{"id":117,"date":"2022-07-01T16:06:30","date_gmt":"2022-07-01T16:06:30","guid":{"rendered":"https:\/\/kateshomephysiotherapy.co.uk\/?page_id=117"},"modified":"2024-10-02T13:16:28","modified_gmt":"2024-10-02T13:16:28","slug":"contact-us","status":"publish","type":"page","link":"https:\/\/kateshomephysiotherapy.co.uk\/?page_id=117","title":{"rendered":"Contact Me"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"117\" class=\"elementor elementor-117\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-6bc4ef80 elementor-section-content-middle elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"6bc4ef80\" data-element_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-50 elementor-top-column elementor-element elementor-element-646a739f\" data-id=\"646a739f\" data-element_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-25b63010 elementor-invisible elementor-widget elementor-widget-heading\" data-id=\"25b63010\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInUp&quot;}\" 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\">Contact Me<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ebf410d elementor-icon-list--layout-inline elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"ebf410d\" data-element_type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul class=\"elementor-icon-list-items elementor-inline-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item elementor-inline-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"tel:07951978105\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-phone-alt\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">07951 978105<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item elementor-inline-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"mailto:kate@kateshomephysiotherapy.co.uk\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-envelope\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">kate@kateshomephysiotherapy.co.uk<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\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<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-55a1a67\" data-id=\"55a1a67\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1bb51139 elementor-icon-list--layout-inline elementor-align-end elementor-mobile-align-center elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"1bb51139\" data-element_type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul class=\"elementor-icon-list-items elementor-inline-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item elementor-inline-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/kateshomephysiotherapy.co.uk\">\n\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Home<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item elementor-inline-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-chevron-right\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Contact Me<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\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-11fc7d75 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"11fc7d75\" data-element_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-50 elementor-top-column elementor-element elementor-element-7c7b4d54 elementor-invisible\" data-id=\"7c7b4d54\" data-element_type=\"column\" data-settings=\"{&quot;animation&quot;:&quot;fadeInLeft&quot;}\">\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-5674c8bc elementor-widget elementor-widget-heading\" data-id=\"5674c8bc\" 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<h6 class=\"elementor-heading-title elementor-size-default\">Contact Me<\/h6>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-17be8e43 elementor-widget elementor-widget-heading\" data-id=\"17be8e43\" 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\">Get in Touch.<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ff5951a elementor-widget elementor-widget-text-editor\" data-id=\"ff5951a\" data-element_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>You can contact me by phone, email or by filling in the online form below.<\/p><p>I&#8217;d love to hear from you, whether to make an appointment, ask me about my services or to give me your valued feedback. If you have any questions or thoughts you\u2019d like to share with me, please let me know.\u00a0<\/p><p>You can also fill out the online patient consent form here. It is found at the bottom of this page. This will save some time in your appointment.<\/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-6c699712 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"6c699712\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\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<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-70528cbb elementor-invisible\" data-id=\"70528cbb\" data-element_type=\"column\" data-settings=\"{&quot;animation&quot;:&quot;fadeInRight&quot;}\">\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-5393a985 elementor-widget elementor-widget-image\" data-id=\"5393a985\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"2560\" height=\"1440\" src=\"https:\/\/kateshomephysiotherapy.co.uk\/wp-content\/uploads\/2022\/07\/MGC1260-scaled.jpeg\" class=\"attachment-full size-full wp-image-670\" alt=\"\" srcset=\"https:\/\/kateshomephysiotherapy.co.uk\/wp-content\/uploads\/2022\/07\/MGC1260-scaled.jpeg 2560w, https:\/\/kateshomephysiotherapy.co.uk\/wp-content\/uploads\/2022\/07\/MGC1260-300x169.jpeg 300w, https:\/\/kateshomephysiotherapy.co.uk\/wp-content\/uploads\/2022\/07\/MGC1260-1024x576.jpeg 1024w, https:\/\/kateshomephysiotherapy.co.uk\/wp-content\/uploads\/2022\/07\/MGC1260-768x432.jpeg 768w, https:\/\/kateshomephysiotherapy.co.uk\/wp-content\/uploads\/2022\/07\/MGC1260-1536x864.jpeg 1536w, https:\/\/kateshomephysiotherapy.co.uk\/wp-content\/uploads\/2022\/07\/MGC1260-2048x1152.jpeg 2048w\" sizes=\"(max-width: 2560px) 100vw, 2560px\" \/>\t\t\t\t\t\t\t\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-39b3c91f elementor-widget__width-auto elementor-absolute elementor-widget elementor-widget-image\" data-id=\"39b3c91f\" data-element_type=\"widget\" data-settings=\"{&quot;_position&quot;:&quot;absolute&quot;}\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"https:\/\/kateshomephysiotherapy.co.uk\/wp-content\/uploads\/elementor\/thumbs\/bg_img_2-pr4ltflzloh21pqmcbxfs3crjot03gytwzzgf9s2vm.png\" title=\"bg_img_2.png\" alt=\"bg_img_2.png\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-39d0466 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"39d0466\" data-element_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-7bdd61a\" data-id=\"7bdd61a\" data-element_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-2afcded elementor-widget elementor-widget-google_maps\" data-id=\"2afcded\" data-element_type=\"widget\" data-widget_type=\"google_maps.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-custom-embed\">\n\t\t\t<iframe loading=\"lazy\"\n\t\t\t\t\tsrc=\"https:\/\/maps.google.com\/maps?q=Wymondham%2C%20United%20Kingdom&#038;t=m&#038;z=11&#038;output=embed&#038;iwloc=near\"\n\t\t\t\t\ttitle=\"Wymondham, United Kingdom\"\n\t\t\t\t\taria-label=\"Wymondham, United Kingdom\"\n\t\t\t><\/iframe>\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<section class=\"elementor-section elementor-top-section elementor-element elementor-element-39d48780 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"39d48780\" data-element_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-50 elementor-top-column elementor-element elementor-element-4e468845 elementor-invisible\" data-id=\"4e468845\" data-element_type=\"column\" data-settings=\"{&quot;animation&quot;:&quot;fadeInLeft&quot;,&quot;background_background&quot;:&quot;classic&quot;}\">\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-5b85fa2c elementor-widget elementor-widget-heading\" data-id=\"5b85fa2c\" 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\">Get in Touch<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b092c01 elementor-button-align-stretch elementor-widget elementor-widget-form\" data-id=\"b092c01\" data-element_type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;button_width&quot;:&quot;100&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" name=\"Contact Form\" aria-label=\"Contact Form\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"117\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"b092c01\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"Contact Me\" \/>\n\n\t\t\t\t\t\t\t<input type=\"hidden\" name=\"queried_id\" value=\"117\"\/>\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_ccc8783 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_ccc8783\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tYour name *\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_ccc8783]\" id=\"form-field-field_ccc8783\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Name\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_9a2e9e5 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_9a2e9e5\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPatient name (if different)\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_9a2e9e5]\" id=\"form-field-field_9a2e9e5\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Name\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-email elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-email\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tYour  email\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[email]\" id=\"form-field-email\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Email\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-tel elementor-field-group elementor-column elementor-field-group-field_6ea4df2 elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_6ea4df2\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tYour phone number *\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input size=\"1\" type=\"tel\" name=\"form_fields[field_6ea4df2]\" id=\"form-field-field_6ea4df2\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Phone\" required=\"required\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Only numbers and phone characters (#, -, *, etc) are accepted.\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-date elementor-field-group elementor-column elementor-field-group-field_ebe513d elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_ebe513d\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPatient date of birth\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[field_ebe513d]\" id=\"form-field-field_ebe513d\" class=\"elementor-field elementor-size-sm  elementor-field-textual elementor-date-field\" placeholder=\"dd \/ mm \/ yyyy\" pattern=\"[0-9]{4}-[0-9]{2}-[0-9]{2}\" min=\"1909-01-01\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_e4787a5 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_e4787a5\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPatient address\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_e4787a5]\" id=\"form-field-field_e4787a5\" rows=\"4\" placeholder=\"Address\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_8bb6cc3 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_8bb6cc3\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tYour message\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_8bb6cc3]\" id=\"form-field-field_8bb6cc3\" rows=\"4\" placeholder=\"Message\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-recaptcha_v3 elementor-field-group elementor-column elementor-field-group-field_3a9123b elementor-col-100 recaptcha_v3-bottomright\">\n\t\t\t\t\t<div class=\"elementor-field\" id=\"form-field-field_3a9123b\"><div class=\"elementor-g-recaptcha\" data-sitekey=\"6LcRTf8jAAAAACuK6ABTVQ7SXptCeou94TbvGmWN\" data-type=\"v3\" data-action=\"Form\" data-badge=\"bottomright\" data-size=\"invisible\"><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-recaptcha_v3 elementor-field-group elementor-column elementor-field-group-field_d059443 elementor-col-100 recaptcha_v3-bottomright\">\n\t\t\t\t\t<div class=\"elementor-field\" id=\"form-field-field_d059443\"><div class=\"elementor-g-recaptcha\" data-sitekey=\"6LcRTf8jAAAAACuK6ABTVQ7SXptCeou94TbvGmWN\" data-type=\"v3\" data-action=\"Form\" data-badge=\"bottomright\" data-size=\"invisible\"><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-md\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Submit<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-44d5379 elementor-widget elementor-widget-text-editor\" data-id=\"44d5379\" data-element_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>* required fields<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-1d987e41\" data-id=\"1d987e41\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\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-d6dde70 elementor-widget elementor-widget-heading\" data-id=\"d6dde70\" 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<h3 class=\"elementor-heading-title elementor-size-default\">Patient Consent Form<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-628e0664 elementor-widget elementor-widget-text-editor\" data-id=\"628e0664\" data-element_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>Please complete prior to first appointment. An authorised person may complete this form if the patient is unable to do so.<\/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-29bc1eb elementor-button-align-stretch elementor-widget elementor-widget-form\" data-id=\"29bc1eb\" data-element_type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;button_width&quot;:&quot;100&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" name=\"New Form\" aria-label=\"New Form\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"117\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"29bc1eb\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"Contact Me\" \/>\n\n\t\t\t\t\t\t\t<input type=\"hidden\" name=\"queried_id\" value=\"117\"\/>\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_ccc8783 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_ccc8783\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPatient name *\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_ccc8783]\" id=\"form-field-field_ccc8783\" class=\"elementor-field elementor-size-md  elementor-field-textual\" placeholder=\"Name\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_ebe513d elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_ebe513d\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPerson completing this form (if not the patient)\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_ebe513d]\" id=\"form-field-field_ebe513d\" class=\"elementor-field elementor-size-md  elementor-field-textual\" placeholder=\"Name\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_9a2e9e5 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_9a2e9e5\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tI consent to assessment and treatment which has been discussed and agreed between myself and Kate\u2019s Home Physiotherapy *\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-field_9a2e9e5-0\" name=\"form_fields[field_9a2e9e5]\" required=\"required\"> <label for=\"form-field-field_9a2e9e5-0\">Yes<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-email elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-email\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tI understand I can withdraw my consent to further assessment or treatment at any time *\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-email-0\" name=\"form_fields[email]\" required=\"required\"> <label for=\"form-field-email-0\">Yes<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_6ea4df2 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_6ea4df2\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tI understand that if I miss or cancel an appointment with less than 24 hours notice, a cancellation charge may be payable *\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-field_6ea4df2-0\" name=\"form_fields[field_6ea4df2]\" required=\"required\"> <label for=\"form-field-field_6ea4df2-0\">Yes<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-date elementor-field-group elementor-column elementor-field-group-field_8bb6cc3 elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_8bb6cc3\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDate *\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[field_8bb6cc3]\" id=\"form-field-field_8bb6cc3\" class=\"elementor-field elementor-size-md  elementor-field-textual elementor-date-field\" placeholder=\"dd \/ mm \/ yyyy\" required=\"required\" pattern=\"[0-9]{4}-[0-9]{2}-[0-9]{2}\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_e4787a5 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_e4787a5\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tInitials *\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_e4787a5]\" id=\"form-field-field_e4787a5\" class=\"elementor-field elementor-size-md  elementor-field-textual\" placeholder=\"e.g. AJW\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-recaptcha_v3 elementor-field-group elementor-column elementor-field-group-field_856d586 elementor-col-100 recaptcha_v3-bottomright\">\n\t\t\t\t\t<div class=\"elementor-field\" id=\"form-field-field_856d586\"><div class=\"elementor-g-recaptcha\" data-sitekey=\"6LcRTf8jAAAAACuK6ABTVQ7SXptCeou94TbvGmWN\" data-type=\"v3\" data-action=\"Form\" data-badge=\"bottomright\" data-size=\"invisible\"><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-md\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Submit<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-33a571a elementor-widget elementor-widget-text-editor\" data-id=\"33a571a\" data-element_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>* required fields<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>07951 978105 kate@kateshomephysiotherapy.co.uk Home Contact Me Get in Touch. You can contact me by phone, email or by filling in the online form below. I&#8217;d love to hear from you, whether to make an appointment, ask me about my services or to give me your valued feedback. If you have any questions or thoughts you\u2019d [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"footnotes":""},"class_list":["post-117","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/kateshomephysiotherapy.co.uk\/index.php?rest_route=\/wp\/v2\/pages\/117","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kateshomephysiotherapy.co.uk\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/kateshomephysiotherapy.co.uk\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/kateshomephysiotherapy.co.uk\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kateshomephysiotherapy.co.uk\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=117"}],"version-history":[{"count":175,"href":"https:\/\/kateshomephysiotherapy.co.uk\/index.php?rest_route=\/wp\/v2\/pages\/117\/revisions"}],"predecessor-version":[{"id":1138,"href":"https:\/\/kateshomephysiotherapy.co.uk\/index.php?rest_route=\/wp\/v2\/pages\/117\/revisions\/1138"}],"wp:attachment":[{"href":"https:\/\/kateshomephysiotherapy.co.uk\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=117"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}