{"id":3137,"date":"2020-07-29T14:22:57","date_gmt":"2020-07-29T20:22:57","guid":{"rendered":"https:\/\/bluetreeapps.com\/website1demo\/?page_id=3137"},"modified":"2020-09-16T12:37:41","modified_gmt":"2020-09-16T18:37:41","slug":"health-intake-form-basic-1-report","status":"publish","type":"page","link":"https:\/\/bluetreeapps.com\/website1demo\/health-intake-form-basic-1-report\/","title":{"rendered":"Health Intake Form &#8211; Standard Report"},"content":{"rendered":"<h2>Standard Health Intake Survey Demo<\/h2>\n<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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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\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_6' style='display:none'><form method='post' enctype='multipart\/form-data'  id='gform_6'  action='\/website1demo\/wp-json\/wp\/v2\/pages\/3137' data-formid='6' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_6' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_6_4\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-icon 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_6_4'>Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_4' id='input_6_4' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_6_4_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_6_4_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_6_4' class='gform_hidden' value='https:\/\/bluetreeapps.com\/website1demo\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_6_1\" class=\"gfield gfield--type-name 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 gfield_label_before_complex' >Child Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><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_6_1'>\n                            \n                            <span id='input_6_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_6_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_6_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_6_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_6_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_6_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_6_16\" class=\"gfield gfield--type-survey 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\"  ><label class='gfield_label gform-field-label' >What school does this child attend?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_16'>\n\t\t\t<li class='gchoice gchoice_6_16_0'>\n\t\t\t\t<input name='input_16' type='radio' value='gsurvey166a1407f5'  id='choice_6_16_0'    \/>\n\t\t\t\t<label for='choice_6_16_0' id='label_6_16_0' class='gform-field-label gform-field-label--type-inline'>Preschool<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_16_1'>\n\t\t\t\t<input name='input_16' type='radio' value='gsurvey16cdcf1593'  id='choice_6_16_1'    \/>\n\t\t\t\t<label for='choice_6_16_1' id='label_6_16_1' class='gform-field-label gform-field-label--type-inline'>Elementary<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_16_2'>\n\t\t\t\t<input name='input_16' type='radio' value='gsurvey161ee90298'  id='choice_6_16_2'    \/>\n\t\t\t\t<label for='choice_6_16_2' id='label_6_16_2' class='gform-field-label gform-field-label--type-inline'>Secondary<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_17\" class=\"gfield gfield--type-survey 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\"  ><label class='gfield_label gform-field-label' >What is the child&#039;s home classroom or department?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_17'>\n\t\t\t<li class='gchoice gchoice_6_17_0'>\n\t\t\t\t<input name='input_17' type='radio' value='gsurvey17d5d1d0be'  id='choice_6_17_0'    \/>\n\t\t\t\t<label for='choice_6_17_0' id='label_6_17_0' class='gform-field-label gform-field-label--type-inline'>Infants<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_17_1'>\n\t\t\t\t<input name='input_17' type='radio' value='gsurvey17699dc8f9'  id='choice_6_17_1'    \/>\n\t\t\t\t<label for='choice_6_17_1' id='label_6_17_1' class='gform-field-label gform-field-label--type-inline'>Toddlers<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_17_2'>\n\t\t\t\t<input name='input_17' type='radio' value='gsurvey177119feeb'  id='choice_6_17_2'    \/>\n\t\t\t\t<label for='choice_6_17_2' id='label_6_17_2' class='gform-field-label gform-field-label--type-inline'>Preschool<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_19\" class=\"gfield gfield--type-survey 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\"  ><label class='gfield_label gform-field-label' >What Grade is the child in?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_19'>\n\t\t\t<li class='gchoice gchoice_6_19_0'>\n\t\t\t\t<input name='input_19' type='radio' value='gsurvey19a4a78c24'  id='choice_6_19_0'    \/>\n\t\t\t\t<label for='choice_6_19_0' id='label_6_19_0' class='gform-field-label gform-field-label--type-inline'>Kindergarten<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_19_1'>\n\t\t\t\t<input name='input_19' type='radio' value='gsurvey191bf9bf1e'  id='choice_6_19_1'    \/>\n\t\t\t\t<label for='choice_6_19_1' id='label_6_19_1' class='gform-field-label gform-field-label--type-inline'>1st Grade<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_19_2'>\n\t\t\t\t<input name='input_19' type='radio' value='gsurvey1965349127'  id='choice_6_19_2'    \/>\n\t\t\t\t<label for='choice_6_19_2' id='label_6_19_2' class='gform-field-label gform-field-label--type-inline'>2nd Grade<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_19_3'>\n\t\t\t\t<input name='input_19' type='radio' value='gsurvey19b3c81491'  id='choice_6_19_3'    \/>\n\t\t\t\t<label for='choice_6_19_3' id='label_6_19_3' class='gform-field-label gform-field-label--type-inline'>3rd Grade<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_19_4'>\n\t\t\t\t<input name='input_19' type='radio' value='gsurvey199d215881'  id='choice_6_19_4'    \/>\n\t\t\t\t<label for='choice_6_19_4' id='label_6_19_4' class='gform-field-label gform-field-label--type-inline'>4th Grade<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_19_5'>\n\t\t\t\t<input name='input_19' type='radio' value='gsurvey19af45cf5c'  id='choice_6_19_5'    \/>\n\t\t\t\t<label for='choice_6_19_5' id='label_6_19_5' class='gform-field-label gform-field-label--type-inline'>5th Grade<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_19_6'>\n\t\t\t\t<input name='input_19' type='radio' value='gsurvey195e327011'  id='choice_6_19_6'    \/>\n\t\t\t\t<label for='choice_6_19_6' id='label_6_19_6' class='gform-field-label gform-field-label--type-inline'>6th Grade<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_18\" class=\"gfield gfield--type-survey 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\"  ><label class='gfield_label gform-field-label' >Who is the Kindergarten homeroom teacher?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_18'>\n\t\t\t<li class='gchoice gchoice_6_18_0'>\n\t\t\t\t<input name='input_18' type='radio' value='gsurvey184a361aaa'  id='choice_6_18_0'    \/>\n\t\t\t\t<label for='choice_6_18_0' id='label_6_18_0' class='gform-field-label gform-field-label--type-inline'>Hutchins, Hollee<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_18_1'>\n\t\t\t\t<input name='input_18' type='radio' value='gsurvey18e77cca5f'  id='choice_6_18_1'    \/>\n\t\t\t\t<label for='choice_6_18_1' id='label_6_18_1' class='gform-field-label gform-field-label--type-inline'>Wade, Linda<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_20\" class=\"gfield gfield--type-survey 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\"  ><label class='gfield_label gform-field-label' >Who is the your child&#039;s 1st Grade homeroom teacher?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_20'>\n\t\t\t<li class='gchoice gchoice_6_20_0'>\n\t\t\t\t<input name='input_20' type='radio' value='gsurvey184a361aaa'  id='choice_6_20_0'    \/>\n\t\t\t\t<label for='choice_6_20_0' id='label_6_20_0' class='gform-field-label gform-field-label--type-inline'>Christenson, Emily<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_20_1'>\n\t\t\t\t<input name='input_20' type='radio' value='gsurvey18e77cca5f'  id='choice_6_20_1'    \/>\n\t\t\t\t<label for='choice_6_20_1' id='label_6_20_1' class='gform-field-label gform-field-label--type-inline'>Tourjee, Shirley<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_21\" class=\"gfield gfield--type-survey 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\"  ><label class='gfield_label gform-field-label' >Who is your child&#039;s 2nd Grade homeroom teacher?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_21'>\n\t\t\t<li class='gchoice gchoice_6_21_0'>\n\t\t\t\t<input name='input_21' type='radio' value='gsurvey184a361aaa'  id='choice_6_21_0'    \/>\n\t\t\t\t<label for='choice_6_21_0' id='label_6_21_0' class='gform-field-label gform-field-label--type-inline'>Kuster, Amanda<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_21_1'>\n\t\t\t\t<input name='input_21' type='radio' value='gsurvey18e77cca5f'  id='choice_6_21_1'    \/>\n\t\t\t\t<label for='choice_6_21_1' id='label_6_21_1' class='gform-field-label gform-field-label--type-inline'>Savage, Shanti<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_21_2'>\n\t\t\t\t<input name='input_21' type='radio' value='gsurvey21bfc94e36'  id='choice_6_21_2'    \/>\n\t\t\t\t<label for='choice_6_21_2' id='label_6_21_2' class='gform-field-label gform-field-label--type-inline'>Yokeum, Danene<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_23\" class=\"gfield gfield--type-survey 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\"  ><label class='gfield_label gform-field-label' >Who is your child&#039;s 3rd Grade homeroom teacher?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_23'>\n\t\t\t<li class='gchoice gchoice_6_23_0'>\n\t\t\t\t<input name='input_23' type='radio' value='gsurvey184a361aaa'  id='choice_6_23_0'    \/>\n\t\t\t\t<label for='choice_6_23_0' id='label_6_23_0' class='gform-field-label gform-field-label--type-inline'>Lowe, Angela<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_23_1'>\n\t\t\t\t<input name='input_23' type='radio' value='gsurvey18e77cca5f'  id='choice_6_23_1'    \/>\n\t\t\t\t<label for='choice_6_23_1' id='label_6_23_1' class='gform-field-label gform-field-label--type-inline'>Russell, Casey<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_25\" class=\"gfield gfield--type-survey 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\"  ><label class='gfield_label gform-field-label' >Who is your child&#039;s 4th Grade homeroom teacher?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_25'>\n\t\t\t<li class='gchoice gchoice_6_25_0'>\n\t\t\t\t<input name='input_25' type='radio' value='gsurvey184a361aaa'  id='choice_6_25_0'    \/>\n\t\t\t\t<label for='choice_6_25_0' id='label_6_25_0' class='gform-field-label gform-field-label--type-inline'>Hanson, Ellen<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_26\" class=\"gfield gfield--type-survey 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\"  ><label class='gfield_label gform-field-label' >Who is your child&#039;s 5th Grade homeroom teacher?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_26'>\n\t\t\t<li class='gchoice gchoice_6_26_0'>\n\t\t\t\t<input name='input_26' type='radio' value='gsurvey184a361aaa'  id='choice_6_26_0'    \/>\n\t\t\t\t<label for='choice_6_26_0' id='label_6_26_0' class='gform-field-label gform-field-label--type-inline'>Jones, Sandy<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_26_1'>\n\t\t\t\t<input name='input_26' type='radio' value='gsurvey26b975c8e7'  id='choice_6_26_1'    \/>\n\t\t\t\t<label for='choice_6_26_1' id='label_6_26_1' class='gform-field-label gform-field-label--type-inline'>Lein, Kathryn<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_26_2'>\n\t\t\t\t<input name='input_26' type='radio' value='gsurvey26e1d69a01'  id='choice_6_26_2'    \/>\n\t\t\t\t<label for='choice_6_26_2' id='label_6_26_2' class='gform-field-label gform-field-label--type-inline'>Werner, Lucas<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_27\" class=\"gfield gfield--type-survey 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\"  ><label class='gfield_label gform-field-label' >Who is your child&#039;s 6th Grade homeroom teacher?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_27'>\n\t\t\t<li class='gchoice gchoice_6_27_0'>\n\t\t\t\t<input name='input_27' type='radio' value='gsurvey184a361aaa'  id='choice_6_27_0'    \/>\n\t\t\t\t<label for='choice_6_27_0' id='label_6_27_0' class='gform-field-label gform-field-label--type-inline'>Barry, Jennifer<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_27_1'>\n\t\t\t\t<input name='input_27' type='radio' value='gsurvey26b975c8e7'  id='choice_6_27_1'    \/>\n\t\t\t\t<label for='choice_6_27_1' id='label_6_27_1' class='gform-field-label gform-field-label--type-inline'>Smith, Glenn<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_5\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_5'>Temperature of Child?<\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_6_5' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_2\" class=\"gfield gfield--type-survey 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\"  ><label class='gfield_label gform-field-label' >Does the child have a fever of  100.4\u00b0F or higher?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_2'>\n\t\t\t<li class='gchoice gchoice_6_2_0'>\n\t\t\t\t<input name='input_2' type='radio' value='gsurvey289c0118c'  id='choice_6_2_0'    \/>\n\t\t\t\t<label for='choice_6_2_0' id='label_6_2_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_2_1'>\n\t\t\t\t<input name='input_2' type='radio' value='gsurvey230f6ed4b'  id='choice_6_2_1'    \/>\n\t\t\t\t<label for='choice_6_2_1' id='label_6_2_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_31\" class=\"gfield gfield--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\"  ><\/br><\/li><li id=\"field_6_30\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Select Yes or No if you or your child is experiencing any of the following symptoms:<\/h2><\/li><li id=\"field_6_7\" class=\"gfield gfield--type-survey 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\"  ><label class='gfield_label gform-field-label' >Cough?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_7'>\n\t\t\t<li class='gchoice gchoice_6_7_0'>\n\t\t\t\t<input name='input_7' type='radio' value='gsurvey281816209'  id='choice_6_7_0'    \/>\n\t\t\t\t<label for='choice_6_7_0' id='label_6_7_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_7_1'>\n\t\t\t\t<input name='input_7' type='radio' value='gsurvey2a4eaa315'  id='choice_6_7_1'    \/>\n\t\t\t\t<label for='choice_6_7_1' id='label_6_7_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_8\" class=\"gfield gfield--type-survey 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\"  ><label class='gfield_label gform-field-label' >Shortness of breath or difficulty breathing?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_8'>\n\t\t\t<li class='gchoice gchoice_6_8_0'>\n\t\t\t\t<input name='input_8' type='radio' value='gsurvey281816209'  id='choice_6_8_0'    \/>\n\t\t\t\t<label for='choice_6_8_0' id='label_6_8_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_8_1'>\n\t\t\t\t<input name='input_8' type='radio' value='gsurvey2a4eaa315'  id='choice_6_8_1'    \/>\n\t\t\t\t<label for='choice_6_8_1' id='label_6_8_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_10\" class=\"gfield gfield--type-survey 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\"  ><label class='gfield_label gform-field-label' >Muscle aches?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_10'>\n\t\t\t<li class='gchoice gchoice_6_10_0'>\n\t\t\t\t<input name='input_10' type='radio' value='gsurvey281816209'  id='choice_6_10_0'    \/>\n\t\t\t\t<label for='choice_6_10_0' id='label_6_10_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_10_1'>\n\t\t\t\t<input name='input_10' type='radio' value='gsurvey2a4eaa315'  id='choice_6_10_1'    \/>\n\t\t\t\t<label for='choice_6_10_1' id='label_6_10_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_9\" class=\"gfield gfield--type-survey 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\"  ><label class='gfield_label gform-field-label' >New loss of taste or smell?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_9'>\n\t\t\t<li class='gchoice gchoice_6_9_0'>\n\t\t\t\t<input name='input_9' type='radio' value='gsurvey281816209'  id='choice_6_9_0'    \/>\n\t\t\t\t<label for='choice_6_9_0' id='label_6_9_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_9_1'>\n\t\t\t\t<input name='input_9' type='radio' value='gsurvey2a4eaa315'  id='choice_6_9_1'    \/>\n\t\t\t\t<label for='choice_6_9_1' id='label_6_9_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_11\" class=\"gfield gfield--type-survey 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\"  ><label class='gfield_label gform-field-label' >Exposed to someone with COVID or with symptoms?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_11'>\n\t\t\t<li class='gchoice gchoice_6_11_0'>\n\t\t\t\t<input name='input_11' type='radio' value='gsurvey281816209'  id='choice_6_11_0'    \/>\n\t\t\t\t<label for='choice_6_11_0' id='label_6_11_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_11_1'>\n\t\t\t\t<input name='input_11' type='radio' value='gsurvey2a4eaa315'  id='choice_6_11_1'    \/>\n\t\t\t\t<label for='choice_6_11_1' id='label_6_11_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><\/ul><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_6' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Submit'  \/> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_6' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_6' id='gform_theme_6' value='legacy' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_6' id='gform_style_settings_6' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_6' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='6' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='fuGvQ\/R9lYGxS3cRTBkMCE2wQTjQqPj\/07N60PqVzCTMHlu\/FO5VybcJG5PSW6rPILZDLQrUy9itJt7dsKUfPFT+wNRFwXxO54LyBOZNWVBF+iU=' \/>\n            <input type='hidden' 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);<\/script><\/p><\/form>\n                        <\/div><script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\n gform.initializeOnLoaded( function() {gformInitSpinner( 6, 'https:\/\/bluetreeapps.com\/website1demo\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery('#gform_ajax_frame_6').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_6');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_6').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', 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For example if you select \u201cElementary School\u201d, Grade Level Question pop up.<\/li>\n<li><strong>Email Notification:<\/strong> Email notifications can be sent to one or more addresses based on answers to the questions. For example, if you answer \u201cYes\u201d to any of the symptom questions, an email can be sent to the school nurse.<\/li>\n<li><strong>Customized Confirmaions: <\/strong>Different pop ups, links and landing pages can display based on given answers. Parent instructions, links to health organizations.<\/li>\n<li><strong>Reports:\u00a0<\/strong>Summary reports are created as CSV and emailed daily to teachers at a specific time. Report includes those who have completed the report only. 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