{"id":3358,"date":"2020-06-16T14:00:52","date_gmt":"2020-06-16T13:00:52","guid":{"rendered":"https:\/\/dev1.mustardburp.co.uk\/?page_id=3358"},"modified":"2022-09-15T11:49:48","modified_gmt":"2022-09-15T10:49:48","slug":"make-a-referral","status":"publish","type":"page","link":"https:\/\/www.kisimul.co.uk\/make-a-referral\/","title":{"rendered":"Make a Referral"},"content":{"rendered":"<div class=\"wpb-content-wrapper\">[vc_row][vc_column][vc_single_image image=&#8221;6257&#8243;][vc_empty_space][vc_column_text]\n<h1 style=\"text-align: center;\">Make a Referral<\/h1>\n<h3 style=\"text-align: center;\">So we can make sure your referral is directed to the most appropriate person, it would help us if you could provide as much information as possible and upload any relevant paperwork.<\/h3>\n[\/vc_column_text][vc_empty_space][\/vc_column][\/vc_row][vc_row][vc_column width=&#8221;1\/4&#8243;][\/vc_column][vc_column width=&#8221;1\/2&#8243;]\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f3360-o1\" lang=\"en-GB\" dir=\"ltr\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/wp-json\/wp\/v2\/pages\/3358#wpcf7-f3360-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"3360\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"5.9.3\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_GB\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f3360-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<p><label> Your Name (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-name\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-name\" \/><\/span> <\/label>\n<\/p>\n<p><label> Your Email (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span> <\/label>\n<\/p>\n<p><label> Your Phone (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-phone\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-phone\" \/><\/span> <\/label>\n<\/p>\n<p><label> Age of referred Individual (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"age\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"age\" \/><\/span> <\/label>\n<\/p>\n<p><label> Is Post 19 Required (required) <\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"post19\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><span class=\"wpcf7-list-item-label\">Yes<\/span><input type=\"radio\" name=\"post19\" value=\"Yes\" \/><\/label><\/span><span class=\"wpcf7-list-item last\"><label><span class=\"wpcf7-list-item-label\">No<\/span><input type=\"radio\" name=\"post19\" value=\"No\" \/><\/label><\/span><\/span><\/span>\n<\/p>\n<p><label> What type of service is being sought (required) <\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"service\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"service\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Adult Residential Placement\">Adult Residential Placement<\/option><option value=\"College Day Placement\">College Day Placement<\/option><option value=\"Adult Supported Living Placement\">Adult Supported Living Placement<\/option><option value=\"Children\u2019s Day Placement\">Children\u2019s Day Placement<\/option><option value=\"Children\u2019s Residential Placement\">Children\u2019s Residential Placement<\/option><\/select><\/span>\n<\/p>\n<p><label> Any other Details (Please be as specific as possible)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"referral-details\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"referral-details\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><b>GDPR<\/b><br \/>\nWould you like to receive Â鶹ÊÓƵ news updates and information about our services?\n<\/p>\n<p>We promise to treat your personal details with the utmost care, and will never sell, distribute or lease your data to other companies to use for their own marketing purposes.\n<\/p>\n<p>Yes please (tick box) <span class=\"wpcf7-form-control-wrap\" data-name=\"acceptance-13\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"acceptance-13\" value=\"1\" aria-invalid=\"false\" \/><\/span><\/span><\/span>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send\" \/>\n<\/p><p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"_wpcf7_ak_\"><label>&#916;<textarea name=\"_wpcf7_ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"_wpcf7_ak_js\" value=\"167\"\/><script>document.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );<\/script><\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n[\/vc_column][vc_column width=&#8221;1\/4&#8243;][\/vc_column][\/vc_row][vc_row][vc_column][vc_empty_space][\/vc_column][\/vc_row]\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row][vc_column][vc_single_image image=&#8221;6257&#8243;][vc_empty_space][vc_column_text] Make a Referral So we can make sure your referral is directed to the most appropriate person, it would help us if you could provide as much information as possible and upload any relevant paperwork. [\/vc_column_text][vc_empty_space][\/vc_column][\/vc_row][vc_row][vc_column width=&#8221;1\/4&#8243;][\/vc_column][vc_column width=&#8221;1\/2&#8243;][\/vc_column][vc_column width=&#8221;1\/4&#8243;][\/vc_column][\/vc_row][vc_row][vc_column][vc_empty_space][\/vc_column][\/vc_row]<\/p>\n","protected":false},"author":20,"featured_media":0,"parent":0,"menu_order":99,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.kisimul.co.uk\/wp-json\/wp\/v2\/pages\/3358"}],"collection":[{"href":"https:\/\/www.kisimul.co.uk\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.kisimul.co.uk\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.kisimul.co.uk\/wp-json\/wp\/v2\/users\/20"}],"replies":[{"embeddable":true,"href":"https:\/\/www.kisimul.co.uk\/wp-json\/wp\/v2\/comments?post=3358"}],"version-history":[{"count":16,"href":"https:\/\/www.kisimul.co.uk\/wp-json\/wp\/v2\/pages\/3358\/revisions"}],"predecessor-version":[{"id":7484,"href":"https:\/\/www.kisimul.co.uk\/wp-json\/wp\/v2\/pages\/3358\/revisions\/7484"}],"wp:attachment":[{"href":"https:\/\/www.kisimul.co.uk\/wp-json\/wp\/v2\/media?parent=3358"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}