Responsive & new no index appointment booking form updated
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app/appointment-booking-form/ContactClient.js
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254
app/appointment-booking-form/ContactClient.js
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"use client";
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import { useState, useEffect } from "react";
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import ReCAPTCHA from "react-google-recaptcha";
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import axios from "axios";
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import Link from "next/link";
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import { servicesList } from "@/utils/Services.utils";
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export default function ContactClient() {
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const [formData, setFormData] = useState({
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username: "",
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email: "",
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phone: "",
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service: "",
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message: "",
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});
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const [formErrors, setFormErrors] = useState({});
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const [captchaToken, setCaptchaToken] = useState(null);
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const [alert, setAlert] = useState({ show: false, type: "", message: "" });
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const handleChange = (e) => {
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const { name, value } = e.target;
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setFormData((prev) => ({ ...prev, [name]: value }));
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};
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const handleCaptchaChange = (token) => {
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setCaptchaToken(token);
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};
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const handleSubmit = async (e) => {
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e.preventDefault();
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const errors = {};
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if (!formData.username.trim()) errors.username = "Name is required.";
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if (!formData.email.trim()) errors.email = "Email is required.";
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if (!formData.phone.trim()) errors.phone = "Phone is required.";
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if (!formData.service.trim()) errors.service = "Please select a service.";
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if (!formData.message.trim()) errors.message = "Message is required.";
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// if (!captchaToken) errors.captcha = "Please verify the CAPTCHA.";
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setFormErrors(errors);
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if (Object.keys(errors).length > 0) return;
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const emailData = {
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name: formData.username,
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phone: formData.phone,
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email: formData.email,
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subject: formData.service,
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message: `Service: ${formData.service}<br /><br />Message: ${formData.message}`,
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to: "bloor@rapharehab.ca",
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senderName: "Rapha Rehab Contact Page",
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recaptchaToken: captchaToken,
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};
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try {
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const res = await axios.post(
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"https://mailserver.metatronnest.com/send",
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emailData,
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{ headers: { "Content-Type": "application/json" } }
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);
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setAlert({
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show: true,
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type: "success",
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message: res?.data?.message || "Message sent successfully!",
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});
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setFormData({ username: "", email: "", phone: "", service: "", message: "" });
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setCaptchaToken(null);
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setFormErrors({});
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} catch (error) {
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setAlert({
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show: true,
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type: "danger",
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message: "Failed to send message. Please try again later.",
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});
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}
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};
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useEffect(() => {
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if (alert.show) {
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const timer = setTimeout(() => {
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setAlert((prev) => ({ ...prev, show: false }));
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}, 5000);
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return () => clearTimeout(timer);
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}
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}, [alert.show]);
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return (
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<div>
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{/* <section className="contact-info-section pt_90">
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<div className="auto-container">
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<div className="row clearfix">
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<div className="col-lg-4 col-md-6 col-sm-12 info-column">
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<div className="info-block-one">
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<h3>Quick Contact</h3>
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<div className="inner-box">
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<div className="icon-box"><i className="icon-2"></i></div>
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<p>
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<Link href="tel:647-722-3434">+647-722-3434</Link><br />
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<Link href="tel:416-622-2873">+416-622-2873</Link>
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</p>
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</div>
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</div>
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</div>
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<div className="col-lg-4 col-md-6 col-sm-12 info-column">
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<div className="info-block-one">
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<h3>Email Address</h3>
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<div className="inner-box">
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<div className="icon-box"><i className="icon-26"></i></div>
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<p>
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<Link href="mailto:bloor@rapharehab.ca">bloor@rapharehab.ca</Link>
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</p>
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</div>
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</div>
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</div>
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<div className="col-lg-4 col-md-6 col-sm-12 info-column">
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<div className="info-block-one">
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<h3>Mailing Address</h3>
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<div className="inner-box">
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<div className="icon-box">
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<img src="/assets/images/icons/icon-2.png" alt="" />
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</div>
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<p>5 – 4335 Bloor Street West <br />Etobicoke, M9C 2A5</p>
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</div>
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</div>
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</div>
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</div>
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</div>
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</section> */}
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<section className="contact-style-three pt_90 pb_90">
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<div className="auto-container">
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<div className="row clearfix">
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<div className="col-lg-8 col-md-12 col-sm-12 form-column">
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<div className="form-inner mr_40">
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<div className="sec-title mb_50">
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<h2>How can we help?</h2>
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<p className="mt-3">
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Please complete the contact information below and let us know your needs.
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Upon receipt of your information one of our team members will reach out.
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</p>
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</div>
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{alert.show && (
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<div className={`alert alert-${alert.type}`}>{alert.message}</div>
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)}
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<form onSubmit={handleSubmit} className="default-form">
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<div className="row clearfix">
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<div className="col-lg-6 col-md-6 col-sm-12 form-group">
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<input
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type="text"
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name="username"
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placeholder="Name"
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value={formData.username}
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onChange={handleChange}
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/>
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{formErrors.username && <small className="text-danger">{formErrors.username}</small>}
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</div>
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<div className="col-lg-6 col-md-6 col-sm-12 form-group">
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<input
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type="text"
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name="phone"
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placeholder="Phone"
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value={formData.phone}
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onChange={handleChange}
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/>
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{formErrors.phone && <small className="text-danger">{formErrors.phone}</small>}
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</div>
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<div className="col-lg-6 col-md-6 col-sm-12 form-group">
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<input
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type="email"
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name="email"
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placeholder="Your Email"
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value={formData.email}
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onChange={handleChange}
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/>
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{formErrors.email && <small className="text-danger">{formErrors.email}</small>}
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</div>
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<div className="col-lg-6 col-md-6 col-sm-12 form-group">
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<select
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name="service"
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value={formData.service}
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onChange={handleChange}
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className="form-control"
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>
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<option value="">Select Service</option>
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{servicesList.map((service) => (
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<option key={service.slug} value={service.shortTitle}>
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{service.shortTitle}
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</option>
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))}
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</select>
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{formErrors.service && <small className="text-danger">{formErrors.service}</small>}
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</div>
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<div className="col-lg-12 col-md-6 col-sm-12 form-group">
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<textarea
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name="message"
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placeholder="Message"
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value={formData.message}
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onChange={handleChange}
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></textarea>
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{formErrors.message && <small className="text-danger">{formErrors.message}</small>}
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</div>
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<div className="col-lg-12 mb-3">
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<ReCAPTCHA
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sitekey="6Lckq9MrAAAAABjBD9rQYm19BMGFFWiwb9mPiw2K"
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onChange={handleCaptchaChange}
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/>
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{formErrors.captcha && <small className="text-danger">{formErrors.captcha}</small>}
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</div>
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<div className="col-lg-12 col-md-12 col-sm-12 form-group message-btn">
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<button className="theme-btn btn-one" type="submit" name="submit-form">
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<span>Send Message</span>
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</button>
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</div>
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</div>
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</form>
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</div>
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</div>
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<div className="col-lg-4 col-md-12 col-sm-12 image-column">
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<figure className="image-box">
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<img src="/assets/images/contact/img.webp" alt="Physiotherapy at Rapharehab" />
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</figure>
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</div>
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</div>
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</div>
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</section>
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{/* <section className="google-map-section">
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<div className="map-inner">
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<iframe
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src="https://www.google.com/maps/embed?pb=!1m18!1m12!1m3!1d2886.847666572518!2d-79.57789668450145!3d43.6308386791466!2m3!1f0!2f0!3f0!3m2!1i1024!2i768!4f13.1!3m3!1m2!1s0x882b3811bd400001%3A0x87ffabfe7d6aeeca!2s4335+Bloor+St+W+%236%2C+Etobicoke%2C+ON+M9C+5S2%2C+Canada!5e0!3m2!1sen!2sca!4v1693224000000!5m2!1sen!2sca"
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height={570}
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style={{ border: 0, width: "100%" }}
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allowFullScreen
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loading="lazy"
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referrerPolicy="no-referrer-when-downgrade"
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/>
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</div>
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</section> */}
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</div>
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);
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}
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27
app/appointment-booking-form/page.js
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27
app/appointment-booking-form/page.js
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import Head from "next/head";
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import Layout from "@/components/layout/Layout";
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import ContactClient from "../appointment-booking-form/ContactClient";
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export const metadata = {
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title: "Contact Rapharehab – Book Your Appointment Today",
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description:
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"Reach out to Rapharehab for expert rehab and therapy services. Call or message us to schedule your consultation with our professional care team.",
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robots: {
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index: false,
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follow: false,
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},
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};
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export default function Appointment() {
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return (
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<Layout
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headerStyle={1}
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footerStyle={1}
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breadcrumbTitle="Appointment Booking"
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bannerImage="/assets/images/contact/contact-us-banner.webp"
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>
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<ContactClient />
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</Layout>
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);
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}
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{/* Top Intro */}
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<div className="sec-title mb_50 text-center">
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<h2 className="mb-3">COVID 19 UPDATES</h2>
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<p>
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<p className="section-para">
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The COVID 19 pandemic has created increased stress and anxiety levels for many people.
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We would like to take this opportunity to remind you that virtual therapy and at-home
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or mobile therapy are effective alternatives to in-clinic therapy for many of our clients.
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@ -92,15 +92,15 @@ export default function Team() {
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<div className="row align-items-center">
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{/* LEFT IMAGE / RIGHT CONTENT */}
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<div className="col-lg-6 col-md-12 col-sm-12 image-column order-2 order-lg-1">
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<div className="image_block_two pr_30">
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<div className="image_block_two">
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<div className="image-box">
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<figure className="image image-1-ho"><img src="/assets/images/why-us/back-1.webp" alt="health care professionals" /></figure>
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<figure className="image image-1-ho renderd-area"><img src="/assets/images/why-us/back-1.webp" alt="health care professionals" /></figure>
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<figure className="image image-2"><img src="/assets/images/why-us/front-1.webp" alt="health care professionals" /></figure>
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<div className="icon-box"><img src="/assets/images/why-us/icon-1.webp" alt="health care professionals" /></div>
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</div>
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</div>
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</div>
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<div className="col-lg-6 col-md-12 col-sm-12 content-column order-1 order-lg-2">
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<div className="col-lg-6 col-md-12 col-sm-12 content-column order-1 order-lg-2 pr_30">
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<div className="content_block_one">
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<div className="content-box">
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{/* <div className="sec-title mb_15">
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@ -129,9 +129,9 @@ export default function Team() {
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<div className="row align-items-center flex-row-reverse">
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{/* RIGHT IMAGE / LEFT CONTENT */}
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<div className="col-lg-6 col-md-12 col-sm-12 image-column order-2 order-lg-1">
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<div className="image_block_two pl_30">
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<div className="image_block_two">
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<div className="image-box">
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<figure className="image image-1-ho"><img src="/assets/images/why-us/back-2.webp" alt="Top-Notch Treatment " /></figure>
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<figure className="image image-1-ho renderd-area"><img src="/assets/images/why-us/back-2.webp" alt="Top-Notch Treatment " /></figure>
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<figure className="image image-2 rowImage"><img src="/assets/images/why-us/front-2.webp" alt="Top-Notch Treatment " /></figure>
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<div className="icon-box"><img src="/assets/images/why-us/icon-2.webp" alt="Top-Notch Treatment" /></div>
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</div>
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@ -174,6 +174,14 @@
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}
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.renderd-area img{
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position: relative;
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top: -150px;
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left: -17px;
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}
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.image .image-1-ho .aligned-image img{
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@ -3615,6 +3615,11 @@
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}
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}
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.section-para{
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font-size: 14px !important;
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}
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.custom-table {
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border: 1px solid #101A30;
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