{"id":72,"date":"2018-06-12T19:47:35","date_gmt":"2018-06-12T19:47:35","guid":{"rendered":"http:\/\/www.hohb.drnoce.biz\/?page_id=72"},"modified":"2018-07-03T17:07:18","modified_gmt":"2018-07-03T17:07:18","slug":"enrollment-application","status":"publish","type":"page","link":"http:\/\/www.hohb.drnoce.biz\/index.php\/forms\/enrollment-application\/","title":{"rendered":"Enrollment Application"},"content":{"rendered":"<h1 style=\"text-align: center;\"><\/h1>\n<noscript class=\"ninja-forms-noscript-message\">\n\tNotice: JavaScript is required for this content.<\/noscript>\n<div id=\"nf-form-2-cont\" class=\"nf-form-cont\" aria-live=\"polite\" aria-labelledby=\"nf-form-title-2\" aria-describedby=\"nf-form-errors-2\" role=\"form\">\n\n    <div class=\"nf-loading-spinner\"><\/div>\n\n<\/div>\n        <!-- That data is being printed as a workaround to page builders reordering the order of the scripts loaded-->\n        <script>var formDisplay=1;var nfForms=nfForms||[];var form=[];form.id='2';form.settings={\"objectType\":\"Form Setting\",\"editActive\":true,\"title\":\"Enrollment Application\",\"show_title\":0,\"clear_complete\":1,\"hide_complete\":0,\"default_label_pos\":\"above\",\"wrapper_class\":\"\",\"element_class\":\"\",\"key\":\"\",\"add_submit\":1,\"currency\":\"\",\"unique_field_error\":\"A form with this value has already been submitted.\",\"logged_in\":false,\"not_logged_in_msg\":\"\",\"sub_limit_msg\":\"The form has reached its submission limit.\",\"calculations\":[],\"formContentData\":[\"personal_info_1523911398130\",\"firstname_1523911360962\",\"lastname_1523911357220\",\"email_1523911364558\",\"phone_1523911366932\",\"address_1523911369006\",\"address_1523911370832\",\"city_1523911372094\",\"us_state_1524662288192\",\"zip_1523911383214\",\"applicant_s_school_employer_1528830332123\",\"where_did_you_hear_about_hohb_1528833248569\",\"does_applicant_have_any_previous_experience_1528830411672\",\"if_yes_please_describe_1528833269824\",\"hr_1528830950649\",\"parent_guardian_first_name_1528830521765\",\"parent_guardian_last_name_1528830527555\",\"address_if_different_from_above_1528830620347\",\"phone_and_email_if_different_than_above_1528830641815\",\"mother_s_employer_1528830655728\",\"mother_s_occupation_1528830666463\",\"father_s_employer_1528830684984\",\"father_s_occupation_1528830698379\",\"emergency_contact_other_than_parent_1528830736515\",\"relationship_1528830745437\",\"phone_1528830759503\",\"hr_1528830937990\",\"psycho_social_function_1528830831182\",\"goals_1528830851284\",\"html_1528830878367\",\"hr_1528830928806\",\"html_1528830923477\",\"listselect_1528831050623\",\"html_1528831145495\",\"usage_agreement_1528833028456\",\"today_s_date_1528831381775\",\"hr_1528831416162\",\"diagnosis_or_disability_1528831535188\",\"date_of_onset_1528831642503\",\"html_1528831452835\",\"does_the_applicant_have_1528833129928\",\"has_the_participant_ever_been_treated_for_any_of_the_following_1528832569782\",\"if_yes_to_any_of_the_above_please_describe_and_date_occurrence_1528832776279\",\"in_the_past_12_months_has_the_participant_1528833388706\",\"if_yes_please_explain_1528833454948\",\"does_the_participant_need_assistance_to_maintain_an_upright_position_or_head_control_1528833489400\",\"hr_1528833675793\",\"physician_release_1528833688681\",\"first_name_of_person_completing_form_1528833558438\",\"last_name_of_person_completing_form_1528833570879\",\"date_1528833518081\",\"listcheckbox_1528834292407\",\"relationship_to_participant_1528833589481\",\"hr_1528833732781\",\"html_1528833735736\",\"participant_s_first_name_1528833846465\",\"participant_s_last_name_1528833853204\",\"seizure_treating_physician_1528833869248\",\"physician_s_phone_1528833895034\",\"types_of_seizures_1528833919069\",\"date_of_previous_seizure_1528834069080\",\"duration_of_each_seizure_1528834112107\",\"frequency_of_seizures_1528834091504\",\"typical_cause_of_seizure_activity_1528834124727\",\"seizure_activity_indicators_1528834154147\",\"after_effect_if_any_1528834225012\",\"during_a_seizure_i_my_child_patient_check_all_that_apply_1528906679605\",\"other_please_explain_1528906852559\",\"are_you_is_your_child_patient_able_to_know_and_express_when_a_seizure_may_occur_what_are_the_signs_1528906878442\",\"should_you_your_child_experience_a_seizure_while_at_trec_beyond_employing_general_first_aid_what_actions_do_you_suggest_we_take_1528906994668\",\"other_please_specify_1528907079836\",\"today_s_date_1528907125828\",\"i_hereby_declare_that_all_the_information_i_have_provided_regarding_seizures_either_for_myself_or_a_third-party_is_completely_accurate_and_correct_1528906957091\",\"hr_1528907174525\",\"physical_function_1528907202049\",\"please_indicate_current_or_past_special_needs_in_the_following_areas_1528907233420\",\"comments_about_the_conditions_above_1528907440726\",\"medications_1528907473050\",\"medical_devices_1528907527741\",\"submit_form_1528907558034\"],\"drawerDisabled\":false,\"created_at\":\"2018-06-12 19:05:06\",\"changeEmailErrorMsg\":\"Please enter a valid email address!\",\"changeDateErrorMsg\":\"Please enter a valid date!\",\"confirmFieldErrorMsg\":\"These fields must match!\",\"fieldNumberNumMinError\":\"Number Min Error\",\"fieldNumberNumMaxError\":\"Number Max Error\",\"fieldNumberIncrementBy\":\"Please increment by \",\"formErrorsCorrectErrors\":\"Please correct errors before submitting this form.\",\"validateRequiredField\":\"This is a required field.\",\"honeypotHoneypotError\":\"Honeypot Error\",\"fieldsMarkedRequired\":\"Fields marked with an <span class=\\\"ninja-forms-req-symbol\\\">*<\\\/span> are required\",\"ninjaForms\":\"Ninja Forms\",\"fieldTextareaRTEInsertLink\":\"Insert Link\",\"fieldTextareaRTEInsertMedia\":\"Insert Media\",\"fieldTextareaRTESelectAFile\":\"Select a file\",\"tableInsertRowAbove\":\"Insert Row Above\",\"tableInsertRowBelow\":\"Insert Row Below\",\"tableInsertColumnLeft\":\"Insert Column Left\",\"tableInsertColumnRight\":\"Insert Column Right\",\"tableDeleteRow\":\"Delete Row\",\"tableDeleteColumn\":\"Delete Column\",\"tableDeleteTable\":\"Delete Table\",\"tableLegacyNotice\":\"This content has tables in the old editor format. Custom styles are preserved until converted. Editing will update to the new format.\",\"tableLegacyConvert\":\"Convert Now\",\"tableInsertTable\":\"Insert Table\",\"dismiss\":\"Dismiss\",\"insertLink\":\"Insert Link\",\"formHoneypot\":\"If you are a human seeing this field, please leave it empty.\",\"fileUploadOldCodeFileUploadInProgress\":\"File Upload in Progress.\",\"fileUploadOldCodeFileUpload\":\"FILE UPLOAD\",\"currencySymbol\":false,\"thousands_sep\":\",\",\"decimal_point\":\".\",\"siteLocale\":\"en_US\",\"dateFormat\":\"m\\\/d\\\/Y\",\"startOfWeek\":\"1\",\"of\":\"of\",\"previousMonth\":\"Previous Month\",\"nextMonth\":\"Next Month\",\"months\":[\"January\",\"February\",\"March\",\"April\",\"May\",\"June\",\"July\",\"August\",\"September\",\"October\",\"November\",\"December\"],\"monthsShort\":[\"Jan\",\"Feb\",\"Mar\",\"Apr\",\"May\",\"Jun\",\"Jul\",\"Aug\",\"Sep\",\"Oct\",\"Nov\",\"Dec\"],\"weekdays\":[\"Sunday\",\"Monday\",\"Tuesday\",\"Wednesday\",\"Thursday\",\"Friday\",\"Saturday\"],\"weekdaysShort\":[\"Sun\",\"Mon\",\"Tue\",\"Wed\",\"Thu\",\"Fri\",\"Sat\"],\"weekdaysMin\":[\"Su\",\"Mo\",\"Tu\",\"We\",\"Th\",\"Fr\",\"Sa\"],\"recaptchaConsentMissing\":\"reCaptcha validation couldn&#039;t load.\",\"recaptchaMissingCookie\":\"reCaptcha v3 validation couldn&#039;t load the cookie needed to submit the form.\",\"recaptchaConsentEvent\":\"Accept reCaptcha cookies before sending the form.\",\"embed_form\":\"\",\"currency_symbol\":\"\",\"beforeForm\":\"\",\"beforeFields\":\"\",\"afterFields\":\"\",\"afterForm\":\"\"};form.fields=[{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":1,\"label\":\"Personal Info\",\"type\":\"html\",\"default\":\"<h3>Personal Information<\\\/h3>\",\"container_class\":\"\",\"element_class\":\"\",\"key\":\"personal_info_1523911398130\",\"drawerDisabled\":false,\"created_at\":\"2018-06-12 19:05:07\",\"id\":5,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"<h3>Personal Information<\\\/h3>\",\"label_pos\":\"above\",\"parentType\":\"html\",\"element_templates\":[\"html\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":2,\"label\":\"First Name\",\"type\":\"firstname\",\"key\":\"firstname_1523911360962\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"one-half first\",\"element_class\":\"\",\"admin_label\":\"\",\"help_text\":\"\",\"custom_name_attribute\":\"fname\",\"created_at\":\"2018-06-12 19:05:07\",\"personally_identifiable\":1,\"id\":6,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"firstname\",\"element_templates\":[\"firstname\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":3,\"label\":\"Last Name\",\"type\":\"lastname\",\"key\":\"lastname_1523911357220\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"one-half second\",\"element_class\":\"\",\"admin_label\":\"\",\"help_text\":\"\",\"custom_name_attribute\":\"lname\",\"created_at\":\"2018-06-12 19:05:07\",\"personally_identifiable\":1,\"id\":7,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"lastname\",\"element_templates\":[\"lastname\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":4,\"label\":\"Email\",\"type\":\"email\",\"key\":\"email_1523911364558\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"admin_label\":\"\",\"help_text\":\"\",\"custom_name_attribute\":\"email\",\"created_at\":\"2018-06-12 19:05:07\",\"personally_identifiable\":1,\"id\":8,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"email\",\"element_templates\":[\"email\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":5,\"label\":\"Phone\",\"type\":\"phone\",\"key\":\"phone_1523911366932\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"mask\":\"\",\"custom_mask\":\"\",\"custom_name_attribute\":\"phone\",\"created_at\":\"2018-06-12 19:05:07\",\"personally_identifiable\":1,\"id\":9,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textbox\",\"element_templates\":[\"tel\",\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":6,\"label\":\"Address\",\"type\":\"address\",\"key\":\"address_1523911369006\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"mask\":\"\",\"custom_mask\":\"\",\"custom_name_attribute\":\"address\",\"created_at\":\"2018-06-12 19:05:07\",\"personally_identifiable\":1,\"id\":10,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"address\",\"element_templates\":[\"address\",\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":7,\"label\":\"Address\",\"type\":\"address\",\"key\":\"address_1523911370832\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"mask\":\"\",\"custom_mask\":\"\",\"custom_name_attribute\":\"address\",\"created_at\":\"2018-06-12 19:05:07\",\"personally_identifiable\":1,\"id\":11,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"address\",\"element_templates\":[\"address\",\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":8,\"label\":\"City\",\"type\":\"city\",\"key\":\"city_1523911372094\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"one-third first\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"mask\":\"\",\"custom_mask\":\"\",\"custom_name_attribute\":\"city\",\"created_at\":\"2018-06-12 19:05:07\",\"personally_identifiable\":\"\",\"id\":12,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"city\",\"element_templates\":[\"city\",\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":9,\"label\":\"US State\",\"type\":\"liststate\",\"key\":\"us_state_1524662288192\",\"label_pos\":\"above\",\"required\":false,\"options\":[{\"errors\":[],\"max_options\":0,\"label\":\"Alabama\",\"value\":\"AL\",\"calc\":\"\",\"selected\":0,\"order\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Alaska\",\"value\":\"AK\",\"calc\":\"\",\"selected\":0,\"order\":1,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Arizona\",\"value\":\"AZ\",\"calc\":\"\",\"selected\":0,\"order\":2,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Arkansas\",\"value\":\"AR\",\"calc\":\"\",\"selected\":0,\"order\":3,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"California\",\"value\":\"CA\",\"calc\":\"\",\"selected\":0,\"order\":4,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Colorado\",\"value\":\"CO\",\"calc\":\"\",\"selected\":0,\"order\":5,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Connecticut\",\"value\":\"CT\",\"calc\":\"\",\"selected\":0,\"order\":6,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Delaware\",\"value\":\"DE\",\"calc\":\"\",\"selected\":0,\"order\":7,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Florida\",\"value\":\"FL\",\"calc\":\"\",\"selected\":0,\"order\":8,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Georgia\",\"value\":\"GA\",\"calc\":\"\",\"selected\":0,\"order\":9,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Hawaii\",\"value\":\"HI\",\"calc\":\"\",\"selected\":0,\"order\":10,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Idaho\",\"value\":\"ID\",\"calc\":\"\",\"selected\":0,\"order\":11,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Illinois\",\"value\":\"IL\",\"calc\":\"\",\"selected\":0,\"order\":12,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Indiana\",\"value\":\"IN\",\"calc\":\"\",\"selected\":0,\"order\":13,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Iowa\",\"value\":\"IA\",\"calc\":\"\",\"selected\":0,\"order\":14,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Kansas\",\"value\":\"KS\",\"calc\":\"\",\"selected\":0,\"order\":15,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Kentucky\",\"value\":\"KY\",\"calc\":\"\",\"selected\":0,\"order\":16,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Louisiana\",\"value\":\"LA\",\"calc\":\"\",\"selected\":0,\"order\":17,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Maine\",\"value\":\"ME\",\"calc\":\"\",\"selected\":0,\"order\":18,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Maryland\",\"value\":\"MD\",\"calc\":\"\",\"selected\":0,\"order\":19,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Massachusetts\",\"value\":\"MA\",\"calc\":\"\",\"selected\":0,\"order\":20,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Michigan\",\"value\":\"MI\",\"calc\":\"\",\"selected\":0,\"order\":21,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Minnesota\",\"value\":\"MN\",\"calc\":\"\",\"selected\":0,\"order\":22,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Mississippi\",\"value\":\"MS\",\"calc\":\"\",\"selected\":0,\"order\":23,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Missouri\",\"value\":\"MO\",\"calc\":\"\",\"selected\":0,\"order\":24,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Montana\",\"value\":\"MT\",\"calc\":\"\",\"selected\":0,\"order\":25,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Nebraska\",\"value\":\"NE\",\"calc\":\"\",\"selected\":0,\"order\":26,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Nevada\",\"value\":\"NV\",\"calc\":\"\",\"selected\":0,\"order\":27,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"New Hampshire\",\"value\":\"NH\",\"calc\":\"\",\"selected\":0,\"order\":28,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"New Jersey\",\"value\":\"NJ\",\"calc\":\"\",\"selected\":0,\"order\":29,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"New Mexico\",\"value\":\"NM\",\"calc\":\"\",\"selected\":0,\"order\":30,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"New York\",\"value\":\"NY\",\"calc\":\"\",\"selected\":0,\"order\":31,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"North Carolina\",\"value\":\"NC\",\"calc\":\"\",\"selected\":0,\"order\":32,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"North Dakota\",\"value\":\"ND\",\"calc\":\"\",\"selected\":0,\"order\":33,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Ohio\",\"value\":\"OH\",\"calc\":\"\",\"selected\":0,\"order\":34,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Oklahoma\",\"value\":\"OK\",\"calc\":\"\",\"selected\":0,\"order\":35,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Oregon\",\"value\":\"OR\",\"calc\":\"\",\"selected\":0,\"order\":36,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Pennsylvania\",\"value\":\"PA\",\"calc\":\"\",\"selected\":0,\"order\":37,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Rhode Island\",\"value\":\"RI\",\"calc\":\"\",\"selected\":0,\"order\":38,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"South Carolina\",\"value\":\"SC\",\"calc\":\"\",\"selected\":0,\"order\":39,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"South Dakota\",\"value\":\"SD\",\"calc\":\"\",\"selected\":0,\"order\":40,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Tennessee\",\"value\":\"TN\",\"calc\":\"\",\"selected\":0,\"order\":41,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Texas\",\"value\":\"TX\",\"calc\":\"\",\"selected\":0,\"order\":42,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Utah\",\"value\":\"UT\",\"calc\":\"\",\"selected\":0,\"order\":43,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Vermont\",\"value\":\"VT\",\"calc\":\"\",\"selected\":0,\"order\":44,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Virginia\",\"value\":\"VA\",\"calc\":\"\",\"selected\":0,\"order\":45,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Washington\",\"value\":\"WA\",\"calc\":\"\",\"selected\":0,\"order\":46,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"West Virginia\",\"value\":\"WV\",\"calc\":\"\",\"selected\":0,\"order\":47,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Wisconsin\",\"value\":\"WI\",\"calc\":\"\",\"selected\":0,\"order\":48,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Wyoming\",\"value\":\"WY\",\"calc\":\"\",\"selected\":0,\"order\":49,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Washington DC\",\"value\":\"DC\",\"calc\":\"\",\"selected\":0,\"order\":50,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"ARMED FORCES AFRICA \\\\ CANADA \\\\ EUROPE \\\\ MIDDLE EAST\",\"value\":\"AE\",\"calc\":\"\",\"selected\":0,\"order\":51,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"ARMED FORCES AMERICA (EXCEPT CANADA)\",\"value\":\"AA\",\"calc\":\"\",\"selected\":0,\"order\":52,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"ARMED FORCES PACIFIC\",\"value\":\"AP\",\"calc\":\"\",\"selected\":0,\"order\":53,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}}],\"container_class\":\"one-third second\",\"element_class\":\"\",\"admin_label\":\"\",\"help_text\":\"\",\"drawerDisabled\":false,\"created_at\":\"2018-06-12 19:05:07\",\"id\":13,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"list\",\"element_templates\":[\"liststate\",\"listselect\",\"input\"],\"old_classname\":\"list-select\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":10,\"label\":\"Zip\",\"type\":\"zip\",\"key\":\"zip_1523911383214\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"one-third third\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"mask\":\"\",\"custom_mask\":\"\",\"custom_name_attribute\":\"zip\",\"drawerDisabled\":false,\"created_at\":\"2018-06-12 19:05:07\",\"personally_identifiable\":\"\",\"id\":14,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"zip\",\"element_templates\":[\"zip\",\"textbox\",\"input\",\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":11,\"label\":\"Applicant's School \\\/ Employer\",\"type\":\"html\",\"default\":\"<h3>Applicant's School \\\/ Employer<br><\\\/h3>\",\"container_class\":\"\",\"element_class\":\"\",\"key\":\"applicant_s_school_employer_1528830332123\",\"drawerDisabled\":false,\"created_at\":\"2018-06-12 19:05:07\",\"id\":15,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"<h3>Applicant's School \\\/ Employer<br><\\\/h3>\",\"label_pos\":\"above\",\"parentType\":\"html\",\"element_templates\":[\"html\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":12,\"label\":\"Where did you hear about HOHB?\",\"type\":\"textarea\",\"key\":\"where_did_you_hear_about_hohb_1528833248569\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"textarea_rte\":\"\",\"disable_rte_mobile\":\"\",\"textarea_media\":\"\",\"drawerDisabled\":false,\"id\":59,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textarea\",\"element_templates\":[\"textarea\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":13,\"label\":\"Does applicant have any previous experience? \",\"type\":\"textbox\",\"key\":\"does_applicant_have_any_previous_experience_1528830411672\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"two-thirds first\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"<p>Yes\\\/No<\\\/p>\",\"mask\":\"\",\"custom_mask\":\"\",\"custom_name_attribute\":\"\",\"drawerDisabled\":false,\"created_at\":\"2018-06-12 19:05:07\",\"personally_identifiable\":\"\",\"id\":21,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textbox\",\"element_templates\":[\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":14,\"label\":\"If yes, please describe\",\"type\":\"textarea\",\"key\":\"if_yes_please_describe_1528833269824\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"textarea_rte\":\"\",\"disable_rte_mobile\":\"\",\"textarea_media\":\"\",\"drawerDisabled\":false,\"id\":60,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textarea\",\"element_templates\":[\"textarea\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":15,\"label\":\"Divider\",\"type\":\"hr\",\"container_class\":\"\",\"element_class\":\"\",\"key\":\"hr_1528830950649\",\"id\":28,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"label_pos\":\"above\",\"parentType\":\"hr\",\"element_templates\":[\"hr\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":16,\"label\":\"Parent\\\/Guardian First Name\",\"type\":\"firstname\",\"key\":\"parent_guardian_first_name_1528830521765\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"admin_label\":\"\",\"help_text\":\"\",\"desc_text\":\"<p>If applicant is under the age of 18, the parent\\\/guardian information must be completed.&nbsp;<\\\/p>\",\"custom_name_attribute\":\"fname\",\"personally_identifiable\":1,\"drawerDisabled\":false,\"id\":29,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"firstname\",\"element_templates\":[\"firstname\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":17,\"label\":\"Parent\\\/Guardian Last Name\",\"type\":\"lastname\",\"key\":\"parent_guardian_last_name_1528830527555\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"admin_label\":\"\",\"help_text\":\"\",\"custom_name_attribute\":\"lname\",\"personally_identifiable\":1,\"id\":30,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"lastname\",\"element_templates\":[\"lastname\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":18,\"label\":\"Address (If different from above)\",\"type\":\"textbox\",\"key\":\"address_if_different_from_above_1528830620347\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"two-thirds first\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"mask\":\"\",\"custom_mask\":\"\",\"custom_name_attribute\":\"\",\"drawerDisabled\":false,\"created_at\":\"2018-06-12 19:05:07\",\"personally_identifiable\":\"\",\"id\":25,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textbox\",\"element_templates\":[\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":19,\"label\":\"Phone &amp; Email (If different than above)\",\"type\":\"textbox\",\"key\":\"phone_and_email_if_different_than_above_1528830641815\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"two-thirds first\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"mask\":\"\",\"custom_mask\":\"\",\"custom_name_attribute\":\"\",\"drawerDisabled\":false,\"created_at\":\"2018-06-12 19:05:07\",\"personally_identifiable\":\"\",\"id\":31,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textbox\",\"element_templates\":[\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":20,\"label\":\"Mother's Employer\",\"type\":\"textbox\",\"key\":\"mother_s_employer_1528830655728\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"two-thirds first\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"mask\":\"\",\"custom_mask\":\"\",\"custom_name_attribute\":\"\",\"drawerDisabled\":false,\"created_at\":\"2018-06-12 19:05:07\",\"personally_identifiable\":\"\",\"id\":32,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textbox\",\"element_templates\":[\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":21,\"label\":\"Mother's Occupation\",\"type\":\"textbox\",\"key\":\"mother_s_occupation_1528830666463\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"two-thirds first\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"mask\":\"\",\"custom_mask\":\"\",\"custom_name_attribute\":\"\",\"drawerDisabled\":false,\"created_at\":\"2018-06-12 19:05:07\",\"personally_identifiable\":\"\",\"id\":33,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textbox\",\"element_templates\":[\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":22,\"label\":\"Father's Employer\",\"type\":\"textbox\",\"key\":\"father_s_employer_1528830684984\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"two-thirds first\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"mask\":\"\",\"custom_mask\":\"\",\"custom_name_attribute\":\"\",\"drawerDisabled\":false,\"created_at\":\"2018-06-12 19:05:07\",\"personally_identifiable\":\"\",\"id\":34,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textbox\",\"element_templates\":[\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":23,\"label\":\"Father's Occupation\",\"type\":\"textbox\",\"key\":\"father_s_occupation_1528830698379\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"two-thirds first\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"mask\":\"\",\"custom_mask\":\"\",\"custom_name_attribute\":\"\",\"drawerDisabled\":false,\"created_at\":\"2018-06-12 19:05:07\",\"personally_identifiable\":\"\",\"id\":35,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textbox\",\"element_templates\":[\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":24,\"label\":\"Emergency Contact (other than parent)\",\"type\":\"textbox\",\"key\":\"emergency_contact_other_than_parent_1528830736515\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"two-thirds first\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"mask\":\"\",\"custom_mask\":\"\",\"custom_name_attribute\":\"\",\"drawerDisabled\":false,\"created_at\":\"2018-06-12 19:05:07\",\"personally_identifiable\":\"\",\"id\":36,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textbox\",\"element_templates\":[\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":25,\"label\":\"Relationship\",\"type\":\"textbox\",\"key\":\"relationship_1528830745437\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"two-thirds first\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"mask\":\"\",\"custom_mask\":\"\",\"custom_name_attribute\":\"\",\"drawerDisabled\":false,\"created_at\":\"2018-06-12 19:05:07\",\"personally_identifiable\":\"\",\"id\":37,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textbox\",\"element_templates\":[\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":26,\"label\":\"Phone\",\"type\":\"phone\",\"key\":\"phone_1528830759503\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"mask\":\"\",\"custom_mask\":\"\",\"custom_name_attribute\":\"phone\",\"personally_identifiable\":1,\"id\":38,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textbox\",\"element_templates\":[\"tel\",\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":27,\"label\":\"Divider\",\"type\":\"hr\",\"container_class\":\"\",\"element_class\":\"\",\"key\":\"hr_1528830937990\",\"id\":39,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"label_pos\":\"above\",\"parentType\":\"hr\",\"element_templates\":[\"hr\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":28,\"label\":\"PSYCHO\\\/SOCIAL FUNCTION \",\"type\":\"textarea\",\"key\":\"psycho_social_function_1528830831182\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"<p>&nbsp;(i.e. Work\\\/school including grade completed, leisure interests,\\nrelationships-family structure, support systems, companion animals, fears\\\/concerns, etc)&nbsp;<br><\\\/p>\",\"textarea_rte\":\"\",\"disable_rte_mobile\":\"\",\"textarea_media\":\"\",\"drawerDisabled\":false,\"desc_text\":\"<p>&nbsp;(i.e. Work\\\/school including grade completed, leisure interests, relationships-family structure, support systems, companion animals, fears\\\/concerns, etc)&nbsp;<br><\\\/p>\",\"id\":40,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textarea\",\"element_templates\":[\"textarea\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":29,\"label\":\"GOALS\",\"type\":\"textarea\",\"key\":\"goals_1528830851284\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"<p>&nbsp;(i.e.: Why are you applying for participation? What would you like to accomplish?)<br><\\\/p>\",\"textarea_rte\":\"\",\"disable_rte_mobile\":\"\",\"textarea_media\":\"\",\"drawerDisabled\":false,\"desc_text\":\"<p>&nbsp;(i.e.: Why are you applying for participation? What would you like to accomplish?)<br><\\\/p>\",\"id\":41,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textarea\",\"element_templates\":[\"textarea\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":30,\"label\":\"HTML\",\"type\":\"html\",\"default\":\"<p>\\n  You will be contacted to set up an appointment with our instructors for an evaluation interview\\n  \\n  <br><\\\/p>\",\"container_class\":\"\",\"element_class\":\"\",\"key\":\"html_1528830878367\",\"drawerDisabled\":false,\"id\":42,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"<p>\\n  You will be contacted to set up an appointment with our instructors for an evaluation interview\\n  \\n  <br><\\\/p>\",\"label_pos\":\"above\",\"parentType\":\"html\",\"element_templates\":[\"html\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":31,\"label\":\"Divider\",\"type\":\"hr\",\"container_class\":\"\",\"element_class\":\"\",\"key\":\"hr_1528830928806\",\"id\":43,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"label_pos\":\"above\",\"parentType\":\"hr\",\"element_templates\":[\"hr\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":32,\"label\":\"HTML\",\"type\":\"html\",\"default\":\"<h1>HOHB CLIENT LIABILITY AND MEDICAL RELEASE<\\\/h1>\\n<p>The undersigned, (as parent or guardian of this form's applicant, where applicable or if\\nclient is under 18 years of age), in consideration of the instruction given in the horseback riding program\\nfurnished by Hope on Horseback Therapeutic Riding Center, does hereby release, discharge, and\\nindemnify HOHB from all claims which the undersigned (or said minor) may have now or in the future\\nresulting from personal injury, death, or property damage to the person or property, caused or in any way\\ngrowing out of acts of HOHB. It is the understanding that HOHB and its personnel shall take all reasonable\\nprecautions regarding the operation of the riding program. I intend to be legally bound by this agreement.\\nFurther, the undersigned authorizes any licensed physician and\\\/or emergency medical personnel to\\nprovide any medical\\\/surgical care and\\\/or hospitalization for the client, including anesthetic, which they\\ndetermine necessary or advisable, pending receipt of specific consent from the undersigned.<br><\\\/p>\",\"container_class\":\"\",\"element_class\":\"\",\"key\":\"html_1528830923477\",\"drawerDisabled\":false,\"id\":44,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"<h1>HOHB CLIENT LIABILITY AND MEDICAL RELEASE<\\\/h1>\\n<p>The undersigned, (as parent or guardian of this form's applicant, where applicable or if\\nclient is under 18 years of age), in consideration of the instruction given in the horseback riding program\\nfurnished by Hope on Horseback Therapeutic Riding Center, does hereby release, discharge, and\\nindemnify HOHB from all claims which the undersigned (or said minor) may have now or in the future\\nresulting from personal injury, death, or property damage to the person or property, caused or in any way\\ngrowing out of acts of HOHB. It is the understanding that HOHB and its personnel shall take all reasonable\\nprecautions regarding the operation of the riding program. I intend to be legally bound by this agreement.\\nFurther, the undersigned authorizes any licensed physician and\\\/or emergency medical personnel to\\nprovide any medical\\\/surgical care and\\\/or hospitalization for the client, including anesthetic, which they\\ndetermine necessary or advisable, pending receipt of specific consent from the undersigned.<br><\\\/p>\",\"label_pos\":\"above\",\"parentType\":\"html\",\"element_templates\":[\"html\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":33,\"label\":\"\",\"type\":\"listselect\",\"key\":\"listselect_1528831050623\",\"label_pos\":\"above\",\"required\":1,\"options\":[{\"errors\":[],\"max_options\":0,\"label\":\"Accept\",\"value\":\"accept\",\"calc\":\"\",\"selected\":0,\"order\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Decline\",\"value\":\"decline\",\"calc\":\"\",\"selected\":1,\"order\":1,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}}],\"container_class\":\"\",\"element_class\":\"\",\"admin_label\":\"\",\"help_text\":\"\",\"drawerDisabled\":false,\"id\":45,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"list\",\"element_templates\":[\"listselect\",\"input\"],\"old_classname\":\"list-select\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":34,\"label\":\"HTML\",\"type\":\"html\",\"default\":\"<h1>PHOTO\\\/PUBLICITY RELEASE<\\\/h1>\\n<p>\\n  I hereby ______ Hope on Horseback Therapeutic Riding Center permission to use my child's name or photographs in its public relations efforts for the primary purpose of promoting Hope on\\nHorseback Therapeutic Riding Center and for soliciting financial support for HOHB.\\n  <br><\\\/p>\",\"container_class\":\"\",\"element_class\":\"\",\"key\":\"html_1528831145495\",\"drawerDisabled\":false,\"id\":46,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"<h1>PHOTO\\\/PUBLICITY RELEASE<\\\/h1>\\n<p>\\n  I hereby ______ Hope on Horseback Therapeutic Riding Center permission to use my child's name or photographs in its public relations efforts for the primary purpose of promoting Hope on\\nHorseback Therapeutic Riding Center and for soliciting financial support for HOHB.\\n  <br><\\\/p>\",\"label_pos\":\"above\",\"parentType\":\"html\",\"element_templates\":[\"html\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":35,\"label\":\"Usage Agreement\",\"type\":\"listradio\",\"key\":\"usage_agreement_1528833028456\",\"label_pos\":\"above\",\"required\":1,\"options\":[{\"errors\":[],\"max_options\":0,\"label\":\"I Give Permission\",\"value\":\"1\",\"calc\":\"1\",\"selected\":0,\"order\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"label\":\"I Do Not Give Permission\",\"value\":\"0\",\"calc\":\"0\",\"selected\":0,\"order\":1,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true}],\"container_class\":\"\",\"element_class\":\"\",\"admin_label\":\"\",\"help_text\":\"\",\"drawerDisabled\":false,\"id\":47,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"list\",\"element_templates\":[\"listradio\",\"input\"],\"old_classname\":\"list-radio\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":36,\"label\":\"Today's Date\",\"type\":\"date\",\"key\":\"today_s_date_1528831381775\",\"label_pos\":\"above\",\"required\":1,\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"date_default\":1,\"date_format\":\"default\",\"year_range_start\":\"\",\"year_range_end\":\"\",\"drawerDisabled\":false,\"hours_options\":\"<option value=\\\"00\\\" >00<\\\/option><option value=\\\"01\\\" >01<\\\/option><option value=\\\"02\\\" >02<\\\/option><option value=\\\"03\\\" >03<\\\/option><option value=\\\"04\\\" >04<\\\/option><option value=\\\"05\\\" >05<\\\/option><option value=\\\"06\\\" >06<\\\/option><option value=\\\"07\\\" >07<\\\/option><option value=\\\"08\\\" >08<\\\/option><option value=\\\"09\\\" >09<\\\/option><option value=\\\"10\\\" >10<\\\/option><option value=\\\"11\\\" >11<\\\/option><option value=\\\"12\\\" >12<\\\/option><option value=\\\"13\\\" >13<\\\/option><option value=\\\"14\\\" >14<\\\/option><option value=\\\"15\\\" >15<\\\/option><option value=\\\"16\\\" >16<\\\/option><option value=\\\"17\\\" >17<\\\/option><option value=\\\"18\\\" >18<\\\/option><option value=\\\"19\\\" >19<\\\/option><option value=\\\"20\\\" >20<\\\/option><option value=\\\"21\\\" >21<\\\/option><option value=\\\"22\\\" >22<\\\/option><option value=\\\"23\\\" >23<\\\/option>\",\"minutes_options\":\"<option value=\\\"00\\\" >00<\\\/option><option value=\\\"01\\\" >01<\\\/option><option value=\\\"02\\\" >02<\\\/option><option value=\\\"03\\\" >03<\\\/option><option value=\\\"04\\\" >04<\\\/option><option value=\\\"05\\\" >05<\\\/option><option value=\\\"06\\\" >06<\\\/option><option value=\\\"07\\\" >07<\\\/option><option value=\\\"08\\\" >08<\\\/option><option value=\\\"09\\\" >09<\\\/option><option value=\\\"10\\\" >10<\\\/option><option value=\\\"11\\\" >11<\\\/option><option value=\\\"12\\\" >12<\\\/option><option value=\\\"13\\\" >13<\\\/option><option value=\\\"14\\\" >14<\\\/option><option value=\\\"15\\\" >15<\\\/option><option value=\\\"16\\\" >16<\\\/option><option value=\\\"17\\\" >17<\\\/option><option value=\\\"18\\\" >18<\\\/option><option value=\\\"19\\\" >19<\\\/option><option value=\\\"20\\\" >20<\\\/option><option value=\\\"21\\\" >21<\\\/option><option value=\\\"22\\\" >22<\\\/option><option value=\\\"23\\\" >23<\\\/option><option value=\\\"24\\\" >24<\\\/option><option value=\\\"25\\\" >25<\\\/option><option value=\\\"26\\\" >26<\\\/option><option value=\\\"27\\\" >27<\\\/option><option value=\\\"28\\\" >28<\\\/option><option value=\\\"29\\\" >29<\\\/option><option value=\\\"30\\\" >30<\\\/option><option value=\\\"31\\\" >31<\\\/option><option value=\\\"32\\\" >32<\\\/option><option value=\\\"33\\\" >33<\\\/option><option value=\\\"34\\\" >34<\\\/option><option value=\\\"35\\\" >35<\\\/option><option value=\\\"36\\\" >36<\\\/option><option value=\\\"37\\\" >37<\\\/option><option value=\\\"38\\\" >38<\\\/option><option value=\\\"39\\\" >39<\\\/option><option value=\\\"40\\\" >40<\\\/option><option value=\\\"41\\\" >41<\\\/option><option value=\\\"42\\\" >42<\\\/option><option value=\\\"43\\\" >43<\\\/option><option value=\\\"44\\\" >44<\\\/option><option value=\\\"45\\\" >45<\\\/option><option value=\\\"46\\\" >46<\\\/option><option value=\\\"47\\\" >47<\\\/option><option value=\\\"48\\\" >48<\\\/option><option value=\\\"49\\\" >49<\\\/option><option value=\\\"50\\\" >50<\\\/option><option value=\\\"51\\\" >51<\\\/option><option value=\\\"52\\\" >52<\\\/option><option value=\\\"53\\\" >53<\\\/option><option value=\\\"54\\\" >54<\\\/option><option value=\\\"55\\\" >55<\\\/option><option value=\\\"56\\\" >56<\\\/option><option value=\\\"57\\\" >57<\\\/option><option value=\\\"58\\\" >58<\\\/option><option value=\\\"59\\\" >59<\\\/option>\",\"id\":48,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"date\",\"element_templates\":[\"date\",\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":37,\"label\":\"Divider\",\"type\":\"hr\",\"container_class\":\"\",\"element_class\":\"\",\"key\":\"hr_1528831416162\",\"id\":49,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"label_pos\":\"above\",\"parentType\":\"hr\",\"element_templates\":[\"hr\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":38,\"label\":\"Diagnosis or disability\",\"type\":\"textbox\",\"key\":\"diagnosis_or_disability_1528831535188\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"mask\":\"\",\"custom_mask\":\"\",\"custom_name_attribute\":\"\",\"personally_identifiable\":\"\",\"drawerDisabled\":false,\"id\":50,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textbox\",\"element_templates\":[\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":39,\"label\":\"Date of Onset\",\"type\":\"date\",\"key\":\"date_of_onset_1528831642503\",\"label_pos\":\"above\",\"required\":false,\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"date_format\":\"default\",\"year_range_start\":\"\",\"year_range_end\":\"\",\"drawerDisabled\":false,\"hours_options\":\"<option value=\\\"00\\\" >00<\\\/option><option value=\\\"01\\\" >01<\\\/option><option value=\\\"02\\\" >02<\\\/option><option value=\\\"03\\\" >03<\\\/option><option value=\\\"04\\\" >04<\\\/option><option value=\\\"05\\\" >05<\\\/option><option value=\\\"06\\\" >06<\\\/option><option value=\\\"07\\\" >07<\\\/option><option value=\\\"08\\\" >08<\\\/option><option value=\\\"09\\\" >09<\\\/option><option value=\\\"10\\\" >10<\\\/option><option value=\\\"11\\\" >11<\\\/option><option value=\\\"12\\\" >12<\\\/option><option value=\\\"13\\\" >13<\\\/option><option value=\\\"14\\\" >14<\\\/option><option value=\\\"15\\\" >15<\\\/option><option value=\\\"16\\\" >16<\\\/option><option value=\\\"17\\\" >17<\\\/option><option value=\\\"18\\\" >18<\\\/option><option value=\\\"19\\\" >19<\\\/option><option value=\\\"20\\\" >20<\\\/option><option value=\\\"21\\\" >21<\\\/option><option value=\\\"22\\\" >22<\\\/option><option value=\\\"23\\\" >23<\\\/option>\",\"minutes_options\":\"<option value=\\\"00\\\" >00<\\\/option><option value=\\\"01\\\" >01<\\\/option><option value=\\\"02\\\" >02<\\\/option><option value=\\\"03\\\" >03<\\\/option><option value=\\\"04\\\" >04<\\\/option><option value=\\\"05\\\" >05<\\\/option><option value=\\\"06\\\" >06<\\\/option><option value=\\\"07\\\" >07<\\\/option><option value=\\\"08\\\" >08<\\\/option><option value=\\\"09\\\" >09<\\\/option><option value=\\\"10\\\" >10<\\\/option><option value=\\\"11\\\" >11<\\\/option><option value=\\\"12\\\" >12<\\\/option><option value=\\\"13\\\" >13<\\\/option><option value=\\\"14\\\" >14<\\\/option><option value=\\\"15\\\" >15<\\\/option><option value=\\\"16\\\" >16<\\\/option><option value=\\\"17\\\" >17<\\\/option><option value=\\\"18\\\" >18<\\\/option><option value=\\\"19\\\" >19<\\\/option><option value=\\\"20\\\" >20<\\\/option><option value=\\\"21\\\" >21<\\\/option><option value=\\\"22\\\" >22<\\\/option><option value=\\\"23\\\" >23<\\\/option><option value=\\\"24\\\" >24<\\\/option><option value=\\\"25\\\" >25<\\\/option><option value=\\\"26\\\" >26<\\\/option><option value=\\\"27\\\" >27<\\\/option><option value=\\\"28\\\" >28<\\\/option><option value=\\\"29\\\" >29<\\\/option><option value=\\\"30\\\" >30<\\\/option><option value=\\\"31\\\" >31<\\\/option><option value=\\\"32\\\" >32<\\\/option><option value=\\\"33\\\" >33<\\\/option><option value=\\\"34\\\" >34<\\\/option><option value=\\\"35\\\" >35<\\\/option><option value=\\\"36\\\" >36<\\\/option><option value=\\\"37\\\" >37<\\\/option><option value=\\\"38\\\" >38<\\\/option><option value=\\\"39\\\" >39<\\\/option><option value=\\\"40\\\" >40<\\\/option><option value=\\\"41\\\" >41<\\\/option><option value=\\\"42\\\" >42<\\\/option><option value=\\\"43\\\" >43<\\\/option><option value=\\\"44\\\" >44<\\\/option><option value=\\\"45\\\" >45<\\\/option><option value=\\\"46\\\" >46<\\\/option><option value=\\\"47\\\" >47<\\\/option><option value=\\\"48\\\" >48<\\\/option><option value=\\\"49\\\" >49<\\\/option><option value=\\\"50\\\" >50<\\\/option><option value=\\\"51\\\" >51<\\\/option><option value=\\\"52\\\" >52<\\\/option><option value=\\\"53\\\" >53<\\\/option><option value=\\\"54\\\" >54<\\\/option><option value=\\\"55\\\" >55<\\\/option><option value=\\\"56\\\" >56<\\\/option><option value=\\\"57\\\" >57<\\\/option><option value=\\\"58\\\" >58<\\\/option><option value=\\\"59\\\" >59<\\\/option>\",\"id\":51,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"date\",\"element_templates\":[\"date\",\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":40,\"label\":\"HTML\",\"type\":\"html\",\"default\":\"<p style=\\\"text-align: center; \\\">If the answer to any of the following HEALTH QUESTIONS\\nis YES, <\\\/p><p style=\\\"text-align: center; \\\">a Physician\\u2019s Release form is required&nbsp;<br><\\\/p>\",\"container_class\":\"\",\"element_class\":\"\",\"key\":\"html_1528831452835\",\"drawerDisabled\":false,\"id\":52,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"<p style=\\\"text-align: center; \\\">If the answer to any of the following HEALTH QUESTIONS\\nis YES, <\\\/p><p style=\\\"text-align: center; \\\">a Physician\\u2019s Release form is required&nbsp;<br><\\\/p>\",\"label_pos\":\"above\",\"parentType\":\"html\",\"element_templates\":[\"html\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":41,\"label\":\"Does the applicant have? \",\"type\":\"listcheckbox\",\"key\":\"does_the_applicant_have_1528833129928\",\"label_pos\":\"above\",\"required\":false,\"options\":[{\"errors\":[],\"max_options\":0,\"label\":\"Braces\",\"value\":\"braces\",\"calc\":\"0\",\"selected\":0,\"order\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"label\":\"Wheelchair\",\"value\":\"wheelchair\",\"calc\":\"1\",\"selected\":0,\"order\":1,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"label\":\"Walker\",\"value\":\"walker\",\"calc\":\"2\",\"selected\":0,\"order\":2,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"order\":3,\"new\":false,\"options\":[],\"label\":\"Crutches\",\"value\":\"crutches\",\"calc\":\"3\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true}],\"container_class\":\"\",\"element_class\":\"\",\"admin_label\":\"\",\"help_text\":\"\",\"drawerDisabled\":false,\"id\":58,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"list\",\"element_templates\":[\"listcheckbox\",\"input\"],\"old_classname\":\"list-checkbox\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":42,\"label\":\"Has the participant ever been treated for any of the following? \",\"type\":\"listcheckbox\",\"key\":\"has_the_participant_ever_been_treated_for_any_of_the_following_1528832569782\",\"label_pos\":\"above\",\"required\":1,\"options\":[{\"errors\":[],\"max_options\":0,\"label\":\"Down Syndrome\",\"value\":\"down-syndrome\",\"calc\":\"0\",\"selected\":0,\"order\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Spinal Condition ie Injury, scoliosis, fusion\",\"value\":\"spinal-condition-ie-injury-scoliosis-fusion\",\"calc\":\"1\",\"selected\":0,\"order\":1,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"label\":\"Brain Condition ie Cerebral Palsy, Stroke\",\"value\":\"brain-condition-ie-cerebral-palsy-stroke\",\"calc\":\"2\",\"selected\":0,\"order\":2,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}}},{\"errors\":[],\"max_options\":0,\"order\":3,\"new\":false,\"options\":[],\"label\":\"Bleeding or Clotting Disorder\",\"value\":\"bleeding\",\"calc\":\"3\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"order\":4,\"new\":false,\"options\":[],\"label\":\"Disabetes\",\"value\":\"diabetes\",\"calc\":\"4\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"order\":5,\"new\":false,\"options\":[],\"label\":\"Joint Complications such as hip dysplsia\",\"value\":\"joint complications\",\"calc\":\"5\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"order\":6,\"new\":false,\"options\":[],\"label\":\"Epilepsy\",\"value\":\"eplilepsy\",\"calc\":\"6\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"order\":7,\"new\":false,\"options\":[],\"label\":\"Heart Codition\",\"value\":\"heart\",\"calc\":\"7\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"order\":8,\"new\":false,\"options\":[],\"label\":\"Neurological Condition (Including Seizures)\",\"value\":\"neurological\",\"calc\":\"8\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"order\":9,\"new\":false,\"options\":[],\"label\":\"Pulmonary Condition\",\"value\":\"pulmonary\",\"calc\":\"9\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"order\":10,\"new\":false,\"options\":[],\"label\":\"Skin break down or Pressure Sores\",\"value\":\"Skinbreak\",\"calc\":\"10\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true}],\"container_class\":\"\",\"element_class\":\"\",\"admin_label\":\"\",\"help_text\":\"\",\"drawerDisabled\":false,\"id\":54,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"list\",\"element_templates\":[\"listcheckbox\",\"input\"],\"old_classname\":\"list-checkbox\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":43,\"type\":\"textarea\",\"label\":\"If yes to any of the above, please describe and date occurrence: \",\"key\":\"if_yes_to_any_of_the_above_please_describe_and_date_occurrence_1528832776279\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"textarea_rte\":\"\",\"disable_rte_mobile\":\"\",\"textarea_media\":\"\",\"drawerDisabled\":false,\"id\":56,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textarea\",\"element_templates\":[\"textarea\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":44,\"label\":\"In the past 12 months, has the participant:\",\"type\":\"listcheckbox\",\"key\":\"in_the_past_12_months_has_the_participant_1528833388706\",\"label_pos\":\"above\",\"required\":false,\"options\":[{\"errors\":[],\"max_options\":0,\"label\":\"Been hospitalized for any serious injury, condition or surgery? \",\"value\":\"hosp\",\"calc\":\"0\",\"selected\":0,\"order\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"label\":\"Experienced loss of consciousness, including seizures?\",\"value\":\"loss of con\",\"calc\":\"1\",\"selected\":0,\"order\":1,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"label\":\"Experienced a psychotic crisis? \",\"value\":\"crisis\",\"calc\":\"2\",\"selected\":0,\"order\":2,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"order\":3,\"new\":false,\"options\":[],\"label\":\"Has it been necessary to restrict the participant\\u2019s activities due to medical reasons? \",\"value\":\"restrict\",\"calc\":\"3\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true}],\"container_class\":\"\",\"element_class\":\"\",\"admin_label\":\"\",\"help_text\":\"\",\"drawerDisabled\":false,\"id\":61,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"list\",\"element_templates\":[\"listcheckbox\",\"input\"],\"old_classname\":\"list-checkbox\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":45,\"type\":\"textarea\",\"label\":\"If yes, please explain: \",\"key\":\"if_yes_please_explain_1528833454948\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"textarea_rte\":\"\",\"disable_rte_mobile\":\"\",\"textarea_media\":\"\",\"drawerDisabled\":false,\"id\":62,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textarea\",\"element_templates\":[\"textarea\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":46,\"type\":\"checkbox\",\"label\":\"Does the participant need assistance to maintain an upright position or head control?\",\"key\":\"does_the_participant_need_assistance_to_maintain_an_upright_position_or_head_control_1528833489400\",\"label_pos\":\"right\",\"required\":false,\"container_class\":\"\",\"element_class\":\"\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"default_value\":\"unchecked\",\"checked_value\":\"Checked\",\"unchecked_value\":\"Unchecked\",\"drawerDisabled\":false,\"id\":63,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"checkbox\",\"element_templates\":[\"checkbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":47,\"label\":\"Divider\",\"type\":\"hr\",\"container_class\":\"\",\"element_class\":\"\",\"key\":\"hr_1528833675793\",\"id\":70,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"label_pos\":\"above\",\"parentType\":\"hr\",\"element_templates\":[\"hr\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":48,\"type\":\"html\",\"label\":\"Physician Release\",\"default\":\"<p><b>A Physician Release is required if the participant answered yes to any of the health questions above.I hereby affirm, to the best of my knowledge, the health history information is complete and correct.  <\\\/b><br><\\\/p>\",\"container_class\":\"\",\"element_class\":\"\",\"key\":\"physician_release_1528833688681\",\"drawerDisabled\":false,\"id\":64,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"<p><b>A Physician Release is required if the participant answered yes to any of the health questions above.I hereby affirm, to the best of my knowledge, the health history information is complete and correct.  <\\\/b><br><\\\/p>\",\"label_pos\":\"above\",\"parentType\":\"html\",\"element_templates\":[\"html\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":49,\"type\":\"firstname\",\"label\":\"First Name of Person Completing Form\",\"key\":\"first_name_of_person_completing_form_1528833558438\",\"label_pos\":\"above\",\"required\":1,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"admin_label\":\"\",\"help_text\":\"\",\"custom_name_attribute\":\"fname\",\"personally_identifiable\":1,\"drawerDisabled\":false,\"id\":65,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"firstname\",\"element_templates\":[\"firstname\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":50,\"type\":\"lastname\",\"label\":\"Last Name of Person Completing Form\",\"key\":\"last_name_of_person_completing_form_1528833570879\",\"label_pos\":\"above\",\"required\":1,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"admin_label\":\"\",\"help_text\":\"\",\"custom_name_attribute\":\"lname\",\"personally_identifiable\":1,\"drawerDisabled\":false,\"id\":66,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"lastname\",\"element_templates\":[\"lastname\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":51,\"type\":\"date\",\"label\":\"Date\",\"key\":\"date_1528833518081\",\"label_pos\":\"above\",\"required\":1,\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"date_default\":1,\"date_format\":\"default\",\"year_range_start\":\"\",\"year_range_end\":\"\",\"hours_options\":\"<option value=\\\"00\\\" >00<\\\/option><option value=\\\"01\\\" >01<\\\/option><option value=\\\"02\\\" >02<\\\/option><option value=\\\"03\\\" >03<\\\/option><option value=\\\"04\\\" >04<\\\/option><option value=\\\"05\\\" >05<\\\/option><option value=\\\"06\\\" >06<\\\/option><option value=\\\"07\\\" >07<\\\/option><option value=\\\"08\\\" >08<\\\/option><option value=\\\"09\\\" >09<\\\/option><option value=\\\"10\\\" >10<\\\/option><option value=\\\"11\\\" >11<\\\/option><option value=\\\"12\\\" >12<\\\/option><option value=\\\"13\\\" >13<\\\/option><option value=\\\"14\\\" >14<\\\/option><option value=\\\"15\\\" >15<\\\/option><option value=\\\"16\\\" >16<\\\/option><option value=\\\"17\\\" >17<\\\/option><option value=\\\"18\\\" >18<\\\/option><option value=\\\"19\\\" >19<\\\/option><option value=\\\"20\\\" >20<\\\/option><option value=\\\"21\\\" >21<\\\/option><option value=\\\"22\\\" >22<\\\/option><option value=\\\"23\\\" >23<\\\/option>\",\"minutes_options\":\"<option value=\\\"00\\\" >00<\\\/option><option value=\\\"01\\\" >01<\\\/option><option value=\\\"02\\\" >02<\\\/option><option value=\\\"03\\\" >03<\\\/option><option value=\\\"04\\\" >04<\\\/option><option value=\\\"05\\\" >05<\\\/option><option value=\\\"06\\\" >06<\\\/option><option value=\\\"07\\\" >07<\\\/option><option value=\\\"08\\\" >08<\\\/option><option value=\\\"09\\\" >09<\\\/option><option value=\\\"10\\\" >10<\\\/option><option value=\\\"11\\\" >11<\\\/option><option value=\\\"12\\\" >12<\\\/option><option value=\\\"13\\\" >13<\\\/option><option value=\\\"14\\\" >14<\\\/option><option value=\\\"15\\\" >15<\\\/option><option value=\\\"16\\\" >16<\\\/option><option value=\\\"17\\\" >17<\\\/option><option value=\\\"18\\\" >18<\\\/option><option value=\\\"19\\\" >19<\\\/option><option value=\\\"20\\\" >20<\\\/option><option value=\\\"21\\\" >21<\\\/option><option value=\\\"22\\\" >22<\\\/option><option value=\\\"23\\\" >23<\\\/option><option value=\\\"24\\\" >24<\\\/option><option value=\\\"25\\\" >25<\\\/option><option value=\\\"26\\\" >26<\\\/option><option value=\\\"27\\\" >27<\\\/option><option value=\\\"28\\\" >28<\\\/option><option value=\\\"29\\\" >29<\\\/option><option value=\\\"30\\\" >30<\\\/option><option value=\\\"31\\\" >31<\\\/option><option value=\\\"32\\\" >32<\\\/option><option value=\\\"33\\\" >33<\\\/option><option value=\\\"34\\\" >34<\\\/option><option value=\\\"35\\\" >35<\\\/option><option value=\\\"36\\\" >36<\\\/option><option value=\\\"37\\\" >37<\\\/option><option value=\\\"38\\\" >38<\\\/option><option value=\\\"39\\\" >39<\\\/option><option value=\\\"40\\\" >40<\\\/option><option value=\\\"41\\\" >41<\\\/option><option value=\\\"42\\\" >42<\\\/option><option value=\\\"43\\\" >43<\\\/option><option value=\\\"44\\\" >44<\\\/option><option value=\\\"45\\\" >45<\\\/option><option value=\\\"46\\\" >46<\\\/option><option value=\\\"47\\\" >47<\\\/option><option value=\\\"48\\\" >48<\\\/option><option value=\\\"49\\\" >49<\\\/option><option value=\\\"50\\\" >50<\\\/option><option value=\\\"51\\\" >51<\\\/option><option value=\\\"52\\\" >52<\\\/option><option value=\\\"53\\\" >53<\\\/option><option value=\\\"54\\\" >54<\\\/option><option value=\\\"55\\\" >55<\\\/option><option value=\\\"56\\\" >56<\\\/option><option value=\\\"57\\\" >57<\\\/option><option value=\\\"58\\\" >58<\\\/option><option value=\\\"59\\\" >59<\\\/option>\",\"id\":67,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"date\",\"element_templates\":[\"date\",\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":52,\"label\":\"\",\"type\":\"listcheckbox\",\"key\":\"listcheckbox_1528834292407\",\"label_pos\":\"above\",\"required\":1,\"options\":[{\"errors\":[],\"max_options\":0,\"label\":\"Accept\",\"value\":\"acc\",\"calc\":\"0\",\"selected\":0,\"order\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"label\":\"Decline\",\"value\":\"dec\",\"calc\":\"1\",\"selected\":0,\"order\":1,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true}],\"container_class\":\"\",\"element_class\":\"\",\"admin_label\":\"\",\"help_text\":\"\",\"drawerDisabled\":false,\"id\":83,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"list\",\"element_templates\":[\"listcheckbox\",\"input\"],\"old_classname\":\"list-checkbox\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":53,\"type\":\"textbox\",\"label\":\"Relationship to Participant: \",\"key\":\"relationship_to_participant_1528833589481\",\"label_pos\":\"above\",\"required\":1,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"mask\":\"\",\"custom_mask\":\"\",\"custom_name_attribute\":\"\",\"personally_identifiable\":\"\",\"drawerDisabled\":false,\"id\":68,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textbox\",\"element_templates\":[\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":54,\"label\":\"Divider\",\"type\":\"hr\",\"container_class\":\"\",\"element_class\":\"\",\"key\":\"hr_1528833732781\",\"id\":71,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"label_pos\":\"above\",\"parentType\":\"hr\",\"element_templates\":[\"hr\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":55,\"label\":\"HTML\",\"type\":\"html\",\"default\":\"<h1>Seizure Evaluation Form<\\\/h1>\\n<p>\\n  Instructions: Participants\\\/parent\\\/guardian\\\/treating physicians \\u2013 please complete this form including as\\nmuch information as possible. Since riding and working around horses is a risk activity, conditions that\\nincrease that risk are carefully analyzed. The safety of all participants, volunteers and horses is considered.\\n  \\n  \\n  <br><\\\/p>\",\"container_class\":\"\",\"element_class\":\"\",\"key\":\"html_1528833735736\",\"drawerDisabled\":false,\"id\":72,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"<h1>Seizure Evaluation Form<\\\/h1>\\n<p>\\n  Instructions: Participants\\\/parent\\\/guardian\\\/treating physicians \\u2013 please complete this form including as\\nmuch information as possible. Since riding and working around horses is a risk activity, conditions that\\nincrease that risk are carefully analyzed. The safety of all participants, volunteers and horses is considered.\\n  \\n  \\n  <br><\\\/p>\",\"label_pos\":\"above\",\"parentType\":\"html\",\"element_templates\":[\"html\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":56,\"label\":\"Participant's First Name\",\"type\":\"firstname\",\"key\":\"participant_s_first_name_1528833846465\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"admin_label\":\"\",\"help_text\":\"\",\"custom_name_attribute\":\"fname\",\"personally_identifiable\":1,\"drawerDisabled\":false,\"id\":73,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"firstname\",\"element_templates\":[\"firstname\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":57,\"label\":\"Participant's Last Name\",\"type\":\"lastname\",\"key\":\"participant_s_last_name_1528833853204\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"admin_label\":\"\",\"help_text\":\"\",\"custom_name_attribute\":\"lname\",\"personally_identifiable\":1,\"id\":74,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"lastname\",\"element_templates\":[\"lastname\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":58,\"label\":\"Seizure Treating Physician\",\"type\":\"lastname\",\"key\":\"seizure_treating_physician_1528833869248\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"admin_label\":\"\",\"help_text\":\"\",\"custom_name_attribute\":\"lname\",\"personally_identifiable\":1,\"drawerDisabled\":false,\"id\":75,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"lastname\",\"element_templates\":[\"lastname\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":59,\"label\":\"Physician's Phone\",\"type\":\"phone\",\"key\":\"physician_s_phone_1528833895034\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"mask\":\"\",\"custom_mask\":\"\",\"custom_name_attribute\":\"phone\",\"personally_identifiable\":1,\"drawerDisabled\":false,\"id\":76,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textbox\",\"element_templates\":[\"tel\",\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":60,\"label\":\"Types of Seizures\",\"type\":\"textarea\",\"key\":\"types_of_seizures_1528833919069\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"desc_text\":\"<p>If multiple, List them all&nbsp;<\\\/p>\",\"textarea_rte\":\"\",\"disable_rte_mobile\":\"\",\"textarea_media\":\"\",\"drawerDisabled\":false,\"id\":77,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textarea\",\"element_templates\":[\"textarea\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":61,\"label\":\"Date Of Previous Seizure\",\"type\":\"date\",\"key\":\"date_of_previous_seizure_1528834069080\",\"label_pos\":\"above\",\"required\":false,\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"date_format\":\"default\",\"year_range_start\":\"\",\"year_range_end\":\"\",\"hours_options\":\"<option value=\\\"00\\\" >00<\\\/option><option value=\\\"01\\\" >01<\\\/option><option value=\\\"02\\\" >02<\\\/option><option value=\\\"03\\\" >03<\\\/option><option value=\\\"04\\\" >04<\\\/option><option value=\\\"05\\\" >05<\\\/option><option value=\\\"06\\\" >06<\\\/option><option value=\\\"07\\\" >07<\\\/option><option value=\\\"08\\\" >08<\\\/option><option value=\\\"09\\\" >09<\\\/option><option value=\\\"10\\\" >10<\\\/option><option value=\\\"11\\\" >11<\\\/option><option value=\\\"12\\\" >12<\\\/option><option value=\\\"13\\\" >13<\\\/option><option value=\\\"14\\\" >14<\\\/option><option value=\\\"15\\\" >15<\\\/option><option value=\\\"16\\\" >16<\\\/option><option value=\\\"17\\\" >17<\\\/option><option value=\\\"18\\\" >18<\\\/option><option value=\\\"19\\\" >19<\\\/option><option value=\\\"20\\\" >20<\\\/option><option value=\\\"21\\\" >21<\\\/option><option value=\\\"22\\\" >22<\\\/option><option value=\\\"23\\\" >23<\\\/option>\",\"minutes_options\":\"<option value=\\\"00\\\" >00<\\\/option><option value=\\\"01\\\" >01<\\\/option><option value=\\\"02\\\" >02<\\\/option><option value=\\\"03\\\" >03<\\\/option><option value=\\\"04\\\" >04<\\\/option><option value=\\\"05\\\" >05<\\\/option><option value=\\\"06\\\" >06<\\\/option><option value=\\\"07\\\" >07<\\\/option><option value=\\\"08\\\" >08<\\\/option><option value=\\\"09\\\" >09<\\\/option><option value=\\\"10\\\" >10<\\\/option><option value=\\\"11\\\" >11<\\\/option><option value=\\\"12\\\" >12<\\\/option><option value=\\\"13\\\" >13<\\\/option><option value=\\\"14\\\" >14<\\\/option><option value=\\\"15\\\" >15<\\\/option><option value=\\\"16\\\" >16<\\\/option><option value=\\\"17\\\" >17<\\\/option><option value=\\\"18\\\" >18<\\\/option><option value=\\\"19\\\" >19<\\\/option><option value=\\\"20\\\" >20<\\\/option><option value=\\\"21\\\" >21<\\\/option><option value=\\\"22\\\" >22<\\\/option><option value=\\\"23\\\" >23<\\\/option><option value=\\\"24\\\" >24<\\\/option><option value=\\\"25\\\" >25<\\\/option><option value=\\\"26\\\" >26<\\\/option><option value=\\\"27\\\" >27<\\\/option><option value=\\\"28\\\" >28<\\\/option><option value=\\\"29\\\" >29<\\\/option><option value=\\\"30\\\" >30<\\\/option><option value=\\\"31\\\" >31<\\\/option><option value=\\\"32\\\" >32<\\\/option><option value=\\\"33\\\" >33<\\\/option><option value=\\\"34\\\" >34<\\\/option><option value=\\\"35\\\" >35<\\\/option><option value=\\\"36\\\" >36<\\\/option><option value=\\\"37\\\" >37<\\\/option><option value=\\\"38\\\" >38<\\\/option><option value=\\\"39\\\" >39<\\\/option><option value=\\\"40\\\" >40<\\\/option><option value=\\\"41\\\" >41<\\\/option><option value=\\\"42\\\" >42<\\\/option><option value=\\\"43\\\" >43<\\\/option><option value=\\\"44\\\" >44<\\\/option><option value=\\\"45\\\" >45<\\\/option><option value=\\\"46\\\" >46<\\\/option><option value=\\\"47\\\" >47<\\\/option><option value=\\\"48\\\" >48<\\\/option><option value=\\\"49\\\" >49<\\\/option><option value=\\\"50\\\" >50<\\\/option><option value=\\\"51\\\" >51<\\\/option><option value=\\\"52\\\" >52<\\\/option><option value=\\\"53\\\" >53<\\\/option><option value=\\\"54\\\" >54<\\\/option><option value=\\\"55\\\" >55<\\\/option><option value=\\\"56\\\" >56<\\\/option><option value=\\\"57\\\" >57<\\\/option><option value=\\\"58\\\" >58<\\\/option><option value=\\\"59\\\" >59<\\\/option>\",\"id\":78,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"date\",\"element_templates\":[\"date\",\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":62,\"label\":\"Duration of Each Seizure\",\"type\":\"textbox\",\"key\":\"duration_of_each_seizure_1528834112107\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"mask\":\"\",\"custom_mask\":\"\",\"custom_name_attribute\":\"\",\"personally_identifiable\":\"\",\"id\":79,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textbox\",\"element_templates\":[\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":63,\"label\":\"Frequency of Seizures\",\"type\":\"textbox\",\"key\":\"frequency_of_seizures_1528834091504\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"mask\":\"\",\"custom_mask\":\"\",\"custom_name_attribute\":\"\",\"personally_identifiable\":\"\",\"id\":80,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textbox\",\"element_templates\":[\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":64,\"label\":\"Typical Cause of Seizure Activity\",\"type\":\"textbox\",\"key\":\"typical_cause_of_seizure_activity_1528834124727\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"mask\":\"\",\"custom_mask\":\"\",\"custom_name_attribute\":\"\",\"personally_identifiable\":\"\",\"drawerDisabled\":false,\"id\":81,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textbox\",\"element_templates\":[\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":65,\"label\":\"Seizure Activity Indicators\",\"type\":\"textarea\",\"key\":\"seizure_activity_indicators_1528834154147\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"<p>&nbsp;(aura, behaviors or manifestations of oncoming seizure activity)<br><\\\/p>\",\"desc_text\":\"<p>&nbsp;(aura, behaviors or manifestations of oncoming seizure activity)<br><\\\/p>\",\"textarea_rte\":\"\",\"disable_rte_mobile\":\"\",\"textarea_media\":\"\",\"drawerDisabled\":false,\"id\":82,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textarea\",\"element_templates\":[\"textarea\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":66,\"label\":\"After effect (If any)\",\"type\":\"textarea\",\"key\":\"after_effect_if_any_1528834225012\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"textarea_rte\":\"\",\"disable_rte_mobile\":\"\",\"textarea_media\":\"\",\"drawerDisabled\":false,\"id\":84,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textarea\",\"element_templates\":[\"textarea\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":67,\"type\":\"listcheckbox\",\"label\":\"During a seizure, I \\\/ my child \\\/ patient (check all that apply):\",\"key\":\"during_a_seizure_i_my_child_patient_check_all_that_apply_1528906679605\",\"label_pos\":\"above\",\"required\":false,\"options\":[{\"errors\":[],\"max_options\":0,\"label\":\"May Stare briefly\",\"value\":\"stare\",\"calc\":\"\",\"selected\":0,\"order\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"label\":\"May walk around\",\"value\":\"walk\",\"calc\":\"\",\"selected\":0,\"order\":1,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"label\":\"May perform aimless tasks\",\"value\":\"aim\",\"calc\":\"\",\"selected\":0,\"order\":2,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"order\":3,\"new\":false,\"options\":[],\"label\":\"May suddenly cry\\\/fall\\\/become rigid followed by muscle jerks \\\/ saliva on lips \\\/ blueish skin color\",\"value\":\"shaking\",\"calc\":\"\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"order\":4,\"new\":false,\"options\":[],\"label\":\"May experience loss of bladder or bowel control\",\"value\":\"Control\",\"calc\":\"\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"order\":5,\"new\":false,\"options\":[],\"label\":\"May be confused, have a headache, be fatigued; \",\"value\":\"confused\",\"calc\":\"\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true}],\"container_class\":\"\",\"element_class\":\"\",\"admin_label\":\"\",\"help_text\":\"\",\"drawerDisabled\":false,\"id\":85,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"list\",\"element_templates\":[\"listcheckbox\",\"input\"],\"old_classname\":\"list-checkbox\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":68,\"type\":\"textbox\",\"label\":\"Other, Please explain: \",\"key\":\"other_please_explain_1528906852559\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"mask\":\"\",\"custom_mask\":\"\",\"custom_name_attribute\":\"\",\"personally_identifiable\":\"\",\"drawerDisabled\":false,\"id\":86,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textbox\",\"element_templates\":[\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":69,\"type\":\"textarea\",\"label\":\"Are you \\\/ is your child \\\/ patient able to know and express when a seizure may occur? What are the signs?\",\"key\":\"are_you_is_your_child_patient_able_to_know_and_express_when_a_seizure_may_occur_what_are_the_signs_1528906878442\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"textarea_rte\":\"\",\"disable_rte_mobile\":\"\",\"textarea_media\":\"\",\"drawerDisabled\":false,\"id\":87,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textarea\",\"element_templates\":[\"textarea\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":70,\"type\":\"listcheckbox\",\"label\":\"Should you \\\/ your child experience a seizure while at TREC, beyond employing general first aid, what actions do you suggest we take?\",\"key\":\"should_you_your_child_experience_a_seizure_while_at_trec_beyond_employing_general_first_aid_what_actions_do_you_suggest_we_take_1528906994668\",\"label_pos\":\"above\",\"required\":false,\"options\":[{\"errors\":[],\"max_options\":0,\"label\":\"Do Nothing\",\"value\":\"nothing\",\"calc\":\"\",\"selected\":0,\"order\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"label\":\"Dismount from horse\",\"value\":\"dismount\",\"calc\":\"\",\"selected\":0,\"order\":1,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"label\":\"Allow _ Minutes to rest and reorient\",\"value\":\"minutes\",\"calc\":\"\",\"selected\":0,\"order\":2,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"order\":3,\"new\":false,\"options\":[],\"label\":\"Report observations to parents \\\/ guardians immediately\",\"value\":\"report\",\"calc\":\"\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"order\":4,\"new\":false,\"options\":[],\"label\":\"Send note home to parent \\\/ guardian\",\"value\":\"note\",\"calc\":\"\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true}],\"container_class\":\"\",\"element_class\":\"\",\"admin_label\":\"\",\"help_text\":\"\",\"drawerDisabled\":false,\"id\":88,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"list\",\"element_templates\":[\"listcheckbox\",\"input\"],\"old_classname\":\"list-checkbox\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":71,\"type\":\"textbox\",\"label\":\"Other, please specify: \",\"key\":\"other_please_specify_1528907079836\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"mask\":\"\",\"custom_mask\":\"\",\"custom_name_attribute\":\"\",\"personally_identifiable\":\"\",\"drawerDisabled\":false,\"id\":89,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textbox\",\"element_templates\":[\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":72,\"type\":\"date\",\"label\":\"Today's Date\",\"key\":\"today_s_date_1528907125828\",\"label_pos\":\"above\",\"required\":1,\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"date_default\":1,\"date_format\":\"default\",\"year_range_start\":\"\",\"year_range_end\":\"\",\"drawerDisabled\":false,\"hours_options\":\"<option value=\\\"00\\\" >00<\\\/option><option value=\\\"01\\\" >01<\\\/option><option value=\\\"02\\\" >02<\\\/option><option value=\\\"03\\\" >03<\\\/option><option value=\\\"04\\\" >04<\\\/option><option value=\\\"05\\\" >05<\\\/option><option value=\\\"06\\\" >06<\\\/option><option value=\\\"07\\\" >07<\\\/option><option value=\\\"08\\\" >08<\\\/option><option value=\\\"09\\\" >09<\\\/option><option value=\\\"10\\\" >10<\\\/option><option value=\\\"11\\\" >11<\\\/option><option value=\\\"12\\\" >12<\\\/option><option value=\\\"13\\\" >13<\\\/option><option value=\\\"14\\\" >14<\\\/option><option value=\\\"15\\\" >15<\\\/option><option value=\\\"16\\\" >16<\\\/option><option value=\\\"17\\\" >17<\\\/option><option value=\\\"18\\\" >18<\\\/option><option value=\\\"19\\\" >19<\\\/option><option value=\\\"20\\\" >20<\\\/option><option value=\\\"21\\\" >21<\\\/option><option value=\\\"22\\\" >22<\\\/option><option value=\\\"23\\\" >23<\\\/option>\",\"minutes_options\":\"<option value=\\\"00\\\" >00<\\\/option><option value=\\\"01\\\" >01<\\\/option><option value=\\\"02\\\" >02<\\\/option><option value=\\\"03\\\" >03<\\\/option><option value=\\\"04\\\" >04<\\\/option><option value=\\\"05\\\" >05<\\\/option><option value=\\\"06\\\" >06<\\\/option><option value=\\\"07\\\" >07<\\\/option><option value=\\\"08\\\" >08<\\\/option><option value=\\\"09\\\" >09<\\\/option><option value=\\\"10\\\" >10<\\\/option><option value=\\\"11\\\" >11<\\\/option><option value=\\\"12\\\" >12<\\\/option><option value=\\\"13\\\" >13<\\\/option><option value=\\\"14\\\" >14<\\\/option><option value=\\\"15\\\" >15<\\\/option><option value=\\\"16\\\" >16<\\\/option><option value=\\\"17\\\" >17<\\\/option><option value=\\\"18\\\" >18<\\\/option><option value=\\\"19\\\" >19<\\\/option><option value=\\\"20\\\" >20<\\\/option><option value=\\\"21\\\" >21<\\\/option><option value=\\\"22\\\" >22<\\\/option><option value=\\\"23\\\" >23<\\\/option><option value=\\\"24\\\" >24<\\\/option><option value=\\\"25\\\" >25<\\\/option><option value=\\\"26\\\" >26<\\\/option><option value=\\\"27\\\" >27<\\\/option><option value=\\\"28\\\" >28<\\\/option><option value=\\\"29\\\" >29<\\\/option><option value=\\\"30\\\" >30<\\\/option><option value=\\\"31\\\" >31<\\\/option><option value=\\\"32\\\" >32<\\\/option><option value=\\\"33\\\" >33<\\\/option><option value=\\\"34\\\" >34<\\\/option><option value=\\\"35\\\" >35<\\\/option><option value=\\\"36\\\" >36<\\\/option><option value=\\\"37\\\" >37<\\\/option><option value=\\\"38\\\" >38<\\\/option><option value=\\\"39\\\" >39<\\\/option><option value=\\\"40\\\" >40<\\\/option><option value=\\\"41\\\" >41<\\\/option><option value=\\\"42\\\" >42<\\\/option><option value=\\\"43\\\" >43<\\\/option><option value=\\\"44\\\" >44<\\\/option><option value=\\\"45\\\" >45<\\\/option><option value=\\\"46\\\" >46<\\\/option><option value=\\\"47\\\" >47<\\\/option><option value=\\\"48\\\" >48<\\\/option><option value=\\\"49\\\" >49<\\\/option><option value=\\\"50\\\" >50<\\\/option><option value=\\\"51\\\" >51<\\\/option><option value=\\\"52\\\" >52<\\\/option><option value=\\\"53\\\" >53<\\\/option><option value=\\\"54\\\" >54<\\\/option><option value=\\\"55\\\" >55<\\\/option><option value=\\\"56\\\" >56<\\\/option><option value=\\\"57\\\" >57<\\\/option><option value=\\\"58\\\" >58<\\\/option><option value=\\\"59\\\" >59<\\\/option>\",\"id\":91,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"date\",\"element_templates\":[\"date\",\"textbox\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":73,\"type\":\"listradio\",\"label\":\"I hereby declare that all  the information I have provided regarding seizures, either for myself or a third-party, is completely accurate and correct. \",\"key\":\"i_hereby_declare_that_all_the_information_i_have_provided_regarding_seizures_either_for_myself_or_a_third-party_is_completely_accurate_and_correct_1528906957091\",\"label_pos\":\"above\",\"required\":1,\"options\":[{\"errors\":[],\"max_options\":0,\"label\":\"Agree\",\"value\":\"agree\",\"calc\":\"\",\"selected\":0,\"order\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"label\":\"Decline\",\"value\":\"decline\",\"calc\":\"\",\"selected\":0,\"order\":1,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true}],\"container_class\":\"\",\"element_class\":\"\",\"admin_label\":\"\",\"help_text\":\"\",\"drawerDisabled\":false,\"id\":90,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"list\",\"element_templates\":[\"listradio\",\"input\"],\"old_classname\":\"list-radio\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":74,\"type\":\"hr\",\"label\":\"Divider\",\"container_class\":\"\",\"element_class\":\"\",\"key\":\"hr_1528907174525\",\"id\":92,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"label_pos\":\"above\",\"parentType\":\"hr\",\"element_templates\":[\"hr\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":75,\"type\":\"textarea\",\"label\":\"PHYSICAL FUNCTION\",\"key\":\"physical_function_1528907202049\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"<p>&nbsp;(i.e. Mobility skills such as transfers, walking, wheelchair use, sitting balance)\\nDescribe your abilities\\\/difficulties (include assistance required or equipment needed)<br><\\\/p>\",\"desc_text\":\"<p>&nbsp;(i.e. Mobility skills such as transfers, walking, wheelchair use, sitting balance)\\nDescribe your abilities\\\/difficulties (include assistance required or equipment needed)<br><\\\/p>\",\"textarea_rte\":\"\",\"disable_rte_mobile\":\"\",\"textarea_media\":\"\",\"drawerDisabled\":false,\"id\":93,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textarea\",\"element_templates\":[\"textarea\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":76,\"type\":\"listcheckbox\",\"label\":\"Please indicate current or past special needs in the following areas:\",\"key\":\"please_indicate_current_or_past_special_needs_in_the_following_areas_1528907233420\",\"label_pos\":\"above\",\"required\":false,\"options\":[{\"errors\":[],\"max_options\":0,\"label\":\"Vision\",\"value\":\"Vision\",\"calc\":\"\",\"selected\":0,\"order\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"label\":\"Hearing\",\"value\":\"Hearing\",\"calc\":\"\",\"selected\":0,\"order\":1,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"label\":\"Sensation\",\"value\":\"Sensation\",\"calc\":\"\",\"selected\":0,\"order\":2,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"order\":3,\"new\":false,\"options\":[],\"label\":\"Communication\",\"value\":\"Communication\",\"calc\":\"\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"order\":4,\"new\":false,\"options\":[],\"label\":\"Heart\",\"value\":\"Heart\",\"calc\":\"\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"order\":5,\"new\":false,\"options\":[],\"label\":\"Breathing\",\"value\":\"Breathing\",\"calc\":\"\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"order\":6,\"new\":false,\"options\":[],\"label\":\"Circulation\",\"value\":\"Circulation\",\"calc\":\"\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"order\":7,\"new\":false,\"options\":[],\"label\":\"Emotional \\\/ Mental Health\",\"value\":\"Emotional \",\"calc\":\"\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"order\":8,\"new\":false,\"options\":[],\"label\":\"Behavioral\",\"value\":\"Behavioral\",\"calc\":\"\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"order\":9,\"new\":false,\"options\":[],\"label\":\"Pain\",\"value\":\"Pain\",\"calc\":\"\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"order\":10,\"new\":false,\"options\":[],\"label\":\"Fatigue\",\"value\":\"Fatigue\",\"calc\":\"\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"order\":11,\"new\":false,\"options\":[],\"label\":\"Bone \\\/ Joint\",\"value\":\"Bone  Joint\",\"calc\":\"\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"order\":12,\"new\":false,\"options\":[],\"label\":\"Muscular\",\"value\":\"Muscular\",\"calc\":\"\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"order\":13,\"new\":false,\"options\":[],\"label\":\"Thinking \\\/ Cognition\",\"value\":\"Thinking  Cognition\",\"calc\":\"\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"order\":14,\"new\":false,\"options\":[],\"label\":\"Allergies\",\"value\":\"Allergies\",\"calc\":\"\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true},{\"errors\":[],\"max_options\":0,\"order\":15,\"new\":false,\"options\":[],\"label\":\"Seizures\",\"value\":\"Seizures\",\"calc\":\"\",\"selected\":0,\"settingModel\":{\"settings\":false,\"hide_merge_tags\":false,\"error\":false,\"name\":\"options\",\"type\":\"option-repeater\",\"label\":\"Options <a href=\\\"#\\\" class=\\\"nf-add-new\\\">Add New<\\\/a> <a href=\\\"#\\\" class=\\\"extra nf-open-import-tooltip\\\"><i class=\\\"fa fa-sign-in\\\" aria-hidden=\\\"true\\\"><\\\/i> Import<\\\/a>\",\"width\":\"full\",\"group\":\"\",\"value\":[{\"label\":\"One\",\"value\":\"one\",\"calc\":\"\",\"selected\":0,\"order\":0},{\"label\":\"Two\",\"value\":\"two\",\"calc\":\"\",\"selected\":0,\"order\":1},{\"label\":\"Three\",\"value\":\"three\",\"calc\":\"\",\"selected\":0,\"order\":2}],\"columns\":{\"label\":{\"header\":\"Label\",\"default\":\"\"},\"value\":{\"header\":\"Value\",\"default\":\"\"},\"calc\":{\"header\":\"Calc Value\",\"default\":\"\"},\"selected\":{\"header\":\"<span class=\\\"dashicons dashicons-yes\\\"><\\\/span>\",\"default\":0}}},\"manual_value\":true}],\"container_class\":\"\",\"element_class\":\"\",\"admin_label\":\"\",\"help_text\":\"\",\"drawerDisabled\":false,\"id\":94,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"list\",\"element_templates\":[\"listcheckbox\",\"input\"],\"old_classname\":\"list-checkbox\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":77,\"type\":\"textarea\",\"label\":\"Comments about the conditions above: \",\"key\":\"comments_about_the_conditions_above_1528907440726\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"desc_text\":\"<p>Please be as specific as possible<\\\/p>\",\"textarea_rte\":\"\",\"disable_rte_mobile\":\"\",\"textarea_media\":\"\",\"drawerDisabled\":false,\"id\":95,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textarea\",\"element_templates\":[\"textarea\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":78,\"type\":\"textarea\",\"label\":\"MEDICATIONS \",\"key\":\"medications_1528907473050\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"<p>(include prescription, over-the-counter; name, dose and frequency)<br><\\\/p>\",\"desc_text\":\"<p>(include prescription, over-the-counter; name, dose and frequency)<br><\\\/p>\",\"textarea_rte\":\"\",\"disable_rte_mobile\":\"\",\"textarea_media\":\"\",\"drawerDisabled\":false,\"id\":96,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textarea\",\"element_templates\":[\"textarea\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":79,\"type\":\"textarea\",\"label\":\"Medical Devices\",\"key\":\"medical_devices_1528907527741\",\"label_pos\":\"above\",\"required\":false,\"default\":\"\",\"placeholder\":\"\",\"container_class\":\"\",\"element_class\":\"\",\"input_limit\":\"\",\"input_limit_type\":\"characters\",\"input_limit_msg\":\"Character(s) left\",\"manual_key\":false,\"admin_label\":\"\",\"help_text\":\"\",\"desc_text\":\"<p>&nbsp;Feeding tubes, shunts etc.:&nbsp;<br><\\\/p>\",\"textarea_rte\":\"\",\"disable_rte_mobile\":\"\",\"textarea_media\":\"\",\"drawerDisabled\":false,\"id\":97,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"parentType\":\"textarea\",\"element_templates\":[\"textarea\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap\"},{\"objectType\":\"Field\",\"objectDomain\":\"fields\",\"editActive\":false,\"order\":80,\"type\":\"submit\",\"label\":\"Submit Form\",\"processing_label\":\"Processing\",\"container_class\":\"\",\"element_class\":\"\",\"key\":\"submit_form_1528907558034\",\"created_at\":\"2018-06-12 19:05:07\",\"drawerDisabled\":false,\"id\":27,\"beforeField\":\"\",\"afterField\":\"\",\"value\":\"\",\"label_pos\":\"above\",\"parentType\":\"textbox\",\"element_templates\":[\"submit\",\"button\",\"input\"],\"old_classname\":\"\",\"wrap_template\":\"wrap-no-label\"}];nfForms.push(form);<\/script>\n        \n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":80,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-72","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"http:\/\/www.hohb.drnoce.biz\/index.php\/wp-json\/wp\/v2\/pages\/72","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.hohb.drnoce.biz\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/www.hohb.drnoce.biz\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/www.hohb.drnoce.biz\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.hohb.drnoce.biz\/index.php\/wp-json\/wp\/v2\/comments?post=72"}],"version-history":[{"count":3,"href":"http:\/\/www.hohb.drnoce.biz\/index.php\/wp-json\/wp\/v2\/pages\/72\/revisions"}],"predecessor-version":[{"id":392,"href":"http:\/\/www.hohb.drnoce.biz\/index.php\/wp-json\/wp\/v2\/pages\/72\/revisions\/392"}],"up":[{"embeddable":true,"href":"http:\/\/www.hohb.drnoce.biz\/index.php\/wp-json\/wp\/v2\/pages\/80"}],"wp:attachment":[{"href":"http:\/\/www.hohb.drnoce.biz\/index.php\/wp-json\/wp\/v2\/media?parent=72"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}