{"id":11354,"date":"2024-03-26T22:53:02","date_gmt":"2024-03-27T02:53:02","guid":{"rendered":"https:\/\/toimoibebe.ca\/?page_id=11354"},"modified":"2024-05-06T11:14:37","modified_gmt":"2024-05-06T15:14:37","slug":"create-a-profile-form","status":"publish","type":"page","link":"https:\/\/toimoibebe.ca\/en\/create-a-profile-form\/","title":{"rendered":"Create a profile"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"11354\" class=\"elementor elementor-11354 elementor-10953\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f09ffba e-flex e-con-boxed e-con e-parent\" data-id=\"f09ffba\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-26dd527 elementor-widget elementor-widget-html\" data-id=\"26dd527\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<ul>\n    <li><a href=\"\/en\/create-a-profile\/\">1<\/a><\/li>\n    <li class=\"active\">2<\/li>\n    <li>3<\/li>\n<\/ul>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-b552763 e-flex e-con-boxed e-con e-parent\" data-id=\"b552763\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d9bb5cc elementor-widget elementor-widget-shortcode\" data-id=\"d9bb5cc\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\">\n<div class=\"um um-register um-9215\">\n\t<div class=\"um-form\" data-mode=\"register\">\n\t\t<form method=\"post\" action=\"\">\n\t\t\t<div class=\"um-row _um_row_1 \" style=\"padding: 0px 0px 0px 0px;margin: 0px 0px 50px 0px;border-width: 0px 0px 0px 0px;border-style: solid;border-radius: 0px;\"><div class=\"um-col-1\"><div  id=\"um_field_9215_first_name\" class=\"um-field um-field-text  um-field-first_name um-field-text um-field-type_text\" data-key=\"first_name\"><div class=\"um-field-area\"><div class=\"um-field-icon\"><i class=\"um-faicon-user\"><\/i><\/div><input  autocomplete=\"off\" class=\"um-form-field valid not-required um-iconed \" type=\"text\" name=\"first_name-9215\" id=\"first_name-9215\" value=\"\" placeholder=\"First Name\" data-validate=\"\" data-key=\"first_name\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_9215_last_name\" class=\"um-field um-field-text  um-field-last_name um-field-text um-field-type_text\" data-key=\"last_name\"><div class=\"um-field-area\"><div class=\"um-field-icon\"><i class=\"um-faicon-user\"><\/i><\/div><input  autocomplete=\"off\" class=\"um-form-field valid not-required um-iconed \" type=\"text\" name=\"last_name-9215\" id=\"last_name-9215\" value=\"\" placeholder=\"Last Name\" data-validate=\"\" data-key=\"last_name\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_9215_user_email\" class=\"um-field um-field-text  um-field-user_email um-field-text um-field-type_text\" data-key=\"user_email\"><div class=\"um-field-area\"><div class=\"um-field-icon\"><i class=\"um-icon-email\"><\/i><\/div><input  autocomplete=\"off\" class=\"um-form-field valid not-required um-iconed \" type=\"text\" name=\"user_email-9215\" id=\"user_email-9215\" value=\"\" placeholder=\"E-mail Address\" data-validate=\"unique_email\" data-key=\"user_email\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_9215_user_password\" class=\"um-field um-field-password  um-field-user_password um-field-password um-field-type_password\" data-key=\"user_password\"><div class=\"um-field-area\"><div class=\"um-field-icon\"><i class=\"um-faicon-key\"><\/i><\/div><input class=\"um-form-field valid um-iconed \" type=\"password\" name=\"user_password-9215\" id=\"user_password-9215\" value=\"\" placeholder=\"Password\" data-validate=\"\" data-key=\"user_password\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_9215_confirm_user_password\" class=\"um-field um-field-password  um-field-user_password um-field-password um-field-type_password\" data-key=\"confirm_user_password\"><div class=\"um-field-area\"><div class=\"um-field-icon\"><i class=\"um-faicon-key\"><\/i><\/div><input class=\"um-form-field valid um-iconed \" type=\"password\" name=\"confirm_user_password-9215\" id=\"confirm_user_password-9215\" value=\"\" placeholder=\"Confirm Password\" data-validate=\"\" data-key=\"confirm_user_password\"  aria-invalid=\"false\" \/><\/div><\/div><\/div><\/div><div class=\"um-row _um_row_2 form-section-2\" style=\"padding: 0px 0px 0px 0px;margin: 0px 0px 50px 0px;border-width: 0px 0px 0px 0px;border-style: solid;border-radius: 0px;\"><div class=\"um-col-1\"><div  id=\"um_field_9215_raison_participation_10\" class=\"um-field um-field-radio  um-field-raison_participation_10 um-field-radio um-field-type_radio\" data-key=\"raison_participation_10\"  aria-invalid=\"false\" ><div class=\"um-field-label\"><label for=\"raison_participation_10-9215\">You are...<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><label class=\"um-field-radio  um-field-half \"><input  type=\"radio\" name=\"raison_participation_10[]\" value=\"Pregnant\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">Pregnant<\/span><\/label><label class=\"um-field-radio  um-field-half  right \"><input  type=\"radio\" name=\"raison_participation_10[]\" value=\"A mother\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">A mother<\/span><\/label><div class=\"um-clear\"><\/div><label class=\"um-field-radio  um-field-half \"><input  type=\"radio\" name=\"raison_participation_10[]\" value=\"Someone who take care of a pregnant person\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">Someone who take care of a pregnant person<\/span><\/label><label class=\"um-field-radio  um-field-half  right \"><input  type=\"radio\" name=\"raison_participation_10[]\" value=\"A healthcare professional\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">A healthcare professional<\/span><\/label><div class=\"um-clear\"><\/div><label class=\"um-field-radio  um-field-half \"><input  type=\"radio\" name=\"raison_participation_10[]\" value=\"Other (please specify)\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">Other (please specify)<\/span><\/label><div class=\"um-clear\"><\/div><\/div><\/div><div  id=\"um_field_9215_recrutee-autre_10\" class=\"um-field um-field-text  um-field-recrutee-autre_10 um-field-text um-field-type_text\" data-key=\"recrutee-autre_10\"><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid not-required \" type=\"text\" name=\"recrutee-autre_10-9215\" id=\"recrutee-autre_10-9215\" value=\"\" placeholder=\"Other (specify)\" data-validate=\"\" data-key=\"recrutee-autre_10\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><\/div><\/div><div class=\"um-row _um_row_3 form-section-2\" style=\"padding: 0px 0px 0px 0px;margin: 0px 0px 50px 0px;border-width: 0px 0px 0px 0px;border-style: solid;border-radius: 0px;\"><div class=\"um-col-1\"><div  id=\"um_field_9215_raison_participation\" class=\"um-field um-field-radio  um-field-raison_participation um-field-radio um-field-type_radio\" data-key=\"raison_participation\"  aria-invalid=\"false\" ><div class=\"um-field-label\"><label for=\"raison_participation-9215\">How did you hear about You, Me, Baby?<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><label class=\"um-field-radio  um-field-half \"><input  type=\"radio\" name=\"raison_participation[]\" value=\"Social network\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">Social network<\/span><\/label><label class=\"um-field-radio  um-field-half  right \"><input  type=\"radio\" name=\"raison_participation[]\" value=\"Consultation with a care provider\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">Consultation with a care provider<\/span><\/label><div class=\"um-clear\"><\/div><label class=\"um-field-radio  um-field-half \"><input  type=\"radio\" name=\"raison_participation[]\" value=\"Hospitalization\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">Hospitalization<\/span><\/label><label class=\"um-field-radio  um-field-half  right \"><input  type=\"radio\" name=\"raison_participation[]\" value=\"Someone you know\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">Someone you know<\/span><\/label><div class=\"um-clear\"><\/div><label class=\"um-field-radio  um-field-half \"><input  type=\"radio\" name=\"raison_participation[]\" value=\"Other (please specify)\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">Other (please specify)<\/span><\/label><div class=\"um-clear\"><\/div><\/div><\/div><div  id=\"um_field_9215_recrutee-autre\" class=\"um-field um-field-text  um-field-recrutee-autre um-field-text um-field-type_text\" data-key=\"recrutee-autre\"><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid not-required \" type=\"text\" name=\"recrutee-autre-9215\" id=\"recrutee-autre-9215\" value=\"\" placeholder=\"Other (specify)\" data-validate=\"\" data-key=\"recrutee-autre\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><\/div><\/div>\t<input type=\"hidden\" name=\"form_id\" id=\"form_id_9215\" value=\"9215\" \/>\n\t\t<p class=\"um_request_name\">\n\t\t<label for=\"um_request_9215\">Only fill in if you are not human<\/label>\n\t\t<input type=\"hidden\" name=\"um_request\" id=\"um_request_9215\" class=\"input\" value=\"\" size=\"25\" autocomplete=\"off\" \/>\n\t<\/p>\n\t<input type=\"hidden\" id=\"_wpnonce\" name=\"_wpnonce\" value=\"8c4848a59f\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/en\/wp-json\/wp\/v2\/pages\/11354\" \/>\n<div class=\"g-recaptcha\" id=\"um-9215\" data-mode=\"register\"><\/div>\n\n\n\t<div class=\"um-col-alt\">\n\n\t\t\n\t\t\t<div class=\"um-center\">\n\t\t\t\t<input type=\"submit\" value=\"Finish\" class=\"um-button\" id=\"um-submit-btn\" \/>\n\t\t\t<\/div>\n\n\t\t\n\t\t<div class=\"um-clear\"><\/div>\n\n\t<\/div>\n\n\t\t\t<\/form>\n\t<\/div>\n<\/div>\n<style>\n\t\t\t.um-9215.um {\n\t\t\tmax-width: 800px;\n\t\t}\n\t\t<\/style>\n<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>1 2 3<\/p>\n","protected":false},"author":13861,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"site-sidebar-layout":"no-sidebar","site-content-layout":"page-builder","ast-site-content-layout":"full-width-container","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"disabled","ast-breadcrumbs-content":"","ast-featured-img":"disabled","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"h5ap_radio_sources":[],"footnotes":""},"wf_page_folders":[61],"class_list":["post-11354","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/toimoibebe.ca\/en\/wp-json\/wp\/v2\/pages\/11354","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/toimoibebe.ca\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/toimoibebe.ca\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/toimoibebe.ca\/en\/wp-json\/wp\/v2\/users\/13861"}],"replies":[{"embeddable":true,"href":"https:\/\/toimoibebe.ca\/en\/wp-json\/wp\/v2\/comments?post=11354"}],"version-history":[{"count":19,"href":"https:\/\/toimoibebe.ca\/en\/wp-json\/wp\/v2\/pages\/11354\/revisions"}],"predecessor-version":[{"id":11842,"href":"https:\/\/toimoibebe.ca\/en\/wp-json\/wp\/v2\/pages\/11354\/revisions\/11842"}],"wp:attachment":[{"href":"https:\/\/toimoibebe.ca\/en\/wp-json\/wp\/v2\/media?parent=11354"}],"wp:term":[{"taxonomy":"wf_page_folders","embeddable":true,"href":"https:\/\/toimoibebe.ca\/en\/wp-json\/wp\/v2\/wf_page_folders?post=11354"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}