<div class="main-form appointment-form-2">
    <div class="row">
        <div class="col-sm-12">
            <div class="input-group">[text your-name placeholder "Your Name *"]</div>
            <div class="input-group">[text your-email placeholder "Your Email *"]</div>
            <div class="input-group">[select SelectYourDoctor "Select Your Doctor" "Dr. Anna Willey" "Dr. Edward Berry" "Dr. Eliza William" "Dr. Charlie Smith" "Dr. Maria Mitchell"]</div>
            <div class="input-group input-button">[textarea message placeholder 40x4 "Comment"]</div>
            <div class="input-group">[submit  "Services at One Glance"]</div>
        </div>
    </div>
</div>