{"id":1430,"date":"2022-03-30T14:54:11","date_gmt":"2022-03-30T01:54:11","guid":{"rendered":"https:\/\/medpro.co.nz\/?page_id=1430"},"modified":"2022-03-30T14:54:11","modified_gmt":"2022-03-30T01:54:11","slug":"flu-vaccination-enquiry","status":"publish","type":"page","link":"https:\/\/medpro.co.nz\/flu-vaccination-enquiry\/","title":{"rendered":"Request a Flu Vaccination Proposal"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; admin_label=&#8221;Our Classes Section&#8221; _builder_version=&#8221;4.15&#8243; custom_padding=&#8221;70px|0px|40px|0px|false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row use_custom_gutter=&#8221;on&#8221; gutter_width=&#8221;1&#8243; module_class=&#8221; et_pb_row_fullwidth&#8221; _builder_version=&#8221;4.15&#8243; width=&#8221;100%&#8221; width_tablet=&#8221;100%&#8221; width_phone=&#8221;&#8221; width_last_edited=&#8221;on|desktop&#8221; max_width=&#8221;100%&#8221; max_width_tablet=&#8221;100%&#8221; max_width_phone=&#8221;&#8221; max_width_last_edited=&#8221;on|desktop&#8221; custom_padding=&#8221;0px||0||false|false&#8221; make_fullwidth=&#8221;on&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.15&#8243; custom_padding=&#8221;|||&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_text _builder_version=&#8221;4.15.1&#8243; text_font_size=&#8221;16px&#8221; header_font_size=&#8221;63px&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h3 style=\"text-align: center;\">Request a Flu Vaccination Proposal<\/h3>\n<p style=\"text-align: center;\">[\/et_pb_text][et_pb_divider divider_weight=&#8221;3px&#8221; _builder_version=&#8221;4.15.1&#8243; max_width=&#8221;100px&#8221; module_alignment=&#8221;center&#8221; custom_margin=&#8221;25px||0px&#8221; custom_padding=&#8221;||0px&#8221; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;][\/et_pb_divider][et_pb_text _builder_version=&#8221;4.15.1&#8243; text_font_size=&#8221;16px&#8221; header_font_size=&#8221;63px&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p style=\"text-align: center;\"><span>Please enter the information below so that we can provide you with a workplace vaccination proposal. If we require additional information, our account manager will be in touch.<\/span><\/p>\n<p style=\"text-align: center;\"><span>Alternatively, you can contact us on 09 383 3555 (Monday &#8211; Friday, 8:30am to 5:00pm).<\/span><\/p>\n<p>[\/et_pb_text][et_pb_divider divider_weight=&#8221;3px&#8221; _builder_version=&#8221;4.15.1&#8243; max_width=&#8221;100px&#8221; module_alignment=&#8221;center&#8221; custom_margin=&#8221;25px||0px&#8221; custom_padding=&#8221;||0px&#8221; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;][\/et_pb_divider][et_pb_text _builder_version=&#8221;4.15.1&#8243; max_width=&#8221;51%&#8221; max_width_tablet=&#8221;&#8221; max_width_phone=&#8221;94%&#8221; max_width_last_edited=&#8221;on|desktop&#8221; module_alignment=&#8221;center&#8221; custom_margin=&#8221;0px||&#8221; custom_padding=&#8221;0px||&#8221; filter_brightness=&#8221;96%&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<script 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If we require additional information, our account manager will be in touch. Alternatively, you can contact us on 09 383 3555 (Monday &#8211; Friday, 8:30am to 5:00pm).\n                <div class='gf_browser_unknown gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='1' id='gform_wrapper_2' >\n                        <div class='gform_heading'>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_2'  action='\/wp-json\/wp\/v2\/pages\/1430' data-formid='2' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_2' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_2_16\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_16\" ><label class='gfield_label gform-field-label' for='input_2_16'>Name<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_16' id='input_2_16' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_2_7\" class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_7\" ><label class='gfield_label gform-field-label' for='input_2_7'>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_7' id='input_2_7' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_2_17\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_17\" ><label class='gfield_label gform-field-label' for='input_2_17'>Contact Number<\/label><div class='ginput_container ginput_container_text'><input name='input_17' id='input_2_17' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_2_11\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_11\" ><label class='gfield_label gform-field-label' for='input_2_11'>Company Name<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_11' id='input_2_11' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_2_12\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_12\" ><label class='gfield_label gform-field-label' for='input_2_12'>Total Number of Staff<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_12' id='input_2_12' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_2_13\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_13\" ><label class='gfield_label gform-field-label' for='input_2_13'>Location<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_2_13' type='text' value='' class='large'  aria-describedby=\"gfield_description_2_13\"   aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><div class='gfield_description' id='gfield_description_2_13'>City and region (If multiple locations, please include all which require vaccination)<\/div><\/div><fieldset id=\"field_2_14\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_14\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Work arrangements<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_2_14'><div class='gchoice gchoice_2_14_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.1' type='checkbox'  value='Onsite'  id='choice_2_14_1'   aria-describedby=\"gfield_description_2_14\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_2_14_1' id='label_2_14_1' class='gform-field-label gform-field-label--type-inline'>Onsite<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_14_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.2' type='checkbox'  value='Hybrid'  id='choice_2_14_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_14_2' id='label_2_14_2' class='gform-field-label gform-field-label--type-inline'>Hybrid<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_14_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.3' type='checkbox'  value='Work From Home'  id='choice_2_14_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_14_3' id='label_2_14_3' class='gform-field-label gform-field-label--type-inline'>Work From Home<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_14_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.4' type='checkbox'  value='Multiple Sites (including multiple sites in the same city)'  id='choice_2_14_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_14_4' id='label_2_14_4' class='gform-field-label gform-field-label--type-inline'>Multiple Sites (including multiple sites in the same city)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_14_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.5' type='checkbox'  value='Shift work or 24\/7'  id='choice_2_14_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_14_5' id='label_2_14_5' class='gform-field-label gform-field-label--type-inline'>Shift work or 24\/7<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_2_14'>Please select all relevant work arrangements<\/div><\/fieldset><div 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