{"id":12334,"date":"2022-07-06T12:12:36","date_gmt":"2022-07-06T16:12:36","guid":{"rendered":"https:\/\/www.hampstead.qc.ca\/service-de-verification-du-bien-etre\/"},"modified":"2022-07-07T11:40:44","modified_gmt":"2022-07-07T15:40:44","slug":"social-wellness-check","status":"publish","type":"page","link":"https:\/\/www.hampstead.qc.ca\/en\/social-wellness-check\/","title":{"rendered":"Social Wellness Check"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"12334\" class=\"elementor elementor-12334 elementor-12326\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-03bc824 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"03bc824\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-9b5131c\" data-id=\"9b5131c\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-700721d elementor-widget elementor-widget-text-editor\" data-id=\"700721d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>The Social Wellness Check is a weekly phone call to ensure that a senior or a person with a specific medical or physical condition can confirm that their general condition is suitable for maintaining functioning abilities.<\/p><p>Please note that you may discontinue this service at any time. However, it can temporarily help you through a difficult time such as bereavement.<\/p><p>Please fill out the form below to register.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-1675c3f elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"1675c3f\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-66 elementor-top-column elementor-element elementor-element-132694e\" data-id=\"132694e\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-bc84e3d elementor-button-align-stretch elementor-widget elementor-widget-form\" data-id=\"bc84e3d\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;button_width&quot;:&quot;100&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" name=\"New Form\" aria-label=\"New Form\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"12334\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"bc84e3d\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"Social Wellness Check  - Hampstead\" \/>\n\n\t\t\t\t\t\t\t<input type=\"hidden\" name=\"queried_id\" value=\"12334\"\/>\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-name elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-name\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tName\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[name]\" id=\"form-field-name\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Name\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-email elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-email\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPhone number\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[email]\" id=\"form-field-email\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Phone number\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_2b4c2e0 elementor-col-100\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"I fit the criteria described in the introduction (age or condition)\" id=\"form-field-field_2b4c2e0-0\" name=\"form_fields[field_2b4c2e0]\"> <label for=\"form-field-field_2b4c2e0-0\">I fit the criteria described in the introduction (age or condition)<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_f4a2edd elementor-col-100\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"I understand that this service is not a public health care service.\" id=\"form-field-field_f4a2edd-0\" name=\"form_fields[field_f4a2edd]\"> <label for=\"form-field-field_f4a2edd-0\">I understand that this service is not a public health care service.<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_1e89012 elementor-col-100\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"I understand that I will receive a weekly call whenever possible during the office hours of the municipal administration.\" id=\"form-field-field_1e89012-0\" name=\"form_fields[field_1e89012]\"> <label for=\"form-field-field_1e89012-0\">I understand that I will receive a weekly call whenever possible during the office hours of the municipal administration.<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_89eb13a elementor-col-100\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"I understand that in the event of a significant alteration or deterioration of your general condition, it may be our duty to call a service to assist you.\" id=\"form-field-field_89eb13a-0\" name=\"form_fields[field_89eb13a]\"> <label for=\"form-field-field_89eb13a-0\">I understand that in the event of a significant alteration or deterioration of your general condition, it may be our duty to call a service to assist you.<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-sm\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Envoyer<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-f05a4be\" data-id=\"f05a4be\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-03b8a92 elementor-widget elementor-widget-text-editor\" data-id=\"03b8a92\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p style=\"text-align: center;\"><strong>I am concerned about the health of a loved one. Visit the <a href=\"https:\/\/www.patientsafetyinstitute.ca\/en\/toolsresources\/deteriorating-patient-condition\/public\/pages\/default.aspx\">Canadian Patient Safety Institute website.<\/a><\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-ba2e3ea elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"ba2e3ea\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-66 elementor-top-column elementor-element elementor-element-cc45bd1\" data-id=\"cc45bd1\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-95a1508\" data-id=\"95a1508\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-0847d75 elementor-button-align-stretch elementor-widget elementor-widget-form\" data-id=\"0847d75\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;button_width&quot;:&quot;100&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" name=\"New Form\" aria-label=\"New Form\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"12334\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"0847d75\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"Social Wellness Check  - Hampstead\" \/>\n\n\t\t\t\t\t\t\t<input type=\"hidden\" name=\"queried_id\" value=\"12334\"\/>\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-satisfaction_radio elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-satisfaction_radio\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t<div style=\"color:#888\">Help us to optimize our site.<\/div>\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"oui\" id=\"form-field-satisfaction_radio-0\" name=\"form_fields[satisfaction_radio]\"> <label for=\"form-field-satisfaction_radio-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"non\" id=\"form-field-satisfaction_radio-1\" name=\"form_fields[satisfaction_radio]\"> <label for=\"form-field-satisfaction_radio-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-message elementor-col-100\">\n\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[message]\" id=\"form-field-message\" rows=\"4\" placeholder=\"Please explain\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-sm\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Send<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>The Social Wellness Check is a weekly phone call to ensure that a senior or a person with a specific medical or physical condition can confirm that their general condition is suitable for maintaining functioning abilities. Please note that you may discontinue this service at any time. However, it can temporarily help you through a difficult time such as bereavement. Please fill out the form below to register. I am concerned about the health of a loved one. Visit the Canadian Patient Safety Institute website.<\/p>\n","protected":false},"author":11,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-12334","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.hampstead.qc.ca\/en\/wp-json\/wp\/v2\/pages\/12334","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hampstead.qc.ca\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.hampstead.qc.ca\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.hampstead.qc.ca\/en\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hampstead.qc.ca\/en\/wp-json\/wp\/v2\/comments?post=12334"}],"version-history":[{"count":0,"href":"https:\/\/www.hampstead.qc.ca\/en\/wp-json\/wp\/v2\/pages\/12334\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.hampstead.qc.ca\/en\/wp-json\/wp\/v2\/media?parent=12334"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}