{"id":34,"date":"2026-10-25T12:04:15","date_gmt":"2026-10-25T19:04:15","guid":{"rendered":"https:\/\/demo.uncoderbuilder.com\/brivelle\/book-appointment\/"},"modified":"2026-10-25T12:04:17","modified_gmt":"2026-10-25T19:04:17","slug":"book-appointment","status":"publish","type":"page","link":"https:\/\/demo.uncoderbuilder.com\/brivelle\/book-appointment\/","title":{"rendered":"Book an Appointment"},"content":{"rendered":"<div class=\"uncoder uncoder-34 uncoder--page\" data-uncoder-doc=\"34\"><section class=\"uncoder-container uncoder-txfv862\"><div class=\"uncoder-container uncoder-edv72xl uncoder-container--boxed\"><div class=\"uncoder-container__inner\"><div class=\"uncoder-container uncoder-s472k2j\"><div class=\"uncoder-text-editor uncoder-dubtxjw uncoder-text\"><p>Book Your Visit<\/p><\/div><h1 class=\"uncoder-heading uncoder-j5k5nw9\">Your Next Smile Starts Here.<\/h1><div class=\"uncoder-text-editor uncoder-uy2xobi uncoder-text\"><p>Tell us a little about your needs and preferred appointment time. Our team will contact you to confirm availability. Submitting this form is a request, not a confirmed appointment.<\/p><\/div><\/div><\/div><\/div><\/section><section class=\"uncoder-container uncoder-r8gd0of uncoder-container--boxed\"><div class=\"uncoder-container__inner\"><div class=\"uncoder-container uncoder-n4205vn\"><div class=\"uncoder-container uncoder-cduo362\"><div class=\"uncoder-container uncoder-z473mk4\"><h2 class=\"uncoder-heading uncoder-z5uw8m4\">Appointment Request<\/h2><div class=\"uncoder-text-editor uncoder-fk1p2h0 uncoder-text\"><p>Fields marked as optional can be left blank.<\/p><\/div><\/div><form class=\"uncoder-form uncoder-ss0ggdv\" data-settings=\"{&quot;minTime&quot;:3,&quot;noLinks&quot;:false,&quot;maxLen&quot;:5000,&quot;tokenUrl&quot;:&quot;https:\\\/\\\/demo.uncoderbuilder.com\\\/brivelle\\\/wp-json\\\/uncoder\\\/v1\\\/forms\\\/token&quot;,&quot;messages&quot;:{&quot;required&quot;:&quot;This field is required.&quot;,&quot;email&quot;:&quot;Enter a valid email address.&quot;,&quot;url&quot;:&quot;Enter a valid web address.&quot;,&quot;tel&quot;:&quot;Enter a valid phone number.&quot;,&quot;number&quot;:&quot;Enter a number.&quot;,&quot;min&quot;:&quot;Enter a number of at least %s.&quot;,&quot;max&quot;:&quot;Enter a number no greater than %s.&quot;,&quot;date&quot;:&quot;Enter a valid date.&quot;,&quot;option&quot;:&quot;Choose one of the available options.&quot;,&quot;length&quot;:&quot;Use %s characters or fewer.&quot;,&quot;links&quot;:&quot;Links are not allowed in this field.&quot;,&quot;file_type&quot;:&quot;This file type is not allowed.&quot;,&quot;file_size&quot;:&quot;The file is too large (maximum %s).&quot;,&quot;file&quot;:&quot;The file could not be uploaded. Please try again.&quot;,&quot;fix&quot;:&quot;Please correct the highlighted fields.&quot;,&quot;network&quot;:&quot;The form could not be sent. Check your connection and try again.&quot;}}\" data-uncoder-js=\"form\" method=\"post\" accept-charset=\"UTF-8\" aria-label=\"Appointment request\" action=\"https:\/\/demo.uncoderbuilder.com\/brivelle\/wp-json\/uncoder\/v1\/forms\/submit?_redirect=https%3A%2F%2Fdemo.uncoderbuilder.com%2Fbrivelle%2Fbook-appointment%2F\"><div class=\"uncoder-form__fields\"><div class=\"uncoder-form__group uncoder-form__group--text uncoder-ri-q2aj7gn uncoder-form__group--mw is-required\" data-field=\"name\" data-type=\"text\" data-required=\"1\"><label class=\"uncoder-form__label\" for=\"uncoder-form-ss0ggdv-name\">Full Name<\/label><input id=\"uncoder-form-ss0ggdv-name\" name=\"fields[name]\" class=\"uncoder-form__field uncoder-form__field--text\" required aria-required=\"true\" aria-describedby=\"uncoder-form-ss0ggdv-name-error\" type=\"text\" placeholder=\"Your full name\" autocomplete=\"name\" maxlength=\"5000\"><p class=\"uncoder-form__error\" id=\"uncoder-form-ss0ggdv-name-error\" aria-live=\"polite\"><\/p><\/div><div class=\"uncoder-form__group uncoder-form__group--email uncoder-ri-e4cktm5 uncoder-form__group--mw is-required\" data-field=\"email\" data-type=\"email\" data-required=\"1\"><label class=\"uncoder-form__label\" for=\"uncoder-form-ss0ggdv-email\">Email Address<\/label><input id=\"uncoder-form-ss0ggdv-email\" name=\"fields[email]\" class=\"uncoder-form__field uncoder-form__field--email\" required aria-required=\"true\" aria-describedby=\"uncoder-form-ss0ggdv-email-error\" type=\"email\" placeholder=\"you@example.com\" autocomplete=\"email\" maxlength=\"5000\"><p class=\"uncoder-form__error\" id=\"uncoder-form-ss0ggdv-email-error\" aria-live=\"polite\"><\/p><\/div><div class=\"uncoder-form__group uncoder-form__group--tel uncoder-ri-ix6rbh1 uncoder-form__group--mw is-required\" data-field=\"phone\" data-type=\"tel\" data-required=\"1\"><label class=\"uncoder-form__label\" for=\"uncoder-form-ss0ggdv-phone\">Phone Number<\/label><input id=\"uncoder-form-ss0ggdv-phone\" name=\"fields[phone]\" class=\"uncoder-form__field uncoder-form__field--tel\" required aria-required=\"true\" aria-describedby=\"uncoder-form-ss0ggdv-phone-error\" type=\"tel\" placeholder=\"+1 (555) 000-0000\" autocomplete=\"tel\" maxlength=\"5000\" inputmode=\"tel\"><p class=\"uncoder-form__error\" id=\"uncoder-form-ss0ggdv-phone-error\" aria-live=\"polite\"><\/p><\/div><div class=\"uncoder-form__group uncoder-form__group--select uncoder-ri-x0uasmp uncoder-form__group--mw is-required\" data-field=\"patient_type\" data-type=\"select\" data-required=\"1\"><label class=\"uncoder-form__label\" for=\"uncoder-form-ss0ggdv-patient_type\">New or Existing Patient?<\/label><div class=\"uncoder-form__select\"><select id=\"uncoder-form-ss0ggdv-patient_type\" name=\"fields[patient_type]\" class=\"uncoder-form__field uncoder-form__field--select\" required aria-required=\"true\" aria-describedby=\"uncoder-form-ss0ggdv-patient_type-error\"><option value=\"\">Select an option<\/option><option value=\"New patient\" selected>New patient<\/option><option value=\"Existing patient\">Existing patient<\/option><\/select><\/div><p class=\"uncoder-form__error\" id=\"uncoder-form-ss0ggdv-patient_type-error\" aria-live=\"polite\"><\/p><\/div><div class=\"uncoder-form__group uncoder-form__group--date uncoder-ri-g886qmn uncoder-form__group--mw is-required\" data-field=\"preferred_date\" data-type=\"date\" data-required=\"1\"><label class=\"uncoder-form__label\" for=\"uncoder-form-ss0ggdv-preferred_date\">Preferred Date<\/label><input id=\"uncoder-form-ss0ggdv-preferred_date\" name=\"fields[preferred_date]\" class=\"uncoder-form__field uncoder-form__field--date\" required aria-required=\"true\" aria-describedby=\"uncoder-form-ss0ggdv-preferred_date-error\" type=\"date\"><p class=\"uncoder-form__error\" id=\"uncoder-form-ss0ggdv-preferred_date-error\" aria-live=\"polite\"><\/p><\/div><div class=\"uncoder-form__group uncoder-form__group--select uncoder-ri-r2czdt1 uncoder-form__group--mw is-required\" data-field=\"preferred_time\" data-type=\"select\" data-required=\"1\"><label class=\"uncoder-form__label\" for=\"uncoder-form-ss0ggdv-preferred_time\">Preferred Time<\/label><div class=\"uncoder-form__select\"><select id=\"uncoder-form-ss0ggdv-preferred_time\" name=\"fields[preferred_time]\" class=\"uncoder-form__field uncoder-form__field--select\" required aria-required=\"true\" aria-describedby=\"uncoder-form-ss0ggdv-preferred_time-error\"><option value=\"\">Select an option<\/option><option value=\"Morning (9 AM\u201312 PM)\" selected>Morning (9 AM\u201312 PM)<\/option><option value=\"Afternoon (12 PM\u20133 PM)\">Afternoon (12 PM\u20133 PM)<\/option><option value=\"Late afternoon (3 PM\u20136 PM)\">Late afternoon (3 PM\u20136 PM)<\/option><option value=\"Saturday morning (9 AM\u20132 PM)\">Saturday morning (9 AM\u20132 PM)<\/option><\/select><\/div><p class=\"uncoder-form__error\" id=\"uncoder-form-ss0ggdv-preferred_time-error\" aria-live=\"polite\"><\/p><\/div><div class=\"uncoder-form__group uncoder-form__group--select uncoder-ri-f4ton9a uncoder-form__group--mw is-required\" data-field=\"service\" data-type=\"select\" data-required=\"1\"><label class=\"uncoder-form__label\" for=\"uncoder-form-ss0ggdv-service\">Service of Interest<\/label><div class=\"uncoder-form__select\"><select id=\"uncoder-form-ss0ggdv-service\" name=\"fields[service]\" class=\"uncoder-form__field uncoder-form__field--select\" required aria-required=\"true\" aria-describedby=\"uncoder-form-ss0ggdv-service-error\"><option value=\"\">Select an option<\/option><option value=\"General Dentistry\" selected>General Dentistry<\/option><option value=\"Dental Hygiene\">Dental Hygiene<\/option><option value=\"Teeth Whitening\">Teeth Whitening<\/option><option value=\"Dental Implants\">Dental Implants<\/option><option value=\"Root Canal Treatment\">Root Canal Treatment<\/option><option value=\"Tooth Extraction\">Tooth Extraction<\/option><option value=\"Cosmetic Dentistry\">Cosmetic Dentistry<\/option><option value=\"Emergency Dental Care\">Emergency Dental Care<\/option><option value=\"Not sure yet\">Not sure yet<\/option><\/select><\/div><p class=\"uncoder-form__error\" id=\"uncoder-form-ss0ggdv-service-error\" aria-live=\"polite\"><\/p><\/div><div class=\"uncoder-form__group uncoder-form__group--textarea uncoder-ri-b6fysie uncoder-form__group--mw\" data-field=\"note\" data-type=\"textarea\"><label class=\"uncoder-form__label\" for=\"uncoder-form-ss0ggdv-note\">Brief Note (optional)<\/label><textarea id=\"uncoder-form-ss0ggdv-note\" name=\"fields[note]\" class=\"uncoder-form__field uncoder-form__field--textarea\" aria-describedby=\"uncoder-form-ss0ggdv-note-error\" rows=\"5\" placeholder=\"Anything we should know before we call?\" maxlength=\"5000\"><\/textarea><p class=\"uncoder-form__error\" id=\"uncoder-form-ss0ggdv-note-error\" aria-live=\"polite\"><\/p><\/div><div class=\"uncoder-form__group uncoder-form__group--acceptance uncoder-ri-j4dy66y uncoder-form__group--mw is-required uncoder-form__group--single\" data-field=\"consent\" data-type=\"acceptance\" data-required=\"1\"><div class=\"uncoder-form__option\"><input type=\"checkbox\" class=\"uncoder-form__choice\" id=\"uncoder-form-ss0ggdv-consent\" name=\"fields[consent]\" value=\"yes\" required aria-required=\"true\" aria-describedby=\"uncoder-form-ss0ggdv-consent-error\"><label class=\"uncoder-form__option-label\" for=\"uncoder-form-ss0ggdv-consent\">I agree that BRIVELLE may contact me about this appointment request.<\/label><\/div><p class=\"uncoder-form__error\" id=\"uncoder-form-ss0ggdv-consent-error\" aria-live=\"polite\"><\/p><\/div><div class=\"uncoder-form__group uncoder-form__group--submit\"><button type=\"submit\" class=\"uncoder-btn uncoder-btn--primary uncoder-btn--md uncoder-form__submit\"><span class=\"uncoder-btn__text\">Request Appointment<\/span><\/button><\/div><\/div><div class=\"uncoder-form__hp\" aria-hidden=\"true\"><label for=\"uncoder-form-ss0ggdv-hp\">Leave this field empty<\/label><input type=\"text\" id=\"uncoder-form-ss0ggdv-hp\" name=\"_hp\" value=\"\" tabindex=\"-1\" autocomplete=\"off\"><\/div><input type=\"hidden\" name=\"doc_id\" value=\"34\"><input type=\"hidden\" name=\"post_id\" value=\"34\"><input type=\"hidden\" name=\"element_id\" value=\"ss0ggdv\"><input type=\"hidden\" name=\"ts\" value=\"1792959000\"><input type=\"hidden\" name=\"token\" value=\"c32060050bd4e05c760f989da1817bb37d5062ab7416a02c8533c4720961f66c\"><div class=\"uncoder-form__notice\" id=\"uncoder-form-ss0ggdv-sent\" tabindex=\"-1\">Thank you. Your request is in \u2014 our team will contact you to confirm availability. This is not yet a confirmed appointment.<\/div><div class=\"uncoder-form__message uncoder-form__message--success\" role=\"status\" aria-live=\"polite\"><\/div><div class=\"uncoder-form__message uncoder-form__message--error\" role=\"alert\"><\/div><\/form><\/div><div class=\"uncoder-container uncoder-m1fltrh\"><div class=\"uncoder-container uncoder-vs7ydcm\"><div class=\"uncoder-text-editor uncoder-pa8ru98 uncoder-text\"><p>What Happens Next<\/p><\/div><div class=\"uncoder-container uncoder-qs5ad5w\"><div class=\"uncoder-container uncoder-empul9b\"><div class=\"uncoder-text-editor uncoder-ls2tnqd uncoder-text\"><p>01<\/p><\/div><\/div><div class=\"uncoder-text-editor uncoder-drcjukm uncoder-text\"><p>We review your request.<\/p><\/div><\/div><div class=\"uncoder-container uncoder-wygl227\"><div class=\"uncoder-container uncoder-x9rd0cg\"><div class=\"uncoder-text-editor uncoder-qjmibhk uncoder-text\"><p>02<\/p><\/div><\/div><div class=\"uncoder-text-editor uncoder-qz1ke12 uncoder-text\"><p>Our team contacts you to discuss availability.<\/p><\/div><\/div><div class=\"uncoder-container uncoder-nc59lgv\"><div class=\"uncoder-container uncoder-lbxu1vg\"><div class=\"uncoder-text-editor uncoder-lcx3un8 uncoder-text\"><p>03<\/p><\/div><\/div><div class=\"uncoder-text-editor uncoder-i4kwklv uncoder-text\"><p>Your appointment is confirmed once you receive confirmation from our team.<\/p><\/div><\/div><\/div><div class=\"uncoder-container uncoder-dukm6ax\"><div class=\"uncoder-container uncoder-yyyi5js\" aria-hidden=\"true\"><span class=\"uncoder-icon uncoder-z6xkr95\"><span class=\"uncoder-icon-wrap uncoder-icon-wrap--default\"><svg class=\"uncoder-svg uncoder-svg--phosphor\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" aria-hidden=\"true\" focusable=\"false\" viewbox=\"0 0 256 256\" fill=\"currentColor\"><path d=\"M120,16V8a8,8,0,0,1,16,0v8a8,8,0,0,1-16,0Zm80,32a8,8,0,0,0,5.66-2.34l8-8a8,8,0,0,0-11.32-11.32l-8,8A8,8,0,0,0,200,48ZM50.34,45.66A8,8,0,0,0,61.66,34.34l-8-8A8,8,0,0,0,42.34,37.66Zm87,26.45a8,8,0,1,0-2.64,15.78C153.67,91.08,168,108.32,168,128a8,8,0,0,0,16,0C184,100.6,163.93,76.57,137.32,72.11ZM232,176v24a16,16,0,0,1-16,16H40a16,16,0,0,1-16-16V176a16,16,0,0,1,16-16V128a88,88,0,0,1,88.67-88c48.15.36,87.33,40.29,87.33,89v31A16,16,0,0,1,232,176ZM56,160H200V129c0-40-32.05-72.71-71.45-73H128a72,72,0,0,0-72,72Zm160,40V176H40v24H216Z\"\/><\/svg><\/span><\/span><\/div><h2 class=\"uncoder-heading uncoder-uajel7j\">Urgent Dental Concerns<\/h2><div class=\"uncoder-text-editor uncoder-gf41h51 uncoder-text\"><p>If you have urgent dental pain or swelling, call the clinic directly for guidance. For severe swelling affecting breathing or swallowing, uncontrolled bleeding, or another medical emergency, seek emergency medical care.<\/p><\/div><a class=\"uncoder-container uncoder-r11jx6u\" href=\"tel:+15550147820\"><div class=\"uncoder-container uncoder-zyim89k\" aria-hidden=\"true\"><span class=\"uncoder-icon uncoder-nr4wooh\"><span class=\"uncoder-icon-wrap uncoder-icon-wrap--default\"><svg class=\"uncoder-svg uncoder-svg--phosphor\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" aria-hidden=\"true\" focusable=\"false\" viewbox=\"0 0 256 256\" fill=\"currentColor\"><path d=\"M222.37,158.46l-47.11-21.11-.13-.06a16,16,0,0,0-15.17,1.4,8.12,8.12,0,0,0-.75.56L134.87,160c-15.42-7.49-31.34-23.29-38.83-38.51l20.78-24.71c.2-.25.39-.5.57-.77a16,16,0,0,0,1.32-15.06l0-.12L97.54,33.64a16,16,0,0,0-16.62-9.52A56.26,56.26,0,0,0,32,80c0,79.4,64.6,144,144,144a56.26,56.26,0,0,0,55.88-48.92A16,16,0,0,0,222.37,158.46ZM176,208A128.14,128.14,0,0,1,48,80,40.2,40.2,0,0,1,82.87,40a.61.61,0,0,0,0,.12l21,47L83.2,111.86a6.13,6.13,0,0,0-.57.77,16,16,0,0,0-1,15.7c9.06,18.53,27.73,37.06,46.46,46.11a16,16,0,0,0,15.75-1.14,8.44,8.44,0,0,0,.74-.56L168.89,152l47,21.05h0s.08,0,.11,0A40.21,40.21,0,0,1,176,208Z\"\/><\/svg><\/span><\/span><\/div><div class=\"uncoder-container uncoder-edo4ywb\"><div class=\"uncoder-text-editor uncoder-y7sva5m uncoder-text\"><p>Call the clinic<\/p><\/div><div class=\"uncoder-text-editor uncoder-amm97m4 uncoder-text\"><p>+1 (555) 014-7820<\/p><\/div><\/div><\/a><\/div><\/div><\/div><\/div><\/section><\/div>","protected":false},"excerpt":{"rendered":"<p>Book Your Visit Your Next Smile Starts Here. Tell us a little about your needs and preferred appointment time. Our team will contact you to confirm availability. Submitting&hellip;<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"uncoder-full-width","meta":{"footnotes":""},"class_list":["post-34","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/demo.uncoderbuilder.com\/brivelle\/wp-json\/wp\/v2\/pages\/34","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/demo.uncoderbuilder.com\/brivelle\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/demo.uncoderbuilder.com\/brivelle\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/demo.uncoderbuilder.com\/brivelle\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/demo.uncoderbuilder.com\/brivelle\/wp-json\/wp\/v2\/comments?post=34"}],"version-history":[{"count":0,"href":"https:\/\/demo.uncoderbuilder.com\/brivelle\/wp-json\/wp\/v2\/pages\/34\/revisions"}],"wp:attachment":[{"href":"https:\/\/demo.uncoderbuilder.com\/brivelle\/wp-json\/wp\/v2\/media?parent=34"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}