{"id":10068,"date":"2025-07-21T04:16:30","date_gmt":"2025-07-21T12:16:30","guid":{"rendered":"https:\/\/uat.tzuchi.org.sg\/medical-assistance-web-form\/"},"modified":"2026-09-27T03:39:03","modified_gmt":"2026-09-27T11:39:03","slug":"medical-assistance-enquiry-form","status":"publish","type":"page","link":"https:\/\/uat.tzuchi.org.sg\/zh-hans\/medical-assistance-enquiry-form\/","title":{"rendered":"\u533b\u7597\u63f4\u52a9\u7533\u8bf7\u8868"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"10068\" class=\"elementor elementor-10068 elementor-1968\" data-elementor-settings=\"{&quot;ha_cmc_init_switcher&quot;:&quot;no&quot;}\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-0b695de e-flex e-con-boxed e-con e-parent\" data-id=\"0b695de\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c4b7e90 elementor-widget elementor-widget-heading\" data-id=\"c4b7e90\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">\u533b\u7597\u63f4\u52a9\u7533\u8bf7\u8868<\/h1>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-7eff2d9 steps-form e-flex e-con-boxed e-con e-parent\" data-id=\"7eff2d9\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-559fd36 e-con-full e-flex e-con e-child\" data-id=\"559fd36\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-11ed4dc elementor-button-align-center elementor-widget elementor-widget-form\" data-id=\"11ed4dc\" data-element_type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Continue&quot;,&quot;step_previous_label&quot;:&quot;Back&quot;,&quot;step_type&quot;:&quot;number&quot;,&quot;button_width&quot;:&quot;100&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t\t<template id=\"cfef_logic_data_11ed4dc\" class=\"cfef_logic_data_js\" data-form-id=\"11ed4dc\">{&quot;field_db59d86&quot;:{&quot;display_mode&quot;:&quot;show&quot;,&quot;fire_action&quot;:&quot;All&quot;,&quot;file_types&quot;:&quot;png&quot;,&quot;logic_data&quot;:[{&quot;cfef_logic_field_id&quot;:&quot;applyfor&quot;,&quot;cfef_logic_field_is&quot;:&quot;==&quot;,&quot;cfef_logic_compare_value&quot;:&quot;\\u4ee3\\u4ed6\\u4eba&quot;,&quot;_id&quot;:&quot;6754043&quot;}]},&quot;field_c1fccbc&quot;:{&quot;display_mode&quot;:&quot;show&quot;,&quot;fire_action&quot;:&quot;All&quot;,&quot;file_types&quot;:&quot;png&quot;,&quot;logic_data&quot;:[{&quot;cfef_logic_field_id&quot;:&quot;field_db59d86&quot;,&quot;cfef_logic_field_is&quot;:&quot;==&quot;,&quot;cfef_logic_compare_value&quot;:&quot;\\u5426&quot;,&quot;_id&quot;:&quot;b806d05&quot;}]},&quot;field_c164e97&quot;:{&quot;display_mode&quot;:&quot;show&quot;,&quot;fire_action&quot;:&quot;All&quot;,&quot;file_types&quot;:&quot;png&quot;,&quot;logic_data&quot;:[{&quot;cfef_logic_field_id&quot;:&quot;applyfor&quot;,&quot;cfef_logic_field_is&quot;:&quot;==&quot;,&quot;cfef_logic_compare_value&quot;:&quot;On behalf&quot;,&quot;_id&quot;:&quot;109928a&quot;}]},&quot;field_4d20a01&quot;:{&quot;display_mode&quot;:&quot;show&quot;,&quot;fire_action&quot;:&quot;All&quot;,&quot;file_types&quot;:&quot;png&quot;,&quot;logic_data&quot;:[{&quot;cfef_logic_field_id&quot;:&quot;applyfor&quot;,&quot;cfef_logic_field_is&quot;:&quot;==&quot;,&quot;cfef_logic_compare_value&quot;:&quot;On behalf&quot;,&quot;_id&quot;:&quot;e8c9c93&quot;}]},&quot;field_1f84f07&quot;:{&quot;display_mode&quot;:&quot;show&quot;,&quot;fire_action&quot;:&quot;All&quot;,&quot;file_types&quot;:&quot;png&quot;,&quot;logic_data&quot;:[{&quot;cfef_logic_field_id&quot;:&quot;applyfor&quot;,&quot;cfef_logic_field_is&quot;:&quot;==&quot;,&quot;cfef_logic_compare_value&quot;:&quot;On behalf&quot;,&quot;_id&quot;:&quot;29332e8&quot;}]},&quot;field_7dfb21b&quot;:{&quot;display_mode&quot;:&quot;show&quot;,&quot;fire_action&quot;:&quot;All&quot;,&quot;file_types&quot;:&quot;png&quot;,&quot;logic_data&quot;:[{&quot;cfef_logic_field_id&quot;:&quot;applyfor&quot;,&quot;cfef_logic_field_is&quot;:&quot;==&quot;,&quot;cfef_logic_compare_value&quot;:&quot;On behalf&quot;,&quot;_id&quot;:&quot;a4fb0a7&quot;}]}}<\/template>\t\t<form class=\"elementor-form\" method=\"post\" name=\"Medical Assistance Enquiry CN\" aria-label=\"Medical Assistance Enquiry CN\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"10068\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"11ed4dc\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"\u533b\u7597\u63f4\u52a9\u7533\u8bf7\u8868\" \/>\n\n\t\t\t\t\t\t\t<input type=\"hidden\" name=\"queried_id\" value=\"10068\"\/>\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group-applyfor elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-applyfor\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t\u60a8\u662f\u4e3a\u81ea\u5df1\u7533\u8bf7\uff0c\u8fd8\u662f\u4ee3\u4ed6\u4eba\u7533\u8bf7\uff1f\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-eicon-caret-down\" viewBox=\"0 0 571.4 571.4\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M571 393Q571 407 561 418L311 668Q300 679 286 679T261 668L11 418Q0 407 0 393T11 368 36 357H536Q550 357 561 368T571 393Z\"><\/path><\/svg>\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[applyfor]\" id=\"form-field-applyfor\" class=\"elementor-field-textual elementor-size-sm\" required=\"required\">\n\t\t\t\t\t\t\t\t\t<option value=\"\u81ea\u5df1\">\u81ea\u5df1<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"\u4ee3\u4ed6\u4eba\">\u4ee3\u4ed6\u4eba<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_db59d86 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_db59d86\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t\u60a8\u662f\u5426\u5df2\u83b7\u5f97\u7533\u8bf7\u4eba\u7684\u540c\u610f\uff0c\u63d0\u4f9b\u5176\u4e2a\u4eba\u8d44\u6599\u4ee5\u8fdb\u884c\u8f6c\u4ecb\uff1f\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"\u662f\" id=\"form-field-field_db59d86-0\" name=\"form_fields[field_db59d86]\" required=\"required\"> <label for=\"form-field-field_db59d86-0\">\u662f<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"\u5426\" id=\"form-field-field_db59d86-1\" name=\"form_fields[field_db59d86]\" required=\"required\"> <label for=\"form-field-field_db59d86-1\">\u5426<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_c1fccbc elementor-col-100\">\n\t\t\t\t\t<b>\u5907\u6ce8:<\/b>  \u5728\u63d0\u4f9b\u4ed6\u4eba\u7684\u4e2a\u4eba\u8d44\u6599\u7ed9\u6211\u4eec\u4e4b\u524d\uff0c\u8bf7\u5148\u5f81\u5f97\u5f53\u4e8b\u4eba\u7684\u540c\u610f\uff0c\u4ee5\u786e\u4fdd\u7b26\u5408\u4e2a\u4eba\u8d44\u6599\u4fdd\u62a4\u8981\u6c42\uff0c\u5e76\u5c0a\u91cd\u5f53\u4e8b\u4eba\u7684\u9690\u79c1\u3002\u611f\u8c22\u60a8\u7684\u7406\u89e3\u4e0e\u914d\u5408\u3002\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_c164e97 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_c164e97\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tReferring Person \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_c164e97]\" id=\"form-field-field_c164e97\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Enter Referring Person\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-field_4d20a01 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_4d20a01\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tReferring Person's Contact Number \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[field_4d20a01]\" id=\"form-field-field_4d20a01\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Enter Referring Person&#039;s Contact Number\" required=\"required\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-field_1f84f07 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_1f84f07\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tReferring Person's Email *\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[field_1f84f07]\" id=\"form-field-field_1f84f07\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Enter Referring Person&#039;s Email *\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-field_7dfb21b elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_7dfb21b\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tReferring Person's Email \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[field_7dfb21b]\" id=\"form-field-field_7dfb21b\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Enter Referring Person&#039;s Email\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_9d0e9f7 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_9d0e9f7\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tApplicant\u2019s Name\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_9d0e9f7]\" id=\"form-field-field_9d0e9f7\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Enter Applicant\u2019s Name\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_ffe8149 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_ffe8149\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tApplicant\u2019s Name\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_ffe8149]\" id=\"form-field-field_ffe8149\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Enter Applicant\u2019s Name\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-sm\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Send<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\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":"<p>\u533b\u7597\u63f4\u52a9\u7533\u8bf7\u8868<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":"","_links_to":"","_links_to_target":""},"class_list":["post-10068","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/uat.tzuchi.org.sg\/zh-hans\/wp-json\/wp\/v2\/pages\/10068","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/uat.tzuchi.org.sg\/zh-hans\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/uat.tzuchi.org.sg\/zh-hans\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/uat.tzuchi.org.sg\/zh-hans\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/uat.tzuchi.org.sg\/zh-hans\/wp-json\/wp\/v2\/comments?post=10068"}],"version-history":[{"count":49,"href":"https:\/\/uat.tzuchi.org.sg\/zh-hans\/wp-json\/wp\/v2\/pages\/10068\/revisions"}],"predecessor-version":[{"id":40720,"href":"https:\/\/uat.tzuchi.org.sg\/zh-hans\/wp-json\/wp\/v2\/pages\/10068\/revisions\/40720"}],"wp:attachment":[{"href":"https:\/\/uat.tzuchi.org.sg\/zh-hans\/wp-json\/wp\/v2\/media?parent=10068"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}