{"id":851,"date":"2025-05-14T13:50:22","date_gmt":"2025-05-14T13:50:22","guid":{"rendered":"https:\/\/staffroom.cedarcresthospitals.com\/?page_id=851"},"modified":"2025-05-14T14:08:12","modified_gmt":"2025-05-14T14:08:12","slug":"cug-request-incident-reporting","status":"publish","type":"page","link":"https:\/\/staffroom.cedarcresthospitals.com\/index.php\/cug-request-incident-reporting\/","title":{"rendered":"CUG Request &#038; Incident Reporting"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row css=&#8221;.vc_custom_1747231690178{margin-top: 20px !important;margin-right: 20px !important;margin-bottom: 20px !important;margin-left: 20px !important;}&#8221;][vc_column width=&#8221;1\/4&#8243;][\/vc_column][vc_column width=&#8221;1\/2&#8243;][vc_column_text css=&#8221;&#8221;]<div class='fluentform ff-default fluentform_wrapper_3 ffs_default_wrap'><form data-form_id=\"3\" id=\"fluentform_3\" class=\"frm-fluent-form fluent_form_3 ff-el-form-top ff_form_instance_3_1 ff-form-loading ffs_default\" data-form_instance=\"ff_form_instance_3_1\" method=\"POST\" ><fieldset  style=\"border: none!important;margin: 0!important;padding: 0!important;background-color: transparent!important;box-shadow: none!important;outline: none!important; min-inline-size: 100%;\">\n                    <legend class=\"ff_screen_reader_title\" style=\"display: block; margin: 0!important;padding: 0!important;height: 0!important;text-indent: -999999px;width: 0!important;overflow:hidden;\">Support Form (#3)<\/legend><input type='hidden' name='__fluent_form_embded_post_id' value='851' \/><input type=\"hidden\" id=\"_fluentform_3_fluentformnonce\" name=\"_fluentform_3_fluentformnonce\" value=\"0e9284ee56\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index.php\/wp-json\/wp\/v2\/pages\/851\" \/><div class='ff-el-group  ff-custom_html' tabindex='-1' data-name=\"custom_html-3_1\" ><p>Please complete the form below and describe the issue you are experiencing with your CUG.<\/p><\/div><div data-type=\"name-element\" data-name=\"names\" class=\" ff-field_container ff-name-field-wrapper\" ><div class='ff-t-container'><div class='ff-t-cell '><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_names_first_name_' >First Name<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names[first_name]\" id=\"ff_3_names_first_name_\" class=\"ff-el-form-control\" aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><div class='ff-t-cell '><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_names_last_name_' >Last Name<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names[last_name]\" id=\"ff_3_names_last_name_\" class=\"ff-el-form-control\" aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_phone' aria-label=\"CUG Phone Number\">CUG Phone Number<\/label><\/div><div class='ff-el-input--content'><input name=\"phone\" class=\"ff-el-form-control ff-el-phone\" type=\"tel\" placeholder=\"Mobile Number\" data-name=\"phone\" id=\"ff_3_phone\" inputmode=\"tel\"  aria-invalid='false' aria-required=false><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_email' aria-label=\"Office Email\">Office Email<\/label><\/div><div class='ff-el-input--content'><input type=\"email\" name=\"email\" id=\"ff_3_email\" class=\"ff-el-form-control\" placeholder=\"you@cedarcresthospitals.com\" data-name=\"email\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_input_text' aria-label=\"Department\">Department<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text\" class=\"ff-el-form-control\" data-name=\"input_text\" id=\"ff_3_input_text\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_subject' aria-label=\"Subject\">Subject<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"subject\" class=\"ff-el-form-control\" placeholder=\"Type your subject\" data-name=\"subject\" id=\"ff_3_subject\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description' aria-label=\"Description\">Description<\/label><\/div><div class='ff-el-input--content'><textarea aria-invalid=\"false\" aria-required=false name=\"description\" id=\"ff_3_description\" class=\"ff-el-form-control\" rows=\"4\" cols=\"2\" data-name=\"description\" ><\/textarea><\/div><\/div><div class='ff-el-group ff-text-left ff_submit_btn_wrapper'><button 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