Appointment – Ayush – Autism Speech Clinic

Fill The Form To Book An Appointment

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{ parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false,"expression":"null"}, el) }} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-text" as=${html``} />

parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false,"expression":"null"}, el)} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-telephone" as=${html``} />

<${props.Select} className=${"mf-input mf-input-select " + ( validation.errors['mf-select'] ? 'mf-invalid' : '' )} classNamePrefix="mf_select" name="mf-select" placeholder="${ parent.decodeEntities(`Choose services`) } " isSearchable=${false} options=${[{"label":"Item 1","value":"value-1","isDisabled":false},{"label":"Item 2","value":"value-2","isDisabled":false},{"label":"Item 3","value":"value-3","isDisabled":false}]} value=${parent.getValue("mf-select") ? [{"label":"Item 1","value":"value-1","isDisabled":false},{"label":"Item 2","value":"value-2","isDisabled":false},{"label":"Item 3","value":"value-3","isDisabled":false}].filter(item => item.value === parent.getValue("mf-select"))[0] : []} onChange=${(e)=> parent.handleSelect(e, "mf-select")} ref=${() => { register({ name: "mf-select" }, parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false})); if ( parent.getValue("mf-select") === '' && false ) { parent.setValue( 'mf-select', '', true ); parent.handleChange({ target: { name: 'mf-select', value: '' } }); } }} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-select" as=${html``} />

<${props.Flatpickr} name="mf-date" className="mf-input mf-date-input mf-left-parent " placeholder="${ parent.decodeEntities(`Choose Preferred Time`) } " options=${{"minDate":"","maxDate":"","dateFormat":"m-d-Y","enableTime":"","disable":[],"mode":"single","static":true,"disableMobile":true,"time_24hr":false}} value=${parent.getValue('mf-date')} onInput=${parent.handleDateTime} aria-invalid=${validation.errors['mf-date'] ? 'true' : 'false'} ref=${el => props.DateWidget( el, '', {"message":"This field is required.","required":false}, register, parent )} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-date" as=${html``} />

<${props.Select} isOptionDisabled=${option => option.mf_input_option_status === 'disabled'} className=${"mf-input mf-input-multiselect " + ( validation.errors['mf-multi-select'] ? 'mf-invalid' : '' )} classNamePrefix="mf_multiselect" value=${parent.getValue("mf-multi-select") && [{"label":"Item 1","value":"value-1","_id":"b2dc089","mf_input_option_status":"","mf_input_option_selected":""},{"label":"Item 2","value":"value-2","_id":"e258080","mf_input_option_status":"","mf_input_option_selected":""},{"label":"Item 3","value":"value-3","_id":"90e2f58","mf_input_option_status":"","mf_input_option_selected":""}].filter(item => { if(parent.state.formData['mf-multi-select'] && parent.state.formData['mf-multi-select'].indexOf(item.value) != -1 ){ return item; } })} name='mf-multi-select' placeholder="${ parent.decodeEntities(`Choose Required Medical Care`) } " options=${[{"label":"Item 1","value":"value-1","_id":"b2dc089","mf_input_option_status":"","mf_input_option_selected":""},{"label":"Item 2","value":"value-2","_id":"e258080","mf_input_option_status":"","mf_input_option_selected":""},{"label":"Item 3","value":"value-3","_id":"90e2f58","mf_input_option_status":"","mf_input_option_selected":""}]} onChange=${(el) => { setValue("mf-multi-select", ''); if(el != null){ setValue("mf-multi-select", el, true); } parent.multiSelectChange(el, 'mf-multi-select'); }} ref=${() => { register({ name: "mf-multi-select" }, parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false})); if(parent.state?.submitted !== true){ if ( parent.getValue("mf-multi-select") === '' && false ) { parent.setValue( 'mf-multi-select', '[]'); parent.multiSelectChange('[]', 'mf-multi-select'); } } }} isMulti /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-multi-select" as=${html``} />

<${validation.ErrorMessage} errors=${validation.errors} name="mf-textarea" as=${html``} />