{"id":786,"date":"2023-08-21T14:23:31","date_gmt":"2023-08-21T14:23:31","guid":{"rendered":"https:\/\/mariestopes.or.ug\/?page_id=786"},"modified":"2024-12-05T08:33:41","modified_gmt":"2024-12-05T08:33:41","slug":"book-an-appointment","status":"publish","type":"page","link":"https:\/\/www.mariestopes.or.ug\/sw\/book-an-appointment\/","title":{"rendered":"Weka miadi"},"content":{"rendered":"<div class=\"wp-block-msi-blocks-header-image alignfull\"><div class=\"right-image-block\"><div class=\"container-wide\"><div class=\"input-container\"><h1 class=\"h2-size\">Weka miadi<\/h1><div class=\"description\"><h3>Fill out the form below to book an appointment at one of our clinics.<\/h3><\/div><\/div><div class=\"container-image\"><div class=\"image-container\"><img decoding=\"async\" src=\"https:\/\/mariestopes.or.ug\/wp-content\/uploads\/sites\/27\/2024\/02\/8c96bf7d3a5bbd5504275c698d51a9e3385937c6.jpg\" alt=\"8c96bf7d3a5bbd5504275c698d51a9e3385937c6\" class=\"header-image\" \/><img decoding=\"async\" src=\"image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMTkwIiBoZWlnaHQ9IjE2NCIgdmlld0JveD0iMCAwIDE5MCAxNjQiIGZpbGw9Im5vbmUiIHhtbG5zPSJodHRwOi8vd3d3LnczLm9yZy8yMDAwL3N2ZyI+CjxyZWN0IHk9Ii0yNiIgd2lkdGg9IjE5MCIgaGVpZ2h0PSIxOTAiIHJ4PSI4IiBmaWxsPSIjRUJGM0ZCIi8+Cjwvc3ZnPgo=\" class=\"rectangle first\" \/><img decoding=\"async\" src=\"image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMTg2IiBoZWlnaHQ9IjIzMyIgdmlld0JveD0iMCAwIDE4NiAyMzMiIGZpbGw9Im5vbmUiIHhtbG5zPSJodHRwOi8vd3d3LnczLm9yZy8yMDAwL3N2ZyI+CjxyZWN0IHdpZHRoPSIxODYiIGhlaWdodD0iMjUxIiByeD0iOCIgZmlsbD0iIzlEQ0RGMCIvPgo8L3N2Zz4K\" class=\"rectangle second\" \/><\/div><\/div><\/div><\/div><\/div>\n\n\n<div  class=\"alignwide wp-block-msi-blocks-breadcrumbs\">\r\n\t<h3>\r\n\t\t\t\t\t\t<a class='breadcrumb' href='https:\/\/www.mariestopes.or.ug\/sw'>Nyumbani<\/a>\r\n\t\t\t<span class=\"breadcrumbs_delimiter\"> &nbsp;&nbsp;<svg width=\"6\" height=\"10\" viewbox=\"0 0 6 10\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\r\n<path d=\"M1 9L5 5L1 1\" stroke=\"#283573\" stroke-width=\"2\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/>\r\n<\/svg>\r\n&nbsp;<\/span>\t\t\t\t<span class='breadcrumb'>Weka miadi<\/span>\r\n\t\t\t\t\t\r\n\t<\/h3>\r\n<\/div>\r\n\n\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-1 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<div class=\"wp-block-contact-form-7-contact-form-selector\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f1689-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"1689\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/sw\/wp-json\/wp\/v2\/pages\/786#wpcf7-f1689-o1\" method=\"post\" class=\"wpcf7-form init wpcf7-acceptance-as-validation\" id=\"MSI-form-book-an-appointment\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\" data-trp-original-action=\"\/sw\/wp-json\/wp\/v2\/pages\/786#wpcf7-f1689-o1\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"1689\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.0.5\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f1689-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/div>\n<div class='msi-cf7-book-an-appointment nepal-form nigeria-form book-an-appointment-ke'>\n\t<div>\n\t\t<h5>Jina <span class=\"required\">*<\/span>\n\t\t<\/h5>\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required msi-cf7-input\" autocomplete=\"name\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Enter your full name\" value=\"\" type=\"text\" name=\"your-name\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div>\n\t\t<h5>Mobile phone <span class=\"required\">*<\/span>\n\t\t<\/h5>\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-tel\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel msi-cf7-input\" autocomplete=\"tel\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Enter your phone number\" value=\"\" type=\"tel\" name=\"your-tel\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div>\n\t\t<h5>Email address\n\t\t<\/h5>\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-text wpcf7-validates-as-email msi-cf7-input\" autocomplete=\"email\" aria-invalid=\"false\" placeholder=\"Enter your email address\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div>\n\t\t<h5>Location <span class=\"required\">*<\/span>\n\t\t<\/h5>\n\t\t<p>Your address, closest landmark or preferred centre\n\t\t<\/p>\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"location\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required msi-cf7-input\" autocomplete=\"location\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"location\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div>\n\t\t<h5>Type of service\n\t\t<\/h5>\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"service_type\"><select class=\"wpcf7-form-control wpcf7-select msi-cf7-selector\" aria-invalid=\"false\" name=\"service_type\"><option value=\"\"><\/option><option value=\"Antenatal Care\">Antenatal Care<\/option><option value=\"Gynaecology Consultation\">Gynaecology Consultation<\/option><option value=\"Contraception or Family Planning\">Contraception or Family Planning<\/option><option value=\"STI Testing and Management\">STI Testing and Management<\/option><option value=\"General Health Consultation\">General Health Consultation<\/option><option value=\"Laboratory Services\">Laboratory Services<\/option><option value=\"Breast Examination\">Breast Examination<\/option><option value=\"Cervical Cancer Screening\">Cervical Cancer Screening<\/option><option value=\"Immunizations\">Immunizations<\/option><option value=\"Post Abortion Care\">Post Abortion Care<\/option><option value=\"Ongoing Campaign\">Ongoing Campaign<\/option><\/select><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class='datetime-selector'>\n\t\t<h5>Preferred date of appointment\n\t\t<\/h5>\n\t\t<p>Select a preferred date for your appointment\n\t\t<\/p>\n\t\t<div style='position:relative' class=\"datetime-selector-input\">\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"date-406\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date msi-cf7-selector\" id=\"cf7_date_holder\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"date-406\" \/><\/span><br \/>\n<input class='msi-cf7-selector' id='cf7_text_date_picker' name='date-and-time' type='text' style='position:absolute;top:0;left:0' \/>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"field-gap\">\n\t\t<h5>Comments or questions\n\t\t<\/h5>\n\t\t<p>Let us know if you have any comments or queries\n\t\t<\/p>\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"Message\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea msi-cf7-textarea\" aria-invalid=\"false\" name=\"Message\"><\/textarea><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"field-gap\">\n\t\t<h5>Confirm we can contact you <span class=\"required\">*<\/span>\n\t\t<\/h5>\n\t\t<fieldset class='msi-cf7-fieldset'>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"confirm-contact\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"confirm-contact\" value=\"1\" class=\"classname\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">To make your booking we'll need to contact you. Tick this box to say that's okay<\/span><\/label><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t<\/fieldset>\n\t<\/div>\n\t<div class=\"field-gap\">\n\t\t<h5>Is it unsafe to call you?\n\t\t<\/h5>\n\t\t<fieldset class='msi-cf7-fieldset'>\n\t\t\t<p class='checkbox-label'>If you do not want us to call you, please tick here and we'll use another method of contact (SMS, WhatsApp)\n\t\t\t<\/p>\n\t\t\t<p><input type='hidden' value='No' name='call-you' \/><input class='msi-call-back' type=\"checkbox\" name=\"call-you\" value=\"Yes\" \/>\n\t\t\t<\/p>\n\t\t<\/fieldset>\n\t<\/div>\n\t<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner msi-cf7-submit\" type=\"submit\" value=\"Submit\" \/>\n\t<\/p>\n<\/div><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<input type=\"hidden\" name=\"trp-form-language\" value=\"sw\"\/><\/form>\n<\/div>\n<\/div>\n<\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-786","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.7 - 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