{"id":2604,"date":"2025-04-28T16:12:31","date_gmt":"2025-04-28T05:12:31","guid":{"rendered":"https:\/\/bornfree.life\/2024\/?p=2604"},"modified":"2026-02-04T16:37:56","modified_gmt":"2026-02-04T05:37:56","slug":"oligoscan-provider-submission","status":"publish","type":"page","link":"https:\/\/bornfree.life\/learn\/oligoscan-provider-submission\/","title":{"rendered":"Oligoscan Provider Submission"},"content":{"rendered":"\n\n\n<div class=\"flex flex-col gap-5 items-center title-container\"><a href=\"https:\/\/bornfree.life\/learn\/oligoscan-provider-submission\/\"><h1 class=\"text-center text-5xl text-blue-title font-semibold\">\n        Oligoscan Provider Submission      <\/h1><\/a>\n\n          <\/div>\n\n    <div class=\"border-t h-px border-default-border w-full\"><br><\/div><p><br><\/p>\n<div class=\"frm_forms  with_frm_style frm_style_formidable-style\" id=\"frm_form_2_container\" data-token=\"a7361bc5e13c148509779e3fc1dff601\">\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form \" id=\"form_oligo-submit\" data-token=\"a7361bc5e13c148509779e3fc1dff601\">\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_screen_reader\">Oligoscan Provider Submission<\/legend>\r\n\r\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"2\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_2\" id=\"frm_hide_fields_2\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"oligo-submit\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_2\" name=\"frm_submit_entry_2\" value=\"c0d4b8137d\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/learn\/wp-json\/wp\/v2\/pages\/2604\" \/><div id=\"frm_field_7_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n\t<label for=\"field_y8ffo\" id=\"field_y8ffo_label\" class=\"frm_primary_label\">Provider\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n\t<\/label>\r\n\t<input type=\"text\" id=\"field_y8ffo\" name=\"item_meta[7]\" value=\"\"  data-invmsg=\"Provider is invalid\" aria-invalid=\"false\"  \/>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_8_container\" class=\"frm_form_field form-field  frm_top_container frm4 frm_first\">\r\n\t<label for=\"field_74scm\" id=\"field_74scm_label\" class=\"frm_primary_label\">Region\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n\t<\/label>\r\n\t<input type=\"text\" id=\"field_74scm\" name=\"item_meta[8]\" value=\"\"  data-invmsg=\"Region is invalid\" aria-invalid=\"false\"  \/>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_9_container\" class=\"frm_form_field form-field  frm_top_container frm4\">\r\n\t<label for=\"field_49mlu\" id=\"field_49mlu_label\" class=\"frm_primary_label\">Country\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n\t<\/label>\r\n\t<input type=\"text\" id=\"field_49mlu\" name=\"item_meta[9]\" value=\"\"  data-invmsg=\"Country is invalid\" aria-invalid=\"false\"  \/>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_10_container\" class=\"frm_form_field form-field  frm_top_container frm4\">\r\n\t<label for=\"field_q6shc\" id=\"field_q6shc_label\" class=\"frm_primary_label\">Postcode\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n\t<\/label>\r\n\t<input type=\"text\" id=\"field_q6shc\" name=\"item_meta[10]\" value=\"\"  data-invmsg=\"Postcode is invalid\" aria-invalid=\"false\"  \/>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_11_container\" class=\"frm_form_field form-field  frm_top_container frm6 frm_first\">\r\n\t<label for=\"field_hepyl\" id=\"field_hepyl_label\" class=\"frm_primary_label\">State\/Territory\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n\t<\/label>\r\n\t<input type=\"text\" id=\"field_hepyl\" name=\"item_meta[11]\" value=\"\"  data-invmsg=\"State\/Territory is invalid\" aria-invalid=\"false\"  \/>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_12_container\" class=\"frm_form_field form-field  frm_top_container frm6\">\r\n\t<label for=\"field_awgkq\" id=\"field_awgkq_label\" class=\"frm_primary_label\">City\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n\t<\/label>\r\n\t<input type=\"text\" id=\"field_awgkq\" name=\"item_meta[12]\" value=\"\"  data-invmsg=\"City is invalid\" aria-invalid=\"false\"  \/>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_13_container\" class=\"frm_form_field form-field  frm_top_container frm6 frm_first\">\r\n\t<label for=\"field_a8xa5\" id=\"field_a8xa5_label\" class=\"frm_primary_label\">Street\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n\t<\/label>\r\n\t<input type=\"text\" id=\"field_a8xa5\" name=\"item_meta[13]\" value=\"\"  data-invmsg=\"Street is invalid\" aria-invalid=\"false\"  \/>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_14_container\" class=\"frm_form_field form-field  frm_top_container frm6\">\r\n\t<label for=\"field_vo681\" id=\"field_vo681_label\" class=\"frm_primary_label\">Phone\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n\t<\/label>\r\n\t<input type=\"text\" id=\"field_vo681\" name=\"item_meta[14]\" value=\"\"  data-invmsg=\"Phone is invalid\" aria-invalid=\"false\"  \/>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_15_container\" class=\"frm_form_field form-field  frm_top_container frm6 frm_first\">\r\n\t<label for=\"field_gunst\" id=\"field_gunst_label\" class=\"frm_primary_label\">Website\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n\t<\/label>\r\n\t<input type=\"text\" id=\"field_gunst\" name=\"item_meta[15]\" value=\"\"  data-invmsg=\"Website is invalid\" aria-invalid=\"false\"  \/>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_16_container\" class=\"frm_form_field form-field  frm_top_container frm6\">\r\n\t<label for=\"field_tjyfl\" id=\"field_tjyfl_label\" class=\"frm_primary_label\">Email\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n\t<\/label>\r\n\t<input type=\"text\" id=\"field_tjyfl\" name=\"item_meta[16]\" value=\"\"  data-invmsg=\"Email is invalid\" aria-invalid=\"false\"  \/>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_17_container\" class=\"frm_form_field form-field  frm_top_container frm12 frm_first\">\r\n\t<label for=\"field_pq11n\" id=\"field_pq11n_label\" class=\"frm_primary_label\">Notes\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n\t<\/label>\r\n\t<input type=\"text\" id=\"field_pq11n\" name=\"item_meta[17]\" value=\"\"  data-invmsg=\"Notes is invalid\" aria-invalid=\"false\"  \/>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_18_container\" class=\"frm_form_field form-field  frm_top_container frm6 frm_first\">\r\n\t<label for=\"field_q8yl0\" id=\"field_q8yl0_label\" class=\"frm_primary_label\">In-clinic Price\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n\t<\/label>\r\n\t<input type=\"text\" id=\"field_q8yl0\" name=\"item_meta[18]\" value=\"\"  data-invmsg=\"In-clinic Price is invalid\" aria-invalid=\"false\"  \/>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_19_container\" class=\"frm_form_field form-field  frm_top_container frm6\">\r\n\t<label for=\"field_s2t0e\" id=\"field_s2t0e_label\" class=\"frm_primary_label\">Home Visit\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n\t<\/label>\r\n\t<input type=\"text\" id=\"field_s2t0e\" name=\"item_meta[19]\" value=\"\"  data-invmsg=\"Home Visit is invalid\" aria-invalid=\"false\"  \/>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_20_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio\">\n\t<div  id=\"field_ylrxa_label\" class=\"frm_primary_label\">Type of Submission:\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n\t<\/div>\n\t<div class=\"frm_opt_container\" aria-labelledby=\"field_ylrxa_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_20-0\">\t\t\t<label  for=\"field_ylrxa-0\">\n\t\t\t<input type=\"checkbox\" name=\"item_meta[20][]\" id=\"field_ylrxa-0\" value=\"Addition\"  data-invmsg=\"Type of Submission: is invalid\"   \/> Addition<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_20-1\">\t\t\t<label  for=\"field_ylrxa-1\">\n\t\t\t<input type=\"checkbox\" name=\"item_meta[20][]\" id=\"field_ylrxa-1\" value=\"Update\"  data-invmsg=\"Type of Submission: is invalid\"   \/> Update<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_20-2\">\t\t\t<label  for=\"field_ylrxa-2\">\n\t\t\t<input type=\"checkbox\" name=\"item_meta[20][]\" id=\"field_ylrxa-2\" value=\"Removal\"  data-invmsg=\"Type of Submission: is invalid\"   \/> Removal<\/label><\/div>\n<\/div>\n\t\n\t\n<\/div>\n<div id=\"frm_field_23_container\" class=\"frm_form_field form-field  frm_none_container\">\n\t<label for=\"g-recaptcha-response\" id=\"field_ktpt8_label\" class=\"frm_primary_label\">Captcha\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n\t<\/label>\n\t<div  id=\"field_ktpt8\" class=\"frm-g-recaptcha\" data-sitekey=\"6LdfSVIsAAAAAEZxeYzt5zkjJg799Xi6ItiR21zd\" data-size=\"invisible\" data-theme=\"light\"><\/div>\n\t\n\t\n<\/div>\n<div id=\"frm_field_6_container\" class=\"frm_form_field form-field  frm12 frm_first\">\r\n\t<div class=\"frm_submit frm_flex\">\r\n<button class=\"frm_button_submit\" type=\"submit\"  >Submit<\/button>\r\n\r\n\r\n\r\n<\/div>\r\n<\/div>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t\t\t<div id=\"frm_field_24_container\">\n\t\t\t<label for=\"field_7dja5\" >\n\t\t\t\tIf you are human, leave this field blank.\t\t\t<\/label>\n\t\t\t<input  id=\"field_7dja5\" type=\"text\" class=\"frm_form_field form-field frm_verify\" name=\"item_meta[24]\" value=\"\"  \/>\n\t\t<\/div>\n\t\t<input name=\"frm_state\" type=\"hidden\" value=\"1N86N4kW8RMGwvwUWkCQ4\/mWA+PyJ7mZym7JGIURL\/U=\" \/><\/div>\n<\/fieldset>\n<\/div>\n\n<\/form>\n<\/div>\n\n\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"pagelayer_contact_templates":[],"_pagelayer_content":"","footnotes":""},"class_list":["post-2604","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/bornfree.life\/learn\/wp-json\/wp\/v2\/pages\/2604","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/bornfree.life\/learn\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/bornfree.life\/learn\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/bornfree.life\/learn\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/bornfree.life\/learn\/wp-json\/wp\/v2\/comments?post=2604"}],"version-history":[{"count":0,"href":"https:\/\/bornfree.life\/learn\/wp-json\/wp\/v2\/pages\/2604\/revisions"}],"wp:attachment":[{"href":"https:\/\/bornfree.life\/learn\/wp-json\/wp\/v2\/media?parent=2604"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}