{"id":533,"date":"2021-04-29T17:54:24","date_gmt":"2021-04-29T14:54:24","guid":{"rendered":"http:\/\/peyiagpsurgery.com\/?page_id=533"},"modified":"2021-04-29T20:39:50","modified_gmt":"2021-04-29T17:39:50","slug":"repeat-prescription","status":"publish","type":"page","link":"https:\/\/peyiagpsurgery.com\/el\/repeat-prescription\/","title":{"rendered":"\u0395\u03c0\u03b1\u03bd\u03b1\u03bb\u03b1\u03bc\u03b2\u03b1\u03bd\u03cc\u03bc\u03b5\u03bd\u03b7 \u03a3\u03c5\u03bd\u03c4\u03b1\u03b3\u03ae"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.9.4&#8243; _module_preset=&#8221;default&#8221; background_color=&#8221;#F9F9F9&#8243; custom_padding=&#8221;20px||20px||false|false&#8221;][et_pb_row _builder_version=&#8221;4.9.4&#8243; _module_preset=&#8221;default&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.9.4&#8243; _module_preset=&#8221;default&#8221;][et_pb_post_title meta=&#8221;off&#8221; featured_image=&#8221;off&#8221; title_last_edited=&#8221;off|desktop&#8221; meta_last_edited=&#8221;off|desktop&#8221; author_last_edited=&#8221;off|desktop&#8221; date_last_edited=&#8221;off|desktop&#8221; categories_last_edited=&#8221;off|desktop&#8221; comments_last_edited=&#8221;off|desktop&#8221; featured_image_last_edited=&#8221;off|desktop&#8221; _builder_version=&#8221;4.9.4&#8243; _module_preset=&#8221;default&#8221; title_font=&#8221;Ubuntu||||||||&#8221; title_text_color=&#8221;#0B3481&#8243; title_font_size=&#8221;1.8vw&#8221; meta_font=&#8221;Ubuntu||||||||&#8221; meta_text_color=&#8221;#587494&#8243; meta_font_size=&#8221;1.1vw&#8221; title_font_size_tablet=&#8221;24px&#8221; title_font_size_phone=&#8221;20px&#8221; title_font_size_last_edited=&#8221;on|phone&#8221; meta_font_size_tablet=&#8221;14px&#8221; meta_font_size_phone=&#8221;12px&#8221; meta_font_size_last_edited=&#8221;on|desktop&#8221; custom_css_post_image=&#8221;padding-top:20px;&#8221;][\/et_pb_post_title][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.9.4&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;0px||0px||false|false&#8221;][et_pb_row _builder_version=&#8221;4.9.4&#8243; _module_preset=&#8221;default&#8221; animation_style=&#8221;fade&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.9.4&#8243; _module_preset=&#8221;default&#8221;][et_pb_text _builder_version=&#8221;4.9.4&#8243; _module_preset=&#8221;default&#8221; header_2_font=&#8221;Ubuntu||||||||&#8221; header_2_text_color=&#8221;#0B3481&#8243; header_2_font_size=&#8221;1.6vw&#8221; header_3_font=&#8221;Ubuntu||||||||&#8221; header_3_text_color=&#8221;#FE9D24&#8243; header_3_font_size=&#8221;1.3vw&#8221; header_3_line_height=&#8221;1.1em&#8221; header_2_font_size_tablet=&#8221;20px&#8221; header_2_font_size_phone=&#8221;16px&#8221; header_2_font_size_last_edited=&#8221;on|phone&#8221; header_3_font_size_tablet=&#8221;16px&#8221; header_3_font_size_phone=&#8221;15px&#8221; header_3_font_size_last_edited=&#8221;on|tablet&#8221;]<\/p>\n<h2 style=\"text-align: center;\">For Repeat Prescriptions please select and complete the form below<\/h2>\n<h3 style=\"text-align: center;\">All fields MUST be completed<\/h3>\n<p>[\/et_pb_text][dsm_content_toggle heading_one=&#8221;GESY Prescription&#8221; content_type_one=&#8221;library&#8221; library_id_one=&#8221;557&#8243; heading_two=&#8221;Private Prescription&#8221; content_type_two=&#8221;library&#8221; library_id_two=&#8221;578&#8243; switcher_bg_primary=&#8221;#0B3481&#8243; switcher_inner_bg=&#8221;#FE9D24&#8243; _builder_version=&#8221;4.9.4&#8243; _module_preset=&#8221;default&#8221; width=&#8221;100%&#8221; max_width=&#8221;100%&#8221; custom_margin=&#8221;|0px||0px|false|false&#8221; custom_padding=&#8221;|0px||0px|false|false&#8221; hover_enabled=&#8221;0&#8243; heading_one_font_size_tablet=&#8221;&#8221; heading_one_font_size_phone=&#8221;12px&#8221; heading_one_font_size_last_edited=&#8221;on|phone&#8221; heading_two_font_size_tablet=&#8221;&#8221; heading_two_font_size_phone=&#8221;12px&#8221; heading_two_font_size_last_edited=&#8221;on|phone&#8221; switcher_bg_secondary=&#8221;#0B3481&#8243; sticky_enabled=&#8221;0&#8243;][\/dsm_content_toggle][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>For Repeat Prescriptions please select and complete the form below All fields MUST be completed<div class=\"et_pb_module dsm_content_toggle dsm_content_toggle_0\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<div class=\"et_pb_module_inner\">\n\t\t\t\t\t<div class=\"dsm-content-toggle\">\n\t\t\t\t<div class=\"dsm-content-toggle-header\">\n\t\t\t\t\t<div class=\"dsm-toggle\">\n\t\t\t\t\t\t<div class=\"dsm-toggle-left\">\n\t\t\t\t\t\t\t<h5 class=\"dsm-toggle-head-one\"><label for=\"dsm-input-0\">GESY Prescription<\/label><\/h5>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"dsm-toggle-btn\">\n\t\t\t\t\t\t\t<label class=\"dsm-switch-label\" for=\"dsm-input-0\">\n\t\t\t\t\t\t\t\t<input id=\"dsm-input-0\" class=\"dsm-input dsm-toggle-switch\" type=\"checkbox\"  \/>\n\t\t\t\t\t\t\t\t<span class=\"dsm-switch-inner\"><\/span>\n\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"dsm-toggle-right\">\n\t\t\t\t\t\t\t<h5 class=\"dsm-toggle-head-two\"><label for=\"dsm-input-0\">Private Prescription<\/label><\/h5>\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\t<div class=\"dsm-content-toggle-body\">\n\t\t\t\t\t<div class=\"dsm-content-toggle-front\">\n                    <div class=\"et_pb_row et_pb_row_0\">\n\t\t\t\t<div class=\"et_pb_column et_pb_column_4_4 et_pb_column_0  et_pb_css_mix_blend_mode_passthrough et-last-child\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<div class=\"et_pb_module et_pb_text et_pb_text_0  et_pb_text_align_left et_pb_bg_layout_light\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<div class=\"et_pb_text_inner\"><h2>\u0395\u03c0\u03b1\u03bd\u03b1\u03bb\u03b1\u03bc\u03b2\u03b1\u03bd\u03cc\u03bc\u03b5\u03bd\u03b7 \u03a3\u03c5\u03bd\u03c4\u03b1\u03b3\u03ae<\/h2>\n<p>GESY PATIENTS ONLY<\/p><\/div>\n\t\t\t<\/div><div class=\"et_pb_module et_pb_text et_pb_text_1  et_pb_text_align_left et_pb_bg_layout_light\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<div class=\"et_pb_text_inner\"><p><strong>IMPORTANT<\/strong><br \/>All fields below <strong><span style=\"text-decoration: underline;\">MUST<\/span><\/strong> be completed.\u00a0 Please list your requests in the following format:<\/p>\n<p><strong>Name of Medication<\/strong>\u00a0 \u00a0 <strong>Dosage<\/strong>\u00a0 \u00a0 \u00a0 \u00a0 <strong>Frequency<\/strong><br \/>Aspirin\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a075mg\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a01 per day<br \/>Panadol\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 500mg\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a04 per day<\/p>\n<p>Please note that we can only provide repeat prescriptions with no changes to medication. If you require new medication or changes in your current ones, you need to book in and see the GP<\/p><\/div>\n\t\t\t<\/div><div class=\"et_pb_module et_pb_text et_pb_text_2  et_pb_text_align_left et_pb_bg_layout_light\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<div class=\"et_pb_text_inner\"><p><strong>IMPORTANT<\/strong><br \/>All fields below <strong><span style=\"text-decoration: underline;\">MUST<\/span><\/strong> be completed.\u00a0 Please list your requests in the following format:<\/p>\n<p><strong>Medication<\/strong>\u00a0 <strong>Dosage<\/strong>\u00a0 \u00a0<strong>Frequency<\/strong><br \/>Aspirin\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a075mg\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a01 per day<br \/>Panadol\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 500mg\u00a0 \u00a0 \u00a0 \u00a0 \u00a04 per day<\/p>\n<p>Please note that we can only provide repeat prescriptions with no changes to medication. If you require new medication or changes in your current ones, you need to book in and see the GP<\/p><\/div>\n\t\t\t<\/div>\n\t\t\t<div id=\"et_pb_contact_form_0\" class=\"et_pb_module et_pb_contact_form_0 et_pb_contact_form_container clearfix\" data-form_unique_num=\"0\" data-form_unique_id=\"128815cd-da3d-4895-9e4e-d6c83e6c398e\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<h1 class=\"et_pb_contact_main_title\">Repeat Prescription GESY<\/h1>\n\t\t\t\t<div class=\"et-pb-contact-message\"><\/div>\n\t\t\t\t\n\t\t\t\t<div class=\"et_pb_contact\">\n\t\t\t\t\t<form class=\"et_pb_contact_form clearfix\" method=\"post\" action=\"https:\/\/peyiagpsurgery.com\/el\/wp-json\/wp\/v2\/pages\/533\" data-trp-original-action=\"https:\/\/peyiagpsurgery.com\/el\/wp-json\/wp\/v2\/pages\/533\">\n\t\t\t\t\t\t<p class=\"et_pb_contact_field et_pb_contact_field_0 et_pb_contact_field_half\" data-id=\"name\" data-type=\"input\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<label for=\"et_pb_contact_name_0\" class=\"et_pb_contact_form_label\">Full Name<\/label>\n\t\t\t\t<input type=\"text\" id=\"et_pb_contact_name_0\" class=\"input\" value=\"\" name=\"et_pb_contact_name_0\" data-required_mark=\"required\" data-field_type=\"input\" data-original_id=\"name\" placeholder=\"Full Name\">\n\t\t\t<\/p><p class=\"et_pb_contact_field et_pb_contact_field_1 et_pb_contact_field_half et_pb_contact_field_last\" data-id=\"telephone\" data-type=\"input\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<label for=\"et_pb_contact_telephone_0\" class=\"et_pb_contact_form_label\">Telephone<\/label>\n\t\t\t\t<input type=\"text\" id=\"et_pb_contact_telephone_0\" class=\"input\" value=\"\" name=\"et_pb_contact_telephone_0\" data-required_mark=\"required\" data-field_type=\"input\" data-original_id=\"telephone\" placeholder=\"Telephone\">\n\t\t\t<\/p><p class=\"et_pb_contact_field et_pb_contact_field_2 et_pb_contact_field_half\" data-id=\"email\" data-type=\"email\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<label for=\"et_pb_contact_email_0\" class=\"et_pb_contact_form_label\">Email Address<\/label>\n\t\t\t\t<input type=\"text\" id=\"et_pb_contact_email_0\" class=\"input\" value=\"\" name=\"et_pb_contact_email_0\" data-required_mark=\"required\" data-field_type=\"email\" data-original_id=\"email\" placeholder=\"Email Address\">\n\t\t\t<\/p><p class=\"et_pb_contact_field et_pb_contact_field_3 et_pb_contact_field_half et_pb_contact_field_last\" data-id=\"yellow_slip\" data-type=\"input\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<label for=\"et_pb_contact_yellow_slip_0\" class=\"et_pb_contact_form_label\">Yellow Slip Number<\/label>\n\t\t\t\t<input type=\"text\" id=\"et_pb_contact_yellow_slip_0\" class=\"input\" value=\"\" name=\"et_pb_contact_yellow_slip_0\" data-required_mark=\"required\" data-field_type=\"input\" data-original_id=\"yellow_slip\" placeholder=\"Yellow Slip Number\">\n\t\t\t<\/p><p class=\"et_pb_contact_field et_pb_contact_field_4 et_pb_contact_field_half\" data-id=\"type\" data-type=\"select\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<label for=\"et_pb_contact_type_0\" class=\"et_pb_contact_form_label\">Type of Prescription<\/label>\n\t\t\t\t<select id=\"et_pb_contact_type_0\" class=\"et_pb_contact_select input\" name=\"et_pb_contact_type_0\" data-required_mark=\"required\" data-field_type=\"select\" data-original_id=\"type\">\n\t\t\t\t\t\t<option value=\"\">Type of Prescription<\/option><option value=\"Hard Copy (Collect from Surgery)\">Hard Copy (Collect from Surgery)<\/option><option value=\"Electronic Copy (emailed to you)\">Electronic Copy (emailed to you)<\/option>\n\t\t\t\t\t<\/select>\n\t\t\t<\/p><p class=\"et_pb_contact_field et_pb_contact_field_5 et_pb_contact_field_last\" data-id=\"prescription\" data-type=\"text\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<label for=\"et_pb_contact_prescription_0\" class=\"et_pb_contact_form_label\">Your Request: Medication, Dosage (mg), Frequency (1,2,3 per day) - one request per line<\/label>\n\t\t\t\t<textarea name=\"et_pb_contact_prescription_0\" id=\"et_pb_contact_prescription_0\" class=\"et_pb_contact_message input\" data-required_mark=\"required\" data-field_type=\"text\" data-original_id=\"prescription\" placeholder=\"Your Request: Medication, Dosage (mg), Frequency (1,2,3 per day) - one request per line\"><\/textarea>\n\t\t\t<\/p>\n\t\t\t\t\t\t<input type=\"hidden\" value=\"et_contact_proccess\" name=\"et_pb_contactform_submit_0\"\/>\n\t\t\t\t\t\t<div class=\"et_contact_bottom_container\">\n\t\t\t\t\t\t\t\n\t\t\t<div class=\"et_pb_contact_right\">\n\t\t\t\t<p class=\"clearfix\">\n\t\t\t\t\t<span class=\"et_pb_contact_captcha_question\">4 + 5<\/span> = <input type=\"text\" size=\"2\" class=\"input et_pb_contact_captcha\" data-first_digit=\"4\" data-second_digit=\"5\" value=\"\" name=\"et_pb_contact_captcha_0\" data-required_mark=\"required\" autocomplete=\"off\">\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<button type=\"submit\" name=\"et_builder_submit_button\" class=\"et_pb_contact_submit et_pb_button\">Send Request<\/button>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" id=\"_wpnonce-et-pb-contact-form-submitted-0\" name=\"_wpnonce-et-pb-contact-form-submitted-0\" value=\"86edb61c93\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/el\/wp-json\/wp\/v2\/pages\/533\" \/>\n\t\t\t\t\t<input type=\"hidden\" name=\"trp-form-language\" value=\"el\"\/><\/form>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\n\t\t\t<\/div>\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t<\/div>\n                <\/div> <div class=\"dsm-content-toggle-back\" style=\"display: none\">\n                    <div class=\"et_pb_row et_pb_row_1\">\n\t\t\t\t<div class=\"et_pb_column et_pb_column_4_4 et_pb_column_1  et_pb_css_mix_blend_mode_passthrough et-last-child\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<div class=\"et_pb_module et_pb_text et_pb_text_3  et_pb_text_align_left et_pb_bg_layout_light\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<div class=\"et_pb_text_inner\"><h2>\u0395\u03c0\u03b1\u03bd\u03b1\u03bb\u03b1\u03bc\u03b2\u03b1\u03bd\u03cc\u03bc\u03b5\u03bd\u03b7 \u03a3\u03c5\u03bd\u03c4\u03b1\u03b3\u03ae<\/h2>\n<p>PRIVATE PATIENTS ONLY<\/p><\/div>\n\t\t\t<\/div><div class=\"et_pb_module et_pb_text et_pb_text_4  et_pb_text_align_left et_pb_bg_layout_light\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<div class=\"et_pb_text_inner\"><p><strong>IMPORTANT<\/strong><br \/>All fields below <strong><span style=\"text-decoration: underline;\">MUST<\/span><\/strong> be completed.\u00a0 Please list your requests in the following format:<\/p>\n<p><strong>Name of Medication<\/strong>\u00a0 \u00a0 <strong>Dosage<\/strong>\u00a0 \u00a0 \u00a0 \u00a0 <strong>Frequency<\/strong><br \/>Aspirin\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a075mg\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a01 per day<br \/>Panadol\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 500mg\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a04 per day<\/p>\n<p>Please note that we can only provide repeat prescriptions with no changes to medication. If you require new medication or changes in your current ones, you need to book in and see the GP<\/p>\n<p>The <strong>fee<\/strong>\u00a0for issuing patients with a\u00a0<strong>private prescription is\u00a0<\/strong><strong>\u20ac10<\/strong><\/p><\/div>\n\t\t\t<\/div><div class=\"et_pb_module et_pb_text et_pb_text_5  et_pb_text_align_left et_pb_bg_layout_light\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<div class=\"et_pb_text_inner\"><p><strong>IMPORTANT<\/strong><br \/>All fields below <strong><span style=\"text-decoration: underline;\">MUST<\/span><\/strong> be completed.\u00a0 Please list your requests in the following format:<\/p>\n<p><strong>Medication<\/strong>\u00a0 <strong>Dosage<\/strong>\u00a0 \u00a0<strong>Frequency<\/strong><br \/>Aspirin\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a075mg\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a01 per day<br \/>Panadol\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 500mg\u00a0 \u00a0 \u00a0 \u00a0 \u00a04 per day<\/p>\n<p>Please note that we can only provide repeat prescriptions with no changes to medication. If you require new medication or changes in your current ones, you need to book in and see the GP<\/p>\n<p>The <strong>fee<\/strong>\u00a0for issuing patients with a\u00a0<strong>private prescription is\u00a0<\/strong><strong>\u20ac10<\/strong><\/p><\/div>\n\t\t\t<\/div>\n\t\t\t<div id=\"et_pb_contact_form_1\" class=\"et_pb_module et_pb_contact_form_1 et_pb_contact_form_container clearfix\" data-form_unique_num=\"1\" data-form_unique_id=\"2787112f-b476-4bf4-8c51-c475828cb483\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<h1 class=\"et_pb_contact_main_title\">Repeat Prescription PRIVATE<\/h1>\n\t\t\t\t<div class=\"et-pb-contact-message\"><\/div>\n\t\t\t\t\n\t\t\t\t<div class=\"et_pb_contact\">\n\t\t\t\t\t<form class=\"et_pb_contact_form clearfix\" method=\"post\" action=\"https:\/\/peyiagpsurgery.com\/el\/wp-json\/wp\/v2\/pages\/533\" data-trp-original-action=\"https:\/\/peyiagpsurgery.com\/el\/wp-json\/wp\/v2\/pages\/533\">\n\t\t\t\t\t\t<p class=\"et_pb_contact_field et_pb_contact_field_6 et_pb_contact_field_half\" data-id=\"name\" data-type=\"input\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<label for=\"et_pb_contact_name_1\" class=\"et_pb_contact_form_label\">Full Name<\/label>\n\t\t\t\t<input type=\"text\" id=\"et_pb_contact_name_1\" class=\"input\" value=\"\" name=\"et_pb_contact_name_1\" data-required_mark=\"required\" data-field_type=\"input\" data-original_id=\"name\" placeholder=\"Full Name\">\n\t\t\t<\/p><p class=\"et_pb_contact_field et_pb_contact_field_7 et_pb_contact_field_half et_pb_contact_field_last\" data-id=\"telephone\" data-type=\"input\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<label for=\"et_pb_contact_telephone_1\" class=\"et_pb_contact_form_label\">Telephone<\/label>\n\t\t\t\t<input type=\"text\" id=\"et_pb_contact_telephone_1\" class=\"input\" value=\"\" name=\"et_pb_contact_telephone_1\" data-required_mark=\"required\" data-field_type=\"input\" data-original_id=\"telephone\" placeholder=\"Telephone\">\n\t\t\t<\/p><p class=\"et_pb_contact_field et_pb_contact_field_8 et_pb_contact_field_half\" data-id=\"email\" data-type=\"email\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<label for=\"et_pb_contact_email_1\" class=\"et_pb_contact_form_label\">Email Address<\/label>\n\t\t\t\t<input type=\"text\" id=\"et_pb_contact_email_1\" class=\"input\" value=\"\" name=\"et_pb_contact_email_1\" data-required_mark=\"required\" data-field_type=\"email\" data-original_id=\"email\" placeholder=\"Email Address\">\n\t\t\t<\/p><p class=\"et_pb_contact_field et_pb_contact_field_9 et_pb_contact_field_half et_pb_contact_field_last\" data-id=\"yellow_slip\" data-type=\"input\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<label for=\"et_pb_contact_yellow_slip_1\" class=\"et_pb_contact_form_label\">Yellow Slip Number<\/label>\n\t\t\t\t<input type=\"text\" id=\"et_pb_contact_yellow_slip_1\" class=\"input\" value=\"\" name=\"et_pb_contact_yellow_slip_1\" data-required_mark=\"required\" data-field_type=\"input\" data-original_id=\"yellow_slip\" placeholder=\"Yellow Slip Number\">\n\t\t\t<\/p><p class=\"et_pb_contact_field et_pb_contact_field_10 et_pb_contact_field_half\" data-id=\"dob\" data-type=\"input\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<label for=\"et_pb_contact_dob_1\" class=\"et_pb_contact_form_label\">Date Of Birth (DD\/MM\/YYYY)<\/label>\n\t\t\t\t<input type=\"text\" id=\"et_pb_contact_dob_1\" class=\"input\" value=\"\" name=\"et_pb_contact_dob_1\" data-required_mark=\"required\" data-field_type=\"input\" data-original_id=\"dob\" placeholder=\"Date Of Birth (DD\/MM\/YYYY)\">\n\t\t\t<\/p><p class=\"et_pb_contact_field et_pb_contact_field_11 et_pb_contact_field_half et_pb_contact_field_last\" data-id=\"type\" data-type=\"select\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<label for=\"et_pb_contact_type_1\" class=\"et_pb_contact_form_label\">Type of Prescription<\/label>\n\t\t\t\t<select id=\"et_pb_contact_type_1\" class=\"et_pb_contact_select input\" name=\"et_pb_contact_type_1\" data-required_mark=\"required\" data-field_type=\"select\" data-original_id=\"type\">\n\t\t\t\t\t\t<option value=\"\">Type of Prescription<\/option><option value=\"Hard Copy (Collect from Surgery)\">Hard Copy (Collect from Surgery)<\/option><option value=\"Electronic Copy (emailed to you)\">Electronic Copy (emailed to you)<\/option>\n\t\t\t\t\t<\/select>\n\t\t\t<\/p><p class=\"et_pb_contact_field et_pb_contact_field_12 et_pb_contact_field_last\" data-id=\"prescription\" data-type=\"text\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<label for=\"et_pb_contact_prescription_1\" class=\"et_pb_contact_form_label\">Your Request: Medication, Dosage (mg), Frequency (1,2,3 per day) - one request per line<\/label>\n\t\t\t\t<textarea name=\"et_pb_contact_prescription_1\" id=\"et_pb_contact_prescription_1\" class=\"et_pb_contact_message input\" data-required_mark=\"required\" data-field_type=\"text\" data-original_id=\"prescription\" placeholder=\"Your Request: Medication, Dosage (mg), Frequency (1,2,3 per day) - one request per line\"><\/textarea>\n\t\t\t<\/p>\n\t\t\t\t\t\t<input type=\"hidden\" value=\"et_contact_proccess\" name=\"et_pb_contactform_submit_1\"\/>\n\t\t\t\t\t\t<div class=\"et_contact_bottom_container\">\n\t\t\t\t\t\t\t\n\t\t\t<div class=\"et_pb_contact_right\">\n\t\t\t\t<p class=\"clearfix\">\n\t\t\t\t\t<span class=\"et_pb_contact_captcha_question\">5 + 7<\/span> = <input type=\"text\" size=\"2\" class=\"input et_pb_contact_captcha\" data-first_digit=\"5\" data-second_digit=\"7\" value=\"\" name=\"et_pb_contact_captcha_1\" data-required_mark=\"required\" autocomplete=\"off\">\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<button type=\"submit\" name=\"et_builder_submit_button\" class=\"et_pb_contact_submit et_pb_button\">Send Request<\/button>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" id=\"_wpnonce-et-pb-contact-form-submitted-1\" name=\"_wpnonce-et-pb-contact-form-submitted-1\" value=\"86edb61c93\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/el\/wp-json\/wp\/v2\/pages\/533\" \/>\n\t\t\t\t\t<input type=\"hidden\" name=\"trp-form-language\" value=\"el\"\/><\/form>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\n\t\t\t<\/div>\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t<\/div>\n                <\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"class_list":["post-533","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - 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