{"id":16,"date":"2016-05-09T06:29:26","date_gmt":"2016-05-09T06:29:26","guid":{"rendered":"https:\/\/localhost\/ast\/?page_id=16"},"modified":"2016-07-07T20:46:58","modified_gmt":"2016-07-07T20:46:58","slug":"contact-us","status":"publish","type":"page","link":"https:\/\/americansleeptherapy.com\/index.php\/contact-us\/","title":{"rendered":"Contact Us"},"content":{"rendered":"<div class=\"contact-form\">\n<div role=\"form\" class=\"wpcf7\" id=\"wpcf7-f170-o1\" lang=\"en-US\" dir=\"ltr\">\n<div class=\"screen-reader-response\"><\/div>\n<form action=\"\/index.php\/wp-json\/wp\/v2\/pages\/16#wpcf7-f170-o1\" method=\"post\" class=\"wpcf7-form\" novalidate=\"novalidate\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"170\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"4.4.2\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f170-o1\" \/>\n<input type=\"hidden\" name=\"_wpnonce\" value=\"6fd9010463\" \/>\n<\/div>\n<h2>Request a Free Price Quote Today<\/h2>\n<h4>DO YOU SUFFER FROM THE FOLLOWING?<\/h4>\n<p><span>(Check all that apply) *<\/span><\/p>\n<div class=\"row\">\n<div class=\"col-md-3 col-xs-6\">\n<ul>\n<li><span class=\"wpcf7-form-control-wrap pain\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"pain[]\" value=\"NECK PAIN\" \/>&nbsp;<span class=\"wpcf7-list-item-label\">NECK PAIN<\/span><\/span><\/span><\/span><\/li>\n<li><span class=\"wpcf7-form-control-wrap pain\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"pain[]\" value=\"SHOULDER PAIN\" \/>&nbsp;<span class=\"wpcf7-list-item-label\">SHOULDER PAIN<\/span><\/span><\/span><\/span><\/li>\n<li><span class=\"wpcf7-form-control-wrap pain\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"pain[]\" value=\"BACK PAIN\" \/>&nbsp;<span class=\"wpcf7-list-item-label\">BACK PAIN<\/span><\/span><\/span><\/span><\/li>\n<li><span class=\"wpcf7-form-control-wrap pain\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"pain[]\" value=\"ACID REFLUX\" \/>&nbsp;<span class=\"wpcf7-list-item-label\">ACID REFLUX<\/span><\/span><\/span><\/span><\/li>\n<\/ul>\n<\/div>\n<div class=\"col-md-3 col-xs-6\">\n<ul>\n<li><span class=\"wpcf7-form-control-wrap pain\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"pain[]\" value=\"SLEEP APNEA\" \/>&nbsp;<span class=\"wpcf7-list-item-label\">SLEEP APNEA<\/span><\/span><\/span><\/span><\/li>\n<li><span class=\"wpcf7-form-control-wrap pain\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"pain[]\" value=\"ARTHRITIS\" \/>&nbsp;<span class=\"wpcf7-list-item-label\">ARTHRITIS<\/span><\/span><\/span><\/span><\/li>\n<li><span class=\"wpcf7-form-control-wrap pain\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"pain[]\" value=\"SWELLING (EDEMA)\" \/>&nbsp;<span class=\"wpcf7-list-item-label\">SWELLING (EDEMA)<\/span><\/span><\/span><\/span><\/li>\n<li><span class=\"wpcf7-form-control-wrap pain\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"pain[]\" value=\"POOR CIRCULATION\" \/>&nbsp;<span class=\"wpcf7-list-item-label\">POOR CIRCULATION<\/span><\/span><\/span><\/span><\/li>\n<\/ul>\n<\/div>\n<div class=\"col-md-3 col-xs-6\">\n<ul>\n<li><span class=\"wpcf7-form-control-wrap pain\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"pain[]\" value=\"FIBROMYALGIA\" \/>&nbsp;<span class=\"wpcf7-list-item-label\">FIBROMYALGIA<\/span><\/span><\/span><\/span><\/li>\n<li><span class=\"wpcf7-form-control-wrap pain\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"pain[]\" value=\"RESPIRATORY TROUBLE\" \/>&nbsp;<span class=\"wpcf7-list-item-label\">RESPIRATORY TROUBLE<\/span><\/span><\/span><\/span><\/li>\n<li><span class=\"wpcf7-form-control-wrap pain\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"pain[]\" value=\"DIABETES\" \/>&nbsp;<span class=\"wpcf7-list-item-label\">DIABETES<\/span><\/span><\/span><\/span><\/li>\n<li><span class=\"wpcf7-form-control-wrap pain\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"pain[]\" value=\"HEARTBURN\" \/>&nbsp;<span class=\"wpcf7-list-item-label\">HEARTBURN<\/span><\/span><\/span><\/span><\/li>\n<\/ul>\n<\/div>\n<div class=\"col-md-3 col-xs-6\">\n<ul>\n<li><span class=\"wpcf7-form-control-wrap pain\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"pain[]\" value=\"OSTEOPOROSIS\" \/>&nbsp;<span class=\"wpcf7-list-item-label\">OSTEOPOROSIS<\/span><\/span><\/span><\/span><\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div class=\"row\">\n<div class=\"col-md-6\">\n<p>Name (required)<br \/><span class=\"wpcf7-form-control-wrap your-name\"><input type=\"text\" name=\"your-name\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span> <\/p>\n<p>Street (required)<br \/><span class=\"wpcf7-form-control-wrap your-street\"><input type=\"text\" name=\"your-street\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>Town\/City (required)<br \/><span class=\"wpcf7-form-control-wrap your-town-city\"><input type=\"text\" name=\"your-town-city\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>State (required)<br \/><span class=\"wpcf7-form-control-wrap your-state\"><input type=\"text\" name=\"your-state\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<\/div>\n<div class=\"col-md-6\">\n<p>Zip (required)<br \/><span class=\"wpcf7-form-control-wrap your-zip\"><input type=\"text\" name=\"your-zip\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>Email (required)<br \/><span class=\"wpcf7-form-control-wrap your-email\"><input type=\"email\" name=\"your-email\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-email wpcf7-validates-as-required wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>Telephone (required)<br \/><span class=\"wpcf7-form-control-wrap your-tel\"><input type=\"text\" name=\"your-tel\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<\/div>\n<\/div>\n<h4>BEDS AVAILABLE:<\/h4>\n<p><span>(Please check the bed you\u2019re interested in) *<\/span><\/p>\n<div class=\"row\">\n<div class=\"col-md-3 col-xs-6\">\n<ul>\n<li><span class=\"wpcf7-form-control-wrap bed\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"bed[]\" value=\"KING\" \/>&nbsp;<span class=\"wpcf7-list-item-label\">KING<\/span><\/span><\/span><\/span><\/li>\n<li><span class=\"wpcf7-form-control-wrap bed\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"bed[]\" value=\"SPLIT KING\" \/>&nbsp;<span class=\"wpcf7-list-item-label\">SPLIT KING<\/span><\/span><\/span><\/span><\/li>\n<\/ul>\n<\/div>\n<div class=\"col-md-3 col-xs-6\">\n<ul>\n<li><span class=\"wpcf7-form-control-wrap bed\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"bed[]\" value=\"QUEEN\" \/>&nbsp;<span class=\"wpcf7-list-item-label\">QUEEN<\/span><\/span><\/span><\/span><\/li>\n<li><span class=\"wpcf7-form-control-wrap bed\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"bed[]\" value=\"SPLIT QUEEN\" \/>&nbsp;<span class=\"wpcf7-list-item-label\">SPLIT QUEEN<\/span><\/span><\/span><\/span><\/li>\n<\/ul>\n<\/div>\n<div class=\"col-md-3 col-xs-6\">\n<ul>\n<li><span class=\"wpcf7-form-control-wrap bed\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"bed[]\" value=\"DOUBLE\/FULL\" \/>&nbsp;<span class=\"wpcf7-list-item-label\">DOUBLE\/FULL<\/span><\/span><\/span><\/span><\/li>\n<li><span class=\"wpcf7-form-control-wrap bed\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"bed[]\" value=\"TWIN\" \/>&nbsp;<span class=\"wpcf7-list-item-label\">TWIN<\/span><\/span><\/span><\/span><\/li>\n<\/ul>\n<\/div>\n<div class=\"col-md-3 col-xs-6\">\n<ul>\n<li><span class=\"wpcf7-form-control-wrap bed\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"bed[]\" value=\"CUSTOM SIZES\" \/>&nbsp;<span class=\"wpcf7-list-item-label\">CUSTOM SIZES<\/span><\/span><\/span><\/span><\/li>\n<\/ul>\n<\/div>\n<\/div>\n<p>Specify (required)<br \/><span class=\"wpcf7-form-control-wrap your-specify\"><textarea name=\"your-specify\" cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\"><\/textarea><\/span> <\/p>\n<p><input type=\"submit\" value=\"Send\" class=\"wpcf7-form-control wpcf7-submit\" \/><\/p>\n<div class=\"wpcf7-response-output wpcf7-display-none\"><\/div><\/form><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":160,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/americansleeptherapy.com\/index.php\/wp-json\/wp\/v2\/pages\/16"}],"collection":[{"href":"https:\/\/americansleeptherapy.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/americansleeptherapy.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/americansleeptherapy.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/americansleeptherapy.com\/index.php\/wp-json\/wp\/v2\/comments?post=16"}],"version-history":[{"count":12,"href":"https:\/\/americansleeptherapy.com\/index.php\/wp-json\/wp\/v2\/pages\/16\/revisions"}],"predecessor-version":[{"id":383,"href":"https:\/\/americansleeptherapy.com\/index.php\/wp-json\/wp\/v2\/pages\/16\/revisions\/383"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/americansleeptherapy.com\/index.php\/wp-json\/wp\/v2\/media\/160"}],"wp:attachment":[{"href":"https:\/\/americansleeptherapy.com\/index.php\/wp-json\/wp\/v2\/media?parent=16"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}