{"id":6344,"date":"2020-08-28T07:39:17","date_gmt":"2020-08-28T12:39:17","guid":{"rendered":"https:\/\/uamscaregiving.org\/springdale\/?page_id=6344"},"modified":"2021-12-13T10:02:52","modified_gmt":"2021-12-13T16:02:52","slug":"postclasssurvey","status":"publish","type":"page","link":"https:\/\/uamscaregiving.org\/springdale\/postclasssurvey\/","title":{"rendered":"Post-Home Caregiver Training Class Survey"},"content":{"rendered":"<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_200' >\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_200'  action='\/springdale\/wp-json\/wp\/v2\/pages\/6344' data-formid='200' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_200' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_200_40\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_200_40\" ><h4><font color=\"red\"> **STOP** <\/font>This survey should be completed <strong>ONLY<\/strong> <u>on or after the last day of your training class.<\/u><\/h4><\/div><div id=\"field_200_23\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-half gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_200_23\" ><label class='gfield_label gform-field-label' for='input_200_23'>What is today&#039;s date?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='gfield_description' id='gfield_description_200_23'><strong><i>(MM\/DD\/YYYY)<\/i><\/strong><\/div><div class='ginput_container ginput_container_date'>\n                            <input aria-describedby='field_200_23_dmessage' name='input_23' id='input_200_23' type='text' value='04\/25\/2026' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_200_23_date_format gfield_description_200_23\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_200_23_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_200_23' class='gform_hidden' value='https:\/\/uamscaregiving.org\/springdale\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_200_18\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-half gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_200_18\" ><label class='gfield_label gform-field-label' for='input_200_18'>Enter your birthday<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='gfield_description' id='gfield_description_200_18'><strong><i>(MM\/DD\/YYYY)<\/i><\/strong><\/div><div class='ginput_container ginput_container_date'>\n                            <input aria-describedby='field_200_18_dmessage' name='input_18' id='input_200_18' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_200_18_date_format gfield_description_200_18\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_200_18_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_200_18' class='gform_hidden' value='https:\/\/uamscaregiving.org\/springdale\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_200_42\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_200_42\" ><br><br><\/div><fieldset id=\"field_200_24\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_200_24\" ><legend class='gfield_label gform-field-label' >What best describes your reason for taking this class?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_200_24'>\n\t\t\t<div class='gchoice gchoice_200_24_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='I plan to work as a paid caregiver'  id='choice_200_24_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_24_0' id='label_200_24_0' class='gform-field-label gform-field-label--type-inline'>I plan to work as a paid caregiver<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_24_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='I am caring for a friend or family member'  id='choice_200_24_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_24_1' id='label_200_24_1' class='gform-field-label gform-field-label--type-inline'>I am caring for a friend or family member<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_24_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='gf_other_choice'  id='choice_200_24_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_24_2' id='label_200_24_2' class='gform-field-label gform-field-label--type-inline'>Other<\/label><br \/><input id='input_200_24_other' class='gchoice_other_control' name='input_24_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/fieldset><fieldset id=\"field_200_36\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_200_36\" ><legend class='gfield_label gform-field-label' >Based on your current knowledge of this class, do you believe that the class content will enable you to fulfill your role as a paid or family caregiver?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_200_36'>\n\t\t\t<div class='gchoice gchoice_200_36_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='Yes'  id='choice_200_36_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_36_0' id='label_200_36_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_36_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='No'  id='choice_200_36_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_36_1' id='label_200_36_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_36_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='Cannot judge at this time'  id='choice_200_36_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_36_2' id='label_200_36_2' class='gform-field-label gform-field-label--type-inline'>Cannot judge at this time<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_36_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='gf_other_choice'  id='choice_200_36_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_36_3' id='label_200_36_3' class='gform-field-label gform-field-label--type-inline'>Other<\/label><br \/><input id='input_200_36_other' class='gchoice_other_control' name='input_36_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/fieldset><div id=\"field_200_41\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_200_41\" ><br><br><\/div><fieldset id=\"field_200_25\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_200_25\" ><legend class='gfield_label gform-field-label' >Which answer best describes your current level of confidence caring for an older adult?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_200_25'>\n\t\t\t<div class='gchoice gchoice_200_25_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='Very High'  id='choice_200_25_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_25_0' id='label_200_25_0' class='gform-field-label gform-field-label--type-inline'>Very High<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_25_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='High'  id='choice_200_25_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_25_1' id='label_200_25_1' class='gform-field-label gform-field-label--type-inline'>High<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_25_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='Average'  id='choice_200_25_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_25_2' id='label_200_25_2' class='gform-field-label gform-field-label--type-inline'>Average<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_25_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='Low'  id='choice_200_25_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_25_3' id='label_200_25_3' class='gform-field-label gform-field-label--type-inline'>Low<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_25_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='Very Low'  id='choice_200_25_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_25_4' id='label_200_25_4' class='gform-field-label gform-field-label--type-inline'>Very Low<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/fieldset><fieldset id=\"field_200_26\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_200_26\" ><legend class='gfield_label gform-field-label' >How would you rate your current knowledge of caregiving topics?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_200_26'>\n\t\t\t<div class='gchoice gchoice_200_26_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='Very High'  id='choice_200_26_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_26_0' id='label_200_26_0' class='gform-field-label gform-field-label--type-inline'>Very High<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_26_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='High'  id='choice_200_26_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_26_1' id='label_200_26_1' class='gform-field-label gform-field-label--type-inline'>High<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_26_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='Average'  id='choice_200_26_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_26_2' id='label_200_26_2' class='gform-field-label gform-field-label--type-inline'>Average<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_26_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='Low'  id='choice_200_26_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_26_3' id='label_200_26_3' class='gform-field-label gform-field-label--type-inline'>Low<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_26_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='Very Low'  id='choice_200_26_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_26_4' id='label_200_26_4' class='gform-field-label gform-field-label--type-inline'>Very Low<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/fieldset><fieldset id=\"field_200_27\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_200_27\" ><legend class='gfield_label gform-field-label' >How would you rate your current understanding about aging topics?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_200_27'>\n\t\t\t<div class='gchoice gchoice_200_27_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='Very High'  id='choice_200_27_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_27_0' id='label_200_27_0' class='gform-field-label gform-field-label--type-inline'>Very High<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_27_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='High'  id='choice_200_27_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_27_1' id='label_200_27_1' class='gform-field-label gform-field-label--type-inline'>High<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_27_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='Average'  id='choice_200_27_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_27_2' id='label_200_27_2' class='gform-field-label gform-field-label--type-inline'>Average<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_27_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='Low'  id='choice_200_27_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_27_3' id='label_200_27_3' class='gform-field-label gform-field-label--type-inline'>Low<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_27_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='Very Low'  id='choice_200_27_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_27_4' id='label_200_27_4' class='gform-field-label gform-field-label--type-inline'>Very Low<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/fieldset><fieldset id=\"field_200_28\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_200_28\" ><legend class='gfield_label gform-field-label' >How confident are you using a gait belt?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_200_28'>\n\t\t\t<div class='gchoice gchoice_200_28_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='Very High'  id='choice_200_28_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_28_0' id='label_200_28_0' class='gform-field-label gform-field-label--type-inline'>Very High<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_28_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='High'  id='choice_200_28_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_28_1' id='label_200_28_1' class='gform-field-label gform-field-label--type-inline'>High<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_28_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='Average'  id='choice_200_28_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_28_2' id='label_200_28_2' class='gform-field-label gform-field-label--type-inline'>Average<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_28_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='Low'  id='choice_200_28_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_28_3' id='label_200_28_3' class='gform-field-label gform-field-label--type-inline'>Low<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_28_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='Very Low'  id='choice_200_28_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_28_4' id='label_200_28_4' class='gform-field-label gform-field-label--type-inline'>Very Low<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_28_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='No confidence'  id='choice_200_28_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_28_5' id='label_200_28_5' class='gform-field-label gform-field-label--type-inline'>No confidence<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/fieldset><fieldset id=\"field_200_30\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_200_30\" ><legend class='gfield_label gform-field-label' >How confident are you giving a bath to an immobile person?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_200_30'>\n\t\t\t<div class='gchoice gchoice_200_30_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='Very High'  id='choice_200_30_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_30_0' id='label_200_30_0' class='gform-field-label gform-field-label--type-inline'>Very High<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_30_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='High'  id='choice_200_30_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_30_1' id='label_200_30_1' class='gform-field-label gform-field-label--type-inline'>High<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_30_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='Average'  id='choice_200_30_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_30_2' id='label_200_30_2' class='gform-field-label gform-field-label--type-inline'>Average<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_30_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='Low'  id='choice_200_30_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_30_3' id='label_200_30_3' class='gform-field-label gform-field-label--type-inline'>Low<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_30_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='Very Low'  id='choice_200_30_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_30_4' id='label_200_30_4' class='gform-field-label gform-field-label--type-inline'>Very Low<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_30_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='No confidence'  id='choice_200_30_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_30_5' id='label_200_30_5' class='gform-field-label gform-field-label--type-inline'>No confidence<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/fieldset><fieldset id=\"field_200_31\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_200_31\" ><legend class='gfield_label gform-field-label' >Rate your current skill level in transferring a dependent person?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_200_31'>\n\t\t\t<div class='gchoice gchoice_200_31_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='Very High'  id='choice_200_31_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_31_0' id='label_200_31_0' class='gform-field-label gform-field-label--type-inline'>Very High<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_31_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='High'  id='choice_200_31_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_31_1' id='label_200_31_1' class='gform-field-label gform-field-label--type-inline'>High<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_31_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='Average'  id='choice_200_31_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_31_2' id='label_200_31_2' class='gform-field-label gform-field-label--type-inline'>Average<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_31_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='Low'  id='choice_200_31_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_31_3' id='label_200_31_3' class='gform-field-label gform-field-label--type-inline'>Low<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_31_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='Very Low'  id='choice_200_31_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_31_4' id='label_200_31_4' class='gform-field-label gform-field-label--type-inline'>Very Low<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_31_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='No skill'  id='choice_200_31_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_31_5' id='label_200_31_5' class='gform-field-label gform-field-label--type-inline'>No skill<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/fieldset><fieldset id=\"field_200_32\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_200_32\" ><legend class='gfield_label gform-field-label' >Rate your current ability to care for a person with memory impairment?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_200_32'>\n\t\t\t<div class='gchoice gchoice_200_32_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='Very High'  id='choice_200_32_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_32_0' id='label_200_32_0' class='gform-field-label gform-field-label--type-inline'>Very High<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_32_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='High'  id='choice_200_32_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_32_1' id='label_200_32_1' class='gform-field-label gform-field-label--type-inline'>High<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_32_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='Average'  id='choice_200_32_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_32_2' id='label_200_32_2' class='gform-field-label gform-field-label--type-inline'>Average<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_32_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='Low'  id='choice_200_32_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_32_3' id='label_200_32_3' class='gform-field-label gform-field-label--type-inline'>Low<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_32_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='Very Low'  id='choice_200_32_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_32_4' id='label_200_32_4' class='gform-field-label gform-field-label--type-inline'>Very Low<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_32_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='No ability'  id='choice_200_32_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_32_5' id='label_200_32_5' class='gform-field-label gform-field-label--type-inline'>No ability<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/fieldset><fieldset id=\"field_200_33\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_200_33\" ><legend class='gfield_label gform-field-label' >How confident are you providing person-centered care for an older adult?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_200_33'>\n\t\t\t<div class='gchoice gchoice_200_33_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='Very High'  id='choice_200_33_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_33_0' id='label_200_33_0' class='gform-field-label gform-field-label--type-inline'>Very High<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_33_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='High'  id='choice_200_33_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_33_1' id='label_200_33_1' class='gform-field-label gform-field-label--type-inline'>High<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_33_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='Average'  id='choice_200_33_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_33_2' id='label_200_33_2' class='gform-field-label gform-field-label--type-inline'>Average<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_33_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='Low'  id='choice_200_33_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_33_3' id='label_200_33_3' class='gform-field-label gform-field-label--type-inline'>Low<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_33_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='Very Low'  id='choice_200_33_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_33_4' id='label_200_33_4' class='gform-field-label gform-field-label--type-inline'>Very Low<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_33_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='No confidence'  id='choice_200_33_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_33_5' id='label_200_33_5' class='gform-field-label gform-field-label--type-inline'>No confidence<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/fieldset><fieldset id=\"field_200_34\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_200_34\" ><legend class='gfield_label gform-field-label' >Rate your ability to dress a person who requires assistance?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_200_34'>\n\t\t\t<div class='gchoice gchoice_200_34_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='Very High'  id='choice_200_34_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_34_0' id='label_200_34_0' class='gform-field-label gform-field-label--type-inline'>Very High<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_34_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='High'  id='choice_200_34_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_34_1' id='label_200_34_1' class='gform-field-label gform-field-label--type-inline'>High<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_34_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='Average'  id='choice_200_34_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_34_2' id='label_200_34_2' class='gform-field-label gform-field-label--type-inline'>Average<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_34_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='Low'  id='choice_200_34_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_34_3' id='label_200_34_3' class='gform-field-label gform-field-label--type-inline'>Low<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_34_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='Very Low'  id='choice_200_34_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_34_4' id='label_200_34_4' class='gform-field-label gform-field-label--type-inline'>Very Low<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_34_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='No ability'  id='choice_200_34_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_34_5' id='label_200_34_5' class='gform-field-label gform-field-label--type-inline'>No ability<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/fieldset><fieldset id=\"field_200_35\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_200_35\" ><legend class='gfield_label gform-field-label' >How would you rate your current understanding of chronic disease?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_200_35'>\n\t\t\t<div class='gchoice gchoice_200_35_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='Very High'  id='choice_200_35_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_35_0' id='label_200_35_0' class='gform-field-label gform-field-label--type-inline'>Very High<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_35_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='High'  id='choice_200_35_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_35_1' id='label_200_35_1' class='gform-field-label gform-field-label--type-inline'>High<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_35_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='Average'  id='choice_200_35_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_35_2' id='label_200_35_2' class='gform-field-label gform-field-label--type-inline'>Average<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_35_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='Low'  id='choice_200_35_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_35_3' id='label_200_35_3' class='gform-field-label gform-field-label--type-inline'>Low<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_200_35_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='Very Low'  id='choice_200_35_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_200_35_4' id='label_200_35_4' class='gform-field-label gform-field-label--type-inline'>Very Low<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/fieldset><div id=\"field_200_43\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_200_43\" ><br><br><\/div><div id=\"field_200_4\" class=\"gfield gfield--type-textarea gfield--input-type-textarea field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_200_4\" ><label class='gfield_label gform-field-label' for='input_200_4'>Do you have comments, questions, or suggestions about the registration process for this class?<\/label><div class='gfield_description' id='gfield_description_200_4'><strong><i>Please begin on a new line and number each new item. <\/strong><\/i><\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_4' id='input_200_4' class='textarea medium'  aria-describedby=\"gfield_description_200_4\"  placeholder='1. 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