{"id":12557,"date":"2026-08-11T14:36:02","date_gmt":"2026-08-11T14:36:02","guid":{"rendered":"https:\/\/gmcanesthesia.com\/divi-redirects\/?page_id=12557"},"modified":"2026-08-11T14:36:39","modified_gmt":"2026-08-11T14:36:39","slug":"for-patients-families-thank-you","status":"publish","type":"page","link":"https:\/\/gmcanesthesia.com\/divi-redirects\/for-patients-families-thank-you\/","title":{"rendered":"For Patient &#038; Families: Thank You"},"content":{"rendered":"<div class=\"et_pb_section_0 et_pb_section et_section_regular et_flex_section preset--module--divi-section--10000000-0000-4000-8000-000000000013 preset--module--divi-section--default\">\n<div class=\"et_pb_row_0 et_pb_row et_flex_row preset--module--divi-row--default\">\n<div class=\"et_pb_column_0 et_pb_column et-last-child et_flex_column et_pb_css_mix_blend_mode_passthrough et_flex_column_24_24 et_flex_column_24_24_tablet et_flex_column_24_24_phone preset--module--divi-column--_default\">\n<div class=\"et_pb_text_0 et_pb_text et_pb_bg_layout_light et_pb_module et_flex_module preset--module--divi-text--10000000-0000-4000-8000-000000000003\"><div class=\"et_pb_text_inner\"><h1>Success! Message Sent.<\/h1>\n<\/div><\/div>\n<\/div>\n<\/div>\n<\/div>\n\n<div class=\"et_pb_section_1 et_pb_section et_section_regular et_flex_section\">\n<div class=\"et_pb_row_1 et_pb_row et_flex_row preset--module--divi-row--default\">\n<div class=\"et_pb_column_1 et_pb_column et-last-child et_flex_column et_pb_css_mix_blend_mode_passthrough et_flex_column_24_24 et_flex_column_24_24_tablet et_flex_column_24_24_phone preset--module--divi-column--default\">\n<div class=\"et_pb_text_1 et_pb_text et_pb_bg_layout_light et_pb_module et_flex_module preset--module--divi-text--default\"><div class=\"et_pb_text_inner\"><p>Thank You for contacting us, we will respond promptly.<\/p>\n<\/div><\/div>\n<\/div>\n<\/div>\n<\/div><div class=\"et_pb_section_2 et_pb_section et_pb_section--fixed et_section_regular et_flex_section et-interaction-target-9k22r59v8f\" data-interaction-target=\"9k22r59v8f\" id=\"form-pop-tabs\"><div class=\"et_pb_row_2 et_pb_row et_flex_row preset--module--divi-row--default\"><div class=\"et_pb_column_2 et_pb_column et-last-child et_flex_column et_pb_css_mix_blend_mode_passthrough et_flex_column_24_24 et_flex_column_24_24_tablet et_flex_column_24_24_phone preset--module--divi-column--default\"><div class=\"et_pb_code_0 et_pb_code et_pb_module\"><div class=\"et_pb_code_inner\">  <div class=\"gmc-wtf\" id=\"gmc-wtf\">\n      <div class=\"gmc-wtf__nav\" role=\"tablist\" aria-label=\"Intake forms, by audience\">\n        <button type=\"button\" class=\"gmc-wtf__btn is-active\" role=\"tab\" aria-selected=\"true\" aria-controls=\"gmc-wtf-panel-0\" id=\"gmc-wtf-tab-0\" data-hash=\"form-providers\" tabindex=\"0\">For Medical Providers<\/button>\n        <button type=\"button\" class=\"gmc-wtf__btn\" role=\"tab\" aria-selected=\"false\" aria-controls=\"gmc-wtf-panel-1\" id=\"gmc-wtf-tab-1\" data-hash=\"form-patients\" tabindex=\"-1\">For Patients &amp; Families<\/button>\n      <\/div>\n\n      <div class=\"gmc-wtf__panel is-active\" role=\"tabpanel\" id=\"gmc-wtf-panel-0\" aria-labelledby=\"gmc-wtf-tab-0\">\n        <h2>Medical Providers Form<\/h2>\n        <p>Complete the form below to request a consultation.<\/p>\n        <div class=\"frm_forms  with_frm_style frm_style_formidable-style\" id=\"frm_form_2_container\" >\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form \" id=\"form_xlhz298c514147c\" >\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_hidden\">Contact Us Form<\/legend>\r\n\r\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"2\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_2\" id=\"frm_hide_fields_2\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"xlhz298c514147c\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_2\" name=\"frm_submit_entry_2\" value=\"74e7cb3da9\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/divi-redirects\/wp-json\/wp\/v2\/pages\/12557\" \/><div id=\"frm_field_7_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label for=\"field_qk6x\" class=\"frm_primary_label\">First Name\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_qk6x\" name=\"item_meta[7]\" value=\"\"  data-reqmsg=\"First Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Full Name is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_8_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <label for=\"field_auafh\" class=\"frm_primary_label\">Last Name\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_auafh\" name=\"item_meta[8]\" value=\"\"  data-reqmsg=\"Last Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Full Name is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_9_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label for=\"field_gban9\" class=\"frm_primary_label\">Phone\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"tel\" id=\"field_gban9\" name=\"item_meta[9]\" value=\"\"  data-reqmsg=\"Phone cannot be blank.\" aria-required=\"true\" data-invmsg=\"Phone is invalid\" aria-invalid=\"false\" pattern=\"((\\+\\d{1,3}(-|.| )?\\(?\\d\\)?(-| |.)?\\d{1,5})|(\\(?\\d{2,6}\\)?))(-|.| )?(\\d{3,4})(-|.| )?(\\d{4})(( x| ext)\\d{1,5}){0,1}$\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_10_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <label for=\"field_j4ile\" class=\"frm_primary_label\">Email\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_j4ile\" name=\"item_meta[10]\" value=\"\"  data-reqmsg=\"Email cannot be blank.\" aria-required=\"true\" data-invmsg=\"Email Address is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_11_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_69vx6c0c506d16\" class=\"frm_primary_label\">Message\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[11]\" id=\"field_69vx6c0c506d16\" rows=\"5\"  data-reqmsg=\"Message cannot be blank.\" aria-required=\"true\" data-invmsg=\"Message is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12_container\" class=\"frm_form_field form-field  frm_none_container\">\r\n\t<label for=\"h-captcha-response\" id=\"field_2jdzg_label\" class=\"frm_primary_label\">Captcha\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n\t<\/label>\r\n\t<div  id=\"field_2jdzg\" class=\"h-captcha\" data-sitekey=\"6b3aa1f8-07de-4d1a-b0da-87c2f8f8b68c\" data-size=\"normal\" data-theme=\"light\"><\/div>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_15_container\" class=\"frm_form_field form-field \">\r\n\t<div class=\"frm_submit\">\r\n\r\n<button class=\"frm_button_submit\" type=\"submit\"  >Submit<\/button>\r\n\r\n<\/div>\r\n<\/div>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t\t\t<div id=\"frm_field_34_container\">\n\t\t\t<label for=\"field_bt4q1\" >\n\t\t\t\tIf you are human, leave this field blank.\t\t\t<\/label>\n\t\t\t<input  id=\"field_bt4q1\" type=\"text\" class=\"frm_form_field form-field frm_verify\" name=\"item_meta[34]\" value=\"\"  \/>\n\t\t<\/div>\n\t\t<input name=\"frm_state\" type=\"hidden\" value=\"ngXyKB000CyKpoWZ4uG2Vo0kBQOPBmVvAGM9fAuEdAI=\" \/><\/div>\n<\/fieldset>\n<\/div>\n\n<\/form>\n<\/div>\n\n      <\/div>\n\n      <div class=\"gmc-wtf__panel\" role=\"tabpanel\" id=\"gmc-wtf-panel-1\" aria-labelledby=\"gmc-wtf-tab-1\" hidden=\"\">\n        <h2>Patients &amp; Families Form<\/h2>\n        <p>Use the form below to ask a question about your procedure.<\/p>\n        <div class=\"frm_forms  with_frm_style frm_style_formidable-style\" id=\"frm_form_4_container\" >\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form \" id=\"form_xlhz298c514147c22\" >\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_hidden\">Patients & Families Form<\/legend>\r\n\r\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"4\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_4\" id=\"frm_hide_fields_4\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"xlhz298c514147c22\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_4\" name=\"frm_submit_entry_4\" value=\"74e7cb3da9\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/divi-redirects\/wp-json\/wp\/v2\/pages\/12557\" \/><div id=\"frm_field_25_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label for=\"field_qk6x3\" class=\"frm_primary_label\">First Name\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_qk6x3\" name=\"item_meta[25]\" value=\"\"  data-reqmsg=\"First Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Full Name is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_26_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <label for=\"field_auafh3\" class=\"frm_primary_label\">Last Name\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_auafh3\" name=\"item_meta[26]\" value=\"\"  data-reqmsg=\"Last Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Full Name is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_27_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label for=\"field_gban93\" class=\"frm_primary_label\">Phone\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"tel\" id=\"field_gban93\" name=\"item_meta[27]\" value=\"\"  data-reqmsg=\"Phone cannot be blank.\" aria-required=\"true\" data-invmsg=\"Phone is invalid\" aria-invalid=\"false\" pattern=\"((\\+\\d{1,3}(-|.| )?\\(?\\d\\)?(-| |.)?\\d{1,5})|(\\(?\\d{2,6}\\)?))(-|.| )?(\\d{3,4})(-|.| )?(\\d{4})(( x| ext)\\d{1,5}){0,1}$\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_28_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <label for=\"field_j4ile3\" class=\"frm_primary_label\">Email\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_j4ile3\" name=\"item_meta[28]\" value=\"\"  data-reqmsg=\"Email cannot be blank.\" aria-required=\"true\" data-invmsg=\"Email Address is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_29_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_69vx6c0c506d163\" class=\"frm_primary_label\">Message\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[29]\" id=\"field_69vx6c0c506d163\" rows=\"5\"  data-reqmsg=\"Message cannot be blank.\" aria-required=\"true\" data-invmsg=\"Message is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_30_container\" class=\"frm_form_field form-field  frm_none_container\">\r\n\t<label for=\"h-captcha-response\" id=\"field_2jdzg3_label\" class=\"frm_primary_label\">Captcha\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n\t<\/label>\r\n\t<div  id=\"field_2jdzg3\" class=\"h-captcha\" data-sitekey=\"6b3aa1f8-07de-4d1a-b0da-87c2f8f8b68c\" data-size=\"normal\" data-theme=\"light\"><\/div>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_33_container\" class=\"frm_form_field form-field \">\r\n\t<div class=\"frm_submit\">\r\n\r\n<button class=\"frm_button_submit\" type=\"submit\"  >Submit<\/button>\r\n\r\n<\/div>\r\n<\/div>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t\t\t<div id=\"frm_field_35_container\">\n\t\t\t<label for=\"field_do81o\" >\n\t\t\t\tIf you are human, leave this field blank.\t\t\t<\/label>\n\t\t\t<input  id=\"field_do81o\" type=\"text\" class=\"frm_form_field form-field frm_verify\" name=\"item_meta[35]\" value=\"\"  \/>\n\t\t<\/div>\n\t\t<input name=\"frm_state\" type=\"hidden\" value=\"ngXyKB000CyKpoWZ4uG2VhtmWXFYPRrh6h\/R3AzD8Xs=\" \/><\/div>\n<\/fieldset>\n<\/div>\n\n<\/form>\n<\/div>\n\n      <\/div>\n    <\/div>\n\n<style>\n\/* Trigger links *\/\n.tabs-popup { cursor: pointer; }\n.gmc-wtf__panel p {\n    margin-bottom: 2em;\n    margin-top: -1em;\n}\n\/* Tabs *\/\n.gmc-wtf{max-width:100%}\n.gmc-wtf__nav{display:flex;gap:24px;border-bottom:1px solid #dde3ea;margin-bottom:24px}\n.gmc-wtf__btn{background:none;border:none;padding:12px 0;font-size:16px;font-weight:600;color:#5a6472;cursor:pointer;border-bottom:2px solid transparent}\n.gmc-wtf__btn.is-active{color:#0b2545;border-bottom-color:#1a73e8}\n.gmc-wtf__panel[hidden]{display:none}\n\n\/* Divi section IS the modal box *\/\n#form-pop-tabs { display: none; }\n#form-pop-tabs.is-open {\n  display: block !important;\n  position: fixed !important;\n  top: 5vh; left: 50%;\n  transform: translateX(-50%);\n  width: 90%; max-width: 720px;\n  max-height: 90vh; overflow-y: auto;\n  background: #fff;\n  border-radius: 8px;\n  z-index: 10000;\n  padding: 0 !important;\n}\n\n\/* Backdrop injected by JS *\/\n.gmc-modal-backdrop {\n  position: fixed; inset: 0;\n  background: #0a2349d4;\n  z-index: 9999;\n  backdrop-filter: blur(10px);\n  -webkit-backdrop-filter: blur(10px);\n}\n\n.gmc-modal__close {\n    position: fixed;\n    top: 12px;\n    right: 16px;\n    background: none;\n    border: none;\n    font-size: 16px;\n    cursor: pointer;\n    line-height: 1;\n    z-index: 10001;\n    background: #CC0000;\n    color: #fff;\n    width: 34px;\n    height: 34px;\n    line-height: 22px;\n    border-radius: 20px;\n}\n<\/style>\n\n<script>\n(function () {\n  var root = document.getElementById('gmc-wtf');\n  var modal = document.getElementById('form-pop-tabs');\n  if (!root) { console.warn('[gmc-wtf] #gmc-wtf not found on page'); return; }\n  if (!modal) { console.warn('[gmc-wtf-popup] #form-pop-tabs not found'); return; }\n\n  \/\/ Move the popup to end of <body> so it isn't trapped inside a stacking\n  \/\/ context created by the header\/menu (transform, z-index, etc.)\n  if (modal.parentNode !== document.body) {\n    document.body.appendChild(modal);\n    console.log('[gmc-wtf-popup] #form-pop-tabs moved to <body>');\n  }\n\n  var tabs = Array.prototype.slice.call(root.querySelectorAll('.gmc-wtf__btn'));\n  var panels = Array.prototype.slice.call(root.querySelectorAll('.gmc-wtf__panel'));\n  var hashes = tabs.map(function (t) { return t.getAttribute('data-hash'); });\n\n  console.log('[gmc-wtf] init \u2014 tabs:', tabs.length, 'panels:', panels.length, 'hashes:', hashes);\n\n  function activate(index, updateHash) {\n    tabs.forEach(function (t, i) {\n      var active = i === index;\n      t.classList.toggle('is-active', active);\n      t.setAttribute('aria-selected', active ? 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Contact Us Form First Name * Last Name * Phone * Email * Message * Captcha Submit If you are human, leave this field blank. Patients &amp; Families Form Use the form below to ask a question&#8230;<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-12557","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>For Patient &amp; Families: Thank You - GMC Anesthesia<\/title>\n<meta name=\"robots\" content=\"noindex, follow\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"For Patient &amp; Families: Thank You - GMC Anesthesia\" \/>\n<meta property=\"og:description\" content=\"For Medical Providers For Patients &amp; Families Medical Providers Form Complete the form below to request a consultation. 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