{"id":7228,"date":"2021-02-23T15:02:24","date_gmt":"2021-02-23T21:02:24","guid":{"rendered":"https:\/\/uamscaregiving.org\/springdale\/?page_id=7228"},"modified":"2026-02-06T13:28:27","modified_gmt":"2026-02-06T19:28:27","slug":"medicarebasics","status":"publish","type":"page","link":"https:\/\/uamscaregiving.org\/springdale\/medicarebasics\/","title":{"rendered":"Let&#8217;s Talk Medicare"},"content":{"rendered":"<p>Let&#8217;s Talk Medicare is offered on the first Wednesday of each month via Zoom ONLY at 1:00 PM<\/p>\n<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_336' ><div id='gf_336' class='gform_anchor' tabindex='-1'><\/div>\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_336'  action='\/springdale\/wp-json\/wp\/v2\/pages\/7228#gf_336' data-formid='336' novalidate>\n        <div id='gf_progressbar_wrapper_336' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<p class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>2<\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_50' style='width:50%;'><span>50%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_336_1' class='gform_page ' data-js='page-field-id-1' >\n                                    <div class='gform_page_fields'><div id='gform_fields_336' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_336_11\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_336_11\" ><label class='gfield_label gform-field-label' for='input_336_11'>Today&#039;s Date<\/label><div class='ginput_container ginput_container_date'>\n                            <input aria-describedby='field_336_11_dmessage' name='input_11' id='input_336_11' type='text' value='04\/25\/2026' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_336_11_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_336_11_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_336_11' class='gform_hidden' value='https:\/\/uamscaregiving.org\/springdale\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_336_13\" 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--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_336_13\" ><label class='gfield_label gform-field-label' for='input_336_13'>Birthday<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input aria-describedby='field_336_13_dmessage' name='input_13' id='input_336_13' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_336_13_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_336_13_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_336_13' class='gform_hidden' value='https:\/\/uamscaregiving.org\/springdale\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><fieldset id=\"field_336_3\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_336_3\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Enter required information below.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_336_3'>\n                            \n                            <span id='input_336_3_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_3.3' id='input_336_3_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_336_3_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_336_3_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_3.6' id='input_336_3_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_336_3_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><\/fieldset><div id=\"field_336_1\" class=\"gfield gfield--type-email gfield--input-type-email 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_336_1\" ><label class='gfield_label gform-field-label' for='input_336_1'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_1' id='input_336_1' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_336_2\" class=\"gfield gfield--type-phone gfield--input-type-phone 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_336_2\" ><label class='gfield_label gform-field-label' for='input_336_2'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_2' id='input_336_2' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_336_6\" class=\"gfield gfield--type-select gfield--input-type-select 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_336_6\" ><label class='gfield_label gform-field-label' for='input_336_6'>Residence County<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_6' id='input_336_6' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='Benton' >Benton<\/option><option value='Washington' >Washington<\/option><option value='Madison' >Madison<\/option><option value='Baxter' >Baxter<\/option><option value='Boone' >Boone<\/option><option value='Carroll' >Carroll<\/option><option value='Izard' >Izard<\/option><option value='Marion' >Marion<\/option><option value='Newton' >Newton<\/option><option value='Searcy' >Searcy<\/option><option value='Stone' >Stone<\/option><option value='other' >other<\/option><\/select><\/div><\/div><div id=\"field_336_9\" class=\"gfield gfield--type-select gfield--input-type-select 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_336_9\" ><label class='gfield_label gform-field-label' for='input_336_9'>Profession<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_9' id='input_336_9' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Public\/Community' >Public\/Community<\/option><option value='Dietician' >Dietician<\/option><option value='Medical Student' >Medical Student<\/option><option value='Nursing' >Nursing<\/option><option value='Nursing Home Administration' >Nursing Home Administration<\/option><option value='Paraprofessional' >Paraprofessional<\/option><option value='Patient' >Patient<\/option><option value='Physical Therapy' >Physical Therapy<\/option><option value='Physician' >Physician<\/option><option value='Resident' >Resident<\/option><option value='Social Work' >Social Work<\/option><option value='Student' >Student<\/option><\/select><\/div><\/div><div id=\"field_336_8\" class=\"gfield gfield--type-select gfield--input-type-select 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_336_8\" ><label class='gfield_label gform-field-label' for='input_336_8'>Gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_8' id='input_336_8' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='Male' >Male<\/option><option value='Female' >Female<\/option><option value='Other' >Other<\/option><\/select><\/div><\/div><div id=\"field_336_7\" class=\"gfield gfield--type-select gfield--input-type-select 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_336_7\" ><label class='gfield_label gform-field-label' for='input_336_7'>Race<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_7' id='input_336_7' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='African-American' >African-American<\/option><option value='American Indian' >American Indian<\/option><option value='Asian\/Pacific Islander' >Asian\/Pacific Islander<\/option><option value='Caucasian' >Caucasian<\/option><option value='Hispanic' >Hispanic<\/option><option value='Middle Eastern' >Middle Eastern<\/option><option value='Other' >Other<\/option><\/select><\/div><\/div><fieldset id=\"field_336_12\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-third field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_336_12\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >How did you learn of this program?<\/legend><div class='gfield_description' id='gfield_description_336_12'>(check all that apply)<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_336_12'><div class='gchoice gchoice_336_12_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.1' type='checkbox'  value='Facebook'  id='choice_336_12_1'   aria-describedby=\"gfield_description_336_12\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_336_12_1' id='label_336_12_1' class='gform-field-label gform-field-label--type-inline'>Facebook<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_336_12_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.2' type='checkbox'  value='Website'  id='choice_336_12_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_336_12_2' id='label_336_12_2' class='gform-field-label gform-field-label--type-inline'>Website<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_336_12_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.3' type='checkbox'  value='Word of Mouth'  id='choice_336_12_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_336_12_3' id='label_336_12_3' class='gform-field-label gform-field-label--type-inline'>Word of Mouth<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_336_12_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.4' type='checkbox'  value='My Center on Aging (the Schmieding Center)'  id='choice_336_12_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_336_12_4' id='label_336_12_4' class='gform-field-label gform-field-label--type-inline'>My Center on Aging (the Schmieding Center)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_336_12_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.5' type='checkbox'  value='My Healthcare Provider (e.g., doctor, nurse, etc.)'  id='choice_336_12_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_336_12_5' id='label_336_12_5' class='gform-field-label gform-field-label--type-inline'>My Healthcare Provider (e.g., doctor, nurse, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_336_12_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_12.6' type='checkbox'  value='Other'  id='choice_336_12_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_336_12_6' id='label_336_12_6' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_336_14' class='gform_next_button gform-theme-button button' value='Next complete the survey'  onclick='jQuery(\"#gform_target_page_number_336\").val(\"2\");  jQuery(\"#gform_336\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_336\").val(\"2\");  jQuery(\"#gform_336\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_336_2' class='gform_page' data-js='page-field-id-14' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_336_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_336_20\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_336_20\" ><strong><h4><mark>Survey data is required by our funder to offer this program at no cost to participants. Only aggregate (group) data from this survey is reported.<\/mark><\/h4><\/strong><\/div><fieldset id=\"field_336_15\" 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_336_15\" ><legend class='gfield_label gform-field-label' >How would you rate your overall knowledge of Medicare?<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_336_15'>\n\t\t\t<div class='gchoice gchoice_336_15_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='4'  id='choice_336_15_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_336_15_0' id='label_336_15_0' class='gform-field-label gform-field-label--type-inline'>Excellent<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_336_15_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='3'  id='choice_336_15_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_336_15_1' id='label_336_15_1' class='gform-field-label gform-field-label--type-inline'>Good<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_336_15_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='2'  id='choice_336_15_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_336_15_2' id='label_336_15_2' class='gform-field-label gform-field-label--type-inline'>Fair<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_336_15_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='1'  id='choice_336_15_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_336_15_3' id='label_336_15_3' class='gform-field-label gform-field-label--type-inline'>Poor<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_336_15_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='0'  id='choice_336_15_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_336_15_4' id='label_336_15_4' class='gform-field-label gform-field-label--type-inline'>SCSHE<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/fieldset><fieldset id=\"field_336_16\" 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_336_16\" ><legend class='gfield_label gform-field-label' >How would you rate your understanding of what the various parts of Medicare cover?<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_336_16'>\n\t\t\t<div class='gchoice gchoice_336_16_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='4'  id='choice_336_16_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_336_16_0' id='label_336_16_0' class='gform-field-label gform-field-label--type-inline'>Excellent<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_336_16_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='3'  id='choice_336_16_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_336_16_1' id='label_336_16_1' class='gform-field-label gform-field-label--type-inline'>Good<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_336_16_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='2'  id='choice_336_16_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_336_16_2' id='label_336_16_2' class='gform-field-label gform-field-label--type-inline'>Fair<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_336_16_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='1'  id='choice_336_16_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_336_16_3' id='label_336_16_3' class='gform-field-label gform-field-label--type-inline'>Poor<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_336_16_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='0'  id='choice_336_16_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_336_16_4' id='label_336_16_4' class='gform-field-label gform-field-label--type-inline'>SCSHE<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/fieldset><fieldset id=\"field_336_17\" 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_336_17\" ><legend class='gfield_label gform-field-label' >How would you rate your understanding of the costs associated with Medicare enrollment?<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_336_17'>\n\t\t\t<div class='gchoice gchoice_336_17_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='4'  id='choice_336_17_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_336_17_0' id='label_336_17_0' class='gform-field-label gform-field-label--type-inline'>Excellent<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_336_17_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='3'  id='choice_336_17_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_336_17_1' id='label_336_17_1' class='gform-field-label gform-field-label--type-inline'>Good<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_336_17_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='2'  id='choice_336_17_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_336_17_2' id='label_336_17_2' class='gform-field-label gform-field-label--type-inline'>Fair<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_336_17_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='1'  id='choice_336_17_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_336_17_3' id='label_336_17_3' class='gform-field-label gform-field-label--type-inline'>Poor<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_336_17_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='0'  id='choice_336_17_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_336_17_4' id='label_336_17_4' class='gform-field-label gform-field-label--type-inline'>SCSHE<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/fieldset><fieldset id=\"field_336_18\" 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_336_18\" ><legend class='gfield_label gform-field-label' >How would you rate your knowledge of how to access resources to help with Medicare planning and questions?<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_336_18'>\n\t\t\t<div class='gchoice gchoice_336_18_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='4'  id='choice_336_18_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_336_18_0' id='label_336_18_0' class='gform-field-label gform-field-label--type-inline'>Excellent<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_336_18_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='3'  id='choice_336_18_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_336_18_1' id='label_336_18_1' class='gform-field-label gform-field-label--type-inline'>Good<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_336_18_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='2'  id='choice_336_18_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_336_18_2' id='label_336_18_2' class='gform-field-label gform-field-label--type-inline'>Fair<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_336_18_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='1'  id='choice_336_18_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_336_18_3' id='label_336_18_3' class='gform-field-label gform-field-label--type-inline'>Poor<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_336_18_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='0'  id='choice_336_18_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_336_18_4' id='label_336_18_4' class='gform-field-label gform-field-label--type-inline'>SCSHE<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/fieldset><fieldset id=\"field_336_19\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_336_19\" ><legend class='gfield_label gform-field-label' >How would you rate your confidence in choosing a Medicare plan that works for you?<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_336_19'>\n\t\t\t<div class='gchoice gchoice_336_19_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='4'  id='choice_336_19_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_336_19_0' id='label_336_19_0' class='gform-field-label gform-field-label--type-inline'>Excellent<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_336_19_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='3'  id='choice_336_19_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_336_19_1' id='label_336_19_1' class='gform-field-label gform-field-label--type-inline'>Good<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_336_19_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='2'  id='choice_336_19_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_336_19_2' id='label_336_19_2' class='gform-field-label gform-field-label--type-inline'>Fair<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_336_19_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='1'  id='choice_336_19_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_336_19_3' id='label_336_19_3' class='gform-field-label gform-field-label--type-inline'>Poor<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_336_19_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='0'  id='choice_336_19_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_336_19_4' id='label_336_19_4' class='gform-field-label gform-field-label--type-inline'>SCSHE<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/fieldset><\/div><\/div>\n        <div class='gform_page_footer top_label'><input type='submit' id='gform_previous_button_336' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Previous'  onclick='if(window[\"gf_submitting_336\"]){return false;}  if( !jQuery(\"#gform_336\")[0].checkValidity || 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