{"id":21,"date":"2026-09-16T14:18:09","date_gmt":"2026-09-16T18:18:09","guid":{"rendered":"https:\/\/dentistnunavik.com\/?page_id=21"},"modified":"2026-10-27T16:52:59","modified_gmt":"2026-10-27T20:52:59","slug":"home","status":"publish","type":"page","link":"https:\/\/dentistnunavik.com\/in\/","title":{"rendered":"\u1403\u14c4\u1483\u144e\u1450\u1466"},"content":{"rendered":"\n<div class=\"dn\">\n<header><div class=\"wrap\">\n  <a class=\"brand\" href=\"\/in\/\" aria-label=\"Kuujjuaq Dental Clinic, home\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/dentistnunavik.com\/wp-content\/uploads\/2026\/09\/uthc-logo.png\" alt=\"Ungava Tulattavik Health Center\" width=\"800\" height=\"177\"><\/a>\n  <nav class=\"lang\" aria-label=\"Language\"><a href=\"\/\" lang=\"en\" title=\"English\">EN<\/a><span aria-hidden=\"true\">|<\/span><a href=\"\/fr\/\" lang=\"fr\" title=\"Fran\u00e7ais\">FR<\/a><span aria-hidden=\"true\">|<\/span><a href=\"\/in\/\" lang=\"iu\" title=\"\u1403\u14c4\u1483\u144e\u1450\u1466\" aria-current=\"page\">IN<\/a><\/nav>\n<\/div><\/header>\n<section class=\"hero\"><div class=\"wrap\">\n  <h1>\u146f\u1466\u152a\u140a\u1449 \u146d\u148d\u144e\u14d5\u1546\u152d\u1405\u1555\u1593<\/h1>\n  <p class=\"lead\"><a href=\"#renovations\">\u14c4\u1455\u1405\u14ef\u14d5\u144e\u1550\u1455\u1405\u14aa\u1546\u14c2\u1583\u1550\u14aa\u1466<\/a> \u14ab\u14d0\u14c7 \u1431\u1405\u14ef\u14d5\u144e\u1550\u1455\u1405\u148b\u140a\u1583\u1550\u14aa\u1455 \u1431\u14bb\u14aa\u1547\u1466 \u1405\u146f\u140a: \u1405\u1438\u148b\u140a\u146d\u14d0\u14c2\u14f4\u1405\u1581\u14ea\u14d7\u148d, \u140b\u14d0\u14c2\u140a\u1456\u1548\u144e\u1405\u148d\u14d0\u14c7\u1450\u14c2\u14ea\u14d7 \u1403\u146f\u14ea\u14da\u144e\u1466\u14ef\u14c2\u1550\u14f4\u1405\u14d7\u14c2, \u1431\u14c7\u14f1\u1466\u144e\u1455\u14d7 \u1431\u14c7\u14f1\u140a\u1550\u1555\u158f\u14ea\u14c2\u1483 \u1431\u1405\u14ef\u14d5\u144e\u1546\u14c2\u1550\u14f4\u1405\u14d7\u14c2 \u14f1\u14c7\u1483\u146f\u1555\u1583\u1405\u144e\u14d5\u1405\u1550\u1455\u1405\u14ef\u140a\u1550\u14d7\u14c2\u14d7.<\/p>\n  <div class=\"alert\" role=\"note\">\n    <p class=\"tag\"><svg width=\"20\" height=\"20\" viewBox=\"0 0 20 20\" aria-hidden=\"true\"><path d=\"M10 1.5 19 18H1L10 1.5z\" fill=\"none\" stroke=\"#C02B0A\" stroke-width=\"1.8\"\/><path d=\"M10 7v5.2M10 14.4v1.3\" stroke=\"#C02B0A\" stroke-width=\"1.8\" stroke-linecap=\"round\"\/><\/svg>Severe emergency<\/p>\n    <p>\u1403\u1472\u152a\u1550\u1455\u1405\u14f4\u1405\u144e\u148b\u148d\u14aa\u148d\u1555\u1466 (\u140a\u14c2\u1550\u144e\u1546\u1550\u1583\u152d\u1466\u14ef\u140a\u158f\u1483\u146f\u1555\u1466, \u146e\u14c0\u1466 \u1433\u14ea\u14d5\u1438\u1466, \u140a\u14ef\u158f\u14ea\u14d7), <strong>\u146f\u1466\u152a\u140a\u1449 \u140b\u14d0\u14c2\u140a\u1555\u1593\u14c5\u1466\u14f4\u1405\u144e\u148b\u148b\u1466<\/strong> \u00b7 <strong><a href=\"tel:+18199649090\">819-964-9090<\/a><\/strong><\/p>\n  <\/div>\n<\/div><\/section>\n<section class=\"hours\" id=\"hours\"><div class=\"wrap\">\n  <h2 class=\"serif\">\u146d\u148d\u144e\u14d5\u1546\u1528\u14a5\u1483 \u1455\u146f\u148d\u14aa\u1557\u1593<\/h2>\n  <p class=\"intro\">To see the dentist, you must complete <strong>both steps<\/strong>. Filling out the form alone is not enough.<\/p>\n<ol class=\"steps\">\n<li><span class=\"num\">Step 1<\/span><div>\n<h3>\u1455\u1455\u1550\u14f4\u14d7\u148d \u1455\u1455\u1550\u14f4\u1490\u1585 \u1583\u1546\u1455\u1405\u152d\u14a6\u1466\u1450\u1585 \u1455\u146f\u152d\u1405\u148d\u14aa\u1405\u144e\u1483<\/h3>\n<p>It takes about 3 minutes. The dental team receives it right away and uses it to see the most urgent cases first.<\/p>\n<p><a class=\"btn-triage\" href=\"#triage\">\u1455\u1455\u1550\u14f4\u14d7\u148d \u1455\u1455\u1550\u14f4\u1490\u1585 \u1583\u1546\u1455\u1405\u152d\u14a6\u1466\u1450\u1585 \u1455\u146f\u152d\u1405\u148d\u14aa\u1405\u144e\u1483 <span aria-hidden=\"true\">&#8594;<\/span><\/a><\/p>\n<\/div><\/li>\n<li><span class=\"num\">Step 2<\/span><div>\n<h3>Come to the hospital during the next emergency hours<\/h3>\n<p>After filling out the online triage form, come to the hospital and give your name to the receptionist. <strong>Do not wait for a call. No one will contact you to schedule an appointment.<\/strong><\/p>\n<\/div>\n<table class=\"sched\"><tbody><tr><th class=\"d\" scope=\"row\">\u140a\u14ea\u14d5\u1547\u14a5<\/th><td class=\"dt\">November 2, 2026<\/td><td class=\"h\">2 \u2013 4 \u157f\u144e\u154b\u14d5\u1547\u14a5<\/td><\/tr><tr><th class=\"d\" scope=\"row\">\u1401\u1449\u1438\u1593\u14d0\u14c2<\/th><td class=\"dt\">November 3, 2026<\/td><td class=\"h\">2 \u2013 4 \u157f\u144e\u154b\u14d5\u1547\u14a5<\/td><\/tr><tr><th class=\"d\" scope=\"row\">\u1431\u1593\u152a\u140a\u14d0\u14c2<\/th><td class=\"dt\">November 4, 2026<\/td><td class=\"h\">2 \u2013 4 \u157f\u144e\u154b\u14d5\u1547\u14a5<\/td><\/tr><tr><th class=\"d\" scope=\"row\">\u14ef\u1455\u14aa\u1593\u14d0\u14c2<\/th><td class=\"dt\">November 5, 2026<\/td><td class=\"h\">2 \u2013 4 \u157f\u144e\u154b\u14d5\u1547\u14a5<\/td><\/tr><tr><th class=\"d\" scope=\"row\">\u14c2\u157f\u1466\u14ef\u1555\u14bb\u14a5<\/th><td class=\"dt\">November 6, 2026<\/td><td class=\"h\">2 \u2013 4 \u157f\u144e\u154b\u14d5\u1547\u14a5<\/td><\/tr><tr class=\"off\"><th class=\"d\" scope=\"row\">\u140a\u14ea\u14d5\u158f\u14f1\u1593\u1550\u14a5<\/th><td class=\"dt\">November 7, 2026<\/td><td class=\"h off\">\u1405\u1483\u146f\u140a\u14ef\u14aa\u152a\u1585<\/td><\/tr><tr class=\"off\"><th class=\"d\" scope=\"row\">\u140a\u14ea\u14d5\u1450\u14c2<\/th><td class=\"dt\">November 8, 2026<\/td><td class=\"h off\">\u1405\u1483\u146f\u140a\u14ef\u14aa\u152a\u1585<\/td><\/tr><tr><th class=\"d\" scope=\"row\">\u140a\u14ea\u14d5\u1547\u14a5<\/th><td class=\"dt\">November 9, 2026<\/td><td class=\"h\">5 \u2013 7 \u157f\u144e\u154b\u14d5\u1547\u14a5<\/td><\/tr><tr><th class=\"d\" scope=\"row\">\u1401\u1449\u1438\u1593\u14d0\u14c2<\/th><td class=\"dt\">November 10, 2026<\/td><td class=\"h\">5 \u2013 7 \u157f\u144e\u154b\u14d5\u1547\u14a5<\/td><\/tr><tr><th class=\"d\" scope=\"row\">\u1431\u1593\u152a\u140a\u14d0\u14c2<\/th><td class=\"dt\">November 11, 2026<\/td><td class=\"h\">5 \u2013 7 \u157f\u144e\u154b\u14d5\u1547\u14a5<\/td><\/tr><tr><th class=\"d\" scope=\"row\">\u14ef\u1455\u14aa\u1593\u14d0\u14c2<\/th><td class=\"dt\">November 12, 2026<\/td><td class=\"h\">5 \u2013 7 \u157f\u144e\u154b\u14d5\u1547\u14a5<\/td><\/tr><tr><th class=\"d\" scope=\"row\">\u14c2\u157f\u1466\u14ef\u1555\u14bb\u14a5<\/th><td class=\"dt\">November 13, 2026<\/td><td class=\"h\">2 \u2013 4 \u157f\u144e\u154b\u14d5\u1547\u14a5<\/td><\/tr><tr class=\"off\"><th class=\"d\" scope=\"row\">\u140a\u14ea\u14d5\u158f\u14f1\u1593\u1550\u14a5<\/th><td class=\"dt\">November 14, 2026<\/td><td class=\"h off\">\u1405\u1483\u146f\u140a\u14ef\u14aa\u152a\u1585<\/td><\/tr><tr class=\"off\"><th class=\"d\" scope=\"row\">\u140a\u14ea\u14d5\u1450\u14c2<\/th><td class=\"dt\">November 15, 2026<\/td><td class=\"h off\">\u1405\u1483\u146f\u140a\u14ef\u14aa\u152a\u1585<\/td><\/tr><tr><th class=\"d\" scope=\"row\">\u140a\u14ea\u14d5\u1547\u14a5<\/th><td class=\"dt\">November 16, 2026<\/td><td class=\"h\">2 \u2013 4 \u157f\u144e\u154b\u14d5\u1547\u14a5<\/td><\/tr><tr><th class=\"d\" scope=\"row\">\u1401\u1449\u1438\u1593\u14d0\u14c2<\/th><td class=\"dt\">November 17, 2026<\/td><td class=\"h\">5 \u2013 7 \u157f\u144e\u154b\u14d5\u1547\u14a5<\/td><\/tr><tr><th class=\"d\" scope=\"row\">\u1431\u1593\u152a\u140a\u14d0\u14c2<\/th><td class=\"dt\">November 18, 2026<\/td><td class=\"h\">5 \u2013 7 \u157f\u144e\u154b\u14d5\u1547\u14a5<\/td><\/tr><tr><th class=\"d\" scope=\"row\">\u14ef\u1455\u14aa\u1593\u14d0\u14c2<\/th><td class=\"dt\">November 19, 2026<\/td><td class=\"h\">5 \u2013 7 \u157f\u144e\u154b\u14d5\u1547\u14a5<\/td><\/tr><tr><th class=\"d\" scope=\"row\">\u14c2\u157f\u1466\u14ef\u1555\u14bb\u14a5<\/th><td class=\"dt\">November 20, 2026<\/td><td class=\"h\">2 \u2013 4 \u157f\u144e\u154b\u14d5\u1547\u14a5<\/td><\/tr><tr class=\"off\"><th class=\"d\" scope=\"row\">\u140a\u14ea\u14d5\u158f\u14f1\u1593\u1550\u14a5<\/th><td class=\"dt\">November 21, 2026<\/td><td class=\"h off\">\u1405\u1483\u146f\u140a\u14ef\u14aa\u152a\u1585<\/td><\/tr><\/tbody><\/table>\n<\/li>\n<\/ol>\n  <p class=\"note\">\u146b\u1559\u14ea\u14da\u148d\u14ef\u1456\u1550\u1583\u14a6\u1466 \u140a\u14a5\u1490\u1550\u14aa\u1455, \u1405\u1403\u14aa\u14c7\u1550\u14ef\u14da\u1546\u1466\u1450\u1403\u146d\u14ef\u140a\u14c2 \u14ef\u1557\u14ea\u14d5\u1438\u1405\u1466\u152d\u1405\u1583\u1466\u1455\u14da\u1593\u152a\u1466. \u14c7\u146f\u1550\u14a6\u1483 \u1403\u1472\u152a\u1550\u14ef\u14aa\u1490\u1466\u14ef.<\/p>\n<\/div><\/section>\n<section class=\"form-sec\" id=\"triage\"><div class=\"wrap\">\n  <h2 class=\"serif\">\u1455\u1455\u14e3\u1483\u1520\u1585 \u1583\u1550\u1450\u140a\u1516\u1450\u1466\u144f\u1466\u1455\u1450\u1585<\/h2>\n<script>\nvar 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9.70711 1.70711L5.70711 5.70711C5.31658 6.09763 4.68342 6.09763 4.29289 5.70711L0.292893 1.70711C-0.0976311 1.31658 -0.0976311 0.683418 0.292893 0.292893Z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-icon-ctrl-search: url(\"data:image\/svg+xml,%3Csvg width='640' height='640' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath d='M256 128c-70.692 0-128 57.308-128 128 0 70.691 57.308 128 128 128 70.691 0 128-57.309 128-128 0-70.692-57.309-128-128-128zM64 256c0-106.039 85.961-192 192-192s192 85.961 192 192c0 41.466-13.146 79.863-35.498 111.248l154.125 154.125c12.496 12.496 12.496 32.758 0 45.254s-32.758 12.496-45.254 0L367.248 412.502C335.862 434.854 297.467 448 256 448c-106.039 0-192-85.962-192-192z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-label-space-y-secondary: var(--gf-label-space-y-md-secondary);--gf-ctrl-border-color: #686e77;--gf-ctrl-size: var(--gf-ctrl-size-md);--gf-ctrl-label-color-primary: #112337;--gf-ctrl-label-color-secondary: #112337;--gf-ctrl-choice-size: var(--gf-ctrl-choice-size-md);--gf-ctrl-checkbox-check-size: var(--gf-ctrl-checkbox-check-size-md);--gf-ctrl-radio-check-size: var(--gf-ctrl-radio-check-size-md);--gf-ctrl-btn-font-size: var(--gf-ctrl-btn-font-size-md);--gf-ctrl-btn-padding-x: var(--gf-ctrl-btn-padding-x-md);--gf-ctrl-btn-size: var(--gf-ctrl-btn-size-md);--gf-ctrl-btn-border-color-secondary: #686e77;--gf-ctrl-btn-bg-color-hover-tertiary: #EBEBEB;--gf-field-img-choice-size: var(--gf-field-img-choice-size-md);--gf-field-img-choice-card-space: var(--gf-field-img-choice-card-space-md);--gf-field-img-choice-check-ind-size: var(--gf-field-img-choice-check-ind-size-md);--gf-field-img-choice-check-ind-icon-size: var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style><div id='gf_1' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_1' id='gform_1'  action='\/in\/wp-json\/wp\/v2\/pages\/21#gf_1' data-formid='1' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_1' class='gform_fields top_label form_sublabel_below description_below validation_below' data-column-layout='fill'><div id=\"field_1_34\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_1_34' class='gfield_label gform-field-label' for='input_1_34'><span class='gform-field-label__text'>Comments<\/span><\/label><div class='ginput_container'><input name='input_34' id='input_1_34' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_1_34'>This field is for validation purposes and should be left unchanged.<\/div><\/div><div id=\"field_1_1\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"g1\" data-field-span=\"12\"><h3 class=\"gsection_title\">\u146d\u14c7\u1405\u14c3\u1550\u14c2\u1483 \u1583\u1405\u1528\u14aa\u1405\u144f\u1466<\/h3><\/div><div id=\"field_1_2\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"g2\" data-field-span=\"12\"><label id='gfield_label_1_2' class='gfield_label gform-field-label' for='input_1_2'><span class='gform-field-label__text'>\u140a\u144f\u1466<\/span><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_2' id='input_1_2' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_1_3\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"g3\" data-field-span=\"12\"><label id='gfield_label_1_3' class='gfield_label gform-field-label' for='input_1_3'><span class='gform-field-label__text'>\u140a\u144e\u14d5\u1550\u1580\u1466<\/span><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_3' id='input_1_3' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_1_4\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"g4\" data-field-span=\"12\"><legend id='gfield_label_1_4' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u14f1\u14c7\u1405\u14c3\u1466<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_1_4'>\n\t\t\t<div class='gchoice gchoice_1_4_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_4' type='radio' value='Female'  id='choice_1_4_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_1_4_0 gfield_label_1_4\"   \/>\n\t\t\t\t\t<label for='choice_1_4_0' id='label_1_4_0' class='gform-field-label gform-field-label--type-inline'>\u140a\u1550\u14c7\u1405\u14aa\u1594\u1449\u1431\u1466<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_4_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_4' type='radio' value='Male'  id='choice_1_4_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_1_4_1' id='label_1_4_1' class='gform-field-label gform-field-label--type-inline'>\u140a\u1591\u1455\u1405\u14bb\u14aa\u1594\u1449\u1431\u1466<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_4_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_4' type='radio' value='Other'  id='choice_1_4_2' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_1_4_2' id='label_1_4_2' class='gform-field-label gform-field-label--type-inline'>\u140a\u14ef\u1593\u1405\u148d\u1555\u1466<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_4_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_4' type='radio' value='Prefer not to say'  id='choice_1_4_3' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_1_4_3' id='label_1_4_3' class='gform-field-label gform-field-label--type-inline'>\u1405\u1583\u1548\u14aa\u1595\u158f\u146f\u1555\u14ea\u14d7<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_1_5\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datefield gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"g5\" data-field-span=\"12\"><legend id='gfield_label_1_5' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u1403\u14c5\u14d5\u1550\u1556\u1466<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_1_5' class='ginput_container ginput_complex gform-grid-row'>\n                                    <div class='gfield_date_day ginput_container ginput_container_date gform-grid-col' id='input_1_5_2_container'>\n                                        <input type=\"text\" inputmode=\"numeric\" pattern=\"[0-9]*\" maxlength=\"2\" autocomplete=\"bday-day\" name='input_5[]' id='input_1_5_2' value=''   aria-required='true'   aria-labelledby=\"input_1_5_2_label gfield_label_1_5\"  placeholder='DD' min='1' max='31' step='1'\/>\n                                        <label for='input_1_5_2' id='input_1_5_2_label' class='gform-field-label gform-field-label--type-sub '>Day<\/label>\n                                    <\/div><div class='gfield_date_month ginput_container ginput_container_date gform-grid-col' id='input_1_5_1_container'>\n                                    <select name=\"input_5[]\" id=\"input_1_5_1\" class=\"dn-month\"><option value=\"\">Month<\/option><option value=\"01\">January<\/option><option value=\"02\">February<\/option><option value=\"03\">March<\/option><option value=\"04\">April<\/option><option value=\"05\">May<\/option><option value=\"06\">June<\/option><option value=\"07\">July<\/option><option value=\"08\">August<\/option><option value=\"09\">September<\/option><option value=\"10\">October<\/option><option value=\"11\">November<\/option><option value=\"12\">December<\/option><\/select>\n                                    <label for='input_1_5_1' id='input_1_5_1_label' class='gform-field-label gform-field-label--type-sub '>Month<\/label>\n                               <\/div><div class='gfield_date_year ginput_container ginput_container_date gform-grid-col' id='input_1_5_3_container'>\n                                    <input type=\"text\" inputmode=\"numeric\" pattern=\"[0-9]*\" maxlength=\"4\" autocomplete=\"bday-year\" name='input_5[]' id='input_1_5_3' value=''   aria-required='true'   placeholder='YYYY' min='1920' max='2027' step='1'\/>\n                                    <label for='input_1_5_3' id='input_1_5_3_label' class='gform-field-label gform-field-label--type-sub '>Year<\/label>\n                               <\/div>\n                            <\/div><\/fieldset><div id=\"field_1_6\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"g6\" data-field-span=\"12\"><label id='gfield_label_1_6' class='gfield_label gform-field-label' for='input_1_6'><span class='gform-field-label__text'>\u1450\u154c\u1548\u144f\u1466<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_1_6' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_1_7\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"g7\" data-field-span=\"12\"><label id='gfield_label_1_7' class='gfield_label gform-field-label' for='input_1_7'><span class='gform-field-label__text'>\u14c4\u14c7\u14d6\u1466<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_7' id='input_1_7' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_1_8\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"g8\" data-field-span=\"12\"><label id='gfield_label_1_8' class='gfield_label gform-field-label' for='input_1_8'><span class='gform-field-label__text'>\u1433\u152e\u1559\u14d0\u14f0\u1466<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_1_8' type='text' value='Quebec' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_1_9\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"g9\" data-field-span=\"12\"><label id='gfield_label_1_9' class='gfield_label gform-field-label' for='input_1_9'><span class='gform-field-label__text'>\u140a\u14ea\u14da\u1456\u1550\u1555\u1431\u1466 \u14c7\u14d7\u14c0\u1483\u146f\u1455\u1593<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_1_9' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_1_10\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"g10\" data-field-span=\"12\"><label id='gfield_label_1_10' class='gfield_label gform-field-label' for='input_1_10'><span class='gform-field-label__text'>\u1405\u1473\u14da\u1405\u144f\u1466<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_10' id='input_1_10' type='tel' value='' class='large'  placeholder='(999) 999-9999'  aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/div><div id=\"field_1_11\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"g11\" data-field-span=\"12\"><label id='gfield_label_1_11' class='gfield_label gform-field-label' for='input_1_11'><span class='gform-field-label__text'>\u1583\u1546\u1455\u1405\u152d\u1483\u146f\u1466 \u140a\u14ea\u14da\u1456\u1550\u1556\u1466<\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_11' id='input_1_11' type='email' value='' class='large'     aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_1_12\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"g12\" data-field-span=\"12\"><h3 class=\"gsection_title\">\u1405\u1403\u14aa\u14c7\u1550\u14ef\u148d\u144e\u148b\u152d\u1550\u1431\u1466 \u1583\u1405\u1528\u14aa\u152d\u1405\u148d\u144e\u148b\u148b\u140a\u14d5\u1593<\/h3><\/div><fieldset id=\"field_1_13\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"g13\" data-field-span=\"12\"><legend id='gfield_label_1_13' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u1583\u14c4\u1403\u148d\u144f\u1466 \u140b\u14d0\u14c2\u140a\u144e\u1466\u14ef\u152a\u1585?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_1_13'>\n\t\t\t<div class='gchoice gchoice_1_13_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_13' type='radio' value='No'  id='choice_1_13_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_1_13_0 gfield_label_1_13\"   \/>\n\t\t\t\t\t<label for='choice_1_13_0' id='label_1_13_0' class='gform-field-label gform-field-label--type-inline'>\u140a\u1405\u1472<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_13_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_13' type='radio' value='Yes'  id='choice_1_13_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_1_13_1' id='label_1_13_1' class='gform-field-label gform-field-label--type-inline'>\u140b<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_1_14\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full dn-scale field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"g14\" data-field-span=\"12\"><legend id='gfield_label_1_14' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u1583\u14c4\u14ea\u14d7\u140a\u144e\u148c\u1483 \u140b\u14d0\u14c2\u140a\u144e\u148b\u14bb\u14aa\u1594\u1449\u1431\u1466 (1=\u140b\u14d0\u14c2\u140a\u14d7\u140a\u1595\u158f\u1450\u1585, 10=\u140b\u14d0\u14c2\u140a\u1559\u1550\u152a\u140a\u1450\u1585)<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_1_14'>\n\t\t\t<div class='gchoice gchoice_1_14_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='1'  id='choice_1_14_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_1_14_0 gfield_label_1_14\"   \/>\n\t\t\t\t\t<label for='choice_1_14_0' id='label_1_14_0' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_14_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='2'  id='choice_1_14_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_1_14_1' id='label_1_14_1' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_14_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='3'  id='choice_1_14_2' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_1_14_2' id='label_1_14_2' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_14_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='4'  id='choice_1_14_3' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_1_14_3' id='label_1_14_3' class='gform-field-label gform-field-label--type-inline'>4<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_14_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='5'  id='choice_1_14_4' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_1_14_4' id='label_1_14_4' class='gform-field-label gform-field-label--type-inline'>5<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_14_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='6'  id='choice_1_14_5' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_1_14_5' id='label_1_14_5' class='gform-field-label gform-field-label--type-inline'>6<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_14_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='7'  id='choice_1_14_6' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_1_14_6' id='label_1_14_6' class='gform-field-label gform-field-label--type-inline'>7<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_14_7'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='8'  id='choice_1_14_7' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_1_14_7' id='label_1_14_7' class='gform-field-label gform-field-label--type-inline'>8<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_14_8'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='9'  id='choice_1_14_8' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_1_14_8' id='label_1_14_8' class='gform-field-label gform-field-label--type-inline'>9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_14_9'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='10'  id='choice_1_14_9' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_1_14_9' id='label_1_14_9' class='gform-field-label gform-field-label--type-inline'>10<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_1_15\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"g15\" data-field-span=\"12\"><legend id='gfield_label_1_15' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u146d\u148d\u144f\u1449\u1431\u1466 \u1431\u14c0\u14d7\u1466\u14ef\u14ef\u14aa\u1405\u144e\u1593 (\u1455\u1550\u14ef\u14d7\u148b\u1466 \u1403\u14d7\u14d0\u14c7\u144e\u1483 \u1583\u14c4\u1403\u14d5\u1593\u14c2\u1550\u14c5\u14d5\u1593\u152a\u1466)<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_1_15'><div class='gchoice gchoice_1_15_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_15.1' type='checkbox'  value='Broken tooth or filling'  id='choice_1_15_1'    aria-labelledby=\"label_1_15_1 gfield_label_1_15\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_1_15_1' id='label_1_15_1' class='gform-field-label gform-field-label--type-inline'>\u146d\u148d\u144e\u1483 \u1403\u14da\u1550\u1450\u14c2\u1550\u14d7\u14c3\u1466 \u14ef\u1581\u14a5\u1466\u14ef\u14aa\u152a\u1585<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_1_15_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_15.2' type='checkbox'  value='Swelling'  id='choice_1_15_2'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_15_2' id='label_1_15_2' class='gform-field-label gform-field-label--type-inline'>\u1433\u14ea\u14d5\u1450\u1593<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_1_15_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_15.3' type='checkbox'  value='Fever'  id='choice_1_15_3'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_15_3' id='label_1_15_3' class='gform-field-label gform-field-label--type-inline'>\u1405\u14c7\u157f\u152a\u1593<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_1_15_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_15.4' type='checkbox'  value='Difficulty eating'  id='choice_1_15_4'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_15_4' id='label_1_15_4' class='gform-field-label gform-field-label--type-inline'>\u14c2\u1546\u1550\u1583\u152d\u1466\u14ef\u140a\u158f\u1466\u1450\u1593<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_1_15_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_15.5' type='checkbox'  value='Difficulty or pain when swallowing'  id='choice_1_15_5'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_15_5' id='label_1_15_5' class='gform-field-label gform-field-label--type-inline'>\u1404\u148b\u140a\u1550\u1583\u152d\u1466\u14ef\u140a\u158f\u1466\u1450\u1593 \u140b\u14d0\u14c2\u1583\u1466\u1455\u1450\u1550\u14d8\u14c3\u1466 \u1404\u148b\u140a\u14d5\u154b\u14a5<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_1_16\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"g16\" data-field-span=\"12\"><legend id='gfield_label_1_16' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u146d\u148d\u144e\u1405\u1449 \u1405\u1555\u14c2\u1593 \u1405\u1583\u1550\u14d8\u14c3\u1466 \u1431\u14c0\u14d7\u1455\u14d5\u1483?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_1_16'>\n\t\t\t<div class='gchoice gchoice_1_16_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='No'  id='choice_1_16_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_1_16_0 gfield_label_1_16\"   \/>\n\t\t\t\t\t<label for='choice_1_16_0' id='label_1_16_0' class='gform-field-label gform-field-label--type-inline'>\u140a\u1405\u1472<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_16_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='Yes'  id='choice_1_16_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_1_16_1' id='label_1_16_1' class='gform-field-label gform-field-label--type-inline'>\u140b<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_1_17\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"g17\" data-field-span=\"12\"><label id='gfield_label_1_17' class='gfield_label gform-field-label' for='input_1_17'><span class='gform-field-label__text'>\u140a\u14ef\u158f\u14ea\u14d6?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_17' id='input_1_17' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_1_18\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"g18\" data-field-span=\"12\"><legend id='gfield_label_1_18' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u14c7\u14ea\u14d5\u140a\u14c3\u1466\u1450\u1585?<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_1_18'><div class='gchoice gchoice_1_18_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.1' type='checkbox'  value='Top'  id='choice_1_18_1'    aria-labelledby=\"label_1_18_1 gfield_label_1_18\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_1_18_1' id='label_1_18_1' class='gform-field-label gform-field-label--type-inline'>\u1584\u1593\u14c2<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_1_18_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.2' type='checkbox'  value='Bottom'  id='choice_1_18_2'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_18_2' id='label_1_18_2' class='gform-field-label gform-field-label--type-inline'>\u140a\u1456\u14c2<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_1_18_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.3' type='checkbox'  value='Left'  id='choice_1_18_3'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_18_3' id='label_1_18_3' class='gform-field-label gform-field-label--type-inline'>\u14f4\u1405\u14a5\u140a\u14c2<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_1_18_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.4' type='checkbox'  value='Right'  id='choice_1_18_4'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_18_4' id='label_1_18_4' class='gform-field-label gform-field-label--type-inline'>\u1455\u14d5\u1550\u1431\u140a\u14c2<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_1_19\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"g19\" data-field-span=\"12\"><legend id='gfield_label_1_19' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u1583\u1593 \u140b\u14d0\u14c2\u140a\u148b\u140a\u14ef\u14d0\u14c2\u157f\u1466 \u1405\u155d\u1559\u14d7\u14d0\u14c3\u1466 \u1583\u1593 \u1583\u14c4\u1403\u148b\u140a\u1595\u1593\u14ef\u14d0\u14c2\u157f\u1466?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_1_19'>\n\t\t\t<div class='gchoice gchoice_1_19_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='Today'  id='choice_1_19_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_1_19_0 gfield_label_1_19\"   \/>\n\t\t\t\t\t<label for='choice_1_19_0' id='label_1_19_0' class='gform-field-label gform-field-label--type-inline'>\u1405\u14ea\u14d7\u14a5<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_19_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='Yesterday'  id='choice_1_19_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_1_19_1' id='label_1_19_1' class='gform-field-label gform-field-label--type-inline'>\u1403\u1449\u1438\u14f4\u1585<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_19_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='Last week'  id='choice_1_19_2' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_1_19_2' id='label_1_19_2' class='gform-field-label gform-field-label--type-inline'>\u1431\u14c7\u14f1\u140a\u1548\u14ef\u1405\u14da\u1405\u152a\u14a5<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_19_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='Last month'  id='choice_1_19_3' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_1_19_3' id='label_1_19_3' class='gform-field-label gform-field-label--type-inline'>\u1455\u1550\u157f\u1405\u14da\u1405\u152a\u14a5<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_1_20\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"g20\" data-field-span=\"12\"><legend id='gfield_label_1_20' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u144e\u14a6\u1466 \u14c8\u14bb\u14aa\u148b\u1595\u158f\u1455\u14a5\u14c4\u1466 \u14f1\u1550\u154b\u1455\u1405\u14f2\u1585?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_1_20'>\n\t\t\t<div class='gchoice gchoice_1_20_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='No'  id='choice_1_20_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_1_20_0 gfield_label_1_20\"   \/>\n\t\t\t\t\t<label for='choice_1_20_0' id='label_1_20_0' class='gform-field-label gform-field-label--type-inline'>\u140a\u1405\u1472<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_20_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='Yes'  id='choice_1_20_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_1_20_1' id='label_1_20_1' class='gform-field-label gform-field-label--type-inline'>\u140b<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_1_21\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"g21\" data-field-span=\"12\"><label id='gfield_label_1_21' class='gfield_label gform-field-label' for='input_1_21'><span class='gform-field-label__text'>\u1450\u146d\u14ef\u14c7\u1550\u144e\u148d\u1483<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_21' id='input_1_21' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_1_22\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"g22\" data-field-span=\"12\"><legend id='gfield_label_1_22' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u1431\u140a\u154b\u1466\u14f4\u1583\u1550\u1580\u1466?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_1_22'>\n\t\t\t<div class='gchoice gchoice_1_22_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='No'  id='choice_1_22_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_1_22_0 gfield_label_1_22\"   \/>\n\t\t\t\t\t<label for='choice_1_22_0' id='label_1_22_0' class='gform-field-label gform-field-label--type-inline'>\u140a\u1405\u1472<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_22_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='Yes'  id='choice_1_22_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_1_22_1' id='label_1_22_1' class='gform-field-label gform-field-label--type-inline'>\u140b<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_22_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='Maybe'  id='choice_1_22_2' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_1_22_2' id='label_1_22_2' class='gform-field-label gform-field-label--type-inline'>\u1583\u1405\u1528\u14aa\u1595\u158f\u14da\u1593<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_1_23\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"g23\" data-field-span=\"12\"><legend id='gfield_label_1_23' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u140b\u14d0\u14c2\u140a\u14ef\u1405\u144e\u1451\u14aa\u1556\u1466?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_1_23'>\n\t\t\t<div class='gchoice gchoice_1_23_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='No'  id='choice_1_23_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_1_23_0 gfield_label_1_23\"   \/>\n\t\t\t\t\t<label for='choice_1_23_0' id='label_1_23_0' class='gform-field-label gform-field-label--type-inline'>\u140a\u1405\u1472<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_23_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='Yes'  id='choice_1_23_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_1_23_1' id='label_1_23_1' class='gform-field-label gform-field-label--type-inline'>\u140b<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_1_24\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"g24\" data-field-span=\"12\"><label id='gfield_label_1_24' class='gfield_label gform-field-label' for='input_1_24'><span class='gform-field-label__text'>\u1450\u146d\u14ef\u14c7\u1550\u144e\u148d\u1483<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_24' id='input_1_24' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_1_25\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"g25\" data-field-span=\"12\"><div class='ginput_container ginput_container_text'><input name='input_25' id='input_1_25' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><fieldset id=\"field_1_31\" class=\"gfield gfield--type-consent gfield--type-choice dn-consent gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"><legend id='gfield_label_1_31' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Consent<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_31.1' id='input_1_31_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_1_31\" aria-labelledby=\"input_1_31_1_label gfield_label_1_31\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label id='input_1_31_1_label' class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_1_31_1' ><span class='gform-field-label__text'>I consent to the Ungava Tulattavik Health Centre collecting and using the health information above to assess my dental condition and contact me about care.<\/span><\/label><input type='hidden' name='input_31.2' value='I consent to the Ungava Tulattavik Health Centre collecting and using the health information above to assess my dental condition and contact me about care.' class='gform_hidden' \/><input type='hidden' name='input_31.3' value='2' class='gform_hidden' \/><\/div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_1_31'><div class='gfield_consent_description_text gform-theme__no-reset--children' tabindex='0'><p class=\"dn-privacy-notice\">The CSTU collects this information only to assess how urgent your dental problem is and to contact you about care. It is stored on a server located in Canada, seen only by the dental team, and deleted after 60 days. You can withdraw your consent, or ask to see or correct your information, at any time at <a href=\"mailto:acces.information.cstu@ssss.gouv.qc.ca\">acces.information.cstu@ssss.gouv.qc.ca<\/a>. For a child under 14, a parent or guardian must complete this form. More in our <a href=\"\/privacy-policy\/\">privacy policy<\/a>.<\/p><\/div><\/div><\/fieldset><fieldset id=\"field_1_32\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full dn-consent dn-must gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"970aac63\" data-field-span=\"12\"><legend id='gfield_label_1_32' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Hospital visit<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_32.1' id='input_1_32_1' type='checkbox' value='1'   aria-labelledby=\"input_1_32_1_label gfield_label_1_32\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label id='input_1_32_1_label' class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_1_32_1' ><span class='gform-field-label__text'>I understand that I have to come to the hospital during the next emergency hours to see the dentist.<\/span><\/label><input type='hidden' name='input_32.2' value='I understand that I have to come to the hospital during the next emergency hours to see the dentist.' class='gform_hidden' \/><input type='hidden' name='input_32.3' value='2' class='gform_hidden' \/><\/div><\/fieldset><div id=\"field_1_29\" class=\"gfield gfield--type-turnstile gfield--input-type-turnstile gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"g29\" data-field-span=\"12\"><div class='ginput_container ginput_container_turnstile'><div class=\"cf-turnstile\" id=\"cf-turnstile_1\" data-js-turnstile data-response-field-name=\"cf-turnstile-response_1\" 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jQuery(this).contents().find('#gform_wrapper_1');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_1').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){form_content.find('form').css('opacity', 0);jQuery('#gform_wrapper_1').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_1').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_1').removeClass('gform_validation_error');}setTimeout( function() { \/* delay the scroll by 50 milliseconds to fix a bug in chrome *\/ jQuery(document).scrollTop(jQuery('#gform_wrapper_1').offset().top - mt); }, 50 );var current_page = jQuery('#gform_source_page_number_1').val();jQuery(document).trigger('gform_page_loaded', [1, current_page]);window['gf_submitting_1'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}jQuery('#gform_wrapper_1').replaceWith(confirmation_content);jQuery(document).scrollTop(jQuery('#gf_1').offset().top - mt);jQuery(document).trigger('gform_confirmation_loaded', [1]);if(window.gform && gform.pagination && gform.pagination.removePageQueryArg){gform.pagination.removePageQueryArg(1);}window['gf_submitting_1'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_1').text());}else{jQuery('#gform_1').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger(\"gform_pre_post_render\", [{ formId: \"1\", currentPage: \"current_page\", abort: function() { this.preventDefault(); } }]);        if (event && event.defaultPrevented) {                return;        }        const gformWrapperDiv = document.getElementById( \"gform_wrapper_1\" );        if ( gformWrapperDiv ) {            const visibilitySpan = document.createElement( \"span\" );            visibilitySpan.id = \"gform_visibility_test_1\";            gformWrapperDiv.insertAdjacentElement( \"afterend\", visibilitySpan );        }        const visibilityTestDiv = document.getElementById( \"gform_visibility_test_1\" );        let postRenderFired = false;        function triggerPostRender() {            if ( postRenderFired ) {                return;            }            postRenderFired = true;            gform.core.triggerPostRenderEvents( 1, current_page );            if ( visibilityTestDiv ) {                visibilityTestDiv.parentNode.removeChild( visibilityTestDiv );            }        }        function debounce( func, wait, immediate ) {            var timeout;            return function() {                var context = this, args = arguments;                var later = function() {                    timeout = null;                 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true,                attributeFilter: [ 'style', 'class' ],            });        } else {            triggerPostRender();        }    } );} );\n<\/script>\n\n<\/div><\/section>\n<section class=\"viz\" id=\"renovations\"><div class=\"wrap\"><div class=\"grid\">\n  <figure>\n    <span class=\"box ph\"><img src=\"https:\/\/dentistnunavik.com\/wp-content\/uploads\/2026\/09\/dentistnunavik-old-clinic-closed.jpg\" srcset=\"https:\/\/dentistnunavik.com\/wp-content\/uploads\/2026\/09\/dentistnunavik-old-clinic-closed-300x169.jpg 300w, https:\/\/dentistnunavik.com\/wp-content\/uploads\/2026\/09\/dentistnunavik-old-clinic-closed-768x432.jpg 768w, https:\/\/dentistnunavik.com\/wp-content\/uploads\/2026\/09\/dentistnunavik-old-clinic-closed-1024x576.jpg 1024w, https:\/\/dentistnunavik.com\/wp-content\/uploads\/2026\/09\/dentistnunavik-old-clinic-closed.jpg 1200w\" sizes=\"auto, (max-width:760px) 92vw, 60vw\" alt=\"The dental clinic reception, closed for renovations\" width=\"1200\" height=\"675\" loading=\"lazy\" decoding=\"async\"><\/span>\n    <figcaption>The current clinic is <b>CLOSED<\/b> during the renovations.<\/figcaption>\n  <\/figure>\n  <figure>\n    <span class=\"box pl\"><img src=\"https:\/\/dentistnunavik.com\/wp-content\/uploads\/2026\/09\/dentistnunavik-future-clinic.jpeg\" srcset=\"https:\/\/dentistnunavik.com\/wp-content\/uploads\/2026\/09\/dentistnunavik-future-clinic-300x300.jpeg 300w, https:\/\/dentistnunavik.com\/wp-content\/uploads\/2026\/09\/dentistnunavik-future-clinic-768x768.jpeg 768w, https:\/\/dentistnunavik.com\/wp-content\/uploads\/2026\/09\/dentistnunavik-future-clinic.jpeg 1024w\" sizes=\"auto, (max-width:760px) 92vw, 34vw\" alt=\"Isometric plan of the renovated dental clinic\" width=\"1024\" height=\"1024\" loading=\"lazy\" decoding=\"async\"><\/span>\n    <figcaption>The renovated clinic will be reopening in <b>WINTER 2027<\/b>.<\/figcaption>\n  <\/figure>\n<\/div>\n  <div class=\"pagefoot\">\n    <p class=\"updated\">Last updated: October 29, 2026 &middot; <a href=\"https:\/\/dentistnunavik.com\/privacy-policy\/\">Privacy policy<\/a><\/p>\n    <nav class=\"langs\" aria-label=\"Language\"><a href=\"https:\/\/dentistnunavik.com\/in\/\">English<\/a><a href=\"https:\/\/dentistnunavik.com\/in\/\">Fran\u00e7ais<\/a><a aria-current=\"page\" href=\"https:\/\/dentistnunavik.com\/in\/\">\u1403\u14c4\u1483\u144e\u1450\u1466<\/a><\/nav>\n  <\/div>\n<\/div><\/section>\n\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>EN|FR|IN \u146f\u1466\u152a\u140a\u1449 \u146d\u148d\u144e\u14d5\u1546\u152d\u1405\u1555\u1593 \u14c4\u1455\u1405\u14ef\u14d5\u144e\u1550\u1455\u1405\u14aa\u1546\u14c2\u1583\u1550\u14aa\u1466 \u14ab\u14d0\u14c7 \u1431\u1405\u14ef\u14d5\u144e\u1550\u1455\u1405\u148b\u140a\u1583\u1550\u14aa\u1455 \u1431\u14bb\u14aa\u1547\u1466 \u1405\u146f\u140a: \u1405\u1438\u148b\u140a\u146d\u14d0\u14c2\u14f4\u1405\u1581\u14ea\u14d7\u148d, \u140b\u14d0\u14c2\u140a\u1456\u1548\u144e\u1405\u148d\u14d0\u14c7\u1450\u14c2\u14ea\u14d7 \u1403\u146f\u14ea\u14da\u144e\u1466\u14ef\u14c2\u1550\u14f4\u1405\u14d7\u14c2, \u1431\u14c7\u14f1\u1466\u144e\u1455\u14d7 \u1431\u14c7\u14f1\u140a\u1550\u1555\u158f\u14ea\u14c2\u1483 \u1431\u1405\u14ef\u14d5\u144e\u1546\u14c2\u1550\u14f4\u1405\u14d7\u14c2 \u14f1\u14c7\u1483\u146f\u1555\u1583\u1405\u144e\u14d5\u1405\u1550\u1455\u1405\u14ef\u140a\u1550\u14d7\u14c2\u14d7. Severe emergency \u1403\u1472\u152a\u1550\u1455\u1405\u14f4\u1405\u144e\u148b\u148d\u14aa\u148d\u1555\u1466 (\u140a\u14c2\u1550\u144e\u1546\u1550\u1583\u152d\u1466\u14ef\u140a\u158f\u1483\u146f\u1555\u1466, \u146e\u14c0\u1466 \u1433\u14ea\u14d5\u1438\u1466, \u140a\u14ef\u158f\u14ea\u14d7), \u146f\u1466\u152a\u140a\u1449 \u140b\u14d0\u14c2\u140a\u1555\u1593\u14c5\u1466\u14f4\u1405\u144e\u148b\u148b\u1466 \u00b7 819-964-9090 \u146d\u148d\u144e\u14d5\u1546\u1528\u14a5\u1483 \u1455\u146f\u148d\u14aa\u1557\u1593 To see the dentist, you must complete both steps. Filling out the form alone is not enough. Step 1 \u1455\u1455\u1550\u14f4\u14d7\u148d \u1455\u1455\u1550\u14f4\u1490\u1585 \u1583\u1546\u1455\u1405\u152d\u14a6\u1466\u1450\u1585 \u1455\u146f\u152d\u1405\u148d\u14aa\u1405\u144e\u1483 It takes about 3 [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-21","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/dentistnunavik.com\/in\/wp-json\/wp\/v2\/pages\/21","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dentistnunavik.com\/in\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dentistnunavik.com\/in\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dentistnunavik.com\/in\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/dentistnunavik.com\/in\/wp-json\/wp\/v2\/comments?post=21"}],"version-history":[{"count":53,"href":"https:\/\/dentistnunavik.com\/in\/wp-json\/wp\/v2\/pages\/21\/revisions"}],"predecessor-version":[{"id":214,"href":"https:\/\/dentistnunavik.com\/in\/wp-json\/wp\/v2\/pages\/21\/revisions\/214"}],"wp:attachment":[{"href":"https:\/\/dentistnunavik.com\/in\/wp-json\/wp\/v2\/media?parent=21"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}