{"id":8831,"date":"2025-02-27T13:01:13","date_gmt":"2025-02-27T05:01:13","guid":{"rendered":"https:\/\/amahvet.com.hk\/?page_id=8831"},"modified":"2025-03-06T12:31:07","modified_gmt":"2025-03-06T04:31:07","slug":"referral","status":"publish","type":"page","link":"https:\/\/amahvet.com.hk\/en\/referral\/","title":{"rendered":"Referral"},"content":{"rendered":"<div data-elementor-type=\"wp-page\" data-elementor-id=\"8831\" class=\"elementor elementor-8831\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-323e382 elementor-section-full_width elementor-section-height-default elementor-section-height-default\" data-id=\"323e382\" data-element_type=\"section\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\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-f1d9d0f\" data-id=\"f1d9d0f\" 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-26d00bc elementor-widget elementor-widget-image\" data-id=\"26d00bc\" 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 decoding=\"async\" width=\"2000\" height=\"600\" src=\"https:\/\/amahvet.com.hk\/wp-content\/uploads\/2023\/02\/amah-referral-banner.jpg\" class=\"attachment-full size-full wp-image-6946\" alt=\"Referral\" srcset=\"https:\/\/amahvet.com.hk\/wp-content\/uploads\/2023\/02\/amah-referral-banner.jpg 2000w, https:\/\/amahvet.com.hk\/wp-content\/uploads\/2023\/02\/amah-referral-banner-300x90.jpg 300w, https:\/\/amahvet.com.hk\/wp-content\/uploads\/2023\/02\/amah-referral-banner-1024x307.jpg 1024w, https:\/\/amahvet.com.hk\/wp-content\/uploads\/2023\/02\/amah-referral-banner-768x230.jpg 768w, https:\/\/amahvet.com.hk\/wp-content\/uploads\/2023\/02\/amah-referral-banner-1536x461.jpg 1536w, https:\/\/amahvet.com.hk\/wp-content\/uploads\/2023\/02\/amah-referral-banner-18x5.jpg 18w\" sizes=\"(max-width: 2000px) 100vw, 2000px\" \/>\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\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-f2db7c2 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"f2db7c2\" data-element_type=\"section\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\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-6daeed0\" data-id=\"6daeed0\" 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-513f659 elementor-widget elementor-widget-text-editor\" data-id=\"513f659\" 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<p>Case Referral form and Imaging Referral form to be completed by rDVM. You can download the forms and email it to us. Please include medical records so we can schedule an appointment as soon as possible. Please fill out the form in English as possible.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-ac87e92 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"ac87e92\" data-element_type=\"section\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\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-inner-column elementor-element elementor-element-481ad96\" data-id=\"481ad96\" 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-e401c80 elementor-mobile-align-left elementor-widget__width-initial elementor-widget elementor-widget-button\" data-id=\"e401c80\" 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 class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"\/wp-content\/uploads\/2025\/03\/20250306_Case-Referral-Form-for-AMAH-fa-1.pdf\" target=\"_blank\">\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\">Case Referral 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<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-c39dc8d\" data-id=\"c39dc8d\" 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-eace679 elementor-mobile-align-left elementor-widget elementor-widget-button\" data-id=\"eace679\" 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 class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"\/wp-content\/uploads\/2025\/03\/20250306_New-Referral-Form-for-AMAH-fa-2.pdf\" target=\"_blank\">\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\">Imaging Referral 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<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\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<section class=\"elementor-section elementor-top-section elementor-element elementor-element-8d1ea13 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"8d1ea13\" data-element_type=\"section\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\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-8d2619f\" data-id=\"8d2619f\" 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-0814de8 elementor-widget elementor-widget-text-editor\" data-id=\"0814de8\" 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<p>Following Case Referral form to be completed by rDVM\uff1a<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-36b98a6 elementor-widget elementor-widget-shortcode\" data-id=\"36b98a6\" 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\">\t\r\n\r\n<script>\r\njQuery(document).ready(function($) {\r\n    function toggleFormLayout() {\r\n        if ($(window).width() < 600) {\r\n            $('.desktop-form').hide();\r\n            $('.mobile-form').show();\r\n        } else {\r\n            $('.desktop-form').show();\r\n            $('.mobile-form').hide();\r\n        }\r\n    }\r\n\r\n    toggleFormLayout();\r\n\r\n    $(window).resize(function() {\r\n        toggleFormLayout();\r\n    });\r\n});\r\n\r\n\r\njQuery(document).ready(function($) {\r\n    var ajaxurl = \"\/wp-admin\/admin-ajax.php\";\r\n\r\n    jQuery('.landing_form').on(\"submit\", function(e) {\r\n        e.preventDefault(); \/\/ Prevent the default form submission\r\n\r\n        const files = $(this).find('#file')[0].files; \/\/ Get files from the current form\r\n        const maxSize = 15 * 1024 * 1024; \r\n        const allowedTypes = ['application\/pdf', 'image\/jpeg', 'image\/jpg', 'application\/zip'];\r\n\r\n        \/\/ Validate file sizes and types\r\n        for (let i = 0; i < files.length; i++) {\r\n            if (files[i].size > maxSize) {\r\n                alert(\"This file exceeds the maximum allowed size of 15MB.\");\r\n                return; \/\/ Stop submission\r\n            }\r\n            if (!allowedTypes.includes(files[i].type)) {\r\n                alert(\"Only PDF, JPG, and ZIP files are allowed.\");\r\n                return; \/\/ Stop submission\r\n            }\r\n        }\r\n\r\n        var _name = $(this).find(\"#form-field-person_name\").val(),\r\n            _user_ip = '172.40.211.242',\r\n            _source = 'T1494',\r\n            _token = 'EB0907A1-AE7E-442F-A366-1FACBAC528D7',\r\n            _website_name = 'AMAH',\r\n            _website_url = 'https:\/\/amahvet.com.hk\/en\/wp-json\/wp\/v2\/pages\/8831\/',\r\n            _tel_prefix = \"+852\",\r\n            _age_group = \"\",\r\n            _shop_area_code = \"KLN09\",\r\n            _booking_date = \"\",\r\n            _booking_time = \"\",\r\n            allergydValues = $(this).find(\"input[name='form_fields[allergy][]']:checked\").map(function(){\r\n                return $(this).val();\r\n            }).get();\r\n\r\n        var _tel = $(this).find(\"#form-field-person_phone\").val(),\r\n            _email = $(this).find(\"#veterinary_email\").val(),\r\n            _enquiry_item = [\"0EA089C6-EA73-4040-BAEE-D494695D89F0\"],\r\n            _remarks = \r\n                \"Owner Appellation: \" + $(this).find(\"input[name='form_fields[person_gender]']:checked\").val() + \r\n                \"<br>Patient Name: \" + $(this).find(\"#pet_name\").val() + \r\n                \"<br>Date of Birth \/ Age: \" + $(this).find(\"#form-field-bday\").val() + \r\n                \"<br>Sex: \" + $(this).find(\"input[name='form_fields[pet_gender]']:checked\").val() + \r\n                \"<br>Breed: \" + $(this).find(\"#form-field-breed\").val() + \r\n                \"<br>Species: \" + $(this).find(\"input[name='form_fields[species]']:checked\").val() +\r\n                \"<br>Neutered: \" + $(this).find(\"input[name='form_fields[neutered]']:checked\").val() +\r\n                \"<br>Referral to: \" + $(this).find(\"input[name='form_fields[referral]:checked']\").map(function() { return $(this).val(); }).get().join(\", \") + \r\n                \"<br>Referral Reason: \" + $(this).find(\"#form-field-referral_reason\").val() + \r\n                \"<br>Clinical: \" + $(this).find(\"#form-field-clinical\").val() + \r\n                \"<br>Allergy: \" + allergydValues.join(\", \") + \r\n                \"<br>Other Allergies: \" + $(this).find(\"#form-field-other_allergies\").val() + \r\n                \"<br><br>rDVM information:<br>Name: \" + $(this).find(\"#veterinarian\").val() + \r\n                \"<br>Clinic: \" + $(this).find(\"#veterinary_clinic\").val() + \r\n                \"<br>Phone: \" + $(this).find(\"#veterinary_phone\").val() + \r\n                \"<br>Email: \" + $(this).find(\"#veterinary_email\").val() + \r\n                \"<br>Address: \" + $(this).find(\"#veterinary_address\").val();\r\n\r\n        jQuery('button[type=\"submit\"]').html(\"\u63d0\u4ea4\u4e2d,\u8acb\u7a0d\u5f8c\");\r\n\r\n        var formData = {\r\n            'action': 'formToMSP',\r\n            'token': _token,\r\n            'source': _source,\r\n            'name': _name,\r\n            'user_ip': _user_ip,\r\n            'website_name': _website_name,\r\n            'website_url': _website_url,\r\n            'enquiry_item': _enquiry_item,\r\n            'tel_prefix': _tel_prefix,\r\n            'tel': _tel,\r\n            'email': _email,\r\n            'age_group': _age_group,\r\n            'shop_area_code': _shop_area_code,\r\n            'booking_date': _booking_date,\r\n            'booking_time': _booking_time,\r\n            'remarks': _remarks\r\n        };\r\n\r\n        console.log(\"Submitting form data to MSP:\", formData);\r\n\r\n        var emailData = new FormData(this); \r\n\r\n        emailData.append('action', 'sendEmail'); \r\n        emailData.append('user_ip', '172.40.211.242'); \r\n        emailData.append('source', 'T1494'); \r\n        emailData.append('token', 'EB0907A1-AE7E-442F-A366-1FACBAC528D7');\r\n\r\n        jQuery.ajax({\r\n            url: ajaxurl,\r\n            type: 'POST',\r\n            data: formData,\r\n            success: function(msg) {\r\n                console.log(\"Received response from MSP:\", msg); \r\n                var jsonObj = JSON.parse(msg);\r\n                \r\n                if (jsonObj.result == 0) {\r\n                    console.log(\"MSP request successful, proceeding to send email.\"); \r\n                    jQuery.ajax({\r\n                        url: ajaxurl,\r\n                        type: 'POST',\r\n                        data: emailData,\r\n                        contentType: false, \r\n                        processData: false, \r\n                        success: function(msg) {\r\n                            console.log(\"Received response:\", msg); \r\n                            var jsonObj = JSON.parse(msg);\r\n                            \r\n                            if (jsonObj.result == 0) {\r\n                                console.log(\"Email sent successfully!\");\r\n                                window.location.replace('https:\/\/amahvet.com.hk\/thanks?prod=referraltesting');\r\n                            } else {\r\n                                console.error(\"Error:\", jsonObj); \r\n                                alert(\"\u90f5\u4ef6\u767c\u9001\u5931\u6557\uff0c\u8acb\u91cd\u8a66\");\r\n                            }\r\n                        },\r\n                        error: function(xhr, status, error) {\r\n                            console.error(\"AJAX error:\", status, error);\r\n                            alert(\"\u7121\u6cd5\u63d0\u4ea4\u95a3\u4e0b\u8cc7\u6599, \u8acb\u91cd\u8a66\");\r\n                        }\r\n                    });\r\n                } else {\r\n                    console.error(\"Error from MSP:\", jsonObj); \r\n                    alert(\"\u7121\u6cd5\u63d0\u4ea4\u95a3\u4e0b\u8cc7\u6599, \u8acb\u91cd\u8a66\");\r\n                }\r\n            },\r\n            error: function(xhr, status, error) {\r\n                console.error(\"AJAX error:\", status, error); \r\n                alert(\"\u7121\u6cd5\u63d0\u4ea4\u95a3\u4e0b\u8cc7\u6599, \u8acb\u91cd\u8a66\");\r\n            }\r\n        });\r\n    });\r\n});\r\n\r\n<\/script>\r\n\r\n<div class=\"container\">\t\t\r\n    <div class=\"formMsg\"><\/div>\t\t\t\t\t\r\n    <form class=\"landing_form desktop-form\" method=\"post\" name=\"referral-form\" enctype=\"multipart\/form-data\" action=\"\">\t\r\n        <div class=\"form-row\">\r\n                <div class=\"form-group col-sm-6\">\r\n                    <label for=\"pet_name\">\u5bf5\u7269\u8cc7\u6599: *<\/label>\r\n                    <input type=\"text\" class=\"form-control\" name=\"form_fields[pet_name]\" id=\"pet_name\" placeholder=\"Patient Name\" required>\r\n                <\/div>\r\n\r\n                <div class=\"form-group col-sm-6\">\r\n                    <label for=\"person_gender\">Owner Information:<\/label>\r\n                    <div>\r\n                        <input type=\"radio\" value=\"Mr. \u5148\u751f\" id=\"person_gender_mr\" name=\"form_fields[person_gender]\"> \r\n                        <label for=\"person_gender_mr\" class=\"answerStyle\">Mr.<\/label>\r\n                        <input type=\"radio\" value=\"Mrs. \u5973\u58eb\" id=\"person_gender_mrs\" name=\"form_fields[person_gender]\"> \r\n                        <label for=\"person_gender_mrs\" class=\"answerStyle\">Mrs.<\/label>\r\n                        <input type=\"radio\" value=\"Ms. \u5c0f\u59d0\" id=\"person_gender_ms\" name=\"form_fields[person_gender]\"> \r\n                        <label for=\"person_gender_ms\" class=\"answerStyle\">Ms.<\/label>\r\n                    <\/div>\r\n                <\/div>\r\n\r\n                <div class=\"form-group col-sm-6\">\r\n                    <input type=\"text\" name=\"form_fields[bday]\" id=\"form-field-bday\" class=\"form-control\" placeholder=\"Date of Birth\" required>\r\n                <\/div>\r\n\r\n                <div class=\"form-group col-sm-6\">\r\n                    <input type=\"text\" name=\"form_fields[person_name]\" id=\"form-field-person_name\" class=\"form-control\" placeholder=\"*Name\" required>\r\n                <\/div>\r\n\r\n                <div class=\"form-group col-sm-6\">\r\n                    <label for=\"pet_gender\">\u5bf5\u7269\u6027\u5225:<\/label>\r\n                    <div>\r\n                        <input type=\"radio\" value=\"Male \u7537\" id=\"pet_gender_male\" name=\"form_fields[pet_gender]\"> \r\n                        <label for=\"pet_gender_male\" class=\"answerStyle\">Male<\/label>\r\n                        <input type=\"radio\" value=\"Female \u5973\" id=\"pet_gender_female\" name=\"form_fields[pet_gender]\"> \r\n                        <label for=\"pet_gender_female\" class=\"answerStyle\">Female<\/label>\r\n                    <\/div>\r\n                <\/div>\r\n\r\n                <div class=\"form-group col-sm-6\">\r\n                    <input type=\"tel\" name=\"form_fields[person_phone]\" id=\"form-field-person_phone\" class=\"form-control\" placeholder=\"*Phone\" required pattern=\"[0-9()#&amp;+*-=.]+\">\r\n                <\/div>\r\n\r\n\r\n            <div class=\"form-group col-sm-6\">\r\n                <input type=\"text\" name=\"form_fields[breed]\" id=\"form-field-breed\" class=\"form-control\" placeholder=\"Breed\">\r\n            <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n                <label for=\"species\">Species:<\/label>\r\n                <div>\r\n                    <input type=\"radio\" value=\"Canine \u72ac\" id=\"species_dog\" name=\"form_fields[species]\"> \r\n                    <label for=\"species_dog\" class=\"answerStyle\">Canine<\/label>\r\n                    <input type=\"radio\" value=\"Feline \u8c93\" id=\"species_cat\" name=\"form_fields[species]\"> \r\n                    <label for=\"species_cat\" class=\"answerStyle\">Feline<\/label>\r\n                <\/div>\r\n            <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n                <label for=\"neutered\">Neutered:<\/label>\r\n                <div>\r\n                    <input type=\"radio\" value=\"Yes \u662f\" id=\"neutered_yes\" name=\"form_fields[neutered]\"> \r\n                    <label for=\"neutered_yes\" class=\"answerStyle\">Yes<\/label>\r\n                    <input type=\"radio\" value=\"No \u4e0d\u662f\" id=\"neutered_no\" name=\"form_fields[neutered]\"> \r\n                    <label for=\"neutered_no\" class=\"answerStyle\">No<\/label>\r\n                <\/div>\r\n            <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n                <label for=\"referral\">Referral to Neurology \/ Cardiology \/ Surgery \/ Internal Medicine or others, please specify :<\/label>\r\n                <div>\r\n                    <div>\r\n                        <input type=\"radio\" value=\"Neurology \u795e\u7d93\u5c08\u79d1\" id=\"referral_neurology\" name=\"form_fields[referral]\"> \r\n                        <label for=\"referral_neurology\" class=\"answerStyle\">Neurology<\/label>\r\n                    <\/div>\r\n                    <div>\r\n                        <input type=\"radio\" value=\"Cardiology \u5fc3\u81df\u5c08\u79d1\" id=\"referral_cardiology\" name=\"form_fields[referral]\"> \r\n                        <label for=\"referral_cardiology\" class=\"answerStyle\">Cardiology<\/label>\r\n                    <\/div>\r\n                    <div>\r\n                        <input type=\"radio\" value=\"Surgery \u5916\u79d1\u5c08\u79d1\" id=\"referral_surgery\" name=\"form_fields[referral]\"> \r\n                        <label for=\"referral_surgery\" class=\"answerStyle\">Surgery<\/label>\r\n                    <\/div>\r\n                    <div>\r\n                        <input type=\"radio\" value=\"Internal Medicine \u5167\u79d1\u5c08\u79d1\" id=\"referral_internal\" name=\"form_fields[referral]\"> \r\n                        <label for=\"referral_internal\" class=\"answerStyle\">Internal Medicine<\/label>\r\n                    <\/div>\r\n                    <div>\r\n                        <input type=\"radio\" value=\"Others \u5176\u4ed6\" id=\"referral_others\" name=\"form_fields[referral]\"> \r\n                        <label for=\"referral_others\" class=\"answerStyle\">Others, please specify:<\/label>\r\n                    <\/div>\r\n                <\/div>\r\n            <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n                <textarea name=\"form_fields[referral_reason]\" id=\"form-field-referral_reason\" class=\"form-control\" rows=\"3\" placeholder=\"Reason for referral\"><\/textarea>\r\n            <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n                <textarea name=\"form_fields[clinical]\" id=\"form-field-clinical\" class=\"form-control\" rows=\"3\" placeholder=\"Clinical information (Patient history \/ Current treatments \/ Specific arrangements required\/ Any Medical Image):\"><\/textarea>\r\n            <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n                <label for=\"allergy\">\u904e\u654f\u75c5\u53f2:<\/label>\r\n                <div>\r\n                    <input type=\"checkbox\" value=\"Contrast medium \u986f\u5f71\u5291\" id=\"allergy_contrast\" name=\"form_fields[allergy][]\"> \r\n                    <label for=\"allergy_contrast\" class=\"answerStyle\">Contrast medium<\/label>\r\n                <\/div>\r\n            <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n                <textarea name=\"form_fields[other_allergies]\" id=\"form-field-other_allergies\" class=\"form-control\" rows=\"1\" placeholder=\"Other allergies\"><\/textarea>\r\n            <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n                <label for=\"veterinarian\">rDVM information: <small>*mandatory<\/small><\/label>\r\n                <input type=\"text\" name=\"form_fields[veterinarian]\" id=\"veterinarian\" class=\"form-control\" placeholder=\"Veterinarian Name\" required>\r\n            <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n                <input type=\"text\" name=\"form_fields[veterinary_clinic]\" id=\"veterinary_clinic\" class=\"form-control\" placeholder=\"Veterinary Clinic\" required>\r\n            <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n                <input type=\"tel\" name=\"form_fields[veterinary_phone]\" id=\"veterinary_phone\" class=\"form-control\" placeholder=\"Clinic Phone\" required pattern=\"[0-9()#&amp;+*-=.]+\">\r\n            <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n                <input type=\"email\" name=\"form_fields[veterinary_email]\" id=\"veterinary_email\" class=\"form-control\" placeholder=\"Email\" required>\r\n            <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n                <input type=\"text\" name=\"form_fields[veterinary_address]\" id=\"veterinary_address\" class=\"form-control\" placeholder=\"Address\" required>\r\n            <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n        <label for=\"file\">Please upload medical records and images (such as laboratory reports, X-rays) in file format (PDF \/ JPG \/ ZIP), and the maximum limit for each file is 25MB.<\/label>\r\n        <input type=\"file\" name=\"form_fields[file][]\" id=\"file\" class=\"form-control\" multiple data-maxsize=\"25\" data-maxsize-message=\"This file exceeds the maximum allowed size.\">\r\n    <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n                <button type=\"submit\" class=\"btn btn-outline-secondary submitBtn\">Submit<\/button>\r\n            <\/div>\r\n        <\/div>\r\n    <input type=\"hidden\" name=\"trp-form-language\" value=\"en\"\/><\/form>\r\n\r\n\r\n    <form class=\"landing_form mobile-form\" method=\"post\" name=\"referral-form\" enctype=\"multipart\/form-data\" action=\"\">\t\r\n        <div class=\"form-row\">\r\n        <div class=\"form-group col-sm-6\">\r\n            <label for=\"person_gender\">Owner Information:<\/label>\r\n                    <div>\r\n                        <input type=\"radio\" value=\"Mr. \u5148\u751f\" id=\"person_gender_mr\" name=\"form_fields[person_gender]\"> \r\n                        <label for=\"person_gender_mr\" class=\"answerStyle\">Mr.<\/label>\r\n                        <input type=\"radio\" value=\"Mrs. \u5973\u58eb\" id=\"person_gender_mrs\" name=\"form_fields[person_gender]\"> \r\n                        <label for=\"person_gender_mrs\" class=\"answerStyle\">Mrs.<\/label>\r\n                        <input type=\"radio\" value=\"Ms. \u5c0f\u59d0\" id=\"person_gender_ms\" name=\"form_fields[person_gender]\"> \r\n                        <label for=\"person_gender_ms\" class=\"answerStyle\">Ms.<\/label>\r\n                    <\/div>\r\n                <\/div>\r\n\r\n                <div class=\"form-group col-sm-6\">\r\n                    <input type=\"text\" name=\"form_fields[person_name]\" id=\"form-field-person_name\" class=\"form-control\" placeholder=\"*Name\" required>\r\n                <\/div>\r\n\r\n                <div class=\"form-group col-sm-6\">\r\n                    <input type=\"tel\" name=\"form_fields[person_phone]\" id=\"form-field-person_phone\" class=\"form-control\" placeholder=\"*Phone\" required pattern=\"[0-9()#&amp;+*-=.]+\" >\r\n                <\/div>\r\n\r\n                <div class=\"form-group col-sm-6\">\r\n                    <label for=\"pet_name\">\u5bf5\u7269\u8cc7\u6599: *<\/label>\r\n                    <input type=\"text\" class=\"form-control\" name=\"form_fields[pet_name]\" id=\"pet_name\" placeholder=\"Patient Name\" required>\r\n                <\/div>\r\n\r\n                <div class=\"form-group col-sm-6\">\r\n                    <input type=\"text\" name=\"form_fields[bday]\" id=\"form-field-bday\" class=\"form-control\" placeholder=\"Date of Birth\" required>\r\n                <\/div>\r\n\r\n                <div class=\"form-group col-sm-6\">\r\n                    <label for=\"pet_gender\">\u5bf5\u7269\u6027\u5225:<\/label>\r\n                    <div>\r\n                        <input type=\"radio\" value=\"Male \u7537\" id=\"pet_gender_male\" name=\"form_fields[pet_gender]\"> \r\n                        <label for=\"pet_gender_male\" class=\"answerStyle\">Male<\/label>\r\n                        <input type=\"radio\" value=\"Female \u5973\" id=\"pet_gender_female\" name=\"form_fields[pet_gender]\"> \r\n                        <label for=\"pet_gender_female\" class=\"answerStyle\">Female<\/label>\r\n                    <\/div>\r\n                <\/div>\r\n            <\/div>\r\n\r\n                \r\n            <div class=\"form-group col-sm-6\">\r\n                <input type=\"text\" name=\"form_fields[breed]\" id=\"form-field-breed\" class=\"form-control\" placeholder=\"Breed\">\r\n            <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n                <label for=\"species\">Species:<\/label>\r\n                <div>\r\n                    <input type=\"radio\" value=\"Canine \u72ac\" id=\"species_dog\" name=\"form_fields[species]\"> \r\n                    <label for=\"species_dog\" class=\"answerStyle\">Canine<\/label>\r\n                    <input type=\"radio\" value=\"Feline \u8c93\" id=\"species_cat\" name=\"form_fields[species]\"> \r\n                    <label for=\"species_cat\" class=\"answerStyle\">Feline<\/label>\r\n                <\/div>\r\n            <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n                <label for=\"neutered\">Neutered:<\/label>\r\n                <div>\r\n                    <input type=\"radio\" value=\"Yes \u662f\" id=\"neutered_yes\" name=\"form_fields[neutered]\"> \r\n                    <label for=\"neutered_yes\" class=\"answerStyle\">Yes<\/label>\r\n                    <input type=\"radio\" value=\"No \u4e0d\u662f\" id=\"neutered_no\" name=\"form_fields[neutered]\"> \r\n                    <label for=\"neutered_no\" class=\"answerStyle\">No<\/label>\r\n                <\/div>\r\n            <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n                <label for=\"referral\">Referral to Neurology \/ Cardiology \/ Surgery \/ Internal Medicine or others, please specify :<\/label>\r\n                <div>\r\n                    <div>\r\n                        <input type=\"radio\" value=\"Neurology \u795e\u7d93\u5c08\u79d1\" id=\"referral_neurology\" name=\"form_fields[referral]\"> \r\n                        <label for=\"referral_neurology\" class=\"answerStyle\">Neurology<\/label>\r\n                    <\/div>\r\n                    <div>\r\n                        <input type=\"radio\" value=\"Cardiology \u5fc3\u81df\u5c08\u79d1\" id=\"referral_cardiology\" name=\"form_fields[referral]\"> \r\n                        <label for=\"referral_cardiology\" class=\"answerStyle\">Cardiology<\/label>\r\n                    <\/div>\r\n                    <div>\r\n                        <input type=\"radio\" value=\"Surgery \u5916\u79d1\u5c08\u79d1\" id=\"referral_surgery\" name=\"form_fields[referral]\"> \r\n                        <label for=\"referral_surgery\" class=\"answerStyle\">Surgery<\/label>\r\n                    <\/div>\r\n                    <div>\r\n                        <input type=\"radio\" value=\"Internal Medicine \u5167\u79d1\u5c08\u79d1\" id=\"referral_internal\" name=\"form_fields[referral]\"> \r\n                        <label for=\"referral_internal\" class=\"answerStyle\">Internal Medicine<\/label>\r\n                    <\/div>\r\n                    <div>\r\n                        <input type=\"radio\" value=\"Others\" id=\"referral_others\" name=\"form_fields[referral]\"> \r\n                        <label for=\"referral_others\" class=\"answerStyle\">Others, please specify:<\/label>\r\n                    <\/div>\r\n                <\/div>\r\n            <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n                <textarea name=\"form_fields[referral_reason]\" id=\"form-field-referral_reason\" class=\"form-control\" rows=\"3\" placeholder=\"Reason for referral\"><\/textarea>\r\n            <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n                <textarea name=\"form_fields[clinical]\" id=\"form-field-clinical\" class=\"form-control\" rows=\"3\" placeholder=\"Clinical information (Patient history \/ Current treatments \/ Specific arrangements required\/ Any Medical Image):\"><\/textarea>\r\n            <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n                <label for=\"allergy\">\u904e\u654f\u75c5\u53f2:<\/label>\r\n                <div>\r\n                    <input type=\"checkbox\" value=\"Contrast medium \u986f\u5f71\u5291\" id=\"allergy_contrast\" name=\"form_fields[allergy][]\"> \r\n                    <label for=\"allergy_contrast\" class=\"answerStyle\">Contrast medium<\/label>\r\n                <\/div>\r\n            <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n                <textarea name=\"form_fields[other_allergies]\" id=\"form-field-other_allergies\" class=\"form-control\" rows=\"1\" placeholder=\"Other allergies\"><\/textarea>\r\n            <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n                <label for=\"veterinarian\">rDVM information: <small>*mandatory<\/small><\/label>\r\n                <input type=\"text\" name=\"form_fields[veterinarian]\" id=\"veterinarian\" class=\"form-control\" placeholder=\"Veterinarian Name\" required>\r\n            <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n                <input type=\"text\" name=\"form_fields[veterinary_clinic]\" id=\"veterinary_clinic\" class=\"form-control\" placeholder=\"Veterinary Clinic\" required>\r\n            <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n                <input type=\"tel\" name=\"form_fields[veterinary_phone]\" id=\"veterinary_phone\" class=\"form-control\" placeholder=\"Clinic Phone\" required pattern=\"[0-9()#&amp;+*-=.]+\">\r\n            <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n                <input type=\"email\" name=\"form_fields[veterinary_email]\" id=\"veterinary_email\" class=\"form-control\" placeholder=\"Email\" required>\r\n            <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n                <input type=\"text\" name=\"form_fields[veterinary_address]\" id=\"veterinary_address\" class=\"form-control\" placeholder=\"Address\" required>\r\n            <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n        <label for=\"file\">Please upload medical records and images (such as laboratory reports, X-rays) in file format (PDF \/ JPG \/ ZIP), and the maximum limit for each file is 25MB.<\/label>\r\n        <input type=\"file\" name=\"form_fields[file][]\" id=\"file\" class=\"form-control\" multiple data-maxsize=\"25\" data-maxsize-message=\"This file exceeds the maximum allowed size.\">\r\n    <\/div>\r\n\r\n            <div class=\"form-group col-sm-12\">\r\n                <button type=\"submit\" class=\"btn btn-outline-secondary submitBtn\">Submit<\/button>\r\n            <\/div>\r\n        <input type=\"hidden\" name=\"trp-form-language\" value=\"en\"\/><\/div>\r\n    <\/form>\r\n<\/div>\r\n\r\n\r\n<style>\r\ninput[type=email], input[type=number], input[type=password], input[type=reset], input[type=search], input[type=tel], input[type=text], input[type=url], select, textarea {\r\n    padding: .75em;\r\n    border-width: 1px;\r\n    border-style: solid;\r\n    border-color: #eaeaea;\r\n    border-radius: 2px;\r\n    background: #fafafa;\r\n    box-shadow: none;\r\n    transition: all .2s linear;\r\n    max-width: 100%;\r\n    border: 1px solid #69727d;\r\n    background-color: transparent;\r\n    color: #1f2124;\r\n    vertical-align: middle;\r\n    flex-grow: 1;\r\n}\r\n\r\n.form-row, .desktop-form, .mobile-form {\r\n    width: 100%;\r\n    display: flex;\r\n    flex-direction: row;\r\n    flex-wrap: wrap;\r\n}\r\ntextarea {\r\n    font-family: \"Noto Sans TC\", Sans-serif;\r\n    font-weight: 300;\r\n}\r\n.form-group {\r\n    display: flex;\r\n    flex-direction: column;\r\n    flex-wrap: wrap;\r\n    padding-right: calc(10px \/ 2);\r\n    padding-left: calc(10px \/ 2);\r\n    justify-content: center;\r\n    margin-bottom: 10px;\r\n}\r\n.form-group.col-sm-6 {\r\n    width: 50%;\r\n}\r\n.form-group.col-sm-12 {\r\n    width: 100%;\r\n}\r\n.submitBtn {\r\n    background-color: var(--e-global-color-primary);\r\n    color: #ffffff;\r\n    min-height: 40px;\r\n    border-radius: 2px !important;\r\n}\r\ninput, .answerStyle {\r\n    display: inline;\r\n    font-family: \"Noto Sans TC\", Sans-serif;\r\n    font-size: 17px;\r\n    font-weight: 300;\r\n    line-height: 1.7em;\r\n}\r\n\r\n@media(max-width: 600px) {\r\n    .form-group.col-sm-6 {\r\n    width: 100%;\r\n}\r\n}\r\n<\/style><\/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>","protected":false},"excerpt":{"rendered":"<p>\u7378\u91ab\u53ef\u4e0b\u8f09\u500b\u6848\u6216\u5f71\u50cf\u8f49\u4ecb\u8868\u683c\uff0c\u5b8c\u6210\u5f8c\u96fb\u90f5\u7d66\u6211\u5011\u3002\u8acb\u63d0\u4f9b\u76f8\u95dc\u75c5\u6b77\u8a18\u9304\u4ee5\u4fbf\u6211\u5011\u76e1\u5feb\u5b89\u6392\u9810\u7d04\u53ca\u8acb\u76e1\u53ef\u80fd\u7528\u82f1\u6587\u586b\u5beb\u4e0b\u5217 &hellip;<\/p>\n<p class=\"read-more\"> <a class=\"\" href=\"https:\/\/amahvet.com.hk\/en\/referral\/\"> <span class=\"screen-reader-text\">Referral<\/span> Read More &raquo;<\/a><\/p>","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-8831","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/amahvet.com.hk\/en\/wp-json\/wp\/v2\/pages\/8831","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/amahvet.com.hk\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/amahvet.com.hk\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/amahvet.com.hk\/en\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/amahvet.com.hk\/en\/wp-json\/wp\/v2\/comments?post=8831"}],"version-history":[{"count":21,"href":"https:\/\/amahvet.com.hk\/en\/wp-json\/wp\/v2\/pages\/8831\/revisions"}],"predecessor-version":[{"id":8875,"href":"https:\/\/amahvet.com.hk\/en\/wp-json\/wp\/v2\/pages\/8831\/revisions\/8875"}],"wp:attachment":[{"href":"https:\/\/amahvet.com.hk\/en\/wp-json\/wp\/v2\/media?parent=8831"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}