
{"id":181919,"date":"2025-06-20T02:14:51","date_gmt":"2025-06-20T09:14:51","guid":{"rendered":"https:\/\/driphydration.com\/?page_id=181919"},"modified":"2025-09-25T14:28:08","modified_gmt":"2025-09-25T21:28:08","slug":"lipostat","status":"publish","type":"page","link":"https:\/\/driphydration.com\/vitamin-injections\/lipostat\/","title":{"rendered":"Vitamin Injections Lipostat"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row css_animation=&#8221;&#8221; row_type=&#8221;row&#8221; use_row_as_full_screen_section=&#8221;no&#8221; type=&#8221;full_width&#8221; angled_section=&#8221;no&#8221; text_align=&#8221;left&#8221; background_image_as_pattern=&#8221;without_pattern&#8221;][vc_column]                    <article class=\"product-intro\">\n                <div class=\"product-intro__slider\">\n                                                                                                                        \t\t\t\t\t                                        \n                    <div class=\"product-intro__wrapper\">\n                                                    <img decoding=\"async\" src=\"https:\/\/driphydration.com\/wp-content\/uploads\/2025\/06\/Lipostat_Drip.png\" alt=\"Lipostat+ Injections\" class=\"product-intro__img\"\/>\n                                                                            <picture>\n                                                                    <source srcset=\"https:\/\/driphydration.com\/wp-content\/uploads\/2025\/06\/Lipostat_Hero_Desktop.jpg\" media=\"(min-width: 200px) and (max-width: 600px)\">\n                                                                <img decoding=\"async\" src=\"https:\/\/driphydration.com\/wp-content\/uploads\/2025\/06\/Lipostat_Hero_Desktop.jpg\" alt=\"Lipostat+ Injections\" class=\"product-intro__bg\"\/>\n                            <\/picture>\n                                                <div class=\"ecommerce_container\">\n                            <div class=\"product-intro___content\">\n                                <div class=\"container_top\">\n                                                                                                                <h1 class=\"title\" data-title=\"\">Lipostat+ Injections<\/h1>\n                                                                                                        <\/div>\n                                <div class=\"container_description\">\n                                                                                            <div class=\"text\">The Fat Burner<\/p>\n<ul>\n<li>Monthly subscription: $199<\/li>\n<li>1-month supply: $299<\/li>\n<\/ul>\n<p><\/div>\n                                                                                        <div class=\"product-intro___rating\">\n                                                                                            <\/div>\n                                <\/div>\n\n                                                                    <!-- Two buttons -->\n                                    <div class=\"row-buttom-im\">\n                                                                                    <a href=\"#order-now\" class=\"btn-new white\"\n                                                                                                >\n                                                ORDER NOW                                            <\/a>\n                                          \n                                                                                    <a href=\"\/complementary-consultation\" class=\"btn-new outline-white\"\n                                                                                                >\n                                                FREE CONSULTATION                                            <\/a>\n                                                                            <\/div>\n                                \n\n                                <div class=\"row-icon\">\n                                                                            <img decoding=\"async\" src=\"https:\/\/driphydration.com\/wp-content\/uploads\/2025\/06\/FSA-4.png\" alt=\"icon\"\/>\n                                                                    <\/div>\n\t\t\t\t\t\t\t\t<div class=\"content-raiting\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n                            <\/div>\n                        <\/div>\n                    <\/div>\n                <\/div>\n            <\/article>\n          \n                [vc_row_inner row_type=&#8221;row&#8221; type=&#8221;full_width&#8221; text_align=&#8221;center&#8221; css_animation=&#8221;&#8221; el_class=&#8221;treatment-image-text&#8221;][vc_column_inner width=&#8221;1\/4&#8243;]<div class=\"image_with_text\"><img decoding=\"async\" itemprop=\"image\" src=\"https:\/\/driphydration.com\/wp-content\/uploads\/2025\/06\/Burn_Fat-1.svg\" alt=\"Enhanced fat burning\" \/><h3 style=\"color:#1b262a;\" class=\"image_with_text_title\">Enhanced fat burning<\/h3><span style=\"margin: 6px 0px;\" class=\"separator transparent\"><\/span><\/div>[\/vc_column_inner][vc_column_inner width=&#8221;1\/4&#8243;]<div class=\"image_with_text\"><img decoding=\"async\" itemprop=\"image\" src=\"https:\/\/driphydration.com\/wp-content\/uploads\/2025\/06\/Energy_Boost.svg\" alt=\"Energy boost\" \/><h3 style=\"color:#1b262a;\" class=\"image_with_text_title\">Energy boost<\/h3><span style=\"margin: 6px 0px;\" class=\"separator transparent\"><\/span><\/div>[\/vc_column_inner][vc_column_inner width=&#8221;1\/4&#8243;]<div class=\"image_with_text\"><img decoding=\"async\" itemprop=\"image\" src=\"https:\/\/driphydration.com\/wp-content\/uploads\/2025\/06\/Detox-1-2.svg\" alt=\"Support liver health\" \/><h3 style=\"color:#1b262a;\" class=\"image_with_text_title\">Support liver health<\/h3><span style=\"margin: 6px 0px;\" class=\"separator transparent\"><\/span><\/div>[\/vc_column_inner][vc_column_inner width=&#8221;1\/4&#8243;]<div class=\"image_with_text\"><img decoding=\"async\" itemprop=\"image\" src=\"https:\/\/driphydration.com\/wp-content\/uploads\/2025\/06\/Improved_Mood-1.svg\" alt=\"Improved mood &amp; focus\" \/><h3 style=\"color:#1b262a;\" class=\"image_with_text_title\">Improved mood &amp; focus<\/h3><span style=\"margin: 6px 0px;\" class=\"separator transparent\"><\/span><\/div>[\/vc_column_inner][\/vc_row_inner]        <article\n            class=\"right-for-you text_on_left\"\n            >\n            <div class=\"ecommerce_container\">\n                                                                    <h2 class=\"right-for-you__title-mobile\">Achieve your weight loss goals faster!<\/h2>\n                                                    <img decoding=\"async\" class=\"\" src=\"https:\/\/driphydration.com\/wp-content\/uploads\/2025\/06\/Ketamine_Square_1.jpg\"                             alt=\"Achieve your weight loss goals faster!\"  \/>\n                                                <div class=\"right-for-you__content\">\n                                            <h2 class=\"right-title\">Achieve your weight loss goals faster!<\/h2>\n                                                                <div class=\"text\"><p>Looking for an effective way to support your weight loss journey? Lipostat+ injections are designed to help accelerate fat burning while providing an energy boost, making it easier to achieve and maintain your ideal weight<\/p>\n<\/div>\n                                        \n                    <div class=\"container__buttons\">\n                                                    <a href=\"#order-now\"\n                            class=\"btn-new white\"\n                                                        >\n                                ORDER NOW                            <\/a>\n                                                                                                     \n                    <\/div>\n                                    <\/div>\n            <\/div>\n        <\/article>\n                <article\n            class=\"right-for-you\"\n                            style=\"background-color: #ffffff !important;\" >\n            <div class=\"ecommerce_container\">\n                                                                    <h2 class=\"right-for-you__title-mobile\">What are Lipostat+ injections?<\/h2>\n                                                    <img decoding=\"async\" class=\"\" src=\"https:\/\/driphydration.com\/wp-content\/uploads\/2025\/06\/Tirzepatide_Square_1.jpg\"                             alt=\"What are Lipostat+ injections?\"  \/>\n                                                <div class=\"right-for-you__content\">\n                                            <h2 class=\"right-title\">What are Lipostat+ injections?<\/h2>\n                                                                <div class=\"text\"><p dir=\"ltr\">Lipostat+ injections are a powerful blend of lipotropic compounds and essential nutrients that work to target stubborn fat areas and improve your body\u2019s metabolism. These injections contain a unique combination of ingredients that support fat breakdown, liver function, and overall health, giving you the edge you need to reach your fitness and weight loss goals.<\/p>\n<p dir=\"ltr\">Our Lipostat+ injections feature a blend of:<\/p>\n<ul>\n<li dir=\"ltr\" role=\"presentation\">Methionine: An essential amino acid that helps the body process fats and supports liver health.<\/li>\n<li dir=\"ltr\" role=\"presentation\">Choline: Supports fat metabolism and liver detoxification.<\/li>\n<li dir=\"ltr\" role=\"presentation\">L-Carnitine: Increases energy production by helping the body convert fat into energy.<\/li>\n<li dir=\"ltr\" role=\"presentation\">Vitamin B5: Boosts energy levels and supports wound healing.<\/li>\n<\/ul>\n<\/div>\n                                        \n                    <div class=\"container__buttons\">\n                                                    <a href=\"#order-now\"\n                            class=\"btn-new white\"\n                                                        >\n                                ORDER NOW                            <\/a>\n                                                                                                     \n                    <\/div>\n                                    <\/div>\n            <\/div>\n        <\/article>\n                <article\n            class=\"right-for-you text_on_left\"\n            >\n            <div class=\"ecommerce_container\">\n                                                                    <h2 class=\"right-for-you__title-mobile\">Who can benefit from Lipostat+ injections?<\/h2>\n                                                    <img decoding=\"async\" class=\"\" src=\"https:\/\/driphydration.com\/wp-content\/uploads\/2025\/06\/TRT-Injections_Square_3-1.jpg\"                             alt=\"Who can benefit from Lipostat+ injections?\"  \/>\n                                                <div class=\"right-for-you__content\">\n                                            <h2 class=\"right-title\">Who can benefit from Lipostat+ injections?<\/h2>\n                                                                <div class=\"text\"><ul>\n<li dir=\"ltr\" role=\"presentation\">Individuals looking to accelerate fat loss and enhance body composition.<\/li>\n<li dir=\"ltr\" role=\"presentation\">Anyone who struggles with stubborn fat areas, particularly around the abdomen, thighs, or arms.<\/li>\n<li dir=\"ltr\" role=\"presentation\">Those who want to maintain energy and focus while working toward weight loss goals.<\/li>\n<li dir=\"ltr\" role=\"presentation\">People interested in improving liver health and overall metabolic function.<\/li>\n<\/ul>\n<\/div>\n                                        \n                    <div class=\"container__buttons\">\n                                                    <a href=\"#order-now\"\n                            class=\"btn-new white\"\n                                                        >\n                                ORDER NOW                            <\/a>\n                                                                                                     \n                    <\/div>\n                                    <\/div>\n            <\/div>\n        <\/article>\n                <article class=\"ordering-easy\">\n            <div class=\"ecommerce_container\">\n                <div class=\"ordering-easy__wrapper\">\n                    <div class=\"ordering-easy__content\">\n                                                    <h2 class=\"ordering-title\">Booking is easy and convenient<\/h2>\n                                                                                                    <a href=\"#order-now\" class=\"btn-new white\">ORDER NOW<\/a>\n                                            <\/div>\n                                            <ul class=\"ordering-easy__text\">\n                                                            <li data-order-key=\"0\">\n                                                                            <h3>Virtual consultation<\/h3>\n                                                                                                                <div class=\"description\"><p><span style=\"color: #425962; font-family: Poppins, sans-serif;\"><span style=\"font-size: 18px; letter-spacing: -0.1px;\">Virtual consultation with our medical team.<\/span><\/span><\/p><\/div>\n                                                                    <\/li>\n                                                            <li data-order-key=\"1\">\n                                                                            <h3>Receive shipment<\/h3>\n                                                                                                                <div class=\"description\"><p><span style=\"color: #425962; font-family: Poppins, sans-serif;\"><span style=\"font-size: 18px; letter-spacing: -0.1px;\">Receive shipment of vitamin injections at your home.<\/span><\/span><\/p><\/div>\n                                                                    <\/li>\n                                                            <li data-order-key=\"2\">\n                                                                            <h3>Self-administer<\/h3>\n                                                                                                                <div class=\"description\"><p><span style=\"color: #425962; font-family: Poppins, sans-serif;\"><span style=\"font-size: 18px; letter-spacing: -0.1px;\">Self-administer vitamin injections at home.<\/span><\/span><\/p><\/div>\n                                                                    <\/li>\n                                                    <\/ul>\n                                    <\/div>\n                                                                                                                        <div class=\"ordering-easy__main not-max\">\n                        <div class=\"slider-order-main\">\n                            <div class=\"swiper-wrapper\">\n                                                                                                                            <div class=\"swiper-slide\">\n                                                                                                                <img decoding=\"async\" src=\"https:\/\/driphydration.com\/wp-content\/uploads\/2025\/06\/Sermorelin_Square_3-1.jpg\"\/>\n                                                                    <\/div>\n                                                    <\/div>\n                    <\/div>\n                                    <\/div>\n                            <\/div>\n        <\/article>\n                <article class=\"embed_social\">\n            <div class=\"ecommerce_container\">\n                                    <h2 class=\"embed-title\">Hear from <strong>our clients<\/strong><\/h2>\n                                                    <div class=\"embed\">\n                        <\/p>\n<div class=\"embedsocial-hashtag\" data-ref=\"1d8d4aff8277c71a36c64e9d3e1081de9447dd0f\"><\/div>\n<p><script> (function(d, s, id) { var js; if (d.getElementById(id)) {return;} js = d.createElement(s); js.id = id; js.src = \"https:\/\/embedsocial.com\/cdn\/ht.js\"; d.getElementsByTagName(\"head\")[0].appendChild(js); }(document, \"script\", \"EmbedSocialHashtagScript\")); <\/script>                    <\/div>\n                            <\/div>\n        <\/article>\n        [vc_row_inner row_type=&#8221;row&#8221; type=&#8221;full_width&#8221; text_align=&#8221;left&#8221; css_animation=&#8221;&#8221; el_id=&#8221;order-now&#8221; el_class=&#8221;stripe-max-width-900&#8243;][vc_column_inner]<article class=\"gform-new\"><h2 class=\"gform-new-title\">Order <b>Lipostat+ injections<\/b><\/h2><div class=\"form-content\"><script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n<div class=\"gfa-return-customer\" id=\"above_login\"><p>Returning customer? You can login <a href=\"#\" class=\"gfa-showlogin\">here<\/a> or continue as a guest checkout<\/p><\/div><div class=\"gfa-above-login\" style=\"display:none;\">\n\n<form action=\"#above_login\" class=\"gfa-form gfa-form-login\" method=\"post\">\n    <p class=\"form-row\">\n    <label for=\"username\">Email address (as your login)<\/label>\n    <input autofocus required type=\"email\" class=\"input-text\" name=\"username\" id=\"username\" autocomplete=\"username\" value=\"\" \/>\n  <\/p>\n  <p class=\"form-row\">\n    <label for=\"password\">Password<\/label>\n    <input required class=\"input-text\" type=\"password\" name=\"password\" id=\"password\" autocomplete=\"current-password\" \/>\n  <\/p>\n  <p class=\"form-row form-row-rememberme\">\n    <label>\n      <input name=\"rememberme\" type=\"checkbox\" id=\"rememberme\" value=\"forever\" \/><span>Remember me<\/span>\n    <\/label>\n  <\/p>\n  <p class=\"form-row\">\n    <input type=\"hidden\" id=\"gfa-login-nonce\" name=\"gfa-login-nonce\" value=\"925b4ededa\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/wp-json\/wp\/v2\/pages\/181919\" \/>    <input type=\"hidden\" name=\"redirect\" value=\"\/wp-json\/wp\/v2\/pages\/181919#gform_wrapper_111\" \/>\n    <input type=\"hidden\" name=\"place\" value=\"form\" \/>\n    <button type=\"submit\" name=\"login\" value=\"Login\">Log in<\/button>\n    <img decoding=\"async\" class=\"gform_ajax_spinner\" style=\"display:none;\" src=\"https:\/\/driphydration.com\/wp-content\/themes\/bridge-child\/img\/spinner.gif\" alt=\"\" \/>\n  <\/p>\n  <p class=\"lost_password\">\n    <a href=\"https:\/\/driphydration.com\/my-account\/lost-password\/\">Lost your password?<\/a>\n  <\/p>\n<\/form>\n<\/div><div class=\"gform-init gform-loading\">\n                <div class='gf_browser_unknown gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_111' style='display:none'><form service=\"Vitamin Injections\" checkout=\"1\"  method='post' enctype='multipart\/form-data' target='gform_ajax_frame_111' id='gform_111'  action='\/wp-json\/wp\/v2\/pages\/181919' data-formid='111' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_111' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_111_1\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_hidden_label gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_111_1'>\n                            \n                            <span id='input_111_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_111_1_3' value=''   aria-required='true'   placeholder='First Name'  \/>\n                                                    <label for='input_111_1_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>First Name<\/label>\n                                                <\/span>\n                            \n                            <span id='input_111_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_111_1_6' value=''   aria-required='true'   placeholder='Last Name'  \/>\n                                                    <label for='input_111_1_6' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Last Name<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_111_2\" class=\"gfield gfield--type-phone gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_111_2'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_2' id='input_111_2' type='tel' value='' class='medium'  placeholder='Phone' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><input type=\"hidden\" name=\"phone_country\"><\/li><li id=\"field_111_3\" class=\"gfield gfield--type-email gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_111_3'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_3' id='input_111_3' type='email' value='' class='medium'   placeholder='Email' aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_111_38\" class=\"gfield gfield--type-countries gfield--width-full gf-custom-countries gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_111_38'>Country<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_38' id='input_111_38' class='medium gfield_select'   aria-required=\"true\" aria-invalid=\"false\" form_id='111' ><option value=\"Hong Kong\">Hong Kong<\/option>\n<option value=\"United States\" selected=\"selected\">United States<\/option>\n<\/select><\/div><\/li><li id=\"field_111_15\" class=\"gfield gfield--type-address gfield--width-full gfield_contains_required field_sublabel_hidden_label gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_zip ginput_container_address gform-grid-row' id='input_111_15' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_111_15_1_container' >\n                                        <input type='text' name='input_15.1' id='input_111_15_1' value=''   placeholder='Street Address' aria-required='true'    \/>\n                                        <label for='input_111_15_1' id='input_111_15_1_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_111_15_2_container' >\n                                        <input type='text' name='input_15.2' id='input_111_15_2' value=''   placeholder='Address Line 2'  aria-required='false'   \/>\n                                        <label for='input_111_15_2' id='input_111_15_2_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_111_15_3_container' >\n                                    <input type='text' name='input_15.3' id='input_111_15_3' value=''   placeholder='City' aria-required='true'    \/>\n                                    <label for='input_111_15_3' id='input_111_15_3_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>City<\/label>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_15.4' id='input_111_15_4' value='California'\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_111_15_5_container' >\n                                    <input type='text' name='input_15.5' id='input_111_15_5' value=''   placeholder='ZIP \/ Postal Code' aria-required='true'    \/>\n                                    <label for='input_111_15_5' id='input_111_15_5_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>ZIP Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_15.6' id='input_111_15_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_111_32\" class=\"gfield gfield--type-states gfield--width-full gf-custom-states gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_111_32'>State<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_32' id='input_111_32' class='medium gfield_select'   aria-required=\"true\" aria-invalid=\"false\" form_id='111' ><option value='' selected='selected' class='gf_placeholder'>State<\/option><option value=\"Alabama\">Alabama<\/option>\n<option value=\"Alaska\">Alaska<\/option>\n<option value=\"Arizona\">Arizona<\/option>\n<option value=\"Arkansas\">Arkansas<\/option>\n<option value=\"California\">California<\/option>\n<option value=\"Colorado\">Colorado<\/option>\n<option value=\"Connecticut\">Connecticut<\/option>\n<option value=\"Delaware\">Delaware<\/option>\n<option value=\"District of Columbia\">District of Columbia<\/option>\n<option value=\"Florida\">Florida<\/option>\n<option value=\"Georgia\">Georgia<\/option>\n<option value=\"Hawaii\">Hawaii<\/option>\n<option value=\"Idaho\">Idaho<\/option>\n<option value=\"Illinois\">Illinois<\/option>\n<option value=\"Indiana\">Indiana<\/option>\n<option value=\"Iowa\">Iowa<\/option>\n<option value=\"Kansas\">Kansas<\/option>\n<option value=\"Kentucky\">Kentucky<\/option>\n<option value=\"Louisiana\">Louisiana<\/option>\n<option value=\"Maine\">Maine<\/option>\n<option value=\"Maryland\">Maryland<\/option>\n<option value=\"Massachusetts\">Massachusetts<\/option>\n<option value=\"Michigan\">Michigan<\/option>\n<option value=\"Minnesota\">Minnesota<\/option>\n<option value=\"Mississippi\">Mississippi<\/option>\n<option value=\"Missouri\">Missouri<\/option>\n<option value=\"Montana\">Montana<\/option>\n<option value=\"Nebraska\">Nebraska<\/option>\n<option value=\"Nevada\">Nevada<\/option>\n<option value=\"New Hampshire\">New Hampshire<\/option>\n<option value=\"New Jersey\">New Jersey<\/option>\n<option value=\"New Mexico\">New Mexico<\/option>\n<option value=\"New York\">New York<\/option>\n<option value=\"North Carolina\">North Carolina<\/option>\n<option value=\"North Dakota\">North Dakota<\/option>\n<option value=\"Ohio\">Ohio<\/option>\n<option value=\"Oklahoma\">Oklahoma<\/option>\n<option value=\"Oregon\">Oregon<\/option>\n<option value=\"Pennsylvania\">Pennsylvania<\/option>\n<option value=\"Rhode Island\">Rhode Island<\/option>\n<option value=\"South Carolina\">South Carolina<\/option>\n<option value=\"South Dakota\">South Dakota<\/option>\n<option value=\"Tennessee\">Tennessee<\/option>\n<option value=\"Texas\">Texas<\/option>\n<option value=\"Utah\">Utah<\/option>\n<option value=\"Vermont\">Vermont<\/option>\n<option value=\"Virginia\">Virginia<\/option>\n<option value=\"Washington\">Washington<\/option>\n<option value=\"West Virginia\">West Virginia<\/option>\n<option value=\"Wisconsin\">Wisconsin<\/option>\n<option value=\"Wyoming\">Wyoming<\/option>\n<\/select><\/div><\/li><li id=\"field_111_33\" class=\"gfield gfield--type-appointment_providers gfield--width-full gappointments_provider gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_111_33'>Provider<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_33' id='input_111_33' class='medium appointment_provider_id gfield_select'   aria-required=\"true\" aria-invalid=\"false\" form_id='111' ><option value='' selected='selected' class='gf_placeholder'><\/option><option value=\"64896\">Abu Dhabi, UAE<\/option>\n<option value=\"96168\">Adelaide, Australia<\/option>\n<option value=\"34263\">Albuquerque<\/option>\n<option value=\"32496\">Amsterdam, Netherlands<\/option>\n<option value=\"34316\">Aspen<\/option>\n<option value=\"13205\">Athens, Greece<\/option>\n<option value=\"10647\">Atlanta<\/option>\n<option value=\"10391\">Austin<\/option>\n<option value=\"18099\">Bakersfield<\/option>\n<option value=\"171326\">Bali, Indonesia<\/option>\n<option value=\"10697\">Baltimore<\/option>\n<option value=\"54027\">Barcelona, Spain<\/option>\n<option value=\"19322\">Bellingham<\/option>\n<option value=\"18941\">Berlin, Germany<\/option>\n<option value=\"43475\">Boca Raton<\/option>\n<option value=\"147829\">Bodrum, Turkey<\/option>\n<option value=\"137123\">Bogota, Colombia<\/option>\n<option value=\"19324\">Boise<\/option>\n<option value=\"11259\">Boston<\/option>\n<option value=\"31851\">Brisbane, Australia<\/option>\n<option value=\"9294\">Bronx<\/option>\n<option value=\"78233\">Brooklyn<\/option>\n<option value=\"186784\">Buenos Aires, Argentina<\/option>\n<option value=\"11869\">Cabo San Lucas, Mexico<\/option>\n<option value=\"137151\">Cali, Colombia<\/option>\n<option value=\"12091\">Cancun, Mexico<\/option>\n<option value=\"42886\">Cannes, France<\/option>\n<option value=\"80072\">Cape Cod<\/option>\n<option value=\"19285\">Cape Town, South Africa<\/option>\n<option value=\"137505\">Cartagena, Colombia<\/option>\n<option value=\"65771\">Central Coast<\/option>\n<option value=\"187106\">Central Connecticut<\/option>\n<option value=\"11056\">Central New Jersey<\/option>\n<option value=\"10147\">Charlotte<\/option>\n<option value=\"13757\">Chicago<\/option>\n<option value=\"12981\">Cincinnati<\/option>\n<option value=\"12654\">Cleveland<\/option>\n<option value=\"74090\">Clinic - Corona<\/option>\n<option value=\"74859\">Clinic - Palo Alto (Inactive)<\/option>\n<option value=\"140087\">Clinic - Scope & Blood<\/option>\n<option value=\"75294\">Clinic - Scottsdale<\/option>\n<option value=\"13341\">Clinic - Tucson<\/option>\n<option value=\"85341\">Clinic - Westlake Village<\/option>\n<option value=\"66354\">Colorado Springs<\/option>\n<option value=\"11747\">Columbus<\/option>\n<option value=\"12763\">Connecticut<\/option>\n<option value=\"12385\">Costa Rica<\/option>\n<option value=\"12100\">Cusco, Peru<\/option>\n<option value=\"11362\">Dallas<\/option>\n<option value=\"13527\">DEFAULT PROVIDER<\/option>\n<option value=\"9328\">Denver<\/option>\n<option value=\"13735\">Detroit<\/option>\n<option value=\"186724\">Driggs<\/option>\n<option value=\"27403\">Dubai, UAE<\/option>\n<option value=\"19815\">Durban, South Africa<\/option>\n<option value=\"185824\">El Paso<\/option>\n<option value=\"139205\">Eugene<\/option>\n<option value=\"140347\">Florence House Call, Italy<\/option>\n<option value=\"133270\">Florence, Italy<\/option>\n<option value=\"43474\">Fort Lauderdale<\/option>\n<option value=\"58023\">Fort Worth<\/option>\n<option value=\"12697\">Fresno &amp; Clovis<\/option>\n<option value=\"29036\">Geneva, Switzerland<\/option>\n<option value=\"31852\">Gold Coast, Australia<\/option>\n<option value=\"188674\">Grand Rapids<\/option>\n<option value=\"28535\">Green Bay<\/option>\n<option value=\"194526\">Gstaad, Switzerland<\/option>\n<option value=\"187116\">Hampton<\/option>\n<option value=\"12043\">Hanoi, Vietnam<\/option>\n<option value=\"65171\">Hawaii - Big Island<\/option>\n<option value=\"12667\">Hawaii - Maui<\/option>\n<option value=\"65170\">Hawaii - Oahu<\/option>\n<option value=\"45711\">Headquarters<\/option>\n<option value=\"35147\">Ho Chi Minh, Vietnam<\/option>\n<option value=\"184812\">Hong Kong<\/option>\n<option value=\"166385\">Hotel - Edwardian, Manchester UK<\/option>\n<option value=\"84194\">Hotel - Londoner, London UK<\/option>\n<option value=\"156927\">Hotel - Montage Deer Valley<\/option>\n<option value=\"84466\">Hotel - Moxy AC<\/option>\n<option value=\"136259\">Hotel - The Pendry Hotel<\/option>\n<option value=\"175148\">Hotel - The Pendry Hotel San Diego<\/option>\n<option value=\"193023\">Hotel - The Pendry Park City<\/option>\n<option value=\"185856\">Hotel \u2013 The Pendry Hotel New Jersey<\/option>\n<option value=\"11361\">Houston<\/option>\n<option value=\"12266\">Ibiza, Spain<\/option>\n<option value=\"16403\">Indianapolis<\/option>\n<option value=\"9449\">Inland Empire and Palm Springs<\/option>\n<option value=\"71171\">Iowa City<\/option>\n<option value=\"150940\">Istanbul, Turkey<\/option>\n<option value=\"30714\">Jackson Hole<\/option>\n<option value=\"40497\">Jacksonville<\/option>\n<option value=\"129319\">Jerusalem, Israel<\/option>\n<option value=\"19814\">Johannesburg, South Africa<\/option>\n<option value=\"67655\">Kansas City<\/option>\n<option value=\"14576\">Knoxville<\/option>\n<option value=\"13731\">Las Vegas<\/option>\n<option value=\"12034\">Lima, Peru<\/option>\n<option value=\"171535\">Lisbon, Portugal<\/option>\n<option value=\"13730\">London, United Kingdom<\/option>\n<option value=\"187111\">Long Island<\/option>\n<option value=\"3861\">Los Angeles<\/option>\n<option value=\"22432\">Louisville<\/option>\n<option value=\"109948\">Lounge - 1Clinic<\/option>\n<option value=\"28534\">Madison<\/option>\n<option value=\"54024\">Madrid, Spain<\/option>\n<option value=\"18687\">Maine<\/option>\n<option value=\"132332\">Manchester, United Kingdom<\/option>\n<option value=\"114128\">Manhattan<\/option>\n<option value=\"158782\">Manila, Philippines<\/option>\n<option value=\"46337\">Marbella, Spain<\/option>\n<option value=\"137510\">Medelin, Colombia<\/option>\n<option value=\"31850\">Melbourne, Australia<\/option>\n<option value=\"39314\">Memphis<\/option>\n<option value=\"12680\">Mexico City, Mexico<\/option>\n<option value=\"9559\">Miami<\/option>\n<option value=\"18412\">Milan, Italy<\/option>\n<option value=\"28533\">Milwaukee<\/option>\n<option value=\"20488\">Minneapolis<\/option>\n<option value=\"149429\">Montana<\/option>\n<option value=\"189644\">Monte Carlo, Monaco<\/option>\n<option value=\"123840\">Montego Bay, Jamaica<\/option>\n<option value=\"117130\">Monterrey, Mexico<\/option>\n<option value=\"21602\">Montreal, Canada<\/option>\n<option value=\"169302\">Mumbai, India<\/option>\n<option value=\"144375\">Munich, Germany<\/option>\n<option value=\"13183\">Mykonos, Greece<\/option>\n<option value=\"80245\">Napa<\/option>\n<option value=\"13356\">Nashville<\/option>\n<option value=\"29812\">New Orleans<\/option>\n<option value=\"56129\">North Dakota<\/option>\n<option value=\"71030\">North New Jersey<\/option>\n<option value=\"33128\">Oklahoma City<\/option>\n<option value=\"10685\">Orange County<\/option>\n<option value=\"11104\">Oregon<\/option>\n<option value=\"15278\">Orlando<\/option>\n<option value=\"10660\">Palo Alto<\/option>\n<option value=\"26769\">Paris, France<\/option>\n<option value=\"117126\">Partnership - Dr.Potter (Texas)<\/option>\n<option value=\"117123\">Partnership - Exhale Spa<\/option>\n<option value=\"31853\">Perth, Australia<\/option>\n<option value=\"13733\">Philadelphia<\/option>\n<option value=\"9453\">Phoenix<\/option>\n<option value=\"16450\">Pittsburgh<\/option>\n<option value=\"13207\">Puerto Vallarta, Mexico<\/option>\n<option value=\"114131\">Queens &amp; Nassau County<\/option>\n<option value=\"10187\">Raleigh &amp; Durham<\/option>\n<option value=\"41765\">Reno<\/option>\n<option value=\"13263\">Rhode Island<\/option>\n<option value=\"30819\">Rockford<\/option>\n<option value=\"18417\">Rome, Italy<\/option>\n<option value=\"9292\">Sacramento<\/option>\n<option value=\"12980\">San Antonio<\/option>\n<option value=\"9611\">San Diego<\/option>\n<option value=\"9493\">San Francisco<\/option>\n<option value=\"108874\">San Juan, Puerto Rico<\/option>\n<option value=\"11877\">Santa Barbara<\/option>\n<option value=\"34779\">Santa Fe<\/option>\n<option value=\"12031\">Santa Teresa, Costa Rica<\/option>\n<option value=\"141168\">Sao Paulo, Brazil<\/option>\n<option value=\"192699\">Sardinia, Italy<\/option>\n<option value=\"9327\">Seattle<\/option>\n<option value=\"187110\">Southwestern Connecticut<\/option>\n<option value=\"19323\">Spokane<\/option>\n<option value=\"12693\">St. Barts<\/option>\n<option value=\"26493\">St. George<\/option>\n<option value=\"53582\">St. Louis<\/option>\n<option value=\"186707\">St. Tropez<\/option>\n<option value=\"78243\">Suffolk County<\/option>\n<option value=\"69418\">Sun Valley<\/option>\n<option value=\"31847\">Sydney, Australia<\/option>\n<option value=\"20460\">Tampa<\/option>\n<option value=\"31855\">Tasmania, Australia<\/option>\n<option value=\"86749\">Tel Aviv, Israel<\/option>\n<option value=\"80650\">Tenerife, Spain<\/option>\n<option value=\"183711\">Toledo<\/option>\n<option value=\"25038\">Toronto, Canada<\/option>\n<option value=\"58165\">Tucson<\/option>\n<option value=\"12199\">Tulum, Mexico<\/option>\n<option value=\"82649\">Unbreakable Performance Gym<\/option>\n<option value=\"9303\">Utah<\/option>\n<option value=\"27094\">Vancouver, Canada<\/option>\n<option value=\"144423\">Vienna, Austria<\/option>\n<option value=\"12511\">Washington, DC<\/option>\n<option value=\"49391\">Washington, DC - Maryland<\/option>\n<option value=\"49388\">Washington, DC - Virginia<\/option>\n<option value=\"43476\">West Palm Beach<\/option>\n<option value=\"188094\">Westchester and Rockland County<\/option>\n<option value=\"29039\">Zurich, Switzerland<\/option>\n<\/select><\/div><\/li><li id=\"field_111_11\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style = \"height:10px;\">&nbsp;<\/div><\/li><li id=\"field_111_23\" class=\"gfield gfield--type-date gfield--input-type-datefield gfield--width-full drchrono_field_dob gfield_contains_required field_sublabel_hidden_label gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div id='input_111_23' class='ginput_container ginput_complex gform-grid-row'><div class=\"clear-multi\"><div class='gfield_date_month ginput_container ginput_container_date gform-grid-col' id='input_111_23_1_container'>\n                                            <input type='number' maxlength='2' name='input_23[]' id='input_111_23_1' value=''   aria-required='true'   placeholder='MM' min='1' max='12' step='1'\/>\n                                            <label for='input_111_23_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>MM<\/label>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date gform-grid-col' id='input_111_23_2_container'>\n                                            <input type='number' maxlength='2' name='input_23[]' id='input_111_23_2' value=''   aria-required='true'   placeholder='DD' min='1' max='31' step='1'\/>\n                                            <label for='input_111_23_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>DD<\/label>\n                                        <\/div><div class='gfield_date_year ginput_container ginput_container_date gform-grid-col' id='input_111_23_3_container'>\n                                            <input type='number' maxlength='4' name='input_23[]' id='input_111_23_3' value=''   aria-required='true'   placeholder='YYYY' min='1920' max='2026' step='1'\/>\n                                            <label for='input_111_23_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>YYYY<\/label>\n                                       <\/div>\n                                   <\/div><\/div><\/li><li id=\"field_111_30\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style = \"height:20px;\">&nbsp;<\/div><\/li><li id=\"field_111_41\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field-user-type gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><fieldset><legend class=\"gfield_label gform-field-label\" >Have you used Drip Hydration before?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_111_41'>\n\t\t\t<li class='gchoice gchoice_111_41_0'>\n\t\t\t\t<input name='input_41' type='radio' value='First Time Client'  id='choice_111_41_0'    \/>\n\t\t\t\t<label for='choice_111_41_0' id='label_111_41_0' class='gform-field-label gform-field-label--type-inline'>First Time Client<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_111_41_1'>\n\t\t\t\t<input name='input_41' type='radio' value='Return Client'  id='choice_111_41_1'    \/>\n\t\t\t\t<label for='choice_111_41_1' id='label_111_41_1' class='gform-field-label gform-field-label--type-inline'>Return Client<\/label>\n\t\t\t<\/li><\/ul><\/div><\/fieldset><\/li><li id=\"field_111_42\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style = \"height:20px;\">&nbsp;<\/div><\/li><li id=\"field_111_43\" class=\"gfield gfield--type-product gfield--input-type-hiddenproduct gfield--width-full no-display gform_hidden gfield_price gfield_price_111_43 gfield_product_111_43 gfield_hidden_product field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_111_43_1'>Vitamin Injections<\/label><div class='ginput_container ginput_container_product_price_hidden'><input type='hidden' name='input_43.3' value='1' id='ginput_quantity_111_43' class='gform_hidden' \/><input type='hidden' name='input_43.1' value='Vitamin Injections' class='gform_hidden' \/><input name='input_43.2' id='ginput_base_price_111_43' type='hidden' value='$0.00' class='gform_hidden ginput_amount' \/><\/div><\/li><li id=\"field_111_51\" class=\"gfield gfield--type-option gfield--input-type-adminonly_hidden gfield--width-full field_admin_only gfield_price gfield_price_111_43 gfield_option_111_43 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_administrative\"  ><fieldset><input name='input_51' id='input_111_51' class='gform_hidden' type='hidden' value=''\/><\/fieldset><\/li><li id=\"field_111_59\" class=\"gfield gfield--type-option gfield--type-choice gfield--input-type-checkbox gfield--width-full cs-norearrange custom-shipped-addons gfield_price gfield_price_111_43 gfield_option_111_43 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><fieldset><legend class=\"gfield_label gform-field-label gfield_label_before_complex\" >Select Vitamin Injections<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_111_59'><li class='gchoice gchoice_111_59_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_59.1' type='checkbox'  value='Biotin|0'  id='choice_111_59_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_111_59_1' id='label_111_59_1' class='gform-field-label gform-field-label--type-inline'>Biotin<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_111_59_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_59.2' type='checkbox'  value='Vitamin B-Complex|0'  id='choice_111_59_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_111_59_2' id='label_111_59_2' class='gform-field-label gform-field-label--type-inline'>Vitamin B-Complex<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_111_59_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_59.3' type='checkbox'  value='Vitamin B12|0'  id='choice_111_59_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_111_59_3' id='label_111_59_3' class='gform-field-label gform-field-label--type-inline'>Vitamin B12<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_111_59_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_59.4' type='checkbox'  value='Glutathione|0'  id='choice_111_59_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_111_59_4' id='label_111_59_4' class='gform-field-label gform-field-label--type-inline'>Glutathione<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_111_59_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_59.5' type='checkbox'  value='Lipostat|0'  id='choice_111_59_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_111_59_5' id='label_111_59_5' class='gform-field-label gform-field-label--type-inline'>Lipostat<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/fieldset><\/li><li id=\"field_111_46\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style = \"height:20px;\">&nbsp;<\/div><\/li><li id=\"field_111_44\" class=\"gfield gfield--type-option gfield--type-choice gfield--input-type-radio gfield--width-full drchrono_field_treatments is-option gfield_price gfield_price_111_43 gfield_option_111_43 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><fieldset><legend class=\"gfield_label gform-field-label\" >Biotin<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_111_44'>\n\t\t\t<li class='gchoice gchoice_111_44_0'>\n\t\t\t\t<input name='input_44' type='radio' value='1 month supply - $299|299'  id='choice_111_44_0'    \/>\n\t\t\t\t<label for='choice_111_44_0' id='label_111_44_0' class='gform-field-label gform-field-label--type-inline'>1 month supply<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_111_44_1'>\n\t\t\t\t<input name='input_44' type='radio' value='Monthly Subscription - $199|199'  id='choice_111_44_1'    \/>\n\t\t\t\t<label for='choice_111_44_1' id='label_111_44_1' class='gform-field-label gform-field-label--type-inline'>Monthly Subscription - $199\/month<\/label>\n\t\t\t<\/li><\/ul><\/div><\/fieldset><\/li><li id=\"field_111_60\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style = \"height:20px;\">&nbsp;<\/div><\/li><li id=\"field_111_47\" class=\"gfield gfield--type-option gfield--type-choice gfield--input-type-radio gfield--width-full drchrono_field_treatments is-option gfield_price gfield_price_111_43 gfield_option_111_43 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><fieldset><legend class=\"gfield_label gform-field-label\" >Vitamin B-Complex<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_111_47'>\n\t\t\t<li class='gchoice gchoice_111_47_0'>\n\t\t\t\t<input name='input_47' type='radio' value='1 month supply - - $299|299'  id='choice_111_47_0'    \/>\n\t\t\t\t<label for='choice_111_47_0' id='label_111_47_0' class='gform-field-label gform-field-label--type-inline'>1 month supply<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_111_47_1'>\n\t\t\t\t<input name='input_47' type='radio' value='Monthly Subscription - - $199|199'  id='choice_111_47_1'    \/>\n\t\t\t\t<label for='choice_111_47_1' id='label_111_47_1' class='gform-field-label gform-field-label--type-inline'>Monthly Subscription - $199\/month<\/label>\n\t\t\t<\/li><\/ul><\/div><\/fieldset><\/li><li id=\"field_111_61\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style = \"height:20px;\">&nbsp;<\/div><\/li><li id=\"field_111_48\" class=\"gfield gfield--type-option gfield--type-choice gfield--input-type-radio gfield--width-full drchrono_field_treatments is-option gfield_price gfield_price_111_43 gfield_option_111_43 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><fieldset><legend class=\"gfield_label gform-field-label\" >Vitamin B12<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_111_48'>\n\t\t\t<li class='gchoice gchoice_111_48_0'>\n\t\t\t\t<input name='input_48' type='radio' value='1 month supply - $299|299'  id='choice_111_48_0'    \/>\n\t\t\t\t<label for='choice_111_48_0' id='label_111_48_0' class='gform-field-label gform-field-label--type-inline'>1 month supply<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_111_48_1'>\n\t\t\t\t<input name='input_48' type='radio' value='Monthly Subscription - $199|199'  id='choice_111_48_1'    \/>\n\t\t\t\t<label for='choice_111_48_1' id='label_111_48_1' class='gform-field-label gform-field-label--type-inline'>Monthly Subscription - $199\/month<\/label>\n\t\t\t<\/li><\/ul><\/div><\/fieldset><\/li><li id=\"field_111_62\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style = \"height:20px;\">&nbsp;<\/div><\/li><li id=\"field_111_49\" class=\"gfield gfield--type-option gfield--type-choice gfield--input-type-radio gfield--width-full drchrono_field_treatments is-option gfield_price gfield_price_111_43 gfield_option_111_43 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><fieldset><legend class=\"gfield_label gform-field-label\" >Glutathione<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_111_49'>\n\t\t\t<li class='gchoice gchoice_111_49_0'>\n\t\t\t\t<input name='input_49' type='radio' value='1 month supply - $299|299'  id='choice_111_49_0'    \/>\n\t\t\t\t<label for='choice_111_49_0' id='label_111_49_0' class='gform-field-label gform-field-label--type-inline'>1 month supply<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_111_49_1'>\n\t\t\t\t<input name='input_49' type='radio' value='Monthly Subscription - $199|199'  id='choice_111_49_1'    \/>\n\t\t\t\t<label for='choice_111_49_1' id='label_111_49_1' class='gform-field-label gform-field-label--type-inline'>Monthly Subscription - $199\/month<\/label>\n\t\t\t<\/li><\/ul><\/div><\/fieldset><\/li><li id=\"field_111_63\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style = \"height:20px;\">&nbsp;<\/div><\/li><li id=\"field_111_50\" class=\"gfield gfield--type-option gfield--type-choice gfield--input-type-radio gfield--width-full drchrono_field_treatments is-option gfield_price gfield_price_111_43 gfield_option_111_43 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><fieldset><legend class=\"gfield_label gform-field-label\" >Lipostat<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_111_50'>\n\t\t\t<li class='gchoice gchoice_111_50_0'>\n\t\t\t\t<input name='input_50' type='radio' value='1 month supply - $299|299'  id='choice_111_50_0'    \/>\n\t\t\t\t<label for='choice_111_50_0' id='label_111_50_0' class='gform-field-label gform-field-label--type-inline'>1 month supply<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_111_50_1'>\n\t\t\t\t<input name='input_50' type='radio' value='Monthly Subscription - $199|199'  id='choice_111_50_1'    \/>\n\t\t\t\t<label for='choice_111_50_1' id='label_111_50_1' class='gform-field-label gform-field-label--type-inline'>Monthly Subscription - $199\/month<\/label>\n\t\t\t<\/li><\/ul><\/div><\/fieldset><\/li><li id=\"field_111_27\" class=\"gfield gfield--type-html gfield--width-full no-display gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style = \"height:20px;\">&nbsp;<\/div><\/li><li id=\"field_111_35\" class=\"gfield gfield--type-fileupload gfield--width-full no-display field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_111_35'>Documents Upload<\/label><div class='gfield_description' id='gfield_description_111_35'>Please upload images of the front and the back of your ID and  insurance card.<\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_111_35' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_111_35&quot;,&quot;container&quot;:&quot;gform_multifile_upload_111_35&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_111_35&quot;,&quot;filelist&quot;:&quot;gform_preview_111_35&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/driphydration.com\\\/?gf_page=ee4eb4af37e03f7&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/driphydration.com\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/driphydration.com\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;52428800b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:111,&quot;field_id&quot;:35},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;4&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_111_35&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_111_35' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_111_35' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_111_35 gfield_description_111_35\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_111_35'>Max. file size: 50 MB, Max. files: 4.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_111_35'><\/ul> <!-- Leave <ul> empty to support CSS :empty selector. --><\/div><div id='gform_preview_111_35' class='ginput_preview_list'><\/div><\/li><li id=\"field_111_31\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style = \"height:20px;\">&nbsp;<\/div><\/li><li id=\"field_111_20\" class=\"gfield gfield--type-coupon gfield--width-full field_coupon field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gf_coupon_code_111'>Coupon<\/label><label class='giftup-coupon-label'><input type='checkbox' name='giftup_code'><span>Select if you are using a Gift Card<\/span><\/label><div class='ginput_container' id='gf_coupons_container_111'><input id='gf_coupon_code_111' class='gf_coupon_code' onkeyup='DisableApplyButton(111);' onchange='DisableApplyButton(111);' onpaste='setTimeout(function(){DisableApplyButton(111);}, 50);' type='text'    \/><input type='button' disabled='disabled' onclick='ApplyCouponCode(111);' value='Apply' id='gf_coupon_button' class='button'  \/> <img style='display:none;' id='gf_coupon_spinner' src='https:\/\/driphydration.com\/wp-content\/themes\/bridge-child\/img\/spinner.gif' alt='please wait'\/><div id='gf_coupon_info'><\/div><input type='hidden' id='gf_coupon_codes_111' name='input_20' value=''  \/><input type='hidden' id='gf_total_no_discount_111'\/><input type='hidden' id='giftup_discount_111' name='giftup_discount_111'\/><input type='hidden' id='gf_coupons_111' name='gf_coupons_111' value='' \/><p>*Note: subscription discounts apply to first month only<\/p><\/div><\/li><li id=\"field_111_64\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style = \"height:20px;\">&nbsp;<\/div><\/li><li id=\"field_111_13\" class=\"gfield gfield--type-total gfield--width-full gfield_price gfield_price_111_ gfield_total gfield_total_111_ field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"   >    <div class=\"gform-order-summary gform-order-summary-old\" tabindex=\"0\">\n        <strong>Order Summary<\/strong>\n            <div class=\"summary-table\">\n                <div class=\"table persons\">\n                    <div class=\"person person-1\">\n                    \n                    <div class=\"col\">\n                        <div class=\"treatment\"><div class=\"added\"><strong>&nbsp;<\/strong><span>&nbsp;<\/span><\/div><\/div>\n                        <div class=\"addons\"><\/div>\n                        <div class=\"labfee\"><\/div>\n                    <\/div>\n                <\/div>\n            <\/div>\n            <div class=\"table summary\">\n                <div class=\"tr sst\">\n                    \n                    <div class=\"col\">\n                        <strong>Subtotal:<\/strong>\n                        <span class=\"subtotal\">$0<\/span>\n                    <\/div>\n                <\/div>\n                    <div class=\"tr sp\">\n        \n        <div class=\"col service\">\n            <strong>Service Fee:<\/strong>\n            <span>$0<\/span>\n        <\/div>\n    <\/div>\n                <div class=\"tr labFee\">\n                    \n                    <div class=\"col\">\n                        <strong>Lab Fee Total:<\/strong>\n                        <span><i class=\"fee\">$0<\/i><\/span>\n                    <\/div>\n                <\/div>\n                    <div class=\"tr tips\">\n        \n        <div class=\"col\">\n            <strong>Tip not included<\/strong>\n        <\/div>\n    <\/div>\n                <div class=\"tr coupons\">\n                    \n                    <div class=\"col\">\n                        <strong class=\"coupon-name\">Coupon<i><\/i> Discount:<\/strong>\n                        <span class=\"coupon\">$0<\/span>\n                    <\/div>\n                <\/div>\n            <\/div>\n        <\/div>\n        <div class=\"summary-ldng\"><\/div>\n    <\/div><div aria-atomic=\"true\" aria-live=\"polite\"><label class='gfield_label gform-field-label' for='input_111_13'>Total<\/label><div class='ginput_container ginput_container_total'>\n\t\t\t\t\t\t\t<span class='ginput_total ginput_total_111'>$0.00<\/span>\n\t\t\t\t\t\t\t<input type='hidden' name='input_13' id='input_111_13' class='gform_hidden'\/>\n\t\t\t\t\t\t<\/div><\/div><input type=\"hidden\" id=\"subtotal\" value=\"\"><input type=\"hidden\" name=\"currency\" value=\"\"\/><input type=\"hidden\" name=\"currency_rate\" value=\"\"\/><input type=\"hidden\" name=\"exclude_coupon_total\" value=\"\"><input type=\"hidden\" name=\"exclude_coupon_sum\" value=\"\"><input type=\"hidden\" name=\"cplf_price\" value=\"\"><input type=\"hidden\" name=\"cplf_price_req\" value=\"\"><input type=\"hidden\" name=\"ga_provider_surcharge_price\" value=\"0|Service Fee\"><input type=\"hidden\" name=\"ga_need_provider_id\" value=\"\"\/><input type=\"hidden\" name=\"ga_provider_distance\" value=\"\"><input type=\"hidden\" name=\"manual_form_sended\" value=\"1\"><input type=\"hidden\" name=\"wordpress_user_id\" value=\"0\"><input type='hidden' name='steps_used' value=''><\/li><li id=\"field_111_29\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style = \"height:20px;\">&nbsp;<\/div><\/li><li id=\"field_111_6\" class=\"gfield gfield--type-textarea gfield--width-full gf_additional_information field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_111_6'>Additional Information<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_6' id='input_111_6' class='textarea medium'    placeholder='Additional Information'  aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_111_40\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style = \"height:20px;\">&nbsp;<\/div><\/li><li id=\"field_111_14\" class=\"gfield gfield--type-stripe_creditcard gfield--width-full field_stripe_creditcard field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gfield_label_before_complex' for='input_111_14_1'>Payment Method<\/label>        <style>\n            .stripe-payment-request-button {\n                width: 100%;\n                background: #888;\n                padding: 10px;\n                display: none;\n                align-content: center;\n                border-radius: 6px;\n                margin: 10px 0;\n                align-items: center;\n            }\n            .stripe-payment-request-button.show{\n              display:flex;\n            }\n            .stripe-payment-request-button label {\n                background: transparent;\n                padding: 8px;\n                color: #fff;\n                border-radius: 6px;\n                width: 100%;\n                cursor: pointer;\n                text-align: center;\n                position: relative;\n            }\n            .stripe-payment-request-button label.active {\n                background: #555;\n            }\n            .stripe-payment-request-button label:last-child {\n                margin-left: 8px;\n            }\n            .stripe-payment-request-button label input {\n                visibility: hidden;\n                position: absolute;\n                top: 0;\n                left: 0;\n            }\n            .stripe-payment-request-button label.stripe-payment-button,\n            .stripe-payment-request-button label.stripe-payment-klarna{\n              display: none;\n            }\n            .stripe-payment-request-button label.stripe-payment-button.show,\n            .stripe-payment-request-button label.stripe-payment-klarna.show{\n              display:block;\n            }\n            .stripe-payment-request-button label.stripe-payment-klarna span{\n              line-height: 1.3;\n            }\n            .stripe-payment-request-button svg{\n              min-width: 16px;\n              min-height: 16px;\n              margin-right: 2px;\n              position: relative;\n              top: 2px;\n            }\n            .stripe-payment-request-button svg path{\n              outline: none;\n            }\n                    <\/style>\n                <div class=\"stripe-payment-request-button\">\n                          <label class=\"stripe-payment-card active\">\n                <input type=\"radio\" name=\"pay_via_stripe_payment_request_button\"\n                       value=\"0\"  checked='checked'>\n                <span>Credit Card<\/span>\n              <\/label>\n              <label class=\"stripe-payment-button \">\n                <input type=\"radio\" name=\"pay_via_stripe_payment_request_button\"\n                       value=\"pay_button\" >\n                <span>Apple\/Google Pay<\/span>\n              <\/label>\n              <label class=\"stripe-payment-klarna \">\n                <input type=\"radio\" name=\"pay_via_stripe_payment_request_button\"\n                       value=\"klarna\" >\n                <svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" role=\"presentation\" width=\"16\" height=\"16\">\n                  <path d=\"M0 2.5A2.5 2.5 0 0 1 2.5 0h11A2.5 2.5 0 0 1 16 2.5v11a2.5 2.5 0 0 1-2.5 2.5h-11A2.5 2.5 0 0 1 0 13.5v-11Z\" fill=\"#FFB3C7\"><\/path>\n                  <path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M5.815 12H4V4h1.815v8ZM8.49 8.54A6.4 6.4 0 0 0 10.348 4H8.572c0 1.472-.67 2.823-1.836 3.707l-.704.533L8.758 12H11L8.491 8.54ZM12.5 10a1 1 0 1 0 0 2 1 1 0 0 0 0-2Z\" fill=\"#0A0B09\"><\/path>\n                <\/svg>\n                <span>Klarna (Buy now, pay later)<\/span>\n              <\/label>\n                    <\/div>\n        <input type=\"hidden\" name=\"payment_request_button_type\" value=\"\">\n                <div class='ginput_complex ginput_container ginput_container_creditcard' id='input_111_14'>\n\t\t\t\t\t\t<div class='ginput_full' id='input_111_14_1_container'>\n\t\t\t\t\t\t\t<div id='input_111_14_1'><\/div>\n\t\t\t\t\t\t\t<label for='input_111_14_1' id='input_111_14_1_label' ><\/label>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class='ginput_full ginput_cardholder' id='input_111_14_5_container'>\n\t\t\t\t\t\t\t<input class='cc-cardholder' type='text' name='input_14.5' id='input_111_14_5' value='' placeholder='Cardholder Name'>\n\t\t\t\t\t\t\t<label for='input_111_14_5' id='input_111_14_5_label' ><\/label>\n\t\t\t\t\t\t<\/div><div class=\"cc-billing-address\"><strong>Billing Address<\/strong><div class=\"inner\"><span><\/span><button type=\"button\" class=\"fa fa-pencil-alt\"><\/button><\/div><\/div><\/div><\/li><li id=\"field_111_10\" class=\"gfield gfield--type-checkbox gfield--type-choice consent-checkbox-field gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Terms of Service<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_111_10'><li class='gchoice gchoice_111_10_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.1' type='checkbox'  value='I agree to the &lt;a target=&quot;_blank&quot; href=&quot;https:\/\/driphydration.com\/terms-of-service\/&quot;&gt;Term of Service&lt;\/a&gt;, &lt;a target=&quot;_blank&quot; href=&quot;https:\/\/driphydration.com\/privacy-policy\/&quot;&gt;Privacy Policy&lt;\/a&gt;, &lt;a target=&quot;_blank&quot; href=&quot;https:\/\/driphydration.com\/consent-to-treat\/&quot;&gt;Consent To Treat&lt;\/a&gt;, and &lt;a target=&quot;_blank&quot; href=&quot;https:\/\/driphydration.com\/cancellation-policy\/&quot;&gt;Cancellation Policy&lt;\/a&gt;'  id='choice_111_10_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_111_10_1' id='label_111_10_1' class='gform-field-label gform-field-label--type-inline'>I agree to the <a target=\"_blank\" href=\"https:\/\/driphydration.com\/terms-of-service\/\">Term of Service<\/a>, <a target=\"_blank\" href=\"https:\/\/driphydration.com\/privacy-policy\/\">Privacy Policy<\/a>, <a target=\"_blank\" href=\"https:\/\/driphydration.com\/consent-to-treat\/\">Consent To Treat<\/a>, and <a target=\"_blank\" href=\"https:\/\/driphydration.com\/cancellation-policy\/\">Cancellation Policy<\/a><\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_111_24\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full wider-checkbox field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Optional Email Signup<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_111_24'><li class='gchoice gchoice_111_24_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.1' type='checkbox'  value='Sign-up for emails to get exclusive offers &amp; be the first to know about new services!' checked='checked' id='choice_111_24_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_111_24_1' id='label_111_24_1' class='gform-field-label gform-field-label--type-inline'>Sign-up for emails to get exclusive offers &amp; be the first to know about new services!<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_111_58\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full wider-checkbox field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >SMS<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_111_58'><li class='gchoice gchoice_111_58_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.1' type='checkbox'  value='&lt;b&gt;Sign up for texts.&lt;\/b&gt; By signing up via text, you agree to receive recurring automated promotional and personalized marketing text messages (e.g. cart reminders) from Drip Hydration at the cell number used when signing up. Consent is not a condition of any purchase. Reply HELP for help and STOP to cancel. Msg frequency varies. Msg &amp; data rates may apply. View &lt;a target = &quot;_blank&quot; href=&quot;https:\/\/attnl.tv\/t\/A9M&quot;&gt;Terms&lt;\/a&gt; &amp; &lt;a target = &quot;_blank&quot; href=&quot;https:\/\/attnl.tv\/p\/A9M&quot;&gt;Privacy&lt;\/a&gt;.'  id='choice_111_58_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_111_58_1' id='label_111_58_1' class='gform-field-label gform-field-label--type-inline'><b>Sign up for texts.<\/b> By signing up via text, you agree to receive recurring automated promotional and personalized marketing text messages (e.g. cart reminders) from Drip Hydration at the cell number used when signing up. Consent is not a condition of any purchase. Reply HELP for help and STOP to cancel. Msg frequency varies. Msg & data rates may apply. View <a target = \"_blank\" href=\"https:\/\/attnl.tv\/t\/A9M\">Terms<\/a> & <a target = \"_blank\" href=\"https:\/\/attnl.tv\/p\/A9M\">Privacy<\/a>.<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_111_25\" class=\"gfield gfield--type-text gfield--width-full no-display field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_111_25'>Form Custom Service<\/label><div class='ginput_container ginput_container_text'><input name='input_25' id='input_111_25' type='text' value='Vitamin Injections' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_111_52\" class=\"gfield gfield--type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_52' id='input_111_52' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='[channel]' \/><\/div><\/li><li id=\"field_111_53\" class=\"gfield gfield--type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_53' id='input_111_53' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='[channeldrilldown1]' \/><\/div><\/li><li id=\"field_111_54\" class=\"gfield gfield--type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_54' id='input_111_54' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='[channeldrilldown2]' \/><\/div><\/li><li id=\"field_111_55\" class=\"gfield gfield--type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_55' id='input_111_55' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='[channeldrilldown3]' \/><\/div><\/li><li id=\"field_111_56\" class=\"gfield gfield--type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_56' id='input_111_56' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='[landingpage]' \/><\/div><\/li><li id=\"field_111_57\" class=\"gfield gfield--type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_57' id='input_111_57' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='[landingpagegroup]' \/><\/div><\/li><\/ul><\/div>\n        <div class='gform-footer gform_footer top_label'> <div class=\"gfa-createaccount\"><label><input type=\"checkbox\" name=\"gfa_createaccount\" value=\"1\"> <b>Create an account?<\/b> (After submitting the form, an account will be created. Login details will be sent to your email address)<\/label><\/div><input type='submit' id='gform_submit_button_111' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Submit'  \/> <input type='hidden' name='gform_ajax' value='form_id=111&amp;title=&amp;description=&amp;tabindex=0&amp;theme=legacy&amp;styles=[]&amp;hash=811485c89602b7b802513957a32d51e4' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_111' value='iframe' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_111' id='gform_theme_111' value='legacy' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_111' id='gform_style_settings_111' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_111' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='111' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_111' value='WyJbXSIsIjZiOTA0ZmMxNTAzMTU4ZGNmMDcxZTkyNTM0NzllMjgxIl0=' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_111' id='gform_target_page_number_111' value='0' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_111' id='gform_source_page_number_111' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            <input type='hidden' name='gform_uploaded_files' id='gform_uploaded_files_111' value='' \/>\n        <\/div>\n                        <\/form>\n                        <\/div>\n\t\t                <iframe style='display:none;width:0px;height:0px;' src='about:blank' name='gform_ajax_frame_111' id='gform_ajax_frame_111' title='This iframe contains the logic required to handle Ajax powered Gravity Forms.'><\/iframe>\n\t\t                <script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\n gform.initializeOnLoaded( function() {gformInitSpinner( 111, 'https:\/\/driphydration.com\/wp-content\/themes\/bridge-child\/img\/spinner.gif', true );jQuery('#gform_ajax_frame_111').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_111');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_111').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){form_content.find('form').css('opacity', 0);let of = jQuery('#gform_wrapper_111'),\n                        nf = form_content.find('.gform_fields'),\n                        cc = of.find('.gform_fields .field_stripe_creditcard'),\n                        tt = of.find('.gform_fields .gfield_total'),\n                        er = form_content.find('.gform_validation_errors'),\n                        nc = '',bt = '',bc = '';\n      of.find('.gform_validation_errors').remove();\n      if(er.length){\n        of.find('form').before(er.prop('outerHTML'));\n      }\n      of.find('#gf_stripe_response,#gf_stripe_credit_card_last_four,#stripe_credit_card_type').remove();\n      of.find('.gform_fields > li').each(function(){\n        let t = jQuery(this);\n        if(t.hasClass('gfield_total')){\n          bt = nc;\n          nc = '';\n        } else if(t.hasClass('field_stripe_creditcard')){\n            bc = nc;\n            nc = '';\n        } else {\n          let f = nf.find('#'+t.attr('id'));\n          if(t.hasClass('lab_fee') && t.hasClass('no-display')){\n            f.addClass('no-display');\n          }\n          nc += f.prop('outerHTML');\n          t.remove();\n        }\n        \/\/t.html(nf.find('#'+t.attr('id')).html());\n      });\n      tt.before(bt);\n      tt.find('.ginput_container_total').prop('outerHTML',nf.find('.gfield_total .ginput_container_total').prop('outerHTML'));\n      cc.before(bc).after(nc);\n      cc.attr('class',nf.find('.field_stripe_creditcard').attr('class')).find('.ginput_cardholder').prop('outerHTML',nf.find('.field_stripe_creditcard .ginput_cardholder').prop('outerHTML'));\n      cc.append(nf.find('.field_stripe_creditcard #gf_stripe_response').prop('outerHTML'));\n      jQuery(document.body).removeClass('form-processing');\n      jQuery('.form-processing-popup').removeAttr('role');\n      of.find('form').data('gfstripesubmitting', false);\n      of.find('.gform_ajax_spinner').remove();\n    if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_111').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_111').removeClass('gform_validation_error');}setTimeout( function() { \/* delay the scroll by 50 milliseconds to fix a bug in chrome *\/  }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_111').val();gformInitSpinner( 111, 'https:\/\/driphydration.com\/wp-content\/themes\/bridge-child\/img\/spinner.gif', true );jQuery(document).trigger('gform_page_loaded', [111, current_page]);window['gf_submitting_111'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}jQuery('#gform_wrapper_111').replaceWith(confirmation_content);jQuery(document).trigger('gform_confirmation_loaded', [111]);window['gf_submitting_111'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_111').text());}else{jQuery('#gform_111').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger(\"gform_pre_post_render\", [{ formId: \"111\", currentPage: \"current_page\", abort: function() { this.preventDefault(); } }]);                if (event && event.defaultPrevented) {                return;         }        const gformWrapperDiv = document.getElementById( \"gform_wrapper_111\" );        if ( gformWrapperDiv ) {            const visibilitySpan = document.createElement( \"span\" );            visibilitySpan.id = \"gform_visibility_test_111\";            gformWrapperDiv.insertAdjacentElement( \"afterend\", visibilitySpan );        }        const visibilityTestDiv = document.getElementById( \"gform_visibility_test_111\" );        let postRenderFired = false;                function triggerPostRender() {            if ( postRenderFired ) {                return;            }            postRenderFired = true;            gform.core.triggerPostRenderEvents( 111, current_page );            if ( visibilityTestDiv ) {                visibilityTestDiv.parentNode.removeChild( visibilityTestDiv );            }        }        function debounce( func, wait, immediate ) {            var timeout;            return function() {                var context = this, args = arguments;                var later = function() {                    timeout = null;                    if ( !immediate ) func.apply( context, args );                };                var callNow = immediate && !timeout;                clearTimeout( timeout );                timeout = setTimeout( later, wait );                if ( callNow ) func.apply( context, args );            };        }        const debouncedTriggerPostRender = debounce( function() {            triggerPostRender();        }, 200 );        if ( visibilityTestDiv && visibilityTestDiv.offsetParent === null ) {            const observer = new MutationObserver( ( mutations ) => {                mutations.forEach( ( mutation ) => {                    if ( mutation.type === 'attributes' && visibilityTestDiv.offsetParent !== null ) {                        debouncedTriggerPostRender();                        observer.disconnect();                    }                });            });            observer.observe( document.body, {                attributes: true,                childList: false,                subtree: true,                attributeFilter: [ 'style', 'class' ],            });        } else {            triggerPostRender();        }    } );} ); \n\/* ]]> *\/\n<\/script>\n<\/div><div class=\"billing-address-popup\">\n    <div class=\"inner\">\n        <div class=\"popup-close btn-cancel\">Close<\/div>\n        <h3 class=\"div-full\">Billing Address<\/h3>\n        <div>\n            <label class=\"gform-field-label\">Country<\/label>\n            <select id=\"ccbadr_country\"><option>Afghanistan<\/option><option>Albania<\/option><option>Algeria<\/option><option>American Samoa<\/option><option>Andorra<\/option><option>Angola<\/option><option>Anguilla<\/option><option>Antarctica<\/option><option>Antigua and Barbuda<\/option><option>Argentina<\/option><option>Armenia<\/option><option>Aruba<\/option><option>Australia<\/option><option>Austria<\/option><option>Azerbaijan<\/option><option>Bahamas<\/option><option>Bahrain<\/option><option>Bangladesh<\/option><option>Barbados<\/option><option>Belarus<\/option><option>Belgium<\/option><option>Belize<\/option><option>Benin<\/option><option>Bermuda<\/option><option>Bhutan<\/option><option>Bolivia<\/option><option>Bonaire, Sint Eustatius and Saba<\/option><option>Bosnia and Herzegovina<\/option><option>Botswana<\/option><option>Bouvet Island<\/option><option>Brazil<\/option><option>British Indian Ocean Territory<\/option><option>Brunei Darussalam<\/option><option>Bulgaria<\/option><option>Burkina Faso<\/option><option>Burundi<\/option><option>Cabo Verde<\/option><option>Cambodia<\/option><option>Cameroon<\/option><option>Canada<\/option><option>Cayman Islands<\/option><option>Central African Republic<\/option><option>Chad<\/option><option>Chile<\/option><option>China<\/option><option>Christmas Island<\/option><option>Cocos Islands<\/option><option>Colombia<\/option><option>Comoros<\/option><option>Congo<\/option><option>Congo, Democratic Republic of the<\/option><option>Cook Islands<\/option><option>Costa Rica<\/option><option>Croatia<\/option><option>Cuba<\/option><option>Cura\u00e7ao<\/option><option>Cyprus<\/option><option>Czechia<\/option><option>C\u00f4te d'Ivoire<\/option><option>Denmark<\/option><option>Djibouti<\/option><option>Dominica<\/option><option>Dominican Republic<\/option><option>Ecuador<\/option><option>Egypt<\/option><option>El Salvador<\/option><option>Equatorial Guinea<\/option><option>Eritrea<\/option><option>Estonia<\/option><option>Eswatini<\/option><option>Ethiopia<\/option><option>Falkland Islands<\/option><option>Faroe Islands<\/option><option>Fiji<\/option><option>Finland<\/option><option>France<\/option><option>French Guiana<\/option><option>French Polynesia<\/option><option>French Southern Territories<\/option><option>Gabon<\/option><option>Gambia<\/option><option>Georgia<\/option><option>Germany<\/option><option>Ghana<\/option><option>Gibraltar<\/option><option>Greece<\/option><option>Greenland<\/option><option>Grenada<\/option><option>Guadeloupe<\/option><option>Guam<\/option><option>Guatemala<\/option><option>Guernsey<\/option><option>Guinea<\/option><option>Guinea-Bissau<\/option><option>Guyana<\/option><option>Haiti<\/option><option>Heard Island and McDonald Islands<\/option><option>Holy See<\/option><option>Honduras<\/option><option>Hong Kong<\/option><option>Hungary<\/option><option>Iceland<\/option><option>India<\/option><option>Indonesia<\/option><option>Iran<\/option><option>Iraq<\/option><option>Ireland<\/option><option>Isle of Man<\/option><option>Israel<\/option><option>Italy<\/option><option>Jamaica<\/option><option>Japan<\/option><option>Jersey<\/option><option>Jordan<\/option><option>Kazakhstan<\/option><option>Kenya<\/option><option>Kiribati<\/option><option>Korea, Democratic People's Republic of<\/option><option>Korea, Republic of<\/option><option>Kuwait<\/option><option>Kyrgyzstan<\/option><option>Lao People's Democratic Republic<\/option><option>Latvia<\/option><option>Lebanon<\/option><option>Lesotho<\/option><option>Liberia<\/option><option>Libya<\/option><option>Liechtenstein<\/option><option>Lithuania<\/option><option>Luxembourg<\/option><option>Macao<\/option><option>Madagascar<\/option><option>Malawi<\/option><option>Malaysia<\/option><option>Maldives<\/option><option>Mali<\/option><option>Malta<\/option><option>Marshall Islands<\/option><option>Martinique<\/option><option>Mauritania<\/option><option>Mauritius<\/option><option>Mayotte<\/option><option>Mexico<\/option><option>Micronesia<\/option><option>Moldova<\/option><option>Monaco<\/option><option>Mongolia<\/option><option>Montenegro<\/option><option>Montserrat<\/option><option>Morocco<\/option><option>Mozambique<\/option><option>Myanmar<\/option><option>Namibia<\/option><option>Nauru<\/option><option>Nepal<\/option><option>Netherlands<\/option><option>New Caledonia<\/option><option>New Zealand<\/option><option>Nicaragua<\/option><option>Niger<\/option><option>Nigeria<\/option><option>Niue<\/option><option>Norfolk Island<\/option><option>North Macedonia<\/option><option>Northern Mariana Islands<\/option><option>Norway<\/option><option>Oman<\/option><option>Pakistan<\/option><option>Palau<\/option><option>Palestine, State of<\/option><option>Panama<\/option><option>Papua New Guinea<\/option><option>Paraguay<\/option><option>Peru<\/option><option>Philippines<\/option><option>Pitcairn<\/option><option>Poland<\/option><option>Portugal<\/option><option>Puerto Rico<\/option><option>Qatar<\/option><option>Romania<\/option><option>Russian Federation<\/option><option>Rwanda<\/option><option>R\u00e9union<\/option><option>Saint Barth\u00e9lemy<\/option><option>Saint Helena, Ascension and Tristan da Cunha<\/option><option>Saint Kitts and Nevis<\/option><option>Saint Lucia<\/option><option>Saint Martin<\/option><option>Saint Pierre and Miquelon<\/option><option>Saint Vincent and the Grenadines<\/option><option>Samoa<\/option><option>San Marino<\/option><option>Sao Tome and Principe<\/option><option>Saudi Arabia<\/option><option>Senegal<\/option><option>Serbia<\/option><option>Seychelles<\/option><option>Sierra Leone<\/option><option>Singapore<\/option><option>Sint Maarten<\/option><option>Slovakia<\/option><option>Slovenia<\/option><option>Solomon Islands<\/option><option>Somalia<\/option><option>South Africa<\/option><option>South Georgia and the South Sandwich Islands<\/option><option>South Sudan<\/option><option>Spain<\/option><option>Sri Lanka<\/option><option>Sudan<\/option><option>Suriname<\/option><option>Svalbard and Jan Mayen<\/option><option>Sweden<\/option><option>Switzerland<\/option><option>Syria Arab Republic<\/option><option>Taiwan<\/option><option>Tajikistan<\/option><option>Tanzania, the United Republic of<\/option><option>Thailand<\/option><option>Timor-Leste<\/option><option>Togo<\/option><option>Tokelau<\/option><option>Tonga<\/option><option>Trinidad and Tobago<\/option><option>Tunisia<\/option><option>Turkmenistan<\/option><option>Turks and Caicos Islands<\/option><option>Tuvalu<\/option><option>T\u00fcrkiye<\/option><option>US Minor Outlying Islands<\/option><option>Uganda<\/option><option>Ukraine<\/option><option>United Arab Emirates<\/option><option>United Kingdom<\/option><option>United States<\/option><option>Uruguay<\/option><option>Uzbekistan<\/option><option>Vanuatu<\/option><option>Venezuela<\/option><option>Viet Nam<\/option><option>Virgin Islands, British<\/option><option>Virgin Islands, U.S.<\/option><option>Wallis and Futuna<\/option><option>Western Sahara<\/option><option>Yemen<\/option><option>Zambia<\/option><option>Zimbabwe<\/option><option>\u00c5land Islands<\/option><\/select>\n        <\/div>\n        <div class=\"div-full\">\n            <label class=\"gform-field-label\">Street Address<\/label>\n            <input id=\"ccbadr_line1\" type=\"text\" placeholder=\"Street Address\">\n        <\/div>\n        <div class=\"div-full\">\n            <label class=\"gform-field-label\">Address Line 2<\/label>\n            <input id=\"ccbadr_line2\" type=\"text\" placeholder=\"Address Line 2\">\n        <\/div>\n        <div>\n            <label class=\"gform-field-label\">State<\/label>\n            <input id=\"ccbadr_state\" type=\"text\" placeholder=\"State\">\n        <\/div>\n        <div>\n            <label class=\"gform-field-label\">City<\/label>\n            <input id=\"ccbadr_city\" type=\"text\" placeholder=\"City\">\n        <\/div>\n        <div>\n            <label class=\"gform-field-label\">ZIP Code<\/label>\n            <input id=\"ccbadr_zip\" type=\"text\" placeholder=\"ZIP Code\">\n        <\/div>\n        <div class=\"btns div-full\">\n            <button type=\"button\" class=\"btn-cancel\">Cancel<\/button>\n            <button type=\"button\" class=\"btn-save\">Save<\/button>\n        <\/div>\n    <\/div>\n<\/div><\/div><\/article>[\/vc_column_inner][\/vc_row_inner]        <article class=\"faq\">\n            <div class=\"ecommerce_container\">\n                                    <h2 class=\"title\">Frequently asked questions<\/h2>\n                                                    <div class=\"accordion\">\n                                                                                <div class=\"accordion__item\">\n                                                                    <div class=\"accordion__head\">What are Lipostat+ injections?<\/div>\n                                                                                                    <div class=\"accordion__body\">\n                                        <p><span style=\"color: #004855; font-family: Poppins, sans-serif; font-size: 18px; letter-spacing: -0.1px;\">Lipostat+ injections are a combination of lipotropic compounds and essential nutrients designed to boost fat metabolism, improve energy levels, and support overall health. They contain a blend of Methionine, Choline Chloride, Carnitine, and Dexpanthenol (Lipo-C), which work together to break down fat and enhance energy production.<\/span><\/p>                                    <\/div>\n                                                            <\/div>\n                                                                                <div class=\"accordion__item\">\n                                                                    <div class=\"accordion__head\">How are Lipostat+ injections administered?<\/div>\n                                                                                                    <div class=\"accordion__body\">\n                                        <p dir=\"ltr\" style=\"background-image: initial; background-position: 0px 0px; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial; border: 0px; margin: 0px; padding: 0px; vertical-align: baseline; outline: 0px; font-family: Poppins, sans-serif; font-size: 18px; line-height: 23px; letter-spacing: -0.1px; color: #004855;\">Lipostat+ injections are subcutaneous injections administered in your thigh, abdomen, or upper arm. Please watch this video for further instructions.<\/p>\n<p style=\"background-image: initial; background-position: 0px 0px; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial; border: 0px; margin: 0px; padding: 0px; vertical-align: baseline; outline: 0px; font-family: Poppins, sans-serif; font-size: 18px; line-height: 23px; letter-spacing: -0.1px; color: #004855;\"><span id=\"docs-internal-guid-b027759d-7fff-eb7e-1325-dab7a1901fab\" style=\"background: 0px 0px; border: 0px; margin: 0px; padding: 0px; vertical-align: baseline; outline: 0px;\"><a style=\"background: 0px 0px; border: 0px; margin: 0px; padding: 0px; vertical-align: baseline; outline: 0px; text-decoration-line: none; cursor: pointer; color: #5fb8bc !important;\" href=\"https:\/\/www.youtube.com\/watch?v=pHos47-1Xqc\">Subcutaneous Self Injections<\/a><\/span><\/p>                                    <\/div>\n                                                            <\/div>\n                                                                                <div class=\"accordion__item\">\n                                                                    <div class=\"accordion__head\">Who should consider Lipostat+ injections?<\/div>\n                                                                                                    <div class=\"accordion__body\">\n                                        <p dir=\"ltr\" style=\"background-image: initial; background-position: 0px 0px; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial; border: 0px; margin: 0px; padding: 0px; vertical-align: baseline; outline: 0px; font-family: Poppins, sans-serif; font-size: 18px; line-height: 23px; letter-spacing: -0.1px; color: #004855;\">Lipostat+ injections are ideal for individuals looking to support their weight loss journey and improve fat metabolism. You should consider Lipostat+ injections if you:<\/p>\n<p style=\"background-image: initial; background-position: 0px 0px; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial; border: 0px; margin: 0px; padding: 0px; vertical-align: baseline; outline: 0px; font-family: Poppins, sans-serif; font-size: 18px; line-height: 23px; letter-spacing: -0.1px; color: #004855;\">&nbsp;<\/p>\n<ul style=\"box-sizing: border-box; background-image: initial; background-position: 0px 0px; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial; border: 0px; margin: 0px; padding: 0px 0px 0px 25px; vertical-align: baseline; outline: 0px; list-style-position: inside; color: #004855; font-family: Poppins, sans-serif; font-size: 18px; letter-spacing: 0.55px;\">\n<li dir=\"ltr\" style=\"background: 0px 0px; border: 0px; margin: 0px; padding: 0px; vertical-align: baseline; outline: 0px; list-style: none; color: var(--neu-06) !important;\" aria-level=\"1\">\n<p dir=\"ltr\" style=\"background: 0px 0px; border: 0px; margin: 0px; padding: 0px; vertical-align: baseline; outline: 0px; font-size: 16px; line-height: 23px; letter-spacing: -0.1px;\" role=\"presentation\">Struggle with stubborn fat areas that are resistant to diet and exercise.<\/p>\n<\/li>\n<li dir=\"ltr\" style=\"background: 0px 0px; border: 0px; margin: 0px; padding: 0px; vertical-align: baseline; outline: 0px; list-style: none; color: var(--neu-06) !important;\" aria-level=\"1\">\n<p dir=\"ltr\" style=\"background: 0px 0px; border: 0px; margin: 0px; padding: 0px; vertical-align: baseline; outline: 0px; font-size: 16px; line-height: 23px; letter-spacing: -0.1px;\" role=\"presentation\">Want to boost your energy levels and feel more active throughout the day.<\/p>\n<\/li>\n<li dir=\"ltr\" style=\"background: 0px 0px; border: 0px; margin: 0px; padding: 0px; vertical-align: baseline; outline: 0px; list-style: none; color: var(--neu-06) !important;\" aria-level=\"1\">\n<p dir=\"ltr\" style=\"background: 0px 0px; border: 0px; margin: 0px; padding: 0px; vertical-align: baseline; outline: 0px; font-size: 16px; line-height: 23px; letter-spacing: -0.1px;\" role=\"presentation\">Are looking for a non-invasive method to enhance your body&rsquo;s natural fat-burning processes.<\/p>\n<\/li>\n<li dir=\"ltr\" style=\"background: 0px 0px; border: 0px; margin: 0px; padding: 0px; vertical-align: baseline; outline: 0px; list-style: none; color: var(--neu-06) !important;\" aria-level=\"1\">\n<p dir=\"ltr\" style=\"background: 0px 0px; border: 0px; margin: 0px; padding: 0px; vertical-align: baseline; outline: 0px; font-size: 16px; line-height: 23px; letter-spacing: -0.1px;\" role=\"presentation\">Have hit a weight loss plateau and need extra support to break through.<\/p>\n<\/li>\n<li dir=\"ltr\" style=\"background: 0px 0px; border: 0px; margin: 0px; padding: 0px; vertical-align: baseline; outline: 0px; list-style: none; color: var(--neu-06) !important;\" aria-level=\"1\">\n<p dir=\"ltr\" style=\"background: 0px 0px; border: 0px; margin: 0px; padding: 0px; vertical-align: baseline; outline: 0px; font-size: 16px; line-height: 23px; letter-spacing: -0.1px;\" role=\"presentation\">Want to maintain healthy liver function while supporting overall metabolic health.<\/p>\n<\/li>\n<li dir=\"ltr\" style=\"background: 0px 0px; border: 0px; margin: 0px; padding: 0px; vertical-align: baseline; outline: 0px; list-style: none; color: var(--neu-06) !important;\" aria-level=\"1\">\n<p dir=\"ltr\" style=\"background: 0px 0px; border: 0px; margin: 0px; padding: 0px; vertical-align: baseline; outline: 0px; font-size: 16px; line-height: 23px; letter-spacing: -0.1px;\" role=\"presentation\">Are seeking a safe and effective way to enhance your weight loss program, in combination with a healthy diet and exercise.<\/p>\n<\/li>\n<\/ul>                                    <\/div>\n                                                            <\/div>\n                                                                                <div class=\"accordion__item\">\n                                                                    <div class=\"accordion__head\">What are the benefits of Lipostat+ injections?<\/div>\n                                                                                                    <div class=\"accordion__body\">\n                                        <p dir=\"ltr\" style=\"background-image: initial; background-position: 0px 0px; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial; border: 0px; margin: 0px; padding: 0px; vertical-align: baseline; outline: 0px; font-family: Poppins, sans-serif; font-size: 18px; line-height: 23px; letter-spacing: -0.1px; color: #004855;\">Key Benefits of Lipostat+ Injections<\/p>\n<p style=\"background-image: initial; background-position: 0px 0px; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial; border: 0px; margin: 0px; padding: 0px; vertical-align: baseline; outline: 0px; font-family: Poppins, sans-serif; font-size: 18px; line-height: 23px; letter-spacing: -0.1px; color: #004855;\">&nbsp;<\/p>\n<ul style=\"box-sizing: border-box; background-image: initial; background-position: 0px 0px; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial; border: 0px; margin: 0px; padding: 0px 0px 0px 25px; vertical-align: baseline; outline: 0px; list-style-position: inside; color: #004855; font-family: Poppins, sans-serif; font-size: 18px; letter-spacing: 0.55px;\">\n<li dir=\"ltr\" style=\"background: 0px 0px; border: 0px; margin: 0px; padding: 0px; vertical-align: baseline; outline: 0px; list-style: none; color: var(--neu-06) !important;\" role=\"presentation\">Enhanced Fat Burning: Break down stubborn fat deposits and speed up your metabolism with key lipotropic agents.<\/li>\n<li dir=\"ltr\" style=\"background: 0px 0px; border: 0px; margin: 0px; padding: 0px; vertical-align: baseline; outline: 0px; list-style: none; color: var(--neu-06) !important;\" role=\"presentation\">Energy Boost: Feel more energized throughout your day with the support of essential nutrients.<\/li>\n<li dir=\"ltr\" style=\"background: 0px 0px; border: 0px; margin: 0px; padding: 0px; vertical-align: baseline; outline: 0px; list-style: none; color: var(--neu-06) !important;\" role=\"presentation\">Support Liver Health: Help your body process fats more efficiently, supporting healthy liver function.<\/li>\n<li dir=\"ltr\" style=\"background: 0px 0px; border: 0px; margin: 0px; padding: 0px; vertical-align: baseline; outline: 0px; list-style: none; color: var(--neu-06) !important;\" role=\"presentation\">Appetite Control: Lipostat+ may assist in reducing cravings, helping you stick to a healthy diet plan.<\/li>\n<li dir=\"ltr\" style=\"background: 0px 0px; border: 0px; margin: 0px; padding: 0px; vertical-align: baseline; outline: 0px; list-style: none; color: var(--neu-06) !important;\" role=\"presentation\">Improved Mood &amp; Focus: With the energy boost from Lipostat+, you may experience better focus and an improved overall mood.<\/li>\n<\/ul>                                    <\/div>\n                                                            <\/div>\n                                                                                <div class=\"accordion__item\">\n                                                                    <div class=\"accordion__head\">How often should I get Lipostat+ injections?<\/div>\n                                                                                                    <div class=\"accordion__body\">\n                                        <p><span style=\"color: #004855; font-family: Poppins, sans-serif; font-size: 18px; letter-spacing: -0.1px;\">The frequency of injections depends on individual needs and medical advice, but our recommended protocol is twice a week.<\/span><\/p>                                    <\/div>\n                                                            <\/div>\n                                                                                <div class=\"accordion__item\">\n                                                                    <div class=\"accordion__head\">Are there any side effects of Lipostat+ injections?<\/div>\n                                                                                                    <div class=\"accordion__body\">\n                                        <p><span style=\"color: #004855; font-family: Poppins, sans-serif; font-size: 18px; letter-spacing: -0.1px;\">Side effects are rare, but some individuals may experience mild discomfort or bruising at the injection site.<\/span><\/p>                                    <\/div>\n                                                            <\/div>\n                                                                                <div class=\"accordion__item\">\n                                                                    <div class=\"accordion__head\">How long does it take to see results from Lipostat+ injections?<\/div>\n                                                                                                    <div class=\"accordion__body\">\n                                        <p><span style=\"color: #004855; font-family: Poppins, sans-serif; font-size: 18px; letter-spacing: -0.1px;\">While individual results may vary, many people notice an increase in energy and improved fat metabolism within a few weeks of regular injections. Combining Lipostat+ injections with a healthy lifestyle can help accelerate and sustain your results.<\/span><\/p>                                    <\/div>\n                                                            <\/div>\n                                                                                <div class=\"accordion__item\">\n                                                                    <div class=\"accordion__head\">Can Lipostat+ injections help me if I\u2019ve hit a weight loss plateau?<\/div>\n                                                                                                    <div class=\"accordion__body\">\n                                        <p><span style=\"color: #004855; font-family: Poppins, sans-serif; font-size: 18px; letter-spacing: -0.1px;\">Yes! Lipostat+ injections are particularly helpful for breaking through weight loss plateaus by enhancing your body&rsquo;s ability to burn fat and maintain energy levels, even when progress has slowed.<\/span><\/p>                                    <\/div>\n                                                            <\/div>\n                                                                                <div class=\"accordion__item\">\n                                                                    <div class=\"accordion__head\">How do Lipostat+ injections help with weight loss?<\/div>\n                                                                                                    <div class=\"accordion__body\">\n                                        <p><span style=\"color: #004855; font-family: Poppins, sans-serif; font-size: 18px; letter-spacing: -0.1px;\">The ingredients in Lipostat+ injections help your body metabolize fats more efficiently, breaking down stubborn fat deposits and supporting liver function. By enhancing fat metabolism, these injections can help accelerate fat loss when combined with a healthy diet and regular exercise.<\/span><\/p>                                    <\/div>\n                                                            <\/div>\n                                                                                <div class=\"accordion__item\">\n                                                                    <div class=\"accordion__head\">Will Lipostat+ injections give me more energy?<\/div>\n                                                                                                    <div class=\"accordion__body\">\n                                        <p><span style=\"color: #004855; font-family: Poppins, sans-serif; font-size: 18px; letter-spacing: -0.1px;\">Yes! The combination of Carnitine and other ingredients in Lipostat+ helps to convert fat into usable energy, giving you a natural energy boost that can help you feel more focused and productive throughout the day.<\/span><\/p>                                    <\/div>\n                                                            <\/div>\n                                                                                <div class=\"accordion__item\">\n                                                                    <div class=\"accordion__head\">Why should I purchase a subscription?<\/div>\n                                                                                                    <div class=\"accordion__body\">\n                                        <p><span style=\"color: #004855; font-family: Poppins, sans-serif; font-size: 18px; letter-spacing: -0.1px;\">Subscriptions are cheaper! You will also achieve better results if you use Lipostat+ consistently.<\/span><\/p>                                    <\/div>\n                                                            <\/div>\n                                                                                <div class=\"accordion__item\">\n                                                                    <div class=\"accordion__head\">How do I cancel my subscription?<\/div>\n                                                                                                    <div class=\"accordion__body\">\n                                        <p><span style=\"color: #004855; font-family: Poppins, sans-serif; font-size: 18px; letter-spacing: -0.1px;\">To cancel your subscription please email&nbsp;<\/span><a style=\"background-image: initial; background-position: 0px 0px; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial; border: 0px; margin: 0px; padding: 0px; vertical-align: baseline; outline: 0px; text-decoration-line: none; cursor: pointer; font-family: Poppins, sans-serif; font-size: 18px; letter-spacing: -0.1px; color: #5fb8bc !important;\" href=\"mailto:operations@conciergemdla.com\">operations@conciergemdla.com<\/a><span style=\"color: #004855; font-family: Poppins, sans-serif; font-size: 18px; letter-spacing: -0.1px;\">&nbsp;or contact your local Concierge MD provider.<\/span><br style=\"color: #004855; font-family: Poppins, sans-serif; font-size: 18px; letter-spacing: -0.1px;\" \/><span style=\"color: #004855; font-family: Poppins, sans-serif; font-size: 18px; letter-spacing: -0.1px;\">Please note we have a 3-month minimum for subscriptions.<\/span><\/p>                                    <\/div>\n                                                            <\/div>\n                                                                                <div class=\"accordion__item\">\n                                                                    <div class=\"accordion__head\">How do I refill my order?<\/div>\n                                                                                                    <div class=\"accordion__body\">\n                                        Subscription orders will be automatically refilled and shipped monthly. Month-to-month orders can be repurchased online.                                    <\/div>\n                                                            <\/div>\n                                                                                <div class=\"accordion__item\">\n                                                                    <div class=\"accordion__head\">How long will it take for my order to arrive?<\/div>\n                                                                                                    <div class=\"accordion__body\">\n                                        Your shipment should arrive within one week after placing the order online.                                    <\/div>\n                                                            <\/div>\n                                                                                <div class=\"accordion__item\">\n                                                                    <div class=\"accordion__head\">Are there any storage instructions I should be aware of?<\/div>\n                                                                                                    <div class=\"accordion__body\">\n                                        This product should be kept refrigerated.                                    <\/div>\n                                                            <\/div>\n                                                                                <div class=\"accordion__item\">\n                                                                    <div class=\"accordion__head\">Is this product covered by insurance?<\/div>\n                                                                                                    <div class=\"accordion__body\">\n                                        This product is not covered by insurance.                                    <\/div>\n                                                            <\/div>\n                                                                                <div class=\"accordion__item\">\n                                                                    <div class=\"accordion__head\">Is a clinical review required, and what happens if I'm not eligible?<\/div>\n                                                                                                    <div class=\"accordion__body\">\n                                        Yes, a clinical review is required to determine your eligibility. If you do not qualify, you will receive a full refund.                                    <\/div>\n                                                            <\/div>\n                                            <\/div>\n                            <\/div>\n        <\/article>\n        [\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row css_animation=&#8221;&#8221; row_type=&#8221;row&#8221; use_row_as_full_screen_section=&#8221;no&#8221; type=&#8221;full_width&#8221; angled_section=&#8221;no&#8221; text_align=&#8221;left&#8221; background_image_as_pattern=&#8221;without_pattern&#8221;][vc_column][vc_row_inner row_type=&#8221;row&#8221; type=&#8221;full_width&#8221; text_align=&#8221;center&#8221; css_animation=&#8221;&#8221; el_class=&#8221;treatment-image-text&#8221;][vc_column_inner width=&#8221;1\/4&#8243;][\/vc_column_inner][vc_column_inner width=&#8221;1\/4&#8243;][\/vc_column_inner][vc_column_inner width=&#8221;1\/4&#8243;][\/vc_column_inner][vc_column_inner width=&#8221;1\/4&#8243;][\/vc_column_inner][\/vc_row_inner][vc_row_inner row_type=&#8221;row&#8221; type=&#8221;full_width&#8221; text_align=&#8221;left&#8221;&#8230;<\/p>\n","protected":false},"author":44779,"featured_media":0,"parent":92620,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"full_width.php","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-181919","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/driphydration.com\/wp-json\/wp\/v2\/pages\/181919","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/driphydration.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/driphydration.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/driphydration.com\/wp-json\/wp\/v2\/users\/44779"}],"replies":[{"embeddable":true,"href":"https:\/\/driphydration.com\/wp-json\/wp\/v2\/comments?post=181919"}],"version-history":[{"count":0,"href":"https:\/\/driphydration.com\/wp-json\/wp\/v2\/pages\/181919\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/driphydration.com\/wp-json\/wp\/v2\/pages\/92620"}],"wp:attachment":[{"href":"https:\/\/driphydration.com\/wp-json\/wp\/v2\/media?parent=181919"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}