{"id":3268,"date":"2022-09-28T16:44:05","date_gmt":"2022-09-28T20:44:05","guid":{"rendered":"https:\/\/cliniquedentaireboca.ca\/?page_id=3268"},"modified":"2022-10-13T14:37:18","modified_gmt":"2022-10-13T18:37:18","slug":"patients-corner","status":"publish","type":"page","link":"https:\/\/cliniquedentaireboca.ca\/en\/patients-corner\/","title":{"rendered":"Patients&#8217; corner"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"3268\" class=\"elementor elementor-3268 elementor-952\">\n\t\t\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-7d5ca7f elementor-section-full_width elementor-section-height-min-height elementor-section-height-default elementor-section-items-middle\" data-id=\"7d5ca7f\" data-element_type=\"section\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[],&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\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-fdd690e\" data-id=\"fdd690e\" 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-b55c946 elementor-widget elementor-widget-heading\" data-id=\"b55c946\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Patients' corner<\/h1>\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-5cb9c8d pv100 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"5cb9c8d\" data-element_type=\"section\" id=\"questionnaire\" data-settings=\"{&quot;jet_parallax_layout_list&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-6dd210f\" data-id=\"6dd210f\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6cff76b elementor-widget elementor-widget-heading\" data-id=\"6cff76b\" 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\">Confidential Medical-Dental<br> Questionnaire<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-45a8828 elementor-widget elementor-widget-text-editor\" data-id=\"45a8828\" 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>The dental record is established as part of the care that will be provided: it is protected by law and professional secrecy. It is kept in the office and only the dentist and his staff have access to it. The patient also has the right of access and rectification. This questionnaire will allow the dentist and his staff to provide the best possible care and reduce the risk of medical complications. It is in the patient\u2019s interest to respond carefully and to inform the dentist of any changes in his or her health.<\/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-6914008 medico-form elementor-widget elementor-widget-wp-widget-gform_widget\" data-id=\"6914008\" data-element_type=\"widget\" data-widget_type=\"wp-widget-gform_widget.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<div class=\"jupiterx-widget widget_gform_widget\"><div class=\"jupiterx-widget-content\"><link rel='stylesheet' id='gform_basic-css' href='https:\/\/cliniquedentaireboca.ca\/wp-content\/plugins\/gravityforms\/assets\/css\/dist\/basic.min.css?ver=2.6.8' type='text\/css' media='all' \/>\n<link rel='stylesheet' id='gform_theme_components-css' href='https:\/\/cliniquedentaireboca.ca\/wp-content\/plugins\/gravityforms\/assets\/css\/dist\/theme-components.min.css?ver=2.6.8' type='text\/css' media='all' \/>\n<link rel='stylesheet' id='gform_theme_ie11-css' href='https:\/\/cliniquedentaireboca.ca\/wp-content\/plugins\/gravityforms\/assets\/css\/dist\/theme-ie11.min.css?ver=2.6.8' type='text\/css' media='all' \/>\n<link rel='stylesheet' id='gform_theme-css' href='https:\/\/cliniquedentaireboca.ca\/wp-content\/plugins\/gravityforms\/assets\/css\/dist\/theme.min.css?ver=2.6.8' type='text\/css' media='all' \/>\n<script type='text\/javascript' src='https:\/\/cliniquedentaireboca.ca\/wp-includes\/js\/dist\/vendor\/regenerator-runtime.min.js?ver=0.13.9' id='regenerator-runtime-js'><\/script>\n<script type='text\/javascript' src='https:\/\/cliniquedentaireboca.ca\/wp-includes\/js\/dist\/vendor\/wp-polyfill.min.js?ver=3.15.0' id='wp-polyfill-js'><\/script>\n<script type='text\/javascript' src='https:\/\/cliniquedentaireboca.ca\/wp-includes\/js\/dist\/dom-ready.min.js?ver=392bdd43726760d1f3ca' id='wp-dom-ready-js'><\/script>\n<script type='text\/javascript' src='https:\/\/cliniquedentaireboca.ca\/wp-includes\/js\/dist\/hooks.min.js?ver=4169d3cf8e8d95a3d6d5' id='wp-hooks-js'><\/script>\n<script type='text\/javascript' src='https:\/\/cliniquedentaireboca.ca\/wp-includes\/js\/dist\/i18n.min.js?ver=9e794f35a71bb98672ae' id='wp-i18n-js'><\/script>\n<script type='text\/javascript' id='wp-i18n-js-after'>\nwp.i18n.setLocaleData( { 'text direction\\u0004ltr': [ 'ltr' ] } );\n<\/script>\n<script type='text\/javascript' id='wp-a11y-js-translations'>\n( function( domain, translations ) {\n\tvar localeData = translations.locale_data[ domain ] || translations.locale_data.messages;\n\tlocaleData[\"\"].domain = domain;\n\twp.i18n.setLocaleData( localeData, domain );\n} )( \"default\", {\"translation-revision-date\":\"2026-03-27 20:44:37+0000\",\"generator\":\"GlotPress\\\/4.0.3\",\"domain\":\"messages\",\"locale_data\":{\"messages\":{\"\":{\"domain\":\"messages\",\"plural-forms\":\"nplurals=2; plural=n != 1;\",\"lang\":\"en_CA\"},\"Notifications\":[\"Notifications\"]}},\"comment\":{\"reference\":\"wp-includes\\\/js\\\/dist\\\/a11y.js\"}} );\n<\/script>\n<script type='text\/javascript' src='https:\/\/cliniquedentaireboca.ca\/wp-includes\/js\/dist\/a11y.min.js?ver=ecce20f002eda4c19664' id='wp-a11y-js'><\/script>\n<script type='text\/javascript' src='https:\/\/cliniquedentaireboca.ca\/wp-includes\/js\/jquery\/jquery.min.js?ver=3.6.1' id='jquery-core-js'><\/script>\n<script type='text\/javascript' src='https:\/\/cliniquedentaireboca.ca\/wp-includes\/js\/jquery\/jquery-migrate.min.js?ver=3.3.2' id='jquery-migrate-js'><\/script>\n<script type='text\/javascript' defer='defer' src='https:\/\/cliniquedentaireboca.ca\/wp-content\/plugins\/gravityforms\/js\/jquery.json.min.js?ver=2.6.8' id='gform_json-js'><\/script>\n<script type='text\/javascript' id='gform_gravityforms-js-extra'>\n\/* <![CDATA[ *\/\nvar gf_global = {\"gf_currency_config\":{\"name\":\"Canadian Dollar\",\"symbol_left\":\"$\",\"symbol_right\":\"CAD\",\"symbol_padding\":\" \",\"thousand_separator\":\",\",\"decimal_separator\":\".\",\"decimals\":2,\"code\":\"CAD\"},\"base_url\":\"https:\\\/\\\/cliniquedentaireboca.ca\\\/wp-content\\\/plugins\\\/gravityforms\",\"number_formats\":[],\"spinnerUrl\":\"https:\\\/\\\/cliniquedentaireboca.ca\\\/wp-content\\\/plugins\\\/gravityforms\\\/images\\\/spinner.svg\",\"strings\":{\"newRowAdded\":\"New row added.\",\"rowRemoved\":\"Row removed\",\"formSaved\":\"The form has been saved.  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gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_gecko gform_wrapper gravity-theme' id='gform_wrapper_9' style='display:none'><div id='gf_9' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_9' id='gform_9'  action='\/en\/wp-json\/wp\/v2\/pages\/3268#gf_9' ><div id='gf_page_steps_9' class='gf_page_steps'><div id='gf_step_9_1' class='gf_step gf_step_active gf_step_first'><span class='gf_step_number'>1<\/span><span class='gf_step_label'>Personal information<\/span><\/div><div id='gf_step_9_2' class='gf_step gf_step_next gf_step_pending'><span class='gf_step_number'>2<\/span><span class='gf_step_label'>Contact information<\/span><\/div><div id='gf_step_9_3' class='gf_step gf_step_pending'><span class='gf_step_number'>3<\/span><span class='gf_step_label'>Dental information<\/span><\/div><div id='gf_step_9_4' class='gf_step gf_step_pending'><span class='gf_step_number'>4<\/span><span class='gf_step_label'>Medical history<\/span><\/div><div id='gf_step_9_5' class='gf_step gf_step_pending'><span class='gf_step_number'>5<\/span><span class='gf_step_label'>Please indicate all medications (including anovulants and hormones) taken at this time or in the last 12 months<\/span><\/div><div id='gf_step_9_6' class='gf_step gf_step_pending'><span class='gf_step_number'>6<\/span><span class='gf_step_label'>Other aspects<\/span><\/div><div id='gf_step_9_7' class='gf_step gf_step_pending'><span class='gf_step_number'>7<\/span><span class='gf_step_label'>Consent to contact a health professional<\/span><\/div><div id='gf_step_9_8' class='gf_step gf_step_last gf_step_pending'><span class='gf_step_number'>8<\/span><span class='gf_step_label'>Consent and Identification<\/span><\/div><\/div>\n                        <div class='gform_body gform-body'><div id='gform_page_9_1' class='gform_page' >\n                                    <div class='gform_page_fields'><div id='gform_fields_9' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_9_1\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_1\"><label class='gfield_label' for='input_9_1' >First name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_1' id='input_9_1' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_2\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_2\"><label class='gfield_label' for='input_9_2' >Last name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_2' id='input_9_2' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_9_3\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_3\"><legend class='gfield_label'  >Gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_3'>\n\t\t\t<div class='gchoice gchoice_9_3_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='Man'  id='choice_9_3_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_3_0' id='label_9_3_0'>Man<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_3_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='Woman'  id='choice_9_3_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_3_1' id='label_9_3_1'>Woman<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_4\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_4\"><label class='gfield_label' for='input_9_4' >Birth date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_4' id='input_9_4' type='text' value='' class='datepicker ymd_slash datepicker_with_icon gdatepicker_with_icon'   placeholder='yyyy\/mm\/dd' aria-describedby=\"input_9_4_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_9_4_date_format' class='screen-reader-text'>YYYY slash MM slash DD<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_9_4' class='gform_hidden' value='https:\/\/cliniquedentaireboca.ca\/wp-content\/uploads\/2022\/09\/calendar-days-regular.svg'\/><\/div><div id=\"field_9_5\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_5\"><label class='gfield_label' for='input_9_5' >Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_9_5' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_6\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_6\"><label class='gfield_label' for='input_9_6' >City<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_9_6' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_7\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_7\"><label class='gfield_label' for='input_9_7' >Postal code<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_7' id='input_9_7' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_8\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_8\"><label class='gfield_label' for='input_9_8' >Province<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_9_8' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_9_9' class='gform_next_button button' value='NEXT'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"2\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"2\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_2' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_2' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_9_10\"  class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_10\"><label class='gfield_label' for='input_9_10' >Home phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_10' id='input_9_10' type='text' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_11\"  class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_11\"><label class='gfield_label' for='input_9_11' >Work phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_11' id='input_9_11' type='text' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_12\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_12\"><label class='gfield_label' for='input_9_12' >Cell phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_12' id='input_9_12' type='text' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_13\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_13\"><label class='gfield_label' for='input_9_13' >Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_13' id='input_9_13' type='text' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_9_70\"  class=\"gfield gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_70\"><h3>In case of emergency, call :<\/h3><\/div><div id=\"field_9_69\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_69\"><label class='gfield_label' for='input_9_69' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_69' id='input_9_69' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_15\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_15\"><label class='gfield_label' for='input_9_15' >Relationship to the patient<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_15' id='input_9_15' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_14\"  class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_14\"><label class='gfield_label' for='input_9_14' >Main phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_14' id='input_9_14' type='text' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_17\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_17\"><label class='gfield_label' for='input_9_17' >Cell phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_17' id='input_9_17' type='text' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_18' class='gform_previous_button button' value='BACK'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"1\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"1\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_9_18' class='gform_next_button button' value='NEXT'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"3\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"3\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_3' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_3' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_9_19\"  class=\"gfield gfield--width-full raison-visite-input gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_19\"><label class='gfield_label' for='input_9_19' >Reason for the visit today:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_9_19' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_20\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_20\"><label class='gfield_label' for='input_9_20' >Are you worried about dental treatments&nbsp;?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_20' id='input_9_20' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select<\/option><option value='Not at all' >Not at all<\/option><option value='A bit' >A bit<\/option><option value='A lot' >A lot<\/option><\/select><\/div><\/div><div id=\"field_9_21\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_21\"><label class='gfield_label' for='input_9_21' >Last visit<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_21' id='input_9_21' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select<\/option><option value='0 to 6 months' >0 to 6 months<\/option><option value='6 to 12 months' >6 to 12 months<\/option><option value='+ of 12 months' >+ of 12 months<\/option><\/select><\/div><\/div><fieldset id=\"field_9_71\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_71\"><legend class='gfield_label'  >With panoramic dental x-ray (large x-ray)&nbsp;?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_71'>\n\t\t\t<div class='gchoice gchoice_9_71_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_71' type='radio' value='Yes'  id='choice_9_71_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_71_0' id='label_9_71_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_71_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_71' type='radio' value='No'  id='choice_9_71_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_71_1' id='label_9_71_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_72\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_72\"><legend class='gfield_label'  >With intraoral dental x-rays (small x-rays)&nbsp;?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_72'>\n\t\t\t<div class='gchoice gchoice_9_72_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='Yes'  id='choice_9_72_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_72_0' id='label_9_72_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_72_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='No'  id='choice_9_72_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_72_1' id='label_9_72_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_25' class='gform_previous_button button' value='BACK'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"2\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"2\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_9_25' class='gform_next_button button' value='NEXT'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"4\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"4\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_4' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_4' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_9_82\"  class=\"gfield gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_82\"><p>Please activate the button only if the condition applies to you<\/p><\/div><fieldset id=\"field_9_73\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_73\"><legend class='gfield_label'  >Are you being followed by a doctor&nbsp;?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_73'>\n\t\t\t<div class='gchoice gchoice_9_73_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_73' type='radio' value='Yes'  id='choice_9_73_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_73_0' id='label_9_73_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_73_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_73' type='radio' value='No'  id='choice_9_73_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_73_1' id='label_9_73_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_29\"  class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_29\"><label class='gfield_label' for='input_9_29' >Reason, details and date:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_29' id='input_9_29' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_9_74\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_74\"><legend class='gfield_label'  >Have you ever been operated on or hospitalized&nbsp;?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_74'>\n\t\t\t<div class='gchoice gchoice_9_74_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_74' type='radio' value='Yes'  id='choice_9_74_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_74_0' id='label_9_74_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_74_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_74' type='radio' value='No'  id='choice_9_74_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_74_1' id='label_9_74_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_31\"  class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_31\"><label class='gfield_label' for='input_9_31' >Reason, details and date:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_31' id='input_9_31' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_9_75\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_75\"><legend class='gfield_label'  >Do you have joint prostheses (hips, knee, etc.)&nbsp;?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_75'>\n\t\t\t<div class='gchoice gchoice_9_75_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_75' type='radio' value='Yes'  id='choice_9_75_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_75_0' id='label_9_75_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_75_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_75' type='radio' value='No'  id='choice_9_75_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_75_1' id='label_9_75_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_76\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_76\"><legend class='gfield_label'  >Are you pregnant&nbsp;?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_76'>\n\t\t\t<div class='gchoice gchoice_9_76_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_76' type='radio' value='Yes'  id='choice_9_76_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_76_0' id='label_9_76_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_76_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_76' type='radio' value='No'  id='choice_9_76_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_76_1' id='label_9_76_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_77\"  class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_77\"><legend class='gfield_label'  >Are you breastfeeding&nbsp;?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_77'>\n\t\t\t<div class='gchoice gchoice_9_77_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_77' type='radio' value='Yes'  id='choice_9_77_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_77_0' id='label_9_77_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_77_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_77' type='radio' value='No'  id='choice_9_77_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_77_1' id='label_9_77_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_79\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_79\"><legend class='gfield_label'  >Are you taking any medications&nbsp;?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_79'>\n\t\t\t<div class='gchoice gchoice_9_79_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_79' type='radio' value='Yes'  id='choice_9_79_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_79_0' id='label_9_79_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_79_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_79' type='radio' value='No'  id='choice_9_79_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_79_1' id='label_9_79_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_80\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_80\"><legend class='gfield_label'  >Do you take any of the following&nbsp;?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_80'>\n\t\t\t<div class='gchoice gchoice_9_80_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_80' type='radio' value='Birth control pills'  id='choice_9_80_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_80_0' id='label_9_80_0'>Birth control pills<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_80_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_80' type='radio' value='Hormones'  id='choice_9_80_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_80_1' id='label_9_80_1'>Hormones<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_80_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_80' type='radio' value='No'  id='choice_9_80_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_80_2' id='label_9_80_2'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_78\"  class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_78\"><legend class='gfield_label'  >Do you take natural or homeopathic products&nbsp;?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_78'>\n\t\t\t<div class='gchoice gchoice_9_78_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_78' type='radio' value='Yes'  id='choice_9_78_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_78_0' id='label_9_78_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_78_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_78' type='radio' value='No'  id='choice_9_78_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_78_1' id='label_9_78_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_36\"  class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_36\"><label class='gfield_label' for='input_9_36' >Specify :<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_36' id='input_9_36' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_39' class='gform_previous_button button' value='BACK'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"3\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"3\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_9_39' class='gform_next_button button' value='NEXT'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"5\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"5\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_5' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_5' class='gform_fields top_label form_sublabel_below description_below'><fieldset id=\"field_9_40\"  class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_40\"><legend class='gfield_label gfield_label_before_complex'  >Please activate the button only if the condition applies to you<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_9_40'><div class='gchoice gchoice_9_40_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.1' type='checkbox'  value='Blood problems (hemophilia, anemia, prolonged bleeding)'  id='choice_9_40_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_40_1' id='label_9_40_1'>Blood problems (hemophilia, anemia, prolonged bleeding)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_40_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.2' type='checkbox'  value='Heart attack, angina, surgery, ect.'  id='choice_9_40_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_40_2' id='label_9_40_2'>Heart attack, angina, surgery, ect.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_40_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.3' type='checkbox'  value='Infection of the heart (endocarditis)'  id='choice_9_40_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_40_3' id='label_9_40_3'>Infection of the heart (endocarditis)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_40_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.4' type='checkbox'  value='Surgery to install or repair valve'  id='choice_9_40_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_40_4' id='label_9_40_4'>Surgery to install or repair valve<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_40_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.5' type='checkbox'  value='Blood pressure'  id='choice_9_40_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_40_5' id='label_9_40_5'>Blood pressure<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_40_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.6' type='checkbox'  value='Dizziness, fainting'  id='choice_9_40_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_40_6' id='label_9_40_6'>Dizziness, fainting<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_40_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.7' type='checkbox'  value='Frequent headaches'  id='choice_9_40_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_40_7' id='label_9_40_7'>Frequent headaches<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_40_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.8' type='checkbox'  value='Pain in jaw joint'  id='choice_9_40_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_40_8' id='label_9_40_8'>Pain in jaw joint<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_40_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.9' type='checkbox'  value='Liver problems (hepatitis A,B,C, cirrhosis, etc.)'  id='choice_9_40_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_40_9' id='label_9_40_9'>Liver problems (hepatitis A,B,C, cirrhosis, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_40_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.11' type='checkbox'  value='Digestive system disorders or diseases'  id='choice_9_40_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_40_11' id='label_9_40_11'>Digestive system disorders or diseases<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_40_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.12' type='checkbox'  value='Stomach trouble'  id='choice_9_40_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_40_12' id='label_9_40_12'>Stomach trouble<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_40_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.13' type='checkbox'  value='Kidney disorders'  id='choice_9_40_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_40_13' id='label_9_40_13'>Kidney disorders<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_40_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.14' type='checkbox'  value='Diabetes'  id='choice_9_40_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_40_14' id='label_9_40_14'>Diabetes<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_40_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.15' type='checkbox'  value='Thyroid disorders'  id='choice_9_40_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_40_15' id='label_9_40_15'>Thyroid disorders<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_40_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.16' type='checkbox'  value='Cancer (tumor)'  id='choice_9_40_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_40_16' id='label_9_40_16'>Cancer (tumor)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_40_17'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.17' type='checkbox'  value='Radiotherapy'  id='choice_9_40_17'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_40_17' id='label_9_40_17'>Radiotherapy<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_40_18'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.18' type='checkbox'  value='Chemotherapy'  id='choice_9_40_18'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_40_18' id='label_9_40_18'>Chemotherapy<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_44\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_44\"><legend class='gfield_label gfield_label_before_complex'  >Blood pressure<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_9_44'><div class='gchoice gchoice_9_44_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.1' type='checkbox'  value='High'  id='choice_9_44_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_44_1' id='label_9_44_1'>High<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_44_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.2' type='checkbox'  value='Low'  id='choice_9_44_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_44_2' id='label_9_44_2'>Low<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_45\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_45\"><legend class='gfield_label gfield_label_before_complex'  >Stomach trouble<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_9_45'><div class='gchoice gchoice_9_45_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.1' type='checkbox'  value='Ulcer'  id='choice_9_45_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_45_1' id='label_9_45_1'>Ulcer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_45_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.2' type='checkbox'  value='Reflux'  id='choice_9_45_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_45_2' id='label_9_45_2'>Reflux<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_83\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_83\"><legend class='gfield_label'  >Do you suffer from dry mouth&nbsp;?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_83'>\n\t\t\t<div class='gchoice gchoice_9_83_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_83' type='radio' value='Yes'  id='choice_9_83_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_83_0' id='label_9_83_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_83_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_83' type='radio' value='No'  id='choice_9_83_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_83_1' id='label_9_83_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_84\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_84\"><legend class='gfield_label'  >Sexually transmitted and blood-borne infections (STBBIs)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_84'>\n\t\t\t<div class='gchoice gchoice_9_84_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_84' type='radio' value='Yes'  id='choice_9_84_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_84_0' id='label_9_84_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_84_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_84' type='radio' value='No'  id='choice_9_84_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_84_1' id='label_9_84_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_46' class='gform_previous_button button' value='BACK'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"4\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"4\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_9_46' class='gform_next_button button' value='NEXT'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"6\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"6\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_6' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_6' class='gform_fields top_label form_sublabel_below description_below'><fieldset id=\"field_9_85\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_85\"><legend class='gfield_label'  >Do you snore&nbsp;?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_85'>\n\t\t\t<div class='gchoice gchoice_9_85_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_85' type='radio' value='Yes'  id='choice_9_85_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_85_0' id='label_9_85_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_85_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_85' type='radio' value='No'  id='choice_9_85_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_85_1' id='label_9_85_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_86\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_86\"><legend class='gfield_label'  >Do you suffer from sleep apnea&nbsp;?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_86'>\n\t\t\t<div class='gchoice gchoice_9_86_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_86' type='radio' value='Yes'  id='choice_9_86_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_86_0' id='label_9_86_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_86_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_86' type='radio' value='No'  id='choice_9_86_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_86_1' id='label_9_86_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_87\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_87\"><legend class='gfield_label'  >Do you smoke&nbsp;?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_87'>\n\t\t\t<div class='gchoice gchoice_9_87_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_87' type='radio' value='Yes'  id='choice_9_87_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_87_0' id='label_9_87_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_87_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_87' type='radio' value='No'  id='choice_9_87_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_87_1' id='label_9_87_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_50\"  class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_50\"><label class='gfield_label' for='input_9_50' >How many cigarettes per day&nbsp;?<\/label><div class='ginput_container ginput_container_number'><input name='input_50' id='input_9_50' type='text'    value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><fieldset id=\"field_9_51\"  class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_51\"><legend class='gfield_label gfield_label_before_complex'  >Others :<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_9_51'><div class='gchoice gchoice_9_51_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_51.1' type='checkbox'  value='Skin diseases'  id='choice_9_51_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_51_1' id='label_9_51_1'>Skin diseases<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_51_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_51.2' type='checkbox'  value='Eye problems'  id='choice_9_51_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_51_2' id='label_9_51_2'>Eye problems<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_51_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_51.3' type='checkbox'  value='Earache'  id='choice_9_51_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_51_3' id='label_9_51_3'>Earache<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_51_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_51.4' type='checkbox'  value='Arthritis'  id='choice_9_51_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_51_4' id='label_9_51_4'>Arthritis<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_51_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_51.5' type='checkbox'  value='Osteoporosis'  id='choice_9_51_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_51_5' id='label_9_51_5'>Osteoporosis<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_51_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_51.6' type='checkbox'  value='Prevention\/treatment (e.g. tablets)'  id='choice_9_51_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_51_6' id='label_9_51_6'>Prevention\/treatment (e.g. tablets)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_51_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_51.7' type='checkbox'  value='Annual or monthly injection'  id='choice_9_51_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_51_7' id='label_9_51_7'>Annual or monthly injection<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_51_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_51.8' type='checkbox'  value='Chronic pain'  id='choice_9_51_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_51_8' id='label_9_51_8'>Chronic pain<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_51_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_51.9' type='checkbox'  value='Epilepsy'  id='choice_9_51_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_51_9' id='label_9_51_9'>Epilepsy<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_51_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_51.11' type='checkbox'  value='Disorders or diseases of the nervous system'  id='choice_9_51_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_51_11' id='label_9_51_11'>Disorders or diseases of the nervous system<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_51_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_51.12' type='checkbox'  value='Psychiatric disorders or diseases'  id='choice_9_51_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_51_12' id='label_9_51_12'>Psychiatric disorders or diseases<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_51_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_51.13' type='checkbox'  value='Common cold or sinusitis'  id='choice_9_51_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_51_13' id='label_9_51_13'>Common cold or sinusitis<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_51_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_51.14' type='checkbox'  value='Tuberculosis or lung problems'  id='choice_9_51_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_51_14' id='label_9_51_14'>Tuberculosis or lung problems<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_51_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_51.15' type='checkbox'  value='Asthma'  id='choice_9_51_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_51_15' id='label_9_51_15'>Asthma<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_51_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_51.16' type='checkbox'  value='Hay fever\/allergies'  id='choice_9_51_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_51_16' id='label_9_51_16'>Hay fever\/allergies<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_54\"  class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_54\"><legend class='gfield_label gfield_label_before_complex'  >Allergy or manifestation to these products<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_9_54'><div class='gchoice gchoice_9_54_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.1' type='checkbox'  value='Latex'  id='choice_9_54_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_54_1' id='label_9_54_1'>Latex<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_54_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.2' type='checkbox'  value='Penicillin'  id='choice_9_54_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_54_2' id='label_9_54_2'>Penicillin<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_54_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.3' type='checkbox'  value='Other antibiotics'  id='choice_9_54_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_54_3' id='label_9_54_3'>Other antibiotics<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_54_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.4' type='checkbox'  value='Codeine'  id='choice_9_54_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_54_4' id='label_9_54_4'>Codeine<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_54_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.5' type='checkbox'  value='Aspirin'  id='choice_9_54_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_54_5' id='label_9_54_5'>Aspirin<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_54_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.6' type='checkbox'  value='Sulfonamides'  id='choice_9_54_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_54_6' id='label_9_54_6'>Sulfonamides<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_54_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.7' type='checkbox'  value='Anesthetics'  id='choice_9_54_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_54_7' id='label_9_54_7'>Anesthetics<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_54_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.8' type='checkbox'  value='Food'  id='choice_9_54_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_54_8' id='label_9_54_8'>Food<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_54_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.9' type='checkbox'  value='Products containing iodine'  id='choice_9_54_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_54_9' id='label_9_54_9'>Products containing iodine<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_54_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.11' type='checkbox'  value='Others'  id='choice_9_54_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_54_11' id='label_9_54_11'>Others<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_57\"  class=\"gfield gfield--width-full couverture-texte field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_57\"><label class='gfield_label' for='input_9_57' >If you have dental coverage, enter the Company Name, Policy No., Certificate No., Name and Date of Birth of the insurance holder<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_57' id='input_9_57' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_58' class='gform_previous_button button' value='BACK'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"5\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"5\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_9_58' class='gform_next_button button' value='NEXT'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"7\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"7\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_7' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_7' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_9_59\"  class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_59\"><label class='gfield_label' for='input_9_59' >Name<\/label><div class='ginput_container ginput_container_text'><input name='input_59' id='input_9_59' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_60\"  class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_60\"><label class='gfield_label' for='input_9_60' >Function<\/label><div class='ginput_container ginput_container_text'><input name='input_60' id='input_9_60' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_61\"  class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_61\"><label class='gfield_label' for='input_9_61' >Establishment\/ Telephone<\/label><div class='ginput_container ginput_container_text'><input name='input_61' id='input_9_61' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_9_65\"  class=\"gfield gfield--width-full gchoice gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_65\"><legend class='gfield_label gfield_label_before_complex'  >Consent<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_65.1' id='input_9_65_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gfield_consent_label\" for='input_9_65_1' >I agree that the dentist and his\/her staff may collect information that is relevant and consistent with the subject matter of the record from or provide such information to the health professionals listed above.<\/label><input type='hidden' name='input_65.2' value='I agree that the dentist and his\/her staff may collect information that is relevant and consistent with the subject matter of the record from or provide such information to the health professionals listed above.' class='gform_hidden' \/><input type='hidden' name='input_65.3' value='2' class='gform_hidden' \/><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_64' class='gform_previous_button button' value='BACK'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"6\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"6\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_9_64' class='gform_next_button button' value='NEXT'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"8\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"8\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_8' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_8' class='gform_fields top_label form_sublabel_below description_below'><fieldset id=\"field_9_66\"  class=\"gfield gfield--width-full colonne-radio gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\"  data-js-reload=\"field_9_66\"><legend class='gfield_label'  >I filled out this medical questionnaire to the best of my knowledge.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_9_66'>Personne qui signe<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_66'>\n\t\t\t<div class='gchoice gchoice_9_66_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_66' type='radio' value='Parent himself'  id='choice_9_66_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_9_66\"   \/>\n\t\t\t\t\t<label for='choice_9_66_0' id='label_9_66_0'>Parent himself<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_66_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_66' type='radio' value='Parent\/Guardian (if less than 14 years old)'  id='choice_9_66_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_66_1' id='label_9_66_1'>Parent\/Guardian (if less than 14 years old)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_66_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_66' type='radio' value='Agent\/Manager'  id='choice_9_66_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_66_2' id='label_9_66_2'>Agent\/Manager<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_66_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_66' type='radio' value='Other'  id='choice_9_66_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_66_3' id='label_9_66_3'>Other<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_89\"  class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_89\"><label class='gfield_label' for='input_9_89' >Date of signature of patient or caregiver<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_89' id='input_9_89' type='text' value='' class='datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='jj\/mm\/aaaa' aria-describedby=\"input_9_89_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_9_89_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_9_89' class='gform_hidden' value='https:\/\/cliniquedentaireboca.ca\/wp-content\/uploads\/2022\/09\/calendar-days-regular.svg'\/><\/div><div id=\"field_9_68\"  class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_9_68\"><label class='gfield_label' for='input_9_68' >Specialist signature date<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_68' id='input_9_68' type='text' value='' class='datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='jj\/mm\/aaaa' aria-describedby=\"input_9_68_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_9_68_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_9_68' class='gform_hidden' value='https:\/\/cliniquedentaireboca.ca\/wp-content\/uploads\/2022\/09\/calendar-days-regular.svg'\/><\/div><\/div><\/div>\n        <div class='gform_page_footer top_label'><input type='submit' id='gform_previous_button_9' class='gform_previous_button button' value='BACK'  onclick='if(window[\"gf_submitting_9\"]){return false;}  window[\"gf_submitting_9\"]=true;  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_9\"]){return false;} window[\"gf_submitting_9\"]=true;  jQuery(\"#gform_9\").trigger(\"submit\",[true]); }' \/> <input type='submit' id='gform_submit_button_9' class='gform_button button' value='SUBMIT'  onclick='if(window[\"gf_submitting_9\"]){return false;}  window[\"gf_submitting_9\"]=true;  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_9\"]){return false;} window[\"gf_submitting_9\"]=true;  jQuery(\"#gform_9\").trigger(\"submit\",[true]); }' \/> <input type='hidden' name='gform_ajax' value='form_id=9&amp;title=&amp;description=&amp;tabindex=0' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_9' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='9' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_9' 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);\n<\/script>\n<\/div><\/div>\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-4cd933f pv100 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"4cd933f\" data-element_type=\"section\" id=\"instructions-post-op\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[],&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-d1c993a\" data-id=\"d1c993a\" 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-9369ce1 elementor-widget elementor-widget-heading\" data-id=\"9369ce1\" 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\">Post-op instructions\n<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-382410f elementor-widget elementor-widget-jet-accordion\" data-id=\"382410f\" data-element_type=\"widget\" data-widget_type=\"jet-accordion.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"jet-accordion\" data-settings=\"{&quot;collapsible&quot;:false,&quot;ajaxTemplate&quot;:false,&quot;switchScrolling&quot;:false,&quot;switchScrollingOffset&quot;:0}\" role=\"tablist\">\n\t\t\t<div class=\"jet-accordion__inner\">\n\t\t\t\t<div class=\"jet-accordion__item jet-toggle jet-toggle-move-up-effect \">\n\t\t\t\t\t\t\t<div id=\"jet-toggle-control-5881\" class=\"jet-toggle__control elementor-menu-anchor\" data-toggle=\"1\" role=\"tab\" aria-controls=\"jet-toggle-content-5881\" aria-expanded=\"false\" data-template-id=\"false\">\n\t\t\t\t\t\t\t\t<div class=\"jet-toggle__label-icon jet-toggle-icon-position-right\"><span class=\"jet-toggle__icon icon-normal jet-tabs-icon\"><i aria-hidden=\"true\" class=\"far fa-plus\"><\/i><\/span><span class=\"jet-toggle__icon icon-active jet-tabs-icon\"><i aria-hidden=\"true\" class=\"far fa-minus\"><\/i><\/span><\/div><div class=\"jet-toggle__label-text\">Cavity repair or filling<\/div>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div id=\"jet-toggle-content-5881\" class=\"jet-toggle__content\" data-toggle=\"1\" role=\"tabpanel\" aria-hidden=\"true\" data-template-id=\"false\">\n\t\t\t\t\t\t\t\t<div class=\"jet-toggle__content-inner\"><p><span style=\"font-weight: 400;\">Depending on your metabolism, the local anaesthesia may last 3 to 4 hours after the treatment. Wait for it to wear off before eating to avoid hurting your cheeks and tongue. The jaw works hard when you keep your mouth open for a long time, so it would be a good idea to take Advil\/Tylenol as a preventive measure.<\/span><\/p><p><span style=\"font-weight: 400;\">Composite fillings (white) harden immediately and don\u2019t require any waiting time before eating or drinking. However, amalgam (grey) fillings take 24 hours to completely harden, so it is best to wait until the next day before eating with the treated teeth.<\/span><\/p><p><span style=\"font-weight: 400;\">Sensitivity to hot\/cold\/sugar may be normal for up to <\/span><b>2 months<\/b><span style=\"font-weight: 400;\"> following the treatment. Using toothpaste for sensitive teeth is recommended to reduce hypersensitivity. You can apply it directly to the tooth without rinsing.<\/span><\/p><p><span style=\"font-weight: 400;\">If sensitivity to <\/span><b>chewing<\/b><span style=\"font-weight: 400;\"> persists after a few days, it is important to call the clinic and have an adjustment done on the fillings. A single micron too high and your jaw can detect it and create pain when there is pressure.<\/span><\/p><\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div><div class=\"jet-accordion__item jet-toggle jet-toggle-move-up-effect \">\n\t\t\t\t\t\t\t<div id=\"jet-toggle-control-5882\" class=\"jet-toggle__control elementor-menu-anchor\" data-toggle=\"2\" role=\"tab\" aria-controls=\"jet-toggle-content-5882\" aria-expanded=\"false\" data-template-id=\"false\">\n\t\t\t\t\t\t\t\t<div class=\"jet-toggle__label-icon jet-toggle-icon-position-right\"><span class=\"jet-toggle__icon icon-normal jet-tabs-icon\"><i aria-hidden=\"true\" class=\"fas fa-plus\"><\/i><\/span><span class=\"jet-toggle__icon icon-active jet-tabs-icon\"><i aria-hidden=\"true\" class=\"fas fa-minus\"><\/i><\/span><\/div><div class=\"jet-toggle__label-text\">Dental surgery<\/div>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div id=\"jet-toggle-content-5882\" class=\"jet-toggle__content\" data-toggle=\"2\" role=\"tabpanel\" aria-hidden=\"true\" data-template-id=\"false\">\n\t\t\t\t\t\t\t\t<div class=\"jet-toggle__content-inner\"><ol>\n \t<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Bite on the compress for about 30 minutes. Then, replace it if the bleeding persists.<\/span><\/li><br>\n \t<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Do not spit<\/b><span style=\"font-weight: 400;\"> or drink with a straw on the day of the operation. It is preferable to let the water flow gently after the surgery instead of spitting.<\/span><\/li><br>\n \t<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Light bleeding is normal in the hours following the operation. It is also possible that you will see traces of blood on your pillow the day after the surgery. If you are unable to control the bleeding after 4 hours by pressing firmly with the cotton 2&#215;2 or if the bleeding seems serious, call 450-232-5202.<\/span><\/li><br>\n \t<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The day after the operation, <\/span><b>rinse your mouth with salt water<\/b><span style=\"font-weight: 400;\">. Rinse 4 to 5 times per day for 10 days.<\/span><\/li><br>\n \t<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Post-operative pain is also possible for the first 24 to 48 hours, and discomfort following the operation may persist for 3 to 5 days.<\/span><\/li><br>\n \t<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">It is preferable to <\/span><b>avoid sports activities<\/b><span style=\"font-weight: 400;\"> or excessive exertion for the first few days following the operation.<\/span><\/li><br>\n \t<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Swelling at the extraction site may occur in the first 48 to 72 hours before fading over the following 2 to 3 days. When the swelling goes down, you may have a bruise for about 10 days. Apply ice intermittently during the first day, and if the swelling persists, apply a hot water bottle the following day (not the same day as the operation). Call us if the swelling increases after 48 hours or lasts longer than 7 days.<\/span><\/li><br>\n \t<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">It is preferable to <\/span><b>eat cold, soft foods<\/b><span style=\"font-weight: 400;\"> for the first 4 to 6 hours after you return home. Hot liquids stimulate circulation, and the bleeding could start up again.<\/span><\/li><br>\n \t<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Avoid drinking alcohol or smoking<\/b><span style=\"font-weight: 400;\"> for the first two weeks following the operation. Alcohol and<\/span> <span style=\"font-weight: 400;\">tobacco impede coagulation, increase the risk of infection, and slow healing.<\/span><\/li>\n<\/ol><\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div><div class=\"jet-accordion__item jet-toggle jet-toggle-move-up-effect \">\n\t\t\t\t\t\t\t<div id=\"jet-toggle-control-5883\" class=\"jet-toggle__control elementor-menu-anchor\" data-toggle=\"3\" role=\"tab\" aria-controls=\"jet-toggle-content-5883\" aria-expanded=\"false\" data-template-id=\"false\">\n\t\t\t\t\t\t\t\t<div class=\"jet-toggle__label-icon jet-toggle-icon-position-right\"><span class=\"jet-toggle__icon icon-normal jet-tabs-icon\"><i aria-hidden=\"true\" class=\"fas fa-plus\"><\/i><\/span><span class=\"jet-toggle__icon icon-active jet-tabs-icon\"><i aria-hidden=\"true\" class=\"fas fa-minus\"><\/i><\/span><\/div><div class=\"jet-toggle__label-text\">Dental scaling<\/div>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div id=\"jet-toggle-content-5883\" class=\"jet-toggle__content\" data-toggle=\"3\" role=\"tabpanel\" aria-hidden=\"true\" data-template-id=\"false\">\n\t\t\t\t\t\t\t\t<div class=\"jet-toggle__content-inner\"><ul><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Brush your teeth for 2 minutes in the morning and evening.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Use dental floss and\/or a fine brush <\/span><b>twice<\/b><span style=\"font-weight: 400;\"> a day.<\/span><ul><li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Make sure to floss properly by scrubbing the walls of the teeth and getting below the gum line (as was explained to you by the hygienist or dentist).<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Mix hydrogen peroxide and baking soda until you achieve the consistency of toothpaste and, using this product, clean between the teeth with a fine brush <\/span><b>(2 to 3 times per week)<\/b><span style=\"font-weight: 400;\">, then gargle with water.<\/span><\/li><\/ul><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Rinse with 15 mL of the prescribed mouthwash for <\/span><b>30 seconds twice a day.\u00a0<\/b><span style=\"font-weight: 400;\">Do not eat or drink for 1 hour. Do this for the first 3 weeks after the treatment only, because the product tends to stain teeth after this period.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Use mouthwash daily (green tea is recommended for its antibacterial properties).\u00a0<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The joint works very hard when you keep your mouth open for a long time, so it would be a good idea to take Advil\/Tylenol as a preventive measure.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Sensitivity to cold may occur following teeth scaling. This sensitivity is usually temporary and can be reduced with toothpaste for sensitive teeth.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">It is important to come to your cleaning\/scaling appointments every 3 months to increase the treatment\u2019s chances of success.<\/span><\/li><\/ul><p><b>Remember that the final result of the treatment depends in large part on the hygiene habits that you adopt after receiving the treatments.<\/b><\/p><\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div><div class=\"jet-accordion__item jet-toggle jet-toggle-move-up-effect \">\n\t\t\t\t\t\t\t<div id=\"jet-toggle-control-5884\" class=\"jet-toggle__control elementor-menu-anchor\" data-toggle=\"4\" role=\"tab\" aria-controls=\"jet-toggle-content-5884\" aria-expanded=\"false\" data-template-id=\"false\">\n\t\t\t\t\t\t\t\t<div class=\"jet-toggle__label-icon jet-toggle-icon-position-right\"><span class=\"jet-toggle__icon icon-normal jet-tabs-icon\"><i aria-hidden=\"true\" class=\"fas fa-plus\"><\/i><\/span><span class=\"jet-toggle__icon icon-active jet-tabs-icon\"><i aria-hidden=\"true\" class=\"fas fa-minus\"><\/i><\/span><\/div><div class=\"jet-toggle__label-text\">Crown and bridge <\/div>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div id=\"jet-toggle-content-5884\" class=\"jet-toggle__content\" data-toggle=\"4\" role=\"tabpanel\" aria-hidden=\"true\" data-template-id=\"false\">\n\t\t\t\t\t\t\t\t<div class=\"jet-toggle__content-inner\"><p><span style=\"font-weight: 400;\">After the 1<\/span><span style=\"font-weight: 400;\">st<\/span><span style=\"font-weight: 400;\"> appointment (temporary restoration).<\/span><\/p><p><span style=\"font-weight: 400;\">It is normal to have discomfort in the gums for a few days after the first appointment. It is a good idea to take painkillers before the anaesthesia wears off to prevent the pain from occurring. The joint also works very hard when you keep your mouth open for a long time, so it would be a good idea to take Advil\/Tylenol as a preventive measure.<\/span><\/p><p><span style=\"font-weight: 400;\">You have a temporary acrylic crown. It is normal for it not to be exactly the right shape or a little rough. It is only temporary, and the final crown will be far more suitable. If you have any discomfort or pain in this tooth, it is also preferable to call us. It is also best not to eat with this tooth. The cement used is temporary and less resistant than the final cement that will be used. If the temporary crown falls out, pick it up, call the clinic, and we will see you as soon as possible to recement or remake it. Until the appointment, it is important not to eat with this tooth.<\/span><\/p><p><span style=\"font-weight: 400;\">It is possible to begin brushing your teeth again on the day when the temporary crown is put in. You can proceed as usual, taking care, however, not to press too hard on the crown.<\/span><b>\u00a0<\/b><span style=\"font-weight: 400;\">Once the temporary crown is in place, be careful when removing dental floss: make sure to remove it by moving it to the side instead of pulling up on it.<\/span><\/p><p><span style=\"font-weight: 400;\">After the 2<\/span><span style=\"font-weight: 400;\">nd<\/span><span style=\"font-weight: 400;\"> appointment (final restoration)<\/span><\/p><p><span style=\"font-weight: 400;\">It is normal to have discomfort in the gums for a few days after the second appointment. You can take painkillers to help reduce the discomfort.<\/span><\/p><p><span style=\"font-weight: 400;\">It is important not to eat with the new crown or bridge on the same day as the cementation. The waiting period is 24 hours.<\/span><\/p><p><span style=\"font-weight: 400;\">If you feel discomfort or pain after 1 week, please call us at the clinic.<\/span><\/p><\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div><div class=\"jet-accordion__item jet-toggle jet-toggle-move-up-effect \">\n\t\t\t\t\t\t\t<div id=\"jet-toggle-control-5885\" class=\"jet-toggle__control elementor-menu-anchor\" data-toggle=\"5\" role=\"tab\" aria-controls=\"jet-toggle-content-5885\" aria-expanded=\"false\" data-template-id=\"false\">\n\t\t\t\t\t\t\t\t<div class=\"jet-toggle__label-icon jet-toggle-icon-position-right\"><span class=\"jet-toggle__icon icon-normal jet-tabs-icon\"><i aria-hidden=\"true\" class=\"fas fa-plus\"><\/i><\/span><span class=\"jet-toggle__icon icon-active jet-tabs-icon\"><i aria-hidden=\"true\" class=\"fas fa-minus\"><\/i><\/span><\/div><div class=\"jet-toggle__label-text\">Root canal<\/div>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div id=\"jet-toggle-content-5885\" class=\"jet-toggle__content\" data-toggle=\"5\" role=\"tabpanel\" aria-hidden=\"true\" data-template-id=\"false\">\n\t\t\t\t\t\t\t\t<div class=\"jet-toggle__content-inner\"><p><b>Following the root canal appointment<\/b><span style=\"font-weight: 400;\">, it is a good idea to take painkillers before the anaesthesia wears off to prevent pain from occurring.<\/span> <span style=\"font-weight: 400;\">The joint also works very hard when you keep your mouth open for a long time, so it would be a good idea to take Advil\/Tylenol as a preventive measure.<\/span><\/p><p><b>Your dentist will place a temporary bandage in the opening of the access cavity in your tooth, so it is important not to eat with this tooth until the procedure is finished. It is very fragile and could break.<\/b><\/p><p><b>An acute awakening of your tooth may occur following the first root canal appointment. If this is the case, you will experience swelling, and it is important to call us.<\/b><\/p><p><b>Discomfort when chewing is normal for 10 to 14 days.<\/b><\/p><\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div><div class=\"jet-accordion__item jet-toggle jet-toggle-move-up-effect \">\n\t\t\t\t\t\t\t<div id=\"jet-toggle-control-5886\" class=\"jet-toggle__control elementor-menu-anchor\" data-toggle=\"6\" role=\"tab\" aria-controls=\"jet-toggle-content-5886\" aria-expanded=\"false\" data-template-id=\"false\">\n\t\t\t\t\t\t\t\t<div class=\"jet-toggle__label-icon jet-toggle-icon-position-right\"><span class=\"jet-toggle__icon icon-normal jet-tabs-icon\"><i aria-hidden=\"true\" class=\"fas fa-plus\"><\/i><\/span><span class=\"jet-toggle__icon icon-active jet-tabs-icon\"><i aria-hidden=\"true\" class=\"fas fa-minus\"><\/i><\/span><\/div><div class=\"jet-toggle__label-text\">Tooth whitening<\/div>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div id=\"jet-toggle-content-5886\" class=\"jet-toggle__content\" data-toggle=\"6\" role=\"tabpanel\" aria-hidden=\"true\" data-template-id=\"false\">\n\t\t\t\t\t\t\t\t<div class=\"jet-toggle__content-inner\"><p><span style=\"font-weight: 400;\">Procedure:<\/span><\/p><ol><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Brush your teeth and floss.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Apply a <\/span><b>very thin layer of solution<\/b><span style=\"font-weight: 400;\"> to the trays (only to teeth that are visible when smiling).<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Place the trays in your mouth and wipe off the excess solution with a cloth or a dry toothbrush.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Once the treatment is complete, remove the trays and rinse them as well as your mouth with warm water.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Brush your teeth.<\/span><\/li><\/ol><p><span style=\"font-weight: 400;\">Possible side effects:<\/span><\/p><ol><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Teeth may <\/span><b>become sensitive<\/b><span style=\"font-weight: 400;\"> to cold and pressure. (Wear the trays for shorter periods or skip a day.)<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Your gums may react to the solution. (Apply less solution to the trays.)<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Discomfort in the jaw. (Wear for shorter periods of time.)<\/span><\/li><\/ol><p><span style=\"font-weight: 400;\">For optimal results:\u00a0<\/span><\/p><ul><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Don\u2019t eat or drink during the treatment.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Don\u2019t smoke immediately after the treatment; wait at least 2 hours.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Strongly coloured foods and beverages should be avoided for at least 48 hours after the treatment or consumed with moderation.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Store the whitening solution in the <\/span><b>refrigerator<\/b><span style=\"font-weight: 400;\">.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Do the treatment for <\/span><b>30 minutes per day for 7 to 14 days<\/b><span style=\"font-weight: 400;\">.<\/span><\/li><\/ul><\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div><div class=\"jet-accordion__item jet-toggle jet-toggle-move-up-effect \">\n\t\t\t\t\t\t\t<div id=\"jet-toggle-control-5887\" class=\"jet-toggle__control elementor-menu-anchor\" data-toggle=\"7\" role=\"tab\" aria-controls=\"jet-toggle-content-5887\" aria-expanded=\"false\" data-template-id=\"false\">\n\t\t\t\t\t\t\t\t<div class=\"jet-toggle__label-icon jet-toggle-icon-position-right\"><span class=\"jet-toggle__icon icon-normal jet-tabs-icon\"><i aria-hidden=\"true\" class=\"fas fa-plus\"><\/i><\/span><span class=\"jet-toggle__icon icon-active jet-tabs-icon\"><i aria-hidden=\"true\" class=\"fas fa-minus\"><\/i><\/span><\/div><div class=\"jet-toggle__label-text\">Spark aligners<\/div>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div id=\"jet-toggle-content-5887\" class=\"jet-toggle__content\" data-toggle=\"7\" role=\"tabpanel\" aria-hidden=\"true\" data-template-id=\"false\">\n\t\t\t\t\t\t\t\t<div class=\"jet-toggle__content-inner\"><p><span style=\"font-weight: 400;\">In the vast majority of cases, Spark shells are replaced every week, but be aware that this does not mean that you don\u2019t have to take care of them.<\/span><\/p><p><span style=\"font-weight: 400;\">During your first appointment to have your shells put in, we will give you a kit with all the necessary equipment to take care of your devices.<\/span><\/p><p><span style=\"font-weight: 400;\">The first element of the kit is the case, which allows you to store your shells when you are not wearing them. It is important to place them in this case and not on a napkin, for example, for the simple reason that napkins quickly end up in the garbage with your shells hidden inside.<\/span><\/p><p><span style=\"font-weight: 400;\">We often recommend that our patients<\/span><b> keep the previous aligner in addition to the shell they are wearing<\/b><span style=\"font-weight: 400;\">. This allows you to always have some aligners as spares in case you lose the shells you are wearing.<\/span><\/p><p><span style=\"font-weight: 400;\">For the entire treatment, it is important to keep your Spark aligners clean.\u00a0<\/span><\/p><p><span style=\"font-weight: 400;\">Here are some tips that will allow you to help yourself:<\/span><\/p><p><span style=\"font-weight: 400;\">\u2013\u00a0 First of all, <\/span><b>eating with your shells on<\/b><span style=\"font-weight: 400;\"> is not recommended because food can slide under the device, and cleaning then becomes more difficult.<\/span><\/p><p><span style=\"font-weight: 400;\">\u00a0\u2013\u00a0 Only drink water when you are wearing your shells, and avoid beverages that stain, such as coffee or tea, at all costs.<\/span><\/p><p><span style=\"font-weight: 400;\">\u2013\u00a0 \u00a0Avoid sugary drinks at all costs with your aligners; the sugar will end up getting stuck on the surface of your teeth.<\/span><\/p><p><span style=\"font-weight: 400;\">\u2013\u00a0 Clean your shells using a toothbrush with toothpaste or liquid soap.<\/span><\/p><p><span style=\"font-weight: 400;\">\u2013\u00a0 It is important to brush your teeth after each meal; otherwise, you will be putting your aligners back on dirty teeth and promoting the appearance of cavities.<\/span><\/p><p><span style=\"font-weight: 400;\">\u2013\u00a0 Be careful not to put your shells under excessively hot water, as this could warp them.<\/span><\/p><p><span style=\"font-weight: 400;\">T<\/span><span style=\"font-weight: 400;\">hat way, you will be able to keep smiling throughout your treatment!<\/span><\/p><\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div><div class=\"jet-accordion__item jet-toggle jet-toggle-move-up-effect \">\n\t\t\t\t\t\t\t<div id=\"jet-toggle-control-5888\" class=\"jet-toggle__control elementor-menu-anchor\" data-toggle=\"8\" role=\"tab\" aria-controls=\"jet-toggle-content-5888\" aria-expanded=\"false\" data-template-id=\"false\">\n\t\t\t\t\t\t\t\t<div class=\"jet-toggle__label-icon jet-toggle-icon-position-right\"><span class=\"jet-toggle__icon icon-normal jet-tabs-icon\"><i aria-hidden=\"true\" class=\"fas fa-plus\"><\/i><\/span><span class=\"jet-toggle__icon icon-active jet-tabs-icon\"><i aria-hidden=\"true\" class=\"fas fa-minus\"><\/i><\/span><\/div><div class=\"jet-toggle__label-text\">Biteplate<\/div>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div id=\"jet-toggle-content-5888\" class=\"jet-toggle__content\" data-toggle=\"8\" role=\"tabpanel\" aria-hidden=\"true\" data-template-id=\"false\">\n\t\t\t\t\t\t\t\t<div class=\"jet-toggle__content-inner\"><p><span style=\"font-weight: 400;\">You have received a biteplate to protect your teeth and joints. To benefit from it fully, please follow these instructions:<\/span><\/p><ol><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Wear your device <\/span><b>every night<\/b><span style=\"font-weight: 400;\">.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">It may take 2 or 3 nights to get used to it.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Never use hot water to clean the plate; <\/span><b>warm water<\/b><span style=\"font-weight: 400;\"> is ideal.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Do not use products to clean the plate; you can brush it with your toothbrush.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Place the plate in the case that was given to you to avoid losing it.\u00a0<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">To make your plate more comfortable, we manufacture it to be as small as possible, which makes it more fragile. Do not drop the plate, because if it falls, it may break.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Always put the plate in place completely with your fingers; do not bite on the plate to put it in place.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">If you make <\/span><b>major changes<\/b><span style=\"font-weight: 400;\"> to one or more of your upper\/lower teeth, bring your plate in so that the dentist can adjust it. In some cases, the adjustment will not work; it will then be necessary to consider <\/span><b>making a new plate<\/b><span style=\"font-weight: 400;\">.<\/span><\/li><\/ol><\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div><div class=\"jet-accordion__item jet-toggle jet-toggle-move-up-effect \">\n\t\t\t\t\t\t\t<div id=\"jet-toggle-control-5889\" class=\"jet-toggle__control elementor-menu-anchor\" data-toggle=\"9\" role=\"tab\" aria-controls=\"jet-toggle-content-5889\" aria-expanded=\"false\" data-template-id=\"false\">\n\t\t\t\t\t\t\t\t<div class=\"jet-toggle__label-icon jet-toggle-icon-position-right\"><span class=\"jet-toggle__icon icon-normal jet-tabs-icon\"><i aria-hidden=\"true\" class=\"fas fa-plus\"><\/i><\/span><span class=\"jet-toggle__icon icon-active jet-tabs-icon\"><i aria-hidden=\"true\" class=\"fas fa-minus\"><\/i><\/span><\/div><div class=\"jet-toggle__label-text\">Dentures (partial and full)<\/div>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div id=\"jet-toggle-content-5889\" class=\"jet-toggle__content\" data-toggle=\"9\" role=\"tabpanel\" aria-hidden=\"true\" data-template-id=\"false\">\n\t\t\t\t\t\t\t\t<div class=\"jet-toggle__content-inner\"><ul><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Wear the prosthesis day and night for a period of 3 weeks.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Then, remove it at night.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Always put the prosthesis in water when it is outside of your mouth. You can always put the prosthesis in a solution such as Polident, Efferdent, or Novadent.\u00a0<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Rinse the prosthesis after each meal.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Clean the prosthesis as shown twice a day (using a prosthesis brush or clasp brush).<\/span><\/li><\/ul><p><span style=\"font-weight: 400;\">*It may be necessary to make some adjustments again if the prosthesis irritates the gums after a few days.<\/span><\/p><p><span style=\"font-weight: 400;\">** A new prosthesis is a major change in your mouth. It is quite possible that you will have difficulty chewing or speaking. To remedy these problems, you must chew consciously and slowly at the start until you get used to it. To improve your speech, you can read aloud for 10 minutes per day for a week. The complete integration of a new prosthesis may take up to 6 weeks.<\/span><\/p><\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\t\t\t\t\t\t\t\t<\/div>\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<section class=\"elementor-section elementor-top-section elementor-element elementor-element-d3122f1 elementor-section-boxed elementor-section-height-default elementor-section-height-default elementor-invisible\" data-id=\"d3122f1\" data-element_type=\"section\" id=\"informed-consent\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[],&quot;animation&quot;:&quot;fadeInUp&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-36e827a\" data-id=\"36e827a\" 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-b758a4a elementor-widget elementor-widget-heading\" data-id=\"b758a4a\" 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\">Informed consent<\/h2>\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-f24c98e ph pb100 elementor-section-boxed elementor-section-height-default elementor-section-height-default elementor-invisible\" data-id=\"f24c98e\" data-element_type=\"section\" id=\"flipbox-download\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[],&quot;animation&quot;:&quot;fadeInUp&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-d90aa83\" data-id=\"d90aa83\" data-element_type=\"column\" id=\"patients-box\">\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-3ab6ce2 elementor-flip-box--effect-fade elementor-widget__width-initial flipbox-telecharger elementor-widget elementor-widget-flip-box\" data-id=\"3ab6ce2\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"elementor-flip-box__image\">\n\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"107\" height=\"105\" src=\"https:\/\/cliniquedentaireboca.ca\/wp-content\/uploads\/2022\/08\/document-icone.png\" class=\"attachment-Image Size 500x500 size-Image Size 500x500\" alt=\"\" loading=\"lazy\" \/>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"elementor-flip-box__layer__description\">\n\t\t\t\t\t\t\t\tSurgery Consent\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"elementor-flip-box__layer__title\">\n\t\t\t\t\t\t\tSurgery Consent\t\t\t\t\t\t<\/h3>\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-flip-box__button elementor-button elementor-size-sm\" href=\"https:\/\/cliniquedentaireboca.ca\/wp-content\/uploads\/2022\/10\/Consent-Oral-Surgery.pdf\" target=\"_blank\" download=\"Surgery Consent\">\n\t\t\t\t\t\t\tDownload here\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c05e584 elementor-flip-box--effect-fade elementor-widget__width-initial flipbox-telecharger elementor-widget elementor-widget-flip-box\" data-id=\"c05e584\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"elementor-flip-box__image\">\n\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"107\" height=\"105\" src=\"https:\/\/cliniquedentaireboca.ca\/wp-content\/uploads\/2022\/08\/document-icone.png\" class=\"attachment-Image Size 500x500 size-Image Size 500x500\" alt=\"\" loading=\"lazy\" \/>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"elementor-flip-box__layer__description\">\n\t\t\t\t\t\t\t\tRoot Canal Consent\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"elementor-flip-box__layer__title\">\n\t\t\t\t\t\t\tRoot Canal Consent\t\t\t\t\t\t<\/h3>\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-flip-box__button elementor-button elementor-size-sm\" href=\"https:\/\/cliniquedentaireboca.ca\/wp-content\/uploads\/2022\/10\/Consent-Root-Canal.pdf\" target=\"_blank\" download=\"Root Canal Consent\">\n\t\t\t\t\t\t\tDownload here\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-97998cd elementor-flip-box--effect-fade elementor-widget__width-initial flipbox-telecharger elementor-widget elementor-widget-flip-box\" data-id=\"97998cd\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"elementor-flip-box__image\">\n\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"107\" height=\"105\" src=\"https:\/\/cliniquedentaireboca.ca\/wp-content\/uploads\/2022\/08\/document-icone.png\" class=\"attachment-Image Size 500x500 size-Image Size 500x500\" alt=\"\" loading=\"lazy\" \/>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"elementor-flip-box__layer__description\">\n\t\t\t\t\t\t\t\tSpark Orthodontic Consent\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"elementor-flip-box__layer__title\">\n\t\t\t\t\t\t\tSpark Orthodontic Consent\t\t\t\t\t\t<\/h3>\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-flip-box__button elementor-button elementor-size-sm\" href=\"https:\/\/cliniquedentaireboca.ca\/wp-content\/uploads\/2022\/10\/Consent-SPARK.pdf\" target=\"_blank\" download=\"Spark Orthodontic Consent\">\n\t\t\t\t\t\t\tDownload here\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6c0cb07 elementor-flip-box--effect-fade elementor-widget__width-initial flipbox-telecharger elementor-widget elementor-widget-flip-box\" data-id=\"6c0cb07\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"elementor-flip-box__image\">\n\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"107\" height=\"105\" src=\"https:\/\/cliniquedentaireboca.ca\/wp-content\/uploads\/2022\/08\/document-icone.png\" class=\"attachment-Image Size 500x500 size-Image Size 500x500\" alt=\"\" loading=\"lazy\" \/>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"elementor-flip-box__layer__description\">\n\t\t\t\t\t\t\t\tOrthopedic<br>Orthodontic Consent\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"elementor-flip-box__layer__title\">\n\t\t\t\t\t\t\tOrthopedic <br>Orthodontic Consent\t\t\t\t\t\t<\/h3>\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-flip-box__button elementor-button elementor-size-sm\" href=\"https:\/\/cliniquedentaireboca.ca\/wp-content\/uploads\/2022\/10\/Consent-Orthopedics.pdf\" target=\"_blank\" download=\"Orthopedic Consent\">\n\t\t\t\t\t\t\tDownload here\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b379e09 elementor-flip-box--effect-fade elementor-widget__width-initial flipbox-telecharger elementor-widget elementor-widget-flip-box\" data-id=\"b379e09\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"elementor-flip-box__image\">\n\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"107\" height=\"105\" src=\"https:\/\/cliniquedentaireboca.ca\/wp-content\/uploads\/2022\/08\/document-icone.png\" class=\"attachment-Image Size 500x500 size-Image Size 500x500\" alt=\"\" loading=\"lazy\" \/>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"elementor-flip-box__layer__description\">\n\t\t\t\t\t\t\t\tOral Sedation Consent\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"elementor-flip-box__layer__title\">\n\t\t\t\t\t\t\tOral Sedation Consent\t\t\t\t\t\t<\/h3>\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-flip-box__button elementor-button elementor-size-sm\" href=\"https:\/\/cliniquedentaireboca.ca\/wp-content\/uploads\/2022\/10\/Consent-Oral-sedation.pdf\" target=\"_blank\" download=\"Oral Sedation Consent\">\n\t\t\t\t\t\t\tDownload here\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0f7ff1a elementor-flip-box--effect-fade elementor-widget__width-initial flipbox-telecharger elementor-widget elementor-widget-flip-box\" data-id=\"0f7ff1a\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"elementor-flip-box__image\">\n\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"107\" height=\"105\" src=\"https:\/\/cliniquedentaireboca.ca\/wp-content\/uploads\/2022\/08\/document-icone.png\" class=\"attachment-Image Size 500x500 size-Image Size 500x500\" alt=\"\" loading=\"lazy\" \/>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"elementor-flip-box__layer__description\">\n\t\t\t\t\t\t\t\tWhitening Consent\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"elementor-flip-box__layer__title\">\n\t\t\t\t\t\t\tWhitening Consent\t\t\t\t\t\t<\/h3>\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-flip-box__button elementor-button elementor-size-sm\" href=\"https:\/\/cliniquedentaireboca.ca\/wp-content\/uploads\/2022\/10\/Consent-Whitening.pdf\" target=\"_blank\" download=\"Whitening Consent\">\n\t\t\t\t\t\t\tDownload here\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\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<section class=\"elementor-section elementor-top-section elementor-element elementor-element-943fc36 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"943fc36\" data-element_type=\"section\" id=\"return-document\" data-settings=\"{&quot;jet_parallax_layout_list&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-69a1a16\" data-id=\"69a1a16\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-4085111 elementor-widget elementor-widget-heading\" data-id=\"4085111\" 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\">Return a document<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7e273fd elementor-widget elementor-widget-text-editor\" data-id=\"7e273fd\" 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>To return a consent form, use this form.<\/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-f1289a1 document-form elementor-widget elementor-widget-wp-widget-gform_widget\" data-id=\"f1289a1\" data-element_type=\"widget\" data-widget_type=\"wp-widget-gform_widget.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<div class=\"jupiterx-widget widget_gform_widget\"><div class=\"jupiterx-widget-content\"><link rel='stylesheet' id='dashicons-css' href='https:\/\/cliniquedentaireboca.ca\/wp-includes\/css\/dashicons.min.css?ver=6.1.10' type='text\/css' media='all' \/>\n<script type='text\/javascript' src='https:\/\/cliniquedentaireboca.ca\/wp-includes\/js\/plupload\/moxie.min.js?ver=1.3.5' id='moxiejs-js'><\/script>\n<script type='text\/javascript' src='https:\/\/cliniquedentaireboca.ca\/wp-includes\/js\/plupload\/plupload.min.js?ver=2.1.9' id='plupload-js'><\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme' id='gform_wrapper_8' ><div id='gf_8' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_8' id='gform_8'  action='\/en\/wp-json\/wp\/v2\/pages\/3268#gf_8' >\n                        <div class='gform_body gform-body'><div id='gform_fields_8' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_8_1\"  class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_8_1\"><label class='gfield_label' for='input_8_1' >First name<\/label><div class='ginput_container ginput_container_text'><input name='input_1' id='input_8_1' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_8_2\"  class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_8_2\"><label class='gfield_label' for='input_8_2' >Last name<\/label><div class='ginput_container ginput_container_text'><input name='input_2' id='input_8_2' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_8_3\"  class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_8_3\"><label class='gfield_label' for='input_8_3' >Phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_3' id='input_8_3' type='text' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_4\"  class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_8_4\"><label class='gfield_label' for='input_8_4' >Email<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_4' id='input_8_4' type='text' value='' class='large'     aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_8_5\"  class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_8_5\"><label class='gfield_label' for='gform_browse_button_8_5' >Files<\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_8_5' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_8_5&quot;,&quot;container&quot;:&quot;gform_multifile_upload_8_5&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_8_5&quot;,&quot;filelist&quot;:&quot;gform_preview_8_5&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/cliniquedentaireboca.ca\\\/?gf_page=a8586c39cddf7ec&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/cliniquedentaireboca.ca\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/cliniquedentaireboca.ca\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;8388608b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:8,&quot;field_id&quot;:5},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;3&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_8_5&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_8_5' class='gform_drop_area'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_8_5' class='button gform_button_select_files' aria-describedby=\"gfield_upload_rules_8_5\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gform_fileupload_rules' id='gfield_upload_rules_8_5'>Max. file size: 8 MB, Max. files: 3.<\/span><ul class='validation_message validation_message--hidden-on-empty gfield_validation_message gform-ul-reset' id='gform_multifile_messages_8_5'><\/ul> <!-- Leave <ul> empty to support CSS :empty selector. --><\/div><div id='gform_preview_8_5'><\/div><\/div><\/div><\/div>\n        <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_8' class='gform_button button' value='Submit'  onclick='if(window[\"gf_submitting_8\"]){return false;}  window[\"gf_submitting_8\"]=true;  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_8\"]){return false;} window[\"gf_submitting_8\"]=true;  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id='gform_uploaded_files_8' value='' \/>\n        <\/div>\n                        <\/form>\n                        <\/div>\n                <iframe style='display:none;width:0px;height:0px;' src='about:blank' name='gform_ajax_frame_8' id='gform_ajax_frame_8' title='This iframe contains the logic required to handle Ajax powered Gravity Forms.'><\/iframe>\n                <script type=\"text\/javascript\">\ngform.initializeOnLoaded( function() {gformInitSpinner( 8, 'https:\/\/cliniquedentaireboca.ca\/wp-content\/plugins\/gravityforms\/images\/spinner.svg' );jQuery('#gform_ajax_frame_8').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_8');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_8').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = 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if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}setTimeout(function(){jQuery('#gform_wrapper_8').replaceWith(confirmation_content);jQuery(document).scrollTop(jQuery('#gf_8').offset().top - mt);jQuery(document).trigger('gform_confirmation_loaded', [8]);window['gf_submitting_8'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_8').text());}, 50);}else{jQuery('#gform_8').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger('gform_post_render', [8, current_page]);} );} );\n<\/script>\n<\/div><\/div>\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-13d4716 pv100 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"13d4716\" data-element_type=\"section\" id=\"infection-control\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[],&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-ede72da\" data-id=\"ede72da\" 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-5a43f34 elementor-widget elementor-widget-heading\" data-id=\"5a43f34\" 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\">Infection control\n<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6f4e694 elementor-widget elementor-widget-text-editor\" data-id=\"6f4e694\" 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><span style=\"font-weight: 400;\">At Clinique Dentaire Boca, we work hard to prevent the contamination of our patients and our staff. To achieve this, we have a rigorous asepsis, disinfection, and sterilization protocol.<\/span><\/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-b35eaa0 elementor-widget elementor-widget-jet-accordion\" data-id=\"b35eaa0\" data-element_type=\"widget\" data-widget_type=\"jet-accordion.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"jet-accordion\" data-settings=\"{&quot;collapsible&quot;:false,&quot;ajaxTemplate&quot;:false,&quot;switchScrolling&quot;:false,&quot;switchScrollingOffset&quot;:0}\" role=\"tablist\">\n\t\t\t<div class=\"jet-accordion__inner\">\n\t\t\t\t<div class=\"jet-accordion__item jet-toggle jet-toggle-move-up-effect \">\n\t\t\t\t\t\t\t<div id=\"jet-toggle-control-1881\" class=\"jet-toggle__control elementor-menu-anchor\" data-toggle=\"1\" role=\"tab\" aria-controls=\"jet-toggle-content-1881\" aria-expanded=\"false\" data-template-id=\"false\">\n\t\t\t\t\t\t\t\t<div class=\"jet-toggle__label-icon jet-toggle-icon-position-right\"><span class=\"jet-toggle__icon icon-normal jet-tabs-icon\"><i aria-hidden=\"true\" class=\"far fa-plus\"><\/i><\/span><span class=\"jet-toggle__icon icon-active jet-tabs-icon\"><i aria-hidden=\"true\" class=\"far fa-minus\"><\/i><\/span><\/div><div class=\"jet-toggle__label-text\">Asepsis<\/div>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div id=\"jet-toggle-content-1881\" class=\"jet-toggle__content\" data-toggle=\"1\" role=\"tabpanel\" aria-hidden=\"true\" data-template-id=\"false\">\n\t\t\t\t\t\t\t\t<div class=\"jet-toggle__content-inner\"><p><span style=\"font-weight: 400;\">Asepsis is described as the absence of micro-organisms that can cause infections. In a dental clinic, asepsis depends on an entire series of actions that must be taken by the dental staff, and each step must occur without introducing micro-organisms.<\/span><\/p><p><span style=\"font-weight: 400;\">Maintaining an aseptic environment in our clinic involves the use of techniques such as hand washing, gloves, masks, eye protection, cleaning and disinfecting work surfaces, and cleaning and sterilizing the instruments that come into contact with the patient\u2019s mouth.<\/span><\/p><\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div><div class=\"jet-accordion__item jet-toggle jet-toggle-move-up-effect \">\n\t\t\t\t\t\t\t<div id=\"jet-toggle-control-1882\" class=\"jet-toggle__control elementor-menu-anchor\" data-toggle=\"2\" role=\"tab\" aria-controls=\"jet-toggle-content-1882\" aria-expanded=\"false\" data-template-id=\"false\">\n\t\t\t\t\t\t\t\t<div class=\"jet-toggle__label-icon jet-toggle-icon-position-right\"><span class=\"jet-toggle__icon icon-normal jet-tabs-icon\"><i aria-hidden=\"true\" class=\"fas fa-plus\"><\/i><\/span><span class=\"jet-toggle__icon icon-active jet-tabs-icon\"><i aria-hidden=\"true\" class=\"fas fa-minus\"><\/i><\/span><\/div><div class=\"jet-toggle__label-text\">Disinfection<\/div>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div id=\"jet-toggle-content-1882\" class=\"jet-toggle__content\" data-toggle=\"2\" role=\"tabpanel\" aria-hidden=\"true\" data-template-id=\"false\">\n\t\t\t\t\t\t\t\t<div class=\"jet-toggle__content-inner\"><p><span style=\"font-weight: 400;\">Disinfection decreases the bacterial population by destroying certain micro-organisms, but not bacterial spores. It is primarily used for work surfaces.<\/span><\/p><p><span style=\"font-weight: 400;\">The effectiveness of the disinfection depends on the product used, and the surface must have been cleaned beforehand for the disinfectant to be effective.<\/span><\/p><\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div><div class=\"jet-accordion__item jet-toggle jet-toggle-move-up-effect \">\n\t\t\t\t\t\t\t<div id=\"jet-toggle-control-1883\" class=\"jet-toggle__control elementor-menu-anchor\" data-toggle=\"3\" role=\"tab\" aria-controls=\"jet-toggle-content-1883\" aria-expanded=\"false\" data-template-id=\"false\">\n\t\t\t\t\t\t\t\t<div class=\"jet-toggle__label-icon jet-toggle-icon-position-right\"><span class=\"jet-toggle__icon icon-normal jet-tabs-icon\"><i aria-hidden=\"true\" class=\"fas fa-plus\"><\/i><\/span><span class=\"jet-toggle__icon icon-active jet-tabs-icon\"><i aria-hidden=\"true\" class=\"fas fa-minus\"><\/i><\/span><\/div><div class=\"jet-toggle__label-text\">Sterilization<\/div>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div id=\"jet-toggle-content-1883\" class=\"jet-toggle__content\" data-toggle=\"3\" role=\"tabpanel\" aria-hidden=\"true\" data-template-id=\"false\">\n\t\t\t\t\t\t\t\t<div class=\"jet-toggle__content-inner\"><p><span style=\"font-weight: 400;\">Sterilization eliminates all micro-organisms, including viruses and bacterial spores. It always starts with a proper cleaning of the instruments to eliminate all traces of blood, saliva, and debris, because these create a screen that limits the action of the sterilization.<\/span><\/p><p><span style=\"font-weight: 400;\">Sterilization is performed on all instruments that are not disposable and that come into contact with the mouth.<\/span><\/p><\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\t\t\t\t\t\t\t\t<\/div>\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\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Patients&#8217; corner Confidential Medical-Dental Questionnaire The dental record is established as part of the care that will be provided: it is protected by law and professional secrecy. It is kept in the office and only the dentist and his staff have access to it. The patient also has the right of access and rectification. This [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":[],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v19.10 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Patients&#039; corner - Clinique dentaire Boca<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/cliniquedentaireboca.ca\/en\/patients-corner\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Patients&#039; corner - Clinique dentaire Boca\" \/>\n<meta property=\"og:description\" content=\"Patients&#8217; corner Confidential Medical-Dental Questionnaire The dental record is established as part of the care that will be provided: it is protected by law and professional secrecy. 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