{"id":13172,"date":"2026-02-23T09:19:43","date_gmt":"2026-02-23T14:19:43","guid":{"rendered":"https:\/\/www.rochester.edu\/oee\/?page_id=13172"},"modified":"2026-02-23T09:19:43","modified_gmt":"2026-02-23T14:19:43","slug":"restorative-practices-referral-form","status":"publish","type":"page","link":"https:\/\/www.rochester.edu\/oee\/restorative-practices-referral-form\/","title":{"rendered":"Restorative Practices Referral Form"},"content":{"rendered":"<script>\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 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data-form-index='0' id='gform_wrapper_62' style='display:none'>\n<div class='gform_heading'>\n<h2 class=\"gform_title\">Restorative Practices Referral Form<\/h2>\n<p class='gform_description'>\n<\/p><\/div>\n<form method='post' enctype='multipart\/form-data'  id='gform_62'  novalidate action='\/oee\/wp-json\/wp\/v2\/pages\/13172' data-formid='62' novalidate>\n<div class='gform-body gform_body'>\n<div id='gform_fields_62' class='gform_fields top_label form_sublabel_below description_below validation_below'>\n<fieldset id=\"field_62_4\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gf-name form-control-icon-complex\"  data-field-class=\"gf-name form-control-icon-complex\" >\n<legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend>\n<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_62_4'>\n<p>                            <span id='input_62_4_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' ><br \/>\n                                                    <input type='text' name='input_4.3' id='input_62_4_3' value=''   aria-required='true'     \/><br \/>\n                                                    <label for='input_62_4_3' class='gform-field-label gform-field-label--type-sub '>First<\/label><br \/>\n                                                <\/span><\/p>\n<p>                            <span id='input_62_4_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' ><br \/>\n                                                    <input type='text' name='input_4.6' id='input_62_4_6' value=''   aria-required='true'     \/><br \/>\n                                                    <label for='input_62_4_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label><br \/>\n                                                <\/span><\/p><\/div>\n<\/fieldset>\n<div id=\"field_62_6\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_62_6'><span class='gform-field-label__text'>Department<\/span><\/label><\/p>\n<div class='ginput_container ginput_container_text'><input name='input_6' id='input_62_6' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div>\n<\/div>\n<div id=\"field_62_7\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full field_sublabel_below gfield--no-description 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