{"id":31,"date":"2018-07-23T06:15:55","date_gmt":"2018-07-23T06:15:55","guid":{"rendered":"http:\/\/en.mehrhospital.org\/?page_id=31"},"modified":"2018-07-23T06:15:55","modified_gmt":"2018-07-23T06:15:55","slug":"suggestion-complaint-form","status":"publish","type":"page","link":"https:\/\/mehrmashhadhospital.ir\/en\/suggestion-complaint-form\/","title":{"rendered":"Suggestion &#038; Complaint Form"},"content":{"rendered":"<p style=\"text-align: center;\"><img fetchpriority=\"high\" decoding=\"async\" class=\"alignnone size-full wp-image-307\" src=\"http:\/\/en.mehrhospital.com\/wp-content\/uploads\/2018\/08\/Mehr-Hospital-Gallery-4-2.jpg\" alt=\"\" width=\"1200\" height=\"267\" srcset=\"https:\/\/mehrmashhadhospital.ir\/en\/wp-content\/uploads\/2018\/08\/Mehr-Hospital-Gallery-4-2.jpg 1200w, https:\/\/mehrmashhadhospital.ir\/en\/wp-content\/uploads\/2018\/08\/Mehr-Hospital-Gallery-4-2-300x67.jpg 300w, https:\/\/mehrmashhadhospital.ir\/en\/wp-content\/uploads\/2018\/08\/Mehr-Hospital-Gallery-4-2-768x171.jpg 768w, https:\/\/mehrmashhadhospital.ir\/en\/wp-content\/uploads\/2018\/08\/Mehr-Hospital-Gallery-4-2-1024x228.jpg 1024w, https:\/\/mehrmashhadhospital.ir\/en\/wp-content\/uploads\/2018\/08\/Mehr-Hospital-Gallery-4-2-600x134.jpg 600w\" sizes=\"(max-width: 1200px) 100vw, 1200px\" \/><\/p>\n<p style=\"text-align: center;\"><style type=\"text\/css\" id=\"101\" data-form-unique-id=\"73979\" ><\/style><div class=\"arf_form ar_main_div_101 arf_form_outer_wrapper \" id=\"arffrm_101_container\"><div id=\"arf_message_success_popup\" style=\"display:none;\"><div class=\"msg-detail\"><div class=\"msg-description-success\">Form is successfully submitted. 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class=\"arf_fieldset arf_materialize_form\" id=\"arf_fieldset_73979\"><div id=\"page_0\" class=\"page_break\"><div id=\"arf_field_133_73979_container\" class=\"arfformfield input-field control-group arfmainformfield  arf_field_type_select  top_container  top_container arfformfield frm_first_half arf_field_133\"    data-field-type=\"select\"><div class=\" sltstandard_front controls\"  ><label for=\"field_r816g1_73979\" class=\"arf_main_label arf_main_label_16px active \">Title<\/label><select name=\"item_meta[133]\" id=\"field_r816g1_73979\" style=\"width:auto;min-width:100px; \" data-size=\"15\" data-default-val=\"Mr.\"   ><option value=\"Mr.\" selected=\"selected\"  data-content=\"Mr.\">Mr.<\/option><option value=\"Mrs.\"  data-content=\"Mrs.\">Mrs.<\/option><option value=\"Ms.\"  data-content=\"Ms.\">Ms.<\/option><option value=\"Dr.\"  data-content=\"Dr.\">Dr.<\/option><option value=\"Prof.\"  data-content=\"Prof.\">Prof.<\/option><\/select><\/div><\/div><div class=\"arf_half_middle\"><\/div><div id=\"arf_field_134_73979_container\" class=\"arfformfield control-group arfmainformfield  arf_field_type_text  top_container top_container arfformfield frm_last_half arf_field_134\"   data-field-type=\"text\" ><div class=\"controls\"   ><label for=\"field_8rc6lz_73979\" class=\"arf_main_label arf_main_label_16px active \">Full Name<\/label><input   type=\"text\" id=\"field_8rc6lz_73979\"  name=\"item_meta[134]\"   \/><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_135_73979_container\" class=\"arfformfield control-group arfmainformfield  arf_field_type_text  top_container top_container arfformfield frm_first_half arf_field_135\"   data-field-type=\"text\" ><div class=\"controls\"   ><label for=\"field_qd65i4_73979\" class=\"arf_main_label arf_main_label_16px active \">Country<\/label><input   type=\"text\" id=\"field_qd65i4_73979\"  name=\"item_meta[135]\"   \/><\/div><\/div><div class=\"arf_half_middle\"><\/div><div id=\"arf_field_136_73979_container\" class=\"arfformfield control-group arfmainformfield  arf_field_type_text  top_container top_container arfformfield frm_last_half arf_field_136\"   data-field-type=\"text\" ><div class=\"controls\"   ><label for=\"field_igqf42_73979\" class=\"arf_main_label arf_main_label_16px active \">City<\/label><input   type=\"text\" id=\"field_igqf42_73979\"  name=\"item_meta[136]\"   \/><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_137_73979_container\" class=\"arfformfield control-group arfmainformfield  arf_field_type_email  top_container  top_container arfformfield frm_first_half arf_field_137\"    data-field-type=\"email\"><div class=\"controls\"   ><label for=\"field_7299x4_73979\" class=\"arf_main_label arf_main_label_16px active \">Email<\/label><input type=\"text\" id=\"field_7299x4_73979\" name=\"item_meta[137]\"  data-validation-regex-regex=\"[A-Za-z0-9._%+-]+@[A-Za-z0-9.-]+\\.[A-Za-z]+\" data-validation-regex-message=\"Email is invalid\"  \/><\/div><\/div><div class=\"arf_half_middle\"><\/div><div id=\"arf_field_138_73979_container\" class=\"arfformfield control-group arfmainformfield  arf_field_type_text  top_container top_container arfformfield frm_last_half arf_field_138\"   data-field-type=\"text\" ><div class=\"controls\"   ><label for=\"field_qjqegr_73979\" class=\"arf_main_label arf_main_label_16px active \">Tel \/ Mobile<\/label><input   type=\"text\" id=\"field_qjqegr_73979\"  name=\"item_meta[138]\"   \/><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_139_73979_container\" class=\"arfformfield control-group arfmainformfield  arf_horizontal_radio  arf_field_type_checkbox   top_container arfformfield frm_first_half top_container arf_field_139\"    data-field-type=\"checkbox\"><label for=\"field_w895cy_73979\" class=\"arf_main_label arf_main_label_16px active \">How should we contact you?<\/label><div class=\"setting_checkbox controls  arf_material_checkbox arf_default_material \" 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class=\"arf_main_label arf_main_label_16px active \">When would you like to be contacted?<\/label><input type=\"text\" id=\"field_f65ccj_73979\"    class=\" frm_date\" data-name='item_meta[140]' data-format='MMM D, YYYY' \/><input type=\"hidden\" name=\"item_meta[140]\" id=\"field_f65ccj_73979_formatted\" \/><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_141_73979_container\" class=\"arfformfield control-group arfmainformfield  arf_horizontal_radio  arf_field_type_checkbox   top_container arfformfield  top_container arf_field_141\"    data-field-type=\"checkbox\"><label for=\"field_ycklta_73979\" class=\"arf_main_label arf_main_label_16px active \">To whom it may refer:<\/label><div class=\"setting_checkbox controls  arf_material_checkbox arf_default_material \" style=\"padding-top:5px;\" ><div class=\"arf_checkbox_style \" id=\"frm_checkbox_141-0\"><div class='arf_checkbox_input_wrapper'><input type=\"checkbox\" name=\"item_meta[141][]\" id=\"field_141-0-73979\" value=\"International Patient Department (VIP Reception)\"    style=''  \/><span><\/span><\/div><label for=\"field_141-0-73979\" >International Patient Department (VIP Reception)<\/label><\/div><div class=\"arf_checkbox_style \" id=\"frm_checkbox_141-1\"><div class='arf_checkbox_input_wrapper'><input type=\"checkbox\" name=\"item_meta[141][]\" id=\"field_141-1-73979\" value=\"Nursing Matron\"    style=''  \/><span><\/span><\/div><label for=\"field_141-1-73979\" >Nursing Matron<\/label><\/div><div class=\"arf_checkbox_style \" id=\"frm_checkbox_141-2\"><div class='arf_checkbox_input_wrapper'><input type=\"checkbox\" name=\"item_meta[141][]\" id=\"field_141-2-73979\" value=\"General Manager\"    style=''  \/><span><\/span><\/div><label for=\"field_141-2-73979\" >General Manager<\/label><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_142_73979_container\" class=\"arfformfield control-group arfmainformfield  arf_field_type_textarea  top_container top_container 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id=\"arf_multi_file_info_4vf2qz_73979\" class=\"arf_multi_file_info_container arf_file_field\" style=\"display:none; margin-top: 0px;\"><\/div><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_144_73979_container\" class=\"arfformfield control-group arfmainformfield  arf_horizontal_radio  arf_field_type_checkbox   top_container arfformfield  top_container arf_field_144\"    data-field-type=\"checkbox\"><label for=\"field_hzy7k0_73979\" class=\"arf_main_label arf_main_label_16px active \">Which services do you want to mention?<\/label><div class=\"setting_checkbox controls  arf_material_checkbox arf_default_material \" style=\"padding-top:5px;\" ><div class=\"arf_checkbox_style \" id=\"frm_checkbox_144-0\"><div class='arf_checkbox_input_wrapper'><input type=\"checkbox\" name=\"item_meta[144][]\" id=\"field_144-0-73979\" value=\"Admission &amp; Discharge\"    style=''  \/><span><\/span><\/div><label for=\"field_144-0-73979\" >Admission & 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