{"id":366,"date":"2026-06-06T06:00:01","date_gmt":"2026-06-06T06:00:01","guid":{"rendered":"https:\/\/quikseo.in\/therapy\/?page_id=366"},"modified":"2026-06-18T18:03:29","modified_gmt":"2026-06-18T18:03:29","slug":"register","status":"publish","type":"page","link":"https:\/\/quikseo.in\/therapy\/register\/","title":{"rendered":"Register"},"content":{"rendered":"\n\n\n<h2>Register of  AOST<\/h2>\nRegister\n\n\n\n{&#8220;title&#8221;:&#8221;&#8221;,&#8221;content&#8221;:&#8221;<nav class=\\\"navbar\\\">\\r\\n    <a href=\\\"\/home\\\">\\r\\n      <span class=\\\"home-icon\\\">\ud83c\udfe0<\/span>\\r\\n      <span>HOME<\/span>\\r\\n    <\/a>\\r\\n    \\r\\n    <span class=\\\"separator\\\">\/<\/span>\\r\\n    \\r\\n    <a href=\\\"#\\\" class=\\\"gallery\\\">\\r\\n     GALLERY<\/a>\\r\\n  <\/nav>&#8220;}\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\nregistration form\n\n&#8220;Feel free to fill out the registration form below. Your message will be sent directly to our team, and we will get back to you as soon as possible.&#8221;\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\nregister\nFill the form\n{&#8220;title&#8221;:&#8221;&#8221;,&#8221;content&#8221;:&#8221;<div class=\\\"reg-tabs\\\">\\r\\n\\r\\n    <div class=\\\"reg-tab-buttons\\\">\\r\\n        <button class=\\\"reg-tab-btn active\\\" onclick=\\\"showRegTab(event,'patient-tab')\\\">Patient Registration<\/button>\\r\\n        <button class=\\\"reg-tab-btn\\\" onclick=\\\"showRegTab(event,'therapist-tab')\\\">Therapist Registration<\/button>\\r\\n        <button class=\\\"reg-tab-btn\\\" onclick=\\\"showRegTab(event,'pharmacist-tab')\\\">Pharmacist Registration<\/button>\\r\\n    <\/div>\\r\\n\\r\\n    <!-- Patient Form -->\\r\\n    <div id=\\\"patient-tab\\\" class=\\\"reg-tab-content active\\\">\\r\\n        <h3>Patient Registration Form<\/h3>\\r\\n\\r\\n        <form action=\\\"\\\" method=\\\"POST\\\">\\r\\n\\r\\n            <input type=\\\"hidden\\\" name=\\\"_subject\\\" value=\\\"New Patient Registration\\\">\\r\\n            <input type=\\\"hidden\\\" name=\\\"_captcha\\\" value=\\\"false\\\">\\r\\n\\r\\n            <div class=\\\"reg-form-group\\\">\\r\\n                <label>Patient Name<\/label>\\r\\n                <input type=\\\"text\\\" name=\\\"Patient Name\\\" required>\\r\\n            <\/div>\\r\\n\\r\\n            <div class=\\\"reg-form-group\\\">\\r\\n                <label>Age<\/label>\\r\\n                <input type=\\\"number\\\" name=\\\"Age\\\" required>\\r\\n            <\/div>\\r\\n\\r\\n            <div class=\\\"reg-form-group\\\">\\r\\n                <label>Gender<\/label>\\r\\n                <select name=\\\"Gender\\\" required>\\r\\n                    <option value=\\\"\\\">Select<\/option>\\r\\n                    <option>Male<\/option>\\r\\n                    <option>Female<\/option>\\r\\n                    <option>Other<\/option>\\r\\n                <\/select>\\r\\n            <\/div>\\r\\n\\r\\n            <div class=\\\"reg-form-group\\\">\\r\\n                <label>Phone Number<\/label>\\r\\n                <input type=\\\"tel\\\" name=\\\"Phone Number\\\" required>\\r\\n            <\/div>\\r\\n\\r\\n            <div class=\\\"reg-form-group\\\">\\r\\n                <label>Email Address<\/label>\\r\\n                <input type=\\\"email\\\" name=\\\"Email Address\\\" required>\\r\\n            <\/div>\\r\\n\\r\\n            <div class=\\\"reg-form-group\\\">\\r\\n                <label>Therapy Required<\/label>\\r\\n                <select name=\\\"Therapy Required\\\">\\r\\n                    <option>Physical Therapy<\/option>\\r\\n                    <option>Occupational Therapy<\/option>\\r\\n                    <option>Speech Therapy<\/option>\\r\\n                <\/select>\\r\\n            <\/div>\\r\\n\\r\\n            <div class=\\\"reg-form-group\\\">\\r\\n                <label>Message<\/label>\\r\\n                <textarea name=\\\"Message\\\"><\/textarea>\\r\\n            <\/div>\\r\\n\\r\\n            <button type=\\\"submit\\\" class=\\\"reg-submit\\\">Register Patient<\/button>\\r\\n\\r\\n        <\/form>\\r\\n    <\/div>\\r\\n\\r\\n    <!-- Therapist Form -->\\r\\n    <div id=\\\"therapist-tab\\\" class=\\\"reg-tab-content\\\">\\r\\n        <h3>Therapist Registration Form<\/h3>\\r\\n\\r\\n        <form action=\\\"\\\" method=\\\"POST\\\" enctype=\\\"multipart\/form-data\\\">\\r\\n\\r\\n            <input type=\\\"hidden\\\" name=\\\"_subject\\\" value=\\\"New Therapist Registration\\\">\\r\\n            <input type=\\\"hidden\\\" name=\\\"_captcha\\\" value=\\\"false\\\">\\r\\n\\r\\n            <div class=\\\"reg-form-group\\\">\\r\\n                <label>Full Name<\/label>\\r\\n                <input type=\\\"text\\\" name=\\\"Full Name\\\" required>\\r\\n            <\/div>\\r\\n\\r\\n            <div class=\\\"reg-form-group\\\">\\r\\n                <label>Qualification<\/label>\\r\\n                <input type=\\\"text\\\" name=\\\"Qualification\\\" required>\\r\\n            <\/div>\\r\\n\\r\\n            <div class=\\\"reg-form-group\\\">\\r\\n                <label>Specialization<\/label>\\r\\n                <input type=\\\"text\\\" name=\\\"Specialization\\\" required>\\r\\n            <\/div>\\r\\n\\r\\n            <div class=\\\"reg-form-group\\\">\\r\\n                <label>Experience (Years)<\/label>\\r\\n                <input type=\\\"number\\\" name=\\\"Experience\\\">\\r\\n            <\/div>\\r\\n\\r\\n            <div class=\\\"reg-form-group\\\">\\r\\n                <label>Phone Number<\/label>\\r\\n                <input type=\\\"tel\\\" name=\\\"Phone Number\\\" required>\\r\\n            <\/div>\\r\\n\\r\\n            <div class=\\\"reg-form-group\\\">\\r\\n                <label>Email Address<\/label>\\r\\n                <input type=\\\"email\\\" name=\\\"Email Address\\\" required>\\r\\n            <\/div>\\r\\n\\r\\n            <!-- <div class=\\\"reg-form-group\\\">\\r\\n                <label>Resume<\/label>\\r\\n                <input type=\\\"file\\\" name=\\\"Resume\\\">\\r\\n            <\/div> -->\\r\\n\\r\\n            <div class=\\\"reg-form-group\\\">\\r\\n                <label>Message<\/label>\\r\\n                <textarea name=\\\"Message\\\"><\/textarea>\\r\\n            <\/div>\\r\\n\\r\\n            <button type=\\\"submit\\\" class=\\\"reg-submit\\\">Register Therapist<\/button>\\r\\n\\r\\n        <\/form>\\r\\n    <\/div>\\r\\n\\r\\n    <!-- Pharmacist Form -->\\r\\n    <div id=\\\"pharmacist-tab\\\" class=\\\"reg-tab-content\\\">\\r\\n        <h3>Pharmacist Registration Form<\/h3>\\r\\n\\r\\n        <form action=\\\"\\\" method=\\\"POST\\\" enctype=\\\"multipart\/form-data\\\">\\r\\n\\r\\n            <input type=\\\"hidden\\\" name=\\\"_subject\\\" value=\\\"New Pharmacist Registration\\\">\\r\\n            <input type=\\\"hidden\\\" name=\\\"_captcha\\\" value=\\\"false\\\">\\r\\n\\r\\n            <div class=\\\"reg-form-group\\\">\\r\\n                <label>Full Name<\/label>\\r\\n                <input type=\\\"text\\\" name=\\\"Full Name\\\" required>\\r\\n            <\/div>\\r\\n\\r\\n            <div class=\\\"reg-form-group\\\">\\r\\n                <label>Qualification<\/label>\\r\\n                <input type=\\\"text\\\" name=\\\"Qualification\\\" required>\\r\\n            <\/div>\\r\\n\\r\\n            <div class=\\\"reg-form-group\\\">\\r\\n                <label>License Number<\/label>\\r\\n                <input type=\\\"text\\\" name=\\\"License Number\\\" required>\\r\\n            <\/div>\\r\\n\\r\\n            <div class=\\\"reg-form-group\\\">\\r\\n                <label>Experience (Years)<\/label>\\r\\n                <input type=\\\"number\\\" name=\\\"Experience\\\">\\r\\n            <\/div>\\r\\n\\r\\n            <div class=\\\"reg-form-group\\\">\\r\\n                <label>Phone Number<\/label>\\r\\n                <input type=\\\"tel\\\" name=\\\"Phone Number\\\" required>\\r\\n            <\/div>\\r\\n\\r\\n            <div class=\\\"reg-form-group\\\">\\r\\n                <label>Email Address<\/label>\\r\\n                <input type=\\\"email\\\" name=\\\"Email Address\\\" required>\\r\\n            <\/div>\\r\\n\\r\\n            <!-- <div class=\\\"reg-form-group\\\">\\r\\n                <label>Resume<\/label>\\r\\n                <input type=\\\"file\\\" name=\\\"Resume\\\">\\r\\n            <\/div> -->\\r\\n\\r\\n            <div class=\\\"reg-form-group\\\">\\r\\n                <label>Message<\/label>\\r\\n                <textarea name=\\\"Message\\\"><\/textarea>\\r\\n            <\/div>\\r\\n\\r\\n            <!-- \\r\\n            <div class=\\\"form-control\\\">\\r\\n                <input type=\\\"text\\\" required \/>\\r\\n                <label>Email<\/label>\\r\\n            <\/div>\\r\\n\\r\\n            <div class=\\\"form-control\\\">\\r\\n                <input type=\\\"text\\\" required \/>\\r\\n                <label>Email<\/label>\\r\\n            <\/div>\\r\\n             -->\\r\\n\\r\\n\\r\\n            <button type=\\\"submit\\\" class=\\\"reg-submit\\\">Register Pharmacist<\/button>\\r\\n\\r\\n        <\/form>\\r\\n    <\/div>\\r\\n\\r\\n<\/div>\\r\\n\\r\\n<script>\\r\\n    function showRegTab(evt, id) {\\r\\n        document.querySelectorAll('.reg-tab-content').forEach(tab => {\\r\\n            tab.classList.remove('active');\\r\\n        });\\r\\n\\r\\n        document.querySelectorAll('.reg-tab-btn').forEach(btn => {\\r\\n            btn.classList.remove('active');\\r\\n        });\\r\\n\\r\\n        document.getElementById(id).classList.add('active');\\r\\n        evt.currentTarget.classList.add('active');\\r\\n    }\\r\\n<\/script>\\r\\n\\r\\n<!-- \\r\\n<script>\\r\\n    const inputs = document.querySelectorAll('.form-control input');\\r\\n    const labels = document.querySelectorAll('.form-control label');\\r\\n\\r\\n    labels.forEach(label => {\\r\\n     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-->&#8220;}\n\n\n\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"pagelayer_contact_templates":[],"_pagelayer_content":"","footnotes":""},"class_list":["post-366","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/quikseo.in\/therapy\/wp-json\/wp\/v2\/pages\/366","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/quikseo.in\/therapy\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/quikseo.in\/therapy\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/quikseo.in\/therapy\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/quikseo.in\/therapy\/wp-json\/wp\/v2\/comments?post=366"}],"version-history":[{"count":10,"href":"https:\/\/quikseo.in\/therapy\/wp-json\/wp\/v2\/pages\/366\/revisions"}],"predecessor-version":[{"id":462,"href":"https:\/\/quikseo.in\/therapy\/wp-json\/wp\/v2\/pages\/366\/revisions\/462"}],"wp:attachment":[{"href":"https:\/\/quikseo.in\/therapy\/wp-json\/wp\/v2\/media?parent=366"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}