{"id":3384,"date":"2022-06-15T14:54:42","date_gmt":"2022-06-15T14:54:42","guid":{"rendered":"https:\/\/713websites.com\/?page_id=3384"},"modified":"2022-06-15T14:54:45","modified_gmt":"2022-06-15T14:54:45","slug":"annual-exam","status":"publish","type":"page","link":"https:\/\/713websites.com\/annual-exam\/","title":{"rendered":"Annual Exam"},"content":{"rendered":"<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_unknown gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_7' ><style>#gform_wrapper_7[data-form-index=\"0\"].gform-theme,[data-parent-form=\"7_0\"]{--gf-color-primary: #204ce5;--gf-color-primary-rgb: 32, 76, 229;--gf-color-primary-contrast: #fff;--gf-color-primary-contrast-rgb: 255, 255, 255;--gf-color-primary-darker: #001AB3;--gf-color-primary-lighter: #527EFF;--gf-color-secondary: #fff;--gf-color-secondary-rgb: 255, 255, 255;--gf-color-secondary-contrast: #112337;--gf-color-secondary-contrast-rgb: 17, 35, 55;--gf-color-secondary-darker: #F5F5F5;--gf-color-secondary-lighter: #FFFFFF;--gf-color-out-ctrl-light: rgba(17, 35, 55, 0.1);--gf-color-out-ctrl-light-rgb: 17, 35, 55;--gf-color-out-ctrl-light-darker: rgba(104, 110, 119, 0.35);--gf-color-out-ctrl-light-lighter: #F5F5F5;--gf-color-out-ctrl-dark: #585e6a;--gf-color-out-ctrl-dark-rgb: 88, 94, 106;--gf-color-out-ctrl-dark-darker: #112337;--gf-color-out-ctrl-dark-lighter: rgba(17, 35, 55, 0.65);--gf-color-in-ctrl: #fff;--gf-color-in-ctrl-rgb: 255, 255, 255;--gf-color-in-ctrl-contrast: #112337;--gf-color-in-ctrl-contrast-rgb: 17, 35, 55;--gf-color-in-ctrl-darker: #F5F5F5;--gf-color-in-ctrl-lighter: #FFFFFF;--gf-color-in-ctrl-primary: #204ce5;--gf-color-in-ctrl-primary-rgb: 32, 76, 229;--gf-color-in-ctrl-primary-contrast: #fff;--gf-color-in-ctrl-primary-contrast-rgb: 255, 255, 255;--gf-color-in-ctrl-primary-darker: #001AB3;--gf-color-in-ctrl-primary-lighter: #527EFF;--gf-color-in-ctrl-light: rgba(17, 35, 55, 0.1);--gf-color-in-ctrl-light-rgb: 17, 35, 55;--gf-color-in-ctrl-light-darker: rgba(104, 110, 119, 0.35);--gf-color-in-ctrl-light-lighter: #F5F5F5;--gf-color-in-ctrl-dark: #585e6a;--gf-color-in-ctrl-dark-rgb: 88, 94, 106;--gf-color-in-ctrl-dark-darker: #112337;--gf-color-in-ctrl-dark-lighter: rgba(17, 35, 55, 0.65);--gf-radius: 3px;--gf-font-size-secondary: 14px;--gf-font-size-tertiary: 13px;--gf-icon-ctrl-number: url(\"data:image\/svg+xml,%3Csvg width='8' height='14' viewBox='0 0 8 14' fill='none' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath fill-rule='evenodd' clip-rule='evenodd' d='M4 0C4.26522 5.96046e-08 4.51957 0.105357 4.70711 0.292893L7.70711 3.29289C8.09763 3.68342 8.09763 4.31658 7.70711 4.70711C7.31658 5.09763 6.68342 5.09763 6.29289 4.70711L4 2.41421L1.70711 4.70711C1.31658 5.09763 0.683417 5.09763 0.292893 4.70711C-0.0976311 4.31658 -0.097631 3.68342 0.292893 3.29289L3.29289 0.292893C3.48043 0.105357 3.73478 0 4 0ZM0.292893 9.29289C0.683417 8.90237 1.31658 8.90237 1.70711 9.29289L4 11.5858L6.29289 9.29289C6.68342 8.90237 7.31658 8.90237 7.70711 9.29289C8.09763 9.68342 8.09763 10.3166 7.70711 10.7071L4.70711 13.7071C4.31658 14.0976 3.68342 14.0976 3.29289 13.7071L0.292893 10.7071C-0.0976311 10.3166 -0.0976311 9.68342 0.292893 9.29289Z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-icon-ctrl-select: url(\"data:image\/svg+xml,%3Csvg width='10' height='6' viewBox='0 0 10 6' fill='none' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath fill-rule='evenodd' clip-rule='evenodd' d='M0.292893 0.292893C0.683417 -0.097631 1.31658 -0.097631 1.70711 0.292893L5 3.58579L8.29289 0.292893C8.68342 -0.0976311 9.31658 -0.0976311 9.70711 0.292893C10.0976 0.683417 10.0976 1.31658 9.70711 1.70711L5.70711 5.70711C5.31658 6.09763 4.68342 6.09763 4.29289 5.70711L0.292893 1.70711C-0.0976311 1.31658 -0.0976311 0.683418 0.292893 0.292893Z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-icon-ctrl-search: url(\"data:image\/svg+xml,%3Csvg version='1.1' xmlns='http:\/\/www.w3.org\/2000\/svg' width='640' height='640'%3E%3Cpath d='M256 128c-70.692 0-128 57.308-128 128 0 70.691 57.308 128 128 128 70.691 0 128-57.309 128-128 0-70.692-57.309-128-128-128zM64 256c0-106.039 85.961-192 192-192s192 85.961 192 192c0 41.466-13.146 79.863-35.498 111.248l154.125 154.125c12.496 12.496 12.496 32.758 0 45.254s-32.758 12.496-45.254 0L367.248 412.502C335.862 434.854 297.467 448 256 448c-106.039 0-192-85.962-192-192z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-label-space-y-secondary: var(--gf-label-space-y-md-secondary);--gf-ctrl-border-color: #686e77;--gf-ctrl-size: var(--gf-ctrl-size-md);--gf-ctrl-label-color-primary: #112337;--gf-ctrl-label-color-secondary: #112337;--gf-ctrl-choice-size: var(--gf-ctrl-choice-size-md);--gf-ctrl-checkbox-check-size: var(--gf-ctrl-checkbox-check-size-md);--gf-ctrl-radio-check-size: var(--gf-ctrl-radio-check-size-md);--gf-ctrl-btn-font-size: var(--gf-ctrl-btn-font-size-md);--gf-ctrl-btn-padding-x: var(--gf-ctrl-btn-padding-x-md);--gf-ctrl-btn-size: var(--gf-ctrl-btn-size-md);--gf-ctrl-btn-border-color-secondary: #686e77;--gf-ctrl-file-btn-bg-color-hover: #EBEBEB;--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Annual exam<\/h2>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_7'  action='\/wp-json\/wp\/v2\/pages\/3384' data-formid='7' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_7' class='gform_fields top_label form_sublabel_below description_below'><fieldset id=\"field_7_1\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_1\" ><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_7_1'>\n                            \n                            <span id='input_7_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_7_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_7_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_7_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_7_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_7_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_7_2\" class=\"gfield gfield--type-phone gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_2\" ><label class='gfield_label gform-field-label' for='input_7_2'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_2' id='input_7_2' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_7_3\" class=\"gfield gfield--type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_3\" ><label class='gfield_label gform-field-label' for='input_7_3'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_3' id='input_7_3' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_7_4\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_4\" ><label class='gfield_label gform-field-label' for='input_7_4'>Pet&#039;s 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_4' id='input_7_4' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_7_5\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_5\" ><legend class='gfield_label gform-field-label' >Who should we contact to make medical decisions today?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_5'>\n\t\t\t<div class='gchoice gchoice_7_5_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_5' type='radio' value='Owner (Named Above)'  id='choice_7_5_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_5_0' id='label_7_5_0' class='gform-field-label gform-field-label--type-inline'>Owner (Named Above)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_5_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_5' type='radio' value='Someone Else (Named Below)'  id='choice_7_5_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_5_1' id='label_7_5_1' class='gform-field-label gform-field-label--type-inline'>Someone Else (Named Below)<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_7_7\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--has-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_7_7\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Reason for visit:<\/legend><div class='gfield_description' id='gfield_description_7_7'>(check all that apply)<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_7_7'><div class='gchoice gchoice_7_7_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.1' type='checkbox'  value='Annual Physical'  id='choice_7_7_1'   aria-describedby=\"gfield_description_7_7\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_7_7_1' id='label_7_7_1' class='gform-field-label gform-field-label--type-inline'>Annual Physical<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_7_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.2' type='checkbox'  value='Heartworm\/Tick test (dogs)'  id='choice_7_7_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_7_2' id='label_7_7_2' class='gform-field-label gform-field-label--type-inline'>Heartworm\/Tick test (dogs)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_7_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.3' type='checkbox'  value='Fecal\/intestinal parasite screen'  id='choice_7_7_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_7_3' id='label_7_7_3' class='gform-field-label gform-field-label--type-inline'>Fecal\/intestinal parasite screen<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_7_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.4' type='checkbox'  value='Deworming treatment'  id='choice_7_7_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_7_4' id='label_7_7_4' class='gform-field-label gform-field-label--type-inline'>Deworming treatment<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_7_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.5' type='checkbox'  value='Annual physical - unsure of other services that are due. Would like to discuss with veterinarian.'  id='choice_7_7_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_7_5' id='label_7_7_5' class='gform-field-label gform-field-label--type-inline'>Annual physical &#8211; unsure of other services that are due. Would like to discuss with veterinarian.<\/label>\n\t\t\t\t\t\t\t<\/div><button type=\"button\" id=\"button_7_select_all\" class=\"gfield_choice_all_toggle gform-theme-button--size-sm\" onclick=\"gformToggleCheckboxes( this )\" data-checked=\"0\" data-label-select=\"Select All\" data-label-deselect=\"Deselect All\">Select All<\/button><\/div><\/div><\/fieldset><fieldset id=\"field_7_53\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_53\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Dog Vaccines<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_7_53'><div class='gchoice gchoice_7_53_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.1' type='checkbox'  value='DHPP'  id='choice_7_53_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_53_1' id='label_7_53_1' class='gform-field-label gform-field-label--type-inline'>DHPP<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_53_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.2' type='checkbox'  value='Lepto'  id='choice_7_53_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_53_2' id='label_7_53_2' class='gform-field-label gform-field-label--type-inline'>Lepto<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_53_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.3' type='checkbox'  value='Rabies'  id='choice_7_53_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_53_3' id='label_7_53_3' class='gform-field-label gform-field-label--type-inline'>Rabies<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_53_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.4' type='checkbox'  value='Lyme'  id='choice_7_53_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_53_4' id='label_7_53_4' class='gform-field-label gform-field-label--type-inline'>Lyme<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_53_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.5' type='checkbox'  value='Bordetella'  id='choice_7_53_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_53_5' id='label_7_53_5' class='gform-field-label gform-field-label--type-inline'>Bordetella<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_53_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.6' type='checkbox'  value='Unsure, would like to discuss recommendations with veterinarian'  id='choice_7_53_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_53_6' id='label_7_53_6' class='gform-field-label gform-field-label--type-inline'>Unsure, would like to discuss recommendations with veterinarian<\/label>\n\t\t\t\t\t\t\t<\/div><button type=\"button\" id=\"button_53_select_all\" class=\"gfield_choice_all_toggle gform-theme-button--size-sm\" onclick=\"gformToggleCheckboxes( this )\" data-checked=\"0\" data-label-select=\"Select All\" data-label-deselect=\"Deselect All\">Select All<\/button><\/div><\/div><\/fieldset><fieldset id=\"field_7_54\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_54\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Feline Vaccines<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_7_54'><div class='gchoice gchoice_7_54_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.1' type='checkbox'  value='FVRCP\/Distemper'  id='choice_7_54_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_54_1' id='label_7_54_1' class='gform-field-label gform-field-label--type-inline'>FVRCP\/Distemper<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_54_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.2' type='checkbox'  value='Rabies'  id='choice_7_54_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_54_2' id='label_7_54_2' class='gform-field-label gform-field-label--type-inline'>Rabies<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_54_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.3' type='checkbox'  value='Feline Leukemia (FeLV)'  id='choice_7_54_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_54_3' id='label_7_54_3' class='gform-field-label gform-field-label--type-inline'>Feline Leukemia (FeLV)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_54_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.4' type='checkbox'  value='Unsure, would like to discuss recommendations with veterinarian'  id='choice_7_54_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_54_4' id='label_7_54_4' class='gform-field-label gform-field-label--type-inline'>Unsure, would like to discuss recommendations with veterinarian<\/label>\n\t\t\t\t\t\t\t<\/div><button type=\"button\" id=\"button_54_select_all\" class=\"gfield_choice_all_toggle gform-theme-button--size-sm\" onclick=\"gformToggleCheckboxes( this )\" data-checked=\"0\" data-label-select=\"Select All\" data-label-deselect=\"Deselect All\">Select All<\/button><\/div><\/div><\/fieldset><fieldset id=\"field_7_55\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full field_sublabel_below gfield--has-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_7_55\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Other procedures:<\/legend><div class='gfield_description' id='gfield_description_7_55'>(All procedures at additional cost)<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_7_55'><div class='gchoice gchoice_7_55_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_55.1' type='checkbox'  value='Anal glands'  id='choice_7_55_1'   aria-describedby=\"gfield_description_7_55\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_7_55_1' id='label_7_55_1' class='gform-field-label gform-field-label--type-inline'>Anal glands<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_55_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_55.2' type='checkbox'  value='Nail trim'  id='choice_7_55_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_55_2' id='label_7_55_2' class='gform-field-label gform-field-label--type-inline'>Nail trim<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_55_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_55.3' type='checkbox'  value='Ear cleaning'  id='choice_7_55_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_55_3' id='label_7_55_3' class='gform-field-label gform-field-label--type-inline'>Ear cleaning<\/label>\n\t\t\t\t\t\t\t<\/div><button type=\"button\" id=\"button_55_select_all\" class=\"gfield_choice_all_toggle gform-theme-button--size-sm\" onclick=\"gformToggleCheckboxes( this )\" data-checked=\"0\" data-label-select=\"Select All\" data-label-deselect=\"Deselect All\">Select All<\/button><\/div><\/div><\/fieldset><fieldset id=\"field_7_9\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_9\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Are there any concerns for the following: (check all that apply)<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_7_9'><div class='gchoice gchoice_7_9_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.1' type='checkbox'  value='Increase in appetite'  id='choice_7_9_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_9_1' id='label_7_9_1' class='gform-field-label gform-field-label--type-inline'>Increase in appetite<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_9_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.2' type='checkbox'  value='Decrease in appetite'  id='choice_7_9_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_9_2' id='label_7_9_2' class='gform-field-label gform-field-label--type-inline'>Decrease in appetite<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_9_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.3' type='checkbox'  value='Increase in drinking'  id='choice_7_9_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_9_3' id='label_7_9_3' class='gform-field-label gform-field-label--type-inline'>Increase in drinking<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_9_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.4' type='checkbox'  value='Decrease in drinking'  id='choice_7_9_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_9_4' id='label_7_9_4' class='gform-field-label gform-field-label--type-inline'>Decrease in drinking<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_9_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.5' type='checkbox'  value='Weight Loss'  id='choice_7_9_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_9_5' id='label_7_9_5' class='gform-field-label gform-field-label--type-inline'>Weight Loss<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_9_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.6' type='checkbox'  value='Weight Gain'  id='choice_7_9_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_9_6' id='label_7_9_6' class='gform-field-label gform-field-label--type-inline'>Weight Gain<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_9_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.7' type='checkbox'  value='Itching\/Scratching'  id='choice_7_9_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_9_7' id='label_7_9_7' class='gform-field-label gform-field-label--type-inline'>Itching\/Scratching<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_9_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.8' type='checkbox'  value='Shaking Head'  id='choice_7_9_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_9_8' id='label_7_9_8' class='gform-field-label gform-field-label--type-inline'>Shaking Head<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_9_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.9' type='checkbox'  value='Bad Breath'  id='choice_7_9_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_9_9' id='label_7_9_9' class='gform-field-label gform-field-label--type-inline'>Bad Breath<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_9_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.11' type='checkbox'  value='Vomiting'  id='choice_7_9_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_9_11' id='label_7_9_11' class='gform-field-label gform-field-label--type-inline'>Vomiting<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_9_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.12' type='checkbox'  value='Diarrhea'  id='choice_7_9_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_9_12' id='label_7_9_12' class='gform-field-label gform-field-label--type-inline'>Diarrhea<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_9_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.13' type='checkbox'  value='Urination Issues'  id='choice_7_9_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_9_13' id='label_7_9_13' class='gform-field-label gform-field-label--type-inline'>Urination Issues<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_9_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.14' type='checkbox'  value='Excessive Sleeping'  id='choice_7_9_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_9_14' id='label_7_9_14' class='gform-field-label gform-field-label--type-inline'>Excessive Sleeping<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_9_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.15' type='checkbox'  value='Scooting'  id='choice_7_9_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_9_15' id='label_7_9_15' class='gform-field-label gform-field-label--type-inline'>Scooting<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_9_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.16' type='checkbox'  value='Difficulty Rising'  id='choice_7_9_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_9_16' id='label_7_9_16' class='gform-field-label gform-field-label--type-inline'>Difficulty Rising<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_9_17'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.17' type='checkbox'  value='Skin Masses (explain below)'  id='choice_7_9_17'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_9_17' id='label_7_9_17' class='gform-field-label gform-field-label--type-inline'>Skin Masses (explain below)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_9_18'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.18' type='checkbox'  value='Car Sickness'  id='choice_7_9_18'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_9_18' id='label_7_9_18' class='gform-field-label gform-field-label--type-inline'>Car Sickness<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_9_19'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.19' type='checkbox'  value='Behavioral Problem'  id='choice_7_9_19'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_9_19' id='label_7_9_19' class='gform-field-label gform-field-label--type-inline'>Behavioral Problem<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_9_21'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.21' type='checkbox'  value='Other (explain below)'  id='choice_7_9_21'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_9_21' id='label_7_9_21' class='gform-field-label gform-field-label--type-inline'>Other (explain below)<\/label>\n\t\t\t\t\t\t\t<\/div><button type=\"button\" id=\"button_9_select_all\" class=\"gfield_choice_all_toggle gform-theme-button--size-sm\" onclick=\"gformToggleCheckboxes( this )\" data-checked=\"0\" data-label-select=\"Select All\" data-label-deselect=\"Deselect All\">Select All<\/button><\/div><\/div><\/fieldset><div id=\"field_7_10\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_10\" ><label class='gfield_label gform-field-label' for='input_7_10'>If there are concerns, how long has your pet been experiencing this problem and what symptoms have they been experiencing?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_10' id='input_7_10' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_7_56\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_56\" ><legend class='gfield_label gform-field-label' >Has your pet ever had any adverse reaction to any medications, vaccination, or other procedure?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_56'>\n\t\t\t<div class='gchoice gchoice_7_56_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_56' type='radio' value='Yes'  id='choice_7_56_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_56_0' id='label_7_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_7_56_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_56' type='radio' value='No'  id='choice_7_56_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_56_1' id='label_7_56_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_7_15\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_15\" ><legend class='gfield_label gform-field-label' >How much do you feed?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_15'>\n\t\t\t<div class='gchoice gchoice_7_15_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='Free fed (food is offered always\/whenever hungry)'  id='choice_7_15_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_15_0' id='label_7_15_0' class='gform-field-label gform-field-label--type-inline'>Free fed (food is offered always\/whenever hungry)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_15_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='Measured amount (specify how much and how often below)'  id='choice_7_15_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_15_1' id='label_7_15_1' class='gform-field-label gform-field-label--type-inline'>Measured amount (specify how much and how often below)<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_7_14\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_14\" ><label class='gfield_label gform-field-label' for='input_7_14'>What brand of food do you feed your pet?<\/label><div class='ginput_container ginput_container_text'><input name='input_14' id='input_7_14' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_7_11\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_11\" ><legend class='gfield_label gform-field-label' >Do you have insurance for your pet?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_11'>\n\t\t\t<div class='gchoice gchoice_7_11_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='Yes'  id='choice_7_11_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_11_0' id='label_7_11_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_7_11_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='No'  id='choice_7_11_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_11_1' id='label_7_11_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_7_13\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_7_13\" ><legend class='gfield_label gform-field-label' >Do you give your pet heartworm or flea\/tick preventative?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_13'>\n\t\t\t<div class='gchoice gchoice_7_13_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_13' type='radio' value='Yes'  id='choice_7_13_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_13_0' id='label_7_13_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_7_13_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_13' type='radio' value='No'  id='choice_7_13_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_13_1' id='label_7_13_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_7_12\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_12\" ><legend class='gfield_label gform-field-label' >Do you wish to take home flea\/tick\/heartworm prevention today?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_12'>\n\t\t\t<div class='gchoice gchoice_7_12_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Yes'  id='choice_7_12_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_12_0' id='label_7_12_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_7_12_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='No'  id='choice_7_12_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_12_1' id='label_7_12_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_12_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Unsure, speak with a veterinarian about recommendations for my pet'  id='choice_7_12_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_12_2' id='label_7_12_2' class='gform-field-label gform-field-label--type-inline'>Unsure, speak with a veterinarian about recommendations for my pet<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_7_16\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_16\" ><label class='gfield_label gform-field-label' for='input_7_16'>What percentage of time does your pet spend outside?<\/label><div class='ginput_container ginput_container_text'><input name='input_16' id='input_7_16' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_7_17\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_17\" ><legend class='gfield_label gform-field-label' >Have you seen any fleas or ticks on your pet?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_17'>\n\t\t\t<div class='gchoice gchoice_7_17_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='Yes'  id='choice_7_17_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_17_0' id='label_7_17_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_7_17_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='No'  id='choice_7_17_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_17_1' id='label_7_17_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_7_19\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_19\" ><legend class='gfield_label gform-field-label' >Do you have other pets?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_19'>\n\t\t\t<div class='gchoice gchoice_7_19_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='Yes'  id='choice_7_19_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_19_0' id='label_7_19_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_7_19_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='No'  id='choice_7_19_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_19_1' id='label_7_19_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_7_21\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--has-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_7_21\" ><legend class='gfield_label gform-field-label' >Does your pet come into contact with other dogs?<\/legend><div class='gfield_description' id='gfield_description_7_21'>Please check all that apply  <\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_21'>\n\t\t\t<div class='gchoice gchoice_7_21_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='None'  id='choice_7_21_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_7_21\"   \/>\n\t\t\t\t\t<label for='choice_7_21_0' id='label_7_21_0' class='gform-field-label gform-field-label--type-inline'>None<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_21_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Boarding'  id='choice_7_21_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_21_1' id='label_7_21_1' class='gform-field-label gform-field-label--type-inline'>Boarding<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_21_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Grooming'  id='choice_7_21_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_21_2' id='label_7_21_2' class='gform-field-label gform-field-label--type-inline'>Grooming<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_21_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Dog Parks'  id='choice_7_21_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_21_3' id='label_7_21_3' class='gform-field-label gform-field-label--type-inline'>Dog Parks<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_21_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Other'  id='choice_7_21_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_21_4' id='label_7_21_4' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_7_23\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_23\" ><legend class='gfield_label gform-field-label' >Is your pet on any medications?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_23'>\n\t\t\t<div class='gchoice gchoice_7_23_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='Yes'  id='choice_7_23_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_23_0' id='label_7_23_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_7_23_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='No'  id='choice_7_23_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_23_1' id='label_7_23_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_7_34\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_34\" ><legend class='gfield_label gform-field-label' >Was your pet last seen by a veterinarian at Your Veterinary Practice?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_34'>\n\t\t\t<div class='gchoice gchoice_7_34_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='Yes'  id='choice_7_34_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_34_0' id='label_7_34_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_7_34_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='No'  id='choice_7_34_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_34_1' id='label_7_34_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_7_39\" class=\"gfield gfield--type-consent gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_7_39\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Once your pet\u2019s exam is completed, we will contact you to go over the exam findings and recommendations.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description gfield_consent_description' id='gfield_consent_description_7_39'> I understand that financial responsibilities for services are rendered at the time of discharge.<\/div><div class='ginput_container ginput_container_consent'><input name='input_39.1' id='input_7_39_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_7_39\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_7_39_1' >I have read and understand.<\/label><input type='hidden' name='input_39.2' value='I have read and understand.' class='gform_hidden' \/><input type='hidden' name='input_39.3' value='7' class='gform_hidden' \/><\/div><\/fieldset><fieldset id=\"field_7_57\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_7_57\" ><legend class='gfield_label gform-field-label' >CPR PERMISSION<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_7_57'>I understand Your Veterinary Practice- requires a CPR status prior to the start of any and all procedures so immediate action can take place in the event of cardiopulmonary arrest during, before, or after anesthesia or anytime in our care. I acknowledge that the attending veterinarian or staff members of Your Veterinary Practice will make every effort to contact me regarding treatment in the case of this unforeseen event. The starting cost of CPR is approximately $400. I understand that there is no guarantee of successful resuscitation.\u00a0<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_57'>\n\t\t\t<div class='gchoice gchoice_7_57_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_57' type='radio' value='Yes, please perform CPR on my pet.'  id='choice_7_57_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_7_57\"   \/>\n\t\t\t\t\t<label for='choice_7_57_0' id='label_7_57_0' class='gform-field-label gform-field-label--type-inline'>Yes, please perform CPR on my pet.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_57_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_57' type='radio' value='No, do not perform CPR on my pet.\u00a0'  id='choice_7_57_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_57_1' id='label_7_57_1' class='gform-field-label gform-field-label--type-inline'>No, do not perform CPR on my pet.\u00a0<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_7_40\" class=\"gfield gfield--type-consent gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_7_40\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >I give Your Veterinary Practice authorization to treat as discussed above.<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_40.1' id='input_7_40_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_7_40_1' >I have read and agree.<\/label><input type='hidden' name='input_40.2' value='I have read and agree.' class='gform_hidden' \/><input type='hidden' name='input_40.3' value='7' class='gform_hidden' \/><\/div><\/fieldset><fieldset id=\"field_7_45\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_45\" ><legend class='gfield_label gform-field-label' >Have you or anyone that you have had close contact with tested positive for COVID-19 in the past 14 days?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_45'>\n\t\t\t<div class='gchoice gchoice_7_45_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_45' type='radio' value='Yes'  id='choice_7_45_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_45_0' id='label_7_45_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_7_45_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_45' type='radio' value='No'  id='choice_7_45_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_45_1' id='label_7_45_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_7_46\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_46\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Have you or anyone in your house experienced the following symptoms in the past 14 days?<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_7_46'><div class='gchoice gchoice_7_46_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.1' type='checkbox'  value='Cough'  id='choice_7_46_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_46_1' id='label_7_46_1' class='gform-field-label gform-field-label--type-inline'>Cough<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_46_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.2' type='checkbox'  value='Shortness of breath'  id='choice_7_46_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_46_2' id='label_7_46_2' class='gform-field-label gform-field-label--type-inline'>Shortness of breath<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_46_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.3' type='checkbox'  value='Fever'  id='choice_7_46_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_46_3' id='label_7_46_3' class='gform-field-label gform-field-label--type-inline'>Fever<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_46_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.4' type='checkbox'  value='Sore throat'  id='choice_7_46_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_46_4' id='label_7_46_4' class='gform-field-label gform-field-label--type-inline'>Sore throat<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_46_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.5' type='checkbox'  value='Chills'  id='choice_7_46_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_46_5' id='label_7_46_5' class='gform-field-label gform-field-label--type-inline'>Chills<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_46_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.6' type='checkbox'  value='Muscle pain'  id='choice_7_46_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_46_6' id='label_7_46_6' class='gform-field-label gform-field-label--type-inline'>Muscle pain<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_46_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.7' type='checkbox'  value='Headache'  id='choice_7_46_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_46_7' id='label_7_46_7' class='gform-field-label gform-field-label--type-inline'>Headache<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_46_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.8' type='checkbox'  value='New loss of taste or smell'  id='choice_7_46_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_46_8' id='label_7_46_8' class='gform-field-label gform-field-label--type-inline'>New loss of taste or smell<\/label>\n\t\t\t\t\t\t\t<\/div><button type=\"button\" id=\"button_46_select_all\" class=\"gfield_choice_all_toggle gform-theme-button--size-sm\" onclick=\"gformToggleCheckboxes( this )\" data-checked=\"0\" data-label-select=\"Select All\" data-label-deselect=\"Deselect All\">Select All<\/button><\/div><\/div><\/fieldset><fieldset id=\"field_7_47\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_47\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Who experienced these symptoms?<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_7_47'><div class='gchoice gchoice_7_47_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.1' type='checkbox'  value='Self'  id='choice_7_47_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_47_1' id='label_7_47_1' class='gform-field-label gform-field-label--type-inline'>Self<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_47_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.2' type='checkbox'  value='Someone else in the house'  id='choice_7_47_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_47_2' id='label_7_47_2' class='gform-field-label gform-field-label--type-inline'>Someone else in the house<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_47_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.3' type='checkbox'  value='No symptoms'  id='choice_7_47_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_47_3' id='label_7_47_3' class='gform-field-label gform-field-label--type-inline'>No symptoms<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_7_49\" class=\"gfield gfield--type-consent gfield--type-choice field_sublabel_below gfield--has-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_7_49\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >If you are ill or have been exposed to someone who is ill, we request that a family member or friend bring  your pet to their appointment*<\/legend><div class='gfield_description gfield_consent_description' id='gfield_consent_description_7_49'>If Curbside care is elected: During the duration of the exam, your pet will be in the care of one of our team members. A team member will collect your pet from outside the building and support them through the exam, any services required, and then bring them back to your vehicle, when your pet is ready to go home. We strongly recommend you head home and a veterinarian or nurse will call you to discuss your pet\u2019s exam and  discuss recommended treatments, preventative measures and give an estimated discharge time.<\/div><div class='ginput_container ginput_container_consent'><input name='input_49.1' id='input_7_49_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_7_49\"  aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_7_49_1' >I have read and understand.<\/label><input type='hidden' name='input_49.2' value='I have read and understand.' class='gform_hidden' \/><input type='hidden' name='input_49.3' value='7' class='gform_hidden' \/><\/div><\/fieldset><fieldset id=\"field_7_41\" class=\"gfield gfield--type-consent gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_7_41\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Communicating during the appointment:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description gfield_consent_description' id='gfield_consent_description_7_41'>Day Admission appointments: A day admission appointment is available if you are unable to wait at the practice for the duration of your pet\u2019s visit. Please note that your pet will be worked into the schedule between scheduled patient appointments for this service. Your pet will be cared for and housed in a kennel until they are able to be seen and picked up. If you need to leave your pet for their appointment, please inform the team member who collects your pet from the car and the receptionist who answers the phone when you first arrive. <\/div><div class='ginput_container ginput_container_consent'><input name='input_41.1' id='input_7_41_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_7_41\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_7_41_1' >I have read and understand.<\/label><input type='hidden' name='input_41.2' value='I have read and understand.' class='gform_hidden' \/><input type='hidden' name='input_41.3' value='7' class='gform_hidden' \/><\/div><\/fieldset><fieldset id=\"field_7_38\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--has-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_7_38\" ><legend class='gfield_label gform-field-label' >Social Media\/Photo Permission<\/legend><div class='gfield_description' id='gfield_description_7_38'>Do we have your permission to post photos of your pet online? Your pets&#8217; picture or video may be taken while they are with us and used for Your Veterinary Practice advertisement (www.truecompanionvetcare.com) or other social media purposes (Facebook, SnapChat, Instagram, etc.). Please indicate if you authorize for their pictures\/videos to be posted or used. * If you do not authorize for your pet\u2019s picture to be included in our marketing materials\/venues, we may still use a picture of your pet in our patient records for our internal identification only*<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_38'>\n\t\t\t<div class='gchoice gchoice_7_38_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='Yes'  id='choice_7_38_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_7_38\"   \/>\n\t\t\t\t\t<label for='choice_7_38_0' id='label_7_38_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_7_38_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='No'  id='choice_7_38_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_7_38_1' id='label_7_38_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_7_58\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_58\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Cancellation Policy<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_7_58'><div class='gchoice gchoice_7_58_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.1' type='checkbox'  value='I understand that appointment cancellations less than 24 hours before appointment and\/or no shows will incur a $30.00 cancellation fee.'  id='choice_7_58_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_58_1' id='label_7_58_1' class='gform-field-label gform-field-label--type-inline'>I understand that appointment cancellations less than 24 hours before appointment and\/or no shows will incur a $30.00 cancellation fee.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_7_50\" class=\"gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_50\" ><label class='gfield_label gform-field-label' for='input_7_50'>Please type your initials.<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_50' id='input_7_50' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_51\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_51\" ><label class='gfield_label gform-field-label' for='input_7_51'>Date<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_51' id='input_7_51' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_7_51_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_7_51_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_7_51' class='gform_hidden' value='https:\/\/713websites.com\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_7_59\" class=\"gfield gfield--type-signature field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_59\" ><label class='gfield_label gform-field-label' for='input_7_59'>Signature<\/label><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_7_59_Container' class='gfield_signature_container ginput_container' style='height:180px; width:300px; ' ><input type='hidden' class='gform_hidden' name='input_7_59_valid' id='input_7_59_valid' \/><canvas id='input_7_59' width='300' height='180'><\/canvas><\/div><\/div><\/div><div id=\"field_7_60\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_60\" ><label class='gfield_label gform-field-label' for='input_7_60'>Name<\/label><div class='ginput_container'><input name='input_60' id='input_7_60' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_7_60'>This field is for validation purposes and should be left unchanged.<\/div><\/div><\/div><\/div>\n        <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_7' class='gform_button button' value='Submit'  onclick='if(window[\"gf_submitting_7\"]){return false;}  if( !jQuery(\"#gform_7\")[0].checkValidity || jQuery(\"#gform_7\")[0].checkValidity()){window[\"gf_submitting_7\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_7\"]){return false;} if( !jQuery(\"#gform_7\")[0].checkValidity || jQuery(\"#gform_7\")[0].checkValidity()){window[\"gf_submitting_7\"]=true;}  jQuery(\"#gform_7\").trigger(\"submit\",[true]); }' \/> \n            <input type='hidden' class='gform_hidden' name='is_submit_7' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='7' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_7' value='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' \/>\n            <input type='hidden' class='gform_hidden' name='gform_target_page_number_7' id='gform_target_page_number_7' value='0' \/>\n            <input type='hidden' class='gform_hidden' name='gform_source_page_number_7' id='gform_source_page_number_7' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/form>\n                        <\/div><script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\n gform.initializeOnLoaded( function() {gformInitSpinner( 7, 'https:\/\/713websites.com\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery('#gform_ajax_frame_7').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_7');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_7').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){jQuery('#gform_wrapper_7').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_7').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_7').removeClass('gform_validation_error');}setTimeout( function() { \/* delay the scroll by 50 milliseconds to fix a bug in chrome *\/  }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_7').val();gformInitSpinner( 7, 'https:\/\/713websites.com\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery(document).trigger('gform_page_loaded', [7, current_page]);window['gf_submitting_7'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}setTimeout(function(){jQuery('#gform_wrapper_7').replaceWith(confirmation_content);jQuery(document).trigger('gform_confirmation_loaded', [7]);window['gf_submitting_7'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_7').text());}, 50);}else{jQuery('#gform_7').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger(\"gform_pre_post_render\", [{ formId: \"7\", currentPage: \"current_page\", abort: function() { this.preventDefault(); } }]);                if (event.defaultPrevented) {                return;         }        const gformWrapperDiv = document.getElementById( \"gform_wrapper_7\" );        if ( gformWrapperDiv ) {            const visibilitySpan = document.createElement( \"span\" );            visibilitySpan.id = \"gform_visibility_test_7\";            gformWrapperDiv.insertAdjacentElement( \"afterend\", visibilitySpan );        }        const visibilityTestDiv = document.getElementById( \"gform_visibility_test_7\" );        let postRenderFired = false;                function triggerPostRender() {            if ( postRenderFired ) {                return;            }            postRenderFired = true;            jQuery( document ).trigger( 'gform_post_render', [7, current_page] );            gform.utils.trigger( { event: 'gform\/postRender', native: false, data: { formId: 7, currentPage: current_page } } );            if ( visibilityTestDiv ) {                visibilityTestDiv.parentNode.removeChild( visibilityTestDiv );            }        }        function debounce( func, wait, immediate ) {            var timeout;            return function() {                var context = this, args = arguments;                var later = function() {                    timeout = null;                    if ( !immediate ) func.apply( context, args );                };                var callNow = immediate && !timeout;                clearTimeout( timeout );                timeout = setTimeout( later, wait );                if ( callNow ) func.apply( context, args );            };        }        const debouncedTriggerPostRender = debounce( function() {            triggerPostRender();        }, 200 );        if ( visibilityTestDiv && visibilityTestDiv.offsetParent === null ) {            const observer = new MutationObserver( ( mutations ) => {                mutations.forEach( ( mutation ) => {                    if ( mutation.type === 'attributes' && visibilityTestDiv.offsetParent !== null ) {                        debouncedTriggerPostRender();                        observer.disconnect();                    }                });            });            observer.observe( document.body, {                attributes: true,                childList: false,                subtree: true,                attributeFilter: [ 'style', 'class' ],            });        } else {            triggerPostRender();        }    } );} ); \n\/* ]]> *\/\n<\/script>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page-fullwidth.php","meta":{"footnotes":""},"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/713websites.com\/wp-json\/wp\/v2\/pages\/3384"}],"collection":[{"href":"https:\/\/713websites.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/713websites.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/713websites.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/713websites.com\/wp-json\/wp\/v2\/comments?post=3384"}],"version-history":[{"count":1,"href":"https:\/\/713websites.com\/wp-json\/wp\/v2\/pages\/3384\/revisions"}],"predecessor-version":[{"id":3385,"href":"https:\/\/713websites.com\/wp-json\/wp\/v2\/pages\/3384\/revisions\/3385"}],"wp:attachment":[{"href":"https:\/\/713websites.com\/wp-json\/wp\/v2\/media?parent=3384"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}