{"id":2585,"date":"2026-05-08T07:38:31","date_gmt":"2026-05-08T07:38:31","guid":{"rendered":"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/?page_id=2585"},"modified":"2026-06-04T07:13:08","modified_gmt":"2026-06-04T07:13:08","slug":"doctor-referrals","status":"publish","type":"page","link":"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/doctor-referrals\/","title":{"rendered":"Doctor Referrals"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"2585\" class=\"elementor elementor-2585\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-8cdae8c e-con-full e-flex e-con e-child\" data-id=\"8cdae8c\" 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-a6f2dc4 elementor-widget elementor-widget-heading\" data-id=\"a6f2dc4\" 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\">Doctor Referrals<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-0b116f5 e-flex e-con-boxed elementor-invisible e-con e-parent\" data-id=\"0b116f5\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;animation&quot;:&quot;fadeInUp&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-a22e7af e-con-full contact-form e-flex e-con e-child\" data-id=\"a22e7af\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-5a866de medianv-form elementor-widget__width-inherit elementor-widget elementor-widget-shortcode\" data-id=\"5a866de\" 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\"><script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_5' style='display:none'><div id='gf_5' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_5' id='gform_5'  action='\/aubintmjorthodonticcenter\/wp-json\/wp\/v2\/pages\/2585#gf_5' data-formid='5' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_5' class='gform_fields top_label form_sublabel_below description_below validation_below' data-column-layout='fill'><div id=\"field_5_18\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_5_18' class='gfield_label gform-field-label' for='input_5_18'><span class='gform-field-label__text'>URL<\/span><\/label><div class='ginput_container'><input name='input_18' id='input_5_18' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_5_18'>This field is for validation purposes and should be left unchanged.<\/div><\/div><div id=\"field_5_1\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third only-letters-field gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\" data-group-id=\"f5129cf4\" data-field-span=\"4\"><label id='gfield_label_5_1' class='gfield_label gform-field-label' for='input_5_1'><span class='gform-field-label__text'>Referring Doctor Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_1' id='input_5_1' type='text' value='' class='large'    placeholder='Referring Doctor Name*' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_5_13\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third only-letters-field gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\" data-group-id=\"f5129cf4\" data-field-span=\"4\"><label id='gfield_label_5_13' class='gfield_label gform-field-label' for='input_5_13'><span class='gform-field-label__text'>Name of Patient Being Referred<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_5_13' type='text' value='' class='large'    placeholder='Name of Patient Being Referred*' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_5_6\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\" data-group-id=\"f5129cf4\" data-field-span=\"4\"><label id='gfield_label_5_6' class='gfield_label gform-field-label' for='input_5_6'><span class='gform-field-label__text'>Phone# of Patient Being Referred<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_6' id='input_5_6' type='tel' value='' class='large'  placeholder='Phone# of Patient Being Referred*' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/div><div id=\"field_5_8\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\" data-group-id=\"27549585\" data-field-span=\"4\"><label id='gfield_label_5_8' class='gfield_label gform-field-label' for='input_5_8'><span class='gform-field-label__text'>Requested Appointment Date<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='Requested Appointment Date*'\n\t\t\t\t\tid='input_5_8'\n\t\t\t\t\tclass='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_8'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\taria-required=\"true\"\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_5_8' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_5_8' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_5_8' aria-label='Requested Appointment Date: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/div><div id=\"field_5_9\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\" data-group-id=\"27549585\" data-field-span=\"4\"><label id='gfield_label_5_9' class='gfield_label gform-field-label' for='input_5_9'><span class='gform-field-label__text'>Requested Appointment Time<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_9' id='input_5_9' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Requested Appointment Time*<\/option><option value='Morning' >Morning<\/option><option value='Afternoon' >Afternoon<\/option><option value='Evening' >Evening<\/option><\/select><\/div><\/div><div id=\"field_5_15\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\" data-group-id=\"27549585\" data-field-span=\"4\"><label id='gfield_label_5_15' class='gfield_label gform-field-label' for='input_5_15'><span class='gform-field-label__text'>Radiographs Enclosed?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_15' id='input_5_15' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Radiographs Enclosed?*<\/option><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/div><div id=\"field_5_16\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"ec49aa0c\" data-field-span=\"12\"><label id='gfield_label_5_16' class='gfield_label gform-field-label' for='input_5_16'><span class='gform-field-label__text'>If yes, please attach below<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input name='input_16' id='input_5_16' type='file' class='large' aria-describedby=\"gfield_upload_rules_5_16\" onchange='javascript:gformValidateFileSize( this, 12884901888 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_5_16'>Accepted file types: jpeg, Max. file size: 12 GB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_5_16'><\/div> <\/div><\/div><fieldset id=\"field_5_14\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"b4ad8fd8\" data-field-span=\"12\"><legend id='gfield_label_5_14' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Patient Being Referred Has Following Orthodontic Problem<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_5_14'><div class='gchoice gchoice_5_14_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.1' type='checkbox'  value='AAO Recommended Checkup'  id='choice_5_14_1'    aria-labelledby=\"label_5_14_1 gfield_label_5_14\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_1' id='label_5_14_1' class='gform-field-label gform-field-label--type-inline'>AAO Recommended Checkup<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_14_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.2' type='checkbox'  value='Crowding'  id='choice_5_14_2'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_2' id='label_5_14_2' class='gform-field-label gform-field-label--type-inline'>Crowding<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_14_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.3' type='checkbox'  value='Overjet \/ Overebite'  id='choice_5_14_3'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_3' id='label_5_14_3' class='gform-field-label gform-field-label--type-inline'>Overjet \/ Overebite<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_14_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.4' type='checkbox'  value='Missing Teeth'  id='choice_5_14_4'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_4' id='label_5_14_4' class='gform-field-label gform-field-label--type-inline'>Missing Teeth<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_14_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.5' type='checkbox'  value='Ectopic Eruption'  id='choice_5_14_5'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_5' id='label_5_14_5' class='gform-field-label gform-field-label--type-inline'>Ectopic Eruption<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_14_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.6' type='checkbox'  value='Impacted Teeth'  id='choice_5_14_6'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_6' id='label_5_14_6' class='gform-field-label gform-field-label--type-inline'>Impacted Teeth<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_14_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.7' type='checkbox'  value='TMJ Symptoms \/ Headache'  id='choice_5_14_7'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_7' id='label_5_14_7' class='gform-field-label gform-field-label--type-inline'>TMJ Symptoms \/ Headache<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_14_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.8' type='checkbox'  value='X-Bite'  id='choice_5_14_8'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_8' id='label_5_14_8' class='gform-field-label gform-field-label--type-inline'>X-Bite<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_14_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.9' type='checkbox'  value='Asymmetry'  id='choice_5_14_9'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_9' id='label_5_14_9' class='gform-field-label gform-field-label--type-inline'>Asymmetry<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_14_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.11' type='checkbox'  value='Underbite \/ CLIII'  id='choice_5_14_11'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_11' id='label_5_14_11' class='gform-field-label gform-field-label--type-inline'>Underbite \/ CLIII<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_14_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.12' type='checkbox'  value='Habits'  id='choice_5_14_12'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_12' id='label_5_14_12' class='gform-field-label gform-field-label--type-inline'>Habits<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_14_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.13' type='checkbox'  value='Grinds Teeth at Night'  id='choice_5_14_13'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_13' id='label_5_14_13' class='gform-field-label gform-field-label--type-inline'>Grinds Teeth at Night<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_14_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.14' type='checkbox'  value='Neckaches'  id='choice_5_14_14'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_14' id='label_5_14_14' class='gform-field-label gform-field-label--type-inline'>Neckaches<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_14_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.15' type='checkbox'  value='Limited Jaw Opening'  id='choice_5_14_15'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_15' id='label_5_14_15' class='gform-field-label gform-field-label--type-inline'>Limited Jaw Opening<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_14_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.16' type='checkbox'  value='Dizziness'  id='choice_5_14_16'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_16' id='label_5_14_16' class='gform-field-label gform-field-label--type-inline'>Dizziness<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_14_17'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.17' type='checkbox'  value='Clicking or Jaw Locking'  id='choice_5_14_17'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_17' id='label_5_14_17' class='gform-field-label gform-field-label--type-inline'>Clicking or Jaw Locking<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_14_18'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.18' type='checkbox'  value='Ear Pain'  id='choice_5_14_18'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_18' id='label_5_14_18' class='gform-field-label gform-field-label--type-inline'>Ear Pain<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_14_19'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.19' type='checkbox'  value='Chronic Fatigue'  id='choice_5_14_19'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_19' id='label_5_14_19' class='gform-field-label gform-field-label--type-inline'>Chronic Fatigue<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_14_21'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.21' type='checkbox'  value='Fainting'  id='choice_5_14_21'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_21' id='label_5_14_21' class='gform-field-label gform-field-label--type-inline'>Fainting<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_14_22'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.22' type='checkbox'  value='Ringing in the Ears'  id='choice_5_14_22'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_22' id='label_5_14_22' class='gform-field-label gform-field-label--type-inline'>Ringing in the Ears<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_14_23'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.23' type='checkbox'  value='Clenching'  id='choice_5_14_23'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_23' id='label_5_14_23' class='gform-field-label gform-field-label--type-inline'>Clenching<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_14_24'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.24' type='checkbox'  value='Shoulder or Back Pain'  id='choice_5_14_24'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_24' id='label_5_14_24' class='gform-field-label gform-field-label--type-inline'>Shoulder or Back Pain<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_14_25'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.25' type='checkbox'  value='Other'  id='choice_5_14_25'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_25' id='label_5_14_25' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_5_17\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"32090fd8\" data-field-span=\"12\"><legend id='gfield_label_5_17' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Consent<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_17.1' id='input_5_17_1' type='checkbox' value='1'   aria-labelledby=\"input_5_17_1_label gfield_label_5_17\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label id='input_5_17_1_label' class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_5_17_1' ><span class='gform-field-label__text'>By providing my phone number, I consent to receive SMS text messages from Aubin Orthodontics for appointment reminders, marketing messages, and general two-way communication. Msg frequency varies. Msg&data rates may apply. Reply HELP for support. Reply STOP to opt out. Refer to our <a href=\"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/privacy-policy\/\">privacy policy<\/a> and <a href=\"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/terms-and-conditions\/\">terms and conditions<\/a> for more information.<\/span><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/label><input type='hidden' name='input_17.2' value='By providing my phone number, I consent to receive SMS text messages from Aubin Orthodontics for appointment reminders, marketing messages, and general two-way communication. Msg frequency varies. Msg&amp;data rates may apply. Reply HELP for support. Reply STOP to opt out. Refer to our &lt;a href=&quot;https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/privacy-policy\/&quot;&gt;privacy policy&lt;\/a&gt; and &lt;a href=&quot;https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/terms-and-conditions\/&quot;&gt;terms and conditions&lt;\/a&gt; for more information.' class='gform_hidden' \/><input type='hidden' name='input_17.3' value='2' class='gform_hidden' \/><\/div><\/fieldset><div id=\"field_5_11\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"333da496\" data-field-span=\"12\"><div class='ginput_container ginput_container_text'><input name='input_11' id='input_5_11' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/wp-json\/wp\/v2\/pages\/2585' \/><\/div><\/div><div id=\"field_5_10\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"a98a9b89\" data-field-span=\"12\"><div class='ginput_container ginput_container_text'><input name='input_10' id='input_5_10' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <button type='submit' id='gform_submit_button_5' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Submit<\/button> <input type='hidden' name='gform_ajax' value='form_id=5&amp;title=&amp;description=1&amp;tabindex=0&amp;theme=gravity-theme&amp;styles=[]&amp;hash=c878f878b969680c11a0ed521908ff2f' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_5' value='iframe' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_5' id='gform_theme_5' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_5' id='gform_style_settings_5' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_5' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='5' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='slKggyD0CFtedCijaIMNVsV6N8v0ZPuztXzhnxjd6LBA8N03LBcQF4NLcLQFzvS\/CgqWGsBWsWes127N2vl2Oy9zD2vIO1Di62Ed\/oeDOk6wOh8=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_5' value='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' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_5' id='gform_target_page_number_5' value='0' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_5' id='gform_source_page_number_5' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/form>\n                        <\/div>\n\t\t                <iframe style='display:none;width:0px;height:0px;' src='about:blank' name='gform_ajax_frame_5' id='gform_ajax_frame_5' title='This iframe contains the logic required to handle Ajax powered Gravity Forms.'><\/iframe>\n\t\t                <script>\ngform.initializeOnLoaded( function() {jQuery('#gform_ajax_frame_5').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_5');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_5').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){form_content.find('form').css('opacity', 0);jQuery('#gform_wrapper_5').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_5').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_5').removeClass('gform_validation_error');}setTimeout( function() { \/* delay the scroll by 50 milliseconds to fix a bug in chrome *\/ jQuery(document).scrollTop(jQuery('#gform_wrapper_5').offset().top - mt); }, 50 );var current_page = jQuery('#gform_source_page_number_5').val();jQuery(document).trigger('gform_page_loaded', [5, current_page]);window['gf_submitting_5'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}jQuery('#gform_wrapper_5').replaceWith(confirmation_content);jQuery(document).scrollTop(jQuery('#gf_5').offset().top - mt);jQuery(document).trigger('gform_confirmation_loaded', [5]);if(window.gform && gform.pagination && gform.pagination.removePageQueryArg){gform.pagination.removePageQueryArg(5);}window['gf_submitting_5'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_5').text());}else{jQuery('#gform_5').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger(\"gform_pre_post_render\", [{ formId: \"5\", currentPage: \"current_page\", abort: function() { this.preventDefault(); } }]);        if (event && event.defaultPrevented) {                return;        }        const gformWrapperDiv = document.getElementById( \"gform_wrapper_5\" );        if ( gformWrapperDiv ) {            const visibilitySpan = document.createElement( \"span\" );            visibilitySpan.id = \"gform_visibility_test_5\";            gformWrapperDiv.insertAdjacentElement( \"afterend\", visibilitySpan );        }        const visibilityTestDiv = document.getElementById( \"gform_visibility_test_5\" );        let postRenderFired = false;        function triggerPostRender() {            if ( postRenderFired ) {                return;            }            postRenderFired = true;            gform.core.triggerPostRenderEvents( 5, current_page );            if ( visibilityTestDiv ) {                visibilityTestDiv.parentNode.removeChild( visibilityTestDiv );            }        }        function debounce( func, wait, immediate ) {            var timeout;            return function() {                var context = this, args = arguments;                var later = function() {                    timeout = null;                    if ( !immediate ) func.apply( context, args );                };                var callNow = immediate && !timeout;                clearTimeout( timeout );                timeout = setTimeout( later, wait );                if ( callNow ) func.apply( context, args );            };        }        const debouncedTriggerPostRender = debounce( function() {            triggerPostRender();        }, 200 );        if ( visibilityTestDiv && visibilityTestDiv.offsetParent === null ) {            const observer = new MutationObserver( ( mutations ) => {                mutations.forEach( ( mutation ) => {                    if ( mutation.type === 'attributes' && visibilityTestDiv.offsetParent !== null ) {                        debouncedTriggerPostRender();                        observer.disconnect();                    }                });            });            observer.observe( document.body, {                attributes: true,                childList: false,                subtree: true,                attributeFilter: [ 'style', 'class' ],            });        } else {            triggerPostRender();        }    } );} );\n<\/script>\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\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-2585","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Doctor Referral Information in Northborough, MA<\/title>\n<meta name=\"description\" content=\"Find referral information and resources for healthcare providers seeking orthodontic or TMJ treatment support in Northborough, MA.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Doctor Referral Information in Northborough, MA\" \/>\n<meta property=\"og:description\" content=\"Find referral information and resources for healthcare providers seeking orthodontic or TMJ treatment support in Northborough, MA.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/doctor-referrals\/\" \/>\n<meta property=\"og:site_name\" content=\"Aubin TMJ &amp; Orthodontic Center\" \/>\n<meta property=\"article:modified_time\" content=\"2026-06-04T07:13:08+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"1 minute\" \/>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Doctor Referral Information in Northborough, MA","description":"Find referral information and resources for healthcare providers seeking orthodontic or TMJ treatment support in Northborough, MA.","robots":{"index":"noindex","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"og_locale":"en_US","og_type":"article","og_title":"Doctor Referral Information in Northborough, MA","og_description":"Find referral information and resources for healthcare providers seeking orthodontic or TMJ treatment support in Northborough, MA.","og_url":"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/doctor-referrals\/","og_site_name":"Aubin TMJ &amp; Orthodontic Center","article_modified_time":"2026-06-04T07:13:08+00:00","twitter_card":"summary_large_image","twitter_misc":{"Est. reading time":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/doctor-referrals\/","url":"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/doctor-referrals\/","name":"Doctor Referral Information in Northborough, MA","isPartOf":{"@id":"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/#website"},"datePublished":"2026-05-08T07:38:31+00:00","dateModified":"2026-06-04T07:13:08+00:00","description":"Find referral information and resources for healthcare providers seeking orthodontic or TMJ treatment support in Northborough, MA.","breadcrumb":{"@id":"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/doctor-referrals\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/doctor-referrals\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/doctor-referrals\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/"},{"@type":"ListItem","position":2,"name":"Doctor Referrals"}]},{"@type":"WebSite","@id":"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/#website","url":"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/","name":"Elementor Templates 1","description":"","publisher":{"@id":"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/#organization","name":"Elementor Templates 1","url":"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/#\/schema\/logo\/image\/","url":"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/wp-content\/uploads\/2025\/11\/logo.svg","contentUrl":"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/wp-content\/uploads\/2025\/11\/logo.svg","width":895,"height":229,"caption":"Elementor Templates 1"},"image":{"@id":"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/#\/schema\/logo\/image\/"}}]}},"_links":{"self":[{"href":"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/wp-json\/wp\/v2\/pages\/2585","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/wp-json\/wp\/v2\/comments?post=2585"}],"version-history":[{"count":4,"href":"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/wp-json\/wp\/v2\/pages\/2585\/revisions"}],"predecessor-version":[{"id":2591,"href":"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/wp-json\/wp\/v2\/pages\/2585\/revisions\/2591"}],"wp:attachment":[{"href":"https:\/\/medianvwp.com\/aubintmjorthodonticcenter\/wp-json\/wp\/v2\/media?parent=2585"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}