{"id":9,"date":"2016-05-26T16:40:22","date_gmt":"2016-05-26T16:40:22","guid":{"rendered":"http:\/\/localhost\/lincolnpharmacy\/?page_id=9"},"modified":"2021-03-15T11:07:28","modified_gmt":"2021-03-15T11:07:28","slug":"pharmacy-patients-refills","status":"publish","type":"page","link":"https:\/\/www.yourlincolnpharmacy.com\/index.php\/pharmacy-patients-refills\/","title":{"rendered":"Patients\/Refills"},"content":{"rendered":"<p>To refill your prescription, please follow the instructions by carefully filling out the form below.<\/p>\n<p>Please make sure to:<\/p>\n<ul>\n<li>Indicate delivery or pick up time<\/li>\n<li>Give us a new address if you have recently moved<\/li>\n<li>Provide an RX# or drug name<\/li>\n<\/ul>\n<div role=\"form\" class=\"wpcf7\" id=\"wpcf7-f604-o1\" lang=\"en-US\" dir=\"ltr\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/index.php\/wp-json\/wp\/v2\/pages\/9#wpcf7-f604-o1\" method=\"post\" class=\"wpcf7-form init\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"604\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"5.4\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f604-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/div>\n<div class=\"head\">\n<div class=\"col\">\n<div class=\"col-1\">\n   <label> Who is this prescription for? <\/label>\n  <\/div>\n<\/div>\n<div class=\"col\">\n<div class=\"col-2\">\n   <label> Last Name <span class=\"required\">*<\/span><br \/>\n     <span class=\"wpcf7-form-control-wrap last-name\"><input type=\"text\" name=\"last-name\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span> <\/label>\n  <\/div>\n<div class=\"col-2\">\n   <label> First Name <span class=\"required\">*<\/span><br \/>\n     <span class=\"wpcf7-form-control-wrap first-name\"><input type=\"text\" name=\"first-name\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span> <\/label>\n  <\/div>\n<\/div>\n<div class=\"col\">\n<div class=\"col-1\">\n   <label> Phone Number <span class=\"required\">*<\/span><br \/>\n     <span class=\"wpcf7-form-control-wrap phone-number\"><input type=\"text\" name=\"phone-number\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span> <\/label>\n  <\/div>\n<\/div>\n<div class=\"col\">\n<div class=\"col-1\">\n   <label> Rx Refill Numbers <\/label>\n  <\/div>\n<\/div>\n<div class=\"col\">\n<div class=\"col-1\">\n   <label> 1 <span class=\"required\">*<\/span><br \/>\n     <span class=\"wpcf7-form-control-wrap first-rx\"><input type=\"text\" name=\"first-rx\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span> <\/label>\n  <\/div>\n<\/div>\n<div class=\"col\">\n<div class=\"col-1\">\n   <label> 2<br \/>\n     <span class=\"wpcf7-form-control-wrap second-rx\"><input type=\"text\" name=\"second-rx\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span> <\/label>\n  <\/div>\n<\/div>\n<div class=\"col\">\n<div class=\"col-1\">\n   <label> 3<br \/>\n     <span class=\"wpcf7-form-control-wrap third-rx\"><input type=\"text\" name=\"third-rx\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span> <\/label>\n  <\/div>\n<\/div>\n<div class=\"col\">\n<div class=\"col-1\">\n   <label> 4<br \/>\n     <span class=\"wpcf7-form-control-wrap fourth-rx\"><input type=\"text\" name=\"fourth-rx\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span> <\/label>\n  <\/div>\n<\/div>\n<div class=\"col\">\n<div class=\"col-1\">\n   <label> 5<br \/>\n     <span class=\"wpcf7-form-control-wrap fifth-rx\"><input type=\"text\" name=\"fifth-rx\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span> <\/label>\n  <\/div>\n<\/div>\n<div class=\"col\">\n<div class=\"col-1\">\n   <label> ADD MORE PRESCRIPTIONS <\/label>\n  <\/div>\n<\/div>\n<div class=\"col\">\n<div class=\"col-2\">\n   <label> Name<br \/>\n     <span class=\"wpcf7-form-control-wrap name_\"><input type=\"text\" name=\"name_\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span> <\/label>\n  <\/div>\n<div class=\"col-2\">\n   <label> Qty<br \/>\n     <span class=\"wpcf7-form-control-wrap qty_\"><input type=\"text\" name=\"qty_\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span> <\/label>\n  <\/div>\n<\/div>\n<div class=\"col\">\n<div class=\"col-2\">\n   <label> Name<br \/>\n     <span class=\"wpcf7-form-control-wrap name__\"><input type=\"text\" name=\"name__\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span> <\/label>\n  <\/div>\n<div class=\"col-2\">\n   <label> Qty<br \/>\n     <span class=\"wpcf7-form-control-wrap qty__\"><input type=\"text\" name=\"qty__\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span> <\/label>\n  <\/div>\n<\/div>\n<div class=\"col\">\n<div class=\"col-2\">\n   <label> Name<br \/>\n     <span class=\"wpcf7-form-control-wrap name___\"><input type=\"text\" name=\"name___\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span> <\/label>\n  <\/div>\n<div class=\"col-2\">\n   <label> Qty<br \/>\n     <span class=\"wpcf7-form-control-wrap qty___\"><input type=\"text\" name=\"qty___\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span> <\/label>\n  <\/div>\n<\/div>\n<div class=\"col\">\n<div class=\"col-2\">\n   <label> Name<br \/>\n     <span class=\"wpcf7-form-control-wrap name____\"><input type=\"text\" name=\"name____\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span> <\/label>\n  <\/div>\n<div class=\"col-2\">\n   <label> Qty<br \/>\n     <span class=\"wpcf7-form-control-wrap qty____\"><input type=\"text\" name=\"qty____\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span> <\/label>\n  <\/div>\n<\/div>\n<div class=\"col\">\n<div class=\"col-2\">\n   <label> Name<br \/>\n     <span class=\"wpcf7-form-control-wrap name_____\"><input type=\"text\" name=\"name_____\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span> <\/label>\n  <\/div>\n<div class=\"col-2\">\n   <label> Qty<br \/>\n     <span class=\"wpcf7-form-control-wrap qty_____\"><input type=\"text\" name=\"qty_____\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span> <\/label>\n  <\/div>\n<\/div>\n<div class=\"col\">\n<div class=\"col-1\">\n   <label> PICK UP OR DELIVERY?<\/label><br \/>\n   <span class=\"wpcf7-form-control-wrap pick-up-or-delivery\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"pick-up-or-delivery\" value=\"Pickup\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Pickup<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"pick-up-or-delivery\" value=\"Delivery\" \/><span class=\"wpcf7-list-item-label\">Delivery<\/span><\/label><\/span><\/span><\/span>\n  <\/div>\n<\/div>\n<div class=\"col\">\n<div class=\"col-1\">\n   <label> Would you like us to notify you when your prescription(s) are ready?<\/label><br \/>\n     <span class=\"wpcf7-form-control-wrap prescription\"><select name=\"prescription\" class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\"><option value=\"No, thanks\">No, thanks<\/option><option value=\"Yes, via phone\">Yes, via phone<\/option><\/select><\/span>\n  <\/div>\n<\/div>\n<p><input type=\"submit\" value=\"Submit\" class=\"wpcf7-form-control wpcf7-submit\" \/>\n<\/p><\/div>\n<div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div><\/form><\/div>\n","protected":false},"excerpt":{"rendered":"<p>To refill your prescription, please follow the instructions by carefully filling out the form below. Please make sure to: Indicate delivery or pick up time Give us a new address if you have recently moved Provide an RX# or drug &hellip; <a href=\"https:\/\/www.yourlincolnpharmacy.com\/index.php\/pharmacy-patients-refills\/\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"open","ping_status":"open","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/www.yourlincolnpharmacy.com\/index.php\/wp-json\/wp\/v2\/pages\/9"}],"collection":[{"href":"https:\/\/www.yourlincolnpharmacy.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.yourlincolnpharmacy.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.yourlincolnpharmacy.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.yourlincolnpharmacy.com\/index.php\/wp-json\/wp\/v2\/comments?post=9"}],"version-history":[{"count":3,"href":"https:\/\/www.yourlincolnpharmacy.com\/index.php\/wp-json\/wp\/v2\/pages\/9\/revisions"}],"predecessor-version":[{"id":607,"href":"https:\/\/www.yourlincolnpharmacy.com\/index.php\/wp-json\/wp\/v2\/pages\/9\/revisions\/607"}],"wp:attachment":[{"href":"https:\/\/www.yourlincolnpharmacy.com\/index.php\/wp-json\/wp\/v2\/media?parent=9"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}