{"id":8766,"date":"2025-11-18T20:18:31","date_gmt":"2025-11-18T19:18:31","guid":{"rendered":"https:\/\/www.medelit.com\/uk\/?p=8766"},"modified":"2026-07-17T11:02:57","modified_gmt":"2026-07-17T10:02:57","slug":"helena-cepparo-fertility-specialist","status":"publish","type":"page","link":"https:\/\/www.medelit.com\/uk\/clinicians\/helena-cepparo-fertility-specialist\/","title":{"rendered":"Dr. Helena Cepparo &#8211; Consultant Gynaecologist and Fertility Specialist in London and Greater London"},"content":{"rendered":"\r\n\r\n\r\n\r\n<p style=\"text-align: center;\"><a href=\"https:\/\/www.medelit.com\/uk\/wp-content\/uploads\/sites\/3\/2025\/11\/H-CEPPARO.webp\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-thumbnail wp-image-8767\" src=\"https:\/\/www.medelit.com\/uk\/wp-content\/uploads\/sites\/3\/2025\/11\/H-CEPPARO-150x150.webp\" alt=\"\" width=\"150\" height=\"150\" srcset=\"https:\/\/www.medelit.com\/uk\/wp-content\/uploads\/sites\/3\/2025\/11\/H-CEPPARO-150x150.webp 150w, https:\/\/www.medelit.com\/uk\/wp-content\/uploads\/sites\/3\/2025\/11\/H-CEPPARO.webp 260w\" sizes=\"auto, (max-width: 150px) 100vw, 150px\" \/><\/a><\/p>\r\n\r\n\r\n<h2 style=\"text-align: center;\"><span style=\"color: #ca1517; font-size: 18pt;\">Dr. Helena Cepparo &#8211; Profile and Clinical Excellence<\/span><\/h2>\r\n<p style=\"text-align: justify;\">Dr Helena Cepparo is a <a href=\"gyn\">Consultant Gynaecologist<\/a> and aFertility Specialist with more than two decades of experience in reproductive medicine, IVF, and women\u2019s health.<\/p>\r\n<p style=\"text-align: justify;\">After qualifying in Medicine with first-class honours and completing her specialist training in Obstetrics and Gynaecology at the University of Milan-Bicocca, she built her career in high-volume fertility centres in Italy, where she managed complete IVF, IVM and IUI cycles and performed hundreds of oocyte retrievals, embryo transfers, and hysterosalpingographies each year. These early years consolidated her expertise in complex infertility, integrating meticulous diagnostic work with evidence-based assisted reproductive technologies.<\/p>\r\n<p style=\"text-align: justify;\"><br aria-hidden=\"true\" \/>Her clinical focus has consistently centred on challenging cases: poor ovarian response, recurrent miscarriage, implantation failure, and the endocrine and immunological conditions that underlie many fertility problems. She has extensive experience in gynaecological endocrinology, including PCOS, premature ovarian insufficiency and menstrual disorders, and has used minimally invasive surgery\u2014laparoscopy and hysteroscopy\u2014to optimise fertility outcomes in women with endometriosis, fibroids, and uterine pathology.<\/p>\r\n<p style=\"text-align: justify;\">Dr Cepparo is also an\u00a0<a href=\"https:\/\/afmccertification.com\/\"><b data-stringify-type=\"bold\">AFMCP-trained graduate in Functional Medicine<\/b><\/a>, and this strongly shapes her approach to care. She routinely integrates <strong>functional medicine<\/strong> principles into her work on fertility and women\u2019s health, looking beyond isolated symptoms to the interplay between hormones, metabolism, gut health, immune balance, stress and lifestyle. Nutrition, sleep, movement, toxin exposure and emotional wellbeing are all considered alongside conventional investigations, allowing her to design highly individualised, root-cause\u2013oriented plans for preconception and fertility support.<\/p>\r\n<p style=\"text-align: justify;\">In 2009 she founded <a href=\"https:\/\/www.medelit.com\/it\/\">Medelit in Italy<\/a>, later expanding it to the <a href=\"https:\/\/www.medelit.com\/uk\/\">UK<\/a>, and has since served as Clinical and Managing Director. In this role she has led large multidisciplinary teams, overseen regulatory compliance with CQC and Italian healthcare standards, and implemented robust clinical governance, digital documentation and patient-centred workflows. Her leadership work has given her a broad perspective on quality, safety and innovation in healthcare delivery.<br aria-hidden=\"true\" \/>Her interest in digital health and education led her to create and curate\u00a0<a href=\"https:\/\/www.myfertilitypod.com\"><b data-stringify-type=\"bold\">myfertilitypod<\/b><\/a>, a fertility-centred blog dedicated to evidence-based and functional medicine approaches to fertility and women\u2019s health. Through this platform she translates complex reproductive and functional medicine science into practical, accessible guidance, helping individuals and couples understand how nutrition, lifestyle, immune health and environment intersect with ovarian function, implantation and pregnancy outcomes.<\/p>\r\n<p style=\"text-align: justify;\">Dr. Cepparo\u2019s career has also been shaped by international training and collaboration, with attachments in leading centres in Canada, Japan, Denmark and the UK, keeping her at the forefront of evolving IVF protocols and technologies.<\/p>\r\n<p style=\"text-align: justify;\">Today she practises as a part-time Consultant Gynaecologist in a private fertility clinic in <strong>Central London<\/strong> while continuing to lead Medelit\u2019s clinical strategy.<\/p>\r\n<p style=\"text-align: justify;\">Bilingual in English and Italian and fluent in French, she brings a <strong>global, holistic and <a href=\"https:\/\/myfertilitypod.com\/about\/\">deeply patient-centred approach<\/a><\/strong> to women&#8217;s health, with a keen interest in hormone, fertility and reproductive health issue.<\/p>\r\n\r\n<h2 style=\"text-align: center;\" data-fontsize=\"18\" data-lineheight=\"27\"><strong><span style=\"color: #ca1517;\">Find out More on our Home Visiting Doctors Service in London<\/span><\/strong><\/h2>\r\n<a class=\"mcp-button\" href=\"https:\/\/www.medelit.com\/uk\/contact-us\/\">Make an Enquiry<\/a>\r\n\r\nonline doctor\r\n\r\n\r\n<p style=\"text-align: center;\"><span style=\"color: #ca1517;\"><strong>Book a Home Visit with Dr. Helena Cepparo<\/strong><\/span><\/p>\r\n<a href=\"#\" data-medelit-modal-open=\"booking\">Book a Home Visit or Video Consultation<\/a>\r\n<table style=\"border-color: #ebebeb; height: 346px; background-color: #ffffff;\" border=\"1px\" width=\"100%\" cellspacing=\"3\" cellpadding=\"5px\">\r\n<tbody>\r\n<tr style=\"border-color: #000000; background-color: #f8f8f8;\">\r\n<td><span style=\"color: #ca1517;\"><strong>We&#8217;re preferred for our:<\/strong><\/span><\/td>\r\n<\/tr>\r\n<tr style=\"background-color: #ffffff;\">\r\n<td><span style=\"color: #ca1517;\">\u2665<\/span>\u00a0<b>High Standards<\/b><\/td>\r\n<\/tr>\r\n<tr style=\"background-color: #ffffff;\">\r\n<td><strong><span style=\"color: #ca1517;\">\u2665<\/span>\u00a0Courtesy<\/strong><\/td>\r\n<\/tr>\r\n<tr>\r\n<td><span style=\"color: #ca1517;\">\u2665<\/span>\u00a0<strong>Comfort<\/strong><\/td>\r\n<\/tr>\r\n<tr>\r\n<td><span style=\"color: #ca1517;\">\u2665\u00a0<\/span><b>Promptness<\/b><\/td>\r\n<\/tr>\r\n<tr>\r\n<td><span style=\"color: #ca1517;\">\u2665\u00a0<\/span><b>Reliability<\/b><\/td>\r\n<\/tr>\r\n<tr style=\"background-color: #ffffff;\">\r\n<td><strong><span style=\"color: #ca1517;\">\u2665\u00a0<\/span>Dedication<\/strong><\/td>\r\n<\/tr>\r\n<tr>\r\n<td><strong><span style=\"color: #ca1517;\">\u2665\u00a0<\/span><\/strong><strong>Efficiency<\/strong><\/td>\r\n<\/tr>\r\n<tr style=\"background-color: #ffffff;\">\r\n<td><strong><span style=\"color: #ca1517;\">\u2665\u00a0<\/span><\/strong><strong>Availability<\/strong><\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n\r\n<table style=\"border-color: #ebebeb; height: 346px; background-color: #ffffff;\" border=\"1px\" width=\"100%\" cellspacing=\"3\" cellpadding=\"5px\">\r\n<tbody>\r\n<tr style=\"border-color: #000000; background-color: #f8f8f8; height: 33px;\">\r\n<td style=\"height: 33px;\"><strong><span style=\"color: #ca1517;\">Medelit House Call Services<\/span><\/strong><\/td>\r\n<\/tr>\r\n<tr style=\"height: 33px;\">\r\n<td style=\"height: 33px;\"><strong><span style=\"color: #ca1517;\">\u27e9<\/span> <a href=\"https:\/\/www.medelit.com\/uk\/services\/doctor-home-visit\/\">Medical Services<\/a><\/strong><\/td>\r\n<\/tr>\r\n<tr style=\"height: 34px;\">\r\n<td style=\"height: 34px;\"><strong><span style=\"color: #ca1517;\">\u27e9 <\/span><a href=\"https:\/\/www.medelit.com\/uk\/services\/physiotherapy-home-visit\/\">Physiotherapy<\/a><\/strong><\/td>\r\n<\/tr>\r\n<tr style=\"background-color: #f8f8f8; height: 34px;\">\r\n<td style=\"height: 34px;\"><strong><span style=\"color: #ca1517;\">\u27e9\u00a0<\/span><span style=\"color: #000000;\"><a href=\"\/uk\/services\/visiting-nursing-service\/\">Nursing Services<\/a><\/span><\/strong><\/td>\r\n<\/tr>\r\n<tr style=\"height: 34px;\">\r\n<td style=\"height: 34px;\"><strong><span style=\"color: #ca1517;\">\u27e9\u00a0<\/span><span style=\"color: #ca1517;\"><a href=\"https:\/\/www.medelit.com\/uk\/services\/acupuncture-home-visit\/\">Acupuncture<\/a><\/span><\/strong><\/td>\r\n<\/tr>\r\n<tr style=\"height: 34px;\">\r\n<td style=\"height: 34px;\"><strong><span style=\"color: #ca1517;\">\u27e9<\/span><span style=\"color: #ca1517;\"><a href=\"https:\/\/www.medelit.com\/uk\/services\/speech-therapy-home-visit\/\">Speech Therapy<\/a><\/span><\/strong><\/td>\r\n<\/tr>\r\n<tr 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xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath fill-rule='evenodd' clip-rule='evenodd' d='M0.292893 0.292893C0.683417 -0.097631 1.31658 -0.097631 1.70711 0.292893L5 3.58579L8.29289 0.292893C8.68342 -0.0976311 9.31658 -0.0976311 9.70711 0.292893C10.0976 0.683417 10.0976 1.31658 9.70711 1.70711L5.70711 5.70711C5.31658 6.09763 4.68342 6.09763 4.29289 5.70711L0.292893 1.70711C-0.0976311 1.31658 -0.0976311 0.683418 0.292893 0.292893Z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-icon-ctrl-search: url(\"data:image\/svg+xml,%3Csvg width='640' height='640' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath d='M256 128c-70.692 0-128 57.308-128 128 0 70.691 57.308 128 128 128 70.691 0 128-57.309 128-128 0-70.692-57.309-128-128-128zM64 256c0-106.039 85.961-192 192-192s192 85.961 192 192c0 41.466-13.146 79.863-35.498 111.248l154.125 154.125c12.496 12.496 12.496 32.758 0 45.254s-32.758 12.496-45.254 0L367.248 412.502C335.862 434.854 297.467 448 256 448c-106.039 0-192-85.962-192-192z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-label-space-y-secondary: var(--gf-label-space-y-md-secondary);--gf-ctrl-border-color: #686e77;--gf-ctrl-size: var(--gf-ctrl-size-md);--gf-ctrl-label-color-primary: #112337;--gf-ctrl-label-color-secondary: #112337;--gf-ctrl-choice-size: var(--gf-ctrl-choice-size-md);--gf-ctrl-checkbox-check-size: var(--gf-ctrl-checkbox-check-size-md);--gf-ctrl-radio-check-size: var(--gf-ctrl-radio-check-size-md);--gf-ctrl-btn-font-size: var(--gf-ctrl-btn-font-size-md);--gf-ctrl-btn-padding-x: var(--gf-ctrl-btn-padding-x-md);--gf-ctrl-btn-size: var(--gf-ctrl-btn-size-md);--gf-ctrl-btn-border-color-secondary: #686e77;--gf-ctrl-file-btn-bg-color-hover: #EBEBEB;--gf-field-img-choice-size: var(--gf-field-img-choice-size-md);--gf-field-img-choice-card-space: var(--gf-field-img-choice-card-space-md);--gf-field-img-choice-check-ind-size: var(--gf-field-img-choice-check-ind-size-md);--gf-field-img-choice-check-ind-icon-size: var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style><div id='gf_57' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_57' id='gform_57'  action='\/uk\/wp-json\/wp\/v2\/pages\/8766#gf_57' data-formid='57' novalidate><input type=\"hidden\" name=\"gpuid_existing_value_24\" id=\"gpuid_existing_value_24\" value=\"7e3e2dc7086e13f14d146a36118ef35a\" \/><input type=\"hidden\" name=\"gpuid_existing_value_50\" id=\"gpuid_existing_value_50\" value=\"7e3e2dc7086e13f14d146a36118ef35a\" \/>\n        <div id='gf_progressbar_wrapper_57' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<p class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>8<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_12' style='width:12%;'><span>12%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_57_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_57' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_57_304\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_57_304'>X\/Twitter<\/label><div class='ginput_container'><input name='input_304' id='input_57_304' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_57_304'>This field is for validation purposes and should be left unchanged.<\/div><\/div><fieldset id=\"field_57_19\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >I am a\u2026<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_57_19'>\n\t\t\t<div class='gchoice gchoice_57_19_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='New'  id='choice_57_19_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_57_19_0' id='label_57_19_0' class='gform-field-label gform-field-label--type-inline'>New<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_57_19_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='Returning'  id='choice_57_19_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_57_19_1' id='label_57_19_1' class='gform-field-label gform-field-label--type-inline'>Returning<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_57_300\" class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_57_300'>Email address (used on your previous booking)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_300' id='input_57_300' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_57_301\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_57_301'>Date of birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_301' id='input_57_301' type='text' value='' class='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon'   placeholder='dd\/mm\/yyyy' aria-describedby=\"input_57_301_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_57_301_date_format' class='screen-reader-text'>DD slash MM slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_57_301' class='gform_hidden' value='https:\/\/www.medelit.com\/uk\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><fieldset id=\"field_57_302\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Sex<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_57_302'>\n\t\t\t<div class='gchoice gchoice_57_302_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_302' type='radio' value='Male'  id='choice_57_302_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_57_302_0' id='label_57_302_0' class='gform-field-label gform-field-label--type-inline'>Male<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_57_302_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_302' type='radio' value='Female'  id='choice_57_302_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_57_302_1' id='label_57_302_1' class='gform-field-label gform-field-label--type-inline'>Female<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_57_60\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_57_60'>incomingurl<\/label><div class='ginput_container ginput_container_text'><input name='input_60' id='input_57_60' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_57_28\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_57_28'>actualurl<\/label><div class='ginput_container ginput_container_text'><input name='input_28' id='input_57_28' type='text' value='https:\/\/www.medelit.com\/uk\/wp-json\/wp\/v2\/pages\/8766' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_57_61\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_57_61'>full url<\/label><div class='ginput_container ginput_container_text'><input name='input_61' id='input_57_61' type='text' value='https:\/\/www.medelit.com\/uk\/wp-json\/wp\/v2\/pages\/8766' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_57_43\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_57_43'>Returning PT ID<\/label><div class='ginput_container ginput_container_text'><input name='input_43' id='input_57_43' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_57_58\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_57_58'>SERV TYPE<\/label><div class='ginput_container ginput_container_text'><input readonly='readonly' name='input_58' id='input_57_58' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_57_62\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_57_62'>FIELD<\/label><div class='ginput_container ginput_container_text'><input readonly='readonly' name='input_62' id='input_57_62' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_57_63\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_57_63'>SUBFIELD<\/label><div class='ginput_container ginput_container_text'><input readonly='readonly' name='input_63' id='input_57_63' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_57_54\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_57_54'>NEW\/RETURNING PT @new_returning<\/label><div class='ginput_container ginput_container_text'><input name='input_54' id='input_57_54' type='text' value='Returning' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_57_25\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >I am interested in\u2026<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_57_25'>\n\t\t\t<div class='gchoice gchoice_57_25_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='HOME VISIT'  id='choice_57_25_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_57_25_0' id='label_57_25_0' class='gform-field-label gform-field-label--type-inline'>HOME VISIT<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_57_25_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='VIDEO CONSULTATION'  id='choice_57_25_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_57_25_1' id='label_57_25_1' class='gform-field-label gform-field-label--type-inline'>VIDEO CONSULTATION<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_57_69' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_57_2' class='gform_page' data-js='page-field-id-69' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_57_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_57_56\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3>No patient found in our system<\/h3><p>Please check that your <strong>email address<\/strong> and <strong>date of birth<\/strong> are entered correctly, and that you selected the right option in the New\/Returning Patient field. Use the Back button to correct your details.<\/p><p>If you cannot be found but have visited us before, you can also continue as a New patient \u2014 we will reconcile your records.<\/p><\/div><div id=\"field_57_303\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3>Welcome back!<\/h3><p>We found your details in our system. Click <strong>Next<\/strong> to continue with your stored information.<\/p><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_57_68' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Back'  \/> <input type='button' id='gform_next_button_57_68' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_57_3' class='gform_page' data-js='page-field-id-68' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_57_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_57_45\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is the visit address still the same as last time?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_57_45'>\n\t\t\t<div class='gchoice gchoice_57_45_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_45' type='radio' value='YES'  id='choice_57_45_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_57_45_0' id='label_57_45_0' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_57_45_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_45' type='radio' value='NO \/ I&#039;M NOT SURE'  id='choice_57_45_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_57_45_1' id='label_57_45_1' class='gform-field-label gform-field-label--type-inline'>NO \/ I'M NOT SURE<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_57_48\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><legend class='gfield_label gform-field-label gfield_label_before_complex' >RETURNING PT SYSTEM VISIT ADDRESS<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_zip has_country ginput_container_address gform-grid-row' id='input_57_48' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_57_48_1_container' >\n                                        <input type='text' name='input_48.1' id='input_57_48_1' value=''    aria-required='true'    \/>\n                                        <label for='input_57_48_1' id='input_57_48_1_label' class='gform-field-label gform-field-label--type-sub '>Street and HOUSE NUMBER<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_57_48_3_container' >\n                                    <input type='text' name='input_48.3' id='input_57_48_3' value=''    aria-required='true'    \/>\n                                    <label for='input_57_48_3' id='input_57_48_3_label' class='gform-field-label gform-field-label--type-sub '>Town \/ City<\/label>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_48.4' id='input_57_48_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_57_48_5_container' >\n                                    <input type='text' name='input_48.5' id='input_57_48_5' value=''    aria-required='true'    \/>\n                                    <label for='input_57_48_5' id='input_57_48_5_label' class='gform-field-label gform-field-label--type-sub '>Postcode<\/label>\n                                <\/span><span class='ginput_left address_country ginput_address_country gform-grid-col' id='input_57_48_6_container' >\n                                        <select name='input_48.6' id='input_57_48_6'   aria-required='true'    ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cape Verde' >Cape Verde<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' selected='selected'>United Kingdom<\/option><option value='United States' >United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option><\/select>\n                                        <label for='input_57_48_6' id='input_57_48_6_label' class='gform-field-label gform-field-label--type-sub '>Country<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_57_55' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Back'  \/> <input type='button' id='gform_next_button_57_55' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_57_4' class='gform_page' data-js='page-field-id-55' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_57_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_57_15\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Visit address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_zip has_country ginput_container_address gform-grid-row' id='input_57_15' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_57_15_1_container' >\n                                        <input type='text' name='input_15.1' id='input_57_15_1' value=''   placeholder='Type your visit address here' aria-required='true'    \/>\n                                        <label for='input_57_15_1' id='input_57_15_1_label' class='gform-field-label gform-field-label--type-sub '>Street and HOUSE NUMBER<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_57_15_3_container' >\n                                    <input type='text' name='input_15.3' id='input_57_15_3' value=''    aria-required='true'    \/>\n                                    <label for='input_57_15_3' id='input_57_15_3_label' class='gform-field-label gform-field-label--type-sub '>Town \/ City<\/label>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_15.4' id='input_57_15_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_57_15_5_container' >\n                                    <input type='text' name='input_15.5' id='input_57_15_5' value=''    aria-required='true'    \/>\n                                    <label for='input_57_15_5' id='input_57_15_5_label' class='gform-field-label gform-field-label--type-sub '>Postcode<\/label>\n                                <\/span><span class='ginput_left address_country ginput_address_country gform-grid-col' id='input_57_15_6_container' >\n                                        <select name='input_15.6' id='input_57_15_6'   aria-required='true'    ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cape Verde' >Cape Verde<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' selected='selected'>United Kingdom<\/option><option value='United States' >United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option><\/select>\n                                        <label for='input_57_15_6' id='input_57_15_6_label' class='gform-field-label gform-field-label--type-sub '>Country<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><input type=\"hidden\" name=\"gpaa_place_15\" class=\"gform_hidden\" value=\"\"><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_57_81' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Back'  \/> <input type='button' id='gform_next_button_57_81' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_57_5' class='gform_page' data-js='page-field-id-81' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_57_5' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_57_47\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Current visit address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_zip has_country ginput_container_address gform-grid-row' id='input_57_47' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_57_47_1_container' >\n                                        <input type='text' name='input_47.1' id='input_57_47_1' value=''    aria-required='true'    \/>\n                                        <label for='input_57_47_1' id='input_57_47_1_label' class='gform-field-label gform-field-label--type-sub '>Street and HOUSE NUMBER<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_57_47_3_container' >\n                                    <input type='text' name='input_47.3' id='input_57_47_3' value=''    aria-required='true'    \/>\n                                    <label for='input_57_47_3' id='input_57_47_3_label' class='gform-field-label gform-field-label--type-sub '>Town \/ City<\/label>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_47.4' id='input_57_47_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_57_47_5_container' >\n                                    <input type='text' name='input_47.5' id='input_57_47_5' value=''    aria-required='true'    \/>\n                                    <label for='input_57_47_5' id='input_57_47_5_label' class='gform-field-label gform-field-label--type-sub '>Postcode<\/label>\n                                <\/span><span class='ginput_left address_country ginput_address_country gform-grid-col' id='input_57_47_6_container' >\n                                        <select name='input_47.6' id='input_57_47_6'   aria-required='true'    ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cape Verde' >Cape Verde<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' selected='selected'>United Kingdom<\/option><option value='United States' >United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option><\/select>\n                                        <label for='input_57_47_6' id='input_57_47_6_label' class='gform-field-label gform-field-label--type-sub '>Country<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><input type=\"hidden\" name=\"gpaa_place_47\" class=\"gform_hidden\" value=\"\"><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_57_72' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Back'  \/> <input type='button' id='gform_next_button_57_72' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_57_6' class='gform_page' data-js='page-field-id-72' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_57_6' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_57_67\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full sn37uk-fallback gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_57_67'>REQUESTED HOME VISIT<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_67' id='input_57_67' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>--<\/option><option value='' >Select a service<\/option><option value='ALM101' >ACUPUNCTURE 1ST VISIT<\/option><option value='MEN105' >DIABETES 1ST VISIT<\/option><option value='MEN101' >ENDOCRINOLOGY 1ST VISIT<\/option><option value='FTM101' >FUNCTIONAL MEDICINE 1ST VISIT HOME VISIT<\/option><option value='MGP101' >GP HOME VISIT<\/option><option value='MGP102' >GP HOME VISIT WITH CERTIFICATE<\/option><option value='MGE101' >GERIATRIC 1ST VISIT<\/option><option value='MGY102' >FERTILITY VISIT<\/option><option value='MGY101' >GYNAECOLOGY VISIT<\/option><option value='MOR101' >ORTHOPAEDIC SURGEON 1ST VISIT<\/option><option value='MPA101' >PALLIATIVE CARE DOCTOR HOME VISIT<\/option><option value='MPR101' >PHYSICAL MED AND REHABILITATION HOME VISIT<\/option><option value='MPR106' >PHYSICAL MED BOTULIN INJECTION<\/option><option value='MPS101' >PSYCHIATRY 1ST VISIT<\/option><option value='NRS104' >BLOOD TEST (INCLUDING LAB TESTS)<\/option><option value='NRS128' >BLOOD TEST (WITHDRAWAL ONLY - NO LAB TRANSPORT)<\/option><option value='NRS120' >ENEMA<\/option><option value='NRS121' >INJECTION<\/option><option value='NRS116' >STANDARD IV DRIP (&lt; 1HR)<\/option><option value='NRS117' >1 - 2 HR IV DRIP<\/option><option value='NRS118' >2 - 3 HR IV DRIP<\/option><option value='NRS101' >NURSING CARE &lt; 3HRS (FEE\/HR)<\/option><option value='NRS102' >NURSING CARE 3-6 HRS (FEE\/HR)<\/option><option value='NRS103' >NURSING CARE &gt;7 HRS (FEE\/HR)<\/option><option value='NRS126' >EAR IRRIGATION<\/option><option value='NRS127' >PERSONAL HYGIENE<\/option><option value='NRS122' >STOMA CARE<\/option><option value='NRS119' >URINARY CATHETER CARE<\/option><option value='NRS124' >PICC CARE<\/option><option value='NRS123' >PORT-A-CATH CARE<\/option><option value='NRS125' >MIDLINE CARE<\/option><option value='NRS115' >WOUND DRESSING<\/option><option value='NRS129' >TISSUE VIABILITY 1ST VISIT<\/option><option value='NTT101' >NUTRITIONAL THERAPY 1S VISIT<\/option><option value='PGL101' >LYMPHATIC MASSAGE 1ST TREATMENT<\/option><option value='PGE106' >NEURO - PHYSIOTHERAPY FIRST SESSION<\/option><option value='PGE101' >PHYSIO - ORTHOPAEDIC &amp; SPORTS - FIRST SESSION<\/option><option value='PRE101' >CARDIOVASCULAR &amp; RESPIRATORY PHYSIOTHERAPY FIRST SESSION<\/option><option value='POD101' >PODIATRY 1ST VISIT<\/option><option value='POD107' >DIABETIC FOOT SCREENING + INITIAL ASSESSMENT<\/option><option value='PSY101' >PSYCHOLOGICAL 1ST CONSULTATION<\/option><option value='SPT101' >SPEECH THERAPY ADULT 1ST VISIT<\/option><option value='SPT107' >SPEECH THERAPY CHILDREN 1ST VISIT<\/option><\/select><\/div><\/div><div id=\"field_57_36\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full sn37uk-fallback gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_57_36'>REQUESTED HOME-VISIT SERVICE<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_36' id='input_57_36' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>--<\/option><option value='' >Select a service<\/option><option value='ALM101' >ACUPUNCTURE 1ST VISIT<\/option><option value='MEN105' >DIABETES 1ST VISIT<\/option><option value='MEN101' >ENDOCRINOLOGY 1ST VISIT<\/option><option value='FTM101' >FUNCTIONAL MEDICINE 1ST VISIT HOME VISIT<\/option><option value='MGP101' >GP HOME VISIT<\/option><option value='MGP102' >GP HOME VISIT WITH CERTIFICATE<\/option><option value='MGE101' >GERIATRIC 1ST VISIT<\/option><option value='MGY102' >FERTILITY VISIT<\/option><option value='MGY101' >GYNAECOLOGY VISIT<\/option><option value='MOR101' >ORTHOPAEDIC SURGEON 1ST VISIT<\/option><option value='MPA101' >PALLIATIVE CARE DOCTOR HOME VISIT<\/option><option value='MPR101' >PHYSICAL MED AND REHABILITATION HOME VISIT<\/option><option value='MPR106' >PHYSICAL MED BOTULIN INJECTION<\/option><option value='MPS101' >PSYCHIATRY 1ST VISIT<\/option><option value='NRS104' >BLOOD TEST (INCLUDING LAB TESTS)<\/option><option value='NRS128' >BLOOD TEST (WITHDRAWAL ONLY - NO LAB TRANSPORT)<\/option><option value='NRS120' >ENEMA<\/option><option value='NRS121' >INJECTION<\/option><option value='NRS116' >STANDARD IV DRIP (&lt; 1HR)<\/option><option value='NRS117' >1 - 2 HR IV DRIP<\/option><option value='NRS118' >2 - 3 HR IV DRIP<\/option><option value='NRS101' >NURSING CARE &lt; 3HRS (FEE\/HR)<\/option><option value='NRS102' >NURSING CARE 3-6 HRS (FEE\/HR)<\/option><option value='NRS103' >NURSING CARE &gt;7 HRS (FEE\/HR)<\/option><option value='NRS126' >EAR IRRIGATION<\/option><option value='NRS127' >PERSONAL HYGIENE<\/option><option value='NRS122' >STOMA CARE<\/option><option value='NRS119' >URINARY CATHETER CARE<\/option><option value='NRS124' >PICC CARE<\/option><option value='NRS123' >PORT-A-CATH CARE<\/option><option value='NRS125' >MIDLINE CARE<\/option><option value='NRS115' >WOUND DRESSING<\/option><option value='NRS129' >TISSUE VIABILITY 1ST VISIT<\/option><option value='NTT101' >NUTRITIONAL THERAPY 1S VISIT<\/option><option value='PGL101' >LYMPHATIC MASSAGE 1ST TREATMENT<\/option><option value='PGE106' >NEURO - PHYSIOTHERAPY FIRST SESSION<\/option><option value='PGE101' >PHYSIO - ORTHOPAEDIC &amp; SPORTS - FIRST SESSION<\/option><option value='PRE101' >CARDIOVASCULAR &amp; RESPIRATORY PHYSIOTHERAPY FIRST SESSION<\/option><option value='POD101' >PODIATRY 1ST VISIT<\/option><option value='POD107' >DIABETIC FOOT SCREENING + INITIAL ASSESSMENT<\/option><option value='PSY101' >PSYCHOLOGICAL 1ST CONSULTATION<\/option><option value='SPT101' >SPEECH THERAPY ADULT 1ST VISIT<\/option><option value='SPT107' >SPEECH THERAPY CHILDREN 1ST VISIT<\/option><\/select><\/div><\/div><div id=\"field_57_76\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full sn37uk-fallback gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_57_76'>REQUESTED VIDEO-CONSULTATION SERVICE<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_76' id='input_57_76' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>--<\/option><option value='' >Select a service<\/option><option value='MEN107' >DIABETES VIDEO 1ST<\/option><option value='MEN103' >ENDOCRINOLOGY VIDEO 1ST<\/option><option value='FTM103' >FUNCTIONAL MEDICINE VIDEO 1ST CONSULTATION<\/option><option value='MGP103' >GP VIDEO CONSULTATION<\/option><option value='MGP104' >GP VIDEO CONSULTATION WITH CERTIFICATE<\/option><option value='MGE103' >GERIATRIC VIDEO 1ST CONSULTATION<\/option><option value='MGY105' >FERTILITY VIDEO CONSULTATION FOLLOW UP<\/option><option value='MGY104' >FERTILITY VIDEO CONSULTATION NEW PATIENT<\/option><option value='MGY103' >GYNAECOLOGY VIDEO CONSULTATION<\/option><option value='MOR103' >ORTHOPAEDIC SURGEON VIDEO CONSULTATION<\/option><option value='MPA102' >PALLIATIVE CARE DOCTOR VIDEO CONSULTATION<\/option><option value='MPR102' >PHYSICAL MED AND REHABILITATION VIDEO 1ST CONSULTATION<\/option><option value='MPS106' >PSYCHIATRY 1st VISIT VIDEO<\/option><option value='NRS132' >NURSE VIDEO CONSULTATION<\/option><option value='NRS133' >TISSUE VIABILITY VIDEO CONSULTATION<\/option><option value='NTT103' >NUTRITIONAL THERAPY VIDEO 1ST VISIT<\/option><option value='PVI101' >PHYSIO VIDEO 1ST + 30 MIN FOLLOWUP<\/option><option value='PSY105' >PSYCHOLOGICY FULL VIDEO\/PHONE CONSULTATION (60 MIN)<\/option><option value='SPT105' >SPEECH THERAPY ADULT VIDEO 1ST VISIT<\/option><option value='SPT111' >SPEECH THERAPY CHILDREN VIDEO 1ST VISIT<\/option><\/select><\/div><\/div><div id=\"field_57_74\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full sn37uk-fallback gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_57_74'>REQUESTED VIDEO-CONSULTATION SERVICE<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_74' id='input_57_74' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>--<\/option><option value='' >Select a service<\/option><option value='MEN107' >DIABETES VIDEO 1ST<\/option><option value='MEN103' >ENDOCRINOLOGY VIDEO 1ST<\/option><option value='FTM103' >FUNCTIONAL MEDICINE VIDEO 1ST CONSULTATION<\/option><option value='MGP103' >GP VIDEO CONSULTATION<\/option><option value='MGP104' >GP VIDEO CONSULTATION WITH CERTIFICATE<\/option><option value='MGE103' >GERIATRIC VIDEO 1ST CONSULTATION<\/option><option value='MGY105' >FERTILITY VIDEO CONSULTATION FOLLOW UP<\/option><option value='MGY104' >FERTILITY VIDEO CONSULTATION NEW PATIENT<\/option><option value='MGY103' >GYNAECOLOGY VIDEO CONSULTATION<\/option><option value='MOR103' >ORTHOPAEDIC SURGEON VIDEO CONSULTATION<\/option><option value='MPA102' >PALLIATIVE CARE DOCTOR VIDEO CONSULTATION<\/option><option value='MPR102' >PHYSICAL MED AND REHABILITATION VIDEO 1ST CONSULTATION<\/option><option value='MPS106' >PSYCHIATRY 1st VISIT VIDEO<\/option><option value='NRS132' >NURSE VIDEO CONSULTATION<\/option><option value='NRS133' >TISSUE VIABILITY VIDEO CONSULTATION<\/option><option value='NTT103' >NUTRITIONAL THERAPY VIDEO 1ST VISIT<\/option><option value='PVI101' >PHYSIO VIDEO 1ST + 30 MIN FOLLOWUP<\/option><option value='PSY105' >PSYCHOLOGICY FULL VIDEO\/PHONE CONSULTATION (60 MIN)<\/option><option value='SPT105' >SPEECH THERAPY ADULT VIDEO 1ST VISIT<\/option><option value='SPT111' >SPEECH THERAPY CHILDREN VIDEO 1ST VISIT<\/option><\/select><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_57_73' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Back'  \/> <input type='button' id='gform_next_button_57_73' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_57_7' class='gform_page' data-js='page-field-id-73' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_57_7' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_57_77\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full sn37uk-fallback gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_57_77'>REQUESTED HOME VISIT<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_77' id='input_57_77' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>--<\/option><option value='' >Select a service<\/option><option value='ALM101' >ACUPUNCTURE 1ST VISIT<\/option><option value='ALM103' >ACUPUNCTURE 5 TREATMENT PACKAGE<\/option><option value='ALM102' >ACUPUNCTURE FOLLOW UP<\/option><option value='MEN105' >DIABETES 1ST VISIT<\/option><option value='MEN106' >DIABETES FOLLOW UP<\/option><option value='MEN101' >ENDOCRINOLOGY 1ST VISIT<\/option><option value='MEN102' >ENDOCRINOLOGY FOLLOW UP<\/option><option value='FTM101' >FUNCTIONAL MEDICINE 1ST VISIT HOME VISIT<\/option><option value='FTM102' >FUNCTIONAL MEDICINE FOLLOW UP HOME VISIT<\/option><option value='MGP101' >GP HOME VISIT<\/option><option value='MGP102' >GP HOME VISIT WITH CERTIFICATE<\/option><option value='MGE101' >GERIATRIC 1ST VISIT<\/option><option value='MGY102' >FERTILITY VISIT<\/option><option value='MGY101' >GYNAECOLOGY VISIT<\/option><option value='MOR101' >ORTHOPAEDIC SURGEON 1ST VISIT<\/option><option value='MOR102' >ORTHOPAEDIC SURGEON FOLLOW UP<\/option><option value='MPA101' >PALLIATIVE CARE DOCTOR HOME VISIT<\/option><option value='MPR101' >PHYSICAL MED AND REHABILITATION HOME VISIT<\/option><option value='MPR106' >PHYSICAL MED BOTULIN INJECTION<\/option><option value='MPR105' >PHYSICAL MED AND REHABILITATION MEDICAL-LEGAL (FEE\/HR)<\/option><option value='MPS101' >PSYCHIATRY 1ST VISIT<\/option><option value='MPS102' >PSYCHIATRY FOLLOW UP<\/option><option value='NRS104' >BLOOD TEST (INCLUDING LAB TESTS)<\/option><option value='NRS128' >BLOOD TEST (WITHDRAWAL ONLY - NO LAB TRANSPORT)<\/option><option value='NRS120' >ENEMA<\/option><option value='NRS121' >INJECTION<\/option><option value='NRS116' >STANDARD IV DRIP (&lt; 1HR)<\/option><option value='NRS117' >1 - 2 HR IV DRIP<\/option><option value='NRS118' >2 - 3 HR IV DRIP<\/option><option value='NRS101' >NURSING CARE &lt; 3HRS (FEE\/HR)<\/option><option value='NRS102' >NURSING CARE 3-6 HRS (FEE\/HR)<\/option><option value='NRS103' >NURSING CARE &gt;7 HRS (FEE\/HR)<\/option><option value='NRS126' >EAR IRRIGATION<\/option><option value='NRS127' >PERSONAL HYGIENE<\/option><option value='NRS122' >STOMA CARE<\/option><option value='NRS119' >URINARY CATHETER CARE<\/option><option value='NRS124' >PICC CARE<\/option><option value='NRS123' >PORT-A-CATH CARE<\/option><option value='NRS125' >MIDLINE CARE<\/option><option value='NRS115' >WOUND DRESSING<\/option><option value='NRS129' >TISSUE VIABILITY 1ST VISIT<\/option><option value='NRS130' >TISSUE VIABILITY FOLLOW UP VISIT<\/option><option value='NRS131' >TISSUE VIABILITY 5 VISIT PACKAGE<\/option><option value='NTT101' >NUTRITIONAL THERAPY 1S VISIT<\/option><option value='NTT102' >NUTRITIONAL THERAPY FOLLOW UP<\/option><option value='PGL101' >LYMPHATIC MASSAGE 1ST TREATMENT<\/option><option value='PGL102' >LYMPHATIC MASSAGE FOLLOW UP<\/option><option value='PGE106' >NEURO - PHYSIOTHERAPY FIRST SESSION<\/option><option value='PGE110' >NEURO-PHYSIOTHERAPY PACKAGE 5 SESSION 60 MIN<\/option><option value='PGE109' >NEURO-PHYSIOTHERAPY PACKAGE 5 SESSIONS 45 MIN<\/option><option value='PGE107' >NEURO - PHYSIOTHERAPY FOLLOW UP (45 MIN)<\/option><option value='PGE108' >NEURO - PHYSIOTHERAPY FOLLOW UP (60 MIN)<\/option><option value='PGE101' >PHYSIO - ORTHOPAEDIC &amp; SPORTS - FIRST SESSION<\/option><option value='PGE104' >PHYSIO - ORTHOPAEDIC &amp; SPORTS - PACKAGE 5 SESSIONS - 45 MIN<\/option><option value='PGE105' >PHYSIO - ORTHOPAEDIC &amp; SPORTS - PACKAGE 5 SESSIONS - 60 MIN<\/option><option value='PGE102' >PHYSIO ORTHOPAEDIC &amp; SPORTS - FOLLOW UP (45 MIN)<\/option><option value='PGE103' >PHYSIO ORTHOPAEDIC &amp; SPORTS - FOLLOW UP (60 MIN)<\/option><option value='PRE101' >CARDIOVASCULAR &amp; RESPIRATORY PHYSIOTHERAPY FIRST SESSION<\/option><option value='PRE104' >CARDIOVASCULAR &amp; RESPIRATORY PHYSIOTHERAPY PACKAGE 5 SESSION<\/option><option value='PRE102' >CARDIOVASCULAR &amp; RESPIRATORY PHYSIOTHERAPY FOLLOW UP (45 MIN)<\/option><option value='PRE103' >CARDIOVASCULAR &amp; RESPIRATORY PHYSIOTHERAPY FOLLOW UP (60 MIN)<\/option><option value='POD101' >PODIATRY 1ST VISIT<\/option><option value='POD107' >DIABETIC FOOT SCREENING + INITIAL ASSESSMENT<\/option><option value='POD102' >PODIATRY FOLLOW UP<\/option><option value='POD104' >PODIATRY 5 VISIT PACKAGE<\/option><option value='PSY101' >PSYCHOLOGICAL 1ST CONSULTATION<\/option><option value='PSY102' >PSYCHOLOGICAL FOLLOW UP CONSULTATION<\/option><option value='SPT101' >SPEECH THERAPY ADULT 1ST VISIT<\/option><option value='SPT103' >SPEECH THERAPY ADULT PACKAGE 5 SESSIONS<\/option><option value='SPT102' >SPEECH THERAPY ADULT FOLLOW UP<\/option><option value='SPT107' >SPEECH THERAPY CHILDREN 1ST VISIT<\/option><option value='SPT109' >SPEECH THERAPY CHILDREN PACKAGE 5 SESSIONS<\/option><option value='SPT108' >SPEECH THERAPY CHILDREN FOLLOW UP<\/option><\/select><\/div><\/div><div id=\"field_57_70\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full sn37uk-fallback gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_57_70'>REQUESTED HOME-VISIT SERVICE<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_70' id='input_57_70' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>--<\/option><option value='' >Select a service<\/option><option value='ALM101' >ACUPUNCTURE 1ST VISIT<\/option><option value='ALM103' >ACUPUNCTURE 5 TREATMENT PACKAGE<\/option><option value='ALM102' >ACUPUNCTURE FOLLOW UP<\/option><option value='MEN105' >DIABETES 1ST VISIT<\/option><option value='MEN106' >DIABETES FOLLOW UP<\/option><option value='MEN101' >ENDOCRINOLOGY 1ST VISIT<\/option><option value='MEN102' >ENDOCRINOLOGY FOLLOW UP<\/option><option value='FTM101' >FUNCTIONAL MEDICINE 1ST VISIT HOME VISIT<\/option><option value='FTM102' >FUNCTIONAL MEDICINE FOLLOW UP HOME VISIT<\/option><option value='MGP101' >GP HOME VISIT<\/option><option value='MGP102' >GP HOME VISIT WITH CERTIFICATE<\/option><option value='MGE101' >GERIATRIC 1ST VISIT<\/option><option value='MGY102' >FERTILITY VISIT<\/option><option value='MGY101' >GYNAECOLOGY VISIT<\/option><option value='MOR101' >ORTHOPAEDIC SURGEON 1ST VISIT<\/option><option value='MOR102' >ORTHOPAEDIC SURGEON FOLLOW UP<\/option><option value='MPA101' >PALLIATIVE CARE DOCTOR HOME VISIT<\/option><option value='MPR101' >PHYSICAL MED AND REHABILITATION HOME VISIT<\/option><option value='MPR106' >PHYSICAL MED BOTULIN INJECTION<\/option><option value='MPR105' >PHYSICAL MED AND REHABILITATION MEDICAL-LEGAL (FEE\/HR)<\/option><option value='MPS101' >PSYCHIATRY 1ST VISIT<\/option><option value='MPS102' >PSYCHIATRY FOLLOW UP<\/option><option value='NRS104' >BLOOD TEST (INCLUDING LAB TESTS)<\/option><option value='NRS128' >BLOOD TEST (WITHDRAWAL ONLY - NO LAB TRANSPORT)<\/option><option value='NRS120' >ENEMA<\/option><option value='NRS121' >INJECTION<\/option><option value='NRS116' >STANDARD IV DRIP (&lt; 1HR)<\/option><option value='NRS117' >1 - 2 HR IV DRIP<\/option><option value='NRS118' >2 - 3 HR IV DRIP<\/option><option value='NRS101' >NURSING CARE &lt; 3HRS (FEE\/HR)<\/option><option value='NRS102' >NURSING CARE 3-6 HRS (FEE\/HR)<\/option><option value='NRS103' >NURSING CARE &gt;7 HRS (FEE\/HR)<\/option><option value='NRS126' >EAR IRRIGATION<\/option><option value='NRS127' >PERSONAL HYGIENE<\/option><option value='NRS122' >STOMA CARE<\/option><option value='NRS119' >URINARY CATHETER CARE<\/option><option value='NRS124' >PICC CARE<\/option><option value='NRS123' >PORT-A-CATH CARE<\/option><option value='NRS125' >MIDLINE CARE<\/option><option value='NRS115' >WOUND DRESSING<\/option><option value='NRS129' >TISSUE VIABILITY 1ST VISIT<\/option><option value='NRS130' >TISSUE VIABILITY FOLLOW UP VISIT<\/option><option value='NRS131' >TISSUE VIABILITY 5 VISIT PACKAGE<\/option><option value='NTT101' >NUTRITIONAL THERAPY 1S VISIT<\/option><option value='NTT102' >NUTRITIONAL THERAPY FOLLOW UP<\/option><option value='PGL101' >LYMPHATIC MASSAGE 1ST TREATMENT<\/option><option value='PGL102' >LYMPHATIC MASSAGE FOLLOW UP<\/option><option value='PGE106' >NEURO - PHYSIOTHERAPY FIRST SESSION<\/option><option value='PGE110' >NEURO-PHYSIOTHERAPY PACKAGE 5 SESSION 60 MIN<\/option><option value='PGE109' >NEURO-PHYSIOTHERAPY PACKAGE 5 SESSIONS 45 MIN<\/option><option value='PGE107' >NEURO - PHYSIOTHERAPY FOLLOW UP (45 MIN)<\/option><option value='PGE108' >NEURO - PHYSIOTHERAPY FOLLOW UP (60 MIN)<\/option><option value='PGE101' >PHYSIO - ORTHOPAEDIC &amp; SPORTS - FIRST SESSION<\/option><option value='PGE104' >PHYSIO - ORTHOPAEDIC &amp; SPORTS - PACKAGE 5 SESSIONS - 45 MIN<\/option><option value='PGE105' >PHYSIO - ORTHOPAEDIC &amp; SPORTS - PACKAGE 5 SESSIONS - 60 MIN<\/option><option value='PGE102' >PHYSIO ORTHOPAEDIC &amp; SPORTS - FOLLOW UP (45 MIN)<\/option><option value='PGE103' >PHYSIO ORTHOPAEDIC &amp; SPORTS - FOLLOW UP (60 MIN)<\/option><option value='PRE101' >CARDIOVASCULAR &amp; RESPIRATORY PHYSIOTHERAPY FIRST SESSION<\/option><option value='PRE104' >CARDIOVASCULAR &amp; RESPIRATORY PHYSIOTHERAPY PACKAGE 5 SESSION<\/option><option value='PRE102' >CARDIOVASCULAR &amp; RESPIRATORY PHYSIOTHERAPY FOLLOW UP (45 MIN)<\/option><option value='PRE103' >CARDIOVASCULAR &amp; RESPIRATORY PHYSIOTHERAPY FOLLOW UP (60 MIN)<\/option><option value='POD101' >PODIATRY 1ST VISIT<\/option><option value='POD107' >DIABETIC FOOT SCREENING + INITIAL ASSESSMENT<\/option><option value='POD102' >PODIATRY FOLLOW UP<\/option><option value='POD104' >PODIATRY 5 VISIT PACKAGE<\/option><option value='PSY101' >PSYCHOLOGICAL 1ST CONSULTATION<\/option><option value='PSY102' >PSYCHOLOGICAL FOLLOW UP CONSULTATION<\/option><option value='SPT101' >SPEECH THERAPY ADULT 1ST VISIT<\/option><option value='SPT103' >SPEECH THERAPY ADULT PACKAGE 5 SESSIONS<\/option><option value='SPT102' >SPEECH THERAPY ADULT FOLLOW UP<\/option><option value='SPT107' >SPEECH THERAPY CHILDREN 1ST VISIT<\/option><option value='SPT109' >SPEECH THERAPY CHILDREN PACKAGE 5 SESSIONS<\/option><option value='SPT108' >SPEECH THERAPY CHILDREN FOLLOW UP<\/option><\/select><\/div><\/div><div id=\"field_57_65\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full sn37uk-fallback gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_57_65'>REQUESTED VIDEO-CONSULTATION SERVICE<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_65' id='input_57_65' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>--<\/option><option value='' >Select a service<\/option><option value='MEN107' >DIABETES VIDEO 1ST<\/option><option value='MEN108' >DIABETES VIDEO FOLLOW UP<\/option><option value='MEN103' >ENDOCRINOLOGY VIDEO 1ST<\/option><option value='MEN104' >ENDOCRINOLOGY VIDEO FOLLOW UP<\/option><option value='FTM103' >FUNCTIONAL MEDICINE VIDEO 1ST CONSULTATION<\/option><option value='FTM107' >FUNCTIONAL MEDICINE COACHING PLAN + FUP SKYPE<\/option><option value='FTM104' >FUNCTIONAL MEDICINE VIDEO FOLLOW UP<\/option><option value='MGP103' >GP VIDEO CONSULTATION<\/option><option value='MGP104' >GP VIDEO CONSULTATION WITH CERTIFICATE<\/option><option value='MGE103' >GERIATRIC VIDEO 1ST CONSULTATION<\/option><option value='MGE104' >GERIATRIC VIDEO FOLLOW UP<\/option><option value='MGY105' >FERTILITY VIDEO CONSULTATION FOLLOW UP<\/option><option value='MGY104' >FERTILITY VIDEO CONSULTATION NEW PATIENT<\/option><option value='MGY103' >GYNAECOLOGY VIDEO CONSULTATION<\/option><option value='MOR103' >ORTHOPAEDIC SURGEON VIDEO CONSULTATION<\/option><option value='MPA102' >PALLIATIVE CARE DOCTOR VIDEO CONSULTATION<\/option><option value='MPR102' >PHYSICAL MED AND REHABILITATION VIDEO 1ST CONSULTATION<\/option><option value='MPR104' >PHYSICAL MED AND REHABILITATION VIDEO FOLLOW UP<\/option><option value='MPS106' >PSYCHIATRY 1st VISIT VIDEO<\/option><option value='MPS105' >PSYCHIATRY FOLLOW UP VIDEO<\/option><option value='NRS132' >NURSE VIDEO CONSULTATION<\/option><option value='NRS133' >TISSUE VIABILITY VIDEO CONSULTATION<\/option><option value='NTT103' >NUTRITIONAL THERAPY VIDEO 1ST VISIT<\/option><option value='NTT104' >NUTRITIONAL THERAPY VIDEO FOLLOW UP<\/option><option value='PVI102' >PHYSIO VIDEO PACKAGE OF 5<\/option><option value='PSY105' >PSYCHOLOGICY FULL VIDEO\/PHONE CONSULTATION (60 MIN)<\/option><option value='PSY106' >PSYCHOLOGY 30 MIN FOLLOW UP VIDEO\/PHONE CONSULTATION<\/option><option value='SPT105' >SPEECH THERAPY ADULT VIDEO 1ST VISIT<\/option><option value='SPT114' >SPEECH THERAPY ADULT VIDEO PACKAGE of 5<\/option><option value='SPT106' >SPEECH THERAPY ADULT VIDEO FOLLOW UP VISIT<\/option><option value='SPT111' >SPEECH THERAPY CHILDREN VIDEO 1ST VISIT<\/option><option value='SPT113' >SPEECH THERAPY CHILDREN VIDEO PACKAGE of 5<\/option><option value='SPT112' >SPEECH THERAPY CHILDREN VIDEO FOLLOW UP VISIT<\/option><\/select><\/div><\/div><div id=\"field_57_49\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full sn37uk-fallback gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_57_49'>REQUESTED VIDEO-CONSULTATION SERVICE<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_49' id='input_57_49' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>--<\/option><option value='' >Select a service<\/option><option value='MEN107' >DIABETES VIDEO 1ST<\/option><option value='MEN108' >DIABETES VIDEO FOLLOW UP<\/option><option value='MEN103' >ENDOCRINOLOGY VIDEO 1ST<\/option><option value='MEN104' >ENDOCRINOLOGY VIDEO FOLLOW UP<\/option><option value='FTM103' >FUNCTIONAL MEDICINE VIDEO 1ST CONSULTATION<\/option><option value='FTM107' >FUNCTIONAL MEDICINE COACHING PLAN + FUP SKYPE<\/option><option value='FTM104' >FUNCTIONAL MEDICINE VIDEO FOLLOW UP<\/option><option value='MGP103' >GP VIDEO CONSULTATION<\/option><option value='MGP104' >GP VIDEO CONSULTATION WITH CERTIFICATE<\/option><option value='MGE103' >GERIATRIC VIDEO 1ST CONSULTATION<\/option><option value='MGE104' >GERIATRIC VIDEO FOLLOW UP<\/option><option value='MGY105' >FERTILITY VIDEO CONSULTATION FOLLOW UP<\/option><option value='MGY104' >FERTILITY VIDEO CONSULTATION NEW PATIENT<\/option><option value='MGY103' >GYNAECOLOGY VIDEO CONSULTATION<\/option><option value='MOR103' >ORTHOPAEDIC SURGEON VIDEO CONSULTATION<\/option><option value='MPA102' >PALLIATIVE CARE DOCTOR VIDEO CONSULTATION<\/option><option value='MPR102' >PHYSICAL MED AND REHABILITATION VIDEO 1ST CONSULTATION<\/option><option value='MPR104' >PHYSICAL MED AND REHABILITATION VIDEO FOLLOW UP<\/option><option value='MPS106' >PSYCHIATRY 1st VISIT VIDEO<\/option><option value='MPS105' >PSYCHIATRY FOLLOW UP VIDEO<\/option><option value='NRS132' >NURSE VIDEO CONSULTATION<\/option><option value='NRS133' >TISSUE VIABILITY VIDEO CONSULTATION<\/option><option value='NTT103' >NUTRITIONAL THERAPY VIDEO 1ST VISIT<\/option><option value='NTT104' >NUTRITIONAL THERAPY VIDEO FOLLOW UP<\/option><option value='PVI102' >PHYSIO VIDEO PACKAGE OF 5<\/option><option value='PSY105' >PSYCHOLOGICY FULL VIDEO\/PHONE CONSULTATION (60 MIN)<\/option><option value='PSY106' >PSYCHOLOGY 30 MIN FOLLOW UP VIDEO\/PHONE CONSULTATION<\/option><option value='SPT105' >SPEECH THERAPY ADULT VIDEO 1ST VISIT<\/option><option value='SPT114' >SPEECH THERAPY ADULT VIDEO PACKAGE of 5<\/option><option value='SPT106' >SPEECH THERAPY ADULT VIDEO FOLLOW UP VISIT<\/option><option value='SPT111' >SPEECH THERAPY CHILDREN VIDEO 1ST VISIT<\/option><option value='SPT113' >SPEECH THERAPY CHILDREN VIDEO PACKAGE of 5<\/option><option value='SPT112' >SPEECH THERAPY CHILDREN VIDEO FOLLOW UP VISIT<\/option><\/select><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_57_79' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Back'  \/> <input type='button' id='gform_next_button_57_79' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_57_8' class='gform_page' data-js='page-field-id-79' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_57_8' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_57_59\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_57_59'>Video pseudo-address<\/label><div class='ginput_container ginput_container_text'><input name='input_59' id='input_57_59' type='text' value='XXXXVID' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_57_37\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_57_37'>servcode<\/label><div class='ginput_container ginput_container_text'><input name='input_37' id='input_57_37' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_57_80\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_57_80'>YOU HAVE SELECTED:<\/label><div class='ginput_container ginput_container_text'><input readonly='readonly' name='input_80' id='input_57_80' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_57_24\" class=\"gfield gfield--type-uid gfield--input-type-uid gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><label class='gfield_label gform-field-label' for='input_57_24'>cnn<\/label><div class='ginput_container ginput_container_hidden'><input name='input_24' id='input_57_24' type='hidden' value=''  \/><\/div><\/div><div id=\"field_57_50\" class=\"gfield gfield--type-uid gfield--input-type-uid gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><label class='gfield_label gform-field-label' for='input_57_50'>PATIENT ID<\/label><div class='ginput_container ginput_container_hidden'><input name='input_50' id='input_57_50' type='hidden' value=''  \/><\/div><\/div><div id=\"field_57_40\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_57_40'>CONNECTED SERVICES servocde<\/label><div class='ginput_container ginput_container_text'><input name='input_40' id='input_57_40' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_57_38\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_57_38'>CONNECTED VIDEO servcode<\/label><div class='ginput_container ginput_container_text'><input name='input_38' id='input_57_38' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_57_32\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_57_32'>GF1 - PASSED<\/label><div class='ginput_container ginput_container_text'><input name='input_32' id='input_57_32' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_57_190\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_190' id='input_57_190' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='N' \/><\/div><\/div><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><input type='submit' id='gform_previous_button_57' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' 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