{"id":263,"date":"2021-07-01T07:25:57","date_gmt":"2021-07-01T07:25:57","guid":{"rendered":"https:\/\/mzcustomfit.com\/?page_id=263"},"modified":"2021-09-30T05:49:48","modified_gmt":"2021-09-30T05:49:48","slug":"request-a-virtual-fitting","status":"publish","type":"page","link":"https:\/\/mzcustomfit.com\/virtual-services\/request-a-virtual-fitting\/","title":{"rendered":"Request a Virtual Fitting"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"263\" class=\"elementor elementor-263\">\n\t\t\t\t\t\t<div class=\"elementor-inner\">\n\t\t\t\t<div class=\"elementor-section-wrap\">\n\t\t\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-7b5978c1 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"7b5978c1\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&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\t\t<div class=\"elementor-row\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-7dbbcd2e\" data-id=\"7dbbcd2e\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-column-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-419307f2 elementor-widget elementor-widget-heading\" data-id=\"419307f2\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Request a Virtual Fitting<\/h1>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\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-1d05faa6 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"1d05faa6\" 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\t\t<div class=\"elementor-row\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-3abef429\" data-id=\"3abef429\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-column-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-0a542eb elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"0a542eb\" 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\t\t<div class=\"elementor-row\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-3966ed4\" data-id=\"3966ed4\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-column-wrap\">\n\t\t\t\t\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\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-25 elementor-inner-column elementor-element elementor-element-40543b2\" data-id=\"40543b2\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-column-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-9475006 elementor-align-justify elementor-widget elementor-widget-button\" data-id=\"9475006\" 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<div class=\"elementor-button-wrapper\">\n\t\t\t<a href=\"https:\/\/mzcustomfit.com\/virtual-services\/in-service-request\/\" class=\"elementor-button-link elementor-button elementor-size-sm\" role=\"button\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-text\">In-Service Request Form<\/span>\n\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\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-25 elementor-inner-column elementor-element elementor-element-3cb75e0\" data-id=\"3cb75e0\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-column-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5ec4361 elementor-align-justify elementor-widget elementor-widget-button\" data-id=\"5ec4361\" 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<div class=\"elementor-button-wrapper\">\n\t\t\t<a href=\"https:\/\/mzcustomfit.com\/virtual-services\/request-a-virtual-fitting\/\" class=\"elementor-button-link elementor-button elementor-size-sm\" role=\"button\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-text\">Virtual\/TeleHealth Request Form<\/span>\n\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\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-25 elementor-inner-column elementor-element elementor-element-8911384\" data-id=\"8911384\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-column-wrap\">\n\t\t\t\t\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<div class=\"elementor-element elementor-element-611e8339 pp-wpforms-labels-yes pp-wpforms-form-button-custom elementor-widget elementor-widget-pp-wpforms\" data-id=\"611e8339\" data-element_type=\"widget\" data-widget_type=\"pp-wpforms.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"pp-contact-form pp-wpforms\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-243\"><form id=\"wpforms-form-243\" class=\"wpforms-validate wpforms-form\" data-formid=\"243\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/wp-json\/wp\/v2\/pages\/263\" data-token=\"d60a0dbd73d15e02e18b1c7a4f7e6f73\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-243-field_1-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"1\"><label class=\"wpforms-field-label\" for=\"wpforms-243-field_1\">PATIENT NAME <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-243-field_1\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][1]\" required><\/div><div id=\"wpforms-243-field_2-container\" class=\"wpforms-field wpforms-field-phone\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-243-field_2\">PHONE NUMBER  <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"tel\" id=\"wpforms-243-field_2\" class=\"wpforms-field-large wpforms-field-required wpforms-smart-phone-field\" data-rule-smart-phone-field=\"true\" name=\"wpforms[fields][2]\" required><\/div><div id=\"wpforms-243-field_3-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-243-field_3\">EMAIL <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-243-field_3\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][3]\" required><\/div><div id=\"wpforms-243-field_4-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"4\"><h3 id=\"wpforms-243-field_4\" name=\"wpforms[fields][4]\">INSURANCE<\/h3><\/div><div id=\"wpforms-243-field_5-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-243-field_5\">INSURANCE PROVIDER <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-243-field_5\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][5]\" required><\/div><div id=\"wpforms-243-field_7-container\" class=\"wpforms-field wpforms-field-select wpforms-conditional-trigger wpforms-field-select-style-classic\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-243-field_7\">CURRENTLY IN THERAPY?<\/label><select id=\"wpforms-243-field_7\" class=\"wpforms-field-large\" name=\"wpforms[fields][7]\"><option value=\"Yes\" >Yes<\/option><option value=\"No\" >No<\/option><\/select><\/div><div id=\"wpforms-243-field_8-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"8\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-243-field_8\">IF SO, WHICH CLINIC\/THERAPIST?<\/label><input type=\"text\" id=\"wpforms-243-field_8\" class=\"wpforms-field-large\" name=\"wpforms[fields][8]\" ><\/div><div id=\"wpforms-243-field_9-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-243-field_9\">HAVE YOU USED US BEFORE?<\/label><select id=\"wpforms-243-field_9\" class=\"wpforms-field-medium\" name=\"wpforms[fields][9]\"><option value=\"Yes\" >Yes<\/option><option value=\"No\" >No<\/option><\/select><\/div><\/div><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"243\"><input type=\"hidden\" name=\"wpforms[author]\" value=\"2\"><button type=\"submit\" name=\"wpforms[submit]\" class=\"wpforms-submit \" id=\"wpforms-submit-243\" value=\"wpforms-submit\" aria-live=\"assertive\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\">Submit<\/button><\/div><\/form><\/div>  <!-- .wpforms-container -->\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Request a Virtual Fitting In-Service Request Form Virtual\/TeleHealth Request Form Please enable JavaScript in your browser to complete this form.PATIENT NAME *PHONE NUMBER *EMAIL * INSURANCE INSURANCE PROVIDER *CURRENTLY IN THERAPY?YesNoIF SO, WHICH CLINIC\/THERAPIST?HAVE YOU USED US BEFORE?YesNoSubmit<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":188,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/mzcustomfit.com\/wp-json\/wp\/v2\/pages\/263"}],"collection":[{"href":"https:\/\/mzcustomfit.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/mzcustomfit.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/mzcustomfit.com\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/mzcustomfit.com\/wp-json\/wp\/v2\/comments?post=263"}],"version-history":[{"count":0,"href":"https:\/\/mzcustomfit.com\/wp-json\/wp\/v2\/pages\/263\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/mzcustomfit.com\/wp-json\/wp\/v2\/pages\/188"}],"wp:attachment":[{"href":"https:\/\/mzcustomfit.com\/wp-json\/wp\/v2\/media?parent=263"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}