{"id":300,"date":"2018-10-01T16:31:09","date_gmt":"2018-10-01T16:31:09","guid":{"rendered":"https:\/\/pilotmedicals.com\/?page_id=300"},"modified":"2025-03-06T17:21:04","modified_gmt":"2025-03-06T17:21:04","slug":"book-your-medical","status":"publish","type":"page","link":"https:\/\/www.pilotmedicals.com\/contact\/book-your-medical\/","title":{"rendered":"Contact Form"},"content":{"rendered":"<div data-id=\"initial-content-section\" data-export-id=\"initial-content-section\" data-label=\"Initial Content\" id=\"initial-content-section\" class=\"content-section content-section-spacing\">\r\n<div class=\"gridContainer\">\r\n<div class=\"row\">\r\n<div class=\"col-xs-12 col-sm-12\">\r\n<div class=\"wpforms-title-desc\">\r\n<p class=\"wpforms-form-name\"><strong>Contacting me +\/- inquiring about booking<\/strong><\/p>\r\n<p>All of my bookings are by email rather than by phone.<\/p>\r\n\r\n<p>Please ensure that you are happy with my <a href=\"https:\/\/www.pilotmedicals.com\/terms-conditions\/\">T&amp;C<\/a> and <a href=\"https:\/\/www.pilotmedicals.com\/aviation-medicals\/rates\" target=\"_blank\" rel=\"noopener noreferrer\">fees<\/a> before making contact.<\/p>\r\n\r\n<p>Please note that by using email, you consent to my\u00a0<a href=\"https:\/\/www.pilotmedicals.com\/gdpr-policy\/\">GDPR Policy<\/a>.<\/p>\r\n\r\n<div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-515\"><form id=\"wpforms-form-515\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"515\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/api\/wp\/v2\/pages\/300\" data-token=\"2651025d7ac43f7684f1e1d11b536cde\" data-token-time=\"1775808265\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-515-field_0-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"0\"><label class=\"wpforms-field-label\" for=\"wpforms-515-field_0\">Name <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-515-field_0\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][0][first]\" placeholder=\"First Name\" required><label for=\"wpforms-515-field_0\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-515-field_0-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][0][last]\" placeholder=\"Last Name\" required><label for=\"wpforms-515-field_0-last\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-515-field_1-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"1\"><label class=\"wpforms-field-label\" for=\"wpforms-515-field_1\">Email <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-515-field_1\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][1]\" spellcheck=\"false\" required><\/div><div id=\"wpforms-515-field_2-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-515-field_2\">Additional information <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-515-field_2\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][2]\" required><\/textarea><div class=\"wpforms-field-description\">UK licence holders, please enter your CAA reference number. Please enter your state of licence issue if you want a non-UK EASA medical, or if you have a general enquiry or wish to add any more information regarding your appointment request, please add it here.<\/div><\/div><div id=\"wpforms-515-field_3-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-inline\" data-field-id=\"3\"><label class=\"wpforms-field-label\">Please select the medical type you wish to book for  <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-515-field_3\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-515-field_3_1\" name=\"wpforms[fields][3][]\" value=\"UK Class 1 (commercial) renewals and revalidation &lt;p style=&quot;     color: red;     font-size: smaller;     font-weight: 700; &quot;&gt;* Please contact an AeMC for initial Class 1 medicals&lt;\/p&gt;\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-515-field_3_1\">UK Class 1 (commercial) renewals and revalidation <p style=\"color: red;font-size: smaller;font-weight: 700\">* Please contact an AeMC for initial Class 1 medicals<\/p><\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-515-field_3_2\" name=\"wpforms[fields][3][]\" value=\"UK class 2 (private)\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-515-field_3_2\">UK class 2 (private)<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"checkbox\" id=\"wpforms-515-field_3_5\" name=\"wpforms[fields][3][]\" value=\"FAA 1st class (airline captain)\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-515-field_3_5\">FAA 1st class (airline captain)<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"checkbox\" id=\"wpforms-515-field_3_6\" name=\"wpforms[fields][3][]\" value=\"FAA 2nd class (commercial)\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-515-field_3_6\">FAA 2nd class (commercial)<\/label><\/li><li class=\"choice-7 depth-1\"><input type=\"checkbox\" id=\"wpforms-515-field_3_7\" name=\"wpforms[fields][3][]\" value=\"FAA 3rd class (private)\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-515-field_3_7\">FAA 3rd class (private)<\/label><\/li><li class=\"choice-8 depth-1\"><input type=\"checkbox\" id=\"wpforms-515-field_3_8\" name=\"wpforms[fields][3][]\" value=\"Aviation ophthalmology query\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-515-field_3_8\">Aviation ophthalmology query<\/label><\/li><li class=\"choice-9 depth-1\"><input type=\"checkbox\" id=\"wpforms-515-field_3_9\" name=\"wpforms[fields][3][]\" value=\"Aviation medical query\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-515-field_3_9\">Aviation medical query<\/label><\/li><\/ul><\/div><div id=\"wpforms-515-field_23-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-2-columns\" data-field-id=\"23\"><label class=\"wpforms-field-label\">Please select where you would like your medical? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-515-field_23\" class=\"wpforms-field-required wpforms-icon-choices wpforms-icon-choices-classic wpforms-icon-choices-large\" data-choice-limit=\"1\" style=\"--wpforms-icon-choices-color: #983636;\"><li class=\"choice-1 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-515-field_23_1\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"80\" height=\"64\" viewBox=\"0 0 576 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M408 120c0 54.6-73.1 151.9-105.2 192c-7.7 9.6-22 9.6-29.6 0C241.1 271.9 168 174.6 168 120C168 53.7 221.7 0 288 0s120 53.7 120 120zm8 80.4c3.5-6.9 6.7-13.8 9.6-20.6c.5-1.2 1-2.5 1.5-3.7l116-46.4C558.9 123.4 576 135 576 152V422.8c0 9.8-6 18.6-15.1 22.3L416 503V200.4zM137.6 138.3c2.4 14.1 7.2 28.3 12.8 41.5c2.9 6.8 6.1 13.7 9.6 20.6V451.8L32.9 502.7C17.1 509 0 497.4 0 480.4V209.6c0-9.8 6-18.6 15.1-22.3l122.6-49zM327.8 332c13.9-17.4 35.7-45.7 56.2-77V504.3L192 449.4V255c20.5 31.3 42.3 59.6 56.2 77c20.5 25.6 59.1 25.6 79.6 0zM288 152a40 40 0 1 0 0-80 40 40 0 1 0 0 80z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-515-field_23_1\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][23][]\" value=\"London Heathrow\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">London Heathrow<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-2 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-515-field_23_2\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"80\" height=\"64\" viewBox=\"0 0 576 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M408 120c0 54.6-73.1 151.9-105.2 192c-7.7 9.6-22 9.6-29.6 0C241.1 271.9 168 174.6 168 120C168 53.7 221.7 0 288 0s120 53.7 120 120zm8 80.4c3.5-6.9 6.7-13.8 9.6-20.6c.5-1.2 1-2.5 1.5-3.7l116-46.4C558.9 123.4 576 135 576 152V422.8c0 9.8-6 18.6-15.1 22.3L416 503V200.4zM137.6 138.3c2.4 14.1 7.2 28.3 12.8 41.5c2.9 6.8 6.1 13.7 9.6 20.6V451.8L32.9 502.7C17.1 509 0 497.4 0 480.4V209.6c0-9.8 6-18.6 15.1-22.3l122.6-49zM327.8 332c13.9-17.4 35.7-45.7 56.2-77V504.3L192 449.4V255c20.5 31.3 42.3 59.6 56.2 77c20.5 25.6 59.1 25.6 79.6 0zM288 152a40 40 0 1 0 0-80 40 40 0 1 0 0 80z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"checkbox\" id=\"wpforms-515-field_23_2\" class=\"wpforms-screen-reader-element\" data-rule-check-limit=\"true\" name=\"wpforms[fields][23][]\" value=\"Glasgow\" required >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Glasgow<\/span>\n\t\t\t<\/label><\/li><\/ul><\/div><div id=\"wpforms-515-field_5-container\" class=\"wpforms-field wpforms-field-date-time\" data-field-id=\"5\"><label class=\"wpforms-field-label\">Date \/ Time <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-date-type-datepicker\"><div class=\"wpforms-datepicker-wrap\"><input type=\"text\" id=\"wpforms-515-field_5\" class=\"wpforms-field-date-time-date wpforms-datepicker wpforms-field-required\" data-date-format=\"m\/d\/Y\" data-disable-past-dates=\"0\" data-input=\"true\" name=\"wpforms[fields][5][date]\" required><a title=\"Clear Date\" data-clear role=\"button\" tabindex=\"0\" class=\"wpforms-datepicker-clear\" aria-label=\"Clear Date\" style=\"display:none;\"><\/a><\/div><label for=\"wpforms-515-field_5\" class=\"wpforms-field-sublabel after\">Date<\/label><\/div><div class=\"wpforms-field-row-block\"><input type=\"text\" id=\"wpforms-515-field_5-time\" class=\"wpforms-field-date-time-time wpforms-timepicker wpforms-field-required\" data-time-format=\"g:i A\" data-step=\"30\" data-rule-time12h=\"true\" name=\"wpforms[fields][5][time]\" required><label for=\"wpforms-515-field_5-time\" class=\"wpforms-field-sublabel after\">Time<\/label><\/div><\/div><div class=\"wpforms-field-description\">Please enter the time &amp; date that suits you best and I will give you the closest options.<\/div><\/div>\t\t<div id=\"wpforms-515-field_6-container\"\n\t\t\tclass=\"wpforms-field wpforms-field-text\"\n\t\t\tdata-field-type=\"text\"\n\t\t\tdata-field-id=\"6\"\n\t\t\t>\n\t\t\t<label class=\"wpforms-field-label\" for=\"wpforms-515-field_6\" >you book would<\/label>\n\t\t\t<input type=\"text\" id=\"wpforms-515-field_6\" class=\"wpforms-field-medium\" name=\"wpforms[fields][6]\" >\n\t\t<\/div>\n\t\t<div id=\"wpforms-515-field_8-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-515-field_8\">Do you require a chaperone? <span class=\"wpforms-required-label\">*<\/span><\/label><select id=\"wpforms-515-field_8\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][8]\" required=\"required\"><option value=\"\" class=\"placeholder\" disabled >Please Choose<\/option><option value=\"No - always present for female medicals\"  selected='selected' class=\"choice-1 depth-1\"  >No - always present for female medicals<\/option><option value=\"Yes\"  class=\"choice-2 depth-1\"  >Yes<\/option><\/select><\/div><div id=\"wpforms-515-field_26-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"26\"><label class=\"wpforms-field-label\">Consent to T &amp; C <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-515-field_26\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-515-field_26_1\" name=\"wpforms[fields][26][]\" value=\"I have read &amp; consent to the Terms &amp; Conditions and will download and sign the consent form before the medical.\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-515-field_26_1\">I have read &amp; consent to the Terms &amp; Conditions and will download and sign the consent form before the medical.<\/label><\/li><\/ul><\/div><div id=\"wpforms-515-field_4-container\" class=\"wpforms-field wpforms-field-gdpr-checkbox\" data-field-id=\"4\"><label class=\"wpforms-field-label\">GDPR Agreement <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-515-field_4\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"checkbox\" id=\"wpforms-515-field_4_1\" name=\"wpforms[fields][4][]\" value=\"I consent to having this website store my submitted information so Pilotmedicals.com can respond to my inquiry.\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-515-field_4_1\">I consent to having this website store my submitted information so Pilotmedicals.com can respond to my inquiry.<\/label><\/li><\/ul><\/div><script>\n\t\t\t\t( function() {\n\t\t\t\t\tconst style = document.createElement( 'style' );\n\t\t\t\t\tstyle.appendChild( document.createTextNode( '#wpforms-515-field_6-container { position: absolute !important; overflow: hidden !important; display: inline !important; height: 1px !important; width: 1px !important; z-index: -1000 !important; padding: 0 !important; } #wpforms-515-field_6-container input { visibility: hidden; } #wpforms-conversational-form-page #wpforms-515-field_6-container label { counter-increment: none; }' ) );\n\t\t\t\t\tdocument.head.appendChild( style );\n\t\t\t\t\tdocument.currentScript?.remove();\n\t\t\t\t} )();\n\t\t\t<\/script><\/div><!-- .wpforms-field-container --><div class=\"wpforms-recaptcha-container wpforms-is-turnstile\" ><div class=\"wpforms-turnstile\" data-sitekey=\"0x4AAAAAACeytraXZvKoOveU\" data-action=\"FormID-515\"><\/div><input type=\"text\" name=\"g-recaptcha-hidden\" class=\"wpforms-recaptcha-hidden\" style=\"position:absolute!important;clip:rect(0,0,0,0)!important;height:1px!important;width:1px!important;border:0!important;overflow:hidden!important;padding:0!important;margin:0!important;\" data-rule-turnstile=\"1\"><\/div><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"515\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/www.pilotmedicals.com\/api\/wp\/v2\/pages\/300\"><input type=\"hidden\" name=\"url_referer\" value=\"\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-515\" class=\"wpforms-submit button color1\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit<\/button><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.pilotmedicals.com\/wp-content\/plugins\/wpforms\/assets\/images\/submit-spin.svg\" class=\"wpforms-submit-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"Loading\"><\/div><\/form><\/div>  <!-- .wpforms-container -->\r\n\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Contacting me +\/- inquiring about booking All of my bookings are by email rather than by phone. Please ensure that you are happy with my T&amp;C and fees before making contact. Please note that by using email, you consent to my\u00a0GDPR Policy.<\/p>\n","protected":false},"author":3,"featured_media":0,"parent":47,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"pro\/page-templates\/full-width-page.php","meta":{"footnotes":""},"class_list":["post-300","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.pilotmedicals.com\/api\/wp\/v2\/pages\/300","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.pilotmedicals.com\/api\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.pilotmedicals.com\/api\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.pilotmedicals.com\/api\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.pilotmedicals.com\/api\/wp\/v2\/comments?post=300"}],"version-history":[{"count":0,"href":"https:\/\/www.pilotmedicals.com\/api\/wp\/v2\/pages\/300\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/www.pilotmedicals.com\/api\/wp\/v2\/pages\/47"}],"wp:attachment":[{"href":"https:\/\/www.pilotmedicals.com\/api\/wp\/v2\/media?parent=300"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}