\"wpcf7-list-item-label\">Other<\/span><\/label><\/span><\/span><\/span>\n  <\/div>\n<\/div>\n\n<hr>\n<h4 class=\"margintop-do\">Insurance Information<\/h4>\n\n<div class=\"form-group mb-2\">\n  <strong>Are you covered by insurance?<\/strong><br>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"insurance-holder\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"insurance-holder\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"insurance-holder\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n<\/div>\n\n<div class=\"form-group mb-3\">\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"insurance-company\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" aria-invalid=\"false\" placeholder=\"Primary Insurance Company (if applicable)\" value=\"\" type=\"text\" name=\"insurance-company\" \/><\/span>\n<\/div>\n\n<div class=\"form-group mb-3\">\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"occupation\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" aria-invalid=\"false\" placeholder=\"Occupation\" value=\"\" type=\"text\" name=\"occupation\" \/><\/span>\n<\/div>\n\n<div class=\"form-group mb-3\">\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"employer\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" aria-invalid=\"false\" placeholder=\"Employer\" value=\"\" type=\"text\" name=\"employer\" \/><\/span>\n<\/div>\n\n<div class=\"form-group mb-3\">\n  <strong>Who is the policy holder of this insurance?<\/strong><br>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"policy-holder\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"policy-holder\" value=\"Self\" \/><span class=\"wpcf7-list-item-label\">Self<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"policy-holder\" value=\"Spouse\" \/><span class=\"wpcf7-list-item-label\">Spouse<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"policy-holder\" value=\"Parent\" \/><span class=\"wpcf7-list-item-label\">Parent<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"policy-holder\" value=\"Child\" \/><span class=\"wpcf7-list-item-label\">Child<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"policy-holder\" value=\"Other\" \/><span class=\"wpcf7-list-item-label\">Other<\/span><\/label><\/span><\/span><\/span>\n<\/div>\n\n<div class=\"row\">\n  <div class=\"form-group col-12 col-md-6 mb-3\">\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"member-first-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" aria-invalid=\"false\" placeholder=\"Member&#039;s First Name\" value=\"\" type=\"text\" name=\"member-first-name\" \/><\/span>\n  <\/div>\n  <div class=\"form-group col-12 col-md-6 mb-3\">\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"member-last-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" aria-invalid=\"false\" placeholder=\"Member&#039;s Last Name\" value=\"\" type=\"text\" name=\"member-last-name\" \/><\/span>\n  <\/div>\n<\/div>\n\n<div class=\"form-group mb-3\">\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"member-birth-date\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date form-control\" aria-invalid=\"false\" placeholder=\"mm\/dd\/yyyy\" value=\"\" type=\"date\" name=\"member-birth-date\" \/><\/span>\n<\/div>\n\n<div class=\"form-group mb-3\">\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"group-policy\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" aria-invalid=\"false\" placeholder=\"Group\/Policy No.\" value=\"\" type=\"text\" name=\"group-policy\" \/><\/span>\n<\/div>\n\n<div class=\"form-group mb-3\">\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"member-id\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" aria-invalid=\"false\" placeholder=\"Member ID No.\" value=\"\" type=\"text\" name=\"member-id\" \/><\/span>\n<\/div>\n\n<div class=\"form-group mb-3\">\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"secondary-insurance\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea form-control\" aria-invalid=\"false\" placeholder=\"Secondary insurance plan details (if applicable)\" name=\"secondary-insurance\"><\/textarea><\/span>\n<\/div>\n\n<hr>\n<h4 class=\"margintop-do\">In Case of Emergency<\/h4>\n\n<div class=\"row\">\n  <div class=\"form-group col-12 col-md-6 mb-3\">\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"emergency-first-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" aria-invalid=\"false\" placeholder=\"Emergency Contact First Name\" value=\"\" type=\"text\" name=\"emergency-first-name\" \/><\/span>\n  <\/div>\n  <div class=\"form-group col-12 col-md-6 mb-3\">\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"emergency-last-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" aria-invalid=\"false\" placeholder=\"Emergency Contact Last Name\" value=\"\" type=\"text\" name=\"emergency-last-name\" \/><\/span>\n  <\/div>\n<\/div>\n\n<div class=\"form-group mb-3\">\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"emergency-phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel form-control\" aria-invalid=\"false\" placeholder=\"Their Phone Number\" value=\"\" type=\"tel\" name=\"emergency-phone\" \/><\/span>\n<\/div>\n\n<div class=\"form-group mb-3\">\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"relation-to-you\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control\" aria-invalid=\"false\" placeholder=\"Relationship to you\" value=\"\" type=\"text\" name=\"relation-to-you\" \/><\/span>\n<\/div>\n\n<hr>\n<h4 class=\"margintop-do\">Agreement<\/h4>\n\n<div class=\"form-group mb-3\">\n  <p><strong>By agreeing, you confirm that:<\/strong><\/p>\n  <p>The above information is true to the best of my knowledge. I authorize my insurance benefits be paid directly to the clinic. I understand I am financially responsible for any balances. I authorize Active Rehab Centre or insurance companies to release any information required to process my claims. I also authorize Active Rehab Centre to release information regarding my medical condition to my family physician.<\/p>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"agreemant-holder\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"agreemant-holder\" value=\"Agree\" \/><span class=\"wpcf7-list-item-label\">Agree<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"agreemant-holder\" value=\"Disagree\" \/><span class=\"wpcf7-list-item-label\">Disagree<\/span><\/label><\/span><\/span><\/span>\n<\/div>\n\n<div class=\"text-center mt-4 btn-fomr\">\n  <input class=\"wpcf7-form-control wpcf7-submit has-spinner btn btn-default px-5 py-2 fw-bold\" type=\"submit\" value=\"SUBMIT\" \/>\n<\/div><input type='hidden' class='wpcf7-pum' value='{\"closepopup\":false,\"closedelay\":0,\"openpopup\":false,\"openpopup_id\":0}' \/><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\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\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-a490b6d e-con-full e-flex e-con e-parent\" data-id=\"a490b6d\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-0eb2cfc elementor-widget elementor-widget-html\" data-id=\"0eb2cfc\" data-element_type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<iframe src=\"https:\/\/www.google.com\/maps\/embed?pb=!1m18!1m12!1m3!1d2528.2634840022547!2d-79.27715062381674!3d43.77555807109661!2m3!1f0!2f0!3f0!3m2!1i1024!2i768!4f13.1!3m3!1m2!1s0x89d4d19bebda1ddd%3A0xc1c4cca0249bf38e!2s2240%20Midland%20Ave%2C%20Scarborough%2C%20ON%20M1P%204R9%2C%20Canada!5e1!3m2!1sen!2s!4v1747122853705!5m2!1sen!2s\" width=\"600\" height=\"450\" style=\"border:0;\" allowfullscreen=\"\" loading=\"lazy\" referrerpolicy=\"no-referrer-when-downgrade\"><\/iframe>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-51cb397 e-flex e-con-boxed e-con e-parent\" data-id=\"51cb397\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-9afec90 e-con-full e-flex e-con e-child\" data-id=\"9afec90\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-b5dc4a3 elementor-widget elementor-widget-heading\" data-id=\"b5dc4a3\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Didn\u2019t find the answers you were looking for?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9698f7b elementor-widget elementor-widget-heading\" data-id=\"9698f7b\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">Just get in touch with us with your preferred method! We will try our best to help you with any and all questions.<\/p>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-1ada86d e-con-full e-flex e-con e-child\" data-id=\"1ada86d\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3edc205 elementor-align-center btn-default wow fadeInUp elementor-widget elementor-widget-button\" data-id=\"3edc205\" data-element_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=\"#\">\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\">Contact Us<\/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<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>New Patient Registration Form Patient Registration Form Didn\u2019t find the answers you were looking for? Just get in touch with us with your preferred method! We will try our best to help you with any and all questions. Contact Us<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-1334","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/softwavetherapycanada.com\/arc\/wp-json\/wp\/v2\/pages\/1334","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/softwavetherapycanada.com\/arc\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/softwavetherapycanada.com\/arc\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/softwavetherapycanada.com\/arc\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/softwavetherapycanada.com\/arc\/wp-json\/wp\/v2\/comments?post=1334"}],"version-history":[{"count":0,"href":"https:\/\/softwavetherapycanada.com\/arc\/wp-json\/wp\/v2\/pages\/1334\/revisions"}],"wp:attachment":[{"href":"https:\/\/softwavetherapycanada.com\/arc\/wp-json\/wp\/v2\/media?parent=1334"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}