{"id":2696,"date":"2022-04-20T14:59:07","date_gmt":"2022-04-20T14:59:07","guid":{"rendered":"https:\/\/crtce.com\/?page_id=2696"},"modified":"2022-07-06T04:36:43","modified_gmt":"2022-07-06T04:36:43","slug":"fax-referral","status":"publish","type":"page","link":"https:\/\/crtce.com\/fr\/fax-referral\/","title":{"rendered":"Fax Referral"},"content":{"rendered":"<div data-elementor-type=\"wp-post\" data-elementor-id=\"2696\" class=\"elementor elementor-2696\" data-elementor-settings=\"[]\">\n\t\t\t\t\t\t<div class=\"elementor-inner\">\n\t\t\t\t\t\t\t<div class=\"elementor-section-wrap\">\n\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-3fbee80 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"3fbee80\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t\t\t<div class=\"elementor-row\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-b1a8e94\" data-id=\"b1a8e94\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-column-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-920db43 elementor-widget elementor-widget-heading\" data-id=\"920db43\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\"><p data-pm-slice=\"1 1 []\"> CRTCE Fax Referral Form<span style=\"color: rgb(0, 159, 202); font-size: 31px;\"><\/span><\/p><\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-8acdf5c elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"8acdf5c\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t\t\t<div class=\"elementor-row\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-a0ec702\" data-id=\"a0ec702\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-column-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-38d76f2 elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"38d76f2\" data-element_type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">&nbsp; &nbsp; Typed referrals are preferred. If hand-written, please ensure writing is legible or we will be unable to process the referral.<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">&nbsp; &nbsp;  We will only accept a fully completed form. <\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">&nbsp; &nbsp; Please ensure that the patient's health card is up to date.<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">&nbsp; &nbsp; Please ensure that the patient meets the clinic's inclusion\/exclusion criteria.<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">&nbsp; &nbsp; For our French language form please contact the Montreal clinic direct at <a href=\"tel:15144817867\" style=\"font-size: 16px; display: inline !important;\">(514) 481-7867<\/a> or send an email to <a href=\"mailto:montreal@crtce.com\" style=\"font-size: 16px; display: inline !important;\">montreal@crtce.com<\/a>.<a href=\"mailto:montreal@crtce.com\"><span style=\"color: var( --e-global-color-secondary ); font-size: 16px;\"><\/span><\/a><\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-54de9af elementor-widget elementor-widget-spacer\" data-id=\"54de9af\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5f2c8e6 elementor-widget elementor-widget-html\" data-id=\"5f2c8e6\" data-element_type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<div>\n<input type=\"checkbox\" id=\"checkme\" onchange=\"isChecked(this, 'downbtn')\">&nbsp; <b>I acknowledge the above policies and will complete the form fully.<\/b>\n<\/div>\n<div id=\"agreest\" hidden><p style=\"color:red;font-weight: bold;\">Please click the above checkbox to agree with the statement!<\/p><\/div>\n<script>\nfunction isChecked(checkbox, btn) {\n    var button = document.getElementById(btn);\n    \n    var div = document.getElementById(\"agreest\");\n\n\n    if (checkbox.checked === true) {\n        \/\/button.disabled = \"\";\n     targetDiv.style.display = \"none\";\n     \n    } \n}\n<\/script>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-c52da41 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"c52da41\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t\t\t<div class=\"elementor-row\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-b36548c\" data-id=\"b36548c\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-column-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-33d2448 elementor-widget elementor-widget-html\" data-id=\"33d2448\" data-element_type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<p>\n<div class=\"elementor-button-wrapper\">\n<button class=\"elementor-button elementor-size-md elementor-animation-hang\" id=\"downbtn\"><i class=\"fa fa-download\"><\/i> Download PDF Form<\/button>\n<\/div>\n\n\n\n<script>\n    const targetDiv = document.getElementById(\"agreest\");\n    const btn = document.getElementById(\"downbtn\");\n    const checkme = document.getElementById(\"checkme\");\n    btn.onclick = function () {\n      if (targetDiv.style.display !== \"none\" && checkme.checked) {\n          \/\/hidde\n        targetDiv.style.display = \"none\";\n      }\n      \n      else if \n    ( checkme.checked) {\n          \/\/hidde\n        targetDiv.style.display = \"none\";\n        window.open('https:\/\/crtce.com\/wp-content\/uploads\/2022\/07\/CRTCE-PhysiciansReferralForm-2022-06-30_Editable.pdf'); 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If hand-written, please ensure writing is legible or we will be unable to process the referral. &nbsp; &nbsp; We will only accept a fully completed form. &nbsp; &nbsp; Please ensure that the patient&#8217;s health card is up to date. &nbsp; &nbsp; Please ensure that the [&hellip;]<\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"inline_featured_image":false},"_links":{"self":[{"href":"https:\/\/crtce.com\/fr\/wp-json\/wp\/v2\/pages\/2696"}],"collection":[{"href":"https:\/\/crtce.com\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/crtce.com\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/crtce.com\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/crtce.com\/fr\/wp-json\/wp\/v2\/comments?post=2696"}],"version-history":[{"count":82,"href":"https:\/\/crtce.com\/fr\/wp-json\/wp\/v2\/pages\/2696\/revisions"}],"predecessor-version":[{"id":2802,"href":"https:\/\/crtce.com\/fr\/wp-json\/wp\/v2\/pages\/2696\/revisions\/2802"}],"wp:attachment":[{"href":"https:\/\/crtce.com\/fr\/wp-json\/wp\/v2\/media?parent=2696"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}