{"id":1490,"date":"2021-12-03T14:28:56","date_gmt":"2021-12-03T14:28:56","guid":{"rendered":"http:\/\/www.phronema.it\/new\/?page_id=1490"},"modified":"2021-12-15T07:45:55","modified_gmt":"2021-12-15T07:45:55","slug":"ipcl-form","status":"publish","type":"page","link":"http:\/\/www.phronema.it\/new\/ipcl-form\/","title":{"rendered":"IPCL FORM"},"content":{"rendered":"<div  data-label=\"Overlappable\" data-id=\"overlappable--1\" data-export-id=\"overlappable-4\" data-category=\"overlappable\" class=\"overlappable-4 content-section content-section-spacing\" data-overlap=\"true\" id=\"overlappable-1\" style=\"background-color: rgb(255, 255, 255);\"><div  class=\"gridContainer\"> <div  data-type=\"row\" class=\"row spaced-cols text-center\"><div  class=\"col-xs-12 col-sm-4 col-padding\"> <a data-cp-link=\"1\" href=\"#contact-1\" target=\"_self\" rel=\"noopener\"><i  class=\"fa icon shadow-large-black aligncenter fa-eye reverse round large color1\"><\/i><\/a> <div  data-type=\"column\" class=\"\"> <h5  class=\"\">IPCL<\/h5> <p  class=\"\">Fill all&nbsp; (*)&nbsp; fields&nbsp;<\/p><\/div> <\/div> <div  class=\"col-xs-12 col-sm-4 col-padding\"> <i  class=\"fa icon shadow-large-black aligncenter fa-eye reverse round large color4\"><\/i> <div  data-type=\"column\" class=\"\"><h5  class=\"\">IPCLT<\/h5> <p  class=\"\">Fill all  (*)  fields<\/p><\/div> <\/div> <div  class=\"col-xs-12 col-sm-4 col-padding\"> <i  class=\"fa icon shadow-large-black aligncenter fa-eye reverse round large color7\"><\/i> <div  data-type=\"column\" class=\"\"><h5  class=\"\">IPCLTD<\/h5> <p  class=\"\">Fill all (*) fields<\/p><\/div> <\/div><\/div> <\/div><\/div><div  data-label=\"Contact\" data-id=\"contact--1\" data-export-id=\"contact-1\" data-category=\"contact\" class=\"contact-1 content-section content-section-spacing white-text content-relative\" data-parallax-depth=\"20\" id=\"contact-1\" style=\"background-color: rgb(255, 255, 255); background-size: cover; background-position: center top; background-image: none;\" data-section-ov=\"1\"><div  class=\"section-separator-top\">\n    <svg  xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 700 10\" preserveAspectRatio=\"none\" data-separator-name=\"arrow-negative\" class=\"section-separator-top\">\n\t<path  class=\"svg-white-bg\" d=\"M360 0L350 9.9 340 0 0 0 0 10 700 10 700 0\"><\/path>\n<\/svg>\n<\/div><div  class=\"gridContainer\"> <div  class=\"row text-center\"><div  class=\"section-title-col\" data-type=\"column\"> <h2  class=\"\">Contact us<\/h2> <p  class=\"lead\">With the Internet spreading linke wildfire and reaching every part of our daily life, more and more traffic is directed to websites in search for information.<\/p><\/div> <\/div> <div  class=\"row text-center\"> <div  class=\"col-xs-12 col-sm-8 col-sm-offset-2 contact-form-wrapper inline-info\"> <div  class=\"card large-padding\"> <div  class=\"\" data-content-shortcode=\"mesmerize_contact_form shortcode=&quot;contact-form-7 id=&amp;amp;quot;1330&amp;amp;quot; title=&amp;amp;quot;IPCL form&amp;amp;quot;&quot;\" data-editable=\"true\"><div role=\"form\" class=\"wpcf7\" id=\"wpcf7-f1330-o1\" lang=\"en-GB\" dir=\"ltr\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/new\/wp-json\/wp\/v2\/pages\/1490#wpcf7-f1330-o1\" method=\"post\" class=\"wpcf7-form init cf7-style ipcl-form\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"1330\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"5.5.1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_GB\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f1330-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/div>\n<div id=\"responsive-form\" class=\"clearfix\">\n<div class=\"form-row\">\n<div class=\"column-full\">\n<label> INFORMATION<\/label>\n<\/div>\n<\/div>\n<div class=\"form-row\">\n<div class=\"column-full\"> <span class=\"wpcf7-form-control-wrap text-446\"><input type=\"text\" name=\"text-446\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Surgeon Name \/ Nome Chirurgo\" \/><\/span> <\/div>\n<div class=\"column-half\"> <span class=\"wpcf7-form-control-wrap text-315\"><input type=\"text\" name=\"text-315\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Telephone No.\" \/><\/span><\/div>\n<div class=\"column-half\"><span class=\"wpcf7-form-control-wrap email-870\"><input type=\"email\" name=\"email-870\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-email wpcf7-validates-as-required wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"E-mail\" \/><\/span><\/div>\n<div class=\"column-full\"><span class=\"wpcf7-form-control-wrap text-346\"><input type=\"text\" name=\"text-346\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Patient&#039;s code\" \/><\/span> <\/div>\n<\/div>\n<div class=\"form-row\">\n<div class=\"column-full\"><label> OD EYE \/ SELEZIONA OCCHIO <\/label><\/div>\n<div class=\"column-half\"><label>  <span class=\"wpcf7-form-control-wrap menu-639\"><select name=\"menu-639\" class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\"><option value=\"\">---<\/option><option value=\"OD RIGHT EYE\">OD RIGHT EYE<\/option><option value=\"OS LEFT EYE\">OS LEFT EYE<\/option><\/select><\/span><\/label><\/div>\n<\/div>\n<div class=\"form-row\">\n<div class=\"column-full\">\n  <label style=\"font-size: 10px\" >Refraction\/Refrazione <\/label> <\/div>\n<div class=\"column-4\"><span class=\"wpcf7-form-control-wrap text-414\"><input type=\"text\" name=\"text-414\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Sphere \/ Sfera\" \/><\/span><\/div>\n<div class=\"column-4\"><span class=\"wpcf7-form-control-wrap text-226\"><input type=\"text\" name=\"text-226\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Cylinder \/ Cilindro\" \/><\/span><\/div>\n<div class=\"column-4\"> <span class=\"wpcf7-form-control-wrap text-101\"><input type=\"text\" name=\"text-101\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Axis\/ Asse (\u00b0)\" \/><\/span><\/div>\n<div class=\"column-4\"><span class=\"wpcf7-form-control-wrap text-787\"><input type=\"text\" name=\"text-787\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Add( D)\" \/><\/span><\/div>\n<\/div>\n<div class=\"form-row\">\n<div class=\"column-full\">\n  <label style=\"font-size: 10px\" >Cyclopegic Ref. \/ Ciclopegica Ref. <\/label> <\/div>\n<div class=\"column-3\"> <span class=\"wpcf7-form-control-wrap text-838\"><input type=\"text\" name=\"text-838\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Sphere \/ Sfera (D)\" \/><\/span><\/div>\n<div class=\"column-3\"><span class=\"wpcf7-form-control-wrap text-935\"><input type=\"text\" name=\"text-935\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Cylinder \/ Cilindro (D)\" \/><\/span>  <\/div>\n<div class=\"column-3\"> <span class=\"wpcf7-form-control-wrap text-583\"><input type=\"text\" name=\"text-583\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Axis\/ Asse (\u00b0)\" \/><\/span> <\/div>\n<\/div>\n<div class=\"form-row\">\n<div class=\"column-full\">\n  <label style=\"font-size: 10px\" >W to W \/ Biano Bianco <\/label> <\/div>\n<div class=\"column-4\"><span class=\"wpcf7-form-control-wrap text-584\"><input type=\"text\" name=\"text-584\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Dig. Caliper \/ Calibro dig.\" \/><\/span> <\/div>\n<div class=\"column-4\"><span class=\"wpcf7-form-control-wrap text-113\"><input type=\"text\" name=\"text-113\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Topog.\" \/><\/span>  <\/div>\n<div class=\"column-4\"> <span class=\"wpcf7-form-control-wrap text-914\"><input type=\"text\" name=\"text-914\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Optical \/ Ottico\" \/><\/span> <\/div>\n<div class=\"column-4\"><span class=\"wpcf7-form-control-wrap text-861\"><input type=\"text\" name=\"text-861\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"IOL Mast.\" \/><\/span>  <\/div>\n<\/div>\n<div class=\"form-row\">\n<div class=\"column-full\">\n  <label style=\"font-size: 10px\" >Pachymetry and ACD \/ Biano Bianco <\/label> <\/div>\n<div class=\"column-half\">  <span class=\"wpcf7-form-control-wrap text-439\"><input type=\"text\" name=\"text-439\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Pachymetry \/ Pachimetria (micron)\" \/><\/span><\/div>\n<div class=\"column-half\">  <span class=\"wpcf7-form-control-wrap text-937\"><input type=\"text\" name=\"text-937\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"ACD from endot. (mm)\" \/><\/span><\/div>\n<\/div>\n<div class=\"form-row\">\n<div class=\"column-full\">\n  <label style=\"font-size: 10px\" >Keratometry \/ Cheratometria <\/label> <\/div>\n<div class=\"column-half\">   <span class=\"wpcf7-form-control-wrap text-406\"><input type=\"text\" name=\"text-406\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"K1\" \/><\/span><\/div>\n<div class=\"column-half\">  <span class=\"wpcf7-form-control-wrap text-965\"><input type=\"text\" name=\"text-965\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Axis\/ Asse (\u00b0)\" \/><\/span> <\/div>\n<\/div>\n<div class=\"column-half\">  <span class=\"wpcf7-form-control-wrap text-657\"><input type=\"text\" name=\"text-657\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"K2\" \/><\/span>  <\/div>\n<div class=\"column-half\">   <span class=\"wpcf7-form-control-wrap text-568\"><input type=\"text\" name=\"text-568\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Axis\/ Asse (\u00b0)\" \/><\/span> <\/div>\n<div class=\"form-row\">\n<div class=\"column-full\">\n  <label style=\"font-size: 10px\" >Axial Legth \/ Lunghezza assiale <\/label> <\/div>\n<div class=\"column-half\"> <span class=\"wpcf7-form-control-wrap text-625\"><input type=\"text\" name=\"text-625\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Optical \/ Ottico\" \/><\/span>   <\/div>\n<div class=\"column-half\">   <\/div>\n<\/div>\n<p><input type=\"submit\" value=\"Send\" class=\"wpcf7-form-control has-spinner wpcf7-submit\" \/><\/p>\n<\/div>\n<div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div><\/form><\/div><\/div><\/div> <\/div><\/div> <\/div><\/div><div  data-label=\"Contact\" data-id=\"contact--2\" data-export-id=\"contact-1\" data-category=\"contact\" class=\"contact-1 content-section content-section-spacing white-text content-relative\" data-parallax-depth=\"20\" id=\"contact-2\" style=\"background-color: rgb(255, 255, 255); background-size: cover; background-position: center top; background-image: none;\" data-section-ov=\"1\"><div  class=\"section-separator-top\">\n    <svg  xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 700 10\" preserveAspectRatio=\"none\" data-separator-name=\"arrow-negative\" class=\"section-separator-top\">\n\t<path  class=\"svg-white-bg\" d=\"M360 0L350 9.9 340 0 0 0 0 10 700 10 700 0\"><\/path>\n<\/svg>\n<\/div><div  class=\"gridContainer\"> <div  class=\"row text-center\"><div  class=\"section-title-col\" data-type=\"column\"> <h2  class=\"\">Contact us<\/h2> <p  class=\"lead\">With the Internet spreading linke wildfire and reaching every part of our daily life, more and more traffic is directed to websites in search for information.<\/p><\/div> <\/div> <div  class=\"row text-center\"> <div  class=\"col-xs-12 col-sm-8 col-sm-offset-2 contact-form-wrapper inline-info\"> <div  class=\"card large-padding\"> <div  class=\"\" data-content-shortcode=\"mesmerize_contact_form\" data-editable=\"true\"><p style=\"text-align:center;color:#ababab\">Contact form will be displayed here. To activate it you have to set the \"contact form shortcode\" parameter in Customizer.<\/p><\/div><\/div> <\/div><\/div> <\/div><\/div><div  data-label=\"Contact\" data-id=\"contact--3\" data-export-id=\"contact-1\" data-category=\"contact\" class=\"contact-1 content-section content-section-spacing white-text content-relative\" data-parallax-depth=\"20\" id=\"contact-3\" style=\"background-color: rgb(255, 255, 255); background-size: cover; background-position: center top; background-image: none;\" data-section-ov=\"1\"><div  class=\"section-separator-top\">\n    <svg  xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 700 10\" preserveAspectRatio=\"none\" data-separator-name=\"arrow-negative\" class=\"section-separator-top\">\n\t<path  class=\"svg-white-bg\" d=\"M360 0L350 9.9 340 0 0 0 0 10 700 10 700 0\"><\/path>\n<\/svg>\n<\/div><div  class=\"gridContainer\"> <div  class=\"row text-center\"><div  class=\"section-title-col\" data-type=\"column\"> <h2  class=\"\">Contact us<\/h2> <p  class=\"lead\">With the Internet spreading linke wildfire and reaching every part of our daily life, more and more traffic is directed to websites in search for information.<\/p><\/div> <\/div> <div  class=\"row text-center\"> <div  class=\"col-xs-12 col-sm-8 col-sm-offset-2 contact-form-wrapper inline-info\"> <div  class=\"card large-padding\"> <div  class=\"\" data-content-shortcode=\"mesmerize_contact_form\" data-editable=\"true\"><p style=\"text-align:center;color:#ababab\">Contact form will be displayed here. To activate it you have to set the \"contact form shortcode\" parameter in Customizer.<\/p><\/div><\/div> <\/div><\/div> <\/div><\/div>","protected":false},"excerpt":{"rendered":"<p>IPCL Fill all&nbsp; (*)&nbsp; fields&nbsp; IPCLT Fill all (*) fields IPCLTD Fill all (*) fields Contact us With the Internet spreading linke wildfire and reaching every part of our daily life, more and more traffic is directed to websites in search for information. Contact us With the Internet spreading linke wildfire and reaching every part&hellip; <br \/> <a class=\"read-more\" href=\"http:\/\/www.phronema.it\/new\/ipcl-form\/\">Read more<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"pro\/page-templates\/full-width-page.php","meta":[],"_links":{"self":[{"href":"http:\/\/www.phronema.it\/new\/wp-json\/wp\/v2\/pages\/1490"}],"collection":[{"href":"http:\/\/www.phronema.it\/new\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/www.phronema.it\/new\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/www.phronema.it\/new\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.phronema.it\/new\/wp-json\/wp\/v2\/comments?post=1490"}],"version-history":[{"count":6,"href":"http:\/\/www.phronema.it\/new\/wp-json\/wp\/v2\/pages\/1490\/revisions"}],"predecessor-version":[{"id":1503,"href":"http:\/\/www.phronema.it\/new\/wp-json\/wp\/v2\/pages\/1490\/revisions\/1503"}],"wp:attachment":[{"href":"http:\/\/www.phronema.it\/new\/wp-json\/wp\/v2\/media?parent=1490"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}