{"id":1678,"date":"2022-02-17T16:29:39","date_gmt":"2022-02-17T09:29:39","guid":{"rendered":"https:\/\/smilesignature.com\/en\/?page_id=1678"},"modified":"2025-01-30T11:01:56","modified_gmt":"2025-01-30T04:01:56","slug":"book-form-tsk","status":"publish","type":"page","link":"https:\/\/smilesignature.com\/en\/contact\/book-form-tsk\/","title":{"rendered":"Appointment Request FORM (TSK)"},"content":{"rendered":"\n<span class=\"scroll-to\" data-label=\"Scroll to: #top\" data-bullet=\"false\" data-link=\"#top\" data-title=\"top\"><a name=\"top\"><\/a><\/span>\n\n<div class=\"row align-equal align-center\"  id=\"row-208929818\">\n\n\n\t<div id=\"col-882232259\" class=\"col medium-12 small-12 large-12\"  >\n\t\t\t\t<div class=\"col-inner\"  >\n\t\t\t\n\t<div class=\"is-border\"\n\t\tstyle=\"border-radius:15px;border-width:1px 1px 1px 1px;\">\n\t<\/div>\n\t\t\t\n\n\t<div class=\"img has-hover x md-x lg-x y md-y lg-y\" id=\"image_1199013133\">\n\t\t\t\t\t\t\t\t<div class=\"img-inner dark\" >\n\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"1020\" height=\"418\" src=\"https:\/\/smilesignature.com\/en\/wp-content\/uploads\/2023\/08\/contact-Dentist-Thailand.webp\" class=\"attachment-large size-large\" alt=\"Dentist Thailand\" srcset=\"https:\/\/smilesignature.com\/en\/wp-content\/uploads\/2023\/08\/contact-Dentist-Thailand.webp 1220w, https:\/\/smilesignature.com\/en\/wp-content\/uploads\/2023\/08\/contact-Dentist-Thailand-800x328.webp 800w, https:\/\/smilesignature.com\/en\/wp-content\/uploads\/2023\/08\/contact-Dentist-Thailand-768x315.webp 768w\" sizes=\"auto, (max-width: 1020px) 100vw, 1020px\" \/>\t\t\t\t\t\t\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\n<style>\n#image_1199013133 {\n  width: 100%;\n}\n<\/style>\n\t<\/div>\n\t\n\n\t<div id=\"gap-1237245646\" class=\"gap-element clearfix\" style=\"display:block; height:auto;\">\n\t\t\n<style>\n#gap-1237245646 {\n  padding-top: 30px;\n}\n<\/style>\n\t<\/div>\n\t\n\n<div class=\"container section-title-container\" ><h1 class=\"section-title section-title-center\"><b aria-hidden=\"true\"><\/b><span class=\"section-title-main\" style=\"color:rgb(0, 0, 0);\"><i class=\"icon-envelop\" aria-hidden=\"true\"><\/i>Book an appointment online<\/span><b aria-hidden=\"true\"><\/b><\/h1><\/div>\n\n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f2536-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"2536\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/en\/wp-json\/wp\/v2\/pages\/1678#wpcf7-f2536-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"2536\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f2536-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_extcf7_conditional_options\" value=\"{&quot;form_id&quot;:2536,&quot;conditions&quot;:[]}\" \/><input type=\"hidden\" name=\"_extcf7_redirect_options\" value=\"{&quot;form_id&quot;:2536,&quot;redirect_options&quot;:{&quot;redirection_enable&quot;:&quot;on&quot;,&quot;custom_url_enable&quot;:&quot;off&quot;,&quot;redirect_page&quot;:&quot;https:\\\/\\\/smilesignature.com\\\/en\\\/contact\\\/book-form-tsk\\\/thank-you-form\\\/&quot;,&quot;custom_urle&quot;:&quot;&quot;,&quot;redirect_new_tab&quot;:&quot;off&quot;,&quot;js_action&quot;:&quot;on&quot;,&quot;javascript_code&quot;:&quot;alert(\\&quot;Thank you for submitting an online request via Smile Signature Dental Clinics.\\&quot;)&quot;}}\" \/><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/fieldset>\n<div class=\"form-flat\">\n\t<p style=\"color:#009edc\"><b>Your Name *<\/b>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Your Name\" value=\"\" type=\"text\" name=\"your-name\" \/><\/span>\n\t<\/p>\n\t<p style=\"color:#009edc\"><b>Date of Birth *<\/b>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-birthday\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"dd\/mm\/yyyy\" value=\"\" type=\"text\" name=\"your-birthday\" \/><\/span>\n\t<\/p>\n\t<p style=\"color:#009edc\"><b>Email *<\/b>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"user@example.com\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span>\n\t<\/p>\n\t<p style=\"color:#009edc\"><b>Mobile Phone *<\/b>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-tel\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"+xxx-xxx-xxxx\" value=\"\" type=\"text\" name=\"your-tel\" \/><\/span>\n\t<\/p>\n\t<p style=\"color:#009edc\"><b>Country *<\/b>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"menu-334\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"menu-334\"><option value=\"Thailand\">Thailand<\/option><option value=\"Afghanistan\">Afghanistan<\/option><option value=\"\u00c5land Islands\">\u00c5land Islands<\/option><option value=\"Albania\">Albania<\/option><option value=\"Algeria\">Algeria<\/option><option value=\"American Samoa\">American Samoa<\/option><option value=\"Andorra\">Andorra<\/option><option value=\"Angola\">Angola<\/option><option value=\"Anguilla\">Anguilla<\/option><option value=\"Antarctica\">Antarctica<\/option><option value=\"Antigua and Barbuda\">Antigua and Barbuda<\/option><option value=\"Argentina\">Argentina<\/option><option value=\"Armenia\">Armenia<\/option><option value=\"Aruba\">Aruba<\/option><option value=\"Australia\">Australia<\/option><option value=\"Austria\">Austria<\/option><option value=\"Azerbaijan\">Azerbaijan<\/option><option value=\"Bahamas\">Bahamas<\/option><option value=\"Bahrain\">Bahrain<\/option><option value=\"Bangladesh\">Bangladesh<\/option><option value=\"Barbados\">Barbados<\/option><option value=\"Belarus\">Belarus<\/option><option value=\"Belgium\">Belgium<\/option><option value=\"Belize\">Belize<\/option><option value=\"Benin\">Benin<\/option><option value=\"Bermuda\">Bermuda<\/option><option value=\"Bhutan\">Bhutan<\/option><option value=\"Bolivia\">Bolivia<\/option><option value=\"Bosnia and Herzegovina\">Bosnia and Herzegovina<\/option><option value=\"Botswana\">Botswana<\/option><option value=\"Bouvet Island\">Bouvet Island<\/option><option value=\"Brazil\">Brazil<\/option><option value=\"British Indian Ocean Territory\">British Indian Ocean Territory<\/option><option value=\"Brunei Darussalam\">Brunei Darussalam<\/option><option value=\"Bulgaria\">Bulgaria<\/option><option value=\"Burkina Faso\">Burkina Faso<\/option><option value=\"Burundi\">Burundi<\/option><option value=\"Cambodia\">Cambodia<\/option><option value=\"Cameroon\">Cameroon<\/option><option value=\"Canada\">Canada<\/option><option value=\"Cape Verde\">Cape Verde<\/option><option value=\"Cayman Islands\">Cayman Islands<\/option><option value=\"Central African Republic\">Central African Republic<\/option><option value=\"Chad\">Chad<\/option><option value=\"Chile\">Chile<\/option><option value=\"China\">China<\/option><option value=\"Christmas Island\">Christmas Island<\/option><option value=\"Cocos (Keeling) Islands\">Cocos (Keeling) Islands<\/option><option value=\"Colombia\">Colombia<\/option><option value=\"Comoros\">Comoros<\/option><option value=\"Congo\">Congo<\/option><option value=\"Congo, The Democratic Republic of the\">Congo, The Democratic Republic of the<\/option><option value=\"Cook Islands\">Cook Islands<\/option><option value=\"Costa Rica\">Costa Rica<\/option><option value=\"Cote D&quot;Ivoire\">Cote D&quot;Ivoire<\/option><option value=\"Croatia\">Croatia<\/option><option value=\"Cuba\">Cuba<\/option><option value=\"Cyprus\">Cyprus<\/option><option value=\"Czech Republic\">Czech Republic<\/option><option value=\"Denmark\">Denmark<\/option><option value=\"Djibouti\">Djibouti<\/option><option value=\"Dominica\">Dominica<\/option><option value=\"Dominican Republic\">Dominican Republic<\/option><option value=\"Ecuador\">Ecuador<\/option><option value=\"Egypt\">Egypt<\/option><option value=\"El Salvador\">El Salvador<\/option><option value=\"Equatorial Guinea\">Equatorial Guinea<\/option><option value=\"Eritrea\">Eritrea<\/option><option value=\"Estonia\">Estonia<\/option><option value=\"Ethiopia\">Ethiopia<\/option><option value=\"Falkland Islands (Malvinas)\">Falkland Islands (Malvinas)<\/option><option value=\"Faroe Islands\">Faroe Islands<\/option><option value=\"Fiji\">Fiji<\/option><option value=\"Finland\">Finland<\/option><option value=\"France\">France<\/option><option value=\"French Guiana\">French Guiana<\/option><option value=\"French Polynesia\">French Polynesia<\/option><option value=\"French Southern Territories\">French Southern Territories<\/option><option value=\"Gabon\">Gabon<\/option><option value=\"Gambia\">Gambia<\/option><option value=\"Georgia\">Georgia<\/option><option value=\"Germany\">Germany<\/option><option value=\"Ghana\">Ghana<\/option><option value=\"Gibraltar\">Gibraltar<\/option><option value=\"Greece\">Greece<\/option><option value=\"Greenland\">Greenland<\/option><option value=\"Grenada\">Grenada<\/option><option value=\"Guadeloupe\">Guadeloupe<\/option><option value=\"Guam\">Guam<\/option><option value=\"Guatemala\">Guatemala<\/option><option value=\"Guernsey\">Guernsey<\/option><option value=\"Guinea\">Guinea<\/option><option value=\"Guinea-Bissau\">Guinea-Bissau<\/option><option value=\"Guyana\">Guyana<\/option><option value=\"Haiti\">Haiti<\/option><option value=\"Heard Island and Mcdonald Islands\">Heard Island and Mcdonald Islands<\/option><option value=\"Holy See (Vatican City State)\">Holy See (Vatican City State)<\/option><option value=\"Honduras\">Honduras<\/option><option value=\"Hong Kong\">Hong Kong<\/option><option value=\"Hungary\">Hungary<\/option><option value=\"Iceland\">Iceland<\/option><option value=\"India\">India<\/option><option value=\"Indonesia\">Indonesia<\/option><option value=\"Iran, Islamic Republic Of\">Iran, Islamic Republic Of<\/option><option value=\"Iraq\">Iraq<\/option><option value=\"Ireland\">Ireland<\/option><option value=\"Isle of Man\">Isle of Man<\/option><option value=\"Israel\">Israel<\/option><option value=\"Italy\">Italy<\/option><option value=\"Jamaica\">Jamaica<\/option><option value=\"Japan\">Japan<\/option><option value=\"Jersey\">Jersey<\/option><option value=\"Jordan\">Jordan<\/option><option value=\"Kazakhstan\">Kazakhstan<\/option><option value=\"Kenya\">Kenya<\/option><option value=\"Kiribati\">Kiribati<\/option><option value=\"Democratic People&quot;s Republic of Korea\">Democratic People&quot;s Republic of Korea<\/option><option value=\"Korea, Republic of\">Korea, Republic of<\/option><option value=\"Kosovo\">Kosovo<\/option><option value=\"Kuwait\">Kuwait<\/option><option value=\"Kyrgyzstan\">Kyrgyzstan<\/option><option value=\"Lao People&quot;s Democratic Republic\">Lao People&quot;s Democratic Republic<\/option><option value=\"Latvia\">Latvia<\/option><option value=\"Lebanon\">Lebanon<\/option><option value=\"Lesotho\">Lesotho<\/option><option value=\"Liberia\">Liberia<\/option><option value=\"Libyan Arab Jamahiriya\">Libyan Arab Jamahiriya<\/option><option value=\"Liechtenstein\">Liechtenstein<\/option><option value=\"Lithuania\">Lithuania<\/option><option value=\"Luxembourg\">Luxembourg<\/option><option value=\"Macao\">Macao<\/option><option value=\"Macedonia, The Former Yugoslav Republic of\">Macedonia, The Former Yugoslav Republic of<\/option><option value=\"Madagascar\">Madagascar<\/option><option value=\"Malawi\">Malawi<\/option><option value=\"Malaysia\">Malaysia<\/option><option value=\"Maldives\">Maldives<\/option><option value=\"Mali\">Mali<\/option><option value=\"Malta\">Malta<\/option><option value=\"Marshall Islands\">Marshall Islands<\/option><option value=\"Martinique\">Martinique<\/option><option value=\"Mauritania\">Mauritania<\/option><option value=\"Mauritius\">Mauritius<\/option><option value=\"Mayotte\">Mayotte<\/option><option value=\"Mexico\">Mexico<\/option><option value=\"Micronesia, Federated States of\">Micronesia, Federated States of<\/option><option value=\"Moldova, Republic of\">Moldova, Republic of<\/option><option value=\"Monaco\">Monaco<\/option><option value=\"Mongolia\">Mongolia<\/option><option value=\"Montenegro\">Montenegro<\/option><option value=\"Montserrat\">Montserrat<\/option><option value=\"Morocco\">Morocco<\/option><option value=\"Mozambique\">Mozambique<\/option><option value=\"Myanmar\">Myanmar<\/option><option value=\"Namibia\">Namibia<\/option><option value=\"Nauru\">Nauru<\/option><option value=\"Nepal\">Nepal<\/option><option value=\"Netherlands\">Netherlands<\/option><option value=\"Netherlands Antilles\">Netherlands Antilles<\/option><option value=\"New Caledonia\">New Caledonia<\/option><option value=\"New Zealand\">New Zealand<\/option><option value=\"Nicaragua\">Nicaragua<\/option><option value=\"Niger\">Niger<\/option><option value=\"Nigeria\">Nigeria<\/option><option value=\"Niue\">Niue<\/option><option value=\"Norfolk Island\">Norfolk Island<\/option><option value=\"Northern Mariana Islands\">Northern Mariana Islands<\/option><option value=\"Norway\">Norway<\/option><option value=\"Oman\">Oman<\/option><option value=\"Pakistan\">Pakistan<\/option><option value=\"Palau\">Palau<\/option><option value=\"Palestinian Territory, Occupied\">Palestinian Territory, Occupied<\/option><option value=\"Panama\">Panama<\/option><option value=\"Papua New Guinea\">Papua New Guinea<\/option><option value=\"Paraguay\">Paraguay<\/option><option value=\"Peru\">Peru<\/option><option value=\"Philippines\">Philippines<\/option><option value=\"Pitcairn\">Pitcairn<\/option><option value=\"Poland\">Poland<\/option><option value=\"Portugal\">Portugal<\/option><option value=\"Puerto Rico\">Puerto Rico<\/option><option value=\"Qatar\">Qatar<\/option><option value=\"Reunion\">Reunion<\/option><option value=\"Romania\">Romania<\/option><option value=\"Russian Federation\">Russian Federation<\/option><option value=\"Rwanda\">Rwanda<\/option><option value=\"Saint Helena\">Saint Helena<\/option><option value=\"Saint Kitts and Nevis\">Saint Kitts and Nevis<\/option><option value=\"Saint Lucia\">Saint Lucia<\/option><option value=\"Saint Pierre and Miquelon\">Saint Pierre and Miquelon<\/option><option value=\"Saint Vincent and the Grenadines\">Saint Vincent and the Grenadines<\/option><option value=\"Samoa\">Samoa<\/option><option value=\"San Marino\">San Marino<\/option><option value=\"Sao Tome and Principe\">Sao Tome and Principe<\/option><option value=\"Saudi Arabia\">Saudi Arabia<\/option><option value=\"Senegal\">Senegal<\/option><option value=\"Serbia\">Serbia<\/option><option value=\"Seychelles\">Seychelles<\/option><option value=\"Sierra Leone\">Sierra Leone<\/option><option value=\"Singapore\">Singapore<\/option><option value=\"Slovakia\">Slovakia<\/option><option value=\"Slovenia\">Slovenia<\/option><option value=\"Solomon Islands\">Solomon Islands<\/option><option value=\"Somalia\">Somalia<\/option><option value=\"South Africa\">South Africa<\/option><option value=\"South Georgia and the South Sandwich Islands\">South Georgia and the South Sandwich Islands<\/option><option value=\"Spain\">Spain<\/option><option value=\"Sri Lanka\">Sri Lanka<\/option><option value=\"Sudan\">Sudan<\/option><option value=\"Suriname\">Suriname<\/option><option value=\"Svalbard and Jan Mayen\">Svalbard and Jan Mayen<\/option><option value=\"Swaziland\">Swaziland<\/option><option value=\"Sweden\">Sweden<\/option><option value=\"Switzerland\">Switzerland<\/option><option value=\"Syrian Arab Republic\">Syrian Arab Republic<\/option><option value=\"Taiwan\">Taiwan<\/option><option value=\"Tajikistan\">Tajikistan<\/option><option value=\"Tanzania, United Republic of\">Tanzania, United Republic of<\/option><option value=\"Timor-Leste\">Timor-Leste<\/option><option value=\"Togo\">Togo<\/option><option value=\"Tokelau\">Tokelau<\/option><option value=\"Tonga\">Tonga<\/option><option value=\"Trinidad and Tobago\">Trinidad and Tobago<\/option><option value=\"Tunisia\">Tunisia<\/option><option value=\"Turkey\">Turkey<\/option><option value=\"Turkmenistan\">Turkmenistan<\/option><option value=\"Turks and Caicos Islands\">Turks and Caicos Islands<\/option><option value=\"Tuvalu\">Tuvalu<\/option><option value=\"Uganda\">Uganda<\/option><option value=\"Ukraine\">Ukraine<\/option><option value=\"United Arab Emirates\">United Arab Emirates<\/option><option value=\"United Kingdom\">United Kingdom<\/option><option value=\"United States\">United States<\/option><option value=\"United States Minor Outlying Islands\">United States Minor Outlying Islands<\/option><option value=\"Uruguay\">Uruguay<\/option><option value=\"Uzbekistan\">Uzbekistan<\/option><option value=\"Vanuatu\">Vanuatu<\/option><option value=\"Venezuela\">Venezuela<\/option><option value=\"Viet Nam\">Viet Nam<\/option><option value=\"Virgin Islands, British\">Virgin Islands, British<\/option><option value=\"Virgin Islands, U.S.\">Virgin Islands, U.S.<\/option><option value=\"Wallis and Futuna\">Wallis and Futuna<\/option><option value=\"Western Sahara\">Western Sahara<\/option><option value=\"Yemen\">Yemen<\/option><option value=\"Zambia\">Zambia<\/option><option value=\"Zimbabwe\">Zimbabwe<\/option><\/select><\/span>\n\t<\/p>\n\t<p style=\"color:#009edc\"><b>Dental Treatment Required <\/b>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"services\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"services[]\" value=\"Oral Examination\" \/><span class=\"wpcf7-list-item-label\">Oral Examination<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"services[]\" value=\"Fillings\" \/><span class=\"wpcf7-list-item-label\">Fillings<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"services[]\" value=\"Tooth Whitening\" \/><span class=\"wpcf7-list-item-label\">Tooth Whitening<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"services[]\" value=\"Teeth Cleaning, Scaling and Polishing\" \/><span class=\"wpcf7-list-item-label\">Teeth Cleaning, Scaling and Polishing<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"services[]\" value=\"Orthodontic Treatment\" \/><span class=\"wpcf7-list-item-label\">Orthodontic Treatment<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"services[]\" value=\"Crowns and Bridges\" \/><span class=\"wpcf7-list-item-label\">Crowns and Bridges<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"services[]\" value=\"Dental Implant\" \/><span class=\"wpcf7-list-item-label\">Dental Implant<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"services[]\" value=\"Dental Veneers\" \/><span class=\"wpcf7-list-item-label\">Dental Veneers<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"services[]\" value=\"Root Canal Treatment\" \/><span class=\"wpcf7-list-item-label\">Root Canal Treatment<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"services[]\" value=\"Dentures\" \/><span class=\"wpcf7-list-item-label\">Dentures<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"services[]\" value=\"Tooth Extractions\" \/><span class=\"wpcf7-list-item-label\">Tooth Extractions<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"services[]\" value=\"Periodontal Treatment\" \/><span class=\"wpcf7-list-item-label\">Periodontal Treatment<\/span><\/label><\/span><\/span><\/span>\n\t<\/p>\n\t<p style=\"color:#009edc\"><b>More Enquiry Information or Concerns<\/b>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-message\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"More Enquiry Information or Concerns...\" name=\"your-message\"><\/textarea><\/span>\n\t<\/p>\n\t<h3>Appointment Booking Terms of Use\n\t<\/h3>\n\t<p>1. Appointment bookings via Smile Signature website are meant for a 3 day or more advance bookings only. If request for a same day or next working day, please kindly call us at +66 2 693 6933 between 9.30am to 7.00pm (GMT+7)on Mondays to Saturdays or 10.00am to 4.00pm (GMT+7) on Sundays\n\t<\/p>\n\t<p>2. A submission request for an appointment does not provide an immediate guaranteed appointment confirmation.\n\t<\/p>\n\t<p>3. Our Smile Signature call center staff will contact you back by email or phone in confirming your requested appointment booking date and time on submission. If you do not hear from us within 1 working day, please kindly call us as we may not have successfully received your request.\n\t<\/p>\n\t<p style=\"color:#FD0004\">Please note: If you do not receive our email reply, please check your junk folder to be sure that our email is not being detected as spam.\n\t<\/p>\n<span class=\"wpcf7-form-control-wrap recaptcha\" data-name=\"recaptcha\"><span data-sitekey=\"6Lc3pT0iAAAAAFTTde8-nXPECwVlgw68GMKyUxEZ\" class=\"wpcf7-form-control wpcf7-recaptcha g-recaptcha\"><\/span>\r\n<noscript>\r\n\t<div class=\"grecaptcha-noscript\">\r\n\t\t<iframe loading=\"lazy\" src=\"https:\/\/www.google.com\/recaptcha\/api\/fallback?k=6Lc3pT0iAAAAAFTTde8-nXPECwVlgw68GMKyUxEZ\" frameborder=\"0\" scrolling=\"no\" width=\"310\" height=\"430\">\r\n\t\t<\/iframe>\r\n\t\t<textarea name=\"g-recaptcha-response\" rows=\"3\" cols=\"40\" placeholder=\"reCaptcha Response Here\">\r\n\t\t<\/textarea>\r\n\t<\/div>\r\n<\/noscript>\r\n<\/span>\n\t<p>&nbsp;\n\t<\/p>\n\t<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner button\" type=\"submit\" value=\"Submit\" \/>\n\t<\/p>\n<\/div><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n\n\t<div id=\"gap-1734742637\" class=\"gap-element clearfix\" style=\"display:block; height:auto;\">\n\t\t\n<style>\n#gap-1734742637 {\n  padding-top: 30px;\n}\n<\/style>\n\t<\/div>\n\t\n\n<div class=\"text-center\"><div class=\"is-divider divider clearfix\" style=\"max-width:80%;\"><\/div><\/div>\n\n\t<div class=\"img has-hover x md-x lg-x y md-y lg-y\" id=\"image_291224416\">\n\t\t\t\t\t\t\t\t<div class=\"img-inner dark\" >\n\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"750\" height=\"224\" src=\"https:\/\/smilesignature.com\/en\/wp-content\/uploads\/2022\/03\/Smile-Signature-SiamSquare.jpg\" class=\"attachment-large size-large\" alt=\"Siam dental\" \/>\t\t\t\t\t\t\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\n<style>\n#image_291224416 {\n  width: 100%;\n}\n<\/style>\n\t<\/div>\n\t\n\n<p>Thailand&#8217;s established and trusted dental clinic network group with over 9 office locations in Bangkok. Servicing international patients for the past 20 years.<\/p>\n\n\t\t<\/div>\n\t\t\t\t\n<style>\n#col-882232259 > .col-inner {\n  padding: 29px 20px 20px 27px;\n  margin: 28px 0px 0px 0px;\n}\n<\/style>\n\t<\/div>\n\n\t\n\n<\/div>\n<div class=\"row align-center\"  id=\"row-462558435\">\n\n\n\t<div id=\"col-1472412847\" class=\"col small-12 large-12\"  >\n\t\t\t\t<div class=\"col-inner text-center\"  >\n\t\t\t\n\t\t\t\n\n<a href=\"#top\" class=\"button success\" style=\"border-radius:99px;\">\n\t\t<span>top<\/span>\n\t<\/a>\n\n\n\n\t\t<\/div>\n\t\t\t\t\n<style>\n#col-1472412847 > .col-inner {\n  margin: -47px 0px 0px 0px;\n}\n<\/style>\n\t<\/div>\n\n\t\n\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":579,"menu_order":3,"comment_status":"closed","ping_status":"closed","template":"page-blank-landingpage.php","meta":{"footnotes":""},"class_list":["post-1678","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.1.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Appointment Request : Smile Signature FORM (TSK)<\/title>\n<meta name=\"description\" content=\"ExpatDen Dentist - Where to go for dental for Thailand Expat and moving to Thailand\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/smilesignature.com\/en\/contact\/book-form-tsk\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Appointment Request : Smile Signature FORM (TSK)\" \/>\n<meta property=\"og:description\" content=\"ExpatDen Dentist - Where to go for dental for Thailand Expat and moving to Thailand\" \/>\n<meta property=\"og:url\" content=\"https:\/\/smilesignature.com\/en\/contact\/book-form-tsk\/\" \/>\n<meta property=\"og:site_name\" content=\"Smile Signature dental clinics\" \/>\n<meta property=\"article:modified_time\" content=\"2025-01-30T04:01:56+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/smilesignature.com\/en\/contact\/book-form-tsk\/\",\"url\":\"https:\/\/smilesignature.com\/en\/contact\/book-form-tsk\/\",\"name\":\"Appointment Request : Smile Signature FORM (TSK)\",\"isPartOf\":{\"@id\":\"https:\/\/smilesignature.com\/en\/#website\"},\"datePublished\":\"2022-02-17T09:29:39+00:00\",\"dateModified\":\"2025-01-30T04:01:56+00:00\",\"description\":\"ExpatDen Dentist - Where to go for dental for Thailand Expat and moving to Thailand\",\"breadcrumb\":{\"@id\":\"https:\/\/smilesignature.com\/en\/contact\/book-form-tsk\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/smilesignature.com\/en\/contact\/book-form-tsk\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/smilesignature.com\/en\/contact\/book-form-tsk\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/smilesignature.com\/en\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Contact\",\"item\":\"https:\/\/smilesignature.com\/en\/contact\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Appointment Request FORM (TSK)\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/smilesignature.com\/en\/#website\",\"url\":\"https:\/\/smilesignature.com\/en\/\",\"name\":\"Smile Signature dental clinics\",\"description\":\"\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/smilesignature.com\/en\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Appointment Request : Smile Signature FORM (TSK)","description":"ExpatDen Dentist - Where to go for dental for Thailand Expat and moving to Thailand","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/smilesignature.com\/en\/contact\/book-form-tsk\/","og_locale":"en_US","og_type":"article","og_title":"Appointment Request : Smile Signature FORM (TSK)","og_description":"ExpatDen Dentist - Where to go for dental for Thailand Expat and moving to Thailand","og_url":"https:\/\/smilesignature.com\/en\/contact\/book-form-tsk\/","og_site_name":"Smile Signature dental clinics","article_modified_time":"2025-01-30T04:01:56+00:00","twitter_card":"summary_large_image","twitter_misc":{"Est. reading time":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/smilesignature.com\/en\/contact\/book-form-tsk\/","url":"https:\/\/smilesignature.com\/en\/contact\/book-form-tsk\/","name":"Appointment Request : Smile Signature FORM (TSK)","isPartOf":{"@id":"https:\/\/smilesignature.com\/en\/#website"},"datePublished":"2022-02-17T09:29:39+00:00","dateModified":"2025-01-30T04:01:56+00:00","description":"ExpatDen Dentist - Where to go for dental for Thailand Expat and moving to Thailand","breadcrumb":{"@id":"https:\/\/smilesignature.com\/en\/contact\/book-form-tsk\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/smilesignature.com\/en\/contact\/book-form-tsk\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/smilesignature.com\/en\/contact\/book-form-tsk\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/smilesignature.com\/en\/"},{"@type":"ListItem","position":2,"name":"Contact","item":"https:\/\/smilesignature.com\/en\/contact\/"},{"@type":"ListItem","position":3,"name":"Appointment Request FORM (TSK)"}]},{"@type":"WebSite","@id":"https:\/\/smilesignature.com\/en\/#website","url":"https:\/\/smilesignature.com\/en\/","name":"Smile Signature dental clinics","description":"","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/smilesignature.com\/en\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"}]}},"_links":{"self":[{"href":"https:\/\/smilesignature.com\/en\/wp-json\/wp\/v2\/pages\/1678","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/smilesignature.com\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/smilesignature.com\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/smilesignature.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/smilesignature.com\/en\/wp-json\/wp\/v2\/comments?post=1678"}],"version-history":[{"count":10,"href":"https:\/\/smilesignature.com\/en\/wp-json\/wp\/v2\/pages\/1678\/revisions"}],"predecessor-version":[{"id":4103,"href":"https:\/\/smilesignature.com\/en\/wp-json\/wp\/v2\/pages\/1678\/revisions\/4103"}],"up":[{"embeddable":true,"href":"https:\/\/smilesignature.com\/en\/wp-json\/wp\/v2\/pages\/579"}],"wp:attachment":[{"href":"https:\/\/smilesignature.com\/en\/wp-json\/wp\/v2\/media?parent=1678"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}