{"id":54390,"date":"2026-10-01T22:37:45","date_gmt":"2026-10-01T22:37:45","guid":{"rendered":"https:\/\/mydentalart.com\/?page_id=54390"},"modified":"2026-10-01T22:58:56","modified_gmt":"2026-10-01T22:58:56","slug":"refer-a-friend","status":"publish","type":"page","link":"https:\/\/mydentalart.com\/pl\/refer-a-friend\/","title":{"rendered":"Dental Art Referral Form"},"content":{"rendered":"<div data-elementor-type=\"wp-page\" data-elementor-id=\"54390\" class=\"elementor elementor-54390\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-0e3dafa elementor-section-full_width elementor-section-stretched elementor-section-height-default elementor-section-height-default\" data-id=\"0e3dafa\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;stretch_section&quot;:&quot;section-stretched&quot;,&quot;ekit_has_onepagescroll_dot&quot;:&quot;yes&quot;}\">\n\t\t\t\t\t\t<div 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gap:24px;\n}\n\n\n.dac-field {\n    margin-bottom:22px;\n}\n\n\n.dac-field label {\n    display:block;\n    font-size:16px;\n    font-weight:600;\n    margin-bottom:8px;\n}\n\n\n.dac-required {\n    color:#b42318;\n}\n\n\n.dac-field input {\n    width:100%;\n    box-sizing:border-box;\n    padding:15px 16px;\n    border:1px solid #c9c9c9;\n    border-radius:6px;\n    background:#fff;\n    font-size:16px;\n    font-family:inherit;\n}\n\n\n.dac-field input:focus {\n    outline:none;\n    border-color:#555;\n    box-shadow:0 0 0 2px rgba(0,0,0,.06);\n}\n\n\n\/* BUTTON *\/\n\n.dac-submit {\n    width:100%;\n    margin-top:12px;\n    padding:17px 25px;\n    border:none;\n    border-radius:6px;\n    background:#111;\n    color:#fff;\n    font-size:17px;\n    font-weight:700;\n    letter-spacing:.4px;\n    cursor:pointer;\n}\n\n\n.dac-submit:hover {\n    opacity:.88;\n    transform:translateY(-1px);\n}\n\n\n\/* SUCCESS *\/\n\n.dac-success {\n    max-width:720px;\n    margin:10px auto 40px;\n    padding:40px 30px;\n    text-align:center;\n    background:#f0f8f2;\n    border:1px solid #c7dfcc;\n    border-radius:10px;\n}\n\n\n.dac-success-icon {\n    width:58px;\n    height:58px;\n    margin:0 auto 15px;\n    display:flex;\n    align-items:center;\n    justify-content:center;\n    border-radius:50%;\n    background:#fff;\n    font-size:34px;\n    font-weight:bold;\n}\n\n\n.dac-success h2 {\n    font-size:30px;\n    margin:5px 0 15px;\n}\n\n\n.dac-success p {\n    max-width:600px;\n    margin:10px auto;\n    font-size:17px;\n    line-height:1.6;\n}\n\n\n\/* ERRORS *\/\n\n.dac-error {\n    padding:18px 20px;\n    margin:0 0 30px;\n    background:#fff3f3;\n    border:1px solid #e1bcbc;\n    border-radius:7px;\n    font-size:16px;\n    font-weight:600;\n}\n\n\n\/* HOW IT WORKS *\/\n\n.dac-how {\n    margin-top:55px;\n    padding-top:40px;\n    border-top:1px solid #ddd;\n}\n\n\n.dac-how h2 {\n    text-align:center;\n    font-size:30px;\n    margin-bottom:30px;\n}\n\n\n.dac-steps {\n    display:grid;\n    grid-template-columns:repeat(3,1fr);\n    gap:25px;\n}\n\n\n.dac-step {\n    text-align:center;\n    padding:25px 20px;\n}\n\n\n.dac-step-number {\n    width:45px;\n    height:45px;\n    margin:0 auto 15px;\n    display:flex;\n    align-items:center;\n    justify-content:center;\n    border-radius:50%;\n    background:#111;\n    color:#fff;\n    font-size:19px;\n    font-weight:700;\n}\n\n\n.dac-step strong {\n    display:block;\n    font-size:18px;\n    margin-bottom:8px;\n}\n\n\n.dac-step p {\n    margin:0;\n    font-size:15px;\n    line-height:1.6;\n}\n\n\n\/* TERMS *\/\n\n.dac-terms {\n    margin-top:40px;\n    padding:25px;\n    background:#f7f7f7;\n    border-radius:8px;\n    font-size:13px;\n    line-height:1.65;\n    color:#444;\n}\n\n\n.dac-terms h3 {\n    margin:0 0 8px;\n    font-size:17px;\n    color:#111;\n}\n\n\n\/* HONEYPOT *\/\n\n.dac-hp {\n    position:absolute !important;\n    left:-9999px !important;\n    width:1px !important;\n    height:1px !important;\n    overflow:hidden !important;\n}\n\n\n\/* TABLET *\/\n\n@media (max-width:900px) {\n\n    .dac-referral-hero {\n        min-height:430px;\n        padding:45px 35px;\n        background-position:58% center;\n    }\n\n    .dac-hero-content {\n        width:52%;\n    }\n\n    .dac-hero-content h1 {\n        font-size:37px;\n    }\n\n    .dac-referral-box {\n        padding:45px 40px;\n    }\n}\n\n\n\/* MOBILE *\/\n\n@media (max-width:700px) {\n\n    .dac-referral-wrap {\n        margin:15px auto 35px;\n    }\n\n    .dac-referral-hero {\n        min-height:520px;\n        align-items:flex-start;\n        padding:25px 18px;\n        border-radius:10px 10px 0 0;\n        background-position:67% center;\n    }\n\n    .dac-hero-content {\n        width:100%;\n        max-width:none;\n        padding:22px;\n        box-sizing:border-box;\n        background:rgba(255,255,255,.88);\n        border-radius:9px;\n    }\n\n    .dac-hero-content h1 {\n        font-size:32px;\n    }\n\n    .dac-hero-content p {\n        font-size:16px;\n    }\n\n    .dac-hero-credit {\n        font-size:21px;\n    }\n\n    .dac-referral-box {\n        padding:30px 20px;\n        border-radius:0 0 10px 10px;\n    }\n\n    .dac-form-heading h2 {\n        font-size:27px;\n    }\n\n    .dac-row {\n        grid-template-columns:1fr;\n        gap:0;\n    }\n\n    .dac-steps {\n        grid-template-columns:1fr;\n        gap:5px;\n    }\n\n    .dac-step {\n        padding:15px 10px;\n    }\n}\n\n<\/style>\n\n\n<div class=\"dac-referral-wrap\">\n\n\n<!-- HERO -->\n\n<section class=\"dac-referral-hero\">\n\n<div class=\"dac-hero-content\">\n\n<h1>\nRefer a Friend &amp;<br>\nGet $25 Credit\n<\/h1>\n\n<p>\nLove your smile? Share Dental Art Clinic\nwith a friend or family member.\n<\/p>\n\n<p>\nRefer a new patient to Dental Art Clinic,\nand when your friend completes their first\neligible appointment with us, you'll receive\na <strong>$25 credit<\/strong> toward eligible\nservices at Dental Art Clinic.\n<\/p>\n\n<div class=\"dac-hero-credit\">\nRefer a Friend \u2192 Get $25 Credit\n<\/div>\n\n<\/div>\n\n<\/section>\n\n\n\n<!-- FORM -->\n\n<section class=\"dac-referral-box\">\n\n\n\n\n<div class=\"dac-form-heading\">\n\n<h2>\nRefer Your Friend\n<\/h2>\n\n<p>\nComplete the information below to submit your referral.\n<\/p>\n\n<\/div>\n\n\n\n\n<form\nmethod=\"post\"\naction=\"https:\/\/mydentalart.com\/wp-admin\/admin-post.php\"\n>\n\n\n<input\ntype=\"hidden\"\nname=\"action\"\nvalue=\"dac_submit_referral\"\n>\n\n\n<input\ntype=\"hidden\"\nname=\"return_url\"\nvalue=\"https:\/\/mydentalart.com\/pl\/refer-a-friend\/\"\n>\n\n\n<input type=\"hidden\" id=\"dac_referral_nonce\" name=\"dac_referral_nonce\" value=\"2ca6e16ec5\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/pl\/wp-json\/wp\/v2\/pages\/54390\" \/>\n\n<!-- HONEYPOT -->\n\n<div class=\"dac-hp\" aria-hidden=\"true\">\n\n<label>\n\nWebsite\n\n<input\ntype=\"text\"\nname=\"dac_website\"\ntabindex=\"-1\"\nautocomplete=\"off\"\n>\n\n<\/label>\n\n<\/div>\n\n\n\n<!-- YOUR INFORMATION -->\n\n<h3>\nYour Information\n<\/h3>\n\n\n<div class=\"dac-row\">\n\n\n<div class=\"dac-field\">\n\n<label for=\"patient_name\">\n\nYour Full Name\n<span class=\"dac-required\">*<\/span>\n\n<\/label>\n\n<input\ntype=\"text\"\nid=\"patient_name\"\nname=\"patient_name\"\nrequired\nautocomplete=\"name\"\n>\n\n<\/div>\n\n\n\n<div class=\"dac-field\">\n\n<label for=\"patient_email\">\n\nYour Email Address\n<span class=\"dac-required\">*<\/span>\n\n<\/label>\n\n<input\ntype=\"email\"\nid=\"patient_email\"\nname=\"patient_email\"\nrequired\nautocomplete=\"email\"\n>\n\n<\/div>\n\n\n<\/div>\n\n\n\n<!-- FRIEND INFORMATION -->\n\n<h3>\nYour Friend's Information\n<\/h3>\n\n\n<div class=\"dac-row\">\n\n\n<div class=\"dac-field\">\n\n<label for=\"friend_name\">\n\nFriend's Full Name\n<span class=\"dac-required\">*<\/span>\n\n<\/label>\n\n<input\ntype=\"text\"\nid=\"friend_name\"\nname=\"friend_name\"\nrequired\n>\n\n<\/div>\n\n\n\n<div class=\"dac-field\">\n\n<label for=\"friend_email\">\n\nFriend's Email Address\n<span class=\"dac-required\">*<\/span>\n\n<\/label>\n\n<input\ntype=\"email\"\nid=\"friend_email\"\nname=\"friend_email\"\nrequired\n>\n\n<\/div>\n\n\n<\/div>\n\n\n<button\ntype=\"submit\"\nclass=\"dac-submit\"\n>\nREFER A FRIEND\n<\/button>\n\n\n<\/form>\n\n\n\n\n\n<!-- HOW IT WORKS -->\n\n<div class=\"dac-how\">\n\n<h2>\nHow It Works\n<\/h2>\n\n\n<div class=\"dac-steps\">\n\n\n<div class=\"dac-step\">\n\n<div class=\"dac-step-number\">\n1\n<\/div>\n\n<strong>\nSubmit a Referral\n<\/strong>\n\n<p>\nEnter your information and your friend's\ninformation using the form above.\n<\/p>\n\n<\/div>\n\n\n\n<div class=\"dac-step\">\n\n<div class=\"dac-step-number\">\n2\n<\/div>\n\n<strong>\nYour Friend Visits Us\n<\/strong>\n\n<p>\nYour friend schedules and completes their\nfirst eligible appointment at Dental Art Clinic.\n<\/p>\n\n<\/div>\n\n\n\n<div class=\"dac-step\">\n\n<div class=\"dac-step-number\">\n3\n<\/div>\n\n<strong>\nGet $25 Credit\n<\/strong>\n\n<p>\nYou'll receive a\n<strong>$25 credit<\/strong>\ntoward eligible services at Dental Art Clinic.\n<\/p>\n\n<\/div>\n\n\n<\/div>\n\n<\/div>\n\n\n\n<!-- TERMS -->\n\n<div class=\"dac-terms\">\n\n<h3>\nReferral Program Terms\n<\/h3>\n\nThe referred person must be a new patient of\nDental Art Clinic.\n\nThe $25 referral credit is issued after the\nreferred patient completes their first eligible\nappointment.\n\nReferral credits have no cash value,\nare non-transferable,\nand cannot be exchanged for cash.\n\nOne referral credit may be earned per\nqualifying new patient.\n\nCredits may be subject to restrictions based on\ninsurance, applicable law,\nor other program requirements.\n\nDental Art Clinic reserves the right to modify\nor discontinue the referral program.\n\n<\/div>\n\n\n<\/section>\n\n<\/div>\n\n\n<\/div>\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>","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_templately_pack_id":"","_templately_imported_at":"","_templately_source":"","_templately_import_session_id":"","footnotes":""},"class_list":["post-54390","page","type-page","status-publish","hentry","entry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Refer a Friend &amp; 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