{"id":2521,"date":"2022-11-27T09:03:52","date_gmt":"2022-11-27T09:03:52","guid":{"rendered":"http:\/\/ftpdemo.com\/lovegiver\/?page_id=2521"},"modified":"2024-05-04T03:55:12","modified_gmt":"2024-05-04T03:55:12","slug":"contact-forms","status":"publish","type":"page","link":"https:\/\/skilledhomecaresolutions.com\/index.php\/contact-forms\/","title":{"rendered":"Contact Forms"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"2521\" class=\"elementor elementor-2521\">\n\t\t\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-f34191b elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"f34191b\" 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-100 elementor-top-column elementor-element elementor-element-64f8de3\" data-id=\"64f8de3\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5bfffd9 elementor-widget elementor-widget-heading\" data-id=\"5bfffd9\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.18.0 - 20-12-2023 *\/\n.elementor-heading-title{padding:0;margin:0;line-height:1}.elementor-widget-heading .elementor-heading-title[class*=elementor-size-]>a{color:inherit;font-size:inherit;line-height:inherit}.elementor-widget-heading .elementor-heading-title.elementor-size-small{font-size:15px}.elementor-widget-heading .elementor-heading-title.elementor-size-medium{font-size:19px}.elementor-widget-heading .elementor-heading-title.elementor-size-large{font-size:29px}.elementor-widget-heading .elementor-heading-title.elementor-size-xl{font-size:39px}.elementor-widget-heading .elementor-heading-title.elementor-size-xxl{font-size:59px}<\/style><span class=\"elementor-heading-title elementor-size-default\">Contact Skilled Home Care Solutions today for a free consultation.<\/span>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a1c0d73 elementor-widget elementor-widget-heading\" data-id=\"a1c0d73\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Contact Form<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-70c47b1 lovegiver elementor-widget elementor-widget-shortcode\" data-id=\"70c47b1\" 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<div class=\"elementor-shortcode\">\n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f4761-o1\" lang=\"en-US\" dir=\"ltr\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/index.php\/wp-json\/wp\/v2\/pages\/2521#wpcf7-f4761-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"4761\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"5.8.5\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f4761-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/div>\n<section class=\"contact-1-section pt-lg-0\">\n\t<div class=\"auto-container\">\n\t\t<div class=\"row align-items-center\">\n\t\t\t<div class=\"col-lg-12 order-lg-2\">\n\t\t\t\t<div class=\"contact-form\">\n\t\t\t\t\t<div id=\"contact-form\">\n\t\t\t\t\t\t<div class=\"row clearfix\">\n\t\t\t\t\t\t\t<div class=\"form-group col-md-6\">\n\t\t\t\t\t\t\t\t<p><label>I am interested in(Please select one)<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"radio-910\"><span class=\"wpcf7-form-control wpcf7-radio radio-2\" id=\"radio-1\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"radio-910\" value=\"Home care\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Home care<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-910\" value=\"S.H.C Career\" \/><span class=\"wpcf7-list-item-label\">S.H.C Career<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"radio-910\" value=\"Franchise Inquiry\" \/><span class=\"wpcf7-list-item-label\">Franchise Inquiry<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"form-group col-md-6\">\n\t\t\t\t\t\t\t\t<p><label>Your Name<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-173\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Your Name\" value=\"\" type=\"text\" name=\"text-173\" \/><\/span>\n\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"form-group col-md-6\">\n\t\t\t\t\t\t\t\t<p>Phone Number<span class=\"wpcf7-form-control-wrap\" data-name=\"text-177\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Phone Number\" value=\"\" type=\"text\" name=\"text-177\" \/><\/span><br \/>\n<label> Is this a cell phone?<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"radio-911\"><span class=\"wpcf7-form-control wpcf7-radio radio-4\" id=\"radio-3\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"radio-911\" value=\"Yes\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"radio-911\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"form-group col-md-6\">\n\t\t\t\t\t\t\t\t<p>Email Address<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"email-104\"><input size=\"40\" 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-104\" \/><\/span><br \/>\n<label><br \/>\nYour contact preference<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"radio-912\"><span class=\"wpcf7-form-control wpcf7-radio radio-6\" id=\"radio-5\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"radio-912\" value=\"Email\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Email<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-912\" value=\"Phone\" \/><span class=\"wpcf7-list-item-label\">Phone<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-912\" value=\"Text\" \/><span class=\"wpcf7-list-item-label\">Text<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"radio-912\" value=\"No preference\" \/><span class=\"wpcf7-list-item-label\">No preference<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"form-group col-md-6\">\n\t\t\t\t\t\t\t\t<p><label>Your Address<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-176\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Address\" value=\"\" type=\"text\" name=\"text-176\" \/><\/span>\n\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"form-group col-md-6\">\n\t\t\t\t\t\t\t\t<p><label>Your City<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-174\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"City\" value=\"\" type=\"text\" name=\"text-174\" \/><\/span>\n\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"form-group col-md-6\">\n\t\t\t\t\t\t\t\t<p><label>Zip Code<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-175\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Zipcode\" value=\"\" type=\"text\" name=\"text-175\" \/><\/span>\n\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"form-group col-md-6\">\n\t\t\t\t\t\t\t\t<p><label>When would you like services to begin?(Please select one)<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"radio-992\"><span class=\"wpcf7-form-control wpcf7-radio radio-994\" id=\"radio-993\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"radio-992\" value=\"Immediately\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Immediately<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-992\" value=\"Within 2 weeks\" \/><span class=\"wpcf7-list-item-label\">Within 2 weeks<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-992\" value=\"Within 4 weeks\" \/><span class=\"wpcf7-list-item-label\">Within 4 weeks<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"radio-992\" value=\"Within 8 weeks\" \/><span class=\"wpcf7-list-item-label\">Within 8 weeks<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"form-group col-md-6\">\n\t\t\t\t\t\t\t\t<p><label>Best time of day to contact you:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-65\"><select class=\"wpcf7-form-control wpcf7-select time-select23\" id=\"time-select12\" aria-invalid=\"false\" name=\"menu-65\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"08:00 AM\">08:00 AM<\/option><option value=\"09:00 AM\">09:00 AM<\/option><option value=\"10:00 AM\">10:00 AM<\/option><option value=\"11:00 AM\">11:00 AM<\/option><option value=\"12:00 PM\">12:00 PM<\/option><option value=\"01:00 PM\">01:00 PM<\/option><option value=\"02:00 PM\">02:00 PM<\/option><option value=\"03:00 PM\">03:00 PM<\/option><option value=\"04:00 PM\">04:00 PM<\/option><option value=\"05:00 PM\">05:00 PM<\/option><option value=\"06:00 PM\">06:00 PM<\/option><option value=\"07:00 PM\">07:00 PM<\/option><option value=\"08:00 PM\">08:00 PM<\/option><option value=\"09:00 PM\">09:00 PM<\/option><option value=\"10:00 PM\">10:00 PM<\/option><\/select><\/span>\n\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"form-group col-md-6\">\n\t\t\t\t\t\t\t\t<p><label>Would you be interested in receiving a Free in Home Care Consultation?<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"radio-592\"><span class=\"wpcf7-form-control wpcf7-radio radio-592a\" id=\"radio-592i\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"radio-592\" value=\"Yes\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"radio-592\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t<div class=\"form-group col-md-6\">\n\t\t\t\t\t\t\t\t\t<p><input id=\"form_botcheck\" class=\"form-control\" name=\"form_botcheck\" type=\"hidden\" value=\"\" \/><br \/>\n<button class=\"btn-1 btn-small\" type=\"submit\" data-loading-text=\"Please wait...\">Submit now <\/button>\n\t\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/section><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<\/div>\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\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Contact Skilled Home Care Solutions today for a free consultation. Contact Form<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"tpl-default-elementor.php","meta":{"footnotes":""},"class_list":["post-2521","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/skilledhomecaresolutions.com\/index.php\/wp-json\/wp\/v2\/pages\/2521","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/skilledhomecaresolutions.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/skilledhomecaresolutions.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/skilledhomecaresolutions.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/skilledhomecaresolutions.com\/index.php\/wp-json\/wp\/v2\/comments?post=2521"}],"version-history":[{"count":16,"href":"https:\/\/skilledhomecaresolutions.com\/index.php\/wp-json\/wp\/v2\/pages\/2521\/revisions"}],"predecessor-version":[{"id":4775,"href":"https:\/\/skilledhomecaresolutions.com\/index.php\/wp-json\/wp\/v2\/pages\/2521\/revisions\/4775"}],"wp:attachment":[{"href":"https:\/\/skilledhomecaresolutions.com\/index.php\/wp-json\/wp\/v2\/media?parent=2521"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}