{"id":7234,"date":"2025-02-18T17:51:11","date_gmt":"2025-02-18T17:51:11","guid":{"rendered":"https:\/\/clinimed.pt\/?page_id=7234"},"modified":"2025-03-13T15:25:12","modified_gmt":"2025-03-13T15:25:12","slug":"internal-medicine","status":"publish","type":"page","link":"https:\/\/clinimed.pt\/en\/internal-medicine\/","title":{"rendered":"Internal Medicine"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; fullwidth=&#8221;on&#8221; custom_padding_last_edited=&#8221;on|desktop&#8221; admin_label=&#8221;Section&#8221; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;|||&#8221; custom_padding_tablet=&#8221;50px|0|50px|0&#8243; custom_padding_phone=&#8221;&#8221; transparent_background=&#8221;off&#8221; padding_mobile=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221; theme_builder_area=&#8221;post_content&#8221;][et_pb_fullwidth_header title=&#8221;Internal Medicine&#8221; background_overlay_color=&#8221;rgba(0,119,189,0.88)&#8221; admin_label=&#8221;Contactos e Localiza\u00e7\u00e3o&#8221; _builder_version=&#8221;4.25.0&#8243; _dynamic_attributes=&#8221;title&#8221; title_font=&#8221;&#8211;et_global_heading_font|&#8211;et_global_heading_font_weight|||||||&#8221; title_font_size=&#8221;32px&#8221; background_color=&#8221;#f69000&#8243; background_image=&#8221;https:\/\/clinimed.pt\/wp-content\/uploads\/2016\/10\/doctor-banner.jpg&#8221; background_last_edited=&#8221;off|phone&#8221; background_url=&#8221;https:\/\/clinimed.pt\/wp-content\/uploads\/2016\/10\/doctor-banner.jpg&#8221; button_one_letter_spacing_hover=&#8221;0&#8243; button_two_letter_spacing_hover=&#8221;0&#8243; saved_tabs=&#8221;advanced,css&#8221; global_colors_info=&#8221;{}&#8221; button_one_text_size__hover_enabled=&#8221;off&#8221; button_two_text_size__hover_enabled=&#8221;off&#8221; button_one_text_color__hover_enabled=&#8221;off&#8221; button_two_text_color__hover_enabled=&#8221;off&#8221; button_one_border_width__hover_enabled=&#8221;off&#8221; button_two_border_width__hover_enabled=&#8221;off&#8221; 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background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; text_orientation=&#8221;center&#8221; module_alignment=&#8221;center&#8221; custom_margin=&#8221;1em||0.4em|&#8221; border_color_all=&#8221;#AADDFA&#8221; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221; saved_tabs=&#8221;all&#8221; global_colors_info=&#8221;{}&#8221; theme_builder_area=&#8221;post_content&#8221;]<\/p>\n<p>Definition<\/p>\n<p>[\/et_pb_text][et_pb_divider color=&#8221;#aaddfa&#8221; divider_weight=&#8221;1px&#8221; disabled_on=&#8221;on|on|off&#8221; admin_label=&#8221;Divider&#8221; _builder_version=&#8221;4.16&#8243; hide_on_mobile=&#8221;on&#8221; global_colors_info=&#8221;{}&#8221; theme_builder_area=&#8221;post_content&#8221;] [\/et_pb_divider][\/et_pb_column][et_pb_column type=&#8221;1_2&#8243; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;|||&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221; theme_builder_area=&#8221;post_content&#8221;][et_pb_text admin_label=&#8221;Text&#8221; _builder_version=&#8221;4.25.0&#8243; text_font=&#8221;Cairo|||on|&#8221; text_text_color=&#8221;#0077BD&#8221; text_font_size=&#8221;20px&#8221; header_font=&#8221;Cairo||||&#8221; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; text_orientation=&#8221;center&#8221; module_alignment=&#8221;center&#8221; custom_margin=&#8221;1em||0.4em|&#8221; border_color_all=&#8221;#AADDFA&#8221; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221; saved_tabs=&#8221;all&#8221; global_colors_info=&#8221;{}&#8221; theme_builder_area=&#8221;post_content&#8221;]<\/p>\n<p>SCHEDULES AND PROFESSIONALS<\/p>\n<p>[\/et_pb_text][et_pb_divider color=&#8221;#aaddfa&#8221; divider_weight=&#8221;1px&#8221; disabled_on=&#8221;on|on|off&#8221; admin_label=&#8221;Divider&#8221; _builder_version=&#8221;4.16&#8243; hide_on_mobile=&#8221;on&#8221; global_colors_info=&#8221;{}&#8221; theme_builder_area=&#8221;post_content&#8221;] [\/et_pb_divider][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=&#8221;1_2,1_2&#8243; padding_mobile=&#8221;off&#8221; column_padding_mobile=&#8221;on&#8221; admin_label=&#8221;Row&#8221; _builder_version=&#8221;4.16&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; global_colors_info=&#8221;{}&#8221; theme_builder_area=&#8221;post_content&#8221;][et_pb_column type=&#8221;1_2&#8243; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;|||&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221; theme_builder_area=&#8221;post_content&#8221;][et_pb_text disabled_on=&#8221;off|off|off&#8221; admin_label=&#8221;Especialidade&#8221; _builder_version=&#8221;4.27.4&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; 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With a comprehensive and integrated approach, internists assess each patient holistically, considering their medical history, lifestyle, and risk factors to develop effective and personalized treatment plans.<\/p>\n<p>This specialty plays a crucial role in the early detection of diseases, the management of chronic conditions, and the coordination of multidisciplinary medical care. 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                          <input type='text' name='input_1.6' id='input_5_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_5_1_6' class='gform-field-label gform-field-label--type-sub '>Nickname<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_5_3\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_3'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_3' id='input_5_3' type='tel' value='' class='large'  placeholder='ex: 912345678' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_5_4\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_4'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_4' id='input_5_4' type='email' value='' class='large'   placeholder='your.email@example.com' aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_5_9\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_9'>Message<\/label><div class='gfield_description' id='gfield_description_5_9'>If necessary, provide any other relevant information regarding your case.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_9' id='input_5_9' class='textarea small'  aria-describedby=\"gfield_description_5_9\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_5_13\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Privacy Policy<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_5_13'><div class='gchoice gchoice_5_13_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.1' type='checkbox'  value='I have read and accept the &lt;a href=&quot;https:\/\/clinimed.pt\/en\/privacy-policy\/&quot; target=&quot;_blank&quot;&gt;Privacy Policy&lt;\/a&gt;'  id='choice_5_13_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_13_1' id='label_5_13_1' class='gform-field-label gform-field-label--type-inline'>I have read and accept the <a href=\"https:\/\/clinimed.pt\/en\/privacy-policy\/\" target=\"_blank\">Privacy Policy<\/a><\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_5_17\" class=\"gfield gfield--type-altcha gfield--input-type-altcha gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_17'>Anti-spam Verification<\/label><div class='ginput_container ginput_container_altcha gfield--type-html'><altcha-widget challengeurl=\"https:\/\/clinimed.pt\/en\/wp-json\/altcha\/v1\/challenge\" strings=\"{&quot;error&quot;:&quot;Verification failed. Try again later.&quot;,&quot;footer&quot;:&quot;Protected by &lt;a href=\\&quot;https:\\\/\\\/altcha.org\\\/\\&quot; target=\\&quot;_blank\\&quot;&gt;ALTCHA&lt;\\\/a&gt;&quot;,&quot;label&quot;:&quot;I&#039;m not a robot&quot;,&quot;verified&quot;:&quot;Verified&quot;,&quot;verifying&quot;:&quot;Verifying...&quot;,&quot;waitAlert&quot;:&quot;Verifying... please wait.&quot;}\" auto=\"onfocus\" hidefooter=\"1\"><\/altcha-widget><noscript><div class=\"altcha-no-javascript\">This form requires JavaScript!<\/div><\/noscript><\/div><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<?xml encoding=\"UTF-8\"><html><body><input type=\"submit\" id=\"gform_submit_button_5\" class=\"gform_button button\" onclick=\"gform.submission.handleButtonClick(this);\" data-submission-type=\"submit\" value=\"Submit\" data-replace-button-html=\"&amp;lt;button type=&amp;quot;submit&amp;quot; id=&amp;quot;gform_submit_button_5&amp;quot; class=&amp;quot;dipi_gf_submit_button gform_button  et_pb_button et_pb_custom_button_icon gform_button button&amp;quot; onclick=&amp;quot;gform.submission.handleButtonClick(this);&amp;quot; data-submission-type=&amp;quot;submit&amp;quot; value=&amp;quot;Submit&amp;quot;&amp;gt;Submit&amp;lt;\/button&amp;gt;\"><\/body><\/html>\n \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_5' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_5' id='gform_theme_5' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_5' id='gform_style_settings_5' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_5' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='5' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_5' value='WyJ7XCIxNlwiOltcIjVlZWEwZTcyOGJlYzBhMmMxNDEwNzUzZjNjZWFlMjEzXCIsXCI4YTJlYzUzNjUxY2M2YzRhYjBhNTYxNWVjMjc1Zjg1ZVwiLFwiZDhmYWQ0OTQ3YmRhMDU1NjJmMTk2Y2NkMDllMzJjNDFcIl0sXCIyMFwiOltcIjc3NTFjYmVjYzNmZDI2Y2JiMzhmODU5MTQ5ZWMxMmRjXCIsXCJlMzA5MGNhY2FhYmI5ODU2M2Q1N2VlNmRlNzU4NTM2MVwiXSxcIjEzLjFcIjpcImVlOTU4M2I4ZjVjY2Y1YWNjMmQ3MDZkYWM5NWZiNjFjXCJ9IiwiYWM4N2I4NjQ4Mjc4N2VhMmQwNjc3ZTE0ZWJiNTlhNmQiXQ==' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_5' id='gform_target_page_number_5' value='0' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_5' id='gform_source_page_number_5' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/form>\n                        <\/div><script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\n gform.initializeOnLoaded( function() {gformInitSpinner( 5, 'https:\/\/clinimed.pt\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery('#gform_ajax_frame_5').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_5');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_5').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_5').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_5').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_5').removeClass('gform_validation_error');}setTimeout( function() { \/* delay the scroll by 50 milliseconds to fix a bug in chrome *\/  }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_5').val();gformInitSpinner( 5, 'https:\/\/clinimed.pt\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery(document).trigger('gform_page_loaded', [5, current_page]);window['gf_submitting_5'] = 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_5').replaceWith(confirmation_content);jQuery(document).trigger('gform_confirmation_loaded', [5]);window['gf_submitting_5'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_5').text());}else{jQuery('#gform_5').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger(\"gform_pre_post_render\", [{ formId: \"5\", currentPage: \"current_page\", abort: function() { this.preventDefault(); } }]);                if (event && event.defaultPrevented) {                return;         }        const gformWrapperDiv = document.getElementById( \"gform_wrapper_5\" );        if ( gformWrapperDiv ) {            const visibilitySpan = document.createElement( \"span\" );            visibilitySpan.id = \"gform_visibility_test_5\";            gformWrapperDiv.insertAdjacentElement( \"afterend\", visibilitySpan );        }        const visibilityTestDiv = document.getElementById( \"gform_visibility_test_5\" );        let postRenderFired = false;                function triggerPostRender() {            if ( postRenderFired ) {                return;            }            postRenderFired = true;            gform.core.triggerPostRenderEvents( 5, 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;                    if ( !immediate ) func.apply( context, args );                };                var callNow = immediate && !timeout;                clearTimeout( timeout );                timeout = setTimeout( later, wait );                if ( callNow ) func.apply( context, args );            };        }        const debouncedTriggerPostRender = debounce( function() {            triggerPostRender();        }, 200 );        if ( visibilityTestDiv && visibilityTestDiv.offsetParent === null ) {            const observer = new MutationObserver( ( mutations ) => {                mutations.forEach( ( mutation ) => {                    if ( mutation.type === 'attributes' && visibilityTestDiv.offsetParent !== null ) {                        debouncedTriggerPostRender();                        observer.disconnect();                    }                });            });            observer.observe( document.body, {                attributes: true,                childList: false,                subtree: true,                attributeFilter: [ 'style', 'class' ],            });        } else {            triggerPostRender();        }    } );} ); \n\/* ]]> *\/\n<\/script>\n[\/et_pb_code][\/et_pb_column][et_pb_column type=&#8221;1_2&#8243; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;|||&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221; theme_builder_area=&#8221;post_content&#8221;][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Definition SCHEDULES AND PROFESSIONALS Internal Medicine is the specialty dedicated to the diagnosis, treatment, and prevention of diseases affecting the adult population. With a comprehensive and integrated approach, internists assess each patient holistically, considering their medical history, lifestyle, and risk factors to develop effective and personalized treatment plans. This specialty plays a crucial role in the early detection of diseases, the management of chronic conditions, and the coordination of multidisciplinary medical care. The goal is to provide continuous and preventive care, ensuring better health and quality of life. If you are looking for specialized medical care tailored to your needs, schedule your appointment and trust the expertise of our team. Not availableNot availableNot availableNot available \n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_5' style='display:none'>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Scheduling Form<\/h2>\n                            <p class='gform_description'><\/p>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_custom\">(Required)<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_5'  action='\/en\/wp-json\/wp\/v2\/pages\/7234' data-formid='5' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_5' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_5_16\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Subject<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_5_16'>\n\t\t\t<div class='gchoice gchoice_5_16_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='New Appointment'  id='choice_5_16_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_16_0' id='label_5_16_0' class='gform-field-label gform-field-label--type-inline'>New Appointment<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_5_16_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='Follow-up Appointment'  id='choice_5_16_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_16_1' id='label_5_16_1' class='gform-field-label gform-field-label--type-inline'>Follow-up Appointment<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_5_16_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='Information'  id='choice_5_16_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_16_2' id='label_5_16_2' class='gform-field-label gform-field-label--type-inline'>Information<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_5_20\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you already a patient of Clinimed?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_5_20'>\n\t\t\t<div class='gchoice gchoice_5_20_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='No' checked='checked' id='choice_5_20_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_20_0' id='label_5_20_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_5_20_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='Yes'  id='choice_5_20_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_20_1' id='label_5_20_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_5_1\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_5_1'>\n                            \n                            <span id='input_5_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_5_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_5_1_3' class='gform-field-label gform-field-label--type-sub '>Name<\/label>\n                                                <\/span>\n                            \n                            <span id='input_5_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_5_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_5_1_6' class='gform-field-label gform-field-label--type-sub '>Nickname<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_5_3\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_3'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_3' id='input_5_3' type='tel' value='' class='large'  placeholder='ex: 912345678' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_5_4\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_4'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_4' id='input_5_4' type='email' value='' class='large'   placeholder='your.email@example.com' aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_5_9\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_9'>Message<\/label><div class='gfield_description' id='gfield_description_5_9'>If necessary, provide any other relevant information regarding your case.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_9' id='input_5_9' class='textarea small'  aria-describedby=\"gfield_description_5_9\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_5_13\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Privacy Policy<span 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