{"id":316,"date":"2021-07-01T02:24:13","date_gmt":"2021-07-01T02:24:13","guid":{"rendered":"https:\/\/allaboutaba.com\/?page_id=316"},"modified":"2021-09-09T20:40:15","modified_gmt":"2021-09-09T20:40:15","slug":"aba-client-intake-form","status":"publish","type":"page","link":"https:\/\/allaboutaba.com\/contact-all-about-aba\/aba-client-intake-form\/","title":{"rendered":"Intake Form"},"content":{"rendered":"<p>[vc_row][vc_column css=&#8221;.vc_custom_1630093111295{background-image: url(https:\/\/allaboutaba.com\/wp-content\/uploads\/2021\/08\/Full-Pattern-Background.png?id=493) !important;background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;border-radius: 30px !important;}&#8221;][vc_column_text]<\/p>\n<h2 style=\"text-align: center; color: #fff;\">Intake Form<\/h2>\n<p>[\/vc_column_text]<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var 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<div class='gform_body gform-body'><div id='gform_fields_14' class='gform_fields top_label form_sublabel_below description_below'><fieldset id=\"field_14_2\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_hidden_label field_description_below hidden_label gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name' id='input_14_2'>\n                            \n                            <span id='input_14_2_3_container' class='name_first' >\n                                                    <input type='text' name='input_2.3' id='input_14_2_3' value=''   aria-required='true'   placeholder='First Name'  \/>\n                                                    <label for='input_14_2_3' class='hidden_sub_label screen-reader-text'>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_14_2_6_container' class='name_last' >\n                                                    <input type='text' name='input_2.6' id='input_14_2_6' value=''   aria-required='true'   placeholder='Last Name'  \/>\n                                                    <label for='input_14_2_6' class='hidden_sub_label screen-reader-text'>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_14_3\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_hidden_label field_description_below hidden_label gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Child&#039;s Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name' id='input_14_3'>\n                            \n                            <span id='input_14_3_3_container' class='name_first' >\n                                                    <input type='text' name='input_3.3' id='input_14_3_3' value=''   aria-required='true'   placeholder='Childs First Name'  \/>\n                                                    <label for='input_14_3_3' class='hidden_sub_label screen-reader-text'>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_14_3_6_container' class='name_last' >\n                                                    <input type='text' name='input_3.6' id='input_14_3_6' value=''   aria-required='true'   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gfield_visibility_visible\" ><label class='gfield_label' for='input_14_5' >Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_5' id='input_14_5' type='text' value='' class='large'   placeholder='Email' aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><fieldset id=\"field_14_6\" class=\"gfield gfield--width-full field_sublabel_hidden_label field_description_above hidden_label gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >City<\/legend>    \n                    <div class='ginput_complex ginput_container has_city ginput_container_address' id='input_14_6' >\n                        <span class='ginput_left address_city ginput_address_city' id='input_14_6_3_container' >\n                                    <input type='text' name='input_6.3' id='input_14_6_3' value=''   placeholder='City' aria-required='false'    \/>\n                                    <label for='input_14_6_3' id='input_14_6_3_label' class='hidden_sub_label screen-reader-text'>City<\/label>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_6.4' id='input_14_6_4' value=''\/><input type='hidden' class='gform_hidden' name='input_6.6' id='input_14_6_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><fieldset id=\"field_14_7\" class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >What services are you interested in?<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_14_7'><div class='gchoice gchoice_14_7_1'>\n\t\t\t\t\t\t\t\t<input 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