Fill The Form To Book An Appointment
Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry’.
{
parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false,"expression":"null"}, el)
}}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-text"
as=${html``}
/>
parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false,"expression":"null"}, el)}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-telephone"
as=${html``}
/>
<${props.Select}
className=${"mf-input mf-input-select " + ( validation.errors['mf-select'] ? 'mf-invalid' : '' )}
classNamePrefix="mf_select"
name="mf-select"
placeholder="${ parent.decodeEntities(`Choose services`) } "
isSearchable=${false}
options=${[{"label":"Item 1","value":"value-1","isDisabled":false},{"label":"Item 2","value":"value-2","isDisabled":false},{"label":"Item 3","value":"value-3","isDisabled":false}]}
value=${parent.getValue("mf-select") ? [{"label":"Item 1","value":"value-1","isDisabled":false},{"label":"Item 2","value":"value-2","isDisabled":false},{"label":"Item 3","value":"value-3","isDisabled":false}].filter(item => item.value === parent.getValue("mf-select"))[0] : []}
onChange=${(e)=> parent.handleSelect(e, "mf-select")}
ref=${() => {
register({ name: "mf-select" }, parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false}));
if ( parent.getValue("mf-select") === '' && false ) {
parent.setValue( 'mf-select', '', true );
parent.handleChange({
target: {
name: 'mf-select',
value: ''
}
});
}
}}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-select"
as=${html``}
/>
<${props.Flatpickr}
name="mf-date"
className="mf-input mf-date-input mf-left-parent "
placeholder="${ parent.decodeEntities(`Choose Preferred Time`) } "
options=${{"minDate":"","maxDate":"","dateFormat":"m-d-Y","enableTime":"","disable":[],"mode":"single","static":true,"disableMobile":true,"time_24hr":false}}
value=${parent.getValue('mf-date')}
onInput=${parent.handleDateTime}
aria-invalid=${validation.errors['mf-date'] ? 'true' : 'false'}
ref=${el => props.DateWidget(
el,
'',
{"message":"This field is required.","required":false},
register,
parent
)}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-date"
as=${html``}
/>
<${props.Select}
isOptionDisabled=${option => option.mf_input_option_status === 'disabled'}
className=${"mf-input mf-input-multiselect " + ( validation.errors['mf-multi-select'] ? 'mf-invalid' : '' )}
classNamePrefix="mf_multiselect"
value=${parent.getValue("mf-multi-select") && [{"label":"Item 1","value":"value-1","_id":"b2dc089","mf_input_option_status":"","mf_input_option_selected":""},{"label":"Item 2","value":"value-2","_id":"e258080","mf_input_option_status":"","mf_input_option_selected":""},{"label":"Item 3","value":"value-3","_id":"90e2f58","mf_input_option_status":"","mf_input_option_selected":""}].filter(item => {
if(parent.state.formData['mf-multi-select'] && parent.state.formData['mf-multi-select'].indexOf(item.value) != -1 ){
return item;
}
})}
name='mf-multi-select'
placeholder="${ parent.decodeEntities(`Choose Required Medical Care`) } "
options=${[{"label":"Item 1","value":"value-1","_id":"b2dc089","mf_input_option_status":"","mf_input_option_selected":""},{"label":"Item 2","value":"value-2","_id":"e258080","mf_input_option_status":"","mf_input_option_selected":""},{"label":"Item 3","value":"value-3","_id":"90e2f58","mf_input_option_status":"","mf_input_option_selected":""}]}
onChange=${(el) => {
setValue("mf-multi-select", '');
if(el != null){
setValue("mf-multi-select", el, true);
}
parent.multiSelectChange(el, 'mf-multi-select');
}}
ref=${() => {
register({ name: "mf-multi-select" }, parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false}));
if(parent.state?.submitted !== true){
if ( parent.getValue("mf-multi-select") === '' && false ) {
parent.setValue( 'mf-multi-select', '[]');
parent.multiSelectChange('[]', 'mf-multi-select');
}
}
}}
isMulti
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-multi-select"
as=${html``}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-textarea"
as=${html``}
/>