{"id":17906,"date":"2024-06-04T00:38:55","date_gmt":"2024-06-04T00:38:55","guid":{"rendered":"https:\/\/visioncare.agency\/seniorcare\/?page_id=17906"},"modified":"2024-06-04T01:16:47","modified_gmt":"2024-06-04T01:16:47","slug":"service-providers","status":"publish","type":"page","link":"https:\/\/visioncare.agency\/seniorcare\/service-providers\/","title":{"rendered":"Service Providers"},"content":{"rendered":"<p style=\"text-align: center;\"><strong>Vision Care Agency Service Provider Information Form<\/strong><\/p>\n<p>We appreciate your interest in partnering with Vision Care Agency. We are currently in the <span style=\"color: #ff6600;\">developmental stage<\/span> and are compiling a list of potential service providers for future collaboration. Please complete the following form with your information so we can contact you once we are ready<\/p>\n<div style=\"display:none\" class=\"fm-form-container fm-theme20\"><div id=\"fm-pages18\" class=\"fm-pages wdform_page_navigation \" show_title=\"false\" show_numbers=\"false\" type=\"none\"><\/div><form name=\"form18\" action=\"\/seniorcare\/wp-json\/wp\/v2\/pages\/17906\" method=\"post\" id=\"form18\" class=\"fm-form form18  \" enctype=\"multipart\/form-data\"><input type=\"hidden\" id=\"fm_page_id18\" value=\"17906\" name=\"fm_page_id18\" \/><input type=\"hidden\" id=\"fm_current_post_type18\" value=\"page\" name=\"fm_current_post_type18\" \/><input type=\"hidden\" id=\"counter18\" value=\"56\" name=\"counter18\" \/><input type=\"hidden\" id=\"Itemid18\" value=\"\" name=\"Itemid18\" \/><input type=\"hidden\" id=\"fm_shake18\" value=\"1\" name=\"fm_shake18\" \/><input type=\"text\" class=\"fm-hide\" id=\"fm_bot_validation18\" value=\"\" name=\"fm_bot_validation18\" \/><input type=\"text\" class=\"fm-hide\" id=\"fm_empty_field_validation18\" value=\"\" name=\"fm_empty_field_validation18\" data-value=\"bd736efb144d599cf463541431fbf5c4\" \/><input type=\"hidden\" id=\"fm_ajax_url18\" data-ajax_url=\"https:\/\/visioncare.agency\/seniorcare\/wp-admin\/admin-ajax.php?action=fm_submit_form&current_id=18&formType=embedded\" \/><input type=\"hidden\" id=\"fm_ajax_redirect_url18\" data-ajax_redirect_url=\"0\" \/><input type=\"hidden\" id=\"fm_form_nonce18\" name=\"fm_form_nonce18\" value=\"f38457292b\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/seniorcare\/wp-json\/wp\/v2\/pages\/17906\" \/><div class=\"wdform-page-and-images fm-form-builder\" style=\"border-width: 1px;\"><div id=\"18form_view1\" class=\"wdform_page\" page_title=\"Untitled page\" next_title=\"Next\" next_type=\"text\" next_class=\"wdform-page-button\" next_checkable=\"true\" previous_title=\"Previous\" previous_type=\"text\" previous_class=\"wdform-page-button\" previous_checkable=\"false\"><div class=\"wdform_section\"><div class=\"wdform_column\"><div wdid=\"55\" class=\"wdform_row\"><div type=\"type_own_select\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_own_select\" ><div class=\"wdform-label-section wd-width-100 wdform_select wd-flex-row\">    <label  for=\"wdform_55_element18\" class=\"wdform-label\">Service Provider<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex wdform_select wd-flex-row wd-width-100\" ><select class=\"wd-width-100\" id=\"wdform_55_element18\" name=\"wdform_55_element18\" ><option value=\"\" selected=\"selected\">Select value<\/option><option value=\"Medical Doctor\" >Medical Doctor<\/option><option value=\"Registered Nurse\" >Registered Nurse<\/option><option value=\"Auxiliary nurses\" >Auxiliary nurses<\/option><option value=\"Nonmedical Doctor\" >Nonmedical Doctor<\/option><option value=\"Home Aid\" >Home Aid<\/option><\/select><\/div><\/div><\/div><div wdid=\"2\" class=\"wdform_row\" style=\"position: relative; left: 0px; top: 0px;\"><div type=\"type_text\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_text\" ><div class=\"wdform-label-section wd-width-100  wd-flex-row wd-align-items-center\">    <label  for=\"wdform_2_element18\" class=\"wdform-label\">Name<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex  wd-flex-row wd-align-items-center wd-width-100\" ><input type=\"text\"                           class=\"wd-width-100\"                           id=\"wdform_2_element18\"                           name=\"wdform_2_element18\"                           value=\"\"                           data-value=\"\"                           title=\"\"                           placeholder=\"\"                                                       \/><\/div><\/div><\/div><div wdid=\"54\" class=\"wdform_row\"><div type=\"type_file_upload\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_file_upload\" ><div class=\"wdform-label-section wd-width-100  wd-flex-column\">    <label  for=\"wdform_54_element18\" class=\"wdform-label\">Upload your picture ID<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex  wd-flex-column wd-width-100\" ><label class=\"file-upload\"><div class=\"file-picker\"><\/div><input type=\"file\" id=\"wdform_54_element18\" name=\"wdform_54_file18[]\"   \/><\/label><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div wdid=\"48\" class=\"wdform_row\" style=\"position: relative; left: 0px; top: 0px;\"><div type=\"type_own_select\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_own_select\" ><div class=\"wdform-label-section wd-width-100 wdform_select wd-flex-row\">    <label  for=\"wdform_48_element18\" class=\"wdform-label\">Select<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex wdform_select wd-flex-row wd-width-100\" ><select class=\"wd-width-100\" id=\"wdform_48_element18\" name=\"wdform_48_element18\" ><option value=\"\" selected=\"selected\">Select value<\/option><option value=\"Non Medical\" >Non Medical<\/option><option value=\"Medical\" >Medical<\/option><\/select><\/div><\/div><\/div><div wdid=\"53\" class=\"wdform_row\" style=\"position: relative; left: 0px; top: 0px;\"><div type=\"type_textarea\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_textarea\" ><div class=\"wdform-label-section wd-width-100 \">    <label  for=\"wdform_53_element18\" class=\"wdform-label\">Textarea<\/label><\/div><div class=\"wdform-element-section wd-flex  wd-width-100\" ><textarea class=\"wd-width-100\"                      id=\"wdform_53_element18\"                      name=\"wdform_53_element18\"                      placeholder=\"What is your specialty\"                      data-value=\"\"                      maxlength=\"\"                      style=\"height: 100px;\"                      ><\/textarea><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div wdid=\"25\" class=\"wdform_row\" style=\"position: relative; left: 0px; top: 0px;\"><div type=\"type_date_fields\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_date_fields\" ><div class=\"wdform-label-section wd-width-100 wdform_date_fields wd-flex-row\">    <label  for=\"wdform_25_day18\" class=\"wdform-label\">Date of Birth<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex wdform_date_fields wd-flex-row wd-width-100\" ><div class=\"wd-flex wd-flex-row wd-width-100 wd-align-items\"><div class=\"wd-flex wd-flex-column\"><select id=\"wdform_25_day18\" name=\"wdform_25_day18\" class=\"wdform_select_day\" style=\"width: 60px;\" ><option value=\"\"><\/option><option value=\"01\" >01<\/option><option value=\"02\" >02<\/option><option value=\"03\" >03<\/option><option value=\"04\" >04<\/option><option value=\"05\" >05<\/option><option value=\"06\" >06<\/option><option value=\"07\" >07<\/option><option value=\"08\" >08<\/option><option value=\"09\" >09<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><option value=\"12\" >12<\/option><option value=\"13\" >13<\/option><option value=\"14\" >14<\/option><option value=\"15\" >15<\/option><option value=\"16\" >16<\/option><option value=\"17\" >17<\/option><option value=\"18\" >18<\/option><option value=\"19\" >19<\/option><option value=\"20\" >20<\/option><option value=\"21\" >21<\/option><option value=\"22\" >22<\/option><option value=\"23\" >23<\/option><option value=\"24\" >24<\/option><option value=\"25\" >25<\/option><option value=\"26\" >26<\/option><option value=\"27\" >27<\/option><option value=\"28\" >28<\/option><option value=\"29\" >29<\/option><option value=\"30\" >30<\/option><option value=\"31\" >31<\/option><\/select><label for=\"wdform_25_day18\" class=\"mini_label\">day<\/label><\/div><span class=\"wdform_separator\">&nbsp;\/&nbsp;<\/span><div class=\"wd-flex wd-flex-column\"><select id=\"wdform_25_month18\" name=\"wdform_25_month18\" class=\"wdform_select_month\" style=\"width: 100px;\" ><option value=\"\"><\/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><label for=\"wdform_25_month18\" class=\"mini_label\">month<\/label><\/div><span class=\"wdform_separator\">&nbsp;\/&nbsp;<\/span><div class=\"wd-flex wd-flex-column\"><select id=\"wdform_25_year18\" name=\"wdform_25_year18\"  from=\"1901\" to=\"2022\" class=\"wdform_select_year\" style=\"width: 80px;\" ><option value=\"\"><\/option><option value=\"2022\" >2022<\/option><option value=\"2021\" >2021<\/option><option value=\"2020\" >2020<\/option><option value=\"2019\" >2019<\/option><option value=\"2018\" >2018<\/option><option value=\"2017\" >2017<\/option><option value=\"2016\" >2016<\/option><option value=\"2015\" >2015<\/option><option value=\"2014\" >2014<\/option><option value=\"2013\" >2013<\/option><option value=\"2012\" >2012<\/option><option value=\"2011\" >2011<\/option><option value=\"2010\" >2010<\/option><option value=\"2009\" >2009<\/option><option value=\"2008\" >2008<\/option><option value=\"2007\" >2007<\/option><option value=\"2006\" >2006<\/option><option value=\"2005\" >2005<\/option><option value=\"2004\" >2004<\/option><option value=\"2003\" >2003<\/option><option value=\"2002\" >2002<\/option><option value=\"2001\" >2001<\/option><option value=\"2000\" >2000<\/option><option value=\"1999\" >1999<\/option><option value=\"1998\" >1998<\/option><option value=\"1997\" >1997<\/option><option value=\"1996\" >1996<\/option><option value=\"1995\" >1995<\/option><option value=\"1994\" >1994<\/option><option value=\"1993\" >1993<\/option><option value=\"1992\" >1992<\/option><option value=\"1991\" >1991<\/option><option value=\"1990\" >1990<\/option><option value=\"1989\" >1989<\/option><option value=\"1988\" >1988<\/option><option value=\"1987\" >1987<\/option><option value=\"1986\" >1986<\/option><option value=\"1985\" >1985<\/option><option value=\"1984\" >1984<\/option><option value=\"1983\" >1983<\/option><option value=\"1982\" >1982<\/option><option value=\"1981\" >1981<\/option><option value=\"1980\" >1980<\/option><option value=\"1979\" >1979<\/option><option value=\"1978\" >1978<\/option><option value=\"1977\" >1977<\/option><option value=\"1976\" >1976<\/option><option value=\"1975\" >1975<\/option><option value=\"1974\" >1974<\/option><option value=\"1973\" >1973<\/option><option value=\"1972\" >1972<\/option><option value=\"1971\" >1971<\/option><option value=\"1970\" >1970<\/option><option value=\"1969\" >1969<\/option><option value=\"1968\" >1968<\/option><option value=\"1967\" >1967<\/option><option value=\"1966\" >1966<\/option><option value=\"1965\" >1965<\/option><option value=\"1964\" >1964<\/option><option value=\"1963\" >1963<\/option><option value=\"1962\" >1962<\/option><option value=\"1961\" >1961<\/option><option value=\"1960\" >1960<\/option><option value=\"1959\" >1959<\/option><option value=\"1958\" >1958<\/option><option value=\"1957\" >1957<\/option><option value=\"1956\" >1956<\/option><option value=\"1955\" >1955<\/option><option value=\"1954\" >1954<\/option><option value=\"1953\" >1953<\/option><option value=\"1952\" >1952<\/option><option value=\"1951\" >1951<\/option><option value=\"1950\" >1950<\/option><option value=\"1949\" >1949<\/option><option value=\"1948\" >1948<\/option><option value=\"1947\" >1947<\/option><option value=\"1946\" >1946<\/option><option value=\"1945\" >1945<\/option><option value=\"1944\" >1944<\/option><option value=\"1943\" >1943<\/option><option value=\"1942\" >1942<\/option><option value=\"1941\" >1941<\/option><option value=\"1940\" >1940<\/option><option value=\"1939\" >1939<\/option><option value=\"1938\" >1938<\/option><option value=\"1937\" >1937<\/option><option value=\"1936\" >1936<\/option><option value=\"1935\" >1935<\/option><option value=\"1934\" >1934<\/option><option value=\"1933\" >1933<\/option><option value=\"1932\" >1932<\/option><option value=\"1931\" >1931<\/option><option value=\"1930\" >1930<\/option><option value=\"1929\" >1929<\/option><option value=\"1928\" >1928<\/option><option value=\"1927\" >1927<\/option><option value=\"1926\" >1926<\/option><option value=\"1925\" >1925<\/option><option value=\"1924\" >1924<\/option><option value=\"1923\" >1923<\/option><option value=\"1922\" >1922<\/option><option value=\"1921\" >1921<\/option><option value=\"1920\" >1920<\/option><option value=\"1919\" >1919<\/option><option value=\"1918\" >1918<\/option><option value=\"1917\" >1917<\/option><option value=\"1916\" >1916<\/option><option value=\"1915\" >1915<\/option><option value=\"1914\" >1914<\/option><option value=\"1913\" >1913<\/option><option value=\"1912\" >1912<\/option><option value=\"1911\" >1911<\/option><option value=\"1910\" >1910<\/option><option value=\"1909\" >1909<\/option><option value=\"1908\" >1908<\/option><option value=\"1907\" >1907<\/option><option value=\"1906\" >1906<\/option><option value=\"1905\" >1905<\/option><option value=\"1904\" >1904<\/option><option value=\"1903\" >1903<\/option><option value=\"1902\" >1902<\/option><option value=\"1901\" >1901<\/option><\/select><label for=\"wdform_25_year18\" class=\"mini_label\">year<\/label><\/div><\/div><\/div><\/div><\/div><div wdid=\"50\" class=\"wdform_row\" style=\"position: relative; left: 0px; top: 0px;\"><div type=\"type_own_select\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_own_select\" ><div class=\"wdform-label-section wd-width-100 wdform_select wd-flex-row\">    <label  for=\"wdform_50_element18\" class=\"wdform-label\">Sex<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex wdform_select wd-flex-row wd-width-100\" ><select class=\"wd-width-100\" id=\"wdform_50_element18\" name=\"wdform_50_element18\" ><option value=\"\" selected=\"selected\">Select value<\/option><option value=\"Male\" >Male<\/option><option value=\"Female\" >Female<\/option><option value=\"Transgender\" >Transgender<\/option><\/select><\/div><\/div><\/div><div wdid=\"26\" class=\"wdform_row\" style=\"position: relative; left: 0px; top: 0px;\"><div type=\"type_text\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_text\" ><div class=\"wdform-label-section wd-width-100  wd-flex-row wd-align-items-center\">    <label  for=\"wdform_26_element18\" class=\"wdform-label\">Height and Weight<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex  wd-flex-row wd-align-items-center wd-width-100\" ><input type=\"text\"                           class=\"wd-width-100\"                           id=\"wdform_26_element18\"                           name=\"wdform_26_element18\"                           value=\"\"                           data-value=\"\"                           title=\"\"                           placeholder=\"\"                                                       \/><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div wdid=\"3\" class=\"wdform_row\"><div type=\"type_address\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_address\" ><div class=\"wdform-label-section wd-width-100 wdform_address wd-flex-column\">    <label  for=\"wdform_3_street118\" class=\"wdform-label\">Address<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex wdform_address wd-flex-column wd-width-100\" ><span class=\"wd-width-100 wd-address\" id=\"wdform_3_address_0\">                <input class=\"wd-width-100 wdform_3_address_0\" type=\"text\" id=\"wdform_3_street118\" name=\"wdform_3_street118\" value=\"\"  \/>                <label for=\"wdform_3_street118\" class=\"mini_label\">Street Address<\/label><\/span><span class=\"wd-width-100 wd-address\" id=\"wdform_3_address_1\">                <input class=\"wd-width-100 wdform_3_address_1\" type=\"text\" id=\"wdform_3_street218\" name=\"wdform_4_street218\" value=\"\"  \/>                <label for=\"wdform_3_street218\" class=\"mini_label\">Street Address Line 2<\/label><\/span><span class=\"wd-width-100 wd-flex wd-flex-row wd-flex-wrap wd-justify-content\"><span class=\"wd-width-49 wd-address\" id=\"wdform_3_address_2\">                <input class=\"wd-width-100 wdform_3_address_2\" type=\"text\" id=\"wdform_3_city18\" name=\"wdform_5_city18\" value=\"\"  \/>                <label for=\"wdform_3_city18\" class=\"mini_label\">City<\/label><\/span><span class=\"wd-width-49 wd-address\" id=\"wdform_3_address_3\">                <input class=\"wd-width-100 wdform_3_address_3\" type=\"text\" id=\"wdform_3_state18\" name=\"wdform_6_state18\" value=\"\"  \/>                <label for=\"wdform_3_state18\" class=\"mini_label\">State \/ Province \/ Region<\/label><\/span><span class=\"wd-width-49 wd-address\" id=\"wdform_3_address_4\">              <input class=\"wd-width-100 wdform_3_address_4\" type=\"text\" id=\"wdform_3_postal18\" name=\"wdform_7_postal18\" value=\"\"  \/>              <label for=\"wdform_3_postal18\" class=\"mini_label\">Postal \/ Zip Code<\/label><\/span><span class=\"wd-width-49 wd-address\" id=\"wdform_3_address_5\">              <select class=\"wd-width-100 wdform_3_address_5\"                      type=\"text\"                      id=\"wdform_3_country18\"                      name=\"wdform_8_country18\"                      onchange=\"wd_change_state_input('wdform_3', '18')\"                      ><option value=\"\" selected=\"selected\"><\/option><option value=\"Afghanistan\" >Afghanistan<\/option><option value=\"Albania\" >Albania<\/option><option value=\"Algeria\" >Algeria<\/option><option value=\"Andorra\" >Andorra<\/option><option value=\"Angola\" >Angola<\/option><option value=\"Antigua and Barbuda\" >Antigua and Barbuda<\/option><option value=\"Argentina\" >Argentina<\/option><option value=\"Armenia\" >Armenia<\/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=\"Bhutan\" >Bhutan<\/option><option value=\"Bolivia\" >Bolivia<\/option><option value=\"Bosnia and Herzegovina\" >Bosnia and Herzegovina<\/option><option value=\"Botswana\" >Botswana<\/option><option value=\"Brazil\" >Brazil<\/option><option value=\"Brunei\" >Brunei<\/option><option value=\"Bulgaria\" >Bulgaria<\/option><option value=\"Burkina\" >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=\"Central African Republic\" >Central African Republic<\/option><option value=\"Chad\" >Chad<\/option><option value=\"Chile\" >Chile<\/option><option value=\"China\" >China<\/option><option value=\"Colombia\" >Colombia<\/option><option value=\"Comoros\" >Comoros<\/option><option value=\"Congo\" >Congo<\/option><option value=\"Congo (Brazzaville)\" >Congo (Brazzaville)<\/option><option value=\"Costa Rica\" >Costa Rica<\/option><option value=\"Cote d&#039;Ivoire\" >Cote d&#039;Ivoire<\/option><option value=\"Croatia\" >Croatia<\/option><option value=\"Cuba\" >Cuba<\/option><option value=\"Curacao\" >Curacao<\/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=\"East Timor (Timor Timur\" >East Timor (Timor Timur)<\/option><option value=\"Ecuador\" >Ecuador<\/option><option value=\"Egypt\" >Egypt<\/option><option value=\"El Salvador\" >El Salvador<\/option><option value=\"Equatorial\" >Equatorial Guinea<\/option><option value=\"Eritrea\" >Eritrea<\/option><option value=\"Estonia\" >Estonia<\/option><option value=\"Eswatini\" >Eswatini<\/option><option value=\"Ethiopia\" >Ethiopia<\/option><option value=\"Fiji\" >Fiji<\/option><option value=\"Finland\" >Finland<\/option><option value=\"France\" >France<\/option><option value=\"Gabon\" >Gabon<\/option><option value=\"Gambia, The\" >Gambia, The<\/option><option value=\"Georgia\" >Georgia<\/option><option value=\"Germany\" >Germany<\/option><option value=\"Ghana\" >Ghana<\/option><option value=\"Greece\" >Greece<\/option><option value=\"Grenada\" >Grenada<\/option><option value=\"Guatemala\" >Guatemala<\/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=\"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\" >Iran<\/option><option value=\"Iraq\" >Iraq<\/option><option value=\"Ireland\" >Ireland<\/option><option value=\"Israel\" >Israel<\/option><option value=\"Italy\" >Italy<\/option><option value=\"Jamaica\" >Jamaica<\/option><option value=\"Japan\" >Japan<\/option><option value=\"Jordan\" >Jordan<\/option><option value=\"Kazakhstan\" >Kazakhstan<\/option><option value=\"Kenya\" >Kenya<\/option><option value=\"Kiribati\" >Kiribati<\/option><option value=\"Korea, North\" >Korea, North<\/option><option value=\"Korea, South\" >Korea, South<\/option><option value=\"Kuwait\" >Kuwait<\/option><option value=\"Kyrgyzstan\" >Kyrgyzstan<\/option><option value=\"Laos\" >Laos<\/option><option value=\"Latvia\" >Latvia<\/option><option value=\"Lebanon\" >Lebanon<\/option><option value=\"Lesotho\" >Lesotho<\/option><option value=\"Liberia\" >Liberia<\/option><option value=\"Libya\" >Libya<\/option><option value=\"Liechtenstein\" >Liechtenstein<\/option><option value=\"Lithuania\" >Lithuania<\/option><option value=\"Luxembourg\" >Luxembourg<\/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=\"Mauritania\" >Mauritania<\/option><option value=\"Mauritius\" >Mauritius<\/option><option value=\"Mexico\" >Mexico<\/option><option value=\"Micronesia\" >Micronesia<\/option><option value=\"Moldova\" >Moldova<\/option><option value=\"Monaco\" >Monaco<\/option><option value=\"Mongolia\" >Mongolia<\/option><option value=\"Montenegro\" >Montenegro<\/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=\"New Zealand\" >New Zealand<\/option><option value=\"Nicaragua\" >Nicaragua<\/option><option value=\"Niger\" >Niger<\/option><option value=\"Nigeria\" >Nigeria<\/option><option value=\"North Macedonia\" >North Macedonia<\/option><option value=\"Norway\" >Norway<\/option><option value=\"Oman\" >Oman<\/option><option value=\"Pakistan\" >Pakistan<\/option><option value=\"Palau\" >Palau<\/option><option value=\"Palestine\" >Palestine<\/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=\"Poland\" >Poland<\/option><option value=\"Portugal\" >Portugal<\/option><option value=\"Puerto Rico\" >Puerto Rico<\/option><option value=\"Qatar\" >Qatar<\/option><option value=\"Romania\" >Romania<\/option><option value=\"Russia\" >Russia<\/option><option value=\"Rwanda\" >Rwanda<\/option><option value=\"Saint Kitts and Nevis\" >Saint Kitts and Nevis<\/option><option value=\"Saint Lucia\" >Saint Lucia<\/option><option value=\"Saint Vincent\" >Saint Vincent<\/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 Sudan\" >South Sudan<\/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=\"Sweden\" >Sweden<\/option><option value=\"Switzerland\" >Switzerland<\/option><option value=\"Syria\" >Syria<\/option><option value=\"Taiwan\" >Taiwan<\/option><option value=\"Tajikistan\" >Tajikistan<\/option><option value=\"Tanzania\" >Tanzania<\/option><option value=\"Thailand\" >Thailand<\/option><option value=\"Togo\" >Togo<\/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=\"Tuvalu\" 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wd-width-100 wd-flex wd-flex-column fm-type_submitter_mail\" ><div class=\"wdform-label-section wd-width-100  wd-flex-row\">    <label  for=\"wdform_9_element18\" class=\"wdform-label\">Email<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex  wd-flex-row wd-width-100\" ><input type=\"text\" class=\"wd-width-100\" id=\"wdform_9_element18\" name=\"wdform_9_element18\" data-value=\"\" value=\"\" title=\"\" placeholder=\"\"   onchange=\"wd_check_email('9', '18', 'This is not a valid email address.')\" \/><\/div><\/div><\/div><div wdid=\"10\" class=\"wdform_row\"><div type=\"type_phone_new\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_phone_new\" ><div class=\"wdform-label-section wd-width-100 \">    <label  for=\"wdform_10_element18\" class=\"wdform-label\">Phone<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex  wd-width-100\" ><input type=\"text\"                       class=\"wd-width-100\"                       id=\"wdform_10_element18\"                       name=\"wdform_10_element18\"                       value=\"\"                       data-value=\"\"                       placeholder=\"\"  \/><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div wdid=\"31\" class=\"wdform_row\" style=\"position: relative; left: 0px; top: 0px;\"><div type=\"type_text\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_text\" ><div class=\"wdform-label-section wd-width-100  wd-flex-row wd-align-items-center\">    <label  for=\"wdform_31_element18\" class=\"wdform-label\">Person to contact in case of emergency, relationship and phone#<\/label><span class=\"wdform-required\">*<\/span><\/div><div class=\"wdform-element-section wd-flex  wd-flex-row wd-align-items-center wd-width-100\" ><input type=\"text\"                           class=\"wd-width-100\"                           id=\"wdform_31_element18\"                           name=\"wdform_31_element18\"                           value=\"\"                           data-value=\"\"                           title=\"\"                           placeholder=\"\"                                                       \/><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div wdid=\"46\" class=\"wdform_row\"><div type=\"type_send_copy\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_send_copy\" ><div class=\"wdform-element-section wd-flex  checkbox-div wd-flex-row-reverse wd-align-items-center wd-justify-content-right wd-width-100\" ><input type=\"checkbox\"                             class=\"wd-flex-row\"                             id=\"wdform_46_element18\"                             name=\"wdform_46_element18\"                                                           \/><label class=\"wd-align-items-center wd-flex wd-flex-row-reverse\" for=\"wdform_46_element18\" class=\"wdform-label\"><span><\/span>Send a copy of this message to yourself<\/label><span class=\"wdform-required\">*<\/span><\/div><\/div><\/div><\/div><div class=\"wdform_column\"><div wdid=\"45\" class=\"wdform_row\"><div type=\"type_recaptcha\" class=\"wdform-field wd-width-100 wd-flex wd-flex-row fm-type_recaptcha\" ><div class=\"wdform-label-section wd-width-30 wd-hidden wd-flex-row\">    <label  class=\"wdform-label\">reCAPTCHA<\/label><\/div><div class=\"wdform-element-section wd-flex wd-flex-row wd-width-100\" ><div id=\"recaptcha1845\" class=\"g-recaptcha\" data-sitekey=\"6LeI_PApAAAAAJ5PZgDRzqaaC-tXVwBh2WU8fHn9\" data-form_id=\"18\" data-badge=\"bottomright\"><\/div><\/div><\/div><\/div><div wdid=\"1\" class=\"wdform_row\" style=\"position: relative; left: 0px; top: 0px;\"><div type=\"type_submit_reset\" class=\"wdform-field wd-width-100 wd-flex wd-flex-column fm-type_submit_reset\" ><div class=\"wdform-element-section wd-flex  wd-flex-row wd-justify-content-right wd-width-100\" ><button  type=\"button\" class=\"button-submit\" 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We are currently in the developmental stage and are compiling a list of potential service providers for future collaboration. Please complete the following &hellip;<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"footnotes":""},"class_list":["post-17906","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Service Providers - My Goldern Jubliee<\/title>\n<meta name=\"description\" content=\"We are recruiting both medical and non-medical health workers for Vision Care Agency. 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