{"id":2986,"date":"2026-03-19T19:07:58","date_gmt":"2026-03-19T19:07:58","guid":{"rendered":"https:\/\/carevetdev.kinsta.cloud\/mulnix\/?page_id=2986"},"modified":"2026-03-19T19:07:58","modified_gmt":"2026-03-19T19:07:58","slug":"acupuncture-form","status":"publish","type":"page","link":"https:\/\/www.carevet.com\/mulnix\/acupuncture-form\/","title":{"rendered":"Acupuncture 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 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<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_9' style='display:none'><div id='gf_9' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_9' id='gform_9'  action='\/mulnix\/wp-json\/wp\/v2\/pages\/2986#gf_9' data-formid='9' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_9' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_9_1\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Welcome to the world of Integrative Veterinary Medicine, the combination of Conventional (or Western) Modern Medicine and Traditional Chinese Medicine. \n\nPlease take the time to fill out this questionnaire to the best of your ability. It may be best to read the questionnaire, fill out the easier points and then observe your pet for the next couple of days to answer questions you are not sure about. The more detailed and accurate your answers, the more accurate the Traditional Chinese Medical diagnosis will be, and therefore the more effective the treatment can be. \n\nTreatment success is based on identifying an individual patient's underlying \u201cpattern\u201d of imbalance and how it may be contributing to health problems unique to them. These questions, along with a Traditional Chinese Medicine Veterinary Exam, will guide how we approach needle placement, and what supplemental food therapies or Herbal therapies we can consider adding to help re-balance the body.  \n<\/div><div id=\"field_9_3\" class=\"gfield gfield--type-html gfield--input-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\"  ><h2 class=\"color--primary\">Medical History<\/h2><\/div><fieldset id=\"field_9_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\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><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_9_4'>\n                            \n                            <span id='input_9_4_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_4.3' id='input_9_4_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_9_4_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_9_4_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_4.6' id='input_9_4_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_9_4_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_9_5\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full 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_9_5'>Patient Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_9_5' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_6\" class=\"gfield gfield--type-textarea gfield--input-type-textarea 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_9_6'>What are the main reasons you are seeking an Integrative consultation and acupuncture treatment? If there is more than one health concern at this time, please list them in order of the most important first.<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_6' id='input_9_6' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_7\" class=\"gfield gfield--type-textarea gfield--input-type-textarea 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_9_7'>What are your expectations\/goals with acupuncture treatments?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_7' id='input_9_7' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_8\" class=\"gfield gfield--type-html gfield--input-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\"  ><h2 class=\"color--primary\">Inherent Constitutions<\/h2>\n\nIn Traditional Chinese Medicine, individuals can be categorized to fit into one or two particular Elements. There are five elements, and it organizes certain characteristics of an individual's personality to describe the relationship between the body's internal organs as well as the relationship between the body and the natural environment in which it exists. The state of an individual's health can be influenced by their \"inherent\" elemental status and influences the animal's body structure, health, emotions, and when exposed to the same stress factors, individuals of different constitutions will react in a different way, whether it is positively or negatively. When a constitution is in balance, there is harmony and health in the system. When unbalanced, there is disease. Check all that apply below for your pet so we can get a better idea of their inherent constitution. Do not worry if you have several symptoms or characteristics that fall into different boxes! \n\n\n\n<\/div><fieldset id=\"field_9_9\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Balanced (Fire)<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_9'><div class='gchoice gchoice_9_9_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.1' type='checkbox'  value='Lively \/ very happy'  id='choice_9_9_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_9_1' id='label_9_9_1' class='gform-field-label gform-field-label--type-inline'>Lively \/ very happy<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_9_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.2' type='checkbox'  value='Very friendly'  id='choice_9_9_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_9_2' id='label_9_9_2' class='gform-field-label gform-field-label--type-inline'>Very friendly<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_9_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.3' type='checkbox'  value='Vocal \/ noisy \/ talker'  id='choice_9_9_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_9_3' id='label_9_9_3' class='gform-field-label gform-field-label--type-inline'>Vocal \/ noisy \/ talker<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_9_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.4' type='checkbox'  value='Loves to be pet'  id='choice_9_9_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_9_4' id='label_9_9_4' class='gform-field-label gform-field-label--type-inline'>Loves to be pet<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_9_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.5' type='checkbox'  value='Center of attention'  id='choice_9_9_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_9_5' id='label_9_9_5' class='gform-field-label gform-field-label--type-inline'>Center of attention<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_9_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.6' type='checkbox'  value='Social butterfly'  id='choice_9_9_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_9_6' id='label_9_9_6' class='gform-field-label gform-field-label--type-inline'>Social butterfly<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_9_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.7' type='checkbox'  value='Excitable'  id='choice_9_9_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_9_7' id='label_9_9_7' class='gform-field-label gform-field-label--type-inline'>Excitable<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_9_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.8' type='checkbox'  value='Pushy \/ needy'  id='choice_9_9_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_9_8' id='label_9_9_8' class='gform-field-label gform-field-label--type-inline'>Pushy \/ needy<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_9_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.9' type='checkbox'  value='Opinionated'  id='choice_9_9_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_9_9' id='label_9_9_9' class='gform-field-label gform-field-label--type-inline'>Opinionated<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_9_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.11' type='checkbox'  value='Charismatic'  id='choice_9_9_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_9_11' id='label_9_9_11' class='gform-field-label gform-field-label--type-inline'>Charismatic<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_10\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Imbalanced (Fire)<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_10'><div class='gchoice gchoice_9_10_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.1' type='checkbox'  value='Insomnia'  id='choice_9_10_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_10_1' id='label_9_10_1' class='gform-field-label gform-field-label--type-inline'>Insomnia<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_10_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.2' type='checkbox'  value='Separation anxiety'  id='choice_9_10_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_10_2' id='label_9_10_2' class='gform-field-label gform-field-label--type-inline'>Separation anxiety<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_10_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.3' type='checkbox'  value='Restless'  id='choice_9_10_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_10_3' id='label_9_10_3' class='gform-field-label gform-field-label--type-inline'>Restless<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_10_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.4' type='checkbox'  value='Excessive heat'  id='choice_9_10_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_10_4' id='label_9_10_4' class='gform-field-label gform-field-label--type-inline'>Excessive heat<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_10_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.5' type='checkbox'  value='Rapid heart rate'  id='choice_9_10_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_10_5' id='label_9_10_5' class='gform-field-label gform-field-label--type-inline'>Rapid heart rate<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_10_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.6' type='checkbox'  value='Heart problems'  id='choice_9_10_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_10_6' id='label_9_10_6' class='gform-field-label gform-field-label--type-inline'>Heart problems<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_10_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.7' type='checkbox'  value='Manic behavior'  id='choice_9_10_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_10_7' id='label_9_10_7' class='gform-field-label gform-field-label--type-inline'>Manic behavior<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_10_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.8' type='checkbox'  value='Hypertension'  id='choice_9_10_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_10_8' id='label_9_10_8' class='gform-field-label gform-field-label--type-inline'>Hypertension<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_10_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.9' type='checkbox'  value='Oral ulcers'  id='choice_9_10_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_10_9' id='label_9_10_9' class='gform-field-label gform-field-label--type-inline'>Oral ulcers<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_10_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.11' type='checkbox'  value='Confusion'  id='choice_9_10_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_10_11' id='label_9_10_11' class='gform-field-label gform-field-label--type-inline'>Confusion<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_11\" class=\"gfield gfield--type-html gfield--input-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\"  ><h3>Earth<\/h3><\/div><fieldset id=\"field_9_12\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Balanced (Earth)<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_12'><div class='gchoice gchoice_9_12_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.1' type='checkbox'  value='Relaxed, laid back'  id='choice_9_12_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_12_1' id='label_9_12_1' class='gform-field-label gform-field-label--type-inline'>Relaxed, laid back<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_12_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.2' type='checkbox'  value='Sociable'  id='choice_9_12_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_12_2' id='label_9_12_2' class='gform-field-label gform-field-label--type-inline'>Sociable<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_12_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.3' type='checkbox'  value='Heavier set body'  id='choice_9_12_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_12_3' id='label_9_12_3' class='gform-field-label gform-field-label--type-inline'>Heavier set body<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_12_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.4' type='checkbox'  value='Loyal'  id='choice_9_12_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_12_4' id='label_9_12_4' class='gform-field-label gform-field-label--type-inline'>Loyal<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_12_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.5' type='checkbox'  value='Serene \/ balanced'  id='choice_9_12_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_12_5' id='label_9_12_5' class='gform-field-label gform-field-label--type-inline'>Serene \/ balanced<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_12_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.6' type='checkbox'  value='People pleaser'  id='choice_9_12_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_12_6' id='label_9_12_6' class='gform-field-label gform-field-label--type-inline'>People pleaser<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_12_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.7' type='checkbox'  value='Peacemaker'  id='choice_9_12_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_12_7' id='label_9_12_7' class='gform-field-label gform-field-label--type-inline'>Peacemaker<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_12_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.8' type='checkbox'  value='Agreeable'  id='choice_9_12_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_12_8' id='label_9_12_8' class='gform-field-label gform-field-label--type-inline'>Agreeable<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_12_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.9' type='checkbox'  value='Nurturing \/ motherly'  id='choice_9_12_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_12_9' id='label_9_12_9' class='gform-field-label gform-field-label--type-inline'>Nurturing \/ motherly<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_12_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.11' type='checkbox'  value='No one is a stranger'  id='choice_9_12_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_12_11' id='label_9_12_11' class='gform-field-label gform-field-label--type-inline'>No one is a stranger<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_13\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Imbalanced (Earth)<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_13'><div class='gchoice gchoice_9_13_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.1' type='checkbox'  value='Diarrhea'  id='choice_9_13_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_13_1' id='label_9_13_1' class='gform-field-label gform-field-label--type-inline'>Diarrhea<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_13_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.2' type='checkbox'  value='Constipation'  id='choice_9_13_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_13_2' id='label_9_13_2' class='gform-field-label gform-field-label--type-inline'>Constipation<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_13_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.3' type='checkbox'  value='Obesity'  id='choice_9_13_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_13_3' id='label_9_13_3' class='gform-field-label gform-field-label--type-inline'>Obesity<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_13_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.4' type='checkbox'  value='Vomiting'  id='choice_9_13_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_13_4' id='label_9_13_4' class='gform-field-label gform-field-label--type-inline'>Vomiting<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_13_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.5' type='checkbox'  value='Gum disease'  id='choice_9_13_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_13_5' id='label_9_13_5' class='gform-field-label gform-field-label--type-inline'>Gum disease<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_13_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.6' type='checkbox'  value='Weak muscles'  id='choice_9_13_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_13_6' id='label_9_13_6' class='gform-field-label gform-field-label--type-inline'>Weak muscles<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_13_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.7' type='checkbox'  value='Excessive worry'  id='choice_9_13_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_13_7' id='label_9_13_7' class='gform-field-label gform-field-label--type-inline'>Excessive worry<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_13_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.8' type='checkbox'  value='Lipomas'  id='choice_9_13_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_13_8' id='label_9_13_8' class='gform-field-label gform-field-label--type-inline'>Lipomas<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_13_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.9' type='checkbox'  value='Smothering'  id='choice_9_13_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_13_9' id='label_9_13_9' class='gform-field-label gform-field-label--type-inline'>Smothering<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_13_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.11' type='checkbox'  value='Overprotective'  id='choice_9_13_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_13_11' id='label_9_13_11' class='gform-field-label gform-field-label--type-inline'>Overprotective<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_13_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.12' type='checkbox'  value='Loss of appetite'  id='choice_9_13_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_13_12' id='label_9_13_12' class='gform-field-label gform-field-label--type-inline'>Loss of appetite<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_14\" class=\"gfield gfield--type-html gfield--input-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\"  ><h3>Metal<\/h3><\/div><fieldset id=\"field_9_15\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Balanced (Metal)<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_15'><div class='gchoice gchoice_9_15_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_15.1' type='checkbox'  value='Loves order \/ structure'  id='choice_9_15_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_15_1' id='label_9_15_1' class='gform-field-label gform-field-label--type-inline'>Loves order \/ structure<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_15_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_15.2' type='checkbox'  value='Obeys the rules'  id='choice_9_15_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_15_2' id='label_9_15_2' class='gform-field-label gform-field-label--type-inline'>Obeys the rules<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_15_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_15.3' type='checkbox'  value='Aloof'  id='choice_9_15_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_15_3' id='label_9_15_3' class='gform-field-label gform-field-label--type-inline'>Aloof<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_15_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_15.4' type='checkbox'  value='Symmetrical body'  id='choice_9_15_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_15_4' id='label_9_15_4' class='gform-field-label gform-field-label--type-inline'>Symmetrical body<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_15_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_15.5' type='checkbox'  value='Disciplined attitude'  id='choice_9_15_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_15_5' id='label_9_15_5' class='gform-field-label gform-field-label--type-inline'>Disciplined attitude<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_15_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_15.6' type='checkbox'  value='Perfectionist'  id='choice_9_15_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_15_6' id='label_9_15_6' class='gform-field-label gform-field-label--type-inline'>Perfectionist<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_15_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_15.7' type='checkbox'  value='Intellectual'  id='choice_9_15_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_15_7' id='label_9_15_7' class='gform-field-label gform-field-label--type-inline'>Intellectual<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_15_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_15.8' type='checkbox'  value='Emotions in check'  id='choice_9_15_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_15_8' id='label_9_15_8' class='gform-field-label gform-field-label--type-inline'>Emotions in check<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_15_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_15.9' type='checkbox'  value='Hard worker'  id='choice_9_15_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_15_9' id='label_9_15_9' class='gform-field-label gform-field-label--type-inline'>Hard worker<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_15_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_15.11' type='checkbox'  value='Loner'  id='choice_9_15_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_15_11' id='label_9_15_11' class='gform-field-label gform-field-label--type-inline'>Loner<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_16\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Imbalanced (Metal)<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_16'><div class='gchoice gchoice_9_16_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.1' type='checkbox'  value='Obsessive behavior'  id='choice_9_16_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_16_1' id='label_9_16_1' class='gform-field-label gform-field-label--type-inline'>Obsessive behavior<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_16_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.2' type='checkbox'  value='Rigid in beliefs'  id='choice_9_16_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_16_2' id='label_9_16_2' class='gform-field-label gform-field-label--type-inline'>Rigid in beliefs<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_16_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.3' type='checkbox'  value='Holds grudges'  id='choice_9_16_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_16_3' id='label_9_16_3' class='gform-field-label gform-field-label--type-inline'>Holds grudges<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_16_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.4' type='checkbox'  value='Distances'  id='choice_9_16_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_16_4' id='label_9_16_4' class='gform-field-label gform-field-label--type-inline'>Distances<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_16_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.5' type='checkbox'  value='Roams \/ wanders'  id='choice_9_16_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_16_5' id='label_9_16_5' class='gform-field-label gform-field-label--type-inline'>Roams \/ wanders<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_16_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.6' type='checkbox'  value='Coughing \/ sinus \/ asthma'  id='choice_9_16_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_16_6' id='label_9_16_6' class='gform-field-label gform-field-label--type-inline'>Coughing \/ sinus \/ asthma<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_16_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.7' type='checkbox'  value='Dry hair coat'  id='choice_9_16_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_16_7' id='label_9_16_7' class='gform-field-label gform-field-label--type-inline'>Dry hair coat<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_16_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.8' type='checkbox'  value='Nose problems'  id='choice_9_16_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_16_8' id='label_9_16_8' class='gform-field-label gform-field-label--type-inline'>Nose problems<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_16_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.9' type='checkbox'  value='Resists training'  id='choice_9_16_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_16_9' id='label_9_16_9' class='gform-field-label gform-field-label--type-inline'>Resists training<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_16_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.11' type='checkbox'  value='Needs recognition'  id='choice_9_16_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_16_11' id='label_9_16_11' class='gform-field-label gform-field-label--type-inline'>Needs recognition<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_17\" class=\"gfield gfield--type-html gfield--input-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\"  ><h3>Wood<\/h3><\/div><fieldset id=\"field_9_18\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Balanced (Wood)<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_18'><div class='gchoice gchoice_9_18_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.1' type='checkbox'  value='Decisive'  id='choice_9_18_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_18_1' id='label_9_18_1' class='gform-field-label gform-field-label--type-inline'>Decisive<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_18_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.2' type='checkbox'  value='Assertive'  id='choice_9_18_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_18_2' id='label_9_18_2' class='gform-field-label gform-field-label--type-inline'>Assertive<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_18_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.3' type='checkbox'  value='Confident'  id='choice_9_18_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_18_3' id='label_9_18_3' class='gform-field-label gform-field-label--type-inline'>Confident<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_18_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.4' type='checkbox'  value='Strong \/ leader'  id='choice_9_18_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_18_4' id='label_9_18_4' class='gform-field-label gform-field-label--type-inline'>Strong \/ leader<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_18_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.5' type='checkbox'  value='Impulsive'  id='choice_9_18_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_18_5' id='label_9_18_5' class='gform-field-label gform-field-label--type-inline'>Impulsive<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_18_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.6' type='checkbox'  value='Athletic'  id='choice_9_18_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_18_6' id='label_9_18_6' class='gform-field-label gform-field-label--type-inline'>Athletic<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_18_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.7' type='checkbox'  value='Goal-oriented'  id='choice_9_18_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_18_7' id='label_9_18_7' class='gform-field-label gform-field-label--type-inline'>Goal-oriented<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_18_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.8' type='checkbox'  value='Does well under pressure'  id='choice_9_18_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_18_8' id='label_9_18_8' class='gform-field-label gform-field-label--type-inline'>Does well under pressure<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_18_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.9' type='checkbox'  value='Impatient'  id='choice_9_18_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_18_9' id='label_9_18_9' class='gform-field-label gform-field-label--type-inline'>Impatient<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_18_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.11' type='checkbox'  value='Alpha animal'  id='choice_9_18_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_18_11' id='label_9_18_11' class='gform-field-label gform-field-label--type-inline'>Alpha animal<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_19\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Imbalanced (Wood)<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_19'><div class='gchoice gchoice_9_19_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.1' type='checkbox'  value='Angers easily'  id='choice_9_19_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_19_1' id='label_9_19_1' class='gform-field-label gform-field-label--type-inline'>Angers easily<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_19_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.2' type='checkbox'  value='Irritable'  id='choice_9_19_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_19_2' id='label_9_19_2' class='gform-field-label gform-field-label--type-inline'>Irritable<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_19_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.3' type='checkbox'  value='Arrogant'  id='choice_9_19_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_19_3' id='label_9_19_3' class='gform-field-label gform-field-label--type-inline'>Arrogant<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_19_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.4' type='checkbox'  value='Selfish'  id='choice_9_19_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_19_4' id='label_9_19_4' class='gform-field-label gform-field-label--type-inline'>Selfish<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_19_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.5' type='checkbox'  value='Lashes out'  id='choice_9_19_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_19_5' id='label_9_19_5' class='gform-field-label gform-field-label--type-inline'>Lashes out<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_19_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.6' type='checkbox'  value='Gets frustrated'  id='choice_9_19_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_19_6' id='label_9_19_6' class='gform-field-label gform-field-label--type-inline'>Gets frustrated<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_19_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.7' type='checkbox'  value='Edgy \/ tense'  id='choice_9_19_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_19_7' id='label_9_19_7' class='gform-field-label gform-field-label--type-inline'>Edgy \/ tense<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_19_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.8' type='checkbox'  value='Tendon issues'  id='choice_9_19_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_19_8' id='label_9_19_8' class='gform-field-label gform-field-label--type-inline'>Tendon issues<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_19_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.9' type='checkbox'  value='Eye disease'  id='choice_9_19_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_19_9' id='label_9_19_9' class='gform-field-label gform-field-label--type-inline'>Eye disease<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_19_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.11' type='checkbox'  value='Liver disease'  id='choice_9_19_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_19_11' id='label_9_19_11' class='gform-field-label gform-field-label--type-inline'>Liver disease<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_19_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.12' type='checkbox'  value='Ear issues'  id='choice_9_19_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_19_12' id='label_9_19_12' class='gform-field-label gform-field-label--type-inline'>Ear issues<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_19_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.13' type='checkbox'  value='Nail \/ footpad issues'  id='choice_9_19_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_19_13' id='label_9_19_13' class='gform-field-label gform-field-label--type-inline'>Nail \/ footpad issues<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_19_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.14' type='checkbox'  value='Anal sac issues'  id='choice_9_19_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_19_14' id='label_9_19_14' class='gform-field-label gform-field-label--type-inline'>Anal sac issues<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_20\" class=\"gfield gfield--type-html gfield--input-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\"  ><h3>Water<\/h3><\/div><fieldset id=\"field_9_21\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Balanced (Water)<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_21'><div class='gchoice gchoice_9_21_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.1' type='checkbox'  value='Careful \/ cautious'  id='choice_9_21_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_21_1' id='label_9_21_1' class='gform-field-label gform-field-label--type-inline'>Careful \/ cautious<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_21_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.2' type='checkbox'  value='Curious'  id='choice_9_21_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_21_2' id='label_9_21_2' class='gform-field-label gform-field-label--type-inline'>Curious<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_21_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.3' type='checkbox'  value='Self-contained'  id='choice_9_21_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_21_3' id='label_9_21_3' class='gform-field-label gform-field-label--type-inline'>Self-contained<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_21_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.4' type='checkbox'  value='Likes to hide'  id='choice_9_21_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_21_4' id='label_9_21_4' class='gform-field-label gform-field-label--type-inline'>Likes to hide<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_21_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.5' type='checkbox'  value='Meditative'  id='choice_9_21_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_21_5' id='label_9_21_5' class='gform-field-label gform-field-label--type-inline'>Meditative<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_21_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.6' type='checkbox'  value='Slow and consistent'  id='choice_9_21_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_21_6' id='label_9_21_6' class='gform-field-label gform-field-label--type-inline'>Slow and consistent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_21_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.7' type='checkbox'  value='Introvert \/ wallflower'  id='choice_9_21_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_21_7' id='label_9_21_7' class='gform-field-label gform-field-label--type-inline'>Introvert \/ wallflower<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_21_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.8' type='checkbox'  value='Not spontaneous'  id='choice_9_21_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_21_8' id='label_9_21_8' class='gform-field-label gform-field-label--type-inline'>Not spontaneous<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_21_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.9' type='checkbox'  value='Restrained'  id='choice_9_21_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_21_9' id='label_9_21_9' class='gform-field-label gform-field-label--type-inline'>Restrained<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_21_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.11' type='checkbox'  value='Unobtrusive'  id='choice_9_21_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_21_11' id='label_9_21_11' class='gform-field-label gform-field-label--type-inline'>Unobtrusive<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_22\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Imbalanced (Water)<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_22'><div class='gchoice gchoice_9_22_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.1' type='checkbox'  value='Fearful'  id='choice_9_22_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_22_1' id='label_9_22_1' class='gform-field-label gform-field-label--type-inline'>Fearful<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_22_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.2' type='checkbox'  value='Withdrawn'  id='choice_9_22_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_22_2' id='label_9_22_2' class='gform-field-label gform-field-label--type-inline'>Withdrawn<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_22_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.3' type='checkbox'  value='Hates newness'  id='choice_9_22_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_22_3' id='label_9_22_3' class='gform-field-label gform-field-label--type-inline'>Hates newness<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_22_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.4' type='checkbox'  value='Rear weakness'  id='choice_9_22_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_22_4' id='label_9_22_4' class='gform-field-label gform-field-label--type-inline'>Rear weakness<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_22_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.5' type='checkbox'  value='Arthritis'  id='choice_9_22_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_22_5' id='label_9_22_5' class='gform-field-label gform-field-label--type-inline'>Arthritis<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_22_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.6' type='checkbox'  value='Bone \/ back issues'  id='choice_9_22_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_22_6' id='label_9_22_6' class='gform-field-label gform-field-label--type-inline'>Bone \/ back issues<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_22_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.7' type='checkbox'  value='Urinary disease'  id='choice_9_22_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_22_7' id='label_9_22_7' class='gform-field-label gform-field-label--type-inline'>Urinary disease<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_22_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.8' type='checkbox'  value='Overwhelmed'  id='choice_9_22_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_22_8' id='label_9_22_8' class='gform-field-label gform-field-label--type-inline'>Overwhelmed<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_22_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.9' type='checkbox'  value='Noise phobias'  id='choice_9_22_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_22_9' id='label_9_22_9' class='gform-field-label gform-field-label--type-inline'>Noise phobias<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_22_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.11' type='checkbox'  value='Deafness'  id='choice_9_22_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_22_11' id='label_9_22_11' class='gform-field-label gform-field-label--type-inline'>Deafness<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_22_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.12' type='checkbox'  value='Congenital diseases'  id='choice_9_22_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_22_12' id='label_9_22_12' class='gform-field-label gform-field-label--type-inline'>Congenital diseases<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_22_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.13' type='checkbox'  value='Reproductive issues'  id='choice_9_22_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_22_13' id='label_9_22_13' class='gform-field-label gform-field-label--type-inline'>Reproductive issues<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_24\" class=\"gfield gfield--type-html gfield--input-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\"  ><h2 class=\"color--primary\">Temperature \/ Energetics<\/h2><\/div><fieldset id=\"field_9_23\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is your pet mostly<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_23'>\n\t\t\t<div class='gchoice gchoice_9_23_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='Heat seeking (Likes to be under blankets, in the sun for long periods, has an aversion to going outside when it is cold)'  id='choice_9_23_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_23_0' id='label_9_23_0' class='gform-field-label gform-field-label--type-inline'>Heat seeking (Likes to be under blankets, in the sun for long periods, has an aversion to going outside when it is cold)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_23_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='Cold seeking (Likes to be on cool floors, seeks shade. sleeps on top of blankets, pants often and drinks water frequently)'  id='choice_9_23_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_23_1' id='label_9_23_1' class='gform-field-label gform-field-label--type-inline'>Cold seeking (Likes to be on cool floors, seeks shade. sleeps on top of blankets, pants often and drinks water frequently)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_23_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='Neutral'  id='choice_9_23_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_23_2' id='label_9_23_2' class='gform-field-label gform-field-label--type-inline'>Neutral<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_28\" class=\"gfield gfield--type-html gfield--input-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\"  ><p>Check all that apply<\/p><\/div><fieldset id=\"field_9_25\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >YIN (Excess Cold)<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_25'><div class='gchoice gchoice_9_25_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_25.1' type='checkbox'  value='Pet pants very little at rest'  id='choice_9_25_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_25_1' id='label_9_25_1' class='gform-field-label gform-field-label--type-inline'>Pet pants very little at rest<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_25_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_25.2' type='checkbox'  value='Pet sleeps under the warm covers'  id='choice_9_25_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_25_2' id='label_9_25_2' class='gform-field-label gform-field-label--type-inline'>Pet sleeps under the warm covers<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_25_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_25.3' type='checkbox'  value='Pet loves to cuddle'  id='choice_9_25_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_25_3' id='label_9_25_3' class='gform-field-label gform-field-label--type-inline'>Pet loves to cuddle<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_25_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_25.4' type='checkbox'  value='Pet loves to sleep in the sun'  id='choice_9_25_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_25_4' id='label_9_25_4' class='gform-field-label gform-field-label--type-inline'>Pet loves to sleep in the sun<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_25_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_25.5' type='checkbox'  value='Pet does not like the snow\/cold'  id='choice_9_25_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_25_5' id='label_9_25_5' class='gform-field-label gform-field-label--type-inline'>Pet does not like the snow\/cold<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_25_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_25.6' type='checkbox'  value='Pet is sluggish'  id='choice_9_25_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_25_6' id='label_9_25_6' class='gform-field-label gform-field-label--type-inline'>Pet is sluggish<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_25_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_25.7' type='checkbox'  value='Pet is older\/geriatric'  id='choice_9_25_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_25_7' id='label_9_25_7' class='gform-field-label gform-field-label--type-inline'>Pet is older\/geriatric<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_25_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_25.8' type='checkbox'  value='Pet drinks very little'  id='choice_9_25_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_25_8' id='label_9_25_8' class='gform-field-label gform-field-label--type-inline'>Pet drinks very little<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_25_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_25.9' type='checkbox'  value='Pet has a wet nose with clear drainage'  id='choice_9_25_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_25_9' id='label_9_25_9' class='gform-field-label gform-field-label--type-inline'>Pet has a wet nose with clear drainage<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_25_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_25.11' type='checkbox'  value='Pet typically feels cool to the touch'  id='choice_9_25_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_25_11' id='label_9_25_11' class='gform-field-label gform-field-label--type-inline'>Pet typically feels cool to the touch<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_26\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >YANG (Excess Heat)<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_26'><div class='gchoice gchoice_9_26_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.1' type='checkbox'  value='Pet pants a lot at rest'  id='choice_9_26_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_26_1' id='label_9_26_1' class='gform-field-label gform-field-label--type-inline'>Pet pants a lot at rest<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_26_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.2' type='checkbox'  value='Pet sleeps on cold title \/ linoleum floor'  id='choice_9_26_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_26_2' id='label_9_26_2' class='gform-field-label gform-field-label--type-inline'>Pet sleeps on cold title \/ linoleum floor<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_26_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.3' type='checkbox'  value='Pet does not like to cuddle'  id='choice_9_26_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_26_3' id='label_9_26_3' class='gform-field-label gform-field-label--type-inline'>Pet does not like to cuddle<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_26_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.4' type='checkbox'  value='Pet prefers to sleep in the shade'  id='choice_9_26_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_26_4' id='label_9_26_4' class='gform-field-label gform-field-label--type-inline'>Pet prefers to sleep in the shade<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_26_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.5' type='checkbox'  value='Pet loves to play in the snow \/ cold'  id='choice_9_26_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_26_5' id='label_9_26_5' class='gform-field-label gform-field-label--type-inline'>Pet loves to play in the snow \/ cold<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_26_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.6' type='checkbox'  value='Pet is hyperactive \/ restless'  id='choice_9_26_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_26_6' id='label_9_26_6' class='gform-field-label gform-field-label--type-inline'>Pet is hyperactive \/ restless<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_26_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.7' type='checkbox'  value='Pet is young'  id='choice_9_26_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_26_7' id='label_9_26_7' class='gform-field-label gform-field-label--type-inline'>Pet is young<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_26_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.8' type='checkbox'  value='Pet drinks excessively'  id='choice_9_26_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_26_8' id='label_9_26_8' class='gform-field-label gform-field-label--type-inline'>Pet drinks excessively<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_26_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.9' type='checkbox'  value='Pet has a dry \/ cracked nose or pads'  id='choice_9_26_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_26_9' id='label_9_26_9' class='gform-field-label gform-field-label--type-inline'>Pet has a dry \/ cracked nose or pads<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_26_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.11' type='checkbox'  value='Pet typically feels warm to the touch'  id='choice_9_26_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_26_11' id='label_9_26_11' class='gform-field-label gform-field-label--type-inline'>Pet typically feels warm to the touch<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_29\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"color--primary\">General Behavior<\/h2><\/div><fieldset id=\"field_9_30\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Does your pet sleep through the night?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_30'>\n\t\t\t<div class='gchoice gchoice_9_30_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='Yes'  id='choice_9_30_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_30_0' id='label_9_30_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_30_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='No'  id='choice_9_30_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_30_1' id='label_9_30_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_31\" class=\"gfield gfield--type-textarea gfield--input-type-textarea 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_9_31'>You selected &quot;No&quot;, please describe what happens<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_31' id='input_9_31' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_32\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full 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_9_32'>What is your pet\u2019s current energy level? How does this compare to their usual?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_32' id='input_9_32' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_33\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"color--primary\">Appetite and Drinking Behavior<\/h2><\/div><fieldset id=\"field_9_34\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Appetite<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_34'>\n\t\t\t<div class='gchoice gchoice_9_34_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='Normal'  id='choice_9_34_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_34_0' id='label_9_34_0' class='gform-field-label gform-field-label--type-inline'>Normal<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_34_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='Decreased'  id='choice_9_34_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_34_1' id='label_9_34_1' class='gform-field-label gform-field-label--type-inline'>Decreased<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_34_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='Increased'  id='choice_9_34_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_34_2' id='label_9_34_2' class='gform-field-label gform-field-label--type-inline'>Increased<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_35\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Eating Habits<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_35'>\n\t\t\t<div class='gchoice gchoice_9_35_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='Changed'  id='choice_9_35_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_35_0' id='label_9_35_0' class='gform-field-label gform-field-label--type-inline'>Changed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_35_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='Unchanged'  id='choice_9_35_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_35_1' id='label_9_35_1' class='gform-field-label gform-field-label--type-inline'>Unchanged<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_36\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Water Intake<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_36'>\n\t\t\t<div class='gchoice gchoice_9_36_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='Normal'  id='choice_9_36_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_36_0' id='label_9_36_0' class='gform-field-label gform-field-label--type-inline'>Normal<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_36_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='Decreased'  id='choice_9_36_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_36_1' id='label_9_36_1' class='gform-field-label gform-field-label--type-inline'>Decreased<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_36_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='Increased'  id='choice_9_36_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_36_2' id='label_9_36_2' class='gform-field-label gform-field-label--type-inline'>Increased<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_38\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"color--primary\">Vomiting and Defecation<\/h2><\/div><fieldset id=\"field_9_39\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Vomiting?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_39'>\n\t\t\t<div class='gchoice gchoice_9_39_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_39' type='radio' value='Yes'  id='choice_9_39_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_39_0' id='label_9_39_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_39_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_39' type='radio' value='No'  id='choice_9_39_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_39_1' id='label_9_39_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_40\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >How often is your pet vomiting?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_40'>\n\t\t\t<div class='gchoice gchoice_9_40_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='Daily'  id='choice_9_40_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_40_0' id='label_9_40_0' class='gform-field-label gform-field-label--type-inline'>Daily<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_40_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='Weekly'  id='choice_9_40_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_40_1' id='label_9_40_1' class='gform-field-label gform-field-label--type-inline'>Weekly<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_40_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='Every 2-3 weeks'  id='choice_9_40_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_40_2' id='label_9_40_2' class='gform-field-label gform-field-label--type-inline'>Every 2-3 weeks<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_40_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='Monthly'  id='choice_9_40_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_40_3' id='label_9_40_3' class='gform-field-label gform-field-label--type-inline'>Monthly<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_40_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='Every few months'  id='choice_9_40_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_40_4' id='label_9_40_4' class='gform-field-label gform-field-label--type-inline'>Every few months<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_41\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >What time of day is your pet vomiting?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_41'>\n\t\t\t<div class='gchoice gchoice_9_41_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_41' type='radio' value='Unknown'  id='choice_9_41_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_41_0' id='label_9_41_0' class='gform-field-label gform-field-label--type-inline'>Unknown<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_41_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_41' type='radio' value='After eating'  id='choice_9_41_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_41_1' id='label_9_41_1' class='gform-field-label gform-field-label--type-inline'>After eating<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_41_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_41' type='radio' value='Mornings'  id='choice_9_41_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_41_2' id='label_9_41_2' class='gform-field-label gform-field-label--type-inline'>Mornings<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_41_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_41' type='radio' value='Evenings'  id='choice_9_41_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_41_3' id='label_9_41_3' class='gform-field-label gform-field-label--type-inline'>Evenings<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_41_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_41' type='radio' value='Anytime'  id='choice_9_41_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_41_4' id='label_9_41_4' class='gform-field-label gform-field-label--type-inline'>Anytime<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_42\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >What are the contents of the vomit?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_42'>\n\t\t\t<div class='gchoice gchoice_9_42_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='Undigested food'  id='choice_9_42_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_42_0' id='label_9_42_0' class='gform-field-label gform-field-label--type-inline'>Undigested food<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_42_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='Hair'  id='choice_9_42_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_42_1' id='label_9_42_1' class='gform-field-label gform-field-label--type-inline'>Hair<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_42_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='White \/ clear fluid'  id='choice_9_42_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_42_2' id='label_9_42_2' class='gform-field-label gform-field-label--type-inline'>White \/ clear fluid<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_42_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='Yellow bile'  id='choice_9_42_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_42_3' id='label_9_42_3' class='gform-field-label gform-field-label--type-inline'>Yellow bile<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_42_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='Blood tinged fluid'  id='choice_9_42_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_42_4' id='label_9_42_4' class='gform-field-label gform-field-label--type-inline'>Blood tinged fluid<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_42_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='gf_other_choice'  id='choice_9_42_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_42_5' id='label_9_42_5' class='gform-field-label gform-field-label--type-inline'>Other<\/label><br \/><input id='input_9_42_other' class='gchoice_other_control' name='input_42_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_50\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Have you noticed any of the following signs of acid reflux?<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_50'><div class='gchoice gchoice_9_50_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.1' type='checkbox'  value='Dry gagging or hacking cough'  id='choice_9_50_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_50_1' id='label_9_50_1' class='gform-field-label gform-field-label--type-inline'>Dry gagging or hacking cough<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_50_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.2' type='checkbox'  value='Repeated swallowing'  id='choice_9_50_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_50_2' id='label_9_50_2' class='gform-field-label gform-field-label--type-inline'>Repeated swallowing<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_50_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.3' type='checkbox'  value='Lip licking'  id='choice_9_50_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_50_3' id='label_9_50_3' class='gform-field-label gform-field-label--type-inline'>Lip licking<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_50_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.4' type='checkbox'  value='Burping'  id='choice_9_50_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_50_4' id='label_9_50_4' class='gform-field-label gform-field-label--type-inline'>Burping<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_50_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.5' type='checkbox'  value='Foul breath (like rancid food)'  id='choice_9_50_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_50_5' id='label_9_50_5' class='gform-field-label gform-field-label--type-inline'>Foul breath (like rancid food)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_50_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.6' type='checkbox'  value='Licking surfaces (floors, walls, carpet)'  id='choice_9_50_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_50_6' id='label_9_50_6' class='gform-field-label gform-field-label--type-inline'>Licking surfaces (floors, walls, carpet)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_44\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are your pet&#039;s stools:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_44'>\n\t\t\t<div class='gchoice gchoice_9_44_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='Normal'  id='choice_9_44_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_44_0' id='label_9_44_0' class='gform-field-label gform-field-label--type-inline'>Normal<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_44_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='Abnormal'  id='choice_9_44_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_44_1' id='label_9_44_1' class='gform-field-label gform-field-label--type-inline'>Abnormal<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_45\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full 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_9_45'>Describe what they look like?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_45' id='input_9_45' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_9_46\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >How often is your pet having abnormal stool?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_46'>\n\t\t\t<div class='gchoice gchoice_9_46_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='Daily'  id='choice_9_46_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_46_0' id='label_9_46_0' class='gform-field-label gform-field-label--type-inline'>Daily<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_46_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='Weekly'  id='choice_9_46_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_46_1' id='label_9_46_1' class='gform-field-label gform-field-label--type-inline'>Weekly<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_46_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='Monthly'  id='choice_9_46_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_46_2' id='label_9_46_2' class='gform-field-label gform-field-label--type-inline'>Monthly<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_46_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='Every 2-3 months'  id='choice_9_46_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_46_3' id='label_9_46_3' class='gform-field-label gform-field-label--type-inline'>Every 2-3 months<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_48\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Does your pet experience any of the following?<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_48'><div class='gchoice gchoice_9_48_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_48.1' type='checkbox'  value='Intestines that gurgle'  id='choice_9_48_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_48_1' id='label_9_48_1' class='gform-field-label gform-field-label--type-inline'>Intestines that gurgle<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_48_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_48.2' type='checkbox'  value='Flatulent \/ passing gas'  id='choice_9_48_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_48_2' id='label_9_48_2' class='gform-field-label gform-field-label--type-inline'>Flatulent \/ passing gas<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_48_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_48.3' type='checkbox'  value='Fecal incontinence'  id='choice_9_48_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_48_3' id='label_9_48_3' class='gform-field-label gform-field-label--type-inline'>Fecal incontinence<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_48_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_48.4' type='checkbox'  value='Constipation'  id='choice_9_48_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_48_4' id='label_9_48_4' class='gform-field-label gform-field-label--type-inline'>Constipation<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_51\" class=\"gfield gfield--type-html gfield--input-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\"  ><h2 class=\"color--primary\">Urination and Drinking<\/h2><\/div><fieldset id=\"field_9_52\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is your pet&#039;s urination:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_52'>\n\t\t\t<div class='gchoice gchoice_9_52_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_52' type='radio' value='Normal'  id='choice_9_52_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_52_0' id='label_9_52_0' class='gform-field-label gform-field-label--type-inline'>Normal<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_52_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_52' type='radio' value='Increased amount'  id='choice_9_52_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_52_1' id='label_9_52_1' class='gform-field-label gform-field-label--type-inline'>Increased amount<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_52_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_52' type='radio' value='Decreased amount'  id='choice_9_52_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_52_2' id='label_9_52_2' class='gform-field-label gform-field-label--type-inline'>Decreased amount<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_52_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_52' type='radio' value='Bloody'  id='choice_9_52_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_52_3' id='label_9_52_3' class='gform-field-label gform-field-label--type-inline'>Bloody<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_52_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_52' type='radio' value='Incontinent (dribbling or leaving puddles when resting)'  id='choice_9_52_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_52_4' id='label_9_52_4' class='gform-field-label gform-field-label--type-inline'>Incontinent (dribbling or leaving puddles when resting)<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_53\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is your pet&#039;s water intake:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_53'>\n\t\t\t<div class='gchoice gchoice_9_53_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_53' type='radio' value='Normal'  id='choice_9_53_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_53_0' id='label_9_53_0' class='gform-field-label gform-field-label--type-inline'>Normal<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_53_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_53' type='radio' value='Increased'  id='choice_9_53_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_53_1' id='label_9_53_1' class='gform-field-label gform-field-label--type-inline'>Increased<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_53_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_53' type='radio' value='Decreased'  id='choice_9_53_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_53_2' id='label_9_53_2' class='gform-field-label gform-field-label--type-inline'>Decreased<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_54\" class=\"gfield gfield--type-html gfield--input-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\"  ><h2 class=\"color--primary\">Coughing and Sneezing<\/h2><\/div><fieldset id=\"field_9_55\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is your pet coughing?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_55'>\n\t\t\t<div class='gchoice gchoice_9_55_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='Yes'  id='choice_9_55_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_55_0' id='label_9_55_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_55_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='No'  id='choice_9_55_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_55_1' id='label_9_55_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_56\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is your pet sneezing?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_56'>\n\t\t\t<div class='gchoice gchoice_9_56_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_56' type='radio' value='Yes'  id='choice_9_56_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_56_0' id='label_9_56_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_56_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_56' type='radio' value='No'  id='choice_9_56_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_56_1' id='label_9_56_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_57\" class=\"gfield gfield--type-html gfield--input-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\"  ><h2 class=\"color--primary\">Skin and Hair Coat<\/h2><\/div><fieldset id=\"field_9_58\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >What, if any, skin and hair coat issues is your pet experiencing?<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_58'><div class='gchoice gchoice_9_58_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.1' type='checkbox'  value='Dry skin \/ dandruff'  id='choice_9_58_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_58_1' id='label_9_58_1' class='gform-field-label gform-field-label--type-inline'>Dry skin \/ dandruff<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_58_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.2' type='checkbox'  value='Rash'  id='choice_9_58_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_58_2' id='label_9_58_2' class='gform-field-label gform-field-label--type-inline'>Rash<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_58_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.3' type='checkbox'  value='Odor to skin'  id='choice_9_58_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_58_3' id='label_9_58_3' class='gform-field-label gform-field-label--type-inline'>Odor to skin<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_58_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.4' type='checkbox'  value='Skin masses \/ growths'  id='choice_9_58_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_58_4' id='label_9_58_4' class='gform-field-label gform-field-label--type-inline'>Skin masses \/ growths<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_58_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.5' type='checkbox'  value='Greasy coat'  id='choice_9_58_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_58_5' id='label_9_58_5' class='gform-field-label gform-field-label--type-inline'>Greasy coat<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_58_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.6' type='checkbox'  value='Pestules'  id='choice_9_58_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_58_6' id='label_9_58_6' class='gform-field-label gform-field-label--type-inline'>Pestules<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_58_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.7' type='checkbox'  value='Flaky \/ broken nails'  id='choice_9_58_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_58_7' id='label_9_58_7' class='gform-field-label gform-field-label--type-inline'>Flaky \/ broken nails<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_58_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.8' type='checkbox'  value='Dry \/ cracked pads'  id='choice_9_58_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_58_8' id='label_9_58_8' class='gform-field-label gform-field-label--type-inline'>Dry \/ cracked pads<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_58_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.9' type='checkbox'  value='Dull coat'  id='choice_9_58_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_58_9' id='label_9_58_9' class='gform-field-label gform-field-label--type-inline'>Dull coat<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_58_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.11' type='checkbox'  value='Scabs'  id='choice_9_58_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_58_11' id='label_9_58_11' class='gform-field-label gform-field-label--type-inline'>Scabs<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_58_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.12' type='checkbox'  value='Ear infection'  id='choice_9_58_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_58_12' id='label_9_58_12' class='gform-field-label gform-field-label--type-inline'>Ear infection<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_58_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.13' type='checkbox'  value='Dry \/ cracked nose'  id='choice_9_58_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_58_13' id='label_9_58_13' class='gform-field-label gform-field-label--type-inline'>Dry \/ cracked nose<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_58_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.14' type='checkbox'  value='Hair loss'  id='choice_9_58_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_58_14' id='label_9_58_14' class='gform-field-label gform-field-label--type-inline'>Hair loss<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_58_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.15' type='checkbox'  value='Skin discoloration'  id='choice_9_58_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_58_15' id='label_9_58_15' class='gform-field-label gform-field-label--type-inline'>Skin discoloration<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_58_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.16' type='checkbox'  value='Anal sac issues'  id='choice_9_58_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_58_16' id='label_9_58_16' class='gform-field-label gform-field-label--type-inline'>Anal sac issues<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_58_17'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.17' type='checkbox'  value='Fleas \/ parasites'  id='choice_9_58_17'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_58_17' id='label_9_58_17' class='gform-field-label gform-field-label--type-inline'>Fleas \/ parasites<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_59\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full 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_9_59'>Rate your pet\u2019s level of scratching on a scale from 0 (no scratching at all) to 10 (pet is unable to stop scratching for any reason)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_59' id='input_9_59' type='number' step='any' min='0' max='10' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_instruction_9_59\" \/><div class='gfield_description instruction ' id='gfield_instruction_9_59'>Please enter a number from <strong>0<\/strong> to <strong>10<\/strong>.<\/div><\/div><\/div><div id=\"field_9_60\" class=\"gfield gfield--type-html gfield--input-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\"  ><h2 class=\"color--primary\">Mental Status<\/h2><\/div><fieldset id=\"field_9_61\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Has your pet undergone or experienced any recent stress? Check any that apply<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_61'><div class='gchoice gchoice_9_61_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_61.1' type='checkbox'  value='Loss of a housemate (human or animal sibling)'  id='choice_9_61_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_61_1' id='label_9_61_1' class='gform-field-label gform-field-label--type-inline'>Loss of a housemate (human or animal sibling)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_61_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_61.2' type='checkbox'  value='Recent adoption \/ addition of new pets to the household'  id='choice_9_61_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_61_2' id='label_9_61_2' class='gform-field-label gform-field-label--type-inline'>Recent adoption \/ addition of new pets to the household<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_61_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_61.3' type='checkbox'  value='Recent move'  id='choice_9_61_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_61_3' id='label_9_61_3' class='gform-field-label gform-field-label--type-inline'>Recent move<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_61_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_61.4' type='checkbox'  value='Recent stress at boarding or at home while you were traveling'  id='choice_9_61_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_61_4' id='label_9_61_4' class='gform-field-label gform-field-label--type-inline'>Recent stress at boarding or at home while you were traveling<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_62\" class=\"gfield gfield--type-html gfield--input-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\"  ><h2 class=\"color--primary\">Pain<\/h2><\/div><fieldset id=\"field_9_63\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you perceive your pet is in pain?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_63'>\n\t\t\t<div class='gchoice gchoice_9_63_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_63' type='radio' value='Yes'  id='choice_9_63_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_63_0' id='label_9_63_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_63_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_63' type='radio' value='No'  id='choice_9_63_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_63_1' id='label_9_63_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_64\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full 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_9_64'>Where do you think the pain is located?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_64' id='input_9_64' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_65\" class=\"gfield gfield--type-number gfield--input-type-number 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_9_65'>Rate their pain on a scale of 0 (no pain) to 10 (extreme pain)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_65' id='input_9_65' type='number' step='any' min='0' max='10' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_instruction_9_65\" \/><div class='gfield_description instruction ' id='gfield_instruction_9_65'>Please enter a number from <strong>0<\/strong> to <strong>10<\/strong>.<\/div><\/div><\/div><div id=\"field_9_66\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"color--primary\">Diet<\/h2><\/div><div id=\"field_9_67\" class=\"gfield gfield--type-textarea gfield--input-type-textarea 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_9_67'>Please detail your pet&#039;s current diet<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_67' id='input_9_67' class='textarea small'    placeholder='Type of food, amount fed, types of treats, etc.' aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_70\" class=\"gfield gfield--type-html gfield--input-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\"  ><h2 class=\"color--primary\">Current Medications and Supplements<\/h2><\/div><div id=\"field_9_69\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full 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_9_69'>Please detail your pet&#039;s medications and supplements<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_69' id='input_9_69' class='textarea small'    placeholder='Medication \/ supplement, dosage, frequency' aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_71\" class=\"gfield gfield--type-html gfield--input-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\"  ><h2 class=\"color--primary\">Further Comments<\/h2><\/div><div id=\"field_9_72\" class=\"gfield gfield--type-textarea gfield--input-type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_72'>Do you have any other comments about your pet\u2019s medical history that were not addressed in the above sections?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_72' id='input_9_72' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_73\" class=\"gfield gfield--type-html gfield--input-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\"  ><h2 class=\"color--primary\">Authorization to Perform Alternative Therapy and Release of Liability<\/h2>\n<\/div><fieldset id=\"field_9_74\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Consent<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_74.1' id='input_9_74_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_9_74\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_9_74_1' >I understand that the following are considered alternative forms of therapy and investigative by mainstream medicine:<\/label><input type='hidden' name='input_74.2' value='I understand that the following are considered alternative forms of therapy and investigative by mainstream medicine:' class='gform_hidden' \/><input type='hidden' name='input_74.3' value='15' class='gform_hidden' \/><\/div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_9_74' tabindex='0'><strong>Acupuncture<\/strong> - including dry needling, acupuncture, electroacupuncture, pneumoacupuncture, and moxibustion<br \/>\nLaser Therapy<br \/>\n<br \/>\n<strong>Chinese Herbal Therapy<\/strong> - using specific herbs\/formulas to address imbalance in the body and promote overall health and wellness in the body<br \/>\n<br \/>\n<strong>Food Therapy<\/strong> - using specific foods to address imbalance in the body to promote overall health and wellness in the body<br \/>\n<br \/>\n<strong>Tui-Na<\/strong> - Chinese massage that uses techniques to stimulate the flow of energy and promote healing.<br \/>\n<\/div><\/fieldset><div id=\"field_9_75\" class=\"gfield gfield--type-text gfield--input-type-text 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_9_75'>Owner\u2019s Full Name - (Filling out this field constitutes your signature)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_75' id='input_9_75' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_76\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datefield gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Today&#039;s Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_9_76' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_month ginput_container ginput_container_date gform-grid-col' id='input_9_76_1_container'>\n                                            <input type='number' maxlength='2' name='input_76[]' id='input_9_76_1' value=''   aria-required='true'   placeholder='MM' min='1' max='12' step='1'\/>\n                                            <label for='input_9_76_1' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Month<\/label>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date gform-grid-col' id='input_9_76_2_container'>\n                                            <input type='number' maxlength='2' name='input_76[]' id='input_9_76_2' value=''   aria-required='true'   placeholder='DD' min='1' max='31' step='1'\/>\n                                            <label for='input_9_76_2' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Day<\/label>\n                                        <\/div><div class='gfield_date_year ginput_container ginput_container_date gform-grid-col' id='input_9_76_3_container'>\n                                            <input type='number' maxlength='4' name='input_76[]' id='input_9_76_3' value=''   aria-required='true'   placeholder='YYYY' min='1920' max='2027' step='1'\/>\n                                            <label for='input_9_76_3' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Year<\/label>\n                                       <\/div>\n                                   <\/div><\/fieldset><fieldset id=\"field_9_77\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Consent<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_77.1' id='input_9_77_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_9_77_1' >I certify that I have read and understand this Agreement, and that the information set forth above is true and correct. I agree to accept all the terms, conditions, and statements of this agreement, and any rules or regulations of CareVet Mulnix Animal Clinic.<\/label><input type='hidden' name='input_77.2' value='I certify that I have read and understand this Agreement, and that the information set forth above is true and correct. I agree to accept all the terms, conditions, and statements of this agreement, and any rules or regulations of CareVet Mulnix Animal Clinic.' class='gform_hidden' \/><input type='hidden' name='input_77.3' value='15' class='gform_hidden' \/><\/div><\/fieldset><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_9' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Submit'  \/> <input type='hidden' name='gform_ajax' value='form_id=9&amp;title=&amp;description=&amp;tabindex=0&amp;theme=gravity-theme&amp;styles=[]&amp;hash=efbbea78976106aa1b3ba7896507690c' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_9' value='iframe' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_9' id='gform_theme_9' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_9' id='gform_style_settings_9' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_9' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='9' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='rntKCTnAsyQY9Seo4XyuxZDlNigdUljM3KjYxzqUoxttwbKwZeVUX23SjLDhy1gKtm9c7iq14psUa6EP26pM7TFj3Ffs6pXiKhk1OAf5u7Pe1KE=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_9' value='["{\"9.1\":\"b90b60684ff0ad9b511a259dc3088ce9\",\"9.2\":\"5ad0b9fb2792a3e23ad6859551b6409b\",\"9.3\":\"4d7bf3af49a1076ede10657cbcad1be9\",\"9.4\":\"c0aa5f6b40e8a705866c38fe9a0c4410\",\"9.5\":\"5362abc947649b3a7597c40f8abb1e19\",\"9.6\":\"780c19d4fc880946856ff14d9e61fc00\",\"9.7\":\"b946cafeb518684f70ff6130e8d685df\",\"9.8\":\"cad24040d3298288343ad546c4a5bf6e\",\"9.9\":\"f7fa79f4c6a76b0022d26a50c6c1d9eb\",\"9.11\":\"ab45e54a3b28a748e84497cebf78a33e\",\"10.1\":\"2ee99296fa9e502bdae700f51552df41\",\"10.2\":\"477b9b6c6f49ca10fdfe937d6689727f\",\"10.3\":\"4855198e4f1e8233bef75aeb8c337a89\",\"10.4\":\"3008dfbe04ac9b897b5381288d7c5cfb\",\"10.5\":\"6e77f5fc6eb2e9b85a73a7dc33c30f4a\",\"10.6\":\"0e68018e111bfe96ef662dfb41ae7fd2\",\"10.7\":\"ecdbd51a8e10ac03f43c8261db9c7e78\",\"10.8\":\"e05bd89f43eddffee315972dd2254a65\",\"10.9\":\"acb2007a896b393238c529872d84cee9\",\"10.11\":\"67104bd3e0599e323dcc1591a0c6697d\",\"12.1\":\"e122898f53fbe6844a0e039cc5787b5d\",\"12.2\":\"1d1303c2b9f6f300b007c7bc1282af1e\",\"12.3\":\"83a247f91b60053ca42a0c755267a885\",\"12.4\":\"090ef37766652096c5db0a2faaebaaae\",\"12.5\":\"5f2007ce1ccfc75012d83248bc1e79dc\",\"12.6\":\"76ad3acadaa6ee6c37997734c35b3f0f\",\"12.7\":\"2d7b4e3060d51c7400e56f2ae57ff76b\",\"12.8\":\"5fdab82294c0f9658c53f15f0cb8c922\",\"12.9\":\"940e9cc7e2d71f5f1061b6513aa6bc62\",\"12.11\":\"39788c0c769f9d7035d1a5a9ba291033\",\"13.1\":\"d3d37b9509291bd83ad19f8d4d9c2eca\",\"13.2\":\"d9f9fe701985c23af719952ae27eaa28\",\"13.3\":\"b0d6218b4d9a8748ea4d89d3f1779c22\",\"13.4\":\"e73b92966b5db80ff825baf06b4e0246\",\"13.5\":\"b9883ee0070c95d00169e0ce9c785df8\",\"13.6\":\"0e32a5b4f19166ce2e5e932b24b2fbba\",\"13.7\":\"7ccbfdd1a68d50b36d789b31fddb9e18\",\"13.8\":\"26c1058b128db72d1704d6820dae80a7\",\"13.9\":\"25ecc508077bbb4a3d2075c053698a91\",\"13.11\":\"b260ddb03b2fbd257fbbe036b9bb9642\",\"13.12\":\"bfe7c70f9d58ef9221f21879caeb6e1f\",\"15.1\":\"d8cf90fbd6f153cae4af6bf6d0c78e39\",\"15.2\":\"bdc5e26f26352c938e128da9e2a06974\",\"15.3\":\"fbcc737a567355fd0d7c8bf3558fe96e\",\"15.4\":\"b80dabeae9b74371532910fc8f7bc040\",\"15.5\":\"d73c9586546fc571cb7ff0d867104ba1\",\"15.6\":\"7112c9629d75e49be9368df9d982f2c4\",\"15.7\":\"f4edb8e26332fada715b49b4d2f003c8\",\"15.8\":\"c9d0b25b6a1b4d7918dd838f064f3fa6\",\"15.9\":\"ff60256ca681d1ff4ddd67c82efe3b5a\",\"15.11\":\"8e039182df2a26953345ec72f6bfcfcb\",\"16.1\":\"dc125800ce15ee9bc78feff3310e4855\",\"16.2\":\"bf3ebebd1d19c478bd624693a9efb874\",\"16.3\":\"ed168eb4bad49c398c3051fecb630128\",\"16.4\":\"fe8e4ae861eb7ca02dd62fe97b56189d\",\"16.5\":\"dd734f4726e86978510989f26ddacae1\",\"16.6\":\"111964889957f2fd88e1cc10f9fe3162\",\"16.7\":\"407f42470b7de078a329b4a0b6ff5b22\",\"16.8\":\"f9a1ad56a959e8914de4ff8e66fbc947\",\"16.9\":\"5d140596268284bff9b6805d5fffd7a2\",\"16.11\":\"a3f6505e2a793a1f41a2cc43d3e1cc05\",\"18.1\":\"700123abd9d4338c2bc69d39ae64962e\",\"18.2\":\"0a521419487f46729c9007d0815c6a49\",\"18.3\":\"8a102a549b8894a1392265ffab99b6e5\",\"18.4\":\"44269746ed64b0f2fc24eab60dcd306d\",\"18.5\":\"cc658e8d66d203e079180958706d7d74\",\"18.6\":\"47a5a573119a61768742f8bc1e4c6c32\",\"18.7\":\"f374615da81f8df35307ad336e1af683\",\"18.8\":\"1bcd274f50a8f34ec33ce7bfc41ca576\",\"18.9\":\"cb47232a53b66aefb2cd5cc1cdfc1132\",\"18.11\":\"6758654f6ec9213a1285eb5e65dc09c5\",\"19.1\":\"cb50c4647ff30623e7f6852301c5c9bf\",\"19.2\":\"0aa884d07664c74607d8d5385ae6866e\",\"19.3\":\"0a197292119723fbbb9d503dfe1b0b6c\",\"19.4\":\"189cfcab5b10112884f61ccc9e78b4b7\",\"19.5\":\"5d5d99fdab9421a7b07aea847c25c4e5\",\"19.6\":\"ffb0192bbdd85d1100bf0bc2a9aea054\",\"19.7\":\"105bb3cba9d167b604931741078bbf32\",\"19.8\":\"30d583e3bd11aad7a53568f4e8b4f992\",\"19.9\":\"352352e733a7319a05bce4a8a4cc91b0\",\"19.11\":\"4550469bbae4709d551603f068a76561\",\"19.12\":\"83ffb875473cdecced2440c1bc79122d\",\"19.13\":\"cefc3cb6c7c8b725588ef90f37cd73f3\",\"19.14\":\"52d8cf4dc3f534469e73ae5547521393\",\"21.1\":\"9fdfaafc9c996247aac3993585e3d37c\",\"21.2\":\"48e886d3717a84f459714bd3030e3993\",\"21.3\":\"83d3c4434fae055103ff60a99d033ac6\",\"21.4\":\"36ef5b50a8cda769a0b961fdd5370542\",\"21.5\":\"9b80be63116e42a47b13fba285f987bc\",\"21.6\":\"576247d0001724d244fb36bd7723f196\",\"21.7\":\"2c376ce089af1d636ea1c5927b588d26\",\"21.8\":\"ce207e990671a049407ce3c64a203611\",\"21.9\":\"a7cbe6e1246fa8ec5a5d2236d0012646\",\"21.11\":\"3eb9701131cf14bbceb0586014711ebd\",\"22.1\":\"f6d52f6dbc4d204cec7a8a6322868d9c\",\"22.2\":\"985d131c749381145a1759058154b64f\",\"22.3\":\"50bdac57da660b179c118943597917b0\",\"22.4\":\"e510762ecd23590bead37b007d9ecd35\",\"22.5\":\"81f01d5a6c7d371b68ae893de0603f78\",\"22.6\":\"1a168da6692d8363afb6acaa0cb1a214\",\"22.7\":\"eca51b6826a4ed4d817a2dee6e6f5ab3\",\"22.8\":\"c0f3d1177b14157c4199812832fd4f57\",\"22.9\":\"eaec6ea8d1f82ff7b69165d85f21d4f1\",\"22.11\":\"bee802e765920d4af767cfb275561731\",\"22.12\":\"e32f6c960ced10da4a5962d32fb1e4f5\",\"22.13\":\"99ac826cb5529a8f2c57a84cf15b5ac7\",\"23\":[\"885a0c8f748b97386d180d962e20761a\",\"c143b95848a030d210e3093f4af9b405\",\"34f79ea4e2811ff0e21c084476dc91c5\"],\"25.1\":\"aafd6f16f26012d8e5978a10d6d0ae56\",\"25.2\":\"c94da407c770978564d9493cf4b97a10\",\"25.3\":\"ef3d777c2a88600f1bf5fecaee076f81\",\"25.4\":\"0d2ac17a0d29ffbc761768dd61c03332\",\"25.5\":\"8e2b607d55bbcca6661267361f9da201\",\"25.6\":\"15e36a11329b4fe519cd6c1c93c33f16\",\"25.7\":\"7139212237107e4a740ce96edfd697cf\",\"25.8\":\"0e80c9331fbf1a198356dcae1dc21f76\",\"25.9\":\"5d1e6ece9e35964df3e033a2b453a7b2\",\"25.11\":\"b0ce557c69c08b0690dec3e5191aa67d\",\"26.1\":\"d4d8686f1440a95a16420d1e61a9813f\",\"26.2\":\"7035573309463f55177c6f31f4ecce41\",\"26.3\":\"3fd4b0f2900840463d41ef7a5fdb1b79\",\"26.4\":\"94d09385eb02cfc9eccbab4cab3afa39\",\"26.5\":\"61ab340bc3e16081da1210c28f34c7f8\",\"26.6\":\"7f275b59377cec0cb52f2235d1d01c3e\",\"26.7\":\"ce0572353f9153d13e84befe62d0250a\",\"26.8\":\"832d929bd9bd71ac6cbf61207687e23e\",\"26.9\":\"edbae694bb40bcae4f22b65058777877\",\"26.11\":\"be96df230b347edd67f703164506f804\",\"30\":[\"e3f8413d36ce97d6a0f1a8ddaebc43b0\",\"e955dc87005e71aa6f06d1bc67542a2e\"],\"34\":[\"d265cf48ee50c082675e8ced93583278\",\"1d5b308b8a4e7084c3e37f90899b1a68\",\"7abcbf7123ee764685e14237ad8cfcdc\"],\"35\":[\"de27f5847261639e78b2b3c13dd0dea1\",\"78afa27e11791503d5fb7f1aef598be5\"],\"36\":[\"d265cf48ee50c082675e8ced93583278\",\"1d5b308b8a4e7084c3e37f90899b1a68\",\"7abcbf7123ee764685e14237ad8cfcdc\"],\"39\":[\"e3f8413d36ce97d6a0f1a8ddaebc43b0\",\"e955dc87005e71aa6f06d1bc67542a2e\"],\"40\":[\"ea99253244c2878abc57fc9adab29383\",\"ca91aa243c5226bfcf3b226388d7cca7\",\"f879346b473b1eccd336921e82473329\",\"d0290dd43080c22b0c432a963c53859c\",\"85939522bece1067e0d0f6ac17805b99\"],\"41\":[\"15798c567bd495b58eff1c989a19cad9\",\"e919f2cbe7f25256b2f6f95c539d8096\",\"fa9859cfe946edaef5210419eefd222d\",\"aa300d42855796deb0f3dc87de56f9cd\",\"db18ced4158a32e4da6c42fbc02b8c30\"],\"42\":[\"0873728bd7def84235187f20b149d8bc\",\"2ee661d943f676511424c92a85c2e08f\",\"48ae2f620a94d6d21372ecb132dd6245\",\"1e1e6bfca336c2bd9f7dcb9727709060\",\"c244b72587749210f8392da06ccb462d\"],\"50.1\":\"6bdf91587ded291966af81ded92b7fca\",\"50.2\":\"afe2d54c5d77e102e7b1e0514912d26c\",\"50.3\":\"e8b18473b16bd5db65593f1fa9c06d7f\",\"50.4\":\"326de70f178680c61ae32af56dafb700\",\"50.5\":\"1e9d732b09245771766fb3e79a82142e\",\"50.6\":\"1bb0ed0ceb475ec3d63003f8e37705da\",\"44\":[\"d265cf48ee50c082675e8ced93583278\",\"5bb3494bda9dbb5a2ed58f465a70a782\"],\"46\":[\"ea99253244c2878abc57fc9adab29383\",\"ca91aa243c5226bfcf3b226388d7cca7\",\"d0290dd43080c22b0c432a963c53859c\",\"ab03067267d759289ca437b1358392b8\"],\"48.1\":\"682fe3c5ba09af08c978b1af917b4cc8\",\"48.2\":\"4b0946bab180fa793a6fa31954a88d7d\",\"48.3\":\"1d5b23641b453e25d98f1caa2d64ae96\",\"48.4\":\"d9f9fe701985c23af719952ae27eaa28\",\"52\":[\"d265cf48ee50c082675e8ced93583278\",\"70a5532da8c9af10f69a28ad0288700b\",\"7870ba36098ab8b49cd671b29093611a\",\"7fcc3760dad68afe2c7b85eb8efee7cf\",\"49059e45f4b72eb5ea8774f15cc3e318\"],\"53\":[\"d265cf48ee50c082675e8ced93583278\",\"7abcbf7123ee764685e14237ad8cfcdc\",\"1d5b308b8a4e7084c3e37f90899b1a68\"],\"55\":[\"e3f8413d36ce97d6a0f1a8ddaebc43b0\",\"e955dc87005e71aa6f06d1bc67542a2e\"],\"56\":[\"e3f8413d36ce97d6a0f1a8ddaebc43b0\",\"e955dc87005e71aa6f06d1bc67542a2e\"],\"58.1\":\"982bd4c47dc04858f374d4f144b4007e\",\"58.2\":\"cc553552cd9c757ea0f24f711a59b1d0\",\"58.3\":\"6609273c0273afa8d0db487d40a673aa\",\"58.4\":\"cd77082f9020506db32de12f4ed6b2da\",\"58.5\":\"175896863773583b3f47ec0bbd84c549\",\"58.6\":\"c2ee7588044611b45d9bc2d767b109e5\",\"58.7\":\"b316e1a409566176e942b1214232172c\",\"58.8\":\"9cdd912c64ad7c01d03fdcdeeb864df6\",\"58.9\":\"231021d43aef41b2da3829eeeeaac0d9\",\"58.11\":\"7683ec1bf29eea93b1bc138d4aa9cc77\",\"58.12\":\"1954ee4c967fb3258a5937baee4fa87a\",\"58.13\":\"474005667fe590b2d4366fc2b316bad1\",\"58.14\":\"6711b5ceabaa8c1fca09c88ee3f5fe94\",\"58.15\":\"4ffc7c224ee840dcbc981f9a11c06f4d\",\"58.16\":\"52d8cf4dc3f534469e73ae5547521393\",\"58.17\":\"152f5adfc63f2318e5deea1ce8ca5a0b\",\"61.1\":\"9e9731722a19c74e8375d03628f7ab19\",\"61.2\":\"2b281a4d74c94f7e98222367ab4f0d51\",\"61.3\":\"509e5ce3d2bee2368d9ba73a5896c110\",\"61.4\":\"3fbdab36b8213f18af6994d9575e9aa2\",\"63\":[\"e3f8413d36ce97d6a0f1a8ddaebc43b0\",\"e955dc87005e71aa6f06d1bc67542a2e\"],\"74.1\":\"a4a486baafa79c305c9695e7889f469b\",\"74.2\":\"25014c17b2ca0c326e146c6c53d613bc\",\"74.3\":\"19e6857730867f02836d8960ac35c41e\",\"77.1\":\"a4a486baafa79c305c9695e7889f469b\",\"77.2\":\"0f2386ada2a2cab7ebd43c1be23b1995\",\"77.3\":\"19e6857730867f02836d8960ac35c41e\"}","526b16f66a111648fd83dc286d23e3ac"]' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_9' id='gform_target_page_number_9' value='0' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_9' id='gform_source_page_number_9' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"ak_\"><label>&#916;<textarea name=\"ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"ak_js\" value=\"31\"\/><script>document.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );<\/script><\/p><\/form>\n                        <\/div>\n\t\t                <iframe style='display:none;width:0px;height:0px;' src='about:blank' name='gform_ajax_frame_9' id='gform_ajax_frame_9' title='This iframe contains the logic required to handle Ajax powered Gravity Forms.'><\/iframe>\n\t\t                <script>\ngform.initializeOnLoaded( function() {gformInitSpinner( 9, 'https:\/\/www.carevet.com\/mulnix\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery('#gform_ajax_frame_9').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_9');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_9').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);jQuery('#gform_wrapper_9').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_9').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_9').removeClass('gform_validation_error');}setTimeout( function() { \/* delay the scroll by 50 milliseconds to fix a bug in chrome *\/ jQuery(document).scrollTop(jQuery('#gform_wrapper_9').offset().top - mt); }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_9').val();gformInitSpinner( 9, 'https:\/\/www.carevet.com\/mulnix\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery(document).trigger('gform_page_loaded', [9, current_page]);window['gf_submitting_9'] = 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_9').replaceWith(confirmation_content);jQuery(document).scrollTop(jQuery('#gf_9').offset().top - mt);jQuery(document).trigger('gform_confirmation_loaded', [9]);window['gf_submitting_9'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_9').text());}else{jQuery('#gform_9').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger(\"gform_pre_post_render\", [{ formId: \"9\", currentPage: \"current_page\", abort: function() { this.preventDefault(); } }]);        if (event && event.defaultPrevented) {                return;        }        const gformWrapperDiv = document.getElementById( \"gform_wrapper_9\" );        if ( gformWrapperDiv ) {            const visibilitySpan = document.createElement( \"span\" );            visibilitySpan.id = \"gform_visibility_test_9\";            gformWrapperDiv.insertAdjacentElement( \"afterend\", visibilitySpan );        }        const visibilityTestDiv = document.getElementById( \"gform_visibility_test_9\" );        let postRenderFired = false;        function triggerPostRender() {            if ( postRenderFired ) {                return;            }            postRenderFired = true;            gform.core.triggerPostRenderEvents( 9, 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<\/script>\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-2986","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.carevet.com\/mulnix\/wp-json\/wp\/v2\/pages\/2986","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.carevet.com\/mulnix\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.carevet.com\/mulnix\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.carevet.com\/mulnix\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.carevet.com\/mulnix\/wp-json\/wp\/v2\/comments?post=2986"}],"version-history":[{"count":1,"href":"https:\/\/www.carevet.com\/mulnix\/wp-json\/wp\/v2\/pages\/2986\/revisions"}],"predecessor-version":[{"id":2987,"href":"https:\/\/www.carevet.com\/mulnix\/wp-json\/wp\/v2\/pages\/2986\/revisions\/2987"}],"wp:attachment":[{"href":"https:\/\/www.carevet.com\/mulnix\/wp-json\/wp\/v2\/media?parent=2986"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}