{"id":518,"date":"2023-12-30T14:49:11","date_gmt":"2023-12-30T19:49:11","guid":{"rendered":"https:\/\/numericadentaire.ca\/nouvelle-prothese-rdv\/"},"modified":"2024-04-11T16:07:32","modified_gmt":"2024-04-11T20:07:32","slug":"new-prosthesis-implant-form","status":"publish","type":"page","link":"https:\/\/numericadentaire.ca\/en\/new-prosthesis-implant-form\/","title":{"rendered":"Book an appointment"},"content":{"rendered":"<h2>Need a digital dental implant or prosthesis?<\/h2>\n<p>Get a <strong>free 60-minute consultation*<\/strong> with one of our professionals.<\/p>\n<p>With the click of a button, schedule an appointment with the Num\u00e9rica Dentaire team to assess your dental health and eligibility for a first surgical denture or dental implant.<\/p>\n<p>Your free consultation entitles you to an evaluation with a dental surgeon (for the implant) and a denturologist (for the prosthesis). The consultation includes an X-ray and an intro-oral scan. All with no obligation on your part and <strong>a value of $600!<\/strong><\/p>\n<p>To make an appointment, please fill out the following consultation form, and our team will be happy to contact you as soon as possible to choose the day and time that's right for you.<\/p>\n<p><strong>*Terms of use:<\/strong><\/p>\n<ul>\n<li>A 48-hour notice is required for cancellations.<\/li>\n<li>Fees may be charged for failure to keep an appointment without prior cancellation.<\/li>\n<\/ul>\n<h2>Free consultation form <strong>60 minutes free of charge*<\/strong>.<\/h2>\n<h4>First prosthesis and digital dental implant placement<\/h4>\n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f538-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"538\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/en\/wp-json\/wp\/v2\/pages\/518#wpcf7-f538-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" 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value=\"{&quot;form_id&quot;:538,&quot;conditions&quot;:[],&quot;settings&quot;:{&quot;animation&quot;:&quot;yes&quot;,&quot;animation_intime&quot;:200,&quot;animation_outtime&quot;:200,&quot;conditions_ui&quot;:&quot;normal&quot;,&quot;notice_dismissed&quot;:false,&quot;notice_dismissed_rollback-cf7-5.8.7&quot;:true,&quot;notice_dismissed_rollback-cf7-5.9.2&quot;:true}}\" \/>\n<\/fieldset>\n<p>\t\t<div id=\"cf7md-form\" class=\"cf7md-form\">\n\t\t\t<div class=\"mdc-layout-grid\">\n\t\t\t\t<div class=\"mdc-layout-grid__inner\">\n\t\t\t\t\t\t\t\t\t\t\n\t\t\n\t\t<div class=\"cf7md-item cf7md-text mdc-layout-grid__cell mdc-layout-grid__cell--span-6-desktop mdc-layout-grid__cell--span-6-tablet mdc-layout-grid__cell--span-4-phone\">\n\t\t\t<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"prenom\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"prenom\" \/><\/span><br \/>\n\t\t\t\t\t\t<div style=\"display: none;\" class=\"cf7md-text-html\">\n\t\t\t\t<div class=\"mdc-text-field  mdc-text-field--outlined\">\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"mdc-notched-outline\">\n\t\t\t\t\t\t\t<div class=\"mdc-notched-outline__leading\"><\/div>\n\t\t\t\t\t\t\t<div class=\"mdc-notched-outline__notch\">\n\t\t\t\t\t\t\t\t<label class=\"mdc-floating-label\">First name<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"mdc-notched-outline__trailing\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<br \/>\n\t\t\n\t\t<div class=\"cf7md-item cf7md-text mdc-layout-grid__cell mdc-layout-grid__cell--span-6-desktop mdc-layout-grid__cell--span-6-tablet mdc-layout-grid__cell--span-4-phone\">\n\t\t\t<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"nom\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"nom\" \/><\/span><br \/>\n\t\t\t\t\t\t<div style=\"display: none;\" class=\"cf7md-text-html\">\n\t\t\t\t<div class=\"mdc-text-field  mdc-text-field--outlined\">\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"mdc-notched-outline\">\n\t\t\t\t\t\t\t<div class=\"mdc-notched-outline__leading\"><\/div>\n\t\t\t\t\t\t\t<div class=\"mdc-notched-outline__notch\">\n\t\t\t\t\t\t\t\t<label class=\"mdc-floating-label\">Last name<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"mdc-notched-outline__trailing\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<br \/>\n\t\t\n\t\t<div class=\"cf7md-item cf7md-text mdc-layout-grid__cell mdc-layout-grid__cell--span-6-desktop mdc-layout-grid__cell--span-6-tablet mdc-layout-grid__cell--span-4-phone\">\n\t\t\t<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"courriel\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"courriel\" \/><\/span><br \/>\n\t\t\t\t\t\t<div style=\"display: none;\" class=\"cf7md-text-html\">\n\t\t\t\t<div class=\"mdc-text-field  mdc-text-field--outlined\">\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"mdc-notched-outline\">\n\t\t\t\t\t\t\t<div class=\"mdc-notched-outline__leading\"><\/div>\n\t\t\t\t\t\t\t<div class=\"mdc-notched-outline__notch\">\n\t\t\t\t\t\t\t\t<label class=\"mdc-floating-label\">E-mail<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"mdc-notched-outline__trailing\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<br \/>\n\t\t\n\t\t<div class=\"cf7md-item cf7md-text mdc-layout-grid__cell mdc-layout-grid__cell--span-6-desktop mdc-layout-grid__cell--span-6-tablet mdc-layout-grid__cell--span-4-phone\">\n\t\t\t<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"tel\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"tel\" \/><\/span><br \/>\n\t\t\t\t\t\t<div style=\"display: none;\" class=\"cf7md-text-html\">\n\t\t\t\t<div class=\"mdc-text-field  mdc-text-field--outlined\">\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"mdc-notched-outline\">\n\t\t\t\t\t\t\t<div class=\"mdc-notched-outline__leading\"><\/div>\n\t\t\t\t\t\t\t<div class=\"mdc-notched-outline__notch\">\n\t\t\t\t\t\t\t\t<label class=\"mdc-floating-label\">Phone<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"mdc-notched-outline__trailing\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<br \/>\n\t\t<div class=\"cf7md-item cf7md-checkbox mdc-layout-grid__cell mdc-layout-grid__cell--span-12-desktop mdc-layout-grid__cell--span-12-tablet mdc-layout-grid__cell--span-4-phone cf7md-list cf7md-list__stacked\">\n\t\t\t\t\t\t\t<label class=\"cf7md-label cf7md-label--static\">Consultation requested for*<\/label>\n\t\t\t\t\t\t<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-937\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-937&#091;&#093;\" value=\"Dental prosthesis\" \/><span class=\"wpcf7-list-item-label\">Dental prosthesis<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-937&#091;&#093;\" value=\"Dental implant\" \/><span class=\"wpcf7-list-item-label\">Dental implant<\/span><\/label><\/span><\/span><\/span><br \/>\n\t\t\t<div style=\"display: none;\" class=\"cf7md-checkbox-html\">\n\t\t\t\t<div class=\"mdc-checkbox__background\">\n\t\t\t\t\t<svg class=\"mdc-checkbox__checkmark\" viewBox=\"0 0 24 24\">\n\t\t\t\t\t\t<path class=\"mdc-checkbox__checkmark-path\" fill=\"none\" d=\"M1.73,12.91 8.1,19.28 22.79,4.59\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t\t<div class=\"mdc-checkbox__mixedmark\"><\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\n<\/p>\n<p>\n\t\t<div class=\"cf7md-item cf7md-textarea mdc-layout-grid__cell mdc-layout-grid__cell--span-12-desktop mdc-layout-grid__cell--span-12-tablet mdc-layout-grid__cell--span-4-phone cf7md-textarea-autosize\">\n\t\t\t<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-message\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"your-message\"><\/textarea><\/span><br \/>\n\t\t\t\t\t\t<div style=\"display: none;\" class=\"cf7md-text-html\">\n\t\t\t\t<div class=\"mdc-text-field  mdc-text-field--textarea\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"mdc-notched-outline\">\n\t\t\t\t\t\t<div class=\"mdc-notched-outline__leading\"><\/div>\n\t\t\t\t\t\t<div class=\"mdc-notched-outline__notch\">\n\t\t\t\t\t\t\t<label class=\"mdc-floating-label\">Comments or special requests<\/label>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"mdc-notched-outline__trailing\"><\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<br \/>\n<span id=\"wpcf7-69e02d0a3e274-wrapper\" class=\"wpcf7-form-control-wrap email-good-wrap\" ><input type=\"hidden\" name=\"email-good-time-start\" value=\"1776299274\"><input type=\"hidden\" name=\"email-good-time-check\" value=\"4\"><label for=\"wpcf7-69e02d0a3e274-field\" class=\"hp-message\">Please leave this field empty.<\/label><input id=\"wpcf7-69e02d0a3e274-field\"  class=\"wpcf7-form-control wpcf7-text\" type=\"text\" name=\"email-good\" value=\"\" size=\"40\" tabindex=\"-1\" autocomplete=\"new-password\" \/><\/span><br \/>\n\t\t<div class=\"cf7md-item cf7md-checkbox mdc-layout-grid__cell mdc-layout-grid__cell--span-12-desktop mdc-layout-grid__cell--span-8-tablet mdc-layout-grid__cell--span-4-phone cf7md-list cf7md-list__stacked\">\n\t\t\t\t\t\t\t<label class=\"cf7md-label cf7md-label--static\">Please accept the terms of use of the 60 minutes free consultation*<\/label>\n\t\t\t\t\t\t<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"acceptance-758\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"acceptance-758\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">A 48-hour notice is required for cancellations. Fees may be charged for failure to keep an appointment without prior cancellation.<\/span><\/label><\/span><\/span><\/span>\t\t\t<div style=\"display: none;\" class=\"cf7md-checkbox-html\">\n\t\t\t\t<div class=\"mdc-checkbox__background\">\n\t\t\t\t\t<svg class=\"mdc-checkbox__checkmark\" viewBox=\"0 0 24 24\">\n\t\t\t\t\t\t<path class=\"mdc-checkbox__checkmark-path\" fill=\"none\" d=\"M1.73,12.91 8.1,19.28 22.79,4.59\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t\t<div class=\"mdc-checkbox__mixedmark\"><\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\n<\/p>\n\t\t<div class=\"cf7md-item cf7md-checkbox mdc-layout-grid__cell mdc-layout-grid__cell--span-12-desktop mdc-layout-grid__cell--span-8-tablet mdc-layout-grid__cell--span-4-phone cf7md-list cf7md-list__stacked\">\n\t\t\t\t\t\t\t<label class=\"cf7md-label cf7md-label--static\">Privacy policy*<\/label>\n\t\t\t\t\t\t\n<p class=\"politique\">By checking this box, you understand and agree that the information you submit will be stored and accessed in accordance with our <a href=\"\/en\/privacy-policy\/\" target=\"_blank\">privacy policy<\/a>.\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"acceptance-759\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"acceptance-759\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">I have read and accept the privacy policy<\/a>.<\/span><\/label><\/span><\/span><\/span>\t\t\t<div style=\"display: none;\" class=\"cf7md-checkbox-html\">\n\t\t\t\t<div class=\"mdc-checkbox__background\">\n\t\t\t\t\t<svg class=\"mdc-checkbox__checkmark\" viewBox=\"0 0 24 24\">\n\t\t\t\t\t\t<path class=\"mdc-checkbox__checkmark-path\" fill=\"none\" d=\"M1.73,12.91 8.1,19.28 22.79,4.59\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t\t<div class=\"mdc-checkbox__mixedmark\"><\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<br \/>\n<span id=\"wpcf7-69e02d0a3e339-wrapper\" class=\"wpcf7-form-control-wrap email-good-wrap\" ><input type=\"hidden\" name=\"email-good-time-start\" value=\"1776299274\"><input type=\"hidden\" name=\"email-good-time-check\" value=\"4\"><label for=\"wpcf7-69e02d0a3e339-field\" class=\"hp-message\">Please leave this field empty.<\/label><input id=\"wpcf7-69e02d0a3e339-field\"  class=\"wpcf7-form-control wpcf7-text\" type=\"text\" name=\"email-good\" value=\"\" size=\"40\" tabindex=\"-1\" autocomplete=\"new-password\" \/><\/span><br \/>\n\t\t<div class=\"cf7md-item cf7md-submit mdc-layout-grid__cell mdc-layout-grid__cell--span-12-desktop mdc-layout-grid__cell--span-8-tablet mdc-layout-grid__cell--span-4-phone\" data-button-style=\"unelevated\">\n\t\t\t<br \/>\n<input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"SEND\" \/><br \/>\n\t\t\t<svg class=\"cf7md-spinner\" width=\"25px\" height=\"25px\" viewBox=\"0 0 66 66\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t<circle class=\"cf7md-spinner-path\" fill=\"none\" stroke-width=\"6\" stroke-linecap=\"round\" cx=\"33\" cy=\"33\" r=\"30\"><\/circle>\n\t\t\t<\/svg>\n\t\t<\/div>\n\t\t<br \/>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\n<\/p><input type='hidden' class='wpcf7-pum' value='{\"closepopup\":false,\"closedelay\":0,\"openpopup\":false,\"openpopup_id\":0}' \/><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>Need a digital dental implant or prosthesis? Get a free 60-minute consultation* with one of our professionals. With the click of a button, schedule an appointment with the Num\u00e9rica Dentaire team to assess your dental health and eligibility for a first surgical denture or dental implant. Your free consultation entitles you to an evaluation with [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":238,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page-plain.php","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-518","page","type-page","status-publish","has-post-thumbnail","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Book an appointment - Num\u00e9rica Dentaire<\/title>\n<meta name=\"description\" content=\"Get a free 60-minute consultation with one of our professionals. 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