{"id":26268,"date":"2024-09-11T16:20:15","date_gmt":"2024-09-11T20:20:15","guid":{"rendered":"https:\/\/www.elderplan.org\/?page_id=26268"},"modified":"2024-11-13T15:39:58","modified_gmt":"2024-11-13T20:39:58","slug":"physician","status":"publish","type":"page","link":"https:\/\/www.elderplan.org\/zh\/for-providers\/become-a-provider\/physician\/","title":{"rendered":"\u7533\u8acb\u6210\u70ba\u91ab\u751f"},"content":{"rendered":"\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f28595-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"28595\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/zh\/wp-json\/wp\/v2\/pages\/26268#wpcf7-f28595-o1\" method=\"post\" class=\"wpcf7-form init cf7mls-no-scroll cf7mls-no-moving-animation\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"28595\"><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-f28595-o1\"><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\"><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\"><input type=\"hidden\" name=\"_wpcf7cf_hidden_group_fields\" value=\"[]\"><input type=\"hidden\" name=\"_wpcf7cf_hidden_groups\" value=\"[]\"><input type=\"hidden\" name=\"_wpcf7cf_visible_groups\" value=\"[]\"><input type=\"hidden\" name=\"_wpcf7cf_repeaters\" value=\"[]\"><input type=\"hidden\" name=\"_wpcf7cf_steps\" value=\"{}\"><input type=\"hidden\" name=\"_wpcf7cf_options\" value='{\"form_id\":28595,\"conditions\":[{\"then_field\":\"contact_address_group\",\"and_rules\":[{\"if_field\":\"contact_same_address_as_above\",\"operator\":\"is empty\",\"if_value\":\"\"}]}],\"settings\":{\"animation\":\"yes\",\"animation_intime\":200,\"animation_outtime\":200,\"conditions_ui\":\"normal\",\"notice_dismissed\":false,\"notice_dismissed_update-cf7-5.9.8\":true,\"notice_dismissed_update-cf7-6.0\":true,\"notice_dismissed_update-cf7-6.0.1\":true,\"notice_dismissed_update-cf7-6.0.2\":true,\"notice_dismissed_update-cf7-6.0.3\":true,\"notice_dismissed_update-cf7-6.0.6\":true,\"notice_dismissed_update-cf7-6.1.1\":true,\"notice_dismissed_update-cf7-6.1.4\":true,\"notice_dismissed_update-cf7-6.1.5\":true}}'><input type=\"hidden\" name=\"_wpcf7dtx_version\" value=\"5.0.5\"><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\">\n<\/fieldset>\n<div class=\"padding-interior\">\n\t<div class=\"max-width-wrap\">\n\t\t<h2 class=\"font-40 mb-16\">\u52a0\u5165 Elderplan\uff08\u9577\u8001\u8a08\u5283\uff09\u7684\u63d0\u4f9b\u8005\u7db2\u7d61\n\t\t<\/h2>\n\t\t<p class=\"mb-16\">\u8acb\u5b8c\u6574\u586b\u5beb\u53c3\u8207\u7533\u8acb\u8868\u3002\u5728\u6211\u5011\u5be9\u6838\u60a8\u7684\u7533\u8acb\u5f8c\uff0cElderplan \u7684\u4f9b\u61c9\u5546\u4ee3\u8868\u5c07\u65bc 60 \u5929\u5167\u8207\u60a8\u806f\u7d61\u3002\u5982\u6709\u4efb\u4f55\u7591\u554f\uff0c\u8acb\u96a8\u6642\u81f4\u96fb\u6211\u5011\u7684\u5ba2\u6236\u670d\u52d9\u5718\u968a\uff1a<a href=\"tel:+17189217979\">718-921-7979<\/a>\u3002\n\t\t<\/p>\n\t\t<p class=\"mb-32\"><strong>\u6b64\u8868\u683c\u9069\u7528\u65bc\u76ee\u524d\u6c92\u6709\u8ddf Elderplan\uff08\u9577\u8001\u8a08\u5283\uff09\u7c3d\u7d04\u7684\u63d0\u4f9b\u8005\u3002<\/strong> \u5982\u679c\u60a8\u5df2\u7d93\u662f Elderplan\uff08\u9577\u8001\u8a08\u5283\uff09\u63d0\u4f9b\u8005\u7db2\u7d61\u7684\u4e00\u54e1\u6216\u5c07\u8981\u52a0\u5165\u6211\u5011\u7db2\u7d61\u4e2d\u5df2\u6709\u7684\u5718\u9ad4\uff0c\u8acb\u81f4\u96fb <a href=\"tel:+17189217979\">718-921-7979<\/a> \u8207\u6211\u5011\u7684\u63d0\u4f9b\u8005\u670d\u52d9\u90e8\u806f\u7d61\n\t\t<\/p>\n\t\t<div class=\"box box--top box--top-sharp\">\n\t\t\t<h3 class=\"form-section-heading\">\u4e00\u822c\u8cc7\u8a0a\n\t\t\t<\/h3>\n <!-- Group Section -->\n\t\t\t<p><label>\u60a8\u5c6c\u65bc\u67d0\u500b\u5718\u9ad4\u55ce?*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"group_part_of_group\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"group_part_of_group\" value=\"\u662f\"><span class=\"wpcf7-list-item-label\">\u662f<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"group_part_of_group\" value=\"No\" checked><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span><!-- Conditional Section for Group Information -->\n\t\t\t<\/p>\n\t\t\t<div class=\"mb-24\">\n\t\t\t<\/div>\n\t\t\t<div class=\"group-green-box-lt\">\n\t\t\t\t<p><label>\u60a8\u5c6c\u65bc\u67d0\u500b\u5718\u9ad4\u55ce*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"group_practice_name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"group_practice_name\"><\/span>\n\t\t\t\t<\/p>\n\t\t\t\t<div class=\"mb-24\">\n\t\t\t\t<\/div>\n\t\t\t\t<p><label>\u7d44\u7e54\u7a05\u52d9\u8b58\u5225\u865f (TIN)*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"group_tin\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"group_tin\"><\/span>\n\t\t\t\t<\/p>\n\t\t\t\t<div class=\"mb-24\">\n\t\t\t\t<\/div>\n\t\t\t\t<p class=\"small-cf7 input-help mb-24\">\u9019\u662f\u5fc5\u586b\u7684 9 \u4f4d\u6578\u865f\u78bc\u3002\n\t\t\t\t<\/p>\n\t\t\t\t<p><label>\u8a3a\u6240\u985e\u578b*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"practice_type\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"practice_type\" value=\"PC\" checked><span class=\"wpcf7-list-item-label\">PC<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"practice_type\" value=\"LLC\"><span class=\"wpcf7-list-item-label\">LLC<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"practice_type\" value=\"IPA\"><span class=\"wpcf7-list-item-label\">IPA<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"practice_type\" value=\"FQHC\"><span class=\"wpcf7-list-item-label\">FQHC<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\n <!-- Provider Section using Repeater -->\n\t\t<div class=\"box box--top box--top-sharp\">\n\t\t\t<p class=\"mb-16\"><span class=\"font-22\">\u63d0\u4f9b\u8005\u8cc7\u8a0a<\/span>\u6dfb\u52a0\u81f3\u5c11\u4e00\u500b\u63d0\u4f9b\u8005\n\t\t\t<\/p>\n\t\t\t<div data-wpcf7-group-id=\"providers\" id=\"providers-group\" tabindex=\"1\" class=\"wpcf7-field-groups \">\n\t\t\t\t<div class=\"wpcf7-field-group\">\n\t\t\t\t\t<div class=\"box\">\n\t\t\t\t\t\t<p><label>\u540d\u5b57*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"provider_first_name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"provider_first_name\"><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<div class=\"mb-24\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<p><label>\u59d3\u6c0f*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"provider_last_name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"provider_last_name\"><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<div class=\"mb-24\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<p><label>\u500b\u4eba NPI*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"provider_npi\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"provider_npi\"><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<div class=\"mb-24\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<p>\u9019\u662f\u5fc5\u586b\u7684 10 \u4f4d\u6578\u865f\u78bc\u3002\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<p><label>\u9078\u64c7\u5c08\u79d1*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"provider_specialty\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"provider_specialty\"><option value=\"\u91dd\u523a\">\u91dd\u523a<\/option><option value=\"\u6210\u766e\u91ab\u5b78\">\u6210\u766e\u91ab\u5b78<\/option><option value=\"\u6210\u766e\u7cbe\u795e\u75c5\u5b78\">\u6210\u766e\u7cbe\u795e\u75c5\u5b78<\/option><option value=\"\u9752\u5c11\u5e74\u91ab\u5b78\">\u9752\u5c11\u5e74\u91ab\u5b78<\/option><option value=\"\u904e\u654f\u548c\u514d\u75ab\u79d1\">\u904e\u654f\u548c\u514d\u75ab\u79d1<\/option><option value=\"\u9ebb\u9189\u5b78\">\u9ebb\u9189\u5b78<\/option><option value=\"\u5fc3\u8840\u7ba1\u75be\u75c5\u79d1\">\u5fc3\u8840\u7ba1\u75be\u75c5\u79d1<\/option><option value=\"\u810a\u690e\u63a8\u62ff\">\u810a\u690e\u63a8\u62ff<\/option><option value=\"\u81e8\u5e8a\u5fc3\u81df\u96fb\u751f\u7406\u5b78\">\u81e8\u5e8a\u5fc3\u81df\u96fb\u751f\u7406\u5b78<\/option><option value=\"\u81e8\u5e8a\u7d30\u80de\u907a\u50b3\u5b78\">\u81e8\u5e8a\u7d30\u80de\u907a\u50b3\u5b78<\/option><option value=\"\u81e8\u5e8a\u907a\u50b3\u5b78\">\u81e8\u5e8a\u907a\u50b3\u5b78<\/option><option value=\"\u81e8\u5e8a\u795e\u7d93\u751f\u7406\u5b78\">\u81e8\u5e8a\u795e\u7d93\u751f\u7406\u5b78<\/option><option value=\"\u81e8\u5e8a\u793e\u6703\u5de5\u4f5c\">\u81e8\u5e8a\u793e\u6703\u5de5\u4f5c<\/option><option value=\"\u7d50\u8178\u548c\u76f4\u8178\u624b\u8853\">\u7d50\u8178\u548c\u76f4\u8178\u624b\u8853<\/option><option value=\"\u91cd\u75c7\u52a0\u8b77\u91ab\u5b78\">\u91cd\u75c7\u52a0\u8b77\u91ab\u5b78<\/option><option value=\"\u76ae\u819a\u79d1\">\u76ae\u819a\u79d1<\/option><option value=\"\u81b3\u98df\u5b78\u5bb6\/\u71df\u990a\u5e2b\">\u81b3\u98df\u5b78\u5bb6\/\u71df\u990a\u5e2b<\/option><option value=\"\u5167\u5206\u6ccc\u5b78\u7cd6\u5c3f\u75c5\u8207\u4ee3\u8b1d\">\u5167\u5206\u6ccc\u5b78\u7cd6\u5c3f\u75c5\u8207\u4ee3\u8b1d<\/option><option value=\"\u7672\u7647\">\u7672\u7647<\/option><option value=\"\u5bb6\u5ead\u91ab\u5b78\u79d1\">\u5bb6\u5ead\u91ab\u5b78\u79d1<\/option><option value=\"\u5973\u6027\u76c6\u8154\u91ab\u5b78\u8207\u4fee\u5fa9\u5916\u79d1\u624b\u8853\">\u5973\u6027\u76c6\u8154\u91ab\u5b78\u8207\u4fee\u5fa9\u5916\u79d1\u624b\u8853<\/option><option value=\"\u8178\u80c3\u75c5\u79d1\">\u8178\u80c3\u75c5\u79d1<\/option><option value=\"\u666e\u901a\u8840\u7ba1\u5916\u79d1\">\u666e\u901a\u8840\u7ba1\u5916\u79d1<\/option><option value=\"\u8001\u5e74\u91ab\u5b78\">\u8001\u5e74\u91ab\u5b78<\/option><option value=\"\u8001\u5e74\u7cbe\u795e\u75c5\u5b78\">\u8001\u5e74\u7cbe\u795e\u75c5\u5b78<\/option><option value=\"\u5a66\u79d1\u816b\u7624\u79d1\">\u5a66\u79d1\u816b\u7624\u79d1<\/option><option value=\"\u624b\u5916\u79d1\">\u624b\u5916\u79d1<\/option><option value=\"\u8840\u6db2\u79d1\">\u8840\u6db2\u79d1<\/option><option value=\"\u5584\u7d42\u670d\u52d9\u548c\u8212\u7de9\u6cbb\u7642\">\u5584\u7d42\u670d\u52d9\u548c\u8212\u7de9\u6cbb\u7642<\/option><option value=\"\u50b3\u67d3\u75c5\u5b78\">\u50b3\u67d3\u75c5\u5b78<\/option><option value=\"\u5167\u79d1\">\u5167\u79d1<\/option><option value=\"\u4ecb\u5165\u6027\u5fc3\u81df\u5b78\">\u4ecb\u5165\u6027\u5fc3\u81df\u5b78<\/option><option value=\"\u5b55\u7522\u5a66\u53ca\u80ce\u5152\u91ab\u5b78\">\u5b55\u7522\u5a66\u53ca\u80ce\u5152\u91ab\u5b78<\/option><option value=\"\u816b\u7624\u5167\u79d1\">\u816b\u7624\u5167\u79d1<\/option><option value=\"\u91ab\u7642\u6bd2\u7406\u5b78\">\u91ab\u7642\u6bd2\u7406\u5b78<\/option><option value=\"\u814e\u75c5\u79d1\">\u814e\u75c5\u79d1<\/option><option value=\"\u795e\u7d93\u767c\u80b2\u6b98\u969c\u5b78\">\u795e\u7d93\u767c\u80b2\u6b98\u969c\u5b78<\/option><option value=\"\u795e\u7d93\u5916\u79d1\">\u795e\u7d93\u5916\u79d1<\/option><option value=\"\u795e\u7d93\u79d1\">\u795e\u7d93\u79d1<\/option><option value=\"\u5152\u7ae5\u795e\u7d93\u5fc3\u7406\u5b78 (NEU) \u65b9\u9762\u7684\u7279\u6b8a\u8cc7\u683c\u795e\u7d93\u5b78\">\u5152\u7ae5\u795e\u7d93\u5fc3\u7406\u5b78 (NEU) \u65b9\u9762\u7684\u7279\u6b8a\u8cc7\u683c\u795e\u7d93\u5b78<\/option><option value=\"\u795e\u7d93\u808c\u8089\u91ab\u5b78\">\u795e\u7d93\u808c\u8089\u91ab\u5b78<\/option><option value=\"\u795e\u7d93\u7cfb\u653e\u5c04\u5b78\">\u795e\u7d93\u7cfb\u653e\u5c04\u5b78<\/option><option value=\"\u8033\u795e\u7d93\u75c5\u5b78\">\u8033\u795e\u7d93\u75c5\u5b78<\/option><option value=\"\u6838\u91ab\u5b78\">\u6838\u91ab\u5b78<\/option><option value=\"\u6838\u653e\u5c04\u5b78\">\u6838\u653e\u5c04\u5b78<\/option><option value=\"\u57f7\u696d\u8b77\u58eb\">\u57f7\u696d\u8b77\u58eb<\/option><option value=\"\u52a9\u7522\u8b77\u58eb\">\u52a9\u7522\u8b77\u58eb<\/option><option value=\"\u5a66\u7522\u79d1\u91ab\u5b78\">\u5a66\u7522\u79d1\u91ab\u5b78<\/option><option value=\"\u8077\u696d\u91ab\u5b78\">\u8077\u696d\u91ab\u5b78<\/option><option value=\"\u8077\u696d\u6cbb\u7642\">\u8077\u696d\u6cbb\u7642<\/option><option value=\"\u773c\u79d1\">\u773c\u79d1<\/option><option value=\"\u53e3\u8154\u624b\u8853\">\u53e3\u8154\u624b\u8853<\/option><option value=\"\u9aa8\u79d1\u904b\u52d5\u91ab\u5b78\">\u9aa8\u79d1\u904b\u52d5\u91ab\u5b78<\/option><option value=\"\u77ef\u5f62\u5916\u79d1\">\u77ef\u5f62\u5916\u79d1<\/option><option value=\"\u6574\u9aa8\u91ab\u5b78\">\u6574\u9aa8\u91ab\u5b78<\/option><option value=\"\u8033\u9f3b\u5589\u79d1\">\u8033\u9f3b\u5589\u79d1<\/option><option value=\"\u75bc\u75db\u7ba1\u7406\">\u75bc\u75db\u7ba1\u7406<\/option><option value=\"\u75c5\u7406\u5b78\">\u75c5\u7406\u5b78<\/option><option value=\"\u7269\u7406\u91ab\u5b78\u548c\u5fa9\u5065\">\u7269\u7406\u91ab\u5b78\u548c\u5fa9\u5065<\/option><option value=\"\u7269\u7406\u6cbb\u7642\">\u7269\u7406\u6cbb\u7642<\/option><option value=\"\u91ab\u751f\u52a9\u7406\">\u91ab\u751f\u52a9\u7406<\/option><option value=\"\u6574\u5f62\u5916\u79d1\">\u6574\u5f62\u5916\u79d1<\/option><option value=\"\u8db3\u75c5\u5b78\">\u8db3\u75c5\u5b78<\/option><option value=\"Enfermera \u7cbe\u795e\u79d1\u57f7\u696d\u8b77\u58eb\">Enfermera \u7cbe\u795e\u79d1\u57f7\u696d\u8b77\u58eb<\/option><option value=\"\u7cbe\u795e\u79d1\">\u7cbe\u795e\u79d1<\/option><option value=\"\u5fc3\u7406\u6cbb\u7642\u79d1\">\u5fc3\u7406\u6cbb\u7642\u79d1<\/option><option value=\"\u8eab\u5fc3\u91ab\u5b78\">\u8eab\u5fc3\u91ab\u5b78<\/option><option value=\"\u516c\u5171\u885b\u751f\u548c\u4e00\u822c\u9810\u9632\u91ab\u5b78\">\u516c\u5171\u885b\u751f\u548c\u4e00\u822c\u9810\u9632\u91ab\u5b78<\/option><option value=\"\u80ba\u75c5\u79d1\">\u80ba\u75c5\u79d1<\/option><option value=\"\u653e\u5c04\u816b\u7624\u79d1\">\u653e\u5c04\u816b\u7624\u79d1<\/option><option value=\"\u653e\u5c04\u7269\u7406\u5b78\">\u653e\u5c04\u7269\u7406\u5b78<\/option><option value=\"\u653e\u5c04\u79d1\">\u653e\u5c04\u79d1<\/option><option value=\"\u98a8\u6fd5\u75c5\u79d1\">\u98a8\u6fd5\u75c5\u79d1<\/option><option value=\"\u7761\u7720\u91ab\u5b78\u79d1\">\u7761\u7720\u91ab\u5b78\u79d1<\/option><option value=\"\u5c08\u79d1\u91ab\u751f\u52a9\u7406\">\u5c08\u79d1\u91ab\u751f\u52a9\u7406<\/option><option value=\"\u8a9e\u8a00\u75c5\u7406\u5b78\">\u8a9e\u8a00\u75c5\u7406\u5b78<\/option><option value=\"\u810a\u690e\u640d\u50b7\u91ab\u5b78\">\u810a\u690e\u640d\u50b7\u91ab\u5b78<\/option><option value=\"\u904b\u52d5\u91ab\u5b78\">\u904b\u52d5\u91ab\u5b78<\/option><option value=\"\u624b\u8853\">\u624b\u8853<\/option><option value=\"\u91cd\u75c7\u52a0\u8b77\u91ab\u5b78\">\u91cd\u75c7\u52a0\u8b77\u91ab\u5b78<\/option><option value=\"\u816b\u7624\u5916\u79d1\">\u816b\u7624\u5916\u79d1<\/option><option value=\"\u80f8\u5916\u79d1\">\u80f8\u5916\u79d1<\/option><option value=\"\u79fb\u690d\u809d\u75c5\u5b78\">\u79fb\u690d\u809d\u75c5\u5b78<\/option><option value=\"\u6ccc\u5c3f\u79d1\">\u6ccc\u5c3f\u79d1<\/option><option value=\"\u8840\u7ba1\u548c\u4ecb\u5165\u653e\u5c04\u5b78\">\u8840\u7ba1\u548c\u4ecb\u5165\u653e\u5c04\u5b78<\/option><option value=\"\u8840\u7ba1\u795e\u7d93\u5b78\">\u8840\u7ba1\u795e\u7d93\u5b78<\/option><\/select><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<div class=\"mb-24\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<p><label>\u96fb\u5b50\u90f5\u4ef6*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"provider_email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"provider_email\"><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<div class=\"mb-24\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<p><label>\u8a72\u63d0\u4f9b\u8005\u662f\u5426\u9032\u884c\u5bb6\u8a2a\uff1f*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"provider_home_visits\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"provider_home_visits\" value=\"\u662f\" checked><span class=\"wpcf7-list-item-label\">\u662f<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"provider_home_visits\" value=\"\u5426\"><span class=\"wpcf7-list-item-label\">\u5426<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<p><button type=\"button\" class=\"wpcf7-field-group-remove \">-<\/button><button type=\"button\" class=\"wpcf7-field-group-add \">+<\/button><input type=\"hidden\" class=\"wpcf7-field-group-count\" name=\"_wpcf7_groups_count[providers]\" value=\"1\">\n\t\t\t\t\t<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<p>\u4f7f\u7528\u52a0\u865f\u548c\u6e1b\u865f\u6309\u9215\u6dfb\u52a0\u548c\u522a\u9664\u63d0\u4f9b\u8005\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<div class=\"box\">\n\t\t\t<p class=\"mb-16\"><span class=\"font-22\">\u8a3a\u6240\u5730\u5740<\/span>\n\t\t\t<\/p>\n <!-- Practice Address Section -->\n\t\t\t<p><label>\u8857\u9053\u5730\u5740*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"practice_street_address\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"practice_street_address\"><\/span>\n\t\t\t<\/p>\n\t\t\t<div class=\"mb-24\">\n\t\t\t<\/div>\n\t\t\t<p><label>\u8857\u9053\u5730\u5740 2<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"practice_street_address_2\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"practice_street_address_2\"><\/span>\n\t\t\t<\/p>\n\t\t\t<div class=\"mb-24\">\n\t\t\t<\/div>\n\t\t\t<p><label>\u57ce\u5e02*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"practice_city\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"practice_city\"><\/span>\n\t\t\t<\/p>\n\t\t\t<div class=\"mb-24\">\n\t\t\t<\/div>\n\t\t\t<p><label>\u5dde*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"practice_state\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"practice_state\"><option value=\"\u7d10\u7d04\">\u7d10\u7d04<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t\t<div class=\"mb-24\">\n\t\t\t<\/div>\n\t\t\t<p><label>\u90f5\u905e\u5340\u865f*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"practice_zip\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"practice_zip\"><\/span>\n\t\t\t<\/p>\n\t\t\t<div class=\"mb-24\">\n\t\t\t<\/div>\n\t\t\t<p><label>\u96fb\u8a71\u865f\u78bc*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"practice_phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"practice_phone\"><\/span>\n\t\t\t<\/p>\n\t\t\t<div class=\"mb-32\">\n\t\t\t<\/div>\n\t\t\t<p class=\"small-cf7 input-help mb-24\">\u9019\u662f\u5fc5\u586b\u7684 10 \u4f4d\u6578\u96fb\u8a71\u865f\u78bc\u3002\n\t\t\t<\/p>\n\t\t\t<p class=\"font-22\">\u5982\u679c\u6709\u4efb\u4f55\u554f\u984c\uff0c\u6211\u5011\u61c9\u8a72\u806f\u7d61\u8ab0\uff1f\n\t\t\t<\/p>\n <!-- Contact Section -->\n\t\t\t<p><label>\u5168\u540d*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"contact_full_name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"contact_full_name\"><\/span>\n\t\t\t<\/p>\n\t\t\t<div class=\"mb-24\">\n\t\t\t<\/div>\n\t\t\t<p><label>\u806f\u7d61\u96fb\u5b50\u90f5\u4ef6*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"contact_email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"contact_email\"><\/span>\n\t\t\t<\/p>\n\t\t\t<div class=\"mb-24\">\n\t\t\t<\/div>\n\t\t\t<p><label>\u5730\u5740\u540c\u4e0a<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"contact_same_address_as_above\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"contact_same_address_as_above[]\" value=\"\u662f\" checked><span class=\"wpcf7-list-item-label\">\u662f<\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<div class=\"mb-24\">\n\t\t\t<\/div>\n <!-- Conditional Contact Address Section -->\n\t\t\t<div data-id=\"contact_address_group\" data-orig_data_id=\"contact_address_group\" class=\"\" data-class=\"wpcf7cf_group\">\n\t\t\t\t<p><label>\u8857\u9053\u5730\u5740*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"contact_street_address\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"contact_street_address\"><\/span>\n\t\t\t\t<\/p>\n\t\t\t\t<div class=\"mb-24\">\n\t\t\t\t<\/div>\n\t\t\t\t<p><label>\u8857\u9053\u5730\u5740 2<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"contact_street_address_2\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"contact_street_address_2\"><\/span>\n\t\t\t\t<\/p>\n\t\t\t\t<div class=\"mb-24\">\n\t\t\t\t<\/div>\n\t\t\t\t<p><label>\u57ce\u5e02*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"contact_city\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"contact_city\"><\/span>\n\t\t\t\t<\/p>\n\t\t\t\t<div class=\"mb-24\">\n\t\t\t\t<\/div>\n\t\t\t\t<p><label>\u5dde*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"contact_state\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"contact_state\"><option value=\"\u7d10\u7d04\">\u7d10\u7d04<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t\t<div class=\"mb-24\">\n\t\t\t\t<\/div>\n\t\t\t\t<p><label>\u90f5\u905e\u5340\u865f*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"contact_zip\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"contact_zip\"><\/span>\n\t\t\t\t<\/p>\n\t\t\t\t<div class=\"mb-24\">\n\t\t\t\t<\/div>\n\t\t\t\t<p><label>\u96fb\u8a71\u865f\u78bc*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"contact_phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"contact_phone\"><\/span>\n\t\t\t\t<\/p>\n\t\t\t\t<div class=\"mb-24\">\n\t\t\t\t<\/div>\n\t\t\t\t<p class=\"small-cf7 input-help mb-24\">\u9019\u662f\u5fc5\u586b\u7684 10 \u4f4d\u6578\u96fb\u8a71\u865f\u78bc\u3002\n\t\t\t\t<\/p>\n\t\t\t\t<div class=\"mb-24\">\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<span class=\"wpcf7-form-control-wrap your-unique-id\" data-name=\"your-unique-id\"><input type=\"hidden\" name=\"your-unique-id\" class=\"wpcf7-form-control wpcf7-hidden wpcf7dtx wpcf7dtx-hidden\" aria-invalid=\"false\" value=\"AA2F37B8-5A1B-45FE-A71A-76A992E5D458\"><\/span>\n\n <!-- Submit Button -->\n\t\t\t<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"\u63d0\u4ea4\u53c3\u52a0\u7533\u8acb\u8868\">\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"screen-reader-response\">\n\t<div role=\"status\">\n\t<\/div>\n<\/div><input type=\"hidden\" class=\"wpcf7-pum\" value='{\"closepopup\":false,\"closedelay\":0,\"openpopup\":false,\"openpopup_id\":0}'><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"{:en} Join Elderplan\u2019s Provider Network Please fill out the participation request form completely. After we review your request, an Elderplan Provider Representative will contact you within 60 days. For any [...]","protected":false},"author":21,"featured_media":0,"parent":60,"menu_order":1,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-26268","page","type-page","status-publish","hentry"],"translation":{"provider":"WPGlobus","version":"3.0.2","language":"zh","enabled_languages":["en","es","zh"],"languages":{"en":{"title":true,"content":true,"excerpt":false},"es":{"title":true,"content":true,"excerpt":false},"zh":{"title":true,"content":true,"excerpt":false}}},"acf":[],"jetpack_sharing_enabled":true,"publishpress_future_action":{"enabled":false,"date":"2026-05-06 21:06:26","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category","extraData":[]},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"https:\/\/www.elderplan.org\/zh\/wp-json\/wp\/v2\/pages\/26268","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.elderplan.org\/zh\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.elderplan.org\/zh\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.elderplan.org\/zh\/wp-json\/wp\/v2\/users\/21"}],"replies":[{"embeddable":true,"href":"https:\/\/www.elderplan.org\/zh\/wp-json\/wp\/v2\/comments?post=26268"}],"version-history":[{"count":0,"href":"https:\/\/www.elderplan.org\/zh\/wp-json\/wp\/v2\/pages\/26268\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/www.elderplan.org\/zh\/wp-json\/wp\/v2\/pages\/60"}],"wp:attachment":[{"href":"https:\/\/www.elderplan.org\/zh\/wp-json\/wp\/v2\/media?parent=26268"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}