{"id":1455,"date":"2022-02-14T14:49:48","date_gmt":"2022-02-14T13:49:48","guid":{"rendered":"https:\/\/www.new.yulsmile.com\/referring-a-patient\/"},"modified":"2022-12-30T15:01:28","modified_gmt":"2022-12-30T14:01:28","slug":"referring-a-patient","status":"publish","type":"page","link":"https:\/\/www.yulsmile.com\/en\/referring-a-patient\/","title":{"rendered":"Referring a patient"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1455\" class=\"elementor elementor-1455 elementor-583\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-07ecb50 elementor-section-full_width container mx-auto elementor-section-height-default elementor-section-height-default\" data-id=\"07ecb50\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-ccb6f0b\" data-id=\"ccb6f0b\" data-element_type=\"column\" data-e-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-a2cac7e elementor-widget elementor-widget-heading\" data-id=\"a2cac7e\" data-element_type=\"widget\" data-e-type=\"widget\" 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\">Referring a patient<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a950e15 refer-patient elementor-widget elementor-widget-shortcode\" data-id=\"a950e15\" data-element_type=\"widget\" data-e-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-f2976-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"2976\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/en\/wp-json\/wp\/v2\/pages\/1455#wpcf7-f2976-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"2976\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.6\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f2976-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7cf_hidden_group_fields\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_hidden_groups\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_visible_groups\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_repeaters\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_steps\" value=\"{}\" \/><input type=\"hidden\" name=\"_wpcf7cf_options\" value=\"{&quot;form_id&quot;:2976,&quot;conditions&quot;:[{&quot;then_field&quot;:&quot;spcialite-pedodontie&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;souhait&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Pedodontics&quot;}]},{&quot;then_field&quot;:&quot;spcialite-orthodontie&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;souhait&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Orthodontics&quot;}]},{&quot;then_field&quot;:&quot;spcialite-chirurgie&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;souhait&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Maxillofacial surgery&quot;}]}],&quot;settings&quot;:{&quot;animation&quot;:&quot;yes&quot;,&quot;animation_intime&quot;:200,&quot;animation_outtime&quot;:200,&quot;conditions_ui&quot;:&quot;normal&quot;,&quot;notice_dismissed&quot;:false,&quot;repeater_remove_button&quot;:&quot;bottom&quot;}}\" \/><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/fieldset>\n<div class=\"uacf7-form-wrapper-container uacf7-form-2976  \"><div class=\"cf7-rp-container\">\n<div class=\"cf7-rp-bloc-col\">\n<h3 class=\"rp-bloc-title\">Referring Dentist Information<\/h3>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"nom-prenom\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"First and last name\" value=\"\" type=\"text\" name=\"nom-prenom\" \/><\/span>\n<div class=\"flex cf7-container\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"numero-pratique\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Practice Number\" value=\"\" type=\"text\" name=\"numero-pratique\" \/><\/span>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"phone-referent\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Phone\" value=\"\" type=\"tel\" name=\"phone-referent\" \/><\/span>\n<\/div>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"email-referent\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Email address\" value=\"\" type=\"email\" name=\"email-referent\" \/><\/span>\n<small class=\"small-notice\">This address will be used to send you a confirmation of receipt and\/or consultation report.\n<\/small>\n<h3 class=\"rp-bloc-title\">Patient Information<\/h3>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"sex\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"sex\" value=\"Male\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Male<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"sex\" value=\"Female\" \/><span class=\"wpcf7-list-item-label\">Female<\/span><\/label><\/span><\/span><\/span>\n\n<div class=\"flex cf7-container\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"prenom-mineur\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"First name\" value=\"\" type=\"text\" name=\"prenom-mineur\" \/><\/span>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"nom\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Last Name\" value=\"\" type=\"text\" name=\"nom\" \/><\/span>\n<\/div>\n\n<div class=\"flex cf7-container\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"datenaissance\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Date of birth\" value=\"\" type=\"text\" name=\"datenaissance\" \/><\/span>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"phone-patient\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Phone\" value=\"\" type=\"text\" name=\"phone-patient\" \/><\/span>\n<\/div>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"email-patient\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"E-mail address\" value=\"\" type=\"email\" name=\"email-patient\" \/><\/span>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"adresse\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Address\" value=\"\" type=\"text\" name=\"adresse\" \/><\/span>\n<div class=\"flex cf7-container\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ville\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"City\" value=\"\" type=\"text\" name=\"ville\" \/><\/span>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"codepostal\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Zip code\" value=\"\" type=\"text\" name=\"codepostal\" \/><\/span>\n<\/div>\n<h3 class=\"rp-bloc-title\">First and last name of parent if patient is a minor<\/h3>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"nom-prenom-parent-mineur\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"First and last name of parent\" value=\"\" type=\"text\" name=\"nom-prenom-parent-mineur\" \/><\/span>\n<\/div>\n\n\n<div class=\"cf7-rp-bloc-col\">\n<h3 class=\"rp-bloc-title\">I would like to refer to...<\/h3>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"souhait\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"souhait\" value=\"Pedodontics\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Pedodontics<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"souhait\" value=\"Orthodontics\" \/><span class=\"wpcf7-list-item-label\">Orthodontics<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"souhait\" value=\"Maxillofacial surgery\" \/><span class=\"wpcf7-list-item-label\">Maxillofacial surgery<\/span><\/label><\/span><\/span><\/span>\n\n\n<div data-id=\"spcialite-pedodontie\" data-orig_data_id=\"spcialite-pedodontie\"  class=\"\" data-class=\"wpcf7cf_group\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"spcialite_pedodontie\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"spcialite_pedodontie\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"First available\">First available<\/option><option value=\"Dr. G\u00e9raldine Guerges\">Dr. G\u00e9raldine Guerges<\/option><option value=\"Dr. Eva Payette\">Dr. Eva Payette<\/option><option value=\"Dr. Rita Maria Chami\">Dr. Rita Maria Chami<\/option><\/select><\/span>\n<\/div>\n<div data-id=\"spcialite-orthodontie\" data-orig_data_id=\"spcialite-orthodontie\"  class=\"\" data-class=\"wpcf7cf_group\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"spcialite_orthodontie\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"spcialite_orthodontie\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"First available\">First available<\/option><option value=\"Dr. Jean Rizkallah\">Dr. Jean Rizkallah<\/option><option value=\"Dr. Clarice Nishio\">Dr. Clarice Nishio<\/option><option value=\"Dr. Toufic Boulos\">Dr. Toufic Boulos<\/option><\/select><\/span>\n<\/div>\n<div data-id=\"spcialite-chirurgie\" data-orig_data_id=\"spcialite-chirurgie\"  class=\"\" data-class=\"wpcf7cf_group\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"spcialite_chirurgie\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"spcialite_chirurgie\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Dr. Nadia Rizkallah\">Dr. Nadia Rizkallah<\/option><\/select><\/span>\n<\/div>\n\n\n\n<h3 class=\"rp-bloc-title\">Additional information<\/h3>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"info-sup\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"info-sup\">Enter your details here...<\/textarea><\/span>\n<h3 class=\"rp-bloc-title\">Indicate the tooth or teeth involved if applicable<\/h3>\n<div class=\"flex cf7-container\">\n<div> Right <\/div>\n<div>Left<\/div>\n<\/div>\n<div class=\"flex cf7-container\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"droit1\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"droit1[]\" value=\"19\" \/><span class=\"wpcf7-list-item-label\">19<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"droit1[]\" value=\"18\" \/><span class=\"wpcf7-list-item-label\">18<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"droit1[]\" value=\"17\" \/><span class=\"wpcf7-list-item-label\">17<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"droit1[]\" value=\"16\" \/><span class=\"wpcf7-list-item-label\">16<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"droit1[]\" value=\"15\" \/><span class=\"wpcf7-list-item-label\">15<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"droit1[]\" value=\"14\" \/><span class=\"wpcf7-list-item-label\">14<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"droit1[]\" value=\"13\" \/><span class=\"wpcf7-list-item-label\">13<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"droit1[]\" value=\"12\" \/><span class=\"wpcf7-list-item-label\">12<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"droit1[]\" value=\"11\" \/><span class=\"wpcf7-list-item-label\">11<\/span><\/label><\/span><\/span><\/span>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"gauche1\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"gauche1[]\" value=\"21\" \/><span class=\"wpcf7-list-item-label\">21<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"gauche1[]\" value=\"22\" \/><span class=\"wpcf7-list-item-label\">22<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"gauche1[]\" value=\"23\" \/><span class=\"wpcf7-list-item-label\">23<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"gauche1[]\" value=\"24\" \/><span class=\"wpcf7-list-item-label\">24<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"gauche1[]\" value=\"25\" \/><span class=\"wpcf7-list-item-label\">25<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"gauche1[]\" value=\"26\" \/><span class=\"wpcf7-list-item-label\">26<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"gauche1[]\" value=\"27\" \/><span class=\"wpcf7-list-item-label\">27<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"gauche1[]\" value=\"28\" \/><span class=\"wpcf7-list-item-label\">28<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"gauche1[]\" value=\"29\" \/><span class=\"wpcf7-list-item-label\">29<\/span><\/label><\/span><\/span><\/span>\n<\/div>\n<div class=\"flex cf7-container\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"droit2\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"droit2[]\" value=\"55\" \/><span class=\"wpcf7-list-item-label\">55<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"droit2[]\" value=\"54\" \/><span class=\"wpcf7-list-item-label\">54<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"droit2[]\" value=\"53\" \/><span class=\"wpcf7-list-item-label\">53<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"droit2[]\" value=\"52\" \/><span class=\"wpcf7-list-item-label\">52<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"droit2[]\" value=\"51\" \/><span class=\"wpcf7-list-item-label\">51<\/span><\/label><\/span><\/span><\/span>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"gauche2\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"gauche2[]\" value=\"61\" \/><span class=\"wpcf7-list-item-label\">61<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"gauche2[]\" value=\"62\" \/><span class=\"wpcf7-list-item-label\">62<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"gauche2[]\" value=\"63\" \/><span class=\"wpcf7-list-item-label\">63<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"gauche2[]\" value=\"64\" \/><span class=\"wpcf7-list-item-label\">64<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"gauche2[]\" value=\"65\" \/><span class=\"wpcf7-list-item-label\">65<\/span><\/label><\/span><\/span><\/span>\n<\/div>\n<div class=\"flex cf7-container\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"droit3\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"droit3[]\" value=\"85\" \/><span class=\"wpcf7-list-item-label\">85<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"droit3[]\" value=\"84\" \/><span class=\"wpcf7-list-item-label\">84<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"droit3[]\" value=\"83\" \/><span class=\"wpcf7-list-item-label\">83<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"droit3[]\" value=\"82\" \/><span class=\"wpcf7-list-item-label\">82<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"droit3[]\" value=\"81\" \/><span class=\"wpcf7-list-item-label\">81<\/span><\/label><\/span><\/span><\/span>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"gauche3\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"gauche3[]\" value=\"71\" \/><span class=\"wpcf7-list-item-label\">71<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"gauche3[]\" value=\"72\" \/><span class=\"wpcf7-list-item-label\">72<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"gauche3[]\" value=\"73\" \/><span class=\"wpcf7-list-item-label\">73<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"gauche3[]\" value=\"74\" \/><span class=\"wpcf7-list-item-label\">74<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"gauche3[]\" value=\"75\" \/><span class=\"wpcf7-list-item-label\">75<\/span><\/label><\/span><\/span><\/span>\n<\/div>\n<div class=\"flex cf7-container\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"droit1\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"droit1[]\" value=\"49\" \/><span class=\"wpcf7-list-item-label\">49<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"droit1[]\" value=\"48\" \/><span class=\"wpcf7-list-item-label\">48<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"droit1[]\" value=\"47\" \/><span class=\"wpcf7-list-item-label\">47<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"droit1[]\" value=\"46\" \/><span class=\"wpcf7-list-item-label\">46<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"droit1[]\" value=\"45\" \/><span class=\"wpcf7-list-item-label\">45<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"droit1[]\" value=\"44\" \/><span class=\"wpcf7-list-item-label\">44<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"droit1[]\" value=\"43\" \/><span class=\"wpcf7-list-item-label\">43<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"droit1[]\" value=\"42\" \/><span class=\"wpcf7-list-item-label\">42<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"droit1[]\" value=\"41\" \/><span class=\"wpcf7-list-item-label\">41<\/span><\/label><\/span><\/span><\/span>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"gauche1\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"gauche1[]\" value=\"31\" \/><span class=\"wpcf7-list-item-label\">31<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"gauche1[]\" value=\"32\" \/><span class=\"wpcf7-list-item-label\">32<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"gauche1[]\" value=\"33\" \/><span class=\"wpcf7-list-item-label\">33<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"gauche1[]\" value=\"34\" \/><span class=\"wpcf7-list-item-label\">34<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"gauche1[]\" value=\"35\" \/><span class=\"wpcf7-list-item-label\">35<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"gauche1[]\" value=\"36\" \/><span class=\"wpcf7-list-item-label\">36<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"gauche1[]\" value=\"37\" \/><span class=\"wpcf7-list-item-label\">37<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"gauche1[]\" value=\"38\" \/><span class=\"wpcf7-list-item-label\">38<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"gauche1[]\" value=\"39\" \/><span class=\"wpcf7-list-item-label\">39<\/span><\/label><\/span><\/span><\/span>\n<\/div>\n<h3 class=\"rp-bloc-title\">Attach documents\/photos<\/h3>\n<div class=\"flex cf7-container cf7-rp-container-sb\">\n<div class=\"uploadfile-container\">\n<span class=\"wpcf7-form-control-wrap\" data-name=\"file-refer-patient\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file file-refer-patient\" accept=\"audio\/*,video\/*,image\/*\" aria-invalid=\"false\" type=\"file\" name=\"file-refer-patient\" \/><\/span>\n<ul class=\"choosen-file\" data-title=\"Drag your files here\"><\/ul>\n<\/div>\n\n<\/div>\n\n\n\n<\/div>\n<div class=\"cf7-rp-bloc-button-col\">\n<input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send\" \/>\n<\/div>\n<\/div><\/div><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<\/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-6d5df20 elementor-section-full_width elementor-section-height-default elementor-section-height-default\" data-id=\"6d5df20\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-790f29c\" data-id=\"790f29c\" data-element_type=\"column\" data-e-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-3570244 elementor-widget elementor-widget-imagecta\" data-id=\"3570244\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;none&quot;}\" data-widget_type=\"imagecta.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t        <div class=\"w-full aspect-square bg-cover bg-center image-cta-bg-773\">\n                    <a href=\"https:\/\/www.yulsmile.com\/en\/pedodontics\/\" class=\"yulsmile-ctatitle font-bold text-xl lg:text-6xl text-white cursor-pointer leading-normal\">\n                        <div class=\"transition-[outline] ease-in-out duration-300 w-full h-full p-10 hover:outline hover:outline-offset-[-50px] hover:outline-2 hover:outline-[#F7F7F7] \">\n                            <div class=\"text-3xl lg:text-5xl text-left bottom-[100px] absolute z-10 text-white pl-4 lg:pl-[50px]  drop-shadow-md\">\n                                Pedodontics                            <\/div>\n                        <\/div>\n                    <\/a>\n        <\/div>\n        <style>\n            .image-cta-bg-773 {\n                background:-webkit-linear-gradient(#EFC2853B, #EFC2853B), url(https:\/\/www.yulsmile.com\/wp-content\/uploads\/2022\/09\/Capture-de\u0301cran-le-2022-05-17-a\u0300-09.34.46.png) ;\n                background-size: cover !important;\n            }\n            .image-cta-bg-773:hover {\n                background:url(https:\/\/www.yulsmile.com\/wp-content\/uploads\/2022\/09\/Capture-de\u0301cran-le-2022-05-17-a\u0300-09.34.46.png) ;\n                -webkit-transition: background 2s ease-in-out;\n                transition: background 2s ease-in-out;\n            }\n        <\/style>\n\n\n        \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-33 elementor-top-column elementor-element elementor-element-2b8bb4c\" data-id=\"2b8bb4c\" data-element_type=\"column\" data-e-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-9b68fd0 elementor-widget elementor-widget-imagecta\" data-id=\"9b68fd0\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;none&quot;}\" data-widget_type=\"imagecta.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t        <div class=\"w-full aspect-square bg-cover bg-center image-cta-bg-3994\">\n                    <a href=\"https:\/\/www.yulsmile.com\/en\/orthodontics\/\" class=\"yulsmile-ctatitle font-bold text-xl lg:text-6xl text-white cursor-pointer leading-normal\">\n                        <div class=\"transition-[outline] ease-in-out duration-300 w-full h-full p-10 hover:outline hover:outline-offset-[-50px] hover:outline-2 hover:outline-[#F7F7F7] \">\n                            <div class=\"text-3xl lg:text-5xl text-left bottom-[100px] absolute z-10 text-white pl-4 lg:pl-[50px]  drop-shadow-md\">\n                                Orthodontics                            <\/div>\n                        <\/div>\n                    <\/a>\n        <\/div>\n        <style>\n            .image-cta-bg-3994 {\n                background:-webkit-linear-gradient(#0B6AD945, #0B6AD945), url(https:\/\/www.yulsmile.com\/wp-content\/uploads\/2022\/09\/Composant-56-\u2013-1.png) ;\n                background-size: cover !important;\n            }\n            .image-cta-bg-3994:hover {\n                background:url(https:\/\/www.yulsmile.com\/wp-content\/uploads\/2022\/09\/Composant-56-\u2013-1.png) ;\n                -webkit-transition: background 2s ease-in-out;\n                transition: background 2s ease-in-out;\n            }\n        <\/style>\n\n\n        \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-33 elementor-top-column elementor-element elementor-element-1b16175\" data-id=\"1b16175\" data-element_type=\"column\" data-e-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-76c9d5e elementor-widget elementor-widget-imagecta\" data-id=\"76c9d5e\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;none&quot;}\" data-widget_type=\"imagecta.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t        <div class=\"w-full aspect-square bg-cover bg-center image-cta-bg-5330\">\n                    <a href=\"https:\/\/www.yulsmile.com\/en\/maxillofacial-surgery\/\" class=\"yulsmile-ctatitle font-bold text-xl lg:text-6xl text-white cursor-pointer leading-normal\">\n                        <div class=\"transition-[outline] ease-in-out duration-300 w-full h-full p-10 hover:outline hover:outline-offset-[-50px] hover:outline-2 hover:outline-[#F7F7F7] \">\n                            <div class=\"text-3xl lg:text-5xl text-left bottom-[100px] absolute z-10 text-white pl-4 lg:pl-[50px]  drop-shadow-md\">\n                                Maxillofacial <br>surgery                            <\/div>\n                        <\/div>\n                    <\/a>\n        <\/div>\n        <style>\n            .image-cta-bg-5330 {\n                background:-webkit-linear-gradient(#AC31D936, #AC31D936), url(https:\/\/www.yulsmile.com\/wp-content\/uploads\/2022\/09\/JD3_8535.png) ;\n                background-size: cover !important;\n            }\n            .image-cta-bg-5330:hover {\n                background:url(https:\/\/www.yulsmile.com\/wp-content\/uploads\/2022\/09\/JD3_8535.png) ;\n                -webkit-transition: background 2s ease-in-out;\n                transition: background 2s ease-in-out;\n            }\n        <\/style>\n\n\n        \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>Referring a patient Pedodontics Orthodontics Maxillofacial surgery<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-1455","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is 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