{"id":3947,"date":"2026-04-19T09:01:10","date_gmt":"2026-04-19T09:01:10","guid":{"rendered":"https:\/\/nexacentre.com\/?page_id=3947"},"modified":"2026-05-19T17:51:35","modified_gmt":"2026-05-19T17:51:35","slug":"medical-travel","status":"publish","type":"page","link":"https:\/\/nexacentre.com\/so\/medical-travel\/","title":{"rendered":"Medical &#038; Travel"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"3947\" class=\"elementor elementor-3947\">\n\t\t\t\t<div class=\"elementor-element elementor-element-94b9d84 e-flex e-con-boxed e-con e-parent\" data-id=\"94b9d84\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-1eeb4e5 e-con-full e-flex e-con e-child\" data-id=\"1eeb4e5\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-0308950 e-con-full e-flex e-con e-child\" data-id=\"0308950\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;gradient&quot;}\">\n\t\t<div class=\"elementor-element elementor-element-a5b6806 e-con-full e-flex e-con e-child\" data-id=\"a5b6806\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-03e8eab elementor-widget elementor-widget-heading\" data-id=\"03e8eab\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\"><span style=\"color:#ffffff\">We Help You Find\nthe <\/span> \n<span style=\"color:#FF9635\">Right Care<\/span> \n<span style=\"color:#ffffff\">\u2014\nNot Provide<\/span> \n<span style=\"color:#007991\">Treatment<\/span><\/h1>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1955ceb elementor-widget elementor-widget-text-editor\" data-id=\"1955ceb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\tNexa Centre connects patients with qualified doctors, hospitals, and clinics locally and internationally \u2014 managing the full coordination process so you can focus entirely on your health.\t\t\t\t\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-eb566bb e-con-full e-flex e-con e-child\" data-id=\"eb566bb\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2c0cc4f elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"2c0cc4f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"color: #ffffff;\">Important:<\/span> <span style=\"color: #00b4d8;\">Nexa Centre is not a medical provider. We act as a trusted facilitator and connector only. We do not diagnose, treat, or prescribe \u2014 we coordinate access and manage logistics.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-86c8117 e-flex e-con-boxed e-con e-parent\" data-id=\"86c8117\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-9434ff3 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"9434ff3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t\u2014 OUR TWO SERVICES\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fe575ba elementor-widget__width-initial elementor-widget elementor-widget-heading\" data-id=\"fe575ba\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\"><span style=\"color:#ffffff\">Medical &amp; Travel<\/span> \n<span style=\"color:#FF9635\">Coordination<\/span>  <\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-dd3f264 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"dd3f264\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\tTwo interconnected services \u2014 often used together \u2014 that help patients and travelers navigate international healthcare and logistics with confidence.\t\t\t\t\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-2f59f6a e-con-full e-flex e-con e-child\" data-id=\"2f59f6a\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-7ece7b6 e-con-full e-flex e-con e-child\" data-id=\"7ece7b6\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-8a94438 elementor-widget elementor-widget-image\" data-id=\"8a94438\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"627\" height=\"427\" src=\"https:\/\/nexacentre.com\/wp-content\/uploads\/2026\/04\/photo-1519494026892-80bbd2d6fd0d-1.webp\" class=\"attachment-large size-large wp-image-4016\" alt=\"\" srcset=\"https:\/\/nexacentre.com\/wp-content\/uploads\/2026\/04\/photo-1519494026892-80bbd2d6fd0d-1.webp 627w, https:\/\/nexacentre.com\/wp-content\/uploads\/2026\/04\/photo-1519494026892-80bbd2d6fd0d-1-300x204.webp 300w, https:\/\/nexacentre.com\/wp-content\/uploads\/2026\/04\/photo-1519494026892-80bbd2d6fd0d-1-600x409.webp 600w\" sizes=\"(max-width: 627px) 100vw, 627px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-aa57c6b e-con-full e-flex e-con e-child\" data-id=\"aa57c6b\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-54ff072 elementor-widget__width-initial elementor-view-default elementor-widget elementor-widget-icon\" data-id=\"54ff072\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-wrapper\">\n\t\t\t<div class=\"elementor-icon\">\n\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-stethoscope\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M447.1 112c-34.2.5-62.3 28.4-63 62.6-.5 24.3 12.5 45.6 32 56.8V344c0 57.3-50.2 104-112 104-60 0-109.2-44.1-111.9-99.2C265 333.8 320 269.2 320 192V36.6c0-11.4-8.1-21.3-19.3-23.5L237.8.5c-13-2.6-25.6 5.8-28.2 18.8L206.4 35c-2.6 13 5.8 25.6 18.8 28.2l30.7 6.1v121.4c0 52.9-42.2 96.7-95.1 97.2-53.4.5-96.9-42.7-96.9-96V69.4l30.7-6.1c13-2.6 21.4-15.2 18.8-28.2l-3.1-15.7C107.7 6.4 95.1-2 82.1.6L19.3 13C8.1 15.3 0 25.1 0 36.6V192c0 77.3 55.1 142 128.1 156.8C130.7 439.2 208.6 512 304 512c97 0 176-75.4 176-168V231.4c19.1-11.1 32-31.7 32-55.4 0-35.7-29.2-64.5-64.9-64zm.9 80c-8.8 0-16-7.2-16-16s7.2-16 16-16 16 7.2 16 16-7.2 16-16 16z\"><\/path><\/svg>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-94ae7f4 elementor-widget elementor-widget-text-editor\" data-id=\"94ae7f4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><strong>Health Access &amp; Medical Coordination<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e27e72b elementor-widget-tablet__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"e27e72b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\tWe connect patients from Somaliland with qualified doctors, hospitals, and clinics locally and internationally \u2014 handling every step of the coordination process from inquiry to appointment.\n\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-61624dd e-con-full e-flex e-con e-child\" data-id=\"61624dd\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t<div class=\"elementor-element elementor-element-7df7600 e-con-full e-flex e-con e-child\" data-id=\"7df7600\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-72741b6 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"72741b6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>\u2192<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-eee6725 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"eee6725\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\tConnecting patients to verified doctors &#038; hospitals\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-cc419ed e-con-full e-flex e-con e-child\" data-id=\"cc419ed\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6cd05ae elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"6cd05ae\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>\u2192<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0408814 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"0408814\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Appointment booking and scheduling coordination<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-82e8b1d e-con-full e-flex e-con e-child\" data-id=\"82e8b1d\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-334eae9 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"334eae9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>\u2192<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-90a027b elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"90a027b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<div class=\"wc-item teal\">Medical travel facilitation and planning<\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-318c869 e-con-full e-flex e-con e-child\" data-id=\"318c869\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-e7c85fa elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"e7c85fa\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>\u2192<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a33f25e elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"a33f25e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Information support on procedures and options<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-51a2f53 e-con-full e-flex e-con e-child\" data-id=\"51a2f53\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-bc0f6bd elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"bc0f6bd\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>\u2192<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8fdd27b elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"8fdd27b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\tCountry-specific healthcare guidance\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0985881 elementor-tablet-align-justify elementor-widget-tablet__width-initial elementor-mobile-align-left elementor-widget elementor-widget-button\" data-id=\"0985881\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"#medical-consultation\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Book medical consultation \u2192<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-308d1f4 e-con-full e-flex e-con e-child\" data-id=\"308d1f4\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-a40445e elementor-widget elementor-widget-image\" data-id=\"a40445e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"800\" height=\"531\" src=\"https:\/\/nexacentre.com\/wp-content\/uploads\/2026\/04\/photo-1436491865332-7a61a109cc05-2.webp\" class=\"attachment-large size-large wp-image-4015\" alt=\"\" srcset=\"https:\/\/nexacentre.com\/wp-content\/uploads\/2026\/04\/photo-1436491865332-7a61a109cc05-2.webp 800w, https:\/\/nexacentre.com\/wp-content\/uploads\/2026\/04\/photo-1436491865332-7a61a109cc05-2-300x199.webp 300w, https:\/\/nexacentre.com\/wp-content\/uploads\/2026\/04\/photo-1436491865332-7a61a109cc05-2-768x510.webp 768w, https:\/\/nexacentre.com\/wp-content\/uploads\/2026\/04\/photo-1436491865332-7a61a109cc05-2-600x398.webp 600w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-df715f1 e-con-full e-flex e-con e-child\" data-id=\"df715f1\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4fc6745 elementor-widget__width-initial elementor-view-default elementor-widget elementor-widget-icon\" data-id=\"4fc6745\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-wrapper\">\n\t\t\t<div class=\"elementor-icon\">\n\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-plane-departure\" viewBox=\"0 0 640 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M624 448H16c-8.84 0-16 7.16-16 16v32c0 8.84 7.16 16 16 16h608c8.84 0 16-7.16 16-16v-32c0-8.84-7.16-16-16-16zM80.55 341.27c6.28 6.84 15.1 10.72 24.33 10.71l130.54-.18a65.62 65.62 0 0 0 29.64-7.12l290.96-147.65c26.74-13.57 50.71-32.94 67.02-58.31 18.31-28.48 20.3-49.09 13.07-63.65-7.21-14.57-24.74-25.27-58.25-27.45-29.85-1.94-59.54 5.92-86.28 19.48l-98.51 49.99-218.7-82.06a17.799 17.799 0 0 0-18-1.11L90.62 67.29c-10.67 5.41-13.25 19.65-5.17 28.53l156.22 98.1-103.21 52.38-72.35-36.47a17.804 17.804 0 0 0-16.07.02L9.91 230.22c-10.44 5.3-13.19 19.12-5.57 28.08l76.21 82.97z\"><\/path><\/svg>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-57fca9b elementor-widget elementor-widget-text-editor\" data-id=\"57fca9b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><strong>Travel &amp; Hotel Facilitation<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ac76473 elementor-widget-tablet__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"ac76473\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\tComprehensive travel support for patients, diaspora, and students \u2014 coordinating hotels, transport, and logistics so every journey is smooth, organized, and stress-free from start to finish.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-00d8c89 e-con-full e-flex e-con e-child\" data-id=\"00d8c89\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t<div class=\"elementor-element elementor-element-f15ce4c e-con-full e-flex e-con e-child\" data-id=\"f15ce4c\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-b80f667 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"b80f667\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>\u2192<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-93d4fe2 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"93d4fe2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<div class=\"wc-item or\">Travel request coordination and planning<\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-19ccd67 e-con-full e-flex e-con e-child\" data-id=\"19ccd67\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-330ead5 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"330ead5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>\u2192<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7204090 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"7204090\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\tHotel booking and accommodation support\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-63c40fc e-con-full e-flex e-con e-child\" data-id=\"63c40fc\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f82b546 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"f82b546\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>\u2192<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4f6488a elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"4f6488a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\tTravel coordination for medical appointments\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-09ca2b5 e-con-full e-flex e-con e-child\" data-id=\"09ca2b5\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-94b7b22 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"94b7b22\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>\u2192<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4a31690 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"4a31690\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<div class=\"wc-item or\">Student travel for education or exams abroad<\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-e293029 e-con-full e-flex e-con e-child\" data-id=\"e293029\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-9c41ee0 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"9c41ee0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>\u2192<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d3e7747 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"d3e7747\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\tDiaspora visiting home \u2014 logistics support\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3e98a49 elementor-tablet-align-justify elementor-widget-tablet__width-initial elementor-mobile-align-left elementor-widget elementor-widget-button\" data-id=\"3e98a49\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"#travel-consultation\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Book Travel consultation \u2192<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-d0c9c85 e-flex e-con-boxed e-con e-parent\" data-id=\"d0c9c85\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c4fc58e elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"c4fc58e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t\u2014 STEP BY STEP\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ffa28bd elementor-widget__width-initial elementor-widget elementor-widget-heading\" data-id=\"ffa28bd\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\"><span style=\"color:#ffffff\">The Patient<\/span> \n<span style=\"color:#007991\">Journey<\/span>  <\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d3bf84c elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"d3bf84c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\tFrom your first message to us \u2014 to returning home after treatment. Every step is guided, supported, and coordinated by Nexa Centre.\t\t\t\t\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-b62b3e5 e-con-full e-flex e-con e-child\" data-id=\"b62b3e5\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-4c1c7eb e-con-full e-flex e-con e-child\" data-id=\"4c1c7eb\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1b10cb1 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"1b10cb1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>01<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3d44d6e elementor-widget elementor-widget-text-editor\" data-id=\"3d44d6e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<strong>Submit Inquiry<\/strong>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2111a1f elementor-widget elementor-widget-text-editor\" data-id=\"2111a1f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\tComplete our Medical Request form with your condition, country preference, and documents.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-be2ef9b e-con-full e-flex e-con e-child\" data-id=\"be2ef9b\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-5d49657 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"5d49657\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>02<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-936f3be elementor-widget elementor-widget-text-editor\" data-id=\"936f3be\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<strong>Case Review<\/strong>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7248994 elementor-widget elementor-widget-text-editor\" data-id=\"7248994\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\tOur team reviews your case, identifies suitable doctors and hospitals, and contacts you within 48 hours.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-ee414de e-con-full e-flex e-con e-child\" data-id=\"ee414de\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-a832519 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"a832519\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>03<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-cae16c5 elementor-widget elementor-widget-text-editor\" data-id=\"cae16c5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<strong>Appointment Coordination\n<\/strong>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b369072 elementor-widget elementor-widget-text-editor\" data-id=\"b369072\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\tWe coordinate the appointment, documents, and travel timeline with the hospital and your schedule.\n\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-e7d39e0 e-con-full e-flex e-con e-child\" data-id=\"e7d39e0\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c842e73 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"c842e73\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>04<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a01cd17 elementor-widget elementor-widget-text-editor\" data-id=\"a01cd17\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<strong>Travel &#038; Logistics<\/strong>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9ededd7 elementor-widget elementor-widget-text-editor\" data-id=\"9ededd7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\tHotel, transport, and logistics are arranged and confirmed before your departure.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-1755891 e-con-full e-flex e-con e-child\" data-id=\"1755891\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-0e3b673 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"0e3b673\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>05<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c034d66 elementor-widget elementor-widget-text-editor\" data-id=\"c034d66\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<strong>Follow-Up Support<\/strong>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ab00030 elementor-widget elementor-widget-text-editor\" data-id=\"ab00030\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\tPost-visit check-in, follow-up coordination, and continued support for ongoing care needs.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-f13ebb5 e-flex e-con-boxed e-con e-parent\" data-id=\"f13ebb5\" data-element_type=\"container\" data-e-type=\"container\" id=\"medical-consultation\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-18b3499 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"18b3499\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t\u2014 Our Medical Network\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-468bf9b elementor-widget__width-initial elementor-widget elementor-widget-heading\" data-id=\"468bf9b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\"><span style=\"color:#ffffff\">Verified Doctors &amp; <\/span> \n<span style=\"color:#FF9635\">Hospitals<\/span>  <\/h2>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-fadf8d4 e-flex e-con-boxed e-con e-parent\" data-id=\"fadf8d4\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-be00e53 elementor-widget elementor-widget-html\" data-id=\"be00e53\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t\t<div style=\"display:flex;flex-wrap:wrap;gap:10px;margin-bottom:16px;\">\r\n  <button class=\"mf-btn active\" onclick=\"mFilter('all',this)\">All Countries<\/button>\r\n  <button class=\"mf-btn\" onclick=\"mFilter('turkey',this)\"> Turkey<\/button>\r\n  <button class=\"mf-btn\" onclick=\"mFilter('india',this)\">India<\/button>\r\n  <button class=\"mf-btn\" onclick=\"mFilter('ethiopia',this)\">Ethiopia<\/button>\r\n  <button class=\"mf-btn\" onclick=\"mFilter('uae',this)\"> UAE<\/button>\r\n<\/div>\r\n\r\n<div style=\"display:flex;flex-wrap:wrap;gap:10px;margin-bottom:16px;\" id=\"city-filter\" >\r\n  <button class=\"mf-btn city-btn active\" onclick=\"cFilter('all',this)\"> All Cities<\/button>\r\n<\/div>\r\n\r\n<div style=\"display:flex;flex-wrap:wrap;gap:10px;margin-bottom:32px;\">\r\n  <button class=\"mf-btn active\" onclick=\"tFilter('all',this)\">All Types<\/button>\r\n  <button class=\"mf-btn\" onclick=\"tFilter('doctor',this)\">Doctor<\/button>\r\n  <button class=\"mf-btn\" onclick=\"tFilter('hospital',this)\">Hospital<\/button>\r\n  <button class=\"mf-btn\" onclick=\"tFilter('clinic',this)\">Clinic<\/button>\r\n<\/div>\r\n\r\n<script>\r\nvar activeCountry = 'all';\r\nvar activeCity = 'all';\r\nvar activeType = 'all';\r\n\r\nvar cities = {\r\n  turkey: ['Istanbul','Ankara','Izmir','Antalya','Bursa','Adana','Gaziantep'],\r\n  india: ['Mumbai','Delhi','Chennai','Bangalore','Hyderabad','Kolkata','Pune'],\r\n  ethiopia: ['Addis Ababa','Dire Dawa','Mekelle','Gondar','Hawassa','Bahir Dar','Jimma'],\r\n  uae: ['Dubai','Abu Dhabi','Sharjah','Ajman','Ras Al Khaimah','Fujairah','Al Ain']\r\n};\r\n\r\nfunction mFilter(country, btn) {\r\n  document.querySelectorAll('.mf-btn:not(.city-btn):not([onclick*=\"tFilter\"])').forEach(b => b.classList.remove('active'));\r\n  btn.classList.add('active');\r\n  activeCountry = country;\r\n  activeCity = 'all';\r\n\r\n  \/\/ City buttons update karo\r\n  var cityDiv = document.getElementById('city-filter');\r\n  cityDiv.innerHTML = '<button class=\"mf-btn city-btn active\" onclick=\"cFilter(\\'all\\',this)\">\ufe0f All Cities<\/button>';\r\n\r\n  if(country !== 'all' && cities[country]) {\r\n    cities[country].forEach(function(city) {\r\n      var btn2 = document.createElement('button');\r\n      btn2.className = 'mf-btn city-btn';\r\n      btn2.textContent = city;\r\n      btn2.onclick = function() { cFilter(city.toLowerCase(), this); };\r\n      cityDiv.appendChild(btn2);\r\n    });\r\n  }\r\n\r\n  applyFilter();\r\n}\r\n\r\nfunction cFilter(city, btn) {\r\n  document.querySelectorAll('.city-btn').forEach(b => b.classList.remove('active'));\r\n  btn.classList.add('active');\r\n  activeCity = city;\r\n  applyFilter();\r\n}\r\n\r\nfunction tFilter(type, btn) {\r\n  document.querySelectorAll('.mf-btn:not(.city-btn):not([onclick*=\"mFilter\"])').forEach(b => b.classList.remove('active'));\r\n  btn.classList.add('active');\r\n  activeType = type;\r\n  applyFilter();\r\n}\r\n\r\nfunction applyFilter() {\r\n  document.querySelectorAll('.provider-card').forEach(function(card) {\r\n    var country = (card.dataset.country || '').toLowerCase();\r\n    var type = (card.dataset.type || '').toLowerCase();\r\n    var city = (card.dataset.city || '').toLowerCase();\r\n\r\n    var showCountry = activeCountry === 'all' || country === activeCountry;\r\n    var showCity = activeCity === 'all' || city === activeCity.toLowerCase();\r\n    var showType = activeType === 'all' || type === activeType;\r\n\r\n    card.style.display = (showCountry && showCity && showType) ? '' : 'none';\r\n  });\r\n}\r\n<\/script>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-06dacee e-flex e-con-boxed e-con e-parent\" data-id=\"06dacee\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-e895f06 elementor-widget elementor-widget-shortcode\" data-id=\"e895f06\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><div class=\"provider-card\" \r\n     data-country=\"Turkey\" \r\n     data-type=\"Doctor\"\r\n     data-city=\"Ankara\">\r\n\r\n  <div class=\"pc-img-wrap\">\r\n    <img decoding=\"async\" class=\"pc-img\" \r\n         src=\"https:\/\/nexacentre.com\/wp-content\/uploads\/2023\/11\/deardocblogimg-02.png\" \r\n         alt=\"Dr. Ahmet Yilmaz\">\r\n    <div class=\"pc-country-tag\">Turkey<\/div>\r\n    <div class=\"pc-type-badge\">Doctor<\/div>\r\n  <\/div>\r\n\r\n  <div class=\"pc-body\">\r\n    <div class=\"pc-name\">Dr. Ahmet Yilmaz<\/div>\r\n    <div class=\"pc-specialty\">Cardiology<\/div>\r\n    <div class=\"pc-affiliation\">10 Years<\/div>\r\n    <div class=\"pc-desc\"><p>Cardiac Surgery Angioplasty Heart Failure<\/p>\n<\/div>\r\n    <div class=\"pc-lang\"><p>Specialist in cardiac surgery, angioplasty, and heart failure management with 18+ years of experience treating international patients.<\/p>\n<\/div>\r\n    <div class=\"pc-footer\">\r\n      <span class=\"pc-city\">Turkey<\/span>\r\n      <button class=\"req-btn tl\" \r\n        onclick=\"openMedModal('Dr. Ahmet Yilmaz', 'Cardiology \u00b7 Turkey')\">\r\n  Request Coordination \u2192\r\n<\/button>\r\n    <\/div>\r\n  <\/div>\r\n\r\n<\/div><div class=\"provider-card\" \r\n     data-country=\"Turkey\" \r\n     data-type=\"Doctor\"\r\n     data-city=\"Istanbul\">\r\n\r\n  <div class=\"pc-img-wrap\">\r\n    <img decoding=\"async\" class=\"pc-img\" \r\n         src=\"https:\/\/nexacentre.com\/wp-content\/uploads\/2023\/11\/deardocblogimg-01.png\" \r\n         alt=\"Dr. Ahmet Yilmaz\">\r\n    <div class=\"pc-country-tag\">Turkey<\/div>\r\n    <div class=\"pc-type-badge\">Doctor<\/div>\r\n  <\/div>\r\n\r\n  <div class=\"pc-body\">\r\n    <div class=\"pc-name\">Dr. Ahmet Yilmaz<\/div>\r\n    <div class=\"pc-specialty\">Cardiology<\/div>\r\n    <div class=\"pc-affiliation\">10 Years<\/div>\r\n    <div class=\"pc-desc\"><p>Cardiac Surgery Angioplasty Heart Failure<\/p>\n<\/div>\r\n    <div class=\"pc-lang\"><p>Specialist in cardiac surgery, angioplasty, and heart failure management with 18+ years of experience treating international patients.<\/p>\n<\/div>\r\n    <div class=\"pc-footer\">\r\n      <span class=\"pc-city\">Turkey<\/span>\r\n      <button class=\"req-btn tl\" \r\n        onclick=\"openMedModal('Dr. Ahmet Yilmaz', 'Cardiology \u00b7 Turkey')\">\r\n  Request Coordination \u2192\r\n<\/button>\r\n    <\/div>\r\n  <\/div>\r\n\r\n<\/div><div class=\"provider-card\" \r\n     data-country=\"India\" \r\n     data-type=\"Hospital\"\r\n     data-city=\"Bangalore\">\r\n\r\n  <div class=\"pc-img-wrap\">\r\n    <img decoding=\"async\" class=\"pc-img\" \r\n         src=\"https:\/\/nexacentre.com\/wp-content\/uploads\/2023\/11\/deardocblogimg-03.png\" \r\n         alt=\"Dr. Rajesh Kumar\">\r\n    <div class=\"pc-country-tag\">India<\/div>\r\n    <div class=\"pc-type-badge\">Hospital<\/div>\r\n  <\/div>\r\n\r\n  <div class=\"pc-body\">\r\n    <div class=\"pc-name\">Dr. Rajesh Kumar<\/div>\r\n    <div class=\"pc-specialty\">Cardiology<\/div>\r\n    <div class=\"pc-affiliation\">5 Years<\/div>\r\n    <div class=\"pc-desc\"><p>Oncology &#038; Cancer Treatment<\/p>\n<\/div>\r\n    <div class=\"pc-lang\"><p>Senior oncologist specializing in cancer diagnosis and treatment, with extensive experience in chemotherapy, radiation therapy, and surgical oncology for international patients.<\/p>\n<\/div>\r\n    <div class=\"pc-footer\">\r\n      <span class=\"pc-city\">India<\/span>\r\n      <button class=\"req-btn tl\" \r\n        onclick=\"openMedModal('Dr. Rajesh Kumar', 'Cardiology \u00b7 India')\">\r\n  Request Coordination \u2192\r\n<\/button>\r\n    <\/div>\r\n  <\/div>\r\n\r\n<\/div><div class=\"provider-card\" \r\n     data-country=\"India\" \r\n     data-type=\"Hospital\"\r\n     data-city=\"Chennai\">\r\n\r\n  <div class=\"pc-img-wrap\">\r\n    <img decoding=\"async\" class=\"pc-img\" \r\n         src=\"https:\/\/nexacentre.com\/wp-content\/uploads\/2023\/11\/deardocblogimg-02.png\" \r\n         alt=\"Tikur Anbessa Specialized Hospital\">\r\n    <div class=\"pc-country-tag\">India<\/div>\r\n    <div class=\"pc-type-badge\">Hospital<\/div>\r\n  <\/div>\r\n\r\n  <div class=\"pc-body\">\r\n    <div class=\"pc-name\">Tikur Anbessa Specialized Hospital<\/div>\r\n    <div class=\"pc-specialty\">Cardiology<\/div>\r\n    <div class=\"pc-affiliation\">5 Years<\/div>\r\n    <div class=\"pc-desc\"><p>Cardiac Surgery Angioplasty Heart Failure<\/p>\n<\/div>\r\n    <div class=\"pc-lang\"><p>Ethiopia&#8217;s premier specialized hospital, the most accessible international option for patients from Somaliland. Short travel distance, Somali-speaking staff available, and strong diagnostic capabilities.<\/p>\n<\/div>\r\n    <div class=\"pc-footer\">\r\n      <span class=\"pc-city\">India<\/span>\r\n      <button class=\"req-btn tl\" \r\n        onclick=\"openMedModal('Tikur Anbessa Specialized Hospital', 'Cardiology \u00b7 India')\">\r\n  Request Coordination \u2192\r\n<\/button>\r\n    <\/div>\r\n  <\/div>\r\n\r\n<\/div><div class=\"provider-card\" \r\n     data-country=\"India\" \r\n     data-type=\"Hospital\"\r\n     data-city=\"Delhi\">\r\n\r\n  <div class=\"pc-img-wrap\">\r\n    <img decoding=\"async\" class=\"pc-img\" \r\n         src=\"https:\/\/nexacentre.com\/wp-content\/uploads\/2023\/11\/deardocblogimg-02.png\" \r\n         alt=\"Tikur Anbessa Specialized Hospital\">\r\n    <div class=\"pc-country-tag\">India<\/div>\r\n    <div class=\"pc-type-badge\">Hospital<\/div>\r\n  <\/div>\r\n\r\n  <div class=\"pc-body\">\r\n    <div class=\"pc-name\">Tikur Anbessa Specialized Hospital<\/div>\r\n    <div class=\"pc-specialty\">Cardiology<\/div>\r\n    <div class=\"pc-affiliation\">5 Years<\/div>\r\n    <div class=\"pc-desc\"><p>Cardiac Surgery Angioplasty Heart Failure<\/p>\n<\/div>\r\n    <div class=\"pc-lang\"><p>Ethiopia&#8217;s premier specialized hospital, the most accessible international option for patients from Somaliland. Short travel distance, Somali-speaking staff available, and strong diagnostic capabilities.<\/p>\n<\/div>\r\n    <div class=\"pc-footer\">\r\n      <span class=\"pc-city\">India<\/span>\r\n      <button class=\"req-btn tl\" \r\n        onclick=\"openMedModal('Tikur Anbessa Specialized Hospital', 'Cardiology \u00b7 India')\">\r\n  Request Coordination \u2192\r\n<\/button>\r\n    <\/div>\r\n  <\/div>\r\n\r\n<\/div><div class=\"provider-card\" \r\n     data-country=\"India\" \r\n     data-type=\"Hospital\"\r\n     data-city=\"Chennai\">\r\n\r\n  <div class=\"pc-img-wrap\">\r\n    <img decoding=\"async\" class=\"pc-img\" \r\n         src=\"https:\/\/nexacentre.com\/wp-content\/uploads\/2023\/11\/deardocblogimg-03.png\" \r\n         alt=\"Tikur Anbessa Specialized Hospital\">\r\n    <div class=\"pc-country-tag\">India<\/div>\r\n    <div class=\"pc-type-badge\">Hospital<\/div>\r\n  <\/div>\r\n\r\n  <div class=\"pc-body\">\r\n    <div class=\"pc-name\">Tikur Anbessa Specialized Hospital<\/div>\r\n    <div class=\"pc-specialty\">Cardiology<\/div>\r\n    <div class=\"pc-affiliation\">5 Years<\/div>\r\n    <div class=\"pc-desc\"><p>Cardiac Surgery Angioplasty Heart Failure<\/p>\n<\/div>\r\n    <div class=\"pc-lang\"><p>Ethiopia&#8217;s premier specialized hospital, the most accessible international option for patients from Somaliland. Short travel distance, Somali-speaking staff available, and strong diagnostic capabilities.<\/p>\n<\/div>\r\n    <div class=\"pc-footer\">\r\n      <span class=\"pc-city\">India<\/span>\r\n      <button class=\"req-btn tl\" \r\n        onclick=\"openMedModal('Tikur Anbessa Specialized Hospital', 'Cardiology \u00b7 India')\">\r\n  Request Coordination \u2192\r\n<\/button>\r\n    <\/div>\r\n  <\/div>\r\n\r\n<\/div><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-741580e e-flex e-con-boxed e-con e-parent\" data-id=\"741580e\" data-element_type=\"container\" data-e-type=\"container\" id=\"travel-consultation\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-8714575 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"8714575\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t\u2014 SUBMIT A REQUEST\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-af624ac elementor-widget__width-initial elementor-widget elementor-widget-heading\" data-id=\"af624ac\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\"><span style=\"color:#ffffff\">Travel<\/span> \n<span style=\"color:#FF9635\">Request Forms<\/span>  <\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-610e608 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"610e608\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\tAll information is handled confidentially and reviewed by our coordination team within 48 hours.\t\t\t\t\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-65dc1c6 e-con-full e-flex e-con e-child\" data-id=\"65dc1c6\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-dc11883 elementor-widget__width-initial elementor-widget elementor-widget-heading\" data-id=\"dc11883\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\"><span style=\"color:#ffffff\">Travel Request Form<\/span> \n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7ca2405 elementor-widget__width-initial elementor-widget elementor-widget-shortcode\" data-id=\"7ca2405\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\">\n<style>\n    .formgent-form-4032 {\n        \/* Form variables *\/\n        --formgent-form-background-color: #18222f;\n        --formgent-form-background-image: ;\n        --formgent-form-background-image-position:\n        center center;\n\n        --formgent-form-padding-desktop: 20px 20px 40px 20px;\n        --formgent-form-padding-tablet: 20px 20px 40px 20px;\n        --formgent-form-padding-mobile: 20px 20px 40px 20px;\n        --formgent-form-margin-desktop: 0 0 0 0;\n        --formgent-form-margin-tablet: 0 0 0 0;\n        --formgent-form-margin-mobile: 0 0 0 0;\n        --formgent-form-border-width: 0;\n        --formgent-form-border: 0 solid transparent;\n        --formgent-form-border-radius: 16px 16px 16px 16px;\n\n        \/* Field variables *\/\n        --formgent-field-vertical-spacing-desktop: 35px;\n        --formgent-field-vertical-spacing-tablet: 35px;\n        --formgent-field-vertical-spacing-mobile: 35px;\n        --formgent-field-horizontal-spacing-desktop: 12px;\n        --formgent-field-horizontal-spacing-tablet: 12px;\n        --formgent-field-horizontal-spacing-mobile: 12px;\n        --formgent-field-background-color: transparent;\n        --formgent-field-background-color-hover: transparent;\n        --formgent-field-placeholder-color: #7a8799;\n        --formgent-field-label-color: #7a8799;\n        --formgent-field-description-color: #212b37;\n        --formgent-field-error-message-color: #c83a3a;\n        --formgent-field-input-color: #4d5761 ;\n        --formgent-field-options-color: #4d5761;\n        --formgent-field-border: 1px solid #d2d6db;\n        --formgent-field-border-radius: 8px 8px 8px 8px;\n        --formgent-field-rating-color: #a1a9b2;\n        --formgent-field-rating-color-hover: #5e53f9;\n        --formgent-field-range-slider-color: #000000;\n        \/* Fixed submit button variables *\/\n        --formgent-fixed-btn-bg-color: #000000;\n        --formgent-fixed-btn-text-color: #ffffff;\n        --formgent-fixed-btn-border-color: #000000;\n        --formgent-fixed-btn-style: default;\n        --formgent-fixed-btn-alignment: left;\n    }\n    .display-none {\n        display: none;\n    }\n<\/style><style>\n    <\/style>\n<div class=\"formgent-form formgent-form-4032 formgent-form-general formgent-shortcode\">\n            <div class=\"formgent-confirmation-wrap formgent-confirmation-wrap--hidden\">\n            <div class=\"formgent-notices formgent-notices--classic-form\"\n                data-message=\"&lt;div style=&quot;background: linear-gradient(135deg, #0d1f2d, #1a2f42); border: 1px solid #00bcd4; border-radius: 14px; padding: 40px 30px; text-align: center; font-family: &#039;Segoe UI&#039;, sans-serif;&quot;&gt;\n&lt;h2 style=&quot;color: #ffffff; font-size: 28px; font-weight: bold; margin: 0 0 12px 0;&quot;&gt;Thank You!&lt;\/h2&gt;\n&lt;p style=&quot;color: #a8d8ea; font-size: 16px; line-height: 1.6; margin: 0;&quot;&gt;Your submission has been received successfully.&lt;br \/&gt;Our team will review your request and contact you within &lt;strong style=&quot;color: #00bcd4;&quot;&gt;24 hours&lt;\/strong&gt;.&lt;\/p&gt;\n&lt;\/div&gt;\">\n            <\/div>\n            <div class=\"formgent-quiz-result\"><\/div>\n        <\/div>\n        <form id=\"formgent-formgent_store1\"         data-wp-interactive=\"formgent\/form\"\n        data-wp-context='{&quot;form_id&quot;:4032,&quot;blocks_settings&quot;:{&quot;full-name&quot;:{&quot;id&quot;:&quot;8WCxwQXmX8ZEH08MZVZeS&quot;,&quot;label_alignment&quot;:&quot;top&quot;,&quot;name&quot;:&quot;full-name&quot;,&quot;block_width&quot;:&quot;100&quot;,&quot;logics&quot;:[],&quot;is_preview&quot;:false,&quot;TrpContentRestriction&quot;:{&quot;restriction_type&quot;:&quot;exclude&quot;,&quot;selected_languages&quot;:[],&quot;panel_open&quot;:true},&quot;field_type&quot;:&quot;name&quot;,&quot;children&quot;:{&quot;first_name&quot;:{&quot;id&quot;:&quot;yOaGeIckgCAz&quot;,&quot;name&quot;:&quot;first_name&quot;,&quot;value&quot;:&quot;&quot;,&quot;label_alignment&quot;:&quot;top&quot;,&quot;required&quot;:true,&quot;character_limit&quot;:false,&quot;limit&quot;:100,&quot;block_width&quot;:&quot;33.33&quot;,&quot;logics&quot;:[],&quot;is_preview&quot;:false,&quot;TrpContentRestriction&quot;:{&quot;restriction_type&quot;:&quot;exclude&quot;,&quot;selected_languages&quot;:[],&quot;panel_open&quot;:true},&quot;metadata&quot;:{&quot;name&quot;:&quot;First Name&quot;},&quot;field_type&quot;:&quot;text&quot;}}},&quot;phone-number&quot;:{&quot;id&quot;:&quot;eXCW1GqHVHd_WiZ5eY_Eg&quot;,&quot;name&quot;:&quot;phone-number&quot;,&quot;value&quot;:&quot;&quot;,&quot;label_alignment&quot;:&quot;top&quot;,&quot;required&quot;:true,&quot;country_code&quot;:true,&quot;country_auto_detection&quot;:false,&quot;default_country&quot;:&quot;US&quot;,&quot;include_plus_sign&quot;:true,&quot;block_width&quot;:&quot;100&quot;,&quot;logics&quot;:[],&quot;is_preview&quot;:false,&quot;TrpContentRestriction&quot;:{&quot;restriction_type&quot;:&quot;exclude&quot;,&quot;selected_languages&quot;:[],&quot;panel_open&quot;:true},&quot;field_type&quot;:&quot;phone-number&quot;},&quot;email-address&quot;:{&quot;id&quot;:&quot;9VigMLY8RBZwXuMTPr_GK&quot;,&quot;name&quot;:&quot;email-address&quot;,&quot;value&quot;:&quot;&quot;,&quot;confirm_placeholder&quot;:&quot;&quot;,&quot;label_alignment&quot;:&quot;top&quot;,&quot;confirm_sub_label&quot;:&quot;&quot;,&quot;show_field_icon&quot;:false,&quot;enable_confirmation_field&quot;:false,&quot;confirm_label&quot;:&quot;Confirm Email&quot;,&quot;required&quot;:false,&quot;character_limit&quot;:false,&quot;limit&quot;:100,&quot;is_invalid_name&quot;:false,&quot;block_width&quot;:&quot;100&quot;,&quot;logics&quot;:[],&quot;is_preview&quot;:false,&quot;TrpContentRestriction&quot;:{&quot;restriction_type&quot;:&quot;exclude&quot;,&quot;selected_languages&quot;:[],&quot;panel_open&quot;:true},&quot;field_type&quot;:&quot;email&quot;},&quot;organization-type&quot;:{&quot;id&quot;:&quot;6m8GVhYwDzUnVpkLkuvfZ&quot;,&quot;name&quot;:&quot;organization-type&quot;,&quot;value&quot;:&quot;&quot;,&quot;options&quot;:[{&quot;value&quot;:&quot;1-traveling-alone&quot;},{&quot;value&quot;:&quot;2-traveling-with-companion&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;3-4-small-group-family&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;5-large-group&quot;,&quot;is_default&quot;:false}],&quot;default_option&quot;:&quot;&quot;,&quot;label_alignment&quot;:&quot;top&quot;,&quot;required&quot;:true,&quot;block_width&quot;:&quot;100&quot;,&quot;logics&quot;:[],&quot;is_preview&quot;:false,&quot;enable_numeric_value&quot;:false,&quot;disable_search&quot;:false,&quot;TrpContentRestriction&quot;:{&quot;restriction_type&quot;:&quot;exclude&quot;,&quot;selected_languages&quot;:[],&quot;panel_open&quot;:true},&quot;field_type&quot;:&quot;dropdown&quot;},&quot;organization-type-1&quot;:{&quot;id&quot;:&quot;tAOG46DrniYi&quot;,&quot;name&quot;:&quot;organization-type-1&quot;,&quot;value&quot;:&quot;&quot;,&quot;options&quot;:[{&quot;value&quot;:&quot;medical-treatment-or-appointment&quot;},{&quot;value&quot;:&quot;education-university-or-exam&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;diaspora-visiting-somaliland&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;business-travel&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;ielts-or-academic-exam-travel&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;personal-family-visit&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;other&quot;,&quot;is_default&quot;:false}],&quot;default_option&quot;:&quot;&quot;,&quot;label_alignment&quot;:&quot;top&quot;,&quot;required&quot;:true,&quot;block_width&quot;:&quot;100&quot;,&quot;logics&quot;:[],&quot;is_preview&quot;:false,&quot;enable_numeric_value&quot;:false,&quot;disable_search&quot;:false,&quot;TrpContentRestriction&quot;:{&quot;restriction_type&quot;:&quot;exclude&quot;,&quot;selected_languages&quot;:[],&quot;panel_open&quot;:true},&quot;field_type&quot;:&quot;dropdown&quot;},&quot;organization-type-2&quot;:{&quot;id&quot;:&quot;A8amtaAXy_r_&quot;,&quot;name&quot;:&quot;organization-type-2&quot;,&quot;value&quot;:&quot;&quot;,&quot;options&quot;:[{&quot;value&quot;:&quot;ethiopia&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;india&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;turkey&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;uae-dubai-abu-dhabi&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;saudi-arabia&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;united-kingdom&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;kenya&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;other&quot;,&quot;is_default&quot;:false}],&quot;default_option&quot;:&quot;&quot;,&quot;label_alignment&quot;:&quot;top&quot;,&quot;required&quot;:true,&quot;block_width&quot;:&quot;100&quot;,&quot;logics&quot;:[],&quot;is_preview&quot;:false,&quot;enable_numeric_value&quot;:false,&quot;disable_search&quot;:false,&quot;TrpContentRestriction&quot;:{&quot;restriction_type&quot;:&quot;exclude&quot;,&quot;selected_languages&quot;:[],&quot;panel_open&quot;:true},&quot;field_type&quot;:&quot;dropdown&quot;},&quot;text-1&quot;:{&quot;id&quot;:&quot;ZEHiqDsDqN62&quot;,&quot;name&quot;:&quot;text-1&quot;,&quot;value&quot;:&quot;&quot;,&quot;label_alignment&quot;:&quot;top&quot;,&quot;required&quot;:true,&quot;character_limit&quot;:false,&quot;limit&quot;:100,&quot;block_width&quot;:&quot;100&quot;,&quot;logics&quot;:[],&quot;is_preview&quot;:false,&quot;TrpContentRestriction&quot;:{&quot;restriction_type&quot;:&quot;exclude&quot;,&quot;selected_languages&quot;:[],&quot;panel_open&quot;:true},&quot;field_type&quot;:&quot;text&quot;},&quot;date-picker&quot;:{&quot;id&quot;:&quot;eK5fRViUmSGs&quot;,&quot;name&quot;:&quot;date-picker&quot;,&quot;label_alignment&quot;:&quot;top&quot;,&quot;option&quot;:&quot;date&quot;,&quot;range&quot;:false,&quot;separator&quot;:&quot;\\\/&quot;,&quot;date_format&quot;:&quot;MM\\\/dd\\\/yy&quot;,&quot;allowed_days&quot;:[&quot;0&quot;,&quot;1&quot;,&quot;2&quot;,&quot;3&quot;,&quot;4&quot;,&quot;5&quot;,&quot;6&quot;],&quot;block_width&quot;:&quot;100&quot;,&quot;required&quot;:true,&quot;is_preview&quot;:false,&quot;TrpContentRestriction&quot;:{&quot;restriction_type&quot;:&quot;exclude&quot;,&quot;selected_languages&quot;:[],&quot;panel_open&quot;:true},&quot;field_type&quot;:&quot;date-picker&quot;},&quot;date-picker-1&quot;:{&quot;id&quot;:&quot;B00yjZahLJbm&quot;,&quot;name&quot;:&quot;date-picker-1&quot;,&quot;label_alignment&quot;:&quot;top&quot;,&quot;option&quot;:&quot;date&quot;,&quot;range&quot;:false,&quot;separator&quot;:&quot;\\\/&quot;,&quot;date_format&quot;:&quot;MM\\\/dd\\\/yy&quot;,&quot;allowed_days&quot;:[&quot;0&quot;,&quot;1&quot;,&quot;2&quot;,&quot;3&quot;,&quot;4&quot;,&quot;5&quot;,&quot;6&quot;],&quot;block_width&quot;:&quot;100&quot;,&quot;required&quot;:true,&quot;is_preview&quot;:false,&quot;TrpContentRestriction&quot;:{&quot;restriction_type&quot;:&quot;exclude&quot;,&quot;selected_languages&quot;:[],&quot;panel_open&quot;:true},&quot;field_type&quot;:&quot;date-picker&quot;},&quot;organization-type-4&quot;:{&quot;id&quot;:&quot;gmaboOR8Ewnd&quot;,&quot;name&quot;:&quot;organization-type-4&quot;,&quot;value&quot;:&quot;&quot;,&quot;options&quot;:[{&quot;value&quot;:&quot;1-3-days&quot;},{&quot;value&quot;:&quot;4-7-days-1-week&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;1-2-weeks&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;2-4-weeks&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;more-than-1-month&quot;,&quot;is_default&quot;:false}],&quot;default_option&quot;:&quot;&quot;,&quot;label_alignment&quot;:&quot;top&quot;,&quot;required&quot;:true,&quot;block_width&quot;:&quot;100&quot;,&quot;logics&quot;:[],&quot;is_preview&quot;:false,&quot;enable_numeric_value&quot;:false,&quot;disable_search&quot;:false,&quot;TrpContentRestriction&quot;:{&quot;restriction_type&quot;:&quot;exclude&quot;,&quot;selected_languages&quot;:[],&quot;panel_open&quot;:true},&quot;field_type&quot;:&quot;dropdown&quot;},&quot;organization-type-5&quot;:{&quot;id&quot;:&quot;3iTYWOLUrjM4&quot;,&quot;name&quot;:&quot;organization-type-5&quot;,&quot;value&quot;:&quot;&quot;,&quot;options&quot;:[{&quot;value&quot;:&quot;standard-hotel-budget-friendly&quot;},{&quot;value&quot;:&quot;mid-range-hotel&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;serviced-apartment&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;near-hospital-clinic&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;no-preference-please-recommend&quot;,&quot;is_default&quot;:false}],&quot;default_option&quot;:&quot;&quot;,&quot;label_alignment&quot;:&quot;top&quot;,&quot;required&quot;:true,&quot;block_width&quot;:&quot;100&quot;,&quot;logics&quot;:[],&quot;is_preview&quot;:false,&quot;enable_numeric_value&quot;:false,&quot;disable_search&quot;:false,&quot;TrpContentRestriction&quot;:{&quot;restriction_type&quot;:&quot;exclude&quot;,&quot;selected_languages&quot;:[],&quot;panel_open&quot;:true},&quot;field_type&quot;:&quot;dropdown&quot;},&quot;organization-type-6&quot;:{&quot;id&quot;:&quot;2NoGAqMNhHPK&quot;,&quot;name&quot;:&quot;organization-type-6&quot;,&quot;value&quot;:&quot;&quot;,&quot;options&quot;:[{&quot;value&quot;:&quot;under-30&quot;},{&quot;value&quot;:&quot;30-60&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;60-100&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;100-150&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;above-150&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;flexible&quot;,&quot;is_default&quot;:false}],&quot;default_option&quot;:&quot;&quot;,&quot;label_alignment&quot;:&quot;top&quot;,&quot;required&quot;:true,&quot;block_width&quot;:&quot;100&quot;,&quot;logics&quot;:[],&quot;is_preview&quot;:false,&quot;enable_numeric_value&quot;:false,&quot;disable_search&quot;:false,&quot;TrpContentRestriction&quot;:{&quot;restriction_type&quot;:&quot;exclude&quot;,&quot;selected_languages&quot;:[],&quot;panel_open&quot;:true},&quot;field_type&quot;:&quot;dropdown&quot;},&quot;file-upload&quot;:{&quot;id&quot;:&quot;ov44zEph0b5a&quot;,&quot;name&quot;:&quot;file-upload&quot;,&quot;label_alignment&quot;:&quot;top&quot;,&quot;upload_button_text&quot;:&quot;Upload&quot;,&quot;required&quot;:false,&quot;limit_size&quot;:&quot;10MB&quot;,&quot;is_limit_size&quot;:true,&quot;size_type&quot;:&quot;MB&quot;,&quot;limit_files&quot;:5,&quot;is_limit_files&quot;:0,&quot;allowed_types&quot;:[&quot;application\\\/pdf&quot;],&quot;block_width&quot;:&quot;100&quot;,&quot;logics&quot;:[],&quot;is_preview&quot;:false,&quot;TrpContentRestriction&quot;:{&quot;restriction_type&quot;:&quot;exclude&quot;,&quot;selected_languages&quot;:[],&quot;panel_open&quot;:true},&quot;field_type&quot;:&quot;file-upload&quot;},&quot;text&quot;:{&quot;id&quot;:&quot;Dr39rzYjePA-&quot;,&quot;name&quot;:&quot;text&quot;,&quot;value&quot;:&quot;&quot;,&quot;label_alignment&quot;:&quot;top&quot;,&quot;required&quot;:false,&quot;character_limit&quot;:false,&quot;limit&quot;:100,&quot;block_width&quot;:&quot;100&quot;,&quot;logics&quot;:[],&quot;is_preview&quot;:false,&quot;TrpContentRestriction&quot;:{&quot;restriction_type&quot;:&quot;exclude&quot;,&quot;selected_languages&quot;:[],&quot;panel_open&quot;:true},&quot;field_type&quot;:&quot;text&quot;}},&quot;form_type&quot;:&quot;general&quot;,&quot;data&quot;:{&quot;full-name&quot;:{&quot;first_name&quot;:&quot;&quot;},&quot;phone-number&quot;:&quot;&quot;,&quot;email-address&quot;:&quot;&quot;,&quot;organization-type&quot;:&quot;&quot;,&quot;organization-type-1&quot;:&quot;&quot;,&quot;organization-type-2&quot;:&quot;&quot;,&quot;text-1&quot;:&quot;&quot;,&quot;date-picker&quot;:&quot;&quot;,&quot;date-picker-1&quot;:&quot;&quot;,&quot;organization-type-4&quot;:&quot;&quot;,&quot;organization-type-5&quot;:&quot;&quot;,&quot;organization-type-6&quot;:&quot;&quot;,&quot;file-upload&quot;:&quot;&quot;,&quot;text&quot;:&quot;&quot;},&quot;preset_values&quot;:{&quot;site_title&quot;:&quot;Nexa Centre&quot;,&quot;site_name&quot;:&quot;Nexa Centre&quot;,&quot;site_url&quot;:&quot;https:\\\/\\\/nexacentre.com&quot;,&quot;form_title&quot;:&quot;Travel Consultation Request Form&quot;,&quot;browser_name&quot;:&quot;&quot;,&quot;browser_platform&quot;:&quot;&quot;,&quot;embedded_post_id&quot;:&quot;3947&quot;,&quot;embedded_post_title&quot;:&quot;Medical \\u0026 Travel&quot;,&quot;current_date&quot;:&quot;05\\\/26\\\/2026&quot;,&quot;admin_name&quot;:&quot;Abdinasir Muhumed&quot;,&quot;login_url&quot;:&quot;https:\\\/\\\/nexacentre.com\\\/wp-login.php&quot;,&quot;register_url&quot;:&quot;https:\\\/\\\/nexacentre.com\\\/wp-login.php?action=register&quot;,&quot;forgot_password_url&quot;:&quot;https:\\\/\\\/nexacentre.com\\\/wp-login.php?action=lostpassword&quot;,&quot;logout_url&quot;:&quot;https:\\\/\\\/nexacentre.com\\\/wp-login.php?action=logout\\u0026amp;_wpnonce=6420a418aa&quot;},&quot;is_form_loaded&quot;:false,&quot;is_partial_submitting&quot;:false,&quot;global&quot;:{&quot;is_response_submitting&quot;:false,&quot;is_response_token_generating&quot;:false,&quot;is_enabled_honeypot_protection&quot;:true,&quot;payment&quot;:{&quot;enable_summary&quot;:false,&quot;payment_summary&quot;:&quot;&quot;,&quot;items&quot;:[],&quot;total_amount&quot;:&quot;&quot;}},&quot;quiz_result&quot;:false,&quot;show_quiz_results&quot;:true,&quot;confirmation&quot;:{&quot;type&quot;:&quot;message&quot;,&quot;page&quot;:0,&quot;url&quot;:&quot;https:\\\/\\\/google.com&quot;,&quot;after_submission&quot;:&quot;reset&quot;},&quot;_ccOverride&quot;:false,&quot;_confirmationDisplayed&quot;:false,&quot;submit_label&quot;:&quot;Submit&quot;,&quot;redirecting_label&quot;:&quot;You will be redirected in&quot;,&quot;plugin_url&quot;:&quot;https:\\\/\\\/nexacentre.com\\\/wp-content\\\/plugins&quot;,&quot;external_data&quot;:[]}'\n        data-wp-init=\"callbacks.initClassicForm\"\n        data-wp-bind--disabled=\"context.global.is_response_submitting\" data-wp-watch=\"callbacks.watchForm\">\n                        <div class=\"formgent-field-list formgent-field-list--frontend\"\n            data-wp-class--formgent-field-list-loading=\"!context.is_form_loaded\"\n            data-wp-class--formgent-partial-submitting=\"!context.is_partial_submitting\">\n            <div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"full-name\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\" id=\"formgent-8WCxwQXmX8ZEH08MZVZeS\">\n    <div class=\"formgent-field-single formgent-field-align-top\" data-wp-context='{ \"parent_name\": \"full-name\" }'>\n        <span class=\"formgent-field-label formgent-label-align-top\">\n        <strong>Full Name<\/strong>    <\/span>\n    \n<div class=\"formgent-field-list formgent-field-list--frontend\">\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"first_name\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-33\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-yOaGeIckgCAz\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                Full Name                                    <span class=\"formgent-field-required\">\n                        *\n                    <\/span>\n                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <input\n                class=\"formgent-field-single__input\"\n                type=\"text\"\n                id=\"formgent-yOaGeIckgCAz\"\n                placeholder=\"\"\n                data-wp-on--input=\"actions.updateInput\"\n                data-wp-bind--value=\"state.getValue\"\n            \/>\n                    <\/div>\n    <\/div>\n<\/div><\/div>\n    <\/div>\n<\/div>\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"phone-number\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-single--csr formgent-field-align-top\">\n                    <label\n                for=\"formgent-eXCW1GqHVHd_WiZ5eY_Eg\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                <strong>Phone Number<\/strong>                                    <span class=\"formgent-field-required\">\n                        *\n                    <\/span>\n                            <\/label>\n                <div\n            class=\"formgent-field-single__wrapper\"\n        >\n            <div class=\"formgent-field-single__phone\">\n                <div class=\"formgent-field-single__dialer__content\">\n                    <input\n                        class=\"formgent-field-single__input formgent-field-single__input--country-code\"\n                        type=\"tel\"\n                        id=\"formgent-eXCW1GqHVHd_WiZ5eY_Eg\"\n                        placeholder=\"+252 ...\"\n                        data-wp-init=\"callbacks.phoneNumberInit\"\n                    >\n                <\/div>\n            <\/div>\n                    <\/div>\n    <\/div>\n<\/div>\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"email-address\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field formgent-field-width-100 formgent-field-email\">\n    <div class=\"formgent-field-single formgent-field-align-top formgent-field-single-email-primary\">\n                    <label\n                for=\"formgent-9VigMLY8RBZwXuMTPr_GK\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                <strong>Email Address<\/strong>                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <div class='formgent-has-input-icon'>\n                \n                <input\n                    class=\"formgent-field-single__input\"\n                    type=\"email\"\n                    id=\"formgent-9VigMLY8RBZwXuMTPr_GK\"\n                    placeholder=\"your@email.com\"\n                    data-wp-on--input=\"actions.updateInput\"\n                    data-wp-bind--value=\"state.getValue\"\n                \/>\n            <\/div>\n\n                    <\/div>\n    <\/div>\n\n    <\/div>\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{&quot;name&quot;:&quot;organization-type&quot;,&quot;field_label&quot;:&quot;&lt;strong&gt;Number of Travelers&lt;\\\/strong&gt;&quot;,&quot;options&quot;:[{&quot;id&quot;:&quot;CgmW3u2cWPMSioaww_yN8&quot;,&quot;label&quot;:&quot;1 \\u2014 Traveling alone&quot;,&quot;value&quot;:&quot;1-traveling-alone&quot;},{&quot;label&quot;:&quot;2 \\u2014 Traveling with companion&quot;,&quot;id&quot;:&quot;1&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;2-traveling-with-companion&quot;},{&quot;label&quot;:&quot;3\\u20134 \\u2014 Small group \\\/ family&quot;,&quot;id&quot;:&quot;2&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;3-4-small-group-family&quot;},{&quot;label&quot;:&quot;5+ \\u2014 Large group&quot;,&quot;id&quot;:&quot;3&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;5-large-group&quot;}]}' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-6m8GVhYwDzUnVpkLkuvfZ\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                <strong>Number of Travelers<\/strong>                                    <span class=\"formgent-field-required\">\n                        *\n                    <\/span>\n                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <select class=\"formgent-field-single__input formgent-field-single__input--select\"\n                id=\"formgent-6m8GVhYwDzUnVpkLkuvfZ\"\n                data-wp-init=\"callbacks.dropdownInit\"\n                data-placeholder=\" Select ...\"\n                autocomplete=\"off\"\n            >\n                                    <option value=\"\"> Select ...<\/option>\n                                            <option value=\"1-traveling-alone\">\n                            1 \u2014 Traveling alone                        <\/option>\n                                            <option value=\"2-traveling-with-companion\">\n                            2 \u2014 Traveling with companion                        <\/option>\n                                            <option value=\"3-4-small-group-family\">\n                            3\u20134 \u2014 Small group \/ family                        <\/option>\n                                            <option value=\"5-large-group\">\n                            5+ \u2014 Large group                        <\/option>\n                                                <\/select>\n\n                    <\/div>\n    <\/div>\n\n    <!-- <div data-wp-bind--hidden=\"!state.showFieldQuantityInput\" class=\"formgent-field-single formgent-field-quantity\" data-wp-class--formgent-field-quantity-hidden=\"!state.showFieldQuantityInput\">\n        <label for=\"\"\n            class=\"formgent-field-label\" data-wp-text=\"state.getQuantityLabel\">\n        <\/label>\n        <input class=\"formgent-field-single__input\" type=\"number\"\n            id=\"\"\n            name=\"_quantity\"\n            data-wp-on--input=\"actions.updatePaymentQuantity\"\n            data-wp-bind--value=\"state.getFieldQuantity\"\n            data-wp-bind--min=\"state.getFieldQuantityMin\"\n            data-wp-bind--max=\"state.getFieldQuantityMax\"\n            value=\"1\" \/>\n    <\/div> -->\n<\/div>\n\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{&quot;name&quot;:&quot;organization-type-1&quot;,&quot;field_label&quot;:&quot;&lt;strong&gt;Purpose of Travel&lt;\\\/strong&gt;&quot;,&quot;options&quot;:[{&quot;id&quot;:&quot;CgmW3u2cWPMSioaww_yN8&quot;,&quot;label&quot;:&quot;Medical treatment or appointment&quot;,&quot;value&quot;:&quot;medical-treatment-or-appointment&quot;},{&quot;label&quot;:&quot;Education \\u2014 university or exam&quot;,&quot;id&quot;:&quot;1&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;education-university-or-exam&quot;},{&quot;label&quot;:&quot;Diaspora \\u2014 visiting Somaliland&quot;,&quot;id&quot;:&quot;2&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;diaspora-visiting-somaliland&quot;},{&quot;label&quot;:&quot;Business travel&quot;,&quot;id&quot;:&quot;3&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;business-travel&quot;},{&quot;label&quot;:&quot;IELTS or academic exam travel&quot;,&quot;id&quot;:&quot;4&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;ielts-or-academic-exam-travel&quot;},{&quot;label&quot;:&quot;Personal \\\/ family visit&quot;,&quot;id&quot;:&quot;5&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;personal-family-visit&quot;},{&quot;label&quot;:&quot;Other&quot;,&quot;id&quot;:&quot;6&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;other&quot;}]}' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-tAOG46DrniYi\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                <strong>Purpose of Travel<\/strong>                                    <span class=\"formgent-field-required\">\n                        *\n                    <\/span>\n                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <select class=\"formgent-field-single__input formgent-field-single__input--select\"\n                id=\"formgent-tAOG46DrniYi\"\n                data-wp-init=\"callbacks.dropdownInit\"\n                data-placeholder=\" Select purpose ...\"\n                autocomplete=\"off\"\n            >\n                                    <option value=\"\"> Select purpose ...<\/option>\n                                            <option value=\"medical-treatment-or-appointment\">\n                            Medical treatment or appointment                        <\/option>\n                                            <option value=\"education-university-or-exam\">\n                            Education \u2014 university or exam                        <\/option>\n                                            <option value=\"diaspora-visiting-somaliland\">\n                            Diaspora \u2014 visiting Somaliland                        <\/option>\n                                            <option value=\"business-travel\">\n                            Business travel                        <\/option>\n                                            <option value=\"ielts-or-academic-exam-travel\">\n                            IELTS or academic exam travel                        <\/option>\n                                            <option value=\"personal-family-visit\">\n                            Personal \/ family visit                        <\/option>\n                                            <option value=\"other\">\n                            Other                        <\/option>\n                                                <\/select>\n\n                    <\/div>\n    <\/div>\n\n    <!-- <div data-wp-bind--hidden=\"!state.showFieldQuantityInput\" class=\"formgent-field-single formgent-field-quantity\" data-wp-class--formgent-field-quantity-hidden=\"!state.showFieldQuantityInput\">\n        <label for=\"\"\n            class=\"formgent-field-label\" data-wp-text=\"state.getQuantityLabel\">\n        <\/label>\n        <input class=\"formgent-field-single__input\" type=\"number\"\n            id=\"\"\n            name=\"_quantity\"\n            data-wp-on--input=\"actions.updatePaymentQuantity\"\n            data-wp-bind--value=\"state.getFieldQuantity\"\n            data-wp-bind--min=\"state.getFieldQuantityMin\"\n            data-wp-bind--max=\"state.getFieldQuantityMax\"\n            value=\"1\" \/>\n    <\/div> -->\n<\/div>\n\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{&quot;name&quot;:&quot;organization-type-2&quot;,&quot;field_label&quot;:&quot;&lt;strong&gt;Destination Country&lt;\\\/strong&gt;&quot;,&quot;options&quot;:[{&quot;label&quot;:&quot;Ethiopia&quot;,&quot;id&quot;:&quot;1&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;ethiopia&quot;},{&quot;label&quot;:&quot;India&quot;,&quot;id&quot;:&quot;2&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;india&quot;},{&quot;label&quot;:&quot;Turkey&quot;,&quot;id&quot;:&quot;3&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;turkey&quot;},{&quot;label&quot;:&quot;UAE (Dubai \\\/ Abu Dhabi)&quot;,&quot;id&quot;:&quot;4&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;uae-dubai-abu-dhabi&quot;},{&quot;label&quot;:&quot;Saudi Arabia&quot;,&quot;id&quot;:&quot;5&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;saudi-arabia&quot;},{&quot;label&quot;:&quot;United Kingdom&quot;,&quot;id&quot;:&quot;6&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;united-kingdom&quot;},{&quot;label&quot;:&quot;Kenya&quot;,&quot;id&quot;:&quot;7&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;kenya&quot;},{&quot;label&quot;:&quot;Other&quot;,&quot;id&quot;:&quot;8&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;other&quot;}]}' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-A8amtaAXy_r_\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                <strong>Destination Country<\/strong>                                    <span class=\"formgent-field-required\">\n                        *\n                    <\/span>\n                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <select class=\"formgent-field-single__input formgent-field-single__input--select\"\n                id=\"formgent-A8amtaAXy_r_\"\n                data-wp-init=\"callbacks.dropdownInit\"\n                data-placeholder=\" Select destination ...\"\n                autocomplete=\"off\"\n            >\n                                    <option value=\"\"> Select destination ...<\/option>\n                                            <option value=\"ethiopia\">\n                            Ethiopia                        <\/option>\n                                            <option value=\"india\">\n                            India                        <\/option>\n                                            <option value=\"turkey\">\n                            Turkey                        <\/option>\n                                            <option value=\"uae-dubai-abu-dhabi\">\n                            UAE (Dubai \/ Abu Dhabi)                        <\/option>\n                                            <option value=\"saudi-arabia\">\n                            Saudi Arabia                        <\/option>\n                                            <option value=\"united-kingdom\">\n                            United Kingdom                        <\/option>\n                                            <option value=\"kenya\">\n                            Kenya                        <\/option>\n                                            <option value=\"other\">\n                            Other                        <\/option>\n                                                <\/select>\n\n                    <\/div>\n    <\/div>\n\n    <!-- <div data-wp-bind--hidden=\"!state.showFieldQuantityInput\" class=\"formgent-field-single formgent-field-quantity\" data-wp-class--formgent-field-quantity-hidden=\"!state.showFieldQuantityInput\">\n        <label for=\"\"\n            class=\"formgent-field-label\" data-wp-text=\"state.getQuantityLabel\">\n        <\/label>\n        <input class=\"formgent-field-single__input\" type=\"number\"\n            id=\"\"\n            name=\"_quantity\"\n            data-wp-on--input=\"actions.updatePaymentQuantity\"\n            data-wp-bind--value=\"state.getFieldQuantity\"\n            data-wp-bind--min=\"state.getFieldQuantityMin\"\n            data-wp-bind--max=\"state.getFieldQuantityMax\"\n            value=\"1\" \/>\n    <\/div> -->\n<\/div>\n\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"text-1\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-ZEHiqDsDqN62\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                <strong>Destination City<\/strong>                                    <span class=\"formgent-field-required\">\n                        *\n                    <\/span>\n                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <input\n                class=\"formgent-field-single__input\"\n                type=\"text\"\n                id=\"formgent-ZEHiqDsDqN62\"\n                placeholder=\"e.g Istanbul, Chennai...\"\n                data-wp-on--input=\"actions.updateInput\"\n                data-wp-bind--value=\"state.getValue\"\n            \/>\n                    <\/div>\n    <\/div>\n<\/div>\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-init=\"callbacks.initDatePicker\" data-wp-context='{ \"name\": \"date-picker\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-eK5fRViUmSGs\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                <strong>Planned Departure Date<\/strong>                                    <span class=\"formgent-field-required\">\n                        *\n                    <\/span>\n                            <\/label>\n        \n        <div\n            class='formgent-has-input-icon formgent-suffix date'\n            style=\"width: 100%;\"\n        >\n            <input\n                autocomplete=\"off\"\n                class='formgent-field-single__input formgent-datepicker'\n                type=\"text\"\n                readonly\n                id=\"formgent-eK5fRViUmSGs\"\n                data-wp-bind--value=\"state.getDatePickerValue\"\n                placeholder=\"Select date\"\n            \/>\n        <\/div>\n            <\/div>\n<\/div>\n\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-init=\"callbacks.initDatePicker\" data-wp-context='{ \"name\": \"date-picker-1\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-B00yjZahLJbm\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                <strong>Planned Return Date<\/strong>                                    <span class=\"formgent-field-required\">\n                        *\n                    <\/span>\n                            <\/label>\n        \n        <div\n            class='formgent-has-input-icon formgent-suffix date'\n            style=\"width: 100%;\"\n        >\n            <input\n                autocomplete=\"off\"\n                class='formgent-field-single__input formgent-datepicker'\n                type=\"text\"\n                readonly\n                id=\"formgent-B00yjZahLJbm\"\n                data-wp-bind--value=\"state.getDatePickerValue\"\n                placeholder=\"Select date\"\n            \/>\n        <\/div>\n            <\/div>\n<\/div>\n\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{&quot;name&quot;:&quot;organization-type-4&quot;,&quot;field_label&quot;:&quot;&lt;strong&gt;Duration of Stay&lt;\\\/strong&gt;&quot;,&quot;options&quot;:[{&quot;id&quot;:&quot;CgmW3u2cWPMSioaww_yN8&quot;,&quot;label&quot;:&quot;1\\u20133 days&quot;,&quot;value&quot;:&quot;1-3-days&quot;},{&quot;label&quot;:&quot;4\\u20137 days (1 week)&quot;,&quot;id&quot;:&quot;1&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;4-7-days-1-week&quot;},{&quot;label&quot;:&quot;1\\u20132 weeks&quot;,&quot;id&quot;:&quot;2&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;1-2-weeks&quot;},{&quot;label&quot;:&quot;2\\u20134 weeks&quot;,&quot;id&quot;:&quot;3&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;2-4-weeks&quot;},{&quot;label&quot;:&quot;More than 1 month&quot;,&quot;id&quot;:&quot;4&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;more-than-1-month&quot;}]}' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-gmaboOR8Ewnd\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                <strong>Duration of Stay<\/strong>                                    <span class=\"formgent-field-required\">\n                        *\n                    <\/span>\n                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <select class=\"formgent-field-single__input formgent-field-single__input--select\"\n                id=\"formgent-gmaboOR8Ewnd\"\n                data-wp-init=\"callbacks.dropdownInit\"\n                data-placeholder=\"Select...\"\n                autocomplete=\"off\"\n            >\n                                    <option value=\"\">Select...<\/option>\n                                            <option value=\"1-3-days\">\n                            1\u20133 days                        <\/option>\n                                            <option value=\"4-7-days-1-week\">\n                            4\u20137 days (1 week)                        <\/option>\n                                            <option value=\"1-2-weeks\">\n                            1\u20132 weeks                        <\/option>\n                                            <option value=\"2-4-weeks\">\n                            2\u20134 weeks                        <\/option>\n                                            <option value=\"more-than-1-month\">\n                            More than 1 month                        <\/option>\n                                                <\/select>\n\n                    <\/div>\n    <\/div>\n\n    <!-- <div data-wp-bind--hidden=\"!state.showFieldQuantityInput\" class=\"formgent-field-single formgent-field-quantity\" data-wp-class--formgent-field-quantity-hidden=\"!state.showFieldQuantityInput\">\n        <label for=\"\"\n            class=\"formgent-field-label\" data-wp-text=\"state.getQuantityLabel\">\n        <\/label>\n        <input class=\"formgent-field-single__input\" type=\"number\"\n            id=\"\"\n            name=\"_quantity\"\n            data-wp-on--input=\"actions.updatePaymentQuantity\"\n            data-wp-bind--value=\"state.getFieldQuantity\"\n            data-wp-bind--min=\"state.getFieldQuantityMin\"\n            data-wp-bind--max=\"state.getFieldQuantityMax\"\n            value=\"1\" \/>\n    <\/div> -->\n<\/div>\n\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{&quot;name&quot;:&quot;organization-type-5&quot;,&quot;field_label&quot;:&quot;&lt;strong&gt;Accommodation Type&lt;\\\/strong&gt;&quot;,&quot;options&quot;:[{&quot;id&quot;:&quot;CgmW3u2cWPMSioaww_yN8&quot;,&quot;label&quot;:&quot;Standard hotel (budget-friendly)&quot;,&quot;value&quot;:&quot;standard-hotel-budget-friendly&quot;},{&quot;label&quot;:&quot;Mid-range hotel&quot;,&quot;id&quot;:&quot;1&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;mid-range-hotel&quot;},{&quot;label&quot;:&quot;Serviced apartment&quot;,&quot;id&quot;:&quot;2&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;serviced-apartment&quot;},{&quot;label&quot;:&quot;Near hospital \\\/ clinic&quot;,&quot;id&quot;:&quot;3&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;near-hospital-clinic&quot;},{&quot;label&quot;:&quot;No preference \\u2014 please recommend&quot;,&quot;id&quot;:&quot;4&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;no-preference-please-recommend&quot;}]}' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-3iTYWOLUrjM4\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                <strong>Accommodation Type<\/strong>                                    <span class=\"formgent-field-required\">\n                        *\n                    <\/span>\n                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <select class=\"formgent-field-single__input formgent-field-single__input--select\"\n                id=\"formgent-3iTYWOLUrjM4\"\n                data-wp-init=\"callbacks.dropdownInit\"\n                data-placeholder=\"Select...\"\n                autocomplete=\"off\"\n            >\n                                    <option value=\"\">Select...<\/option>\n                                            <option value=\"standard-hotel-budget-friendly\">\n                            Standard hotel (budget-friendly)                        <\/option>\n                                            <option value=\"mid-range-hotel\">\n                            Mid-range hotel                        <\/option>\n                                            <option value=\"serviced-apartment\">\n                            Serviced apartment                        <\/option>\n                                            <option value=\"near-hospital-clinic\">\n                            Near hospital \/ clinic                        <\/option>\n                                            <option value=\"no-preference-please-recommend\">\n                            No preference \u2014 please recommend                        <\/option>\n                                                <\/select>\n\n                    <\/div>\n    <\/div>\n\n    <!-- <div data-wp-bind--hidden=\"!state.showFieldQuantityInput\" class=\"formgent-field-single formgent-field-quantity\" data-wp-class--formgent-field-quantity-hidden=\"!state.showFieldQuantityInput\">\n        <label for=\"\"\n            class=\"formgent-field-label\" data-wp-text=\"state.getQuantityLabel\">\n        <\/label>\n        <input class=\"formgent-field-single__input\" type=\"number\"\n            id=\"\"\n            name=\"_quantity\"\n            data-wp-on--input=\"actions.updatePaymentQuantity\"\n            data-wp-bind--value=\"state.getFieldQuantity\"\n            data-wp-bind--min=\"state.getFieldQuantityMin\"\n            data-wp-bind--max=\"state.getFieldQuantityMax\"\n            value=\"1\" \/>\n    <\/div> -->\n<\/div>\n\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{&quot;name&quot;:&quot;organization-type-6&quot;,&quot;field_label&quot;:&quot;&lt;strong&gt;Budget Range (per night)&lt;\\\/strong&gt;&quot;,&quot;options&quot;:[{&quot;id&quot;:&quot;CgmW3u2cWPMSioaww_yN8&quot;,&quot;label&quot;:&quot;Under $30&quot;,&quot;value&quot;:&quot;under-30&quot;},{&quot;label&quot;:&quot;$30\\u2013$60&quot;,&quot;id&quot;:&quot;1&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;30-60&quot;},{&quot;label&quot;:&quot;$60\\u2013$100&quot;,&quot;id&quot;:&quot;2&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;60-100&quot;},{&quot;label&quot;:&quot;$100\\u2013$150&quot;,&quot;id&quot;:&quot;3&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;100-150&quot;},{&quot;label&quot;:&quot;Above $150&quot;,&quot;id&quot;:&quot;4&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;above-150&quot;},{&quot;label&quot;:&quot;Flexible&quot;,&quot;id&quot;:&quot;5&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;flexible&quot;}]}' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-2NoGAqMNhHPK\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                <strong>Budget Range (per night)<\/strong>                                    <span class=\"formgent-field-required\">\n                        *\n                    <\/span>\n                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <select class=\"formgent-field-single__input formgent-field-single__input--select\"\n                id=\"formgent-2NoGAqMNhHPK\"\n                data-wp-init=\"callbacks.dropdownInit\"\n                data-placeholder=\"Select range...\"\n                autocomplete=\"off\"\n            >\n                                    <option value=\"\">Select range...<\/option>\n                                            <option value=\"under-30\">\n                            Under $30                        <\/option>\n                                            <option value=\"30-60\">\n                            $30\u2013$60                        <\/option>\n                                            <option value=\"60-100\">\n                            $60\u2013$100                        <\/option>\n                                            <option value=\"100-150\">\n                            $100\u2013$150                        <\/option>\n                                            <option value=\"above-150\">\n                            Above $150                        <\/option>\n                                            <option value=\"flexible\">\n                            Flexible                        <\/option>\n                                                <\/select>\n\n                    <\/div>\n    <\/div>\n\n    <!-- <div data-wp-bind--hidden=\"!state.showFieldQuantityInput\" class=\"formgent-field-single formgent-field-quantity\" data-wp-class--formgent-field-quantity-hidden=\"!state.showFieldQuantityInput\">\n        <label for=\"\"\n            class=\"formgent-field-label\" data-wp-text=\"state.getQuantityLabel\">\n        <\/label>\n        <input class=\"formgent-field-single__input\" type=\"number\"\n            id=\"\"\n            name=\"_quantity\"\n            data-wp-on--input=\"actions.updatePaymentQuantity\"\n            data-wp-bind--value=\"state.getFieldQuantity\"\n            data-wp-bind--min=\"state.getFieldQuantityMin\"\n            data-wp-bind--max=\"state.getFieldQuantityMax\"\n            value=\"1\" \/>\n    <\/div> -->\n<\/div>\n\n\n<style>\n        .formgent-upload-container {\n            min-height: 150px;\n            display: flex;\n            align-items: center;\n            justify-content: center;\n            flex-direction: column;\n            cursor: pointer;\n            border-radius: 8px;\n            border: 1px dashed var(--formgent-color-gray-300);\n            background: var(--formgent-field-background-color);\n            width: 100%;\n            padding: 20px;\n            text-align: center;\n        }\n        .formgent-upload-container .formgent-upload-area {\n            border: 0 none;\n        }\n        .formgent-upload-container p {\n            color: var(--formgent-field-placeholder-color);\n            text-align: center;\n            font-size: 14px;\n            font-weight: 400;\n            line-height: 1.6;\n            margin: 8px 0 0 0;\n        }\n        .formgent-upload-button {\n            display: inline-flex;\n            padding: 8px 12px;\n            justify-content: center;\n            align-items: center;\n            gap: 6px;\n            border-radius: 8px;\n            background: var(--formgent-color-gray-500, #747c89);\n            cursor: pointer;\n            color: #fff;\n            text-align: center;\n            font-size: 13px;\n            font-weight: 500;\n            transition: 0.3s ease;\n            border: 0 none;\n            box-shadow: none;\n        }\n    <\/style>\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{\"name\":\"file-upload\",\"highlightFileUpload\":false,\"uploadedFiles\":[],\"maxSizeError\":false,\"maxFileError\":false,\"maxAllowed\":5,\"notAllowed\":false,\"maxAllowedReached\":false}' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-single--file-upload formgent-field-align-top\">\n                    <span\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                <strong>Upload Passport Copy, Appointment Letter, or Exam Confirmation<\/strong>                            <\/span>\n                <div\n            class=\"formgent-upload-container\"\n        >\n            <label aria-disabled=\"false\"\n                for=\"formgent-ov44zEph0b5a\"\n                class=\"formgent-upload-area\"\n                tabindex=\"0\"\n                role=\"button\"\n                aria-label=\"Upload\"\n                data-wp-class--formgent-file-upload-highlight=\"context.highlightFileUpload\"\n                data-wp-class--formgent-file-upload-disabled=\"context.maxAllowedReached\"\n                data-wp-bind--aria-disabled=\"context.maxAllowedReached\"\n                data-wp-on--dragenter=\"actions.fileDragEnter\"\n                data-wp-on--dragover=\"actions.fileDragEnter\"\n                data-wp-on--dragleave=\"actions.fileDragLeave\"\n                data-wp-on--drop=\"actions.fileDrop\"\n                data-wp-on--keydown=\"actions.handleUploadAreaKeydown\"\n            >\n                <span class=\"formgent-upload-button\">\n                    <svg width=\"14\" height=\"14\" viewBox=\"0 0 14 14\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0.333252 1.00016C0.333252 0.631973 0.631729 0.333496 0.999919 0.333496H12.9999C13.3681 0.333496 13.6666 0.631973 13.6666 1.00016C13.6666 1.36835 13.3681 1.66683 12.9999 1.66683H0.999919C0.631729 1.66683 0.333252 1.36835 0.333252 1.00016ZM6.99992 3.00016C7.17673 3.00016 7.3463 3.0704 7.47132 3.19542L11.4713 7.19543C11.7317 7.45577 11.7317 7.87788 11.4713 8.13823C11.211 8.39858 10.7889 8.39858 10.5285 8.13823L7.66659 5.27631V13.0002C7.66659 13.3684 7.36811 13.6668 6.99992 13.6668C6.63173 13.6668 6.33325 13.3684 6.33325 13.0002V5.27631L3.47132 8.13823C3.21097 8.39858 2.78886 8.39858 2.52851 8.13823C2.26816 7.87788 2.26816 7.45577 2.52851 7.19543L6.52851 3.19542C6.65354 3.0704 6.82311 3.00016 6.99992 3.00016Z\" fill=\"currentColor\"\/>\n<\/svg>\n                    Upload                <\/span>\n                <input\n                    multiple\n                    type=\"file\"\n                    class=\"formgent-file-input\"\n                    style=\"display: none;\"\n                    id=\"formgent-ov44zEph0b5a\"\n                    data-wp-on--change=\"actions.onChangeFile\"\n                    data-wp-bind--disabled=\"context.maxAllowedReached\"\n                \/>\n\n                <!-- Hidden validation input for required field validation -->\n                <input\n                    type=\"hidden\"\n                    class=\"formgent-validate-field-input\"\n                    name=\"file-upload\"\n                    value=\"\"\n                \/>\n\n                <p>Drop file here or click to upload<\/p>\n\n                                    <p>Maximum file size allowed: 10MB<\/p>\n                \n                            <\/label>\n\n            <span hidden class=\"formgent-warning-message\" data-wp-bind--hidden=\"!context.maxSizeError\">\n                Maximum file size allowed: 10MB            <\/span>\n            <span hidden class=\"formgent-warning-message\" data-wp-bind--hidden=\"!context.maxFileError\">\n                Maximum number of files allowed: 5            <\/span>\n            <span hidden class=\"formgent-warning-message\" data-wp-bind--hidden=\"!context.notAllowed\">\n                File type not allowed. Allowed file types: application\/pdf            <\/span>\n\n\n            <div hidden class=\"formgent-file-preview\" data-wp-bind--hidden=\"!state.hasFiles\">\n                <ul class=\"formgent-preview-items\">\n                    <template data-wp-each=\"context.uploadedFiles\">\n                        <li class=\"formgent-preview-container\">\n                            <div class=\"formgent-file-preview-media\">\n                                <div>\n                                    <img\n                                        data-wp-bind--hidden=\"!context.item.isImage\"\n                                        class=\"formgent-preview-image\"\n                                        data-wp-bind--src=\"context.item.src\"\n                                    \/>\n                                    <video\n                                        data-wp-bind--hidden=\"!context.item.isVideo\"\n                                        class=\"formgent-preview-image\"\n                                        width=\"120\"\n                                        height=\"100\"\n                                    >\n                                        <source data-wp-bind--src=\"context.item.src\">\n                                    <\/video>\n                                    <span data-wp-bind--hidden=\"!context.item.isOther\">\n                                                                            <\/span>\n                                <\/div>\n                                <p class=\"formgent-file-name\">\n                                    <span data-wp-text=\"context.item.name\"><\/span><br\/>\n                                    <span data-wp-text=\"context.item.size\"><\/span>\n                                <\/p>\n                                <div\n                                    data-wp-bind--hidden=\"context.item.uploaded\"\n                                    class=\"formgent-file-preview-status\"\n                                >\n                                    <span\n                                        data-wp-style----formgent-file-upload-progress=\"context.item.progress\"\n                                        class=\"formgent-file-upload-progress\"\n                                    ><\/span>\n                                    <span\n                                        data-wp-text=\"context.item.progress\"\n                                        class=\"formgent-file-upload-progress-text\"\n                                    >\n                                        0%\n                                    <\/span>\n                                <\/div>\n                            <\/div>\n                            <div data-wp-bind--hidden=\"!context.item.uploaded\" class=\"formgent-file-preview-action\">\n                                <span\n                                    class=\"formgent-file-delete\"\n                                    tabindex=\"0\"\n                                    role=\"button\"\n                                    aria-label=\"Delete file\"\n                                    data-wp-on--click=\"actions.removeFile\"\n                                    data-wp-on--keydown=\"actions.handleRemoveFileKeydown\"\n                                >\n                                    <svg width=\"100%\" height=\"100%\" viewBox=\"0 0 24 24\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n <path d=\"M16 6V5.2C16 4.0799 16 3.51984 15.782 3.09202C15.5903 2.71569 15.2843 2.40973 14.908 2.21799C14.4802 2 13.9201 2 12.8 2H11.2C10.0799 2 9.51984 2 9.09202 2.21799C8.71569 2.40973 8.40973 2.71569 8.21799 3.09202C8 3.51984 8 4.0799 8 5.2V6M10 11.5V16.5M14 11.5V16.5M3 6H21M19 6V17.2C19 18.8802 19 19.7202 18.673 20.362C18.3854 20.9265 17.9265 21.3854 17.362 21.673C16.7202 22 15.8802 22 14.2 22H9.8C8.11984 22 7.27976 22 6.63803 21.673C6.07354 21.3854 5.6146 20.9265 5.32698 20.362C5 19.7202 5 18.8802 5 17.2V6\" stroke=\"currentColor\" stroke-width=\"2\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/>\n <\/svg>\n                                <\/span>\n                            <\/div>\n                        <\/li>\n                    <\/template>\n                <\/ul>\n            <\/div>\n        <\/div>\n    <\/div>\n    <\/div>\n\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"text\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-Dr39rzYjePA-\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                <strong>Additional Notes or Special Requests<\/strong>                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <input\n                class=\"formgent-field-single__input\"\n                type=\"text\"\n                id=\"formgent-Dr39rzYjePA-\"\n                placeholder=\"Wheelchair access, dietary requirements, specific hotel location preference, any other details...\"\n                data-wp-on--input=\"actions.updateInput\"\n                data-wp-bind--value=\"state.getValue\"\n            \/>\n                    <\/div>\n    <\/div>\n<\/div>\n\n<div\n    data-wp-interactive=\"formgent\/form\"\n    data-wp-context='{ \"name\": \"button\" }'\n    data-wp-class--formgent-display-none=\"context.is_multi_step\"\n    data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field  formgent-field-width-100\">\n\n    <div\n        class=\"formgent-field-single formgent-field-single--button formgent-field-align-middle formgent-show-button\"\n        style=\"--formgent-btn-bg-color: #4cafaa; --formgent-btn-text-color: #000000; --formgent-btn-border-color: #000000;\"\n        data-wp-class--formgent-show-button=\"!state.showPaypalButton\"\n        data-wp-class--formgent-hide-button=\"state.showPaypalButton\"\n    >\n        <button type=\"submit\"\n            class=\"formgent-btn formgent-btn-md formgent-btn-default\"\n            data-wp-on--keydown=\"actions.handleSubmitButtonKeydown\"\n        >\n            Submit Travel Request        <\/button>\n    <\/div>\n    \n<div\n    class=\"formgent-field-single formgent-field-single--button formgent-field-single--paypal-button formgent-hide-button formgent-field-align-middle\"\n    data-wp-class--formgent-show-button=\"state.showPaypalButton\"\n    data-wp-class--formgent-hide-button=\"!state.showPaypalButton\"\n>\n    <button type=\"submit\" class=\"formgent-btn formgent-btn-md formgent-btn-paypal\">\n        <span><svg height=\"16px\" id=\"Layer_1\" version=\"1.1\" viewBox=\"0 25 63 16\" width=\"63px\" xml:space=\"preserve\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\"><g><g><path d=\"M49.2,28.2h-3.4c-0.2,0-0.4,0.2-0.5,0.4l-1.4,8.8c0,0.2,0.1,0.3,0.3,0.3h1.8c0.2,0,0.3-0.1,0.3-0.3    l0.4-2.5c0-0.2,0.2-0.4,0.5-0.4h1.1c2.3,0,3.6-1.1,3.9-3.3c0.2-0.9,0-1.7-0.4-2.2C51.2,28.5,50.3,28.2,49.2,28.2 M49.6,31.5    c-0.2,1.2-1.1,1.2-2,1.2H47l0.4-2.3c0-0.1,0.1-0.2,0.3-0.2h0.2c0.6,0,1.2,0,1.5,0.4C49.6,30.7,49.6,31,49.6,31.5\" fill=\"#139AD6\"\/><\/g><g><path d=\"M24.7,28.2h-3.4c-0.2,0-0.4,0.2-0.5,0.4l-1.4,8.8c0,0.2,0.1,0.3,0.3,0.3h1.6c0.2,0,0.4-0.2,0.5-0.4    l0.4-2.4c0-0.2,0.2-0.4,0.5-0.4h1.1c2.3,0,3.6-1.1,3.9-3.3c0.2-0.9,0-1.7-0.4-2.2C26.7,28.5,25.9,28.2,24.7,28.2 M25.1,31.5    c-0.2,1.2-1.1,1.2-2,1.2h-0.5l0.4-2.3c0-0.1,0.1-0.2,0.3-0.2h0.2c0.6,0,1.2,0,1.5,0.4C25.1,30.7,25.2,31,25.1,31.5\" fill=\"#263B80\"\/><\/g><g><path d=\"M35,31.4h-1.6c-0.1,0-0.3,0.1-0.3,0.2L33,32.1l-0.1-0.2c-0.4-0.5-1.1-0.7-1.9-0.7c-1.8,0-3.4,1.4-3.7,3.3    c-0.2,1,0.1,1.9,0.6,2.5c0.5,0.6,1.2,0.8,2.1,0.8c1.5,0,2.3-0.9,2.3-0.9l-0.1,0.5c0,0.2,0.1,0.3,0.3,0.3h1.5    c0.2,0,0.4-0.2,0.5-0.4l0.9-5.6C35.3,31.6,35.1,31.4,35,31.4 M32.7,34.6c-0.2,0.9-0.9,1.6-1.9,1.6c-0.5,0-0.9-0.2-1.1-0.4    c-0.2-0.3-0.3-0.7-0.3-1.2c0.1-0.9,0.9-1.6,1.8-1.6c0.5,0,0.8,0.2,1.1,0.4C32.6,33.7,32.7,34.2,32.7,34.6\" fill=\"#263B80\"\/><\/g><g><path d=\"M59.4,31.4h-1.6c-0.1,0-0.3,0.1-0.3,0.2l-0.1,0.5l-0.1-0.2c-0.4-0.5-1.1-0.7-1.9-0.7    c-1.8,0-3.4,1.4-3.7,3.3c-0.2,1,0.1,1.9,0.6,2.5c0.5,0.6,1.2,0.8,2.1,0.8c1.5,0,2.3-0.9,2.3-0.9l-0.1,0.5c0,0.2,0.1,0.3,0.3,0.3    h1.5c0.2,0,0.4-0.2,0.5-0.4l0.9-5.6C59.7,31.6,59.6,31.4,59.4,31.4 M57.1,34.6c-0.2,0.9-0.9,1.6-1.9,1.6c-0.5,0-0.9-0.2-1.1-0.4    c-0.2-0.3-0.3-0.7-0.3-1.2c0.1-0.9,0.9-1.6,1.8-1.6c0.5,0,0.8,0.2,1.1,0.4C57.1,33.7,57.2,34.2,57.1,34.6\" fill=\"#139AD6\"\/><\/g><g><g><path d=\"M43.7,31.4h-1.7c-0.2,0-0.3,0.1-0.4,0.2L39.4,35l-1-3.2c-0.1-0.2-0.2-0.3-0.5-0.3h-1.6     c-0.2,0-0.3,0.2-0.3,0.4l1.8,5.3l-1.7,2.4c-0.1,0.2,0,0.5,0.2,0.5h1.6c0.2,0,0.3-0.1,0.4-0.2l5.5-7.9     C44.1,31.7,43.9,31.4,43.7,31.4\" fill=\"#263B80\"\/><\/g><g><path d=\"M61.3,28.5l-1.4,9c0,0.2,0.1,0.3,0.3,0.3h1.4c0.2,0,0.4-0.2,0.5-0.4l1.4-8.8c0-0.2-0.1-0.3-0.3-0.3h-1.6     C61.5,28.2,61.4,28.3,61.3,28.5\" fill=\"#139AD6\"\/><\/g><g><path d=\"M12,25.2C11.3,24.4,10,24,8.2,24h-5c-0.3,0-0.6,0.3-0.7,0.6L0.5,37.7c0,0.3,0.2,0.5,0.4,0.5H4l0.8-4.9     l0,0.2c0.1-0.3,0.4-0.6,0.7-0.6h1.5c2.9,0,5.1-1.2,5.8-4.5c0-0.1,0-0.2,0-0.3c-0.1,0-0.1,0,0,0C12.9,26.8,12.7,26,12,25.2\" fill=\"#263B80\"\/><\/g><\/g><g><path d=\"M12.7,28.1L12.7,28.1c0,0.1,0,0.2,0,0.3c-0.7,3.4-2.9,4.5-5.8,4.5H5.4c-0.3,0-0.6,0.3-0.7,0.6l-1,6.1    c0,0.2,0.1,0.4,0.4,0.4h2.6c0.3,0,0.6-0.2,0.6-0.5l0-0.1l0.5-3.1l0-0.2c0-0.3,0.3-0.5,0.6-0.5h0.4c2.5,0,4.5-1,5-4    c0.2-1.2,0.1-2.3-0.5-3C13.2,28.4,13,28.2,12.7,28.1\" fill=\"#139AD6\"\/><\/g><g><path d=\"M12,27.8c-0.1,0-0.2-0.1-0.3-0.1c-0.1,0-0.2,0-0.3-0.1c-0.4-0.1-0.8-0.1-1.3-0.1H6.2c-0.1,0-0.2,0-0.3,0.1    c-0.2,0.1-0.3,0.3-0.3,0.5l-0.8,5.2l0,0.2c0.1-0.3,0.4-0.6,0.7-0.6h1.5c2.9,0,5.1-1.2,5.8-4.5c0-0.1,0-0.2,0.1-0.3    c-0.2-0.1-0.3-0.2-0.5-0.2C12.1,27.8,12.1,27.8,12,27.8\" fill=\"#232C65\"\/><\/g><\/g><\/svg><\/span>\n    <\/button>\n<\/div><\/div>\n                    <\/div>\n                <!-- Honeypot field -->\n                    <input type=\"hidden\" name=\"formgent-honeypot-4032\"\n                id=\"formgent-honeypot-4032\">\n        \n        \n            <\/form>\n\n<\/div>\n\n\n<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-ea79fdc e-flex e-con-boxed e-con e-parent\" data-id=\"ea79fdc\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-68de57a e-con-full e-flex e-con e-child\" data-id=\"68de57a\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3845647 elementor-widget elementor-widget-heading\" data-id=\"3845647\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\"><span style=\"color:#ffffff\">Important: Nexa Centre is a Facilitator, Not a Medical Provider \n<\/span><\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a1ee175 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"a1ee175\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Nexa Centre does not provide medical diagnosis, treatment, or clinical advice. We act as a trusted coordination intermediary \u2014 connecting patients with verified healthcare providers and managing the logistics of international medical access.<\/p><p>Medical decisions and clinical responsibilities remain entirely with the treating doctors and hospitals. Our role is to ensure you reach the right care, safely, efficiently, and with full support throughout the process.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f206c9f elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"f206c9f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>All medical referrals are made based on publicly available information and client preferences. Nexa Centre does not guarantee treatment outcomes.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-9133d37 e-flex e-con-boxed e-con e-parent\" data-id=\"9133d37\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-6b22e93 e-con-full e-flex e-con e-child\" data-id=\"6b22e93\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;gradient&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d3e971f elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"d3e971f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t\u2014 NEED HELP?\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1e96055 elementor-widget elementor-widget-heading\" data-id=\"1e96055\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\"><span style=\"color:#ffffff\">Have Questions About Our Coordination Services?\n<\/span><\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-48e4b80 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"48e4b80\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\tOur team is available Saturday through Thursday, 8AM\u20136PM EAT. Contact us directly for a quick conversation before submitting your request.\t\t\t\t\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-789489b e-con-full e-flex e-con e-child\" data-id=\"789489b\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-0ec0b04 elementor-widget__width-initial elementor-mobile-align-center elementor-align-center elementor-widget elementor-widget-button\" data-id=\"0ec0b04\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/nexacentre.com\/all-courses\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Explore ALL COURSES \u2192 <\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-46e3826 elementor-widget__width-initial elementor-mobile-align-center elementor-align-center elementor-widget elementor-widget-button\" data-id=\"46e3826\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/nexacentre.com\/contact\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">CONTACT US<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-a38e614 e-flex e-con-boxed e-con e-parent\" data-id=\"a38e614\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-7d7e2d0 elementor-widget elementor-widget-html\" data-id=\"7d7e2d0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t\t<!-- Modal Overlay -->\r\n<div id=\"medRequestOverlay\" \r\n     style=\"display:none;\r\n            position:fixed;\r\n            inset:0;\r\n            z-index:9999;\r\n            background:rgba(8,12,18,0.92);\r\n            backdrop-filter:blur(12px);\r\n            overflow-y:auto;\r\n            padding:40px 20px;\">\r\n  \r\n  <div style=\"max-width:600px;\r\n              margin:0 auto;\r\n              background:#111820;\r\n              border:1px solid rgba(255,255,255,0.1);\r\n              border-radius:22px;\r\n              overflow:hidden;\">\r\n    \r\n    <!-- Header -->\r\n    <div style=\"padding:24px 28px;\r\n                border-bottom:1px solid rgba(255,255,255,0.07);\r\n                display:flex;\r\n                align-items:center;\r\n                justify-content:space-between;\r\n                background:linear-gradient(135deg,rgba(0,121,145,0.1),transparent);\">\r\n      <div>\r\n        <div style=\"font-family:'Syne',sans-serif;\r\n                    font-size:20px;\r\n                    font-weight:800;\r\n                    color:#fff;\r\n                    margin-bottom:4px;\">\r\n          Request Medical Coordination\r\n        <\/div>\r\n        <div id=\"selectedProviderName\" \r\n             style=\"font-size:13px;\r\n                    color:#00b4d8;\">\r\n          <!-- Provider name yahan aayega -->\r\n        <\/div>\r\n      <\/div>\r\n      <button onclick=\"closeMedModal()\" \r\n              style=\"background:rgba(255,255,255,0.07);\r\n                     border:1px solid rgba(255,255,255,0.1);\r\n                     border-radius:9px;\r\n                     width:36px;height:36px;\r\n                     color:#7a8799;\r\n                     font-size:18px;\r\n                     cursor:pointer;\r\n                     display:flex;\r\n                     align-items:center;\r\n                     justify-content:center;\">\r\n        \u2715\r\n      <\/button>\r\n    <\/div>\r\n\r\n    <!-- Forminator Form -->\r\n    <div style=\"padding:24px 28px;\">\r\n      \n<style>\n    .formgent-form-4465 {\n        \/* Form variables *\/\n        --formgent-form-background-color: #18222f;\n        --formgent-form-background-image: ;\n        --formgent-form-background-image-position:\n        center center;\n\n        --formgent-form-padding-desktop: 20px 20px 40px 20px;\n        --formgent-form-padding-tablet: 20px 20px 40px 20px;\n        --formgent-form-padding-mobile: 20px 20px 40px 20px;\n        --formgent-form-margin-desktop: 0 0 0 0;\n        --formgent-form-margin-tablet: 0 0 0 0;\n        --formgent-form-margin-mobile: 0 0 0 0;\n        --formgent-form-border-width: 0;\n        --formgent-form-border: 0 solid transparent;\n        --formgent-form-border-radius: 16px 16px 16px 16px;\n\n        \/* Field variables *\/\n     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--formgent-field-range-slider-color: #000000;\n        \/* Fixed submit button variables *\/\n        --formgent-fixed-btn-bg-color: #000000;\n        --formgent-fixed-btn-text-color: #ffffff;\n        --formgent-fixed-btn-border-color: #000000;\n        --formgent-fixed-btn-style: default;\n        --formgent-fixed-btn-alignment: left;\n    }\n    .display-none {\n        display: none;\n    }\n<\/style><style>\n    <\/style>\n<div class=\"formgent-form formgent-form-4465 formgent-form-general formgent-shortcode\">\n            <div class=\"formgent-confirmation-wrap formgent-confirmation-wrap--hidden\">\n            <div class=\"formgent-notices formgent-notices--classic-form\"\n                data-message=\"&lt;div style=&quot;background: linear-gradient(135deg, #0d1f2d, #1a2f42); border: 1px solid #00bcd4; border-radius: 14px; padding: 40px 30px; text-align: center; font-family: &#039;Segoe UI&#039;, sans-serif;&quot;&gt;\n&lt;h2 style=&quot;color: #ffffff; font-size: 28px; font-weight: bold; margin: 0 0 12px 0;&quot;&gt;Thank You!&lt;\/h2&gt;\n&lt;p style=&quot;color: #a8d8ea; font-size: 16px; line-height: 1.6; margin: 0;&quot;&gt;Your submission has been received successfully.&lt;br \/&gt;Our team will review your request and contact you within &lt;strong style=&quot;color: #00bcd4;&quot;&gt;24 hours&lt;\/strong&gt;.&lt;\/p&gt;\n&lt;\/div&gt;\">\n            <\/div>\n            <div class=\"formgent-quiz-result\"><\/div>\n        <\/div>\n        <form id=\"formgent-formgent_store3\"         data-wp-interactive=\"formgent\/form\"\n        data-wp-context='{&quot;form_id&quot;:4465,&quot;blocks_settings&quot;:{&quot;html&quot;:{&quot;id&quot;:&quot;jMa3Zo07Tgf6&quot;,&quot;name&quot;:&quot;html&quot;,&quot;label_alignment&quot;:&quot;top&quot;,&quot;html_content&quot;:&quot;\\u003Cdiv style=\\u0022margin-bottom: 16px;\\u0022\\u003E\\u003Clabel style=\\u0022display: block; color: #7a8799; font-size: 12px; font-weight: bold; text-transform: uppercase; 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Email&quot;,&quot;required&quot;:false,&quot;character_limit&quot;:false,&quot;limit&quot;:100,&quot;is_invalid_name&quot;:false,&quot;block_width&quot;:&quot;100&quot;,&quot;logics&quot;:[],&quot;is_preview&quot;:false,&quot;TrpContentRestriction&quot;:{&quot;restriction_type&quot;:&quot;exclude&quot;,&quot;selected_languages&quot;:[],&quot;panel_open&quot;:true},&quot;field_type&quot;:&quot;email&quot;},&quot;text-1&quot;:{&quot;id&quot;:&quot;Om0lNLwjoeq5&quot;,&quot;name&quot;:&quot;text-1&quot;,&quot;value&quot;:&quot;&quot;,&quot;label_alignment&quot;:&quot;top&quot;,&quot;required&quot;:false,&quot;character_limit&quot;:false,&quot;limit&quot;:100,&quot;block_width&quot;:&quot;100&quot;,&quot;logics&quot;:[],&quot;is_preview&quot;:false,&quot;TrpContentRestriction&quot;:{&quot;restriction_type&quot;:&quot;exclude&quot;,&quot;selected_languages&quot;:[],&quot;panel_open&quot;:true},&quot;field_type&quot;:&quot;text&quot;},&quot;text-2&quot;:{&quot;id&quot;:&quot;fyOi5Zp9OEj-&quot;,&quot;name&quot;:&quot;text-2&quot;,&quot;value&quot;:&quot;&quot;,&quot;label_alignment&quot;:&quot;top&quot;,&quot;required&quot;:false,&quot;character_limit&quot;:false,&quot;limit&quot;:100,&quot;block_width&quot;:&quot;100&quot;,&quot;logics&quot;:[],&quot;is_preview&quot;:false,&quot;TrpContentRestriction&quot;:{&quot;restriction_type&quot;:&quot;exclude&quot;,&quot;selected_languages&quot;:[],&quot;panel_open&quot;:true},&quot;field_type&quot;:&quot;text&quot;},&quot;dropdown&quot;:{&quot;id&quot;:&quot;YmTJnKeir9YU&quot;,&quot;name&quot;:&quot;dropdown&quot;,&quot;value&quot;:&quot;&quot;,&quot;options&quot;:[{&quot;value&quot;:&quot;urgent-within-1-2-weeks&quot;},{&quot;value&quot;:&quot;soon-within-1-month&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;planned-2-3-months&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;flexible&quot;,&quot;is_default&quot;:false}],&quot;default_option&quot;:&quot;&quot;,&quot;label_alignment&quot;:&quot;top&quot;,&quot;required&quot;:true,&quot;block_width&quot;:&quot;100&quot;,&quot;logics&quot;:[],&quot;is_preview&quot;:false,&quot;enable_numeric_value&quot;:false,&quot;disable_search&quot;:false,&quot;TrpContentRestriction&quot;:{&quot;restriction_type&quot;:&quot;exclude&quot;,&quot;selected_languages&quot;:[],&quot;panel_open&quot;:true},&quot;field_type&quot;:&quot;dropdown&quot;},&quot;dropdown-1&quot;:{&quot;id&quot;:&quot;E7pzNvFsNTq-&quot;,&quot;name&quot;:&quot;dropdown-1&quot;,&quot;value&quot;:&quot;&quot;,&quot;options&quot;:[{&quot;value&quot;:&quot;no-first-time-seeking-care&quot;},{&quot;value&quot;:&quot;yes-locally-treated-only&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;yes-previously-abroad-too&quot;,&quot;is_default&quot;:false}],&quot;default_option&quot;:&quot;&quot;,&quot;label_alignment&quot;:&quot;top&quot;,&quot;required&quot;:false,&quot;block_width&quot;:&quot;100&quot;,&quot;logics&quot;:[],&quot;is_preview&quot;:false,&quot;enable_numeric_value&quot;:false,&quot;disable_search&quot;:false,&quot;TrpContentRestriction&quot;:{&quot;restriction_type&quot;:&quot;exclude&quot;,&quot;selected_languages&quot;:[],&quot;panel_open&quot;:true},&quot;field_type&quot;:&quot;dropdown&quot;},&quot;dropdown-2&quot;:{&quot;id&quot;:&quot;iwe2K6VyDkTE&quot;,&quot;name&quot;:&quot;dropdown-2&quot;,&quot;value&quot;:&quot;&quot;,&quot;options&quot;:[{&quot;value&quot;:&quot;yes-please-coordinate-travel-too&quot;},{&quot;value&quot;:&quot;no-i-will-arrange-travel-myself&quot;,&quot;is_default&quot;:false},{&quot;value&quot;:&quot;not-sure-yet&quot;,&quot;is_default&quot;:false}],&quot;default_option&quot;:&quot;&quot;,&quot;label_alignment&quot;:&quot;top&quot;,&quot;required&quot;:false,&quot;block_width&quot;:&quot;100&quot;,&quot;logics&quot;:[],&quot;is_preview&quot;:false,&quot;enable_numeric_value&quot;:false,&quot;disable_search&quot;:false,&quot;TrpContentRestriction&quot;:{&quot;restriction_type&quot;:&quot;exclude&quot;,&quot;selected_languages&quot;:[],&quot;panel_open&quot;:true},&quot;field_type&quot;:&quot;dropdown&quot;},&quot;file-upload&quot;:{&quot;id&quot;:&quot;ov44zEph0b5a&quot;,&quot;name&quot;:&quot;file-upload&quot;,&quot;label_alignment&quot;:&quot;top&quot;,&quot;upload_button_text&quot;:&quot;Upload&quot;,&quot;required&quot;:false,&quot;limit_size&quot;:&quot;10MB&quot;,&quot;is_limit_size&quot;:true,&quot;size_type&quot;:&quot;MB&quot;,&quot;limit_files&quot;:5,&quot;is_limit_files&quot;:0,&quot;allowed_types&quot;:[&quot;application\\\/pdf&quot;],&quot;block_width&quot;:&quot;100&quot;,&quot;logics&quot;:[],&quot;is_preview&quot;:false,&quot;TrpContentRestriction&quot;:{&quot;restriction_type&quot;:&quot;exclude&quot;,&quot;selected_languages&quot;:[],&quot;panel_open&quot;:true},&quot;field_type&quot;:&quot;file-upload&quot;},&quot;text-3&quot;:{&quot;id&quot;:&quot;OPc0nOqSquPe&quot;,&quot;name&quot;:&quot;text-3&quot;,&quot;value&quot;:&quot;&quot;,&quot;label_alignment&quot;:&quot;top&quot;,&quot;required&quot;:false,&quot;character_limit&quot;:false,&quot;limit&quot;:100,&quot;block_width&quot;:&quot;100&quot;,&quot;logics&quot;:[],&quot;is_preview&quot;:false,&quot;TrpContentRestriction&quot;:{&quot;restriction_type&quot;:&quot;exclude&quot;,&quot;selected_languages&quot;:[],&quot;panel_open&quot;:true},&quot;field_type&quot;:&quot;text&quot;}},&quot;form_type&quot;:&quot;general&quot;,&quot;data&quot;:{&quot;html&quot;:&quot;&quot;,&quot;full-name&quot;:{&quot;first_name&quot;:&quot;&quot;},&quot;phone-number&quot;:&quot;&quot;,&quot;text&quot;:&quot;&quot;,&quot;email-address&quot;:&quot;&quot;,&quot;text-1&quot;:&quot;&quot;,&quot;text-2&quot;:&quot;&quot;,&quot;dropdown&quot;:&quot;&quot;,&quot;dropdown-1&quot;:&quot;&quot;,&quot;dropdown-2&quot;:&quot;&quot;,&quot;file-upload&quot;:&quot;&quot;,&quot;text-3&quot;:&quot;&quot;},&quot;preset_values&quot;:{&quot;site_title&quot;:&quot;Nexa Centre&quot;,&quot;site_name&quot;:&quot;Nexa Centre&quot;,&quot;site_url&quot;:&quot;https:\\\/\\\/nexacentre.com&quot;,&quot;form_title&quot;:&quot;Medical Consultation Request Form&quot;,&quot;browser_name&quot;:&quot;&quot;,&quot;browser_platform&quot;:&quot;&quot;,&quot;embedded_post_id&quot;:&quot;3947&quot;,&quot;embedded_post_title&quot;:&quot;Medical \\u0026 Travel&quot;,&quot;current_date&quot;:&quot;05\\\/26\\\/2026&quot;,&quot;admin_name&quot;:&quot;Abdinasir Muhumed&quot;,&quot;login_url&quot;:&quot;https:\\\/\\\/nexacentre.com\\\/wp-login.php&quot;,&quot;register_url&quot;:&quot;https:\\\/\\\/nexacentre.com\\\/wp-login.php?action=register&quot;,&quot;forgot_password_url&quot;:&quot;https:\\\/\\\/nexacentre.com\\\/wp-login.php?action=lostpassword&quot;,&quot;logout_url&quot;:&quot;https:\\\/\\\/nexacentre.com\\\/wp-login.php?action=logout\\u0026amp;_wpnonce=6420a418aa&quot;},&quot;is_form_loaded&quot;:false,&quot;is_partial_submitting&quot;:false,&quot;global&quot;:{&quot;is_response_submitting&quot;:false,&quot;is_response_token_generating&quot;:false,&quot;is_enabled_honeypot_protection&quot;:true,&quot;payment&quot;:{&quot;enable_summary&quot;:false,&quot;payment_summary&quot;:&quot;&quot;,&quot;items&quot;:[],&quot;total_amount&quot;:&quot;&quot;}},&quot;quiz_result&quot;:false,&quot;show_quiz_results&quot;:true,&quot;confirmation&quot;:{&quot;type&quot;:&quot;message&quot;,&quot;page&quot;:0,&quot;url&quot;:&quot;https:\\\/\\\/google.com&quot;,&quot;after_submission&quot;:&quot;reset&quot;},&quot;_ccOverride&quot;:false,&quot;_confirmationDisplayed&quot;:false,&quot;submit_label&quot;:&quot;Submit&quot;,&quot;redirecting_label&quot;:&quot;You will be redirected in&quot;,&quot;plugin_url&quot;:&quot;https:\\\/\\\/nexacentre.com\\\/wp-content\\\/plugins&quot;,&quot;external_data&quot;:[]}'\n        data-wp-init=\"callbacks.initClassicForm\"\n        data-wp-bind--disabled=\"context.global.is_response_submitting\" data-wp-watch=\"callbacks.watchForm\">\n                        <div class=\"formgent-field-list formgent-field-list--frontend\"\n            data-wp-class--formgent-field-list-loading=\"!context.is_form_loaded\"\n            data-wp-class--formgent-partial-submitting=\"!context.is_partial_submitting\">\n            <div\n    class=\"display-none formgent-html-block__content formgent-field formgent-field-width-100\"\n    data-wp-interactive=\"formgent\/form\"\n    data-wp-context='{&quot;name&quot;:&quot;html&quot;,&quot;field_type&quot;:&quot;html&quot;,&quot;html&quot;:&quot;\\u003Cdiv style=\\u0022margin-bottom: 16px;\\u0022\\u003E\\u003Clabel style=\\u0022display: block; color: #7a8799; font-size: 12px; font-weight: bold; text-transform: uppercase; letter-spacing: 0.06em; margin-bottom: 8px;\\u0022\\u003E Selected Doctor \\\/ Hospital \\u003C\\\/label\\u003E \\u003Cinput id=\\u0022fg_selected_provider\\u0022 style=\\u0022width: 100%; padding: 12px 16px; background: rgba(0,121,145,0.1); border: 1px solid rgba(0,121,145,0.3); border-radius: 10px; color: #00b4d8; font-size: 14px; cursor: not-allowed;\\u0022 readonly=\\u0022readonly\\u0022 type=\\u0022text\\u0022 placeholder=\\u0022Will be filled automatically\\u0022 \\\/\\u003E\\u003C\\\/div\\u003E&quot;}'\n    data-wp-bind--hidden=\"state.hideField\"\n    data-wp-init=\"callbacks.initHtmlBlock\"\n    data-wp-watch=\"callbacks.updateHtmlBlock\"\n><\/div>\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"full-name\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\" id=\"formgent-8WCxwQXmX8ZEH08MZVZeS\">\n    <div class=\"formgent-field-single formgent-field-align-top\" data-wp-context='{ \"parent_name\": \"full-name\" }'>\n        <span class=\"formgent-field-label formgent-label-align-top\">\n        <strong>Full Name<\/strong>    <\/span>\n    \n<div class=\"formgent-field-list formgent-field-list--frontend\">\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"first_name\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-33\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-yOaGeIckgCAz\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                Full Name                                    <span class=\"formgent-field-required\">\n                        *\n                    <\/span>\n                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <input\n                class=\"formgent-field-single__input\"\n                type=\"text\"\n                id=\"formgent-yOaGeIckgCAz\"\n                placeholder=\"\"\n                data-wp-on--input=\"actions.updateInput\"\n                data-wp-bind--value=\"state.getValue\"\n            \/>\n                    <\/div>\n    <\/div>\n<\/div><\/div>\n    <\/div>\n<\/div>\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"phone-number\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-single--csr formgent-field-align-top\">\n                    <label\n                for=\"formgent-eXCW1GqHVHd_WiZ5eY_Eg\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                <strong>Phone Number<\/strong>                                    <span class=\"formgent-field-required\">\n                        *\n                    <\/span>\n                            <\/label>\n                <div\n            class=\"formgent-field-single__wrapper\"\n        >\n            <div class=\"formgent-field-single__phone\">\n                <div class=\"formgent-field-single__dialer__content\">\n                    <input\n                        class=\"formgent-field-single__input formgent-field-single__input--country-code\"\n                        type=\"tel\"\n                        id=\"formgent-eXCW1GqHVHd_WiZ5eY_Eg\"\n                        placeholder=\"+252 ...\"\n                        data-wp-init=\"callbacks.phoneNumberInit\"\n                    >\n                <\/div>\n            <\/div>\n                    <\/div>\n    <\/div>\n<\/div>\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"text\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-wWujdW2t11NP\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                <strong>Age<\/strong>                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <input\n                class=\"formgent-field-single__input\"\n                type=\"text\"\n                id=\"formgent-wWujdW2t11NP\"\n                placeholder=\"Patient Age\"\n                data-wp-on--input=\"actions.updateInput\"\n                data-wp-bind--value=\"state.getValue\"\n            \/>\n                    <\/div>\n    <\/div>\n<\/div>\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"email-address\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field formgent-field-width-100 formgent-field-email\">\n    <div class=\"formgent-field-single formgent-field-align-top formgent-field-single-email-primary\">\n                    <label\n                for=\"formgent-9VigMLY8RBZwXuMTPr_GK\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                <strong>Email Address<\/strong>                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <div class='formgent-has-input-icon'>\n                \n                <input\n                    class=\"formgent-field-single__input\"\n                    type=\"email\"\n                    id=\"formgent-9VigMLY8RBZwXuMTPr_GK\"\n                    placeholder=\"your@email.com\"\n                    data-wp-on--input=\"actions.updateInput\"\n                    data-wp-bind--value=\"state.getValue\"\n                \/>\n            <\/div>\n\n                    <\/div>\n    <\/div>\n\n    <\/div>\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"text-1\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-Om0lNLwjoeq5\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                <strong>City \/ Country<\/strong>                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <input\n                class=\"formgent-field-single__input\"\n                type=\"text\"\n                id=\"formgent-Om0lNLwjoeq5\"\n                placeholder=\"Hargeisa, Somaliland...\"\n                data-wp-on--input=\"actions.updateInput\"\n                data-wp-bind--value=\"state.getValue\"\n            \/>\n                    <\/div>\n    <\/div>\n<\/div>\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"text-2\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-fyOi5Zp9OEj-\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                <strong>Medical Condition \/ Reason for Seeking Care\u00a0*<br><\/strong>                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <input\n                class=\"formgent-field-single__input\"\n                type=\"text\"\n                id=\"formgent-fyOi5Zp9OEj-\"\n                placeholder=\"Describe your medical situation, symptoms, or reason for seeking this doctor\/hospital...\"\n                data-wp-on--input=\"actions.updateInput\"\n                data-wp-bind--value=\"state.getValue\"\n            \/>\n                    <\/div>\n    <\/div>\n<\/div>\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{&quot;name&quot;:&quot;dropdown&quot;,&quot;field_label&quot;:&quot;&lt;strong&gt;Urgency Level&lt;\\\/strong&gt;&quot;,&quot;options&quot;:[{&quot;id&quot;:&quot;lzJjzgAs51RXeS5yVkHbx&quot;,&quot;label&quot;:&quot;Urgent \\u2014 Within 1\\u20132 weeks&quot;,&quot;value&quot;:&quot;urgent-within-1-2-weeks&quot;},{&quot;label&quot;:&quot;Soon \\u2014 Within 1 month&quot;,&quot;id&quot;:&quot;1&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;soon-within-1-month&quot;},{&quot;label&quot;:&quot;Planned \\u2014 2\\u20133 months&quot;,&quot;id&quot;:&quot;2&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;planned-2-3-months&quot;},{&quot;label&quot;:&quot;Flexible&quot;,&quot;id&quot;:&quot;3&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;flexible&quot;}]}' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-YmTJnKeir9YU\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                <strong>Urgency Level<\/strong>                                    <span class=\"formgent-field-required\">\n                        *\n                    <\/span>\n                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <select class=\"formgent-field-single__input formgent-field-single__input--select\"\n                id=\"formgent-YmTJnKeir9YU\"\n                data-wp-init=\"callbacks.dropdownInit\"\n                data-placeholder=\"Select...\"\n                autocomplete=\"off\"\n            >\n                                    <option value=\"\">Select...<\/option>\n                                            <option value=\"urgent-within-1-2-weeks\">\n                            Urgent \u2014 Within 1\u20132 weeks                        <\/option>\n                                            <option value=\"soon-within-1-month\">\n                            Soon \u2014 Within 1 month                        <\/option>\n                                            <option value=\"planned-2-3-months\">\n                            Planned \u2014 2\u20133 months                        <\/option>\n                                            <option value=\"flexible\">\n                            Flexible                        <\/option>\n                                                <\/select>\n\n                    <\/div>\n    <\/div>\n\n    <!-- <div data-wp-bind--hidden=\"!state.showFieldQuantityInput\" class=\"formgent-field-single formgent-field-quantity\" data-wp-class--formgent-field-quantity-hidden=\"!state.showFieldQuantityInput\">\n        <label for=\"\"\n            class=\"formgent-field-label\" data-wp-text=\"state.getQuantityLabel\">\n        <\/label>\n        <input class=\"formgent-field-single__input\" type=\"number\"\n            id=\"\"\n            name=\"_quantity\"\n            data-wp-on--input=\"actions.updatePaymentQuantity\"\n            data-wp-bind--value=\"state.getFieldQuantity\"\n            data-wp-bind--min=\"state.getFieldQuantityMin\"\n            data-wp-bind--max=\"state.getFieldQuantityMax\"\n            value=\"1\" \/>\n    <\/div> -->\n<\/div>\n\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{&quot;name&quot;:&quot;dropdown-1&quot;,&quot;field_label&quot;:&quot;&lt;strong&gt;Treated Locally Before?&lt;\\\/strong&gt;&quot;,&quot;options&quot;:[{&quot;id&quot;:&quot;lzJjzgAs51RXeS5yVkHbx&quot;,&quot;label&quot;:&quot;No \\u2014 first time seeking care&quot;,&quot;value&quot;:&quot;no-first-time-seeking-care&quot;},{&quot;label&quot;:&quot;Yes \\u2014 locally treated only&quot;,&quot;id&quot;:&quot;1&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;yes-locally-treated-only&quot;},{&quot;label&quot;:&quot;Yes \\u2014 previously abroad too&quot;,&quot;id&quot;:&quot;2&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;yes-previously-abroad-too&quot;}]}' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-E7pzNvFsNTq-\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                <strong>Treated Locally Before?<\/strong>                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <select class=\"formgent-field-single__input formgent-field-single__input--select\"\n                id=\"formgent-E7pzNvFsNTq-\"\n                data-wp-init=\"callbacks.dropdownInit\"\n                data-placeholder=\"Select...\"\n                autocomplete=\"off\"\n            >\n                                    <option value=\"\">Select...<\/option>\n                                            <option value=\"no-first-time-seeking-care\">\n                            No \u2014 first time seeking care                        <\/option>\n                                            <option value=\"yes-locally-treated-only\">\n                            Yes \u2014 locally treated only                        <\/option>\n                                            <option value=\"yes-previously-abroad-too\">\n                            Yes \u2014 previously abroad too                        <\/option>\n                                                <\/select>\n\n                    <\/div>\n    <\/div>\n\n    <!-- <div data-wp-bind--hidden=\"!state.showFieldQuantityInput\" class=\"formgent-field-single formgent-field-quantity\" data-wp-class--formgent-field-quantity-hidden=\"!state.showFieldQuantityInput\">\n        <label for=\"\"\n            class=\"formgent-field-label\" data-wp-text=\"state.getQuantityLabel\">\n        <\/label>\n        <input class=\"formgent-field-single__input\" type=\"number\"\n            id=\"\"\n            name=\"_quantity\"\n            data-wp-on--input=\"actions.updatePaymentQuantity\"\n            data-wp-bind--value=\"state.getFieldQuantity\"\n            data-wp-bind--min=\"state.getFieldQuantityMin\"\n            data-wp-bind--max=\"state.getFieldQuantityMax\"\n            value=\"1\" \/>\n    <\/div> -->\n<\/div>\n\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{&quot;name&quot;:&quot;dropdown-2&quot;,&quot;field_label&quot;:&quot;&lt;strong&gt;Do You Also Need Travel \\u0026amp; Hotel Support?&lt;\\\/strong&gt;&quot;,&quot;options&quot;:[{&quot;id&quot;:&quot;lzJjzgAs51RXeS5yVkHbx&quot;,&quot;label&quot;:&quot;Yes \\u2014 please coordinate travel too&quot;,&quot;value&quot;:&quot;yes-please-coordinate-travel-too&quot;},{&quot;label&quot;:&quot;No \\u2014 I will arrange travel myself&quot;,&quot;id&quot;:&quot;1&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;no-i-will-arrange-travel-myself&quot;},{&quot;label&quot;:&quot;Not sure yet&quot;,&quot;id&quot;:&quot;2&quot;,&quot;collapsed&quot;:&quot;1&quot;,&quot;is_default&quot;:&quot;&quot;,&quot;value&quot;:&quot;not-sure-yet&quot;}]}' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-iwe2K6VyDkTE\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                <strong>Do You Also Need Travel &amp; Hotel Support?<\/strong>                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <select class=\"formgent-field-single__input formgent-field-single__input--select\"\n                id=\"formgent-iwe2K6VyDkTE\"\n                data-wp-init=\"callbacks.dropdownInit\"\n                data-placeholder=\"Select...\"\n                autocomplete=\"off\"\n            >\n                                    <option value=\"\">Select...<\/option>\n                                            <option value=\"yes-please-coordinate-travel-too\">\n                            Yes \u2014 please coordinate travel too                        <\/option>\n                                            <option value=\"no-i-will-arrange-travel-myself\">\n                            No \u2014 I will arrange travel myself                        <\/option>\n                                            <option value=\"not-sure-yet\">\n                            Not sure yet                        <\/option>\n                                                <\/select>\n\n                    <\/div>\n    <\/div>\n\n    <!-- <div data-wp-bind--hidden=\"!state.showFieldQuantityInput\" class=\"formgent-field-single formgent-field-quantity\" data-wp-class--formgent-field-quantity-hidden=\"!state.showFieldQuantityInput\">\n        <label for=\"\"\n            class=\"formgent-field-label\" data-wp-text=\"state.getQuantityLabel\">\n        <\/label>\n        <input class=\"formgent-field-single__input\" type=\"number\"\n            id=\"\"\n            name=\"_quantity\"\n            data-wp-on--input=\"actions.updatePaymentQuantity\"\n            data-wp-bind--value=\"state.getFieldQuantity\"\n            data-wp-bind--min=\"state.getFieldQuantityMin\"\n            data-wp-bind--max=\"state.getFieldQuantityMax\"\n            value=\"1\" \/>\n    <\/div> -->\n<\/div>\n\n\n<style>\n        .formgent-upload-container {\n            min-height: 150px;\n            display: flex;\n            align-items: center;\n            justify-content: center;\n            flex-direction: column;\n            cursor: pointer;\n            border-radius: 8px;\n            border: 1px dashed var(--formgent-color-gray-300);\n            background: var(--formgent-field-background-color);\n            width: 100%;\n            padding: 20px;\n            text-align: center;\n        }\n        .formgent-upload-container .formgent-upload-area {\n            border: 0 none;\n        }\n        .formgent-upload-container p {\n            color: var(--formgent-field-placeholder-color);\n            text-align: center;\n            font-size: 14px;\n            font-weight: 400;\n            line-height: 1.6;\n            margin: 8px 0 0 0;\n        }\n        .formgent-upload-button {\n            display: inline-flex;\n            padding: 8px 12px;\n            justify-content: center;\n            align-items: center;\n            gap: 6px;\n            border-radius: 8px;\n            background: var(--formgent-color-gray-500, #747c89);\n            cursor: pointer;\n            color: #fff;\n            text-align: center;\n            font-size: 13px;\n            font-weight: 500;\n            transition: 0.3s ease;\n            border: 0 none;\n            box-shadow: none;\n        }\n    <\/style>\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{\"name\":\"file-upload\",\"highlightFileUpload\":false,\"uploadedFiles\":[],\"maxSizeError\":false,\"maxFileError\":false,\"maxAllowed\":5,\"notAllowed\":false,\"maxAllowedReached\":false}' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-single--file-upload formgent-field-align-top\">\n                    <span\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                <strong>Upload Medical Reports, Test Results or Prescriptions<\/strong>                            <\/span>\n                <div\n            class=\"formgent-upload-container\"\n        >\n            <label aria-disabled=\"false\"\n                for=\"formgent-ov44zEph0b5a\"\n                class=\"formgent-upload-area\"\n                tabindex=\"0\"\n                role=\"button\"\n                aria-label=\"Upload\"\n                data-wp-class--formgent-file-upload-highlight=\"context.highlightFileUpload\"\n                data-wp-class--formgent-file-upload-disabled=\"context.maxAllowedReached\"\n                data-wp-bind--aria-disabled=\"context.maxAllowedReached\"\n                data-wp-on--dragenter=\"actions.fileDragEnter\"\n                data-wp-on--dragover=\"actions.fileDragEnter\"\n                data-wp-on--dragleave=\"actions.fileDragLeave\"\n                data-wp-on--drop=\"actions.fileDrop\"\n                data-wp-on--keydown=\"actions.handleUploadAreaKeydown\"\n            >\n                <span class=\"formgent-upload-button\">\n                    <svg width=\"14\" height=\"14\" viewBox=\"0 0 14 14\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0.333252 1.00016C0.333252 0.631973 0.631729 0.333496 0.999919 0.333496H12.9999C13.3681 0.333496 13.6666 0.631973 13.6666 1.00016C13.6666 1.36835 13.3681 1.66683 12.9999 1.66683H0.999919C0.631729 1.66683 0.333252 1.36835 0.333252 1.00016ZM6.99992 3.00016C7.17673 3.00016 7.3463 3.0704 7.47132 3.19542L11.4713 7.19543C11.7317 7.45577 11.7317 7.87788 11.4713 8.13823C11.211 8.39858 10.7889 8.39858 10.5285 8.13823L7.66659 5.27631V13.0002C7.66659 13.3684 7.36811 13.6668 6.99992 13.6668C6.63173 13.6668 6.33325 13.3684 6.33325 13.0002V5.27631L3.47132 8.13823C3.21097 8.39858 2.78886 8.39858 2.52851 8.13823C2.26816 7.87788 2.26816 7.45577 2.52851 7.19543L6.52851 3.19542C6.65354 3.0704 6.82311 3.00016 6.99992 3.00016Z\" fill=\"currentColor\"\/>\n<\/svg>\n                    Upload                <\/span>\n                <input\n                    multiple\n                    type=\"file\"\n                    class=\"formgent-file-input\"\n                    style=\"display: none;\"\n                    id=\"formgent-ov44zEph0b5a\"\n                    data-wp-on--change=\"actions.onChangeFile\"\n                    data-wp-bind--disabled=\"context.maxAllowedReached\"\n                \/>\n\n                <!-- Hidden validation input for required field validation -->\n                <input\n                    type=\"hidden\"\n                    class=\"formgent-validate-field-input\"\n                    name=\"file-upload\"\n                    value=\"\"\n                \/>\n\n                <p>Drop file here or click to upload<\/p>\n\n                                    <p>Maximum file size allowed: 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