{"id":282,"date":"2018-11-27T22:36:10","date_gmt":"2018-11-27T22:36:10","guid":{"rendered":"http:\/\/silveragencydev.com\/paws\/?page_id=282"},"modified":"2019-01-31T21:06:02","modified_gmt":"2019-01-31T21:06:02","slug":"behavioral-problems-application","status":"publish","type":"page","link":"https:\/\/www.positiveapproachdogtraining.com\/index.php\/behavioral-problems-application\/","title":{"rendered":"Behavioral Problems Application"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;3.17.6&#8243; background_color=&#8221;#c0d6df&#8221; background_image=&#8221;https:\/\/www.positiveapproachdogtraining.com\/wp-content\/uploads\/2018\/11\/Dust@2x-8.png&#8221; parallax=&#8221;on&#8221; top_divider_color=&#8221;rgba(0,0,0,0)&#8221; top_divider_height=&#8221;22px&#8221; bottom_divider_style=&#8221;curve&#8221; bottom_divider_color=&#8221;#ffffff&#8221; bottom_divider_height=&#8221;39px&#8221;][et_pb_row _builder_version=&#8221;3.17.6&#8243;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;3.17.6&#8243; parallax=&#8221;off&#8221; parallax_method=&#8221;on&#8221;][et_pb_blurb title=&#8221;Behavioral Consultation&#8221; _builder_version=&#8221;3.19.10&#8243; header_level=&#8221;h1&#8243; header_font=&#8221;||||||||&#8221; text_orientation=&#8221;center&#8221;][\/et_pb_blurb][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;3.17.6&#8243;][et_pb_row _builder_version=&#8221;3.17.6&#8243;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;3.17.6&#8243; parallax=&#8221;off&#8221; parallax_method=&#8221;on&#8221;][et_pb_text _builder_version=&#8221;3.17.6&#8243;]<\/p>\n<div class=\"caldera-grid\" id=\"caldera_form_1\" data-cf-ver=\"1.9.7\" data-cf-form-id=\"CF5bfddec14b5d7\"><div id=\"caldera_notices_1\" data-spinner=\"https:\/\/www.positiveapproachdogtraining.com\/wp-admin\/images\/spinner.gif\"><\/div><form data-instance=\"1\" class=\"CF5bfddec14b5d7 caldera_forms_form cfajax-trigger\" method=\"POST\" enctype=\"multipart\/form-data\" id=\"CF5bfddec14b5d7_1\" data-form-id=\"CF5bfddec14b5d7\" aria-label=\"Behavioral Problems Application\" data-target=\"#caldera_notices_1\" data-template=\"#cfajax_CF5bfddec14b5d7-tmpl\" data-cfajax=\"CF5bfddec14b5d7\" data-load-element=\"_parent\" data-load-class=\"cf_processing\" data-post-disable=\"0\" data-action=\"cf_process_ajax_submit\" data-request=\"https:\/\/www.positiveapproachdogtraining.com\/cf-api\/CF5bfddec14b5d7\" data-hiderows=\"true\">\r\n<input type=\"hidden\" id=\"_cf_verify_CF5bfddec14b5d7\" name=\"_cf_verify\" value=\"207cc6cee5\"  data-nonce-time=\"1782111562\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index.php\/wp-json\/wp\/v2\/pages\/282\" \/><div id=\"cf2-CF5bfddec14b5d7_1\"><\/div><input type=\"hidden\" name=\"_cf_frm_id\" value=\"CF5bfddec14b5d7\">\r\n<input type=\"hidden\" name=\"_cf_frm_ct\" value=\"1\">\r\n<input type=\"hidden\" name=\"cfajax\" value=\"CF5bfddec14b5d7\">\r\n<input type=\"hidden\" name=\"_cf_cr_pst\" value=\"282\">\r\n<span class=\"caldera-grid\"><ol class=\"breadcrumb\" data-form=\"caldera_form_1\" id=\"caldera-forms-breadcrumb_1\">\r\n<li class=\"active\"><a aria-controls=\"form_page_1_pg_1\" aria-expanded=\"true\" id=\"breadcrumb_1_pg_1\" href=\"?cf_pg=1\" data-page=\"1\" data-pagenav=\"caldera_form_1\" title=\"Navigate to About you\">About you<\/a><\/li>\r\n<li><a aria-controls=\"form_page_1_pg_2\" aria-expanded=\"false\" id=\"breadcrumb_1_pg_2\" href=\"?cf_pg=2\" data-page=\"2\" data-pagenav=\"caldera_form_1\" title=\"Navigate to About your pet\">About your pet<\/a><\/li>\r\n<li><a aria-controls=\"form_page_1_pg_3\" aria-expanded=\"false\" id=\"breadcrumb_1_pg_3\" href=\"?cf_pg=3\" data-page=\"3\" data-pagenav=\"caldera_form_1\" title=\"Navigate to Behavior consultation\">Behavior consultation<\/a><\/li>\r\n<li><a aria-controls=\"form_page_1_pg_4\" aria-expanded=\"false\" id=\"breadcrumb_1_pg_4\" href=\"?cf_pg=4\" data-page=\"4\" data-pagenav=\"caldera_form_1\" title=\"Navigate to Environment\/Lifestyle\">Environment\/Lifestyle<\/a><\/li>\r\n<li><a aria-controls=\"form_page_1_pg_5\" aria-expanded=\"false\" id=\"breadcrumb_1_pg_5\" href=\"?cf_pg=5\" data-page=\"5\" data-pagenav=\"caldera_form_1\" title=\"Navigate to Previous Training\">Previous Training<\/a><\/li>\r\n<li><a aria-controls=\"form_page_1_pg_6\" aria-expanded=\"false\" id=\"breadcrumb_1_pg_6\" href=\"?cf_pg=6\" data-page=\"6\" data-pagenav=\"caldera_form_1\" title=\"Navigate to Medical\">Medical<\/a><\/li>\r\n<\/ol><\/span>\r\n<div class=\"hide\" style=\"display:none; overflow:hidden;height:0;width:0;\">\r\n<label>Twitter<\/label><input type=\"text\" name=\"twitter\" value=\"\" autocomplete=\"off\">\r\n<\/div><div id=\"form_page_1_pg_1\" data-formpage=\"1\" class=\"caldera-form-page\" style=\"display:block;\" role=\"region\" aria-labelledby=\"breadcrumb_1_pg_1\" aria-hidden=\"false\"><div id=\"CF5bfddec14b5d7_1-row-1\"  class=\"row  first_row\"><div  class=\"col-sm-12  single\"><div class=\"\"><h3>Information about you<\/h3>\n<\/div><\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-2\"  class=\"row \"><div  class=\"col-sm-3  first_col\">\n<div data-field-wrapper=\"fld_4004783\" class=\"form-group\" id=\"fld_4004783_1-wrap\">\r\n\t<label id=\"fld_4004783Label\" for=\"fld_4004783_1\" class=\"control-label\">Date of Application<\/label>\r\n\t<div class=\"\">\r\n\t\t<input  type=\"text\" data-provide=\"cfdatepicker\" name=\"fld_4004783\" value=\"\" id=\"fld_4004783_1\" data-field=\"fld_4004783\" class=\"form-control cfdatepicker is-cfdatepicker\" data-date-format=\"mm-dd-yyyy\" data-date-start-view=\"month\"  data-date-start-date=\"0d\" data-date-end-date=\"0d\" data-date-autoclose=\"true\"   aria-labelledby=\"fld_4004783Label\"   \/>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-9  last_col\"><div data-field-wrapper=\"fld_7446838\" class=\"form-group\" id=\"fld_7446838_1-wrap\">\r\n\t<label id=\"fld_7446838Label\" for=\"fld_7446838_1\" class=\"control-label\">Referred By<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_7446838\" class=\" form-control\" id=\"fld_7446838_1\" name=\"fld_7446838\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_7446838Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-3\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_6482901\" class=\"form-group\" id=\"fld_6482901_1-wrap\">\r\n\t<label id=\"fld_6482901Label\" for=\"fld_6482901_1\" class=\"control-label\">Owner's Name <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_6482901\" class=\" form-control\" id=\"fld_6482901_1\" name=\"fld_6482901\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_6482901Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-4\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_2385753\" class=\"form-group\" id=\"fld_2385753_1-wrap\">\r\n\t<label id=\"fld_2385753Label\" for=\"fld_2385753_1\" class=\"control-label\">Address <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_2385753\" class=\" form-control\" id=\"fld_2385753_1\" name=\"fld_2385753\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_2385753Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-2 \"><div data-field-wrapper=\"fld_3646205\" class=\"form-group\" id=\"fld_3646205_1-wrap\">\r\n\t<label id=\"fld_3646205Label\" for=\"fld_3646205_1\" class=\"control-label\">City <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_3646205\" class=\" form-control\" id=\"fld_3646205_1\" name=\"fld_3646205\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_3646205Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-2 \"><div data-field-wrapper=\"fld_4131014\" class=\"form-group\" id=\"fld_4131014_1-wrap\">\r\n\t<label id=\"fld_4131014Label\" for=\"fld_4131014_1\" class=\"control-label\">State <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t<select  id=\"fld_4131014_1\" data-field=\"fld_4131014\" class=\"form-control\" name=\"fld_4131014\" required=\"required\">\n\t\t\t<option value=\"\"> - Select Province\/State - <\/option>\n\t\t\t<option value=\"AB\">Alberta<\/option>\n\t\t\t<option value=\"BC\">British Columbia<\/option>\n\t\t\t<option value=\"MB\">Manitoba<\/option>\n\t\t\t<option value=\"NB\">New Brunswick<\/option>\n\t\t\t<option value=\"NL\">Newfoundland and Labrador<\/option>\n\t\t\t<option value=\"NS\">Nova Scotia<\/option>\n\t\t\t<option value=\"NT\">Northwest Territories<\/option>\n\t\t\t<option value=\"NU\">Nunavut<\/option>\n\t\t\t<option value=\"ON\">Ontario<\/option>\n\t\t\t<option value=\"PE\">Prince Edward Island<\/option>\n\t\t\t<option value=\"QC\">Quebec<\/option>\n\t\t\t<option value=\"SK\">Saskatchewan<\/option>\n\t\t\t<option value=\"YT\">Yukon<\/option>\n\t\t\t<option> ==================== <\/option>\n\t\t\t<option value=\"AL\">Alabama<\/option>\n\t\t\t<option value=\"AK\">Alaska<\/option>\n\t\t\t<option value=\"AZ\">Arizona<\/option>\n\t\t\t<option value=\"AR\">Arkansas<\/option>\n\t\t\t<option value=\"CA\">California<\/option>\n\t\t\t<option value=\"CO\">Colorado<\/option>\n\t\t\t<option value=\"CT\">Connecticut<\/option>\n\t\t\t<option value=\"DE\">Delaware<\/option>\n\t\t\t<option value=\"DC\">District Of Columbia<\/option>\n\t\t\t<option value=\"FL\">Florida<\/option>\n\t\t\t<option value=\"GA\">Georgia<\/option>\n\t\t\t<option value=\"HI\">Hawaii<\/option>\n\t\t\t<option value=\"ID\">Idaho<\/option>\n\t\t\t<option value=\"IL\">Illinois<\/option>\n\t\t\t<option value=\"IN\">Indiana<\/option>\n\t\t\t<option value=\"IA\">Iowa<\/option>\n\t\t\t<option value=\"KS\">Kansas<\/option>\n\t\t\t<option value=\"KY\">Kentucky<\/option>\n\t\t\t<option value=\"LA\">Louisiana<\/option>\n\t\t\t<option value=\"ME\">Maine<\/option>\n\t\t\t<option value=\"MD\">Maryland<\/option>\n\t\t\t<option value=\"MA\">Massachusetts<\/option>\n\t\t\t<option value=\"MI\">Michigan<\/option>\n\t\t\t<option value=\"MN\">Minnesota<\/option>\n\t\t\t<option value=\"MS\">Mississippi<\/option>\n\t\t\t<option value=\"MO\">Missouri<\/option>\n\t\t\t<option value=\"MT\">Montana<\/option>\n\t\t\t<option value=\"NE\">Nebraska<\/option>\n\t\t\t<option value=\"NV\">Nevada<\/option>\n\t\t\t<option value=\"NH\">New Hampshire<\/option>\n\t\t\t<option value=\"NJ\">New Jersey<\/option>\n\t\t\t<option value=\"NM\">New Mexico<\/option>\n\t\t\t<option value=\"NY\">New York<\/option>\n\t\t\t<option value=\"NC\">North Carolina<\/option>\n\t\t\t<option value=\"ND\">North Dakota<\/option>\n\t\t\t<option value=\"OH\">Ohio<\/option>\n\t\t\t<option value=\"OK\">Oklahoma<\/option>\n\t\t\t<option value=\"OR\">Oregon<\/option>\n\t\t\t<option value=\"PA\">Pennsylvania<\/option>\n\t\t\t<option value=\"RI\">Rhode Island<\/option>\n\t\t\t<option value=\"SC\">South Carolina<\/option>\n\t\t\t<option value=\"SD\">South Dakota<\/option>\n\t\t\t<option value=\"TN\">Tennessee<\/option>\n\t\t\t<option value=\"TX\">Texas<\/option>\n\t\t\t<option value=\"UT\">Utah<\/option>\n\t\t\t<option value=\"VT\">Vermont<\/option>\n\t\t\t<option value=\"VA\">Virginia<\/option>\n\t\t\t<option value=\"WA\">Washington<\/option>\n\t\t\t<option value=\"WV\">West Virginia<\/option>\n\t\t\t<option value=\"WI\">Wisconsin<\/option>\n\t\t\t<option value=\"WY\">Wyoming<\/option>\n\t\t<\/select>\n\t\t\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-2  last_col\"><div data-field-wrapper=\"fld_8058403\" class=\"form-group\" id=\"fld_8058403_1-wrap\">\r\n\t<label id=\"fld_8058403Label\" for=\"fld_8058403_1\" class=\"control-label\">Zip <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"number\" data-field=\"fld_8058403\" class=\" form-control\" id=\"fld_8058403_1\" name=\"fld_8058403\" value=\"\" data-type=\"number\" data-parsley-type=\"number\" aria-required=\"true\"   aria-labelledby=\"fld_8058403Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-5\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_7076731\" class=\"form-group\" id=\"fld_7076731_1-wrap\">\r\n\t<label id=\"fld_7076731Label\" for=\"fld_7076731_1\" class=\"control-label\">Email <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"email\" data-field=\"fld_7076731\" class=\" form-control\" id=\"fld_7076731_1\" name=\"fld_7076731\" value=\"\" data-type=\"email\" aria-required=\"true\"   aria-labelledby=\"fld_7076731Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3 \"><div data-field-wrapper=\"fld_7836099\" class=\"form-group\" id=\"fld_7836099_1-wrap\">\r\n\t<label id=\"fld_7836099Label\" for=\"fld_7836099_1\" class=\"control-label\">Primary Phone <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input  data-inputmask=\"'mask': '(999)999-9999'\"  required type=\"phone\" data-field=\"fld_7836099\" class=\" form-control\" id=\"fld_7836099_1\" name=\"fld_7836099\" value=\"\" data-type=\"phone\" aria-required=\"true\"   aria-labelledby=\"fld_7836099Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3  last_col\"><div data-field-wrapper=\"fld_3638475\" class=\"form-group\" id=\"fld_3638475_1-wrap\">\r\n\t<label id=\"fld_3638475Label\" for=\"fld_3638475_1\" class=\"control-label\">Other Phone (Work\/Home\/Cell)<\/label>\r\n\t<div class=\"\">\r\n\t\t<input  data-inputmask=\"'mask': '(999)999-9999'\"   type=\"phone\" data-field=\"fld_3638475\" class=\" form-control\" id=\"fld_3638475_1\" name=\"fld_3638475\" value=\"\" data-type=\"phone\"   aria-labelledby=\"fld_3638475Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-6\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_9358296\" class=\"form-group\" id=\"fld_9358296_1-wrap\">\r\n<div class=\"\">\r\n\t<input  class=\"btn btn-default cf-page-btn cf-page-btn-next\" type=\"button\" name=\"fld_9358296\" id=\"fld_9358296_1\" value=\"Next\" data-field=\"fld_9358296\" data-page=\"next\"  >\n<\/div>\r\n<\/div>\r\n\t<input class=\"button_trigger_1\" type=\"hidden\" name=\"fld_9358296\" id=\"fld_9358296_1_btn\" value=\"\" data-field=\"fld_9358296\"  \/>\n<\/div><div  class=\"col-sm-6 \"><\/div><\/div><\/div><div id=\"form_page_1_pg_2\" data-formpage=\"2\" role=\"region\" aria-labelledby=\"breadcrumb_1_pg_2\" aria-hidden=\"true\" class=\"caldera-form-page\" style=\"display:none;\"><div id=\"CF5bfddec14b5d7_1-row-7\"  class=\"row \"><div  class=\"col-sm-12  single\"><div class=\"\"><h3>Information about your pet<\/h3>\n<\/div><\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-8\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_2675849\" class=\"form-group\" id=\"fld_2675849_1-wrap\">\r\n\t<label id=\"fld_2675849Label\" for=\"fld_2675849_1\" class=\"control-label\">Pet Name <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_2675849\" class=\" form-control\" id=\"fld_2675849_1\" name=\"fld_2675849\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_2675849Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_1875195\" class=\"form-group\" id=\"fld_1875195_1-wrap\">\r\n\t<label id=\"fld_1875195Label\" for=\"fld_1875195_1\" class=\"control-label\">Pet Breed <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_1875195\" class=\" form-control\" id=\"fld_1875195_1\" name=\"fld_1875195\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_1875195Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-9\"  class=\"row \"><div  class=\"col-sm-3  first_col\"><div data-field-wrapper=\"fld_9099058\" class=\"form-group\" id=\"fld_9099058_1-wrap\">\r\n\t<label id=\"fld_9099058Label\" for=\"fld_9099058_1\" class=\"control-label\">Date of Birth<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"date\" data-field=\"fld_9099058\" class=\" form-control\" id=\"fld_9099058_1\" name=\"fld_9099058\" value=\"\" data-type=\"date\"   aria-labelledby=\"fld_9099058Label\" aria-describedby=\"fld_9099058Caption\" >\t\t<span id=\"fld_9099058Caption\" class=\"help-block\">Approximate Date<\/span>\r\n\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3 \"><div data-field-wrapper=\"fld_5928014\" class=\"form-group\" id=\"fld_5928014_1-wrap\">\r\n\t<label id=\"fld_5928014Label\" for=\"fld_5928014_1\" class=\"control-label\">Pet Gender <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<select name=\"fld_5928014\" value=\"\" data-field=\"fld_5928014\" class=\"form-control\" id=\"fld_5928014_1\"  required=\"required\"  aria-labelledby=\"fld_5928014Label\" >\n\t\t<option value=\"\"><\/option>\r\n\t\t\t\t\t<option value=\"Male - Neutered\"  data-calc-value=\"Male - Neutered\" >\n\t\t\t\t\t\tMale - Neutered\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Female - Spayed\"  data-calc-value=\"Female - Spayed\" >\n\t\t\t\t\t\tFemale - Spayed\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3 \"><div data-field-wrapper=\"fld_9903819\" class=\"form-group\" id=\"fld_9903819_1-wrap\">\r\n\t<label id=\"fld_9903819Label\" for=\"fld_9903819_1\" class=\"control-label\">Spayed or Neutered <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<select name=\"fld_9903819\" value=\"\" data-field=\"fld_9903819\" class=\"form-control\" id=\"fld_9903819_1\"  required=\"required\"  aria-labelledby=\"fld_9903819Label\" >\n\t\t<option value=\"\"><\/option>\r\n\t\t\t\t\t<option value=\"Yes\"  data-calc-value=\"Yes\" >\n\t\t\t\t\t\tYes\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"No\"  data-calc-value=\"No\" >\n\t\t\t\t\t\tNo\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3  last_col\"><div data-field-wrapper=\"fld_4373625\" class=\"form-group\" id=\"fld_4373625_1-wrap\">\r\n\t<label id=\"fld_4373625Label\" for=\"fld_4373625_1\" class=\"control-label\">Age at time of neuter\/Spay <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"number\" data-field=\"fld_4373625\" class=\" form-control\" id=\"fld_4373625_1\" name=\"fld_4373625\" value=\"\" data-type=\"number\" min=\"1\" max=\"2\" data-parsley-type=\"number\" aria-required=\"true\"   aria-labelledby=\"fld_4373625Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-10\"  class=\"row \"><div  class=\"col-sm-4  first_col\"><div data-field-wrapper=\"fld_7956233\" class=\"form-group\" id=\"fld_7956233_1-wrap\">\r\n\t<label id=\"fld_7956233Label\" for=\"fld_7956233_1\" class=\"control-label\">Pet Age <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"number\" data-field=\"fld_7956233\" class=\" form-control\" id=\"fld_7956233_1\" name=\"fld_7956233\" value=\"\" data-type=\"number\" min=\"0\" max=\"30\" data-parsley-type=\"number\" aria-required=\"true\"   aria-labelledby=\"fld_7956233Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-4 \"><div data-field-wrapper=\"fld_8382301\" class=\"form-group\" id=\"fld_8382301_1-wrap\">\r\n\t<label id=\"fld_8382301Label\" for=\"fld_8382301_1\" class=\"control-label\">Age of Pet when obtained<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"number\" data-field=\"fld_8382301\" class=\" form-control\" id=\"fld_8382301_1\" name=\"fld_8382301\" value=\"\" data-type=\"number\" min=\"1\" max=\"30\" data-parsley-type=\"number\"   aria-labelledby=\"fld_8382301Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-4  last_col\"><div data-field-wrapper=\"fld_6831255\" class=\"form-group\" id=\"fld_6831255_1-wrap\">\r\n\t<label id=\"fld_6831255Label\" for=\"fld_6831255_1\" class=\"control-label\">Pet Weight <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_6831255\" class=\" form-control\" id=\"fld_6831255_1\" name=\"fld_6831255\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_6831255Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-11\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_1581542\" class=\"form-group\" id=\"fld_1581542_1-wrap\">\r\n\t<label id=\"fld_1581542Label\" for=\"fld_1581542_1\" class=\"control-label\">Where did you obtain this pet?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_1581542\" class=\" form-control\" id=\"fld_1581542_1\" name=\"fld_1581542\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_1581542Label\" aria-describedby=\"fld_1581542Caption\" >\t\t<span id=\"fld_1581542Caption\" class=\"help-block\">Breeder\/Friend\/Pet Shop\/Humane Society\/Other<\/span>\r\n\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-12\"  class=\"row \"><div  class=\"col-sm-4  first_col\"><div data-field-wrapper=\"fld_5240767\" class=\"form-group\" id=\"fld_5240767_1-wrap\">\r\n<label id=\"fld_5240767Label\" for=\"fld_5240767_1\" class=\"control-label\">Are you the 1st owner?<\/label>\r\n<div class=\"\">\r\n\t\t\t\t\t<div class=\"radio\">\n\t\t\t\t<label data-label=\"Yes\" for=\"fld_5240767_1_opt1413514\"><input type=\"radio\" id=\"fld_5240767_1_opt1413514\" data-field=\"fld_5240767\" class=\"fld_5240767_1\" name=\"fld_5240767\" value=\"Yes\"    data-radio-field=\"fld_5240767_1\" data-type=\"radio\" data-calc-value=\"Yes\" \/>\n\t\t\tYes\t\t<\/label>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"radio\">\n\t\t\t\t<label data-label=\"No\" for=\"fld_5240767_1_opt1762587\"><input type=\"radio\" id=\"fld_5240767_1_opt1762587\" data-field=\"fld_5240767\" class=\"fld_5240767_1\" name=\"fld_5240767\" value=\"No\"    data-radio-field=\"fld_5240767_1\" data-type=\"radio\" data-calc-value=\"No\" \/>\n\t\t\tNo\t\t<\/label>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-8  last_col\"><div data-field-wrapper=\"fld_4037007\" class=\"form-group\" id=\"fld_4037007_1-wrap\">\r\n\t<label id=\"fld_4037007Label\" for=\"fld_4037007_1\" class=\"control-label\">Describe previous home (If known):<\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_4037007\" value=\"\" data-field=\"fld_4037007\" class=\"form-control\" id=\"fld_4037007_1\" rows=\"3\"    aria-labelledby=\"fld_4037007Label\" ><\/textarea>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-13\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_9308706\" class=\"form-group\" id=\"fld_9308706_1-wrap\">\r\n\t<label id=\"fld_9308706Label\" for=\"fld_9308706_1\" class=\"control-label\">Please list other animals in your household<\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_9308706\" value=\"\" data-field=\"fld_9308706\" class=\"form-control\" id=\"fld_9308706_1\" rows=\"4\"    aria-labelledby=\"fld_9308706Label\" aria-describedby=\"fld_9308706Caption\" ><\/textarea>\n\t\t<span id=\"fld_9308706Caption\" class=\"help-block\">Please list the name, age, gender, and breed of all other animals living in your home.<\/span>\r\n\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_7557127\" class=\"form-group\" id=\"fld_7557127_1-wrap\">\r\n\t<label id=\"fld_7557127Label\" for=\"fld_7557127_1\" class=\"control-label\">Veterinary Clinic<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_7557127\" class=\" form-control\" id=\"fld_7557127_1\" name=\"fld_7557127\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_7557127Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-14\"  class=\"row \"><div  class=\"col-sm-3  first_col\"><div data-field-wrapper=\"fld_5063308\" class=\"form-group\" id=\"fld_5063308_1-wrap\">\r\n<div class=\"\">\r\n\t<input  class=\"btn btn-default cf-page-btn cf-page-btn-prev\" type=\"button\" name=\"fld_5063308\" id=\"fld_5063308_1\" value=\"Back\" data-field=\"fld_5063308\" data-page=\"prev\"  >\n<\/div>\r\n<\/div>\r\n\t<input class=\"button_trigger_1\" type=\"hidden\" name=\"fld_5063308\" id=\"fld_5063308_1_btn\" value=\"\" data-field=\"fld_5063308\"  \/>\n<\/div><div  class=\"col-sm-9 \"><div data-field-wrapper=\"fld_6625582\" class=\"form-group\" id=\"fld_6625582_1-wrap\">\r\n<div class=\"\">\r\n\t<input  class=\"btn btn-default cf-page-btn cf-page-btn-next\" type=\"button\" name=\"fld_6625582\" id=\"fld_6625582_1\" value=\"Next\" data-field=\"fld_6625582\" data-page=\"next\"  >\n<\/div>\r\n<\/div>\r\n\t<input class=\"button_trigger_1\" type=\"hidden\" name=\"fld_6625582\" id=\"fld_6625582_1_btn\" value=\"\" data-field=\"fld_6625582\"  \/>\n<\/div><\/div><\/div><div id=\"form_page_1_pg_3\" data-formpage=\"3\" role=\"region\" aria-labelledby=\"breadcrumb_1_pg_3\" aria-hidden=\"true\" class=\"caldera-form-page\" style=\"display:none;\"><div id=\"CF5bfddec14b5d7_1-row-15\"  class=\"row \"><div  class=\"col-sm-12  single\"><div class=\"\"><h3>Information about your behavior consultation<\/h3>\n<\/div><\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-16\"  class=\"row \"><div  class=\"col-sm-4  first_col\"><div data-field-wrapper=\"fld_184558\" class=\"form-group\" id=\"fld_184558_1-wrap\">\r\n\t<label id=\"fld_184558Label\" for=\"fld_184558_1\" class=\"control-label\">Do you prefer to meet at <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_184558_1_opt1686832\"\n                >\n                            <input\n                                data-parsley-required=\"true\" data-parsley-group=\"fld_184558_1\" data-parsley-multiple=\"fld_184558_1\"                                type=\"checkbox\"\n                                data-label=\"Our facility\"\n                                data-field=\"fld_184558\"\n                                id=\"fld_184558_1_opt1686832\"\n                                class=\"fld_184558_1 option-required\"\n                                name=\"fld_184558[opt1686832]\"\n                                value=\"Our facility\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_184558_1\"\n                                                                data-calc-value=\"Our facility\"\n                            >\n                    Our facility                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_184558_1_opt2073030\"\n                >\n                            <input\n                                data-parsley-required=\"true\" data-parsley-group=\"fld_184558_1\" data-parsley-multiple=\"fld_184558_1\"                                type=\"checkbox\"\n                                data-label=\"Your Home\"\n                                data-field=\"fld_184558\"\n                                id=\"fld_184558_1_opt2073030\"\n                                class=\"fld_184558_1 option-required\"\n                                name=\"fld_184558[opt2073030]\"\n                                value=\"Your Home\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_184558_1\"\n                                                                data-calc-value=\"Your Home\"\n                            >\n                    Your Home                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_184558_1_opt1365103\"\n                >\n                            <input\n                                data-parsley-required=\"true\" data-parsley-group=\"fld_184558_1\" data-parsley-multiple=\"fld_184558_1\"                                type=\"checkbox\"\n                                data-label=\"The Aggressive Dog Class\"\n                                data-field=\"fld_184558\"\n                                id=\"fld_184558_1_opt1365103\"\n                                class=\"fld_184558_1 option-required\"\n                                name=\"fld_184558[opt1365103]\"\n                                value=\"The Aggressive Dog Class\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_184558_1\"\n                                                                data-calc-value=\"The Aggressive Dog Class\"\n                            >\n                    The Aggressive Dog Class                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-8  last_col\"><div data-field-wrapper=\"fld_2348584\" class=\"form-group\" id=\"fld_2348584_1-wrap\">\r\n\t<label id=\"fld_2348584Label\" for=\"fld_2348584_1\" class=\"control-label\">Range of preferred days & times<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_2348584\" class=\" form-control\" id=\"fld_2348584_1\" name=\"fld_2348584\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_2348584Label\" aria-describedby=\"fld_2348584Caption\" >\t\t<span id=\"fld_2348584Caption\" class=\"help-block\">Your preferred time slot is not guaranteed, but we will do our best to accommodate your needs. Call us for the date of the next Aggressive Dog Class.<\/span>\r\n\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-17\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_3668799\" class=\"form-group\" id=\"fld_3668799_1-wrap\">\r\n\t<label id=\"fld_3668799Label\" for=\"fld_3668799_1\" class=\"control-label\">What is the primary problem that you are seeking help for? (briefly) <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_3668799\" class=\" form-control\" id=\"fld_3668799_1\" name=\"fld_3668799\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_3668799Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-18\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_3570802\" class=\"form-group\" id=\"fld_3570802_1-wrap\">\r\n\t<label id=\"fld_3570802Label\" for=\"fld_3570802_1\" class=\"control-label\">How would you describe the severity of the problem?<\/label>\r\n\t<div class=\"\">\r\n\t\t<div style=\"position: relative;\" class=\"row\">\n\t\t\t<div class=\"col-xs-8\" style=\"margin: 8px 0px;\">\t\t\t\t<input type=\"range\" name=\"fld_3570802\" value=\"0\" data-field=\"fld_3570802\" class=\"form-control\" id=\"fld_3570802_1\" data-handle=\"#ffffff\" min=\"0\" max=\"10\" step=\"1\"   >\n\t\t\t<\/div>\n\t\t\t<div class=\"col-xs-4\"><span id=\"fld_3570802_1_value\"><\/span><\/div>\t\t<\/div>\n\t\t<span id=\"fld_3570802Caption\" class=\"help-block\">1 = Mild \u2022 10 = Severe<\/span>\r\n\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_5358798\" class=\"form-group\" id=\"fld_5358798_1-wrap\">\r\n<label id=\"fld_5358798Label\" for=\"fld_5358798_1\" class=\"control-label\">Is euthanasia a possibility if this problem is not solved?<\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"No\" for=\"fld_5358798_1_opt1159905\"><input type=\"radio\" id=\"fld_5358798_1_opt1159905\" data-field=\"fld_5358798\" class=\"fld_5358798_1\" name=\"fld_5358798\" value=\"No\"    data-radio-field=\"fld_5358798_1\" data-type=\"radio\" data-calc-value=\"No\" \/>\n\t\t\tNo\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Yes\" for=\"fld_5358798_1_opt1905004\"><input type=\"radio\" id=\"fld_5358798_1_opt1905004\" data-field=\"fld_5358798\" class=\"fld_5358798_1\" name=\"fld_5358798\" value=\"Yes\"    data-radio-field=\"fld_5358798_1\" data-type=\"radio\" data-calc-value=\"Yes\" \/>\n\t\t\tYes\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Not Sure\" for=\"fld_5358798_1_opt1763209\"><input type=\"radio\" id=\"fld_5358798_1_opt1763209\" data-field=\"fld_5358798\" class=\"fld_5358798_1\" name=\"fld_5358798\" value=\"Not Sure\"    data-radio-field=\"fld_5358798_1\" data-type=\"radio\" data-calc-value=\"Not Sure\" \/>\n\t\t\tNot Sure\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-19\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_6691085\" class=\"form-group\" id=\"fld_6691085_1-wrap\">\r\n\t<label id=\"fld_6691085Label\" for=\"fld_6691085_1\" class=\"control-label\">Describe the problem, beginning with the most recent incident and going back through the last 3 incidents: <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_6691085\" value=\"\" data-field=\"fld_6691085\" class=\"form-control\" id=\"fld_6691085_1\" rows=\"4\"  required=\"required\"  aria-labelledby=\"fld_6691085Label\" ><\/textarea>\n\t\t\t<\/div>\r\n<\/div>\r\n<hr id=\"fld_431137_1\" class=\"\" style=\"width: 100%\" \/><div class=\"\"><p>How often has this occurred in the past...<\/p>\n<\/div><\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-20\"  class=\"row \"><div  class=\"col-sm-3  first_col\"><div data-field-wrapper=\"fld_3414936\" class=\"form-group\" id=\"fld_3414936_1-wrap\">\r\n\t<label id=\"fld_3414936Label\" for=\"fld_3414936_1\" class=\"control-label\">One Month?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"number\" data-field=\"fld_3414936\" class=\" form-control\" id=\"fld_3414936_1\" name=\"fld_3414936\" value=\"\" data-type=\"number\" data-parsley-type=\"number\"   aria-labelledby=\"fld_3414936Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3 \"><div data-field-wrapper=\"fld_5760815\" class=\"form-group\" id=\"fld_5760815_1-wrap\">\r\n\t<label id=\"fld_5760815Label\" for=\"fld_5760815_1\" class=\"control-label\">Three Months?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"number\" data-field=\"fld_5760815\" class=\" form-control\" id=\"fld_5760815_1\" name=\"fld_5760815\" value=\"\" data-type=\"number\" data-parsley-type=\"number\"   aria-labelledby=\"fld_5760815Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3 \"><div data-field-wrapper=\"fld_9625659\" class=\"form-group\" id=\"fld_9625659_1-wrap\">\r\n\t<label id=\"fld_9625659Label\" for=\"fld_9625659_1\" class=\"control-label\">One Year?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"number\" data-field=\"fld_9625659\" class=\" form-control\" id=\"fld_9625659_1\" name=\"fld_9625659\" value=\"\" data-type=\"number\" data-parsley-type=\"number\"   aria-labelledby=\"fld_9625659Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3  last_col\"><div data-field-wrapper=\"fld_83238\" class=\"form-group\" id=\"fld_83238_1-wrap\">\r\n\t<label id=\"fld_83238Label\" for=\"fld_83238_1\" class=\"control-label\">Total Times?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"number\" data-field=\"fld_83238\" class=\" form-control\" id=\"fld_83238_1\" name=\"fld_83238\" value=\"\" data-type=\"number\" data-parsley-type=\"number\"   aria-labelledby=\"fld_83238Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-21\"  class=\"row \"><div  class=\"col-sm-9  first_col\"><div data-field-wrapper=\"fld_3409271\" class=\"form-group\" id=\"fld_3409271_1-wrap\">\r\n\t<label id=\"fld_3409271Label\" for=\"fld_3409271_1\" class=\"control-label\">Describe any change in frequency or severity?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_3409271\" class=\" form-control\" id=\"fld_3409271_1\" name=\"fld_3409271\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_3409271Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3  last_col\"><div data-field-wrapper=\"fld_3368265\" class=\"form-group\" id=\"fld_3368265_1-wrap\">\r\n\t<label id=\"fld_3368265Label\" for=\"fld_3368265_1\" class=\"control-label\">Pet's age when problem started:<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"number\" data-field=\"fld_3368265\" class=\" form-control\" id=\"fld_3368265_1\" name=\"fld_3368265\" value=\"\" data-type=\"number\" max=\"35\" data-parsley-type=\"number\"   aria-labelledby=\"fld_3368265Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-22\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_6238863\" class=\"form-group\" id=\"fld_6238863_1-wrap\">\r\n\t<label id=\"fld_6238863Label\" for=\"fld_6238863_1\" class=\"control-label\">Briefly describe any household changes when the problem first appeared:<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_6238863\" class=\" form-control\" id=\"fld_6238863_1\" name=\"fld_6238863\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_6238863Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_4693260\" class=\"form-group\" id=\"fld_4693260_1-wrap\">\r\n\t<label id=\"fld_4693260Label\" for=\"fld_4693260_1\" class=\"control-label\">Describe what has been done so far to try to correct the problem:<\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_4693260\" value=\"\" data-field=\"fld_4693260\" class=\"form-control\" id=\"fld_4693260_1\" rows=\"4\"    aria-labelledby=\"fld_4693260Label\" aria-describedby=\"fld_4693260Caption\" ><\/textarea>\n\t\t<span id=\"fld_4693260Caption\" class=\"help-block\">For each give: 1) What was tried, 2) How long tried, 3) Dog's response<\/span>\r\n\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-23\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_9617336\" class=\"form-group\" id=\"fld_9617336_1-wrap\">\r\n\t<label id=\"fld_9617336Label\" for=\"fld_9617336_1\" class=\"control-label\">Which if any of the techniques have had any success?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_9617336\" class=\" form-control\" id=\"fld_9617336_1\" name=\"fld_9617336\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_9617336Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_4651929\" class=\"form-group\" id=\"fld_4651929_1-wrap\">\r\n\t<label id=\"fld_4651929Label\" for=\"fld_4651929_1\" class=\"control-label\">Which if any of the techniques have made the problem worse?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_4651929\" class=\" form-control\" id=\"fld_4651929_1\" name=\"fld_4651929\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_4651929Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-24\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_829210\" class=\"form-group\" id=\"fld_829210_1-wrap\">\r\n\t<label id=\"fld_829210Label\" for=\"fld_829210_1\" class=\"control-label\">What do you think is the reason for your dog's problem?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_829210\" class=\" form-control\" id=\"fld_829210_1\" name=\"fld_829210\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_829210Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-25\"  class=\"row \"><div  class=\"col-sm-3  first_col\"><div data-field-wrapper=\"fld_9820534\" class=\"form-group\" id=\"fld_9820534_1-wrap\">\r\n<label id=\"fld_9820534Label\" for=\"fld_9820534_1\" class=\"control-label\">Have your received any advice about this problem?<\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Yes\" for=\"fld_9820534_1_opt1519923\"><input type=\"radio\" id=\"fld_9820534_1_opt1519923\" data-field=\"fld_9820534\" class=\"fld_9820534_1\" name=\"fld_9820534\" value=\"Yes\"    data-radio-field=\"fld_9820534_1\" data-type=\"radio\" data-calc-value=\"Yes\" \/>\n\t\t\tYes\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"No\" for=\"fld_9820534_1_opt1534955\"><input type=\"radio\" id=\"fld_9820534_1_opt1534955\" data-field=\"fld_9820534\" class=\"fld_9820534_1\" name=\"fld_9820534\" value=\"No\"    data-radio-field=\"fld_9820534_1\" data-type=\"radio\" data-calc-value=\"No\" \/>\n\t\t\tNo\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-9  last_col\"><div data-field-wrapper=\"fld_8180230\" class=\"form-group\" id=\"fld_8180230_1-wrap\">\r\n\t<label id=\"fld_8180230Label\" for=\"fld_8180230_1\" class=\"control-label\">Include any additional comments about the principal problem:<\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_8180230\" value=\"\" data-field=\"fld_8180230\" class=\"form-control\" id=\"fld_8180230_1\" rows=\"3\"    aria-labelledby=\"fld_8180230Label\" ><\/textarea>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-26\"  class=\"row \"><div  class=\"col-sm-4  first_col\"><div data-field-wrapper=\"fld_7214341\" class=\"form-group\" id=\"fld_7214341_1-wrap\">\r\n<div class=\"\">\r\n\t<input  class=\"btn btn-default cf-page-btn cf-page-btn-prev\" type=\"button\" name=\"fld_7214341\" id=\"fld_7214341_1\" value=\"Back\" data-field=\"fld_7214341\" data-page=\"prev\"  >\n<\/div>\r\n<\/div>\r\n\t<input class=\"button_trigger_1\" type=\"hidden\" name=\"fld_7214341\" id=\"fld_7214341_1_btn\" value=\"\" data-field=\"fld_7214341\"  \/>\n<\/div><div  class=\"col-sm-8 \"><div data-field-wrapper=\"fld_2077912\" class=\"form-group\" id=\"fld_2077912_1-wrap\">\r\n<div class=\"\">\r\n\t<input  class=\"btn btn-default cf-page-btn cf-page-btn-next\" type=\"button\" name=\"fld_2077912\" id=\"fld_2077912_1\" value=\"Next\" data-field=\"fld_2077912\" data-page=\"next\"  >\n<\/div>\r\n<\/div>\r\n\t<input class=\"button_trigger_1\" type=\"hidden\" name=\"fld_2077912\" id=\"fld_2077912_1_btn\" value=\"\" data-field=\"fld_2077912\"  \/>\n<\/div><\/div><\/div><div id=\"form_page_1_pg_4\" data-formpage=\"4\" role=\"region\" aria-labelledby=\"breadcrumb_1_pg_4\" aria-hidden=\"true\" class=\"caldera-form-page\" style=\"display:none;\"><div id=\"CF5bfddec14b5d7_1-row-27\"  class=\"row \"><div  class=\"col-sm-12  single\"><div class=\"\"><h3>Environment\/Lifestyle<\/h3>\n<\/div><\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-28\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_6908570\" class=\"form-group\" id=\"fld_6908570_1-wrap\">\r\n\t<label id=\"fld_6908570Label\" for=\"fld_6908570_1\" class=\"control-label\">For what purpose was this pet obtained? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_6908570\" class=\" form-control\" id=\"fld_6908570_1\" name=\"fld_6908570\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_6908570Label\" aria-describedby=\"fld_6908570Caption\" >\t\t<span id=\"fld_6908570Caption\" class=\"help-block\">Companion\/Protection\/Show\/Other-Explain<\/span>\r\n\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-29\"  class=\"row \"><div  class=\"col-sm-4  first_col\"><div data-field-wrapper=\"fld_756487\" class=\"form-group\" id=\"fld_756487_1-wrap\">\r\n\t<label id=\"fld_756487Label\" for=\"fld_756487_1\" class=\"control-label\">When is the pet fed? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_756487\" class=\" form-control\" id=\"fld_756487_1\" name=\"fld_756487\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_756487Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-4 \"><div data-field-wrapper=\"fld_1304529\" class=\"form-group\" id=\"fld_1304529_1-wrap\">\r\n\t<label id=\"fld_1304529Label\" for=\"fld_1304529_1\" class=\"control-label\">Who feeds pet? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_1304529\" class=\" form-control\" id=\"fld_1304529_1\" name=\"fld_1304529\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_1304529Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-4  last_col\"><div data-field-wrapper=\"fld_9836377\" class=\"form-group\" id=\"fld_9836377_1-wrap\">\r\n\t<label id=\"fld_9836377Label\" for=\"fld_9836377_1\" class=\"control-label\">Feeding location: <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_9836377\" class=\" form-control\" id=\"fld_9836377_1\" name=\"fld_9836377\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_9836377Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-30\"  class=\"row \"><div  class=\"col-sm-8  first_col\"><div data-field-wrapper=\"fld_9916578\" class=\"form-group\" id=\"fld_9916578_1-wrap\">\r\n\t<label id=\"fld_9916578Label\" for=\"fld_9916578_1\" class=\"control-label\">Favorite treat:<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_9916578\" class=\" form-control\" id=\"fld_9916578_1\" name=\"fld_9916578\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_9916578Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-4  last_col\"><div data-field-wrapper=\"fld_7962604\" class=\"form-group\" id=\"fld_7962604_1-wrap\">\r\n\t<label id=\"fld_7962604Label\" for=\"fld_7962604_1\" class=\"control-label\">Desire for treat:<\/label>\r\n\t<div class=\"\">\r\n\t\t<div style=\"position: relative;\" class=\"row\">\n\t\t\t<div class=\"col-xs-8\" style=\"margin: 8px 0px;\">\t\t\t\t<input type=\"range\" name=\"fld_7962604\" value=\"0\" data-field=\"fld_7962604\" class=\"form-control\" id=\"fld_7962604_1\" data-handle=\"#ffffff\" min=\"0\" max=\"10\" step=\"1\"   >\n\t\t\t<\/div>\n\t\t\t<div class=\"col-xs-4\"><span id=\"fld_7962604_1_value\"><\/span><\/div>\t\t<\/div>\n\t\t<span id=\"fld_7962604Caption\" class=\"help-block\">1 = Mild \u2022\u00a010 = Strong<\/span>\r\n\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-31\"  class=\"row \"><div  class=\"col-sm-12  single\"><div class=\"\"><p>List below household members, ages if under 18, brief schedule, and how the dog gets along with each:<\/p>\n<\/div><\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-32\"  class=\"row \"><div  class=\"col-sm-3  first_col\"><div data-field-wrapper=\"fld_7350451\" class=\"form-group\" id=\"fld_7350451_1-wrap\">\r\n\t<label id=\"fld_7350451Label\" for=\"fld_7350451_1\" class=\"control-label\">HH Member name:<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_7350451\" class=\" form-control\" id=\"fld_7350451_1\" name=\"fld_7350451\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_7350451Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_9975186\" class=\"form-group\" id=\"fld_9975186_1-wrap\">\r\n\t<label id=\"fld_9975186Label\" for=\"fld_9975186_1\" class=\"control-label\">HH Member name:<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_9975186\" class=\" form-control\" id=\"fld_9975186_1\" name=\"fld_9975186\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_9975186Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_1163863\" class=\"form-group\" id=\"fld_1163863_1-wrap\">\r\n\t<label id=\"fld_1163863Label\" for=\"fld_1163863_1\" class=\"control-label\">HH Member name:<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_1163863\" class=\" form-control\" id=\"fld_1163863_1\" name=\"fld_1163863\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_1163863Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_211442\" class=\"form-group\" id=\"fld_211442_1-wrap\">\r\n\t<label id=\"fld_211442Label\" for=\"fld_211442_1\" class=\"control-label\">HH Member name:<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_211442\" class=\" form-control\" id=\"fld_211442_1\" name=\"fld_211442\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_211442Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3 \"><div data-field-wrapper=\"fld_3559744\" class=\"form-group\" id=\"fld_3559744_1-wrap\">\r\n\t<label id=\"fld_3559744Label\" for=\"fld_3559744_1\" class=\"control-label\">Age (if under 18)<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"number\" data-field=\"fld_3559744\" class=\" form-control\" id=\"fld_3559744_1\" name=\"fld_3559744\" value=\"\" data-type=\"number\" data-parsley-type=\"number\"   aria-labelledby=\"fld_3559744Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_7244097\" class=\"form-group\" id=\"fld_7244097_1-wrap\">\r\n\t<label id=\"fld_7244097Label\" for=\"fld_7244097_1\" class=\"control-label\">Age (if under 18)<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"number\" data-field=\"fld_7244097\" class=\" form-control\" id=\"fld_7244097_1\" name=\"fld_7244097\" value=\"\" data-type=\"number\" data-parsley-type=\"number\"   aria-labelledby=\"fld_7244097Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_1994150\" class=\"form-group\" id=\"fld_1994150_1-wrap\">\r\n\t<label id=\"fld_1994150Label\" for=\"fld_1994150_1\" class=\"control-label\">Age (if under 18)<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"number\" data-field=\"fld_1994150\" class=\" form-control\" id=\"fld_1994150_1\" name=\"fld_1994150\" value=\"\" data-type=\"number\" data-parsley-type=\"number\"   aria-labelledby=\"fld_1994150Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_5976402\" class=\"form-group\" id=\"fld_5976402_1-wrap\">\r\n\t<label id=\"fld_5976402Label\" for=\"fld_5976402_1\" class=\"control-label\">Age (if under 18)<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"number\" data-field=\"fld_5976402\" class=\" form-control\" id=\"fld_5976402_1\" name=\"fld_5976402\" value=\"\" data-type=\"number\" data-parsley-type=\"number\"   aria-labelledby=\"fld_5976402Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3 \"><div data-field-wrapper=\"fld_2176779\" class=\"form-group\" id=\"fld_2176779_1-wrap\">\r\n\t<label id=\"fld_2176779Label\" for=\"fld_2176779_1\" class=\"control-label\">Work or school schedule<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_2176779\" class=\" form-control\" id=\"fld_2176779_1\" name=\"fld_2176779\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_2176779Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_5942121\" class=\"form-group\" id=\"fld_5942121_1-wrap\">\r\n\t<label id=\"fld_5942121Label\" for=\"fld_5942121_1\" class=\"control-label\">Work or school schedule<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_5942121\" class=\" form-control\" id=\"fld_5942121_1\" name=\"fld_5942121\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_5942121Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_1049519\" class=\"form-group\" id=\"fld_1049519_1-wrap\">\r\n\t<label id=\"fld_1049519Label\" for=\"fld_1049519_1\" class=\"control-label\">Work or school schedule<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_1049519\" class=\" form-control\" id=\"fld_1049519_1\" name=\"fld_1049519\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_1049519Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_7326783\" class=\"form-group\" id=\"fld_7326783_1-wrap\">\r\n\t<label id=\"fld_7326783Label\" for=\"fld_7326783_1\" class=\"control-label\">Work or school schedule<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_7326783\" class=\" form-control\" id=\"fld_7326783_1\" name=\"fld_7326783\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_7326783Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3  last_col\"><div data-field-wrapper=\"fld_522738\" class=\"form-group\" id=\"fld_522738_1-wrap\">\r\n\t<label id=\"fld_522738Label\" for=\"fld_522738_1\" class=\"control-label\">Relationship with dog<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_522738\" class=\" form-control\" id=\"fld_522738_1\" name=\"fld_522738\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_522738Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_9185759\" class=\"form-group\" id=\"fld_9185759_1-wrap\">\r\n\t<label id=\"fld_9185759Label\" for=\"fld_9185759_1\" class=\"control-label\">Relationship with dog<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_9185759\" class=\" form-control\" id=\"fld_9185759_1\" name=\"fld_9185759\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_9185759Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_6517154\" class=\"form-group\" id=\"fld_6517154_1-wrap\">\r\n\t<label id=\"fld_6517154Label\" for=\"fld_6517154_1\" class=\"control-label\">Relationship with dog<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_6517154\" class=\" form-control\" id=\"fld_6517154_1\" name=\"fld_6517154\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_6517154Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_9763433\" class=\"form-group\" id=\"fld_9763433_1-wrap\">\r\n\t<label id=\"fld_9763433Label\" for=\"fld_9763433_1\" class=\"control-label\">Relationship with dog<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_9763433\" class=\" form-control\" id=\"fld_9763433_1\" name=\"fld_9763433\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_9763433Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-33\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_5584482\" class=\"form-group\" id=\"fld_5584482_1-wrap\">\r\n\t<label id=\"fld_5584482Label\" for=\"fld_5584482_1\" class=\"control-label\">Amount and frequency of exercise\/play: <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_5584482\" value=\"\" data-field=\"fld_5584482\" class=\"form-control\" id=\"fld_5584482_1\" rows=\"4\"  required=\"required\"  aria-labelledby=\"fld_5584482Label\" aria-describedby=\"fld_5584482Caption\" ><\/textarea>\n\t\t<span id=\"fld_5584482Caption\" class=\"help-block\">Exercise type, Times per week, Length of session, By whom<\/span>\r\n\t<\/div>\r\n<\/div>\r\n<div class=\"\"><p>Describe where your dog stays (i.e. in the house or in the yard) and how the dog is confined (i.e. crate, tie-out, kennel, unconfined) at each of the following times:<\/p>\n<\/div><div data-field-wrapper=\"fld_597260\" class=\"form-group\" id=\"fld_597260_1-wrap\">\r\n\t<label id=\"fld_597260Label\" for=\"fld_597260_1\" class=\"control-label\">When owner is home: <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_597260\" class=\" form-control\" id=\"fld_597260_1\" name=\"fld_597260\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_597260Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_7913185\" class=\"form-group\" id=\"fld_7913185_1-wrap\">\r\n\t<label id=\"fld_7913185Label\" for=\"fld_7913185_1\" class=\"control-label\">When owner is away: <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_7913185\" class=\" form-control\" id=\"fld_7913185_1\" name=\"fld_7913185\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_7913185Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_8287549\" class=\"form-group\" id=\"fld_8287549_1-wrap\">\r\n\t<label id=\"fld_8287549Label\" for=\"fld_8287549_1\" class=\"control-label\">At night: <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_8287549\" class=\" form-control\" id=\"fld_8287549_1\" name=\"fld_8287549\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_8287549Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_7894593\" class=\"form-group\" id=\"fld_7894593_1-wrap\">\r\n\t<label id=\"fld_7894593Label\" for=\"fld_7894593_1\" class=\"control-label\">When guests visit: <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_7894593\" class=\" form-control\" id=\"fld_7894593_1\" name=\"fld_7894593\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_7894593Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_5994417\" class=\"form-group\" id=\"fld_5994417_1-wrap\">\r\n\t<label id=\"fld_5994417Label\" for=\"fld_5994417_1\" class=\"control-label\">How long is dog home alone on average day? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_5994417\" class=\" form-control\" id=\"fld_5994417_1\" name=\"fld_5994417\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_5994417Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-34\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_3960545\" class=\"form-group\" id=\"fld_3960545_1-wrap\">\r\n\t<label id=\"fld_3960545Label\" for=\"fld_3960545_1\" class=\"control-label\">Problems when left alone:<\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_3960545_1_opt1996714\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Barks\"\n                                data-field=\"fld_3960545\"\n                                id=\"fld_3960545_1_opt1996714\"\n                                class=\"fld_3960545_1\"\n                                name=\"fld_3960545[opt1996714]\"\n                                value=\"Barks\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_3960545_1\"\n                                                                data-calc-value=\"Barks\"\n                            >\n                    Barks                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_3960545_1_opt1373358\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Destructive\"\n                                data-field=\"fld_3960545\"\n                                id=\"fld_3960545_1_opt1373358\"\n                                class=\"fld_3960545_1\"\n                                name=\"fld_3960545[opt1373358]\"\n                                value=\"Destructive\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_3960545_1\"\n                                                                data-calc-value=\"Destructive\"\n                            >\n                    Destructive                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_3960545_1_opt1569938\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"House soiling\"\n                                data-field=\"fld_3960545\"\n                                id=\"fld_3960545_1_opt1569938\"\n                                class=\"fld_3960545_1\"\n                                name=\"fld_3960545[opt1569938]\"\n                                value=\"House soiling\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_3960545_1\"\n                                                                data-calc-value=\"House soiling\"\n                            >\n                    House soiling                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_3960545_1_opt1441913\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"other\"\n                                data-field=\"fld_3960545\"\n                                id=\"fld_3960545_1_opt1441913\"\n                                class=\"fld_3960545_1\"\n                                name=\"fld_3960545[opt1441913]\"\n                                value=\"other\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_3960545_1\"\n                                                                data-calc-value=\"other\"\n                            >\n                    other                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_11979\" class=\"form-group\" id=\"fld_11979_1-wrap\">\r\n\t<label id=\"fld_11979Label\" for=\"fld_11979_1\" class=\"control-label\">Reaction before departure:<\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_11979_1_opt1996714\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Unconcerned\"\n                                data-field=\"fld_11979\"\n                                id=\"fld_11979_1_opt1996714\"\n                                class=\"fld_11979_1\"\n                                name=\"fld_11979[opt1996714]\"\n                                value=\"Unconcerned\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_11979_1\"\n                                                                data-calc-value=\"Unconcerned\"\n                            >\n                    Unconcerned                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_11979_1_opt1373358\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Disappointed\"\n                                data-field=\"fld_11979\"\n                                id=\"fld_11979_1_opt1373358\"\n                                class=\"fld_11979_1\"\n                                name=\"fld_11979[opt1373358]\"\n                                value=\"Disappointed\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_11979_1\"\n                                                                data-calc-value=\"Disappointed\"\n                            >\n                    Disappointed                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_11979_1_opt1569938\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Nervous\/anxious\"\n                                data-field=\"fld_11979\"\n                                id=\"fld_11979_1_opt1569938\"\n                                class=\"fld_11979_1\"\n                                name=\"fld_11979[opt1569938]\"\n                                value=\"Nervous\/anxious\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_11979_1\"\n                                                                data-calc-value=\"Nervous\/anxious\"\n                            >\n                    Nervous\/anxious                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_11979_1_opt1441913\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Frantic\"\n                                data-field=\"fld_11979\"\n                                id=\"fld_11979_1_opt1441913\"\n                                class=\"fld_11979_1\"\n                                name=\"fld_11979[opt1441913]\"\n                                value=\"Frantic\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_11979_1\"\n                                                                data-calc-value=\"Frantic\"\n                            >\n                    Frantic                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_11979_1_opt2000557\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Other\"\n                                data-field=\"fld_11979\"\n                                id=\"fld_11979_1_opt2000557\"\n                                class=\"fld_11979_1\"\n                                name=\"fld_11979[opt2000557]\"\n                                value=\"Other\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_11979_1\"\n                                                                data-calc-value=\"Other\"\n                            >\n                    Other                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-35\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_1358608\" class=\"form-group\" id=\"fld_1358608_1-wrap\">\r\n<div class=\"\">\r\n\t<input  class=\"btn btn-default cf-page-btn cf-page-btn-prev\" type=\"button\" name=\"fld_1358608\" id=\"fld_1358608_1\" value=\"Previous\" data-field=\"fld_1358608\" data-page=\"prev\"  >\n<\/div>\r\n<\/div>\r\n\t<input class=\"button_trigger_1\" type=\"hidden\" name=\"fld_1358608\" id=\"fld_1358608_1_btn\" value=\"\" data-field=\"fld_1358608\"  \/>\n<\/div><div  class=\"col-sm-6 \"><div data-field-wrapper=\"fld_182589\" class=\"form-group\" id=\"fld_182589_1-wrap\">\r\n<div class=\"\">\r\n\t<input  class=\"btn btn-default cf-page-btn cf-page-btn-next\" type=\"button\" name=\"fld_182589\" id=\"fld_182589_1\" value=\"Next\" data-field=\"fld_182589\" data-page=\"next\"  >\n<\/div>\r\n<\/div>\r\n\t<input class=\"button_trigger_1\" type=\"hidden\" name=\"fld_182589\" id=\"fld_182589_1_btn\" value=\"\" data-field=\"fld_182589\"  \/>\n<\/div><\/div><\/div><div id=\"form_page_1_pg_5\" data-formpage=\"5\" role=\"region\" aria-labelledby=\"breadcrumb_1_pg_5\" aria-hidden=\"true\" class=\"caldera-form-page\" style=\"display:none;\"><div id=\"CF5bfddec14b5d7_1-row-36\"  class=\"row \"><div  class=\"col-sm-12  single\"><div class=\"\"><h3>Previous Training<\/h3>\n<\/div><\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-37\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_2058101\" class=\"form-group\" id=\"fld_2058101_1-wrap\">\r\n\t<label id=\"fld_2058101Label\" for=\"fld_2058101_1\" class=\"control-label\">Describe any obedience training: <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_2058101_1_opt1985398\"\n                >\n                            <input\n                                data-parsley-required=\"true\" data-parsley-group=\"fld_2058101_1\" data-parsley-multiple=\"fld_2058101_1\"                                type=\"checkbox\"\n                                data-label=\"None\"\n                                data-field=\"fld_2058101\"\n                                id=\"fld_2058101_1_opt1985398\"\n                                class=\"fld_2058101_1 option-required\"\n                                name=\"fld_2058101[opt1985398]\"\n                                value=\"None\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_2058101_1\"\n                                                                data-calc-value=\"None\"\n                            >\n                    None                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_2058101_1_opt1232459\"\n                >\n                            <input\n                                data-parsley-required=\"true\" data-parsley-group=\"fld_2058101_1\" data-parsley-multiple=\"fld_2058101_1\"                                type=\"checkbox\"\n                                data-label=\"Group lessons\"\n                                data-field=\"fld_2058101\"\n                                id=\"fld_2058101_1_opt1232459\"\n                                class=\"fld_2058101_1 option-required\"\n                                name=\"fld_2058101[opt1232459]\"\n                                value=\"Group lessons\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_2058101_1\"\n                                                                data-calc-value=\"Group lessons\"\n                            >\n                    Group lessons                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_2058101_1_opt1534943\"\n                >\n                            <input\n                                data-parsley-required=\"true\" data-parsley-group=\"fld_2058101_1\" data-parsley-multiple=\"fld_2058101_1\"                                type=\"checkbox\"\n                                data-label=\"Private training\"\n                                data-field=\"fld_2058101\"\n                                id=\"fld_2058101_1_opt1534943\"\n                                class=\"fld_2058101_1 option-required\"\n                                name=\"fld_2058101[opt1534943]\"\n                                value=\"Private training\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_2058101_1\"\n                                                                data-calc-value=\"Private training\"\n                            >\n                    Private training                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_2058101_1_opt1232655\"\n                >\n                            <input\n                                data-parsley-required=\"true\" data-parsley-group=\"fld_2058101_1\" data-parsley-multiple=\"fld_2058101_1\"                                type=\"checkbox\"\n                                data-label=\"Other\"\n                                data-field=\"fld_2058101\"\n                                id=\"fld_2058101_1_opt1232655\"\n                                class=\"fld_2058101_1 option-required\"\n                                name=\"fld_2058101[opt1232655]\"\n                                value=\"Other\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_2058101_1\"\n                                                                data-calc-value=\"Other\"\n                            >\n                    Other                <\/label>\n\n                \t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_1730779\" class=\"form-group\" id=\"fld_1730779_1-wrap\">\r\n<label id=\"fld_1730779Label\" for=\"fld_1730779_1\" class=\"control-label\">Are you working with a particular trainer, and if so, please pick which one. <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Angie\" for=\"fld_1730779_1_opt1603655\"><input type=\"radio\" id=\"fld_1730779_1_opt1603655\" data-field=\"fld_1730779\" class=\"fld_1730779_1 option-required\" name=\"fld_1730779\" value=\"Angie\"   required=\"required\" data-radio-field=\"fld_1730779_1\" data-type=\"radio\" data-calc-value=\"Angie\" \/>\n\t\t\tAngie\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Jeri Lynn\" for=\"fld_1730779_1_opt1150846\"><input type=\"radio\" id=\"fld_1730779_1_opt1150846\" data-field=\"fld_1730779\" class=\"fld_1730779_1 option-required\" name=\"fld_1730779\" value=\"Jeri Lynn\"   required=\"required\" data-radio-field=\"fld_1730779_1\" data-type=\"radio\" data-calc-value=\"Jeri Lynn\" \/>\n\t\t\tJeri Lynn\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Joy\" for=\"fld_1730779_1_opt1526492\"><input type=\"radio\" id=\"fld_1730779_1_opt1526492\" data-field=\"fld_1730779\" class=\"fld_1730779_1 option-required\" name=\"fld_1730779\" value=\"Joy\"   required=\"required\" data-radio-field=\"fld_1730779_1\" data-type=\"radio\" data-calc-value=\"Joy\" \/>\n\t\t\tJoy\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Sam\" for=\"fld_1730779_1_opt1895314\"><input type=\"radio\" id=\"fld_1730779_1_opt1895314\" data-field=\"fld_1730779\" class=\"fld_1730779_1 option-required\" name=\"fld_1730779\" value=\"Sam\"   required=\"required\" data-radio-field=\"fld_1730779_1\" data-type=\"radio\" data-calc-value=\"Sam\" \/>\n\t\t\tSam\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"I have not started working with a Positive approach dog trainer.\" for=\"fld_1730779_1_opt1925520\"><input type=\"radio\" id=\"fld_1730779_1_opt1925520\" data-field=\"fld_1730779\" class=\"fld_1730779_1 option-required\" name=\"fld_1730779\" value=\"I have not started working with a Positive approach dog trainer.\"   required=\"required\" data-radio-field=\"fld_1730779_1\" data-type=\"radio\" data-calc-value=\"I have not started working with a Positive approach dog trainer.\" \/>\n\t\t\tI have not started working with a Positive approach dog trainer.\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-38\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_3775659\" class=\"form-group\" id=\"fld_3775659_1-wrap\">\r\n\t<label id=\"fld_3775659Label\" for=\"fld_3775659_1\" class=\"control-label\">Training at what age?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"number\" data-field=\"fld_3775659\" class=\" form-control\" id=\"fld_3775659_1\" name=\"fld_3775659\" value=\"\" data-type=\"number\" min=\"1\" max=\"35\" data-parsley-type=\"number\"   aria-labelledby=\"fld_3775659Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_5410948\" class=\"form-group\" id=\"fld_5410948_1-wrap\">\r\n\t<label id=\"fld_5410948Label\" for=\"fld_5410948_1\" class=\"control-label\">With which family member?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_5410948\" class=\" form-control\" id=\"fld_5410948_1\" name=\"fld_5410948\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_5410948Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-39\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_1807221\" class=\"form-group\" id=\"fld_1807221_1-wrap\">\r\n<label id=\"fld_1807221Label\" for=\"fld_1807221_1\" class=\"control-label\">Success of training:<\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Excellent\" for=\"fld_1807221_1_opt1149311\"><input type=\"radio\" id=\"fld_1807221_1_opt1149311\" data-field=\"fld_1807221\" class=\"fld_1807221_1\" name=\"fld_1807221\" value=\"Excellent\"    data-radio-field=\"fld_1807221_1\" data-type=\"radio\" data-calc-value=\"Excellent\" \/>\n\t\t\tExcellent\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Good\" for=\"fld_1807221_1_opt1979038\"><input type=\"radio\" id=\"fld_1807221_1_opt1979038\" data-field=\"fld_1807221\" class=\"fld_1807221_1\" name=\"fld_1807221\" value=\"Good\"    data-radio-field=\"fld_1807221_1\" data-type=\"radio\" data-calc-value=\"Good\" \/>\n\t\t\tGood\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Fair\" for=\"fld_1807221_1_opt1789434\"><input type=\"radio\" id=\"fld_1807221_1_opt1789434\" data-field=\"fld_1807221\" class=\"fld_1807221_1\" name=\"fld_1807221\" value=\"Fair\"    data-radio-field=\"fld_1807221_1\" data-type=\"radio\" data-calc-value=\"Fair\" \/>\n\t\t\tFair\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Failed\" for=\"fld_1807221_1_opt1548002\"><input type=\"radio\" id=\"fld_1807221_1_opt1548002\" data-field=\"fld_1807221\" class=\"fld_1807221_1\" name=\"fld_1807221\" value=\"Failed\"    data-radio-field=\"fld_1807221_1\" data-type=\"radio\" data-calc-value=\"Failed\" \/>\n\t\t\tFailed\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Did not complete\" for=\"fld_1807221_1_opt1552132\"><input type=\"radio\" id=\"fld_1807221_1_opt1552132\" data-field=\"fld_1807221\" class=\"fld_1807221_1\" name=\"fld_1807221\" value=\"Did not complete\"    data-radio-field=\"fld_1807221_1\" data-type=\"radio\" data-calc-value=\"Did not complete\" \/>\n\t\t\tDid not complete\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-40\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_8300330\" class=\"form-group\" id=\"fld_8300330_1-wrap\">\r\n\t<label id=\"fld_8300330Label\" for=\"fld_8300330_1\" class=\"control-label\">Which commands work best?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_8300330\" class=\" form-control\" id=\"fld_8300330_1\" name=\"fld_8300330\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_8300330Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_3139534\" class=\"form-group\" id=\"fld_3139534_1-wrap\">\r\n\t<label id=\"fld_3139534Label\" for=\"fld_3139534_1\" class=\"control-label\">Which family members have most control?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_3139534\" class=\" form-control\" id=\"fld_3139534_1\" name=\"fld_3139534\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_3139534Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_7730614\" class=\"form-group\" id=\"fld_7730614_1-wrap\">\r\n\t<label id=\"fld_7730614Label\" for=\"fld_7730614_1\" class=\"control-label\">Which commands work poorly?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_7730614\" class=\" form-control\" id=\"fld_7730614_1\" name=\"fld_7730614\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_7730614Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_5786187\" class=\"form-group\" id=\"fld_5786187_1-wrap\">\r\n\t<label id=\"fld_5786187Label\" for=\"fld_5786187_1\" class=\"control-label\">Which family members have least control?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_5786187\" class=\" form-control\" id=\"fld_5786187_1\" name=\"fld_5786187\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_5786187Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-41\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_2976826\" class=\"form-group\" id=\"fld_2976826_1-wrap\">\r\n<label id=\"fld_2976826Label\" for=\"fld_2976826_1\" class=\"control-label\">Describe your dog's learning ability:<\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Fast\" for=\"fld_2976826_1_opt1714434\"><input type=\"radio\" id=\"fld_2976826_1_opt1714434\" data-field=\"fld_2976826\" class=\"fld_2976826_1\" name=\"fld_2976826\" value=\"Fast\"    data-radio-field=\"fld_2976826_1\" data-type=\"radio\" data-calc-value=\"Fast\" \/>\n\t\t\tFast\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Slow\" for=\"fld_2976826_1_opt1352378\"><input type=\"radio\" id=\"fld_2976826_1_opt1352378\" data-field=\"fld_2976826\" class=\"fld_2976826_1\" name=\"fld_2976826\" value=\"Slow\"    data-radio-field=\"fld_2976826_1\" data-type=\"radio\" data-calc-value=\"Slow\" \/>\n\t\t\tSlow\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Easily distracted\" for=\"fld_2976826_1_opt1170099\"><input type=\"radio\" id=\"fld_2976826_1_opt1170099\" data-field=\"fld_2976826\" class=\"fld_2976826_1\" name=\"fld_2976826\" value=\"Easily distracted\"    data-radio-field=\"fld_2976826_1\" data-type=\"radio\" data-calc-value=\"Easily distracted\" \/>\n\t\t\tEasily distracted\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Other\" for=\"fld_2976826_1_opt1351947\"><input type=\"radio\" id=\"fld_2976826_1_opt1351947\" data-field=\"fld_2976826\" class=\"fld_2976826_1\" name=\"fld_2976826\" value=\"Other\"    data-radio-field=\"fld_2976826_1\" data-type=\"radio\" data-calc-value=\"Other\" \/>\n\t\t\tOther\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_8856752\" class=\"form-group\" id=\"fld_8856752_1-wrap\">\r\n\t<label id=\"fld_8856752Label\" for=\"fld_8856752_1\" class=\"control-label\">Describe<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_8856752\" class=\" form-control\" id=\"fld_8856752_1\" name=\"fld_8856752\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_8856752Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_6142854\" class=\"form-group\" id=\"fld_6142854_1-wrap\">\r\n\t<label id=\"fld_6142854Label\" for=\"fld_6142854_1\" class=\"control-label\">Describe your dog's personality:<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_6142854\" class=\" form-control\" id=\"fld_6142854_1\" name=\"fld_6142854\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_6142854Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-42\"  class=\"row \"><div  class=\"col-sm-5  first_col\"><div data-field-wrapper=\"fld_5284364\" class=\"form-group\" id=\"fld_5284364_1-wrap\">\r\n<label id=\"fld_5284364Label\" for=\"fld_5284364_1\" class=\"control-label\">Does your dog object to being handled or touched?<\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Yes\" for=\"fld_5284364_1_opt1368593\"><input type=\"radio\" id=\"fld_5284364_1_opt1368593\" data-field=\"fld_5284364\" class=\"fld_5284364_1\" name=\"fld_5284364\" value=\"Yes\"    data-radio-field=\"fld_5284364_1\" data-type=\"radio\" data-calc-value=\"Yes\" \/>\n\t\t\tYes\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"No\" for=\"fld_5284364_1_opt1442838\"><input type=\"radio\" id=\"fld_5284364_1_opt1442838\" data-field=\"fld_5284364\" class=\"fld_5284364_1\" name=\"fld_5284364\" value=\"No\"    data-radio-field=\"fld_5284364_1\" data-type=\"radio\" data-calc-value=\"No\" \/>\n\t\t\tNo\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-7  last_col\"><div data-field-wrapper=\"fld_3904545\" class=\"form-group\" id=\"fld_3904545_1-wrap\">\r\n\t<label id=\"fld_3904545Label\" for=\"fld_3904545_1\" class=\"control-label\">If so, describe:<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_3904545\" class=\" form-control\" id=\"fld_3904545_1\" name=\"fld_3904545\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_3904545Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-43\"  class=\"row \"><div  class=\"col-sm-12  single\"><hr id=\"fld_3656906_1\" class=\"\" style=\"width: 100%\" \/><div class=\"\"><p>How does your dog react to:<\/p>\n<\/div><div data-field-wrapper=\"fld_8554068\" class=\"form-group\" id=\"fld_8554068_1-wrap\">\r\n<label id=\"fld_8554068Label\" for=\"fld_8554068_1\" class=\"control-label\">Other dogs on property <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Ignores\" for=\"fld_8554068_1_opt1940580\"><input type=\"radio\" id=\"fld_8554068_1_opt1940580\" data-field=\"fld_8554068\" class=\"fld_8554068_1 option-required\" name=\"fld_8554068\" value=\"Ignores\"   required=\"required\" data-radio-field=\"fld_8554068_1\" data-type=\"radio\" data-calc-value=\"Ignores\" \/>\n\t\t\tIgnores\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Plays\" for=\"fld_8554068_1_opt1240994\"><input type=\"radio\" id=\"fld_8554068_1_opt1240994\" data-field=\"fld_8554068\" class=\"fld_8554068_1 option-required\" name=\"fld_8554068\" value=\"Plays\"   required=\"required\" data-radio-field=\"fld_8554068_1\" data-type=\"radio\" data-calc-value=\"Plays\" \/>\n\t\t\tPlays\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Barks\" for=\"fld_8554068_1_opt1564479\"><input type=\"radio\" id=\"fld_8554068_1_opt1564479\" data-field=\"fld_8554068\" class=\"fld_8554068_1 option-required\" name=\"fld_8554068\" value=\"Barks\"   required=\"required\" data-radio-field=\"fld_8554068_1\" data-type=\"radio\" data-calc-value=\"Barks\" \/>\n\t\t\tBarks\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Attacks\" for=\"fld_8554068_1_opt1881848\"><input type=\"radio\" id=\"fld_8554068_1_opt1881848\" data-field=\"fld_8554068\" class=\"fld_8554068_1 option-required\" name=\"fld_8554068\" value=\"Attacks\"   required=\"required\" data-radio-field=\"fld_8554068_1\" data-type=\"radio\" data-calc-value=\"Attacks\" \/>\n\t\t\tAttacks\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Other\" for=\"fld_8554068_1_opt1900344\"><input type=\"radio\" id=\"fld_8554068_1_opt1900344\" data-field=\"fld_8554068\" class=\"fld_8554068_1 option-required\" name=\"fld_8554068\" value=\"Other\"   required=\"required\" data-radio-field=\"fld_8554068_1\" data-type=\"radio\" data-calc-value=\"Other\" \/>\n\t\t\tOther\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_1493282\" class=\"form-group\" id=\"fld_1493282_1-wrap\">\r\n<label id=\"fld_1493282Label\" for=\"fld_1493282_1\" class=\"control-label\">Other dogs off property? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Ignores\" for=\"fld_1493282_1_opt1940580\"><input type=\"radio\" id=\"fld_1493282_1_opt1940580\" data-field=\"fld_1493282\" class=\"fld_1493282_1 option-required\" name=\"fld_1493282\" value=\"Ignores\"   required=\"required\" data-radio-field=\"fld_1493282_1\" data-type=\"radio\" data-calc-value=\"Ignores\" \/>\n\t\t\tIgnores\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Plays\" for=\"fld_1493282_1_opt1240994\"><input type=\"radio\" id=\"fld_1493282_1_opt1240994\" data-field=\"fld_1493282\" class=\"fld_1493282_1 option-required\" name=\"fld_1493282\" value=\"Plays\"   required=\"required\" data-radio-field=\"fld_1493282_1\" data-type=\"radio\" data-calc-value=\"Plays\" \/>\n\t\t\tPlays\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Barks\" for=\"fld_1493282_1_opt1564479\"><input type=\"radio\" id=\"fld_1493282_1_opt1564479\" data-field=\"fld_1493282\" class=\"fld_1493282_1 option-required\" name=\"fld_1493282\" value=\"Barks\"   required=\"required\" data-radio-field=\"fld_1493282_1\" data-type=\"radio\" data-calc-value=\"Barks\" \/>\n\t\t\tBarks\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Attacks\" for=\"fld_1493282_1_opt1881848\"><input type=\"radio\" id=\"fld_1493282_1_opt1881848\" data-field=\"fld_1493282\" class=\"fld_1493282_1 option-required\" name=\"fld_1493282\" value=\"Attacks\"   required=\"required\" data-radio-field=\"fld_1493282_1\" data-type=\"radio\" data-calc-value=\"Attacks\" \/>\n\t\t\tAttacks\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Other\" for=\"fld_1493282_1_opt1900344\"><input type=\"radio\" id=\"fld_1493282_1_opt1900344\" data-field=\"fld_1493282\" class=\"fld_1493282_1 option-required\" name=\"fld_1493282\" value=\"Other\"   required=\"required\" data-radio-field=\"fld_1493282_1\" data-type=\"radio\" data-calc-value=\"Other\" \/>\n\t\t\tOther\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_1064383\" class=\"form-group\" id=\"fld_1064383_1-wrap\">\r\n<label id=\"fld_1064383Label\" for=\"fld_1064383_1\" class=\"control-label\">Loud noises? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"No reaction\" for=\"fld_1064383_1_opt1940580\"><input type=\"radio\" id=\"fld_1064383_1_opt1940580\" data-field=\"fld_1064383\" class=\"fld_1064383_1 option-required\" name=\"fld_1064383\" value=\"No reaction\"   required=\"required\" data-radio-field=\"fld_1064383_1\" data-type=\"radio\" data-calc-value=\"No reaction\" \/>\n\t\t\tNo reaction\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Startles, recovers quickly\" for=\"fld_1064383_1_opt1240994\"><input type=\"radio\" id=\"fld_1064383_1_opt1240994\" data-field=\"fld_1064383\" class=\"fld_1064383_1 option-required\" name=\"fld_1064383\" value=\"Startles, recovers quickly\"   required=\"required\" data-radio-field=\"fld_1064383_1\" data-type=\"radio\" data-calc-value=\"Startles, recovers quickly\" \/>\n\t\t\tStartles, recovers quickly\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Startles, recovers slowly\" for=\"fld_1064383_1_opt1564479\"><input type=\"radio\" id=\"fld_1064383_1_opt1564479\" data-field=\"fld_1064383\" class=\"fld_1064383_1 option-required\" name=\"fld_1064383\" value=\"Startles, recovers slowly\"   required=\"required\" data-radio-field=\"fld_1064383_1\" data-type=\"radio\" data-calc-value=\"Startles, recovers slowly\" \/>\n\t\t\tStartles, recovers slowly\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Hides\" for=\"fld_1064383_1_opt1881848\"><input type=\"radio\" id=\"fld_1064383_1_opt1881848\" data-field=\"fld_1064383\" class=\"fld_1064383_1 option-required\" name=\"fld_1064383\" value=\"Hides\"   required=\"required\" data-radio-field=\"fld_1064383_1\" data-type=\"radio\" data-calc-value=\"Hides\" \/>\n\t\t\tHides\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_6678952\" class=\"form-group\" id=\"fld_6678952_1-wrap\">\r\n<label id=\"fld_6678952Label\" for=\"fld_6678952_1\" class=\"control-label\">Sudden movements <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"No reaction\" for=\"fld_6678952_1_opt1940580\"><input type=\"radio\" id=\"fld_6678952_1_opt1940580\" data-field=\"fld_6678952\" class=\"fld_6678952_1 option-required\" name=\"fld_6678952\" value=\"No reaction\"   required=\"required\" data-radio-field=\"fld_6678952_1\" data-type=\"radio\" data-calc-value=\"No reaction\" \/>\n\t\t\tNo reaction\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Startles, recovers quickly\" for=\"fld_6678952_1_opt1240994\"><input type=\"radio\" id=\"fld_6678952_1_opt1240994\" data-field=\"fld_6678952\" class=\"fld_6678952_1 option-required\" name=\"fld_6678952\" value=\"Startles, recovers quickly\"   required=\"required\" data-radio-field=\"fld_6678952_1\" data-type=\"radio\" data-calc-value=\"Startles, recovers quickly\" \/>\n\t\t\tStartles, recovers quickly\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Startles, recovers slowly\" for=\"fld_6678952_1_opt1564479\"><input type=\"radio\" id=\"fld_6678952_1_opt1564479\" data-field=\"fld_6678952\" class=\"fld_6678952_1 option-required\" name=\"fld_6678952\" value=\"Startles, recovers slowly\"   required=\"required\" data-radio-field=\"fld_6678952_1\" data-type=\"radio\" data-calc-value=\"Startles, recovers slowly\" \/>\n\t\t\tStartles, recovers slowly\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Defensive\" for=\"fld_6678952_1_opt1881848\"><input type=\"radio\" id=\"fld_6678952_1_opt1881848\" data-field=\"fld_6678952\" class=\"fld_6678952_1 option-required\" name=\"fld_6678952\" value=\"Defensive\"   required=\"required\" data-radio-field=\"fld_6678952_1\" data-type=\"radio\" data-calc-value=\"Defensive\" \/>\n\t\t\tDefensive\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-44\"  class=\"row \"><div  class=\"col-sm-12  single\"><hr id=\"fld_4030648_1\" class=\"\" style=\"width: 100%\" \/><div class=\"\"><p>Has your dog shown any of the following aggressive reactions towards family members in these circumstances:<\/p>\n<\/div><div data-field-wrapper=\"fld_2066547\" class=\"form-group\" id=\"fld_2066547_1-wrap\">\r\n<label id=\"fld_2066547Label\" for=\"fld_2066547_1\" class=\"control-label\">Petting? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Growl\" for=\"fld_2066547_1_opt1940580\"><input type=\"radio\" id=\"fld_2066547_1_opt1940580\" data-field=\"fld_2066547\" class=\"fld_2066547_1 option-required\" name=\"fld_2066547\" value=\"Growl\"   required=\"required\" data-radio-field=\"fld_2066547_1\" data-type=\"radio\" data-calc-value=\"Growl\" \/>\n\t\t\tGrowl\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Bark\" for=\"fld_2066547_1_opt1240994\"><input type=\"radio\" id=\"fld_2066547_1_opt1240994\" data-field=\"fld_2066547\" class=\"fld_2066547_1 option-required\" name=\"fld_2066547\" value=\"Bark\"   required=\"required\" data-radio-field=\"fld_2066547_1\" data-type=\"radio\" data-calc-value=\"Bark\" \/>\n\t\t\tBark\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Snap\" for=\"fld_2066547_1_opt1564479\"><input type=\"radio\" id=\"fld_2066547_1_opt1564479\" data-field=\"fld_2066547\" class=\"fld_2066547_1 option-required\" name=\"fld_2066547\" value=\"Snap\"   required=\"required\" data-radio-field=\"fld_2066547_1\" data-type=\"radio\" data-calc-value=\"Snap\" \/>\n\t\t\tSnap\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Grab\" for=\"fld_2066547_1_opt1881848\"><input type=\"radio\" id=\"fld_2066547_1_opt1881848\" data-field=\"fld_2066547\" class=\"fld_2066547_1 option-required\" name=\"fld_2066547\" value=\"Grab\"   required=\"required\" data-radio-field=\"fld_2066547_1\" data-type=\"radio\" data-calc-value=\"Grab\" \/>\n\t\t\tGrab\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Glare\" for=\"fld_2066547_1_opt1900344\"><input type=\"radio\" id=\"fld_2066547_1_opt1900344\" data-field=\"fld_2066547\" class=\"fld_2066547_1 option-required\" name=\"fld_2066547\" value=\"Glare\"   required=\"required\" data-radio-field=\"fld_2066547_1\" data-type=\"radio\" data-calc-value=\"Glare\" \/>\n\t\t\tGlare\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Bite, breaking skin\" for=\"fld_2066547_1_opt1621093\"><input type=\"radio\" id=\"fld_2066547_1_opt1621093\" data-field=\"fld_2066547\" class=\"fld_2066547_1 option-required\" name=\"fld_2066547\" value=\"Bite, breaking skin\"   required=\"required\" data-radio-field=\"fld_2066547_1\" data-type=\"radio\" data-calc-value=\"Bite, breaking skin\" \/>\n\t\t\tBite, breaking skin\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_5658260\" class=\"form-group\" id=\"fld_5658260_1-wrap\">\r\n<label id=\"fld_5658260Label\" for=\"fld_5658260_1\" class=\"control-label\">Eating or playing with toy? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Growl\" for=\"fld_5658260_1_opt1940580\"><input type=\"radio\" id=\"fld_5658260_1_opt1940580\" data-field=\"fld_5658260\" class=\"fld_5658260_1 option-required\" name=\"fld_5658260\" value=\"Growl\"   required=\"required\" data-radio-field=\"fld_5658260_1\" data-type=\"radio\" data-calc-value=\"Growl\" \/>\n\t\t\tGrowl\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Bark\" for=\"fld_5658260_1_opt1240994\"><input type=\"radio\" id=\"fld_5658260_1_opt1240994\" data-field=\"fld_5658260\" class=\"fld_5658260_1 option-required\" name=\"fld_5658260\" value=\"Bark\"   required=\"required\" data-radio-field=\"fld_5658260_1\" data-type=\"radio\" data-calc-value=\"Bark\" \/>\n\t\t\tBark\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Snap\" for=\"fld_5658260_1_opt1564479\"><input type=\"radio\" id=\"fld_5658260_1_opt1564479\" data-field=\"fld_5658260\" class=\"fld_5658260_1 option-required\" name=\"fld_5658260\" value=\"Snap\"   required=\"required\" data-radio-field=\"fld_5658260_1\" data-type=\"radio\" data-calc-value=\"Snap\" \/>\n\t\t\tSnap\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Grab\" for=\"fld_5658260_1_opt1881848\"><input type=\"radio\" id=\"fld_5658260_1_opt1881848\" data-field=\"fld_5658260\" class=\"fld_5658260_1 option-required\" name=\"fld_5658260\" value=\"Grab\"   required=\"required\" data-radio-field=\"fld_5658260_1\" data-type=\"radio\" data-calc-value=\"Grab\" \/>\n\t\t\tGrab\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Glare\" for=\"fld_5658260_1_opt1900344\"><input type=\"radio\" id=\"fld_5658260_1_opt1900344\" data-field=\"fld_5658260\" class=\"fld_5658260_1 option-required\" name=\"fld_5658260\" value=\"Glare\"   required=\"required\" data-radio-field=\"fld_5658260_1\" data-type=\"radio\" data-calc-value=\"Glare\" \/>\n\t\t\tGlare\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Bite, breaking skin\" for=\"fld_5658260_1_opt1621093\"><input type=\"radio\" id=\"fld_5658260_1_opt1621093\" data-field=\"fld_5658260\" class=\"fld_5658260_1 option-required\" name=\"fld_5658260\" value=\"Bite, breaking skin\"   required=\"required\" data-radio-field=\"fld_5658260_1\" data-type=\"radio\" data-calc-value=\"Bite, breaking skin\" \/>\n\t\t\tBite, breaking skin\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_8964482\" class=\"form-group\" id=\"fld_8964482_1-wrap\">\r\n<label id=\"fld_8964482Label\" for=\"fld_8964482_1\" class=\"control-label\">Being approached when sleeping? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Growl\" for=\"fld_8964482_1_opt1940580\"><input type=\"radio\" id=\"fld_8964482_1_opt1940580\" data-field=\"fld_8964482\" class=\"fld_8964482_1 option-required\" name=\"fld_8964482\" value=\"Growl\"   required=\"required\" data-radio-field=\"fld_8964482_1\" data-type=\"radio\" data-calc-value=\"Growl\" \/>\n\t\t\tGrowl\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Bark\" for=\"fld_8964482_1_opt1240994\"><input type=\"radio\" id=\"fld_8964482_1_opt1240994\" data-field=\"fld_8964482\" class=\"fld_8964482_1 option-required\" name=\"fld_8964482\" value=\"Bark\"   required=\"required\" data-radio-field=\"fld_8964482_1\" data-type=\"radio\" data-calc-value=\"Bark\" \/>\n\t\t\tBark\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Snap\" for=\"fld_8964482_1_opt1564479\"><input type=\"radio\" id=\"fld_8964482_1_opt1564479\" data-field=\"fld_8964482\" class=\"fld_8964482_1 option-required\" name=\"fld_8964482\" value=\"Snap\"   required=\"required\" data-radio-field=\"fld_8964482_1\" data-type=\"radio\" data-calc-value=\"Snap\" \/>\n\t\t\tSnap\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Grab\" for=\"fld_8964482_1_opt1881848\"><input type=\"radio\" id=\"fld_8964482_1_opt1881848\" data-field=\"fld_8964482\" class=\"fld_8964482_1 option-required\" name=\"fld_8964482\" value=\"Grab\"   required=\"required\" data-radio-field=\"fld_8964482_1\" data-type=\"radio\" data-calc-value=\"Grab\" \/>\n\t\t\tGrab\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Glare\" for=\"fld_8964482_1_opt1900344\"><input type=\"radio\" id=\"fld_8964482_1_opt1900344\" data-field=\"fld_8964482\" class=\"fld_8964482_1 option-required\" name=\"fld_8964482\" value=\"Glare\"   required=\"required\" data-radio-field=\"fld_8964482_1\" data-type=\"radio\" data-calc-value=\"Glare\" \/>\n\t\t\tGlare\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Bite, breaking skin\" for=\"fld_8964482_1_opt1621093\"><input type=\"radio\" id=\"fld_8964482_1_opt1621093\" data-field=\"fld_8964482\" class=\"fld_8964482_1 option-required\" name=\"fld_8964482\" value=\"Bite, breaking skin\"   required=\"required\" data-radio-field=\"fld_8964482_1\" data-type=\"radio\" data-calc-value=\"Bite, breaking skin\" \/>\n\t\t\tBite, breaking skin\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_7356658\" class=\"form-group\" id=\"fld_7356658_1-wrap\">\r\n<label id=\"fld_7356658Label\" for=\"fld_7356658_1\" class=\"control-label\">Punishment or discipline? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Growl\" for=\"fld_7356658_1_opt1940580\"><input type=\"radio\" id=\"fld_7356658_1_opt1940580\" data-field=\"fld_7356658\" class=\"fld_7356658_1 option-required\" name=\"fld_7356658\" value=\"Growl\"   required=\"required\" data-radio-field=\"fld_7356658_1\" data-type=\"radio\" data-calc-value=\"Growl\" \/>\n\t\t\tGrowl\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Bark\" for=\"fld_7356658_1_opt1240994\"><input type=\"radio\" id=\"fld_7356658_1_opt1240994\" data-field=\"fld_7356658\" class=\"fld_7356658_1 option-required\" name=\"fld_7356658\" value=\"Bark\"   required=\"required\" data-radio-field=\"fld_7356658_1\" data-type=\"radio\" data-calc-value=\"Bark\" \/>\n\t\t\tBark\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Snap\" for=\"fld_7356658_1_opt1564479\"><input type=\"radio\" id=\"fld_7356658_1_opt1564479\" data-field=\"fld_7356658\" class=\"fld_7356658_1 option-required\" name=\"fld_7356658\" value=\"Snap\"   required=\"required\" data-radio-field=\"fld_7356658_1\" data-type=\"radio\" data-calc-value=\"Snap\" \/>\n\t\t\tSnap\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Grab\" for=\"fld_7356658_1_opt1881848\"><input type=\"radio\" id=\"fld_7356658_1_opt1881848\" data-field=\"fld_7356658\" class=\"fld_7356658_1 option-required\" name=\"fld_7356658\" value=\"Grab\"   required=\"required\" data-radio-field=\"fld_7356658_1\" data-type=\"radio\" data-calc-value=\"Grab\" \/>\n\t\t\tGrab\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Glare\" for=\"fld_7356658_1_opt1900344\"><input type=\"radio\" id=\"fld_7356658_1_opt1900344\" data-field=\"fld_7356658\" class=\"fld_7356658_1 option-required\" name=\"fld_7356658\" value=\"Glare\"   required=\"required\" data-radio-field=\"fld_7356658_1\" data-type=\"radio\" data-calc-value=\"Glare\" \/>\n\t\t\tGlare\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Bite, breaking skin\" for=\"fld_7356658_1_opt1621093\"><input type=\"radio\" id=\"fld_7356658_1_opt1621093\" data-field=\"fld_7356658\" class=\"fld_7356658_1 option-required\" name=\"fld_7356658\" value=\"Bite, breaking skin\"   required=\"required\" data-radio-field=\"fld_7356658_1\" data-type=\"radio\" data-calc-value=\"Bite, breaking skin\" \/>\n\t\t\tBite, breaking skin\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-45\"  class=\"row \"><div  class=\"col-sm-12  single\"><hr id=\"fld_2075418_1\" class=\"\" style=\"width: 100%\" \/><div class=\"\"><p>Has your dog shown any of the following aggressive reactions towards family members in these circumstances:<\/p>\n<\/div><div data-field-wrapper=\"fld_2419117\" class=\"form-group\" id=\"fld_2419117_1-wrap\">\r\n<label id=\"fld_2419117Label\" for=\"fld_2419117_1\" class=\"control-label\">Entering home <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Growl\" for=\"fld_2419117_1_opt1940580\"><input type=\"radio\" id=\"fld_2419117_1_opt1940580\" data-field=\"fld_2419117\" class=\"fld_2419117_1 option-required\" name=\"fld_2419117\" value=\"Growl\"   required=\"required\" data-radio-field=\"fld_2419117_1\" data-type=\"radio\" data-calc-value=\"Growl\" \/>\n\t\t\tGrowl\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Bark\" for=\"fld_2419117_1_opt1240994\"><input type=\"radio\" id=\"fld_2419117_1_opt1240994\" data-field=\"fld_2419117\" class=\"fld_2419117_1 option-required\" name=\"fld_2419117\" value=\"Bark\"   required=\"required\" data-radio-field=\"fld_2419117_1\" data-type=\"radio\" data-calc-value=\"Bark\" \/>\n\t\t\tBark\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Snap\" for=\"fld_2419117_1_opt1564479\"><input type=\"radio\" id=\"fld_2419117_1_opt1564479\" data-field=\"fld_2419117\" class=\"fld_2419117_1 option-required\" name=\"fld_2419117\" value=\"Snap\"   required=\"required\" data-radio-field=\"fld_2419117_1\" data-type=\"radio\" data-calc-value=\"Snap\" \/>\n\t\t\tSnap\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Grab\" for=\"fld_2419117_1_opt1881848\"><input type=\"radio\" id=\"fld_2419117_1_opt1881848\" data-field=\"fld_2419117\" class=\"fld_2419117_1 option-required\" name=\"fld_2419117\" value=\"Grab\"   required=\"required\" data-radio-field=\"fld_2419117_1\" data-type=\"radio\" data-calc-value=\"Grab\" \/>\n\t\t\tGrab\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Glare\" for=\"fld_2419117_1_opt1900344\"><input type=\"radio\" id=\"fld_2419117_1_opt1900344\" data-field=\"fld_2419117\" class=\"fld_2419117_1 option-required\" name=\"fld_2419117\" value=\"Glare\"   required=\"required\" data-radio-field=\"fld_2419117_1\" data-type=\"radio\" data-calc-value=\"Glare\" \/>\n\t\t\tGlare\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Bite, breaking skin\" for=\"fld_2419117_1_opt1621093\"><input type=\"radio\" id=\"fld_2419117_1_opt1621093\" data-field=\"fld_2419117\" class=\"fld_2419117_1 option-required\" name=\"fld_2419117\" value=\"Bite, breaking skin\"   required=\"required\" data-radio-field=\"fld_2419117_1\" data-type=\"radio\" data-calc-value=\"Bite, breaking skin\" \/>\n\t\t\tBite, breaking skin\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_698869\" class=\"form-group\" id=\"fld_698869_1-wrap\">\r\n<label id=\"fld_698869Label\" for=\"fld_698869_1\" class=\"control-label\">Entering yard <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Growl\" for=\"fld_698869_1_opt1940580\"><input type=\"radio\" id=\"fld_698869_1_opt1940580\" data-field=\"fld_698869\" class=\"fld_698869_1 option-required\" name=\"fld_698869\" value=\"Growl\"   required=\"required\" data-radio-field=\"fld_698869_1\" data-type=\"radio\" data-calc-value=\"Growl\" \/>\n\t\t\tGrowl\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Bark\" for=\"fld_698869_1_opt1240994\"><input type=\"radio\" id=\"fld_698869_1_opt1240994\" data-field=\"fld_698869\" class=\"fld_698869_1 option-required\" name=\"fld_698869\" value=\"Bark\"   required=\"required\" data-radio-field=\"fld_698869_1\" data-type=\"radio\" data-calc-value=\"Bark\" \/>\n\t\t\tBark\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Snap\" for=\"fld_698869_1_opt1564479\"><input type=\"radio\" id=\"fld_698869_1_opt1564479\" data-field=\"fld_698869\" class=\"fld_698869_1 option-required\" name=\"fld_698869\" value=\"Snap\"   required=\"required\" data-radio-field=\"fld_698869_1\" data-type=\"radio\" data-calc-value=\"Snap\" \/>\n\t\t\tSnap\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Grab\" for=\"fld_698869_1_opt1881848\"><input type=\"radio\" id=\"fld_698869_1_opt1881848\" data-field=\"fld_698869\" class=\"fld_698869_1 option-required\" name=\"fld_698869\" value=\"Grab\"   required=\"required\" data-radio-field=\"fld_698869_1\" data-type=\"radio\" data-calc-value=\"Grab\" \/>\n\t\t\tGrab\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Glare\" for=\"fld_698869_1_opt1900344\"><input type=\"radio\" id=\"fld_698869_1_opt1900344\" data-field=\"fld_698869\" class=\"fld_698869_1 option-required\" name=\"fld_698869\" value=\"Glare\"   required=\"required\" data-radio-field=\"fld_698869_1\" data-type=\"radio\" data-calc-value=\"Glare\" \/>\n\t\t\tGlare\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Bite, breaking skin\" for=\"fld_698869_1_opt1621093\"><input type=\"radio\" id=\"fld_698869_1_opt1621093\" data-field=\"fld_698869\" class=\"fld_698869_1 option-required\" name=\"fld_698869\" value=\"Bite, breaking skin\"   required=\"required\" data-radio-field=\"fld_698869_1\" data-type=\"radio\" data-calc-value=\"Bite, breaking skin\" \/>\n\t\t\tBite, breaking skin\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_7480043\" class=\"form-group\" id=\"fld_7480043_1-wrap\">\r\n\t<label id=\"fld_7480043Label\" for=\"fld_7480043_1\" class=\"control-label\">Describe the circumstances of any of the above, including approx dates & severity:<\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_7480043\" value=\"\" data-field=\"fld_7480043\" class=\"form-control\" id=\"fld_7480043_1\" rows=\"4\"    aria-labelledby=\"fld_7480043Label\" ><\/textarea>\n\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_6065865\" class=\"form-group\" id=\"fld_6065865_1-wrap\">\r\n\t<label id=\"fld_6065865Label\" for=\"fld_6065865_1\" class=\"control-label\">Describe any other situations not previously discussed in which your dog has been aggressive:<\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_6065865\" value=\"\" data-field=\"fld_6065865\" class=\"form-control\" id=\"fld_6065865_1\" rows=\"4\"    aria-labelledby=\"fld_6065865Label\" ><\/textarea>\n\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_8341177\" class=\"form-group\" id=\"fld_8341177_1-wrap\">\r\n\t<label id=\"fld_8341177Label\" for=\"fld_8341177_1\" class=\"control-label\">During agressive displays does your dog exhibit any of the following?<\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_8341177_1_opt2042958\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Cowering\"\n                                data-field=\"fld_8341177\"\n                                id=\"fld_8341177_1_opt2042958\"\n                                class=\"fld_8341177_1\"\n                                name=\"fld_8341177[opt2042958]\"\n                                value=\"Cowering\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_8341177_1\"\n                                                                data-calc-value=\"Cowering\"\n                            >\n                    Cowering                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_8341177_1_opt1272526\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Ears back\"\n                                data-field=\"fld_8341177\"\n                                id=\"fld_8341177_1_opt1272526\"\n                                class=\"fld_8341177_1\"\n                                name=\"fld_8341177[opt1272526]\"\n                                value=\"Ears back\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_8341177_1\"\n                                                                data-calc-value=\"Ears back\"\n                            >\n                    Ears back                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_8341177_1_opt1450806\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Tail tucked\"\n                                data-field=\"fld_8341177\"\n                                id=\"fld_8341177_1_opt1450806\"\n                                class=\"fld_8341177_1\"\n                                name=\"fld_8341177[opt1450806]\"\n                                value=\"Tail tucked\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_8341177_1\"\n                                                                data-calc-value=\"Tail tucked\"\n                            >\n                    Tail tucked                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_8341177_1_opt1552972\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Hackles raised\"\n                                data-field=\"fld_8341177\"\n                                id=\"fld_8341177_1_opt1552972\"\n                                class=\"fld_8341177_1\"\n                                name=\"fld_8341177[opt1552972]\"\n                                value=\"Hackles raised\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_8341177_1\"\n                                                                data-calc-value=\"Hackles raised\"\n                            >\n                    Hackles raised                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_8341177_1_opt1534608\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Retreating\"\n                                data-field=\"fld_8341177\"\n                                id=\"fld_8341177_1_opt1534608\"\n                                class=\"fld_8341177_1\"\n                                name=\"fld_8341177[opt1534608]\"\n                                value=\"Retreating\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_8341177_1\"\n                                                                data-calc-value=\"Retreating\"\n                            >\n                    Retreating                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_8341177_1_opt2070539\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Hiding\"\n                                data-field=\"fld_8341177\"\n                                id=\"fld_8341177_1_opt2070539\"\n                                class=\"fld_8341177_1\"\n                                name=\"fld_8341177[opt2070539]\"\n                                value=\"Hiding\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_8341177_1\"\n                                                                data-calc-value=\"Hiding\"\n                            >\n                    Hiding                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-46\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_8811425\" class=\"form-group\" id=\"fld_8811425_1-wrap\">\r\n<label id=\"fld_8811425Label\" for=\"fld_8811425_1\" class=\"control-label\">Aside from the principal problem, does your dog have any other problem behaviors? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Yes\" for=\"fld_8811425_1_opt1940580\"><input type=\"radio\" id=\"fld_8811425_1_opt1940580\" data-field=\"fld_8811425\" class=\"fld_8811425_1 option-required\" name=\"fld_8811425\" value=\"Yes\"   required=\"required\" data-radio-field=\"fld_8811425_1\" data-type=\"radio\" data-calc-value=\"Yes\" \/>\n\t\t\tYes\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"No\" for=\"fld_8811425_1_opt1240994\"><input type=\"radio\" id=\"fld_8811425_1_opt1240994\" data-field=\"fld_8811425\" class=\"fld_8811425_1 option-required\" name=\"fld_8811425\" value=\"No\"   required=\"required\" data-radio-field=\"fld_8811425_1\" data-type=\"radio\" data-calc-value=\"No\" \/>\n\t\t\tNo\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_6045921\" class=\"form-group\" id=\"fld_6045921_1-wrap\">\r\n\t<label id=\"fld_6045921Label\" for=\"fld_6045921_1\" class=\"control-label\">Describe other problems:<\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_6045921\" value=\"\" data-field=\"fld_6045921\" class=\"form-control\" id=\"fld_6045921_1\" rows=\"4\"    aria-labelledby=\"fld_6045921Label\" ><\/textarea>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-47\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_1947916\" class=\"form-group\" id=\"fld_1947916_1-wrap\">\r\n<div class=\"\">\r\n\t<input  class=\"btn btn-default cf-page-btn cf-page-btn-prev\" type=\"button\" name=\"fld_1947916\" id=\"fld_1947916_1\" value=\"Back\" data-field=\"fld_1947916\" data-page=\"prev\"  >\n<\/div>\r\n<\/div>\r\n\t<input class=\"button_trigger_1\" type=\"hidden\" name=\"fld_1947916\" id=\"fld_1947916_1_btn\" value=\"\" data-field=\"fld_1947916\"  \/>\n<\/div><div  class=\"col-sm-6 \"><div data-field-wrapper=\"fld_7586048\" class=\"form-group\" id=\"fld_7586048_1-wrap\">\r\n<div class=\"\">\r\n\t<input  class=\"btn btn-default cf-page-btn cf-page-btn-next\" type=\"button\" name=\"fld_7586048\" id=\"fld_7586048_1\" value=\"Next\" data-field=\"fld_7586048\" data-page=\"next\"  >\n<\/div>\r\n<\/div>\r\n\t<input class=\"button_trigger_1\" type=\"hidden\" name=\"fld_7586048\" id=\"fld_7586048_1_btn\" value=\"\" data-field=\"fld_7586048\"  \/>\n<\/div><\/div><\/div><div id=\"form_page_1_pg_6\" data-formpage=\"6\" role=\"region\" aria-labelledby=\"breadcrumb_1_pg_6\" aria-hidden=\"true\" class=\"caldera-form-page\" style=\"display:none;\"><div id=\"CF5bfddec14b5d7_1-row-48\"  class=\"row \"><div  class=\"col-sm-12  single\"><div class=\"\"><h3>Medical<\/h3>\n<p>Answer the following questions or have your veterinarian send a brief medical history to Positive Approach.<\/p>\n<\/div><\/div><\/div><div id=\"CF5bfddec14b5d7_1-row-49\"  class=\"row  last_row\"><div  class=\"col-sm-12  first_col\"><div data-field-wrapper=\"fld_4096021\" class=\"form-group\" id=\"fld_4096021_1-wrap\">\r\n\t<label id=\"fld_4096021Label\" for=\"fld_4096021_1\" class=\"control-label\">Has your dog had any medical problems? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_4096021_1_opt1288368\"\n                >\n                            <input\n                                data-parsley-required=\"true\" data-parsley-group=\"fld_4096021_1\" data-parsley-multiple=\"fld_4096021_1\"                                type=\"checkbox\"\n                                data-label=\"Ears\"\n                                data-field=\"fld_4096021\"\n                                id=\"fld_4096021_1_opt1288368\"\n                                class=\"fld_4096021_1 option-required\"\n                                name=\"fld_4096021[opt1288368]\"\n                                value=\"Ears\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_4096021_1\"\n                                                                data-calc-value=\"Ears\"\n                            >\n                    Ears                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_4096021_1_opt1935744\"\n                >\n                            <input\n                                data-parsley-required=\"true\" data-parsley-group=\"fld_4096021_1\" data-parsley-multiple=\"fld_4096021_1\"                                type=\"checkbox\"\n                                data-label=\"Back\"\n                                data-field=\"fld_4096021\"\n                                id=\"fld_4096021_1_opt1935744\"\n                                class=\"fld_4096021_1 option-required\"\n                                name=\"fld_4096021[opt1935744]\"\n                                value=\"Back\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_4096021_1\"\n                                                                data-calc-value=\"Back\"\n                            >\n                    Back                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_4096021_1_opt1485990\"\n                >\n                            <input\n                                data-parsley-required=\"true\" data-parsley-group=\"fld_4096021_1\" data-parsley-multiple=\"fld_4096021_1\"                                type=\"checkbox\"\n                                data-label=\"Allergies\"\n                                data-field=\"fld_4096021\"\n                                id=\"fld_4096021_1_opt1485990\"\n                                class=\"fld_4096021_1 option-required\"\n                                name=\"fld_4096021[opt1485990]\"\n                                value=\"Allergies\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_4096021_1\"\n                                                                data-calc-value=\"Allergies\"\n                            >\n                    Allergies                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_4096021_1_opt2071429\"\n                >\n                            <input\n                                data-parsley-required=\"true\" data-parsley-group=\"fld_4096021_1\" data-parsley-multiple=\"fld_4096021_1\"                                type=\"checkbox\"\n                                data-label=\"Hips\"\n                                data-field=\"fld_4096021\"\n                                id=\"fld_4096021_1_opt2071429\"\n                                class=\"fld_4096021_1 option-required\"\n                                name=\"fld_4096021[opt2071429]\"\n                                value=\"Hips\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_4096021_1\"\n                                                                data-calc-value=\"Hips\"\n                            >\n                    Hips                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_4096021_1_opt1852998\"\n                >\n                            <input\n                                data-parsley-required=\"true\" data-parsley-group=\"fld_4096021_1\" data-parsley-multiple=\"fld_4096021_1\"                                type=\"checkbox\"\n                                data-label=\"Skin\"\n                                data-field=\"fld_4096021\"\n                                id=\"fld_4096021_1_opt1852998\"\n                                class=\"fld_4096021_1 option-required\"\n                                name=\"fld_4096021[opt1852998]\"\n                                value=\"Skin\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_4096021_1\"\n                                                                data-calc-value=\"Skin\"\n                            >\n                    Skin                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_4096021_1_opt1688711\"\n                >\n                            <input\n                                data-parsley-required=\"true\" data-parsley-group=\"fld_4096021_1\" data-parsley-multiple=\"fld_4096021_1\"                                type=\"checkbox\"\n                                data-label=\"Other\"\n                                data-field=\"fld_4096021\"\n                                id=\"fld_4096021_1_opt1688711\"\n                                class=\"fld_4096021_1 option-required\"\n                                name=\"fld_4096021[opt1688711]\"\n                                value=\"Other\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_4096021_1\"\n                                                                data-calc-value=\"Other\"\n                            >\n                    Other                <\/label>\n\n                \t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_2324212\" class=\"form-group\" id=\"fld_2324212_1-wrap\">\r\n\t<label id=\"fld_2324212Label\" for=\"fld_2324212_1\" class=\"control-label\">Describe any medications your pet is currently taking, and why: <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_2324212\" value=\"\" data-field=\"fld_2324212\" class=\"form-control\" id=\"fld_2324212_1\" rows=\"4\"  required=\"required\"  aria-labelledby=\"fld_2324212Label\" ><\/textarea>\n\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_5005591\" class=\"form-group\" id=\"fld_5005591_1-wrap\">\r\n\t<label id=\"fld_5005591Label\" for=\"fld_5005591_1\" class=\"control-label\">How does your dog react to nail trimming? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_5005591\" class=\" form-control\" id=\"fld_5005591_1\" name=\"fld_5005591\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_5005591Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_4067479\" class=\"form-group\" id=\"fld_4067479_1-wrap\">\r\n\t<label id=\"fld_4067479Label\" for=\"fld_4067479_1\" class=\"control-label\">How does your dog react to getting medication? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_4067479\" class=\" form-control\" id=\"fld_4067479_1\" name=\"fld_4067479\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_4067479Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_4416855\" class=\"form-group\" id=\"fld_4416855_1-wrap\">\r\n\t<label id=\"fld_4416855Label\" for=\"fld_4416855_1\" class=\"control-label\">How does your dog react to bathing? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_4416855\" class=\" form-control\" id=\"fld_4416855_1\" name=\"fld_4416855\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_4416855Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<hr id=\"fld_590363_1\" class=\"\" style=\"width: 100%\" \/><div data-field-wrapper=\"fld_7919457\" class=\"form-group\" id=\"fld_7919457_1-wrap\">\r\n<label id=\"fld_7919457Label\" for=\"fld_7919457_1\" class=\"control-label\">I hereby authorize Positive Approach to release any recommendations given as a result of this inquiry to my veterinarian. <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"I Agree\" for=\"fld_7919457_1_opt1694079\"><input type=\"radio\" id=\"fld_7919457_1_opt1694079\" data-field=\"fld_7919457\" class=\"fld_7919457_1 option-required\" name=\"fld_7919457\" value=\"I Agree\"   required=\"required\" data-radio-field=\"fld_7919457_1\" data-type=\"radio\" data-calc-value=\"I Agree\" \/>\n\t\t\tI Agree\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"I Don&#039;t Agree\" for=\"fld_7919457_1_opt1763310\"><input type=\"radio\" id=\"fld_7919457_1_opt1763310\" data-field=\"fld_7919457\" class=\"fld_7919457_1 option-required\" name=\"fld_7919457\" value=\"I Don&#039;t Agree\"   required=\"required\" data-radio-field=\"fld_7919457_1\" data-type=\"radio\" data-calc-value=\"I Don&#039;t Agree\" \/>\n\t\t\tI Don't Agree\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_4112120\" class=\"form-group\" id=\"fld_4112120_1-wrap\">\r\n<div class=\"\">\r\n\t<input  class=\"btn btn-default\" type=\"submit\" name=\"fld_4112120\" id=\"fld_4112120_1\" value=\"Submit your Application\" data-field=\"fld_4112120\"  >\n<\/div>\r\n<\/div>\r\n\t<input class=\"button_trigger_1\" type=\"hidden\" name=\"fld_4112120\" id=\"fld_4112120_1_btn\" value=\"\" data-field=\"fld_4112120\"  \/>\n<\/div><\/div><\/div><\/form>\r\n<\/div>\r\n\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"caldera-grid\" id=\"caldera_form_2\" data-cf-ver=\"1.9.7\" data-cf-form-id=\"CF5bfddec14b5d7\"><div id=\"caldera_notices_2\" data-spinner=\"https:\/\/www.positiveapproachdogtraining.com\/wp-admin\/images\/spinner.gif\"><\/div><form data-instance=\"2\" class=\"CF5bfddec14b5d7 caldera_forms_form cfajax-trigger\" method=\"POST\" enctype=\"multipart\/form-data\" id=\"CF5bfddec14b5d7_2\" data-form-id=\"CF5bfddec14b5d7\" aria-label=\"Behavioral Problems Application\" data-target=\"#caldera_notices_2\" data-template=\"#cfajax_CF5bfddec14b5d7-tmpl\" data-cfajax=\"CF5bfddec14b5d7\" data-load-element=\"_parent\" data-load-class=\"cf_processing\" data-post-disable=\"0\" data-action=\"cf_process_ajax_submit\" data-request=\"https:\/\/www.positiveapproachdogtraining.com\/cf-api\/CF5bfddec14b5d7\" data-hiderows=\"true\">\r\n<input type=\"hidden\" id=\"_cf_verify_CF5bfddec14b5d7\" name=\"_cf_verify\" value=\"207cc6cee5\"  data-nonce-time=\"1782111562\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index.php\/wp-json\/wp\/v2\/pages\/282\" \/><div id=\"cf2-CF5bfddec14b5d7_2\"><\/div><input type=\"hidden\" name=\"_cf_frm_id\" value=\"CF5bfddec14b5d7\">\r\n<input type=\"hidden\" name=\"_cf_frm_ct\" value=\"2\">\r\n<input type=\"hidden\" name=\"cfajax\" value=\"CF5bfddec14b5d7\">\r\n<input type=\"hidden\" name=\"_cf_cr_pst\" value=\"282\">\r\n<span class=\"caldera-grid\"><ol class=\"breadcrumb\" data-form=\"caldera_form_2\" id=\"caldera-forms-breadcrumb_2\">\r\n<li class=\"active\"><a aria-controls=\"form_page_2_pg_1\" aria-expanded=\"true\" id=\"breadcrumb_2_pg_1\" href=\"?cf_pg=1\" data-page=\"1\" data-pagenav=\"caldera_form_2\" title=\"Navigate to About you\">About you<\/a><\/li>\r\n<li><a aria-controls=\"form_page_2_pg_2\" aria-expanded=\"false\" id=\"breadcrumb_2_pg_2\" href=\"?cf_pg=2\" data-page=\"2\" data-pagenav=\"caldera_form_2\" title=\"Navigate to About your pet\">About your pet<\/a><\/li>\r\n<li><a aria-controls=\"form_page_2_pg_3\" aria-expanded=\"false\" id=\"breadcrumb_2_pg_3\" href=\"?cf_pg=3\" data-page=\"3\" data-pagenav=\"caldera_form_2\" title=\"Navigate to Behavior consultation\">Behavior consultation<\/a><\/li>\r\n<li><a aria-controls=\"form_page_2_pg_4\" aria-expanded=\"false\" id=\"breadcrumb_2_pg_4\" href=\"?cf_pg=4\" data-page=\"4\" data-pagenav=\"caldera_form_2\" title=\"Navigate to Environment\/Lifestyle\">Environment\/Lifestyle<\/a><\/li>\r\n<li><a aria-controls=\"form_page_2_pg_5\" aria-expanded=\"false\" id=\"breadcrumb_2_pg_5\" href=\"?cf_pg=5\" data-page=\"5\" data-pagenav=\"caldera_form_2\" title=\"Navigate to Previous Training\">Previous Training<\/a><\/li>\r\n<li><a aria-controls=\"form_page_2_pg_6\" aria-expanded=\"false\" id=\"breadcrumb_2_pg_6\" href=\"?cf_pg=6\" data-page=\"6\" data-pagenav=\"caldera_form_2\" title=\"Navigate to Medical\">Medical<\/a><\/li>\r\n<\/ol><\/span>\r\n<div class=\"hide\" style=\"display:none; overflow:hidden;height:0;width:0;\">\r\n<label>Email<\/label><input type=\"text\" name=\"email\" value=\"\" autocomplete=\"off\">\r\n<\/div><div id=\"form_page_2_pg_1\" data-formpage=\"1\" class=\"caldera-form-page\" style=\"display:block;\" role=\"region\" aria-labelledby=\"breadcrumb_2_pg_1\" aria-hidden=\"false\"><div id=\"CF5bfddec14b5d7_2-row-1\"  class=\"row  first_row\"><div  class=\"col-sm-12  single\"><div class=\"\"><h3>Information about you<\/h3>\n<\/div><\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-2\"  class=\"row \"><div  class=\"col-sm-3  first_col\">\n<div data-field-wrapper=\"fld_4004783\" class=\"form-group\" id=\"fld_4004783_2-wrap\">\r\n\t<label id=\"fld_4004783Label\" for=\"fld_4004783_2\" class=\"control-label\">Date of Application<\/label>\r\n\t<div class=\"\">\r\n\t\t<input  type=\"text\" data-provide=\"cfdatepicker\" name=\"fld_4004783\" value=\"\" id=\"fld_4004783_2\" data-field=\"fld_4004783\" class=\"form-control cfdatepicker is-cfdatepicker\" data-date-format=\"mm-dd-yyyy\" data-date-start-view=\"month\"  data-date-start-date=\"0d\" data-date-end-date=\"0d\" data-date-autoclose=\"true\"   aria-labelledby=\"fld_4004783Label\"   \/>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-9  last_col\"><div data-field-wrapper=\"fld_7446838\" class=\"form-group\" id=\"fld_7446838_2-wrap\">\r\n\t<label id=\"fld_7446838Label\" for=\"fld_7446838_2\" class=\"control-label\">Referred By<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_7446838\" class=\" form-control\" id=\"fld_7446838_2\" name=\"fld_7446838\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_7446838Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-3\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_6482901\" class=\"form-group\" id=\"fld_6482901_2-wrap\">\r\n\t<label id=\"fld_6482901Label\" for=\"fld_6482901_2\" class=\"control-label\">Owner's Name <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_6482901\" class=\" form-control\" id=\"fld_6482901_2\" name=\"fld_6482901\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_6482901Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-4\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_2385753\" class=\"form-group\" id=\"fld_2385753_2-wrap\">\r\n\t<label id=\"fld_2385753Label\" for=\"fld_2385753_2\" class=\"control-label\">Address <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_2385753\" class=\" form-control\" id=\"fld_2385753_2\" name=\"fld_2385753\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_2385753Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-2 \"><div data-field-wrapper=\"fld_3646205\" class=\"form-group\" id=\"fld_3646205_2-wrap\">\r\n\t<label id=\"fld_3646205Label\" for=\"fld_3646205_2\" class=\"control-label\">City <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_3646205\" class=\" form-control\" id=\"fld_3646205_2\" name=\"fld_3646205\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_3646205Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-2 \"><div data-field-wrapper=\"fld_4131014\" class=\"form-group\" id=\"fld_4131014_2-wrap\">\r\n\t<label id=\"fld_4131014Label\" for=\"fld_4131014_2\" class=\"control-label\">State <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t<select  id=\"fld_4131014_2\" data-field=\"fld_4131014\" class=\"form-control\" name=\"fld_4131014\" required=\"required\">\n\t\t\t<option value=\"\"> - Select Province\/State - <\/option>\n\t\t\t<option value=\"AB\">Alberta<\/option>\n\t\t\t<option value=\"BC\">British Columbia<\/option>\n\t\t\t<option value=\"MB\">Manitoba<\/option>\n\t\t\t<option value=\"NB\">New Brunswick<\/option>\n\t\t\t<option value=\"NL\">Newfoundland and Labrador<\/option>\n\t\t\t<option value=\"NS\">Nova Scotia<\/option>\n\t\t\t<option value=\"NT\">Northwest Territories<\/option>\n\t\t\t<option value=\"NU\">Nunavut<\/option>\n\t\t\t<option value=\"ON\">Ontario<\/option>\n\t\t\t<option value=\"PE\">Prince Edward Island<\/option>\n\t\t\t<option value=\"QC\">Quebec<\/option>\n\t\t\t<option value=\"SK\">Saskatchewan<\/option>\n\t\t\t<option value=\"YT\">Yukon<\/option>\n\t\t\t<option> ==================== <\/option>\n\t\t\t<option value=\"AL\">Alabama<\/option>\n\t\t\t<option value=\"AK\">Alaska<\/option>\n\t\t\t<option value=\"AZ\">Arizona<\/option>\n\t\t\t<option value=\"AR\">Arkansas<\/option>\n\t\t\t<option value=\"CA\">California<\/option>\n\t\t\t<option value=\"CO\">Colorado<\/option>\n\t\t\t<option value=\"CT\">Connecticut<\/option>\n\t\t\t<option value=\"DE\">Delaware<\/option>\n\t\t\t<option value=\"DC\">District Of Columbia<\/option>\n\t\t\t<option value=\"FL\">Florida<\/option>\n\t\t\t<option value=\"GA\">Georgia<\/option>\n\t\t\t<option value=\"HI\">Hawaii<\/option>\n\t\t\t<option value=\"ID\">Idaho<\/option>\n\t\t\t<option value=\"IL\">Illinois<\/option>\n\t\t\t<option value=\"IN\">Indiana<\/option>\n\t\t\t<option value=\"IA\">Iowa<\/option>\n\t\t\t<option value=\"KS\">Kansas<\/option>\n\t\t\t<option value=\"KY\">Kentucky<\/option>\n\t\t\t<option value=\"LA\">Louisiana<\/option>\n\t\t\t<option value=\"ME\">Maine<\/option>\n\t\t\t<option value=\"MD\">Maryland<\/option>\n\t\t\t<option value=\"MA\">Massachusetts<\/option>\n\t\t\t<option value=\"MI\">Michigan<\/option>\n\t\t\t<option value=\"MN\">Minnesota<\/option>\n\t\t\t<option value=\"MS\">Mississippi<\/option>\n\t\t\t<option value=\"MO\">Missouri<\/option>\n\t\t\t<option value=\"MT\">Montana<\/option>\n\t\t\t<option value=\"NE\">Nebraska<\/option>\n\t\t\t<option value=\"NV\">Nevada<\/option>\n\t\t\t<option value=\"NH\">New Hampshire<\/option>\n\t\t\t<option value=\"NJ\">New Jersey<\/option>\n\t\t\t<option value=\"NM\">New Mexico<\/option>\n\t\t\t<option value=\"NY\">New York<\/option>\n\t\t\t<option value=\"NC\">North Carolina<\/option>\n\t\t\t<option value=\"ND\">North Dakota<\/option>\n\t\t\t<option value=\"OH\">Ohio<\/option>\n\t\t\t<option value=\"OK\">Oklahoma<\/option>\n\t\t\t<option value=\"OR\">Oregon<\/option>\n\t\t\t<option value=\"PA\">Pennsylvania<\/option>\n\t\t\t<option value=\"RI\">Rhode Island<\/option>\n\t\t\t<option value=\"SC\">South Carolina<\/option>\n\t\t\t<option value=\"SD\">South Dakota<\/option>\n\t\t\t<option value=\"TN\">Tennessee<\/option>\n\t\t\t<option value=\"TX\">Texas<\/option>\n\t\t\t<option value=\"UT\">Utah<\/option>\n\t\t\t<option value=\"VT\">Vermont<\/option>\n\t\t\t<option value=\"VA\">Virginia<\/option>\n\t\t\t<option value=\"WA\">Washington<\/option>\n\t\t\t<option value=\"WV\">West Virginia<\/option>\n\t\t\t<option value=\"WI\">Wisconsin<\/option>\n\t\t\t<option value=\"WY\">Wyoming<\/option>\n\t\t<\/select>\n\t\t\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-2  last_col\"><div data-field-wrapper=\"fld_8058403\" class=\"form-group\" id=\"fld_8058403_2-wrap\">\r\n\t<label id=\"fld_8058403Label\" for=\"fld_8058403_2\" class=\"control-label\">Zip <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"number\" data-field=\"fld_8058403\" class=\" form-control\" id=\"fld_8058403_2\" name=\"fld_8058403\" value=\"\" data-type=\"number\" data-parsley-type=\"number\" aria-required=\"true\"   aria-labelledby=\"fld_8058403Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-5\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_7076731\" class=\"form-group\" id=\"fld_7076731_2-wrap\">\r\n\t<label id=\"fld_7076731Label\" for=\"fld_7076731_2\" class=\"control-label\">Email <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"email\" data-field=\"fld_7076731\" class=\" form-control\" id=\"fld_7076731_2\" name=\"fld_7076731\" value=\"\" data-type=\"email\" aria-required=\"true\"   aria-labelledby=\"fld_7076731Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3 \"><div data-field-wrapper=\"fld_7836099\" class=\"form-group\" id=\"fld_7836099_2-wrap\">\r\n\t<label id=\"fld_7836099Label\" for=\"fld_7836099_2\" class=\"control-label\">Primary Phone <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input  data-inputmask=\"'mask': '(999)999-9999'\"  required type=\"phone\" data-field=\"fld_7836099\" class=\" form-control\" id=\"fld_7836099_2\" name=\"fld_7836099\" value=\"\" data-type=\"phone\" aria-required=\"true\"   aria-labelledby=\"fld_7836099Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3  last_col\"><div data-field-wrapper=\"fld_3638475\" class=\"form-group\" id=\"fld_3638475_2-wrap\">\r\n\t<label id=\"fld_3638475Label\" for=\"fld_3638475_2\" class=\"control-label\">Other Phone (Work\/Home\/Cell)<\/label>\r\n\t<div class=\"\">\r\n\t\t<input  data-inputmask=\"'mask': '(999)999-9999'\"   type=\"phone\" data-field=\"fld_3638475\" class=\" form-control\" id=\"fld_3638475_2\" name=\"fld_3638475\" value=\"\" data-type=\"phone\"   aria-labelledby=\"fld_3638475Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-6\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_9358296\" class=\"form-group\" id=\"fld_9358296_2-wrap\">\r\n<div class=\"\">\r\n\t<input  class=\"btn btn-default cf-page-btn cf-page-btn-next\" type=\"button\" name=\"fld_9358296\" id=\"fld_9358296_2\" value=\"Next\" data-field=\"fld_9358296\" data-page=\"next\"  >\n<\/div>\r\n<\/div>\r\n\t<input class=\"button_trigger_2\" type=\"hidden\" name=\"fld_9358296\" id=\"fld_9358296_2_btn\" value=\"\" data-field=\"fld_9358296\"  \/>\n<\/div><div  class=\"col-sm-6 \"><\/div><\/div><\/div><div id=\"form_page_2_pg_2\" data-formpage=\"2\" role=\"region\" aria-labelledby=\"breadcrumb_2_pg_2\" aria-hidden=\"true\" class=\"caldera-form-page\" style=\"display:none;\"><div id=\"CF5bfddec14b5d7_2-row-7\"  class=\"row \"><div  class=\"col-sm-12  single\"><div class=\"\"><h3>Information about your pet<\/h3>\n<\/div><\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-8\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_2675849\" class=\"form-group\" id=\"fld_2675849_2-wrap\">\r\n\t<label id=\"fld_2675849Label\" for=\"fld_2675849_2\" class=\"control-label\">Pet Name <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_2675849\" class=\" form-control\" id=\"fld_2675849_2\" name=\"fld_2675849\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_2675849Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_1875195\" class=\"form-group\" id=\"fld_1875195_2-wrap\">\r\n\t<label id=\"fld_1875195Label\" for=\"fld_1875195_2\" class=\"control-label\">Pet Breed <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_1875195\" class=\" form-control\" id=\"fld_1875195_2\" name=\"fld_1875195\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_1875195Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-9\"  class=\"row \"><div  class=\"col-sm-3  first_col\"><div data-field-wrapper=\"fld_9099058\" class=\"form-group\" id=\"fld_9099058_2-wrap\">\r\n\t<label id=\"fld_9099058Label\" for=\"fld_9099058_2\" class=\"control-label\">Date of Birth<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"date\" data-field=\"fld_9099058\" class=\" form-control\" id=\"fld_9099058_2\" name=\"fld_9099058\" value=\"\" data-type=\"date\"   aria-labelledby=\"fld_9099058Label\" aria-describedby=\"fld_9099058Caption\" >\t\t<span id=\"fld_9099058Caption\" class=\"help-block\">Approximate Date<\/span>\r\n\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3 \"><div data-field-wrapper=\"fld_5928014\" class=\"form-group\" id=\"fld_5928014_2-wrap\">\r\n\t<label id=\"fld_5928014Label\" for=\"fld_5928014_2\" class=\"control-label\">Pet Gender <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<select name=\"fld_5928014\" value=\"\" data-field=\"fld_5928014\" class=\"form-control\" id=\"fld_5928014_2\"  required=\"required\"  aria-labelledby=\"fld_5928014Label\" >\n\t\t<option value=\"\"><\/option>\r\n\t\t\t\t\t<option value=\"Male - Neutered\"  data-calc-value=\"Male - Neutered\" >\n\t\t\t\t\t\tMale - Neutered\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Female - Spayed\"  data-calc-value=\"Female - Spayed\" >\n\t\t\t\t\t\tFemale - Spayed\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3 \"><div data-field-wrapper=\"fld_9903819\" class=\"form-group\" id=\"fld_9903819_2-wrap\">\r\n\t<label id=\"fld_9903819Label\" for=\"fld_9903819_2\" class=\"control-label\">Spayed or Neutered <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<select name=\"fld_9903819\" value=\"\" data-field=\"fld_9903819\" class=\"form-control\" id=\"fld_9903819_2\"  required=\"required\"  aria-labelledby=\"fld_9903819Label\" >\n\t\t<option value=\"\"><\/option>\r\n\t\t\t\t\t<option value=\"Yes\"  data-calc-value=\"Yes\" >\n\t\t\t\t\t\tYes\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"No\"  data-calc-value=\"No\" >\n\t\t\t\t\t\tNo\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3  last_col\"><div data-field-wrapper=\"fld_4373625\" class=\"form-group\" id=\"fld_4373625_2-wrap\">\r\n\t<label id=\"fld_4373625Label\" for=\"fld_4373625_2\" class=\"control-label\">Age at time of neuter\/Spay <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"number\" data-field=\"fld_4373625\" class=\" form-control\" id=\"fld_4373625_2\" name=\"fld_4373625\" value=\"\" data-type=\"number\" min=\"1\" max=\"2\" data-parsley-type=\"number\" aria-required=\"true\"   aria-labelledby=\"fld_4373625Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-10\"  class=\"row \"><div  class=\"col-sm-4  first_col\"><div data-field-wrapper=\"fld_7956233\" class=\"form-group\" id=\"fld_7956233_2-wrap\">\r\n\t<label id=\"fld_7956233Label\" for=\"fld_7956233_2\" class=\"control-label\">Pet Age <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"number\" data-field=\"fld_7956233\" class=\" form-control\" id=\"fld_7956233_2\" name=\"fld_7956233\" value=\"\" data-type=\"number\" min=\"0\" max=\"30\" data-parsley-type=\"number\" aria-required=\"true\"   aria-labelledby=\"fld_7956233Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-4 \"><div data-field-wrapper=\"fld_8382301\" class=\"form-group\" id=\"fld_8382301_2-wrap\">\r\n\t<label id=\"fld_8382301Label\" for=\"fld_8382301_2\" class=\"control-label\">Age of Pet when obtained<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"number\" data-field=\"fld_8382301\" class=\" form-control\" id=\"fld_8382301_2\" name=\"fld_8382301\" value=\"\" data-type=\"number\" min=\"1\" max=\"30\" data-parsley-type=\"number\"   aria-labelledby=\"fld_8382301Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-4  last_col\"><div data-field-wrapper=\"fld_6831255\" class=\"form-group\" id=\"fld_6831255_2-wrap\">\r\n\t<label id=\"fld_6831255Label\" for=\"fld_6831255_2\" class=\"control-label\">Pet Weight <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_6831255\" class=\" form-control\" id=\"fld_6831255_2\" name=\"fld_6831255\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_6831255Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-11\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_1581542\" class=\"form-group\" id=\"fld_1581542_2-wrap\">\r\n\t<label id=\"fld_1581542Label\" for=\"fld_1581542_2\" class=\"control-label\">Where did you obtain this pet?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_1581542\" class=\" form-control\" id=\"fld_1581542_2\" name=\"fld_1581542\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_1581542Label\" aria-describedby=\"fld_1581542Caption\" >\t\t<span id=\"fld_1581542Caption\" class=\"help-block\">Breeder\/Friend\/Pet Shop\/Humane Society\/Other<\/span>\r\n\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-12\"  class=\"row \"><div  class=\"col-sm-4  first_col\"><div data-field-wrapper=\"fld_5240767\" class=\"form-group\" id=\"fld_5240767_2-wrap\">\r\n<label id=\"fld_5240767Label\" for=\"fld_5240767_2\" class=\"control-label\">Are you the 1st owner?<\/label>\r\n<div class=\"\">\r\n\t\t\t\t\t<div class=\"radio\">\n\t\t\t\t<label data-label=\"Yes\" for=\"fld_5240767_2_opt1413514\"><input type=\"radio\" id=\"fld_5240767_2_opt1413514\" data-field=\"fld_5240767\" class=\"fld_5240767_2\" name=\"fld_5240767\" value=\"Yes\"    data-radio-field=\"fld_5240767_2\" data-type=\"radio\" data-calc-value=\"Yes\" \/>\n\t\t\tYes\t\t<\/label>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"radio\">\n\t\t\t\t<label data-label=\"No\" for=\"fld_5240767_2_opt1762587\"><input type=\"radio\" id=\"fld_5240767_2_opt1762587\" data-field=\"fld_5240767\" class=\"fld_5240767_2\" name=\"fld_5240767\" value=\"No\"    data-radio-field=\"fld_5240767_2\" data-type=\"radio\" data-calc-value=\"No\" \/>\n\t\t\tNo\t\t<\/label>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-8  last_col\"><div data-field-wrapper=\"fld_4037007\" class=\"form-group\" id=\"fld_4037007_2-wrap\">\r\n\t<label id=\"fld_4037007Label\" for=\"fld_4037007_2\" class=\"control-label\">Describe previous home (If known):<\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_4037007\" value=\"\" data-field=\"fld_4037007\" class=\"form-control\" id=\"fld_4037007_2\" rows=\"3\"    aria-labelledby=\"fld_4037007Label\" ><\/textarea>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-13\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_9308706\" class=\"form-group\" id=\"fld_9308706_2-wrap\">\r\n\t<label id=\"fld_9308706Label\" for=\"fld_9308706_2\" class=\"control-label\">Please list other animals in your household<\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_9308706\" value=\"\" data-field=\"fld_9308706\" class=\"form-control\" id=\"fld_9308706_2\" rows=\"4\"    aria-labelledby=\"fld_9308706Label\" aria-describedby=\"fld_9308706Caption\" ><\/textarea>\n\t\t<span id=\"fld_9308706Caption\" class=\"help-block\">Please list the name, age, gender, and breed of all other animals living in your home.<\/span>\r\n\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_7557127\" class=\"form-group\" id=\"fld_7557127_2-wrap\">\r\n\t<label id=\"fld_7557127Label\" for=\"fld_7557127_2\" class=\"control-label\">Veterinary Clinic<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_7557127\" class=\" form-control\" id=\"fld_7557127_2\" name=\"fld_7557127\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_7557127Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-14\"  class=\"row \"><div  class=\"col-sm-3  first_col\"><div data-field-wrapper=\"fld_5063308\" class=\"form-group\" id=\"fld_5063308_2-wrap\">\r\n<div class=\"\">\r\n\t<input  class=\"btn btn-default cf-page-btn cf-page-btn-prev\" type=\"button\" name=\"fld_5063308\" id=\"fld_5063308_2\" value=\"Back\" data-field=\"fld_5063308\" data-page=\"prev\"  >\n<\/div>\r\n<\/div>\r\n\t<input class=\"button_trigger_2\" type=\"hidden\" name=\"fld_5063308\" id=\"fld_5063308_2_btn\" value=\"\" data-field=\"fld_5063308\"  \/>\n<\/div><div  class=\"col-sm-9 \"><div data-field-wrapper=\"fld_6625582\" class=\"form-group\" id=\"fld_6625582_2-wrap\">\r\n<div class=\"\">\r\n\t<input  class=\"btn btn-default cf-page-btn cf-page-btn-next\" type=\"button\" name=\"fld_6625582\" id=\"fld_6625582_2\" value=\"Next\" data-field=\"fld_6625582\" data-page=\"next\"  >\n<\/div>\r\n<\/div>\r\n\t<input class=\"button_trigger_2\" type=\"hidden\" name=\"fld_6625582\" id=\"fld_6625582_2_btn\" value=\"\" data-field=\"fld_6625582\"  \/>\n<\/div><\/div><\/div><div id=\"form_page_2_pg_3\" data-formpage=\"3\" role=\"region\" aria-labelledby=\"breadcrumb_2_pg_3\" aria-hidden=\"true\" class=\"caldera-form-page\" style=\"display:none;\"><div id=\"CF5bfddec14b5d7_2-row-15\"  class=\"row \"><div  class=\"col-sm-12  single\"><div class=\"\"><h3>Information about your behavior consultation<\/h3>\n<\/div><\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-16\"  class=\"row \"><div  class=\"col-sm-4  first_col\"><div data-field-wrapper=\"fld_184558\" class=\"form-group\" id=\"fld_184558_2-wrap\">\r\n\t<label id=\"fld_184558Label\" for=\"fld_184558_2\" class=\"control-label\">Do you prefer to meet at <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_184558_2_opt1686832\"\n                >\n                            <input\n                                data-parsley-required=\"true\" data-parsley-group=\"fld_184558_2\" data-parsley-multiple=\"fld_184558_2\"                                type=\"checkbox\"\n                                data-label=\"Our facility\"\n                                data-field=\"fld_184558\"\n                                id=\"fld_184558_2_opt1686832\"\n                                class=\"fld_184558_2 option-required\"\n                                name=\"fld_184558[opt1686832]\"\n                                value=\"Our facility\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_184558_2\"\n                                                                data-calc-value=\"Our facility\"\n                            >\n                    Our facility                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_184558_2_opt2073030\"\n                >\n                            <input\n                                data-parsley-required=\"true\" data-parsley-group=\"fld_184558_2\" data-parsley-multiple=\"fld_184558_2\"                                type=\"checkbox\"\n                                data-label=\"Your Home\"\n                                data-field=\"fld_184558\"\n                                id=\"fld_184558_2_opt2073030\"\n                                class=\"fld_184558_2 option-required\"\n                                name=\"fld_184558[opt2073030]\"\n                                value=\"Your Home\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_184558_2\"\n                                                                data-calc-value=\"Your Home\"\n                            >\n                    Your Home                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_184558_2_opt1365103\"\n                >\n                            <input\n                                data-parsley-required=\"true\" data-parsley-group=\"fld_184558_2\" data-parsley-multiple=\"fld_184558_2\"                                type=\"checkbox\"\n                                data-label=\"The Aggressive Dog Class\"\n                                data-field=\"fld_184558\"\n                                id=\"fld_184558_2_opt1365103\"\n                                class=\"fld_184558_2 option-required\"\n                                name=\"fld_184558[opt1365103]\"\n                                value=\"The Aggressive Dog Class\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_184558_2\"\n                                                                data-calc-value=\"The Aggressive Dog Class\"\n                            >\n                    The Aggressive Dog Class                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-8  last_col\"><div data-field-wrapper=\"fld_2348584\" class=\"form-group\" id=\"fld_2348584_2-wrap\">\r\n\t<label id=\"fld_2348584Label\" for=\"fld_2348584_2\" class=\"control-label\">Range of preferred days & times<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_2348584\" class=\" form-control\" id=\"fld_2348584_2\" name=\"fld_2348584\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_2348584Label\" aria-describedby=\"fld_2348584Caption\" >\t\t<span id=\"fld_2348584Caption\" class=\"help-block\">Your preferred time slot is not guaranteed, but we will do our best to accommodate your needs. Call us for the date of the next Aggressive Dog Class.<\/span>\r\n\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-17\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_3668799\" class=\"form-group\" id=\"fld_3668799_2-wrap\">\r\n\t<label id=\"fld_3668799Label\" for=\"fld_3668799_2\" class=\"control-label\">What is the primary problem that you are seeking help for? (briefly) <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_3668799\" class=\" form-control\" id=\"fld_3668799_2\" name=\"fld_3668799\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_3668799Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-18\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_3570802\" class=\"form-group\" id=\"fld_3570802_2-wrap\">\r\n\t<label id=\"fld_3570802Label\" for=\"fld_3570802_2\" class=\"control-label\">How would you describe the severity of the problem?<\/label>\r\n\t<div class=\"\">\r\n\t\t<div style=\"position: relative;\" class=\"row\">\n\t\t\t<div class=\"col-xs-8\" style=\"margin: 8px 0px;\">\t\t\t\t<input type=\"range\" name=\"fld_3570802\" value=\"0\" data-field=\"fld_3570802\" class=\"form-control\" id=\"fld_3570802_2\" data-handle=\"#ffffff\" min=\"0\" max=\"10\" step=\"1\"   >\n\t\t\t<\/div>\n\t\t\t<div class=\"col-xs-4\"><span id=\"fld_3570802_2_value\"><\/span><\/div>\t\t<\/div>\n\t\t<span id=\"fld_3570802Caption\" class=\"help-block\">1 = Mild \u2022 10 = Severe<\/span>\r\n\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_5358798\" class=\"form-group\" id=\"fld_5358798_2-wrap\">\r\n<label id=\"fld_5358798Label\" for=\"fld_5358798_2\" class=\"control-label\">Is euthanasia a possibility if this problem is not solved?<\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"No\" for=\"fld_5358798_2_opt1159905\"><input type=\"radio\" id=\"fld_5358798_2_opt1159905\" data-field=\"fld_5358798\" class=\"fld_5358798_2\" name=\"fld_5358798\" value=\"No\"    data-radio-field=\"fld_5358798_2\" data-type=\"radio\" data-calc-value=\"No\" \/>\n\t\t\tNo\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Yes\" for=\"fld_5358798_2_opt1905004\"><input type=\"radio\" id=\"fld_5358798_2_opt1905004\" data-field=\"fld_5358798\" class=\"fld_5358798_2\" name=\"fld_5358798\" value=\"Yes\"    data-radio-field=\"fld_5358798_2\" data-type=\"radio\" data-calc-value=\"Yes\" \/>\n\t\t\tYes\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Not Sure\" for=\"fld_5358798_2_opt1763209\"><input type=\"radio\" id=\"fld_5358798_2_opt1763209\" data-field=\"fld_5358798\" class=\"fld_5358798_2\" name=\"fld_5358798\" value=\"Not Sure\"    data-radio-field=\"fld_5358798_2\" data-type=\"radio\" data-calc-value=\"Not Sure\" \/>\n\t\t\tNot Sure\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-19\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_6691085\" class=\"form-group\" id=\"fld_6691085_2-wrap\">\r\n\t<label id=\"fld_6691085Label\" for=\"fld_6691085_2\" class=\"control-label\">Describe the problem, beginning with the most recent incident and going back through the last 3 incidents: <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_6691085\" value=\"\" data-field=\"fld_6691085\" class=\"form-control\" id=\"fld_6691085_2\" rows=\"4\"  required=\"required\"  aria-labelledby=\"fld_6691085Label\" ><\/textarea>\n\t\t\t<\/div>\r\n<\/div>\r\n<hr id=\"fld_431137_2\" class=\"\" style=\"width: 100%\" \/><div class=\"\"><p>How often has this occurred in the past...<\/p>\n<\/div><\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-20\"  class=\"row \"><div  class=\"col-sm-3  first_col\"><div data-field-wrapper=\"fld_3414936\" class=\"form-group\" id=\"fld_3414936_2-wrap\">\r\n\t<label id=\"fld_3414936Label\" for=\"fld_3414936_2\" class=\"control-label\">One Month?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"number\" data-field=\"fld_3414936\" class=\" form-control\" id=\"fld_3414936_2\" name=\"fld_3414936\" value=\"\" data-type=\"number\" data-parsley-type=\"number\"   aria-labelledby=\"fld_3414936Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3 \"><div data-field-wrapper=\"fld_5760815\" class=\"form-group\" id=\"fld_5760815_2-wrap\">\r\n\t<label id=\"fld_5760815Label\" for=\"fld_5760815_2\" class=\"control-label\">Three Months?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"number\" data-field=\"fld_5760815\" class=\" form-control\" id=\"fld_5760815_2\" name=\"fld_5760815\" value=\"\" data-type=\"number\" data-parsley-type=\"number\"   aria-labelledby=\"fld_5760815Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3 \"><div data-field-wrapper=\"fld_9625659\" class=\"form-group\" id=\"fld_9625659_2-wrap\">\r\n\t<label id=\"fld_9625659Label\" for=\"fld_9625659_2\" class=\"control-label\">One Year?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"number\" data-field=\"fld_9625659\" class=\" form-control\" id=\"fld_9625659_2\" name=\"fld_9625659\" value=\"\" data-type=\"number\" data-parsley-type=\"number\"   aria-labelledby=\"fld_9625659Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3  last_col\"><div data-field-wrapper=\"fld_83238\" class=\"form-group\" id=\"fld_83238_2-wrap\">\r\n\t<label id=\"fld_83238Label\" for=\"fld_83238_2\" class=\"control-label\">Total Times?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"number\" data-field=\"fld_83238\" class=\" form-control\" id=\"fld_83238_2\" name=\"fld_83238\" value=\"\" data-type=\"number\" data-parsley-type=\"number\"   aria-labelledby=\"fld_83238Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-21\"  class=\"row \"><div  class=\"col-sm-9  first_col\"><div data-field-wrapper=\"fld_3409271\" class=\"form-group\" id=\"fld_3409271_2-wrap\">\r\n\t<label id=\"fld_3409271Label\" for=\"fld_3409271_2\" class=\"control-label\">Describe any change in frequency or severity?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_3409271\" class=\" form-control\" id=\"fld_3409271_2\" name=\"fld_3409271\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_3409271Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3  last_col\"><div data-field-wrapper=\"fld_3368265\" class=\"form-group\" id=\"fld_3368265_2-wrap\">\r\n\t<label id=\"fld_3368265Label\" for=\"fld_3368265_2\" class=\"control-label\">Pet's age when problem started:<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"number\" data-field=\"fld_3368265\" class=\" form-control\" id=\"fld_3368265_2\" name=\"fld_3368265\" value=\"\" data-type=\"number\" max=\"35\" data-parsley-type=\"number\"   aria-labelledby=\"fld_3368265Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-22\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_6238863\" class=\"form-group\" id=\"fld_6238863_2-wrap\">\r\n\t<label id=\"fld_6238863Label\" for=\"fld_6238863_2\" class=\"control-label\">Briefly describe any household changes when the problem first appeared:<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_6238863\" class=\" form-control\" id=\"fld_6238863_2\" name=\"fld_6238863\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_6238863Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_4693260\" class=\"form-group\" id=\"fld_4693260_2-wrap\">\r\n\t<label id=\"fld_4693260Label\" for=\"fld_4693260_2\" class=\"control-label\">Describe what has been done so far to try to correct the problem:<\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_4693260\" value=\"\" data-field=\"fld_4693260\" class=\"form-control\" id=\"fld_4693260_2\" rows=\"4\"    aria-labelledby=\"fld_4693260Label\" aria-describedby=\"fld_4693260Caption\" ><\/textarea>\n\t\t<span id=\"fld_4693260Caption\" class=\"help-block\">For each give: 1) What was tried, 2) How long tried, 3) Dog's response<\/span>\r\n\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-23\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_9617336\" class=\"form-group\" id=\"fld_9617336_2-wrap\">\r\n\t<label id=\"fld_9617336Label\" for=\"fld_9617336_2\" class=\"control-label\">Which if any of the techniques have had any success?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_9617336\" class=\" form-control\" id=\"fld_9617336_2\" name=\"fld_9617336\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_9617336Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_4651929\" class=\"form-group\" id=\"fld_4651929_2-wrap\">\r\n\t<label id=\"fld_4651929Label\" for=\"fld_4651929_2\" class=\"control-label\">Which if any of the techniques have made the problem worse?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_4651929\" class=\" form-control\" id=\"fld_4651929_2\" name=\"fld_4651929\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_4651929Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-24\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_829210\" class=\"form-group\" id=\"fld_829210_2-wrap\">\r\n\t<label id=\"fld_829210Label\" for=\"fld_829210_2\" class=\"control-label\">What do you think is the reason for your dog's problem?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_829210\" class=\" form-control\" id=\"fld_829210_2\" name=\"fld_829210\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_829210Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-25\"  class=\"row \"><div  class=\"col-sm-3  first_col\"><div data-field-wrapper=\"fld_9820534\" class=\"form-group\" id=\"fld_9820534_2-wrap\">\r\n<label id=\"fld_9820534Label\" for=\"fld_9820534_2\" class=\"control-label\">Have your received any advice about this problem?<\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Yes\" for=\"fld_9820534_2_opt1519923\"><input type=\"radio\" id=\"fld_9820534_2_opt1519923\" data-field=\"fld_9820534\" class=\"fld_9820534_2\" name=\"fld_9820534\" value=\"Yes\"    data-radio-field=\"fld_9820534_2\" data-type=\"radio\" data-calc-value=\"Yes\" \/>\n\t\t\tYes\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"No\" for=\"fld_9820534_2_opt1534955\"><input type=\"radio\" id=\"fld_9820534_2_opt1534955\" data-field=\"fld_9820534\" class=\"fld_9820534_2\" name=\"fld_9820534\" value=\"No\"    data-radio-field=\"fld_9820534_2\" data-type=\"radio\" data-calc-value=\"No\" \/>\n\t\t\tNo\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-9  last_col\"><div data-field-wrapper=\"fld_8180230\" class=\"form-group\" id=\"fld_8180230_2-wrap\">\r\n\t<label id=\"fld_8180230Label\" for=\"fld_8180230_2\" class=\"control-label\">Include any additional comments about the principal problem:<\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_8180230\" value=\"\" data-field=\"fld_8180230\" class=\"form-control\" id=\"fld_8180230_2\" rows=\"3\"    aria-labelledby=\"fld_8180230Label\" ><\/textarea>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-26\"  class=\"row \"><div  class=\"col-sm-4  first_col\"><div data-field-wrapper=\"fld_7214341\" class=\"form-group\" id=\"fld_7214341_2-wrap\">\r\n<div class=\"\">\r\n\t<input  class=\"btn btn-default cf-page-btn cf-page-btn-prev\" type=\"button\" name=\"fld_7214341\" id=\"fld_7214341_2\" value=\"Back\" data-field=\"fld_7214341\" data-page=\"prev\"  >\n<\/div>\r\n<\/div>\r\n\t<input class=\"button_trigger_2\" type=\"hidden\" name=\"fld_7214341\" id=\"fld_7214341_2_btn\" value=\"\" data-field=\"fld_7214341\"  \/>\n<\/div><div  class=\"col-sm-8 \"><div data-field-wrapper=\"fld_2077912\" class=\"form-group\" id=\"fld_2077912_2-wrap\">\r\n<div class=\"\">\r\n\t<input  class=\"btn btn-default cf-page-btn cf-page-btn-next\" type=\"button\" name=\"fld_2077912\" id=\"fld_2077912_2\" value=\"Next\" data-field=\"fld_2077912\" data-page=\"next\"  >\n<\/div>\r\n<\/div>\r\n\t<input class=\"button_trigger_2\" type=\"hidden\" name=\"fld_2077912\" id=\"fld_2077912_2_btn\" value=\"\" data-field=\"fld_2077912\"  \/>\n<\/div><\/div><\/div><div id=\"form_page_2_pg_4\" data-formpage=\"4\" role=\"region\" aria-labelledby=\"breadcrumb_2_pg_4\" aria-hidden=\"true\" class=\"caldera-form-page\" style=\"display:none;\"><div id=\"CF5bfddec14b5d7_2-row-27\"  class=\"row \"><div  class=\"col-sm-12  single\"><div class=\"\"><h3>Environment\/Lifestyle<\/h3>\n<\/div><\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-28\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_6908570\" class=\"form-group\" id=\"fld_6908570_2-wrap\">\r\n\t<label id=\"fld_6908570Label\" for=\"fld_6908570_2\" class=\"control-label\">For what purpose was this pet obtained? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_6908570\" class=\" form-control\" id=\"fld_6908570_2\" name=\"fld_6908570\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_6908570Label\" aria-describedby=\"fld_6908570Caption\" >\t\t<span id=\"fld_6908570Caption\" class=\"help-block\">Companion\/Protection\/Show\/Other-Explain<\/span>\r\n\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-29\"  class=\"row \"><div  class=\"col-sm-4  first_col\"><div data-field-wrapper=\"fld_756487\" class=\"form-group\" id=\"fld_756487_2-wrap\">\r\n\t<label id=\"fld_756487Label\" for=\"fld_756487_2\" class=\"control-label\">When is the pet fed? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_756487\" class=\" form-control\" id=\"fld_756487_2\" name=\"fld_756487\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_756487Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-4 \"><div data-field-wrapper=\"fld_1304529\" class=\"form-group\" id=\"fld_1304529_2-wrap\">\r\n\t<label id=\"fld_1304529Label\" for=\"fld_1304529_2\" class=\"control-label\">Who feeds pet? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_1304529\" class=\" form-control\" id=\"fld_1304529_2\" name=\"fld_1304529\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_1304529Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-4  last_col\"><div data-field-wrapper=\"fld_9836377\" class=\"form-group\" id=\"fld_9836377_2-wrap\">\r\n\t<label id=\"fld_9836377Label\" for=\"fld_9836377_2\" class=\"control-label\">Feeding location: <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_9836377\" class=\" form-control\" id=\"fld_9836377_2\" name=\"fld_9836377\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_9836377Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-30\"  class=\"row \"><div  class=\"col-sm-8  first_col\"><div data-field-wrapper=\"fld_9916578\" class=\"form-group\" id=\"fld_9916578_2-wrap\">\r\n\t<label id=\"fld_9916578Label\" for=\"fld_9916578_2\" class=\"control-label\">Favorite treat:<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_9916578\" class=\" form-control\" id=\"fld_9916578_2\" name=\"fld_9916578\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_9916578Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-4  last_col\"><div data-field-wrapper=\"fld_7962604\" class=\"form-group\" id=\"fld_7962604_2-wrap\">\r\n\t<label id=\"fld_7962604Label\" for=\"fld_7962604_2\" class=\"control-label\">Desire for treat:<\/label>\r\n\t<div class=\"\">\r\n\t\t<div style=\"position: relative;\" class=\"row\">\n\t\t\t<div class=\"col-xs-8\" style=\"margin: 8px 0px;\">\t\t\t\t<input type=\"range\" name=\"fld_7962604\" value=\"0\" data-field=\"fld_7962604\" class=\"form-control\" id=\"fld_7962604_2\" data-handle=\"#ffffff\" min=\"0\" max=\"10\" step=\"1\"   >\n\t\t\t<\/div>\n\t\t\t<div class=\"col-xs-4\"><span id=\"fld_7962604_2_value\"><\/span><\/div>\t\t<\/div>\n\t\t<span id=\"fld_7962604Caption\" class=\"help-block\">1 = Mild \u2022\u00a010 = Strong<\/span>\r\n\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-31\"  class=\"row \"><div  class=\"col-sm-12  single\"><div class=\"\"><p>List below household members, ages if under 18, brief schedule, and how the dog gets along with each:<\/p>\n<\/div><\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-32\"  class=\"row \"><div  class=\"col-sm-3  first_col\"><div data-field-wrapper=\"fld_7350451\" class=\"form-group\" id=\"fld_7350451_2-wrap\">\r\n\t<label id=\"fld_7350451Label\" for=\"fld_7350451_2\" class=\"control-label\">HH Member name:<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_7350451\" class=\" form-control\" id=\"fld_7350451_2\" name=\"fld_7350451\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_7350451Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_9975186\" class=\"form-group\" id=\"fld_9975186_2-wrap\">\r\n\t<label id=\"fld_9975186Label\" for=\"fld_9975186_2\" class=\"control-label\">HH Member name:<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_9975186\" class=\" form-control\" id=\"fld_9975186_2\" name=\"fld_9975186\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_9975186Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_1163863\" class=\"form-group\" id=\"fld_1163863_2-wrap\">\r\n\t<label id=\"fld_1163863Label\" for=\"fld_1163863_2\" class=\"control-label\">HH Member name:<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_1163863\" class=\" form-control\" id=\"fld_1163863_2\" name=\"fld_1163863\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_1163863Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_211442\" class=\"form-group\" id=\"fld_211442_2-wrap\">\r\n\t<label id=\"fld_211442Label\" for=\"fld_211442_2\" class=\"control-label\">HH Member name:<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_211442\" class=\" form-control\" id=\"fld_211442_2\" name=\"fld_211442\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_211442Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3 \"><div data-field-wrapper=\"fld_3559744\" class=\"form-group\" id=\"fld_3559744_2-wrap\">\r\n\t<label id=\"fld_3559744Label\" for=\"fld_3559744_2\" class=\"control-label\">Age (if under 18)<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"number\" data-field=\"fld_3559744\" class=\" form-control\" id=\"fld_3559744_2\" name=\"fld_3559744\" value=\"\" data-type=\"number\" data-parsley-type=\"number\"   aria-labelledby=\"fld_3559744Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_7244097\" class=\"form-group\" id=\"fld_7244097_2-wrap\">\r\n\t<label id=\"fld_7244097Label\" for=\"fld_7244097_2\" class=\"control-label\">Age (if under 18)<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"number\" data-field=\"fld_7244097\" class=\" form-control\" id=\"fld_7244097_2\" name=\"fld_7244097\" value=\"\" data-type=\"number\" data-parsley-type=\"number\"   aria-labelledby=\"fld_7244097Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_1994150\" class=\"form-group\" id=\"fld_1994150_2-wrap\">\r\n\t<label id=\"fld_1994150Label\" for=\"fld_1994150_2\" class=\"control-label\">Age (if under 18)<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"number\" data-field=\"fld_1994150\" class=\" form-control\" id=\"fld_1994150_2\" name=\"fld_1994150\" value=\"\" data-type=\"number\" data-parsley-type=\"number\"   aria-labelledby=\"fld_1994150Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_5976402\" class=\"form-group\" id=\"fld_5976402_2-wrap\">\r\n\t<label id=\"fld_5976402Label\" for=\"fld_5976402_2\" class=\"control-label\">Age (if under 18)<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"number\" data-field=\"fld_5976402\" class=\" form-control\" id=\"fld_5976402_2\" name=\"fld_5976402\" value=\"\" data-type=\"number\" data-parsley-type=\"number\"   aria-labelledby=\"fld_5976402Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3 \"><div data-field-wrapper=\"fld_2176779\" class=\"form-group\" id=\"fld_2176779_2-wrap\">\r\n\t<label id=\"fld_2176779Label\" for=\"fld_2176779_2\" class=\"control-label\">Work or school schedule<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_2176779\" class=\" form-control\" id=\"fld_2176779_2\" name=\"fld_2176779\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_2176779Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_5942121\" class=\"form-group\" id=\"fld_5942121_2-wrap\">\r\n\t<label id=\"fld_5942121Label\" for=\"fld_5942121_2\" class=\"control-label\">Work or school schedule<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_5942121\" class=\" form-control\" id=\"fld_5942121_2\" name=\"fld_5942121\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_5942121Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_1049519\" class=\"form-group\" id=\"fld_1049519_2-wrap\">\r\n\t<label id=\"fld_1049519Label\" for=\"fld_1049519_2\" class=\"control-label\">Work or school schedule<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_1049519\" class=\" form-control\" id=\"fld_1049519_2\" name=\"fld_1049519\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_1049519Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_7326783\" class=\"form-group\" id=\"fld_7326783_2-wrap\">\r\n\t<label id=\"fld_7326783Label\" for=\"fld_7326783_2\" class=\"control-label\">Work or school schedule<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_7326783\" class=\" form-control\" id=\"fld_7326783_2\" name=\"fld_7326783\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_7326783Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3  last_col\"><div data-field-wrapper=\"fld_522738\" class=\"form-group\" id=\"fld_522738_2-wrap\">\r\n\t<label id=\"fld_522738Label\" for=\"fld_522738_2\" class=\"control-label\">Relationship with dog<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_522738\" class=\" form-control\" id=\"fld_522738_2\" name=\"fld_522738\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_522738Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_9185759\" class=\"form-group\" id=\"fld_9185759_2-wrap\">\r\n\t<label id=\"fld_9185759Label\" for=\"fld_9185759_2\" class=\"control-label\">Relationship with dog<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_9185759\" class=\" form-control\" id=\"fld_9185759_2\" name=\"fld_9185759\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_9185759Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_6517154\" class=\"form-group\" id=\"fld_6517154_2-wrap\">\r\n\t<label id=\"fld_6517154Label\" for=\"fld_6517154_2\" class=\"control-label\">Relationship with dog<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_6517154\" class=\" form-control\" id=\"fld_6517154_2\" name=\"fld_6517154\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_6517154Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_9763433\" class=\"form-group\" id=\"fld_9763433_2-wrap\">\r\n\t<label id=\"fld_9763433Label\" for=\"fld_9763433_2\" class=\"control-label\">Relationship with dog<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_9763433\" class=\" form-control\" id=\"fld_9763433_2\" name=\"fld_9763433\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_9763433Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-33\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_5584482\" class=\"form-group\" id=\"fld_5584482_2-wrap\">\r\n\t<label id=\"fld_5584482Label\" for=\"fld_5584482_2\" class=\"control-label\">Amount and frequency of exercise\/play: <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_5584482\" value=\"\" data-field=\"fld_5584482\" class=\"form-control\" id=\"fld_5584482_2\" rows=\"4\"  required=\"required\"  aria-labelledby=\"fld_5584482Label\" aria-describedby=\"fld_5584482Caption\" ><\/textarea>\n\t\t<span id=\"fld_5584482Caption\" class=\"help-block\">Exercise type, Times per week, Length of session, By whom<\/span>\r\n\t<\/div>\r\n<\/div>\r\n<div class=\"\"><p>Describe where your dog stays (i.e. in the house or in the yard) and how the dog is confined (i.e. crate, tie-out, kennel, unconfined) at each of the following times:<\/p>\n<\/div><div data-field-wrapper=\"fld_597260\" class=\"form-group\" id=\"fld_597260_2-wrap\">\r\n\t<label id=\"fld_597260Label\" for=\"fld_597260_2\" class=\"control-label\">When owner is home: <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_597260\" class=\" form-control\" id=\"fld_597260_2\" name=\"fld_597260\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_597260Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_7913185\" class=\"form-group\" id=\"fld_7913185_2-wrap\">\r\n\t<label id=\"fld_7913185Label\" for=\"fld_7913185_2\" class=\"control-label\">When owner is away: <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_7913185\" class=\" form-control\" id=\"fld_7913185_2\" name=\"fld_7913185\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_7913185Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_8287549\" class=\"form-group\" id=\"fld_8287549_2-wrap\">\r\n\t<label id=\"fld_8287549Label\" for=\"fld_8287549_2\" class=\"control-label\">At night: <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_8287549\" class=\" form-control\" id=\"fld_8287549_2\" name=\"fld_8287549\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_8287549Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_7894593\" class=\"form-group\" id=\"fld_7894593_2-wrap\">\r\n\t<label id=\"fld_7894593Label\" for=\"fld_7894593_2\" class=\"control-label\">When guests visit: <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_7894593\" class=\" form-control\" id=\"fld_7894593_2\" name=\"fld_7894593\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_7894593Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_5994417\" class=\"form-group\" id=\"fld_5994417_2-wrap\">\r\n\t<label id=\"fld_5994417Label\" for=\"fld_5994417_2\" class=\"control-label\">How long is dog home alone on average day? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_5994417\" class=\" form-control\" id=\"fld_5994417_2\" name=\"fld_5994417\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_5994417Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-34\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_3960545\" class=\"form-group\" id=\"fld_3960545_2-wrap\">\r\n\t<label id=\"fld_3960545Label\" for=\"fld_3960545_2\" class=\"control-label\">Problems when left alone:<\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_3960545_2_opt1996714\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Barks\"\n                                data-field=\"fld_3960545\"\n                                id=\"fld_3960545_2_opt1996714\"\n                                class=\"fld_3960545_2\"\n                                name=\"fld_3960545[opt1996714]\"\n                                value=\"Barks\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_3960545_2\"\n                                                                data-calc-value=\"Barks\"\n                            >\n                    Barks                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_3960545_2_opt1373358\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Destructive\"\n                                data-field=\"fld_3960545\"\n                                id=\"fld_3960545_2_opt1373358\"\n                                class=\"fld_3960545_2\"\n                                name=\"fld_3960545[opt1373358]\"\n                                value=\"Destructive\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_3960545_2\"\n                                                                data-calc-value=\"Destructive\"\n                            >\n                    Destructive                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_3960545_2_opt1569938\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"House soiling\"\n                                data-field=\"fld_3960545\"\n                                id=\"fld_3960545_2_opt1569938\"\n                                class=\"fld_3960545_2\"\n                                name=\"fld_3960545[opt1569938]\"\n                                value=\"House soiling\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_3960545_2\"\n                                                                data-calc-value=\"House soiling\"\n                            >\n                    House soiling                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_3960545_2_opt1441913\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"other\"\n                                data-field=\"fld_3960545\"\n                                id=\"fld_3960545_2_opt1441913\"\n                                class=\"fld_3960545_2\"\n                                name=\"fld_3960545[opt1441913]\"\n                                value=\"other\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_3960545_2\"\n                                                                data-calc-value=\"other\"\n                            >\n                    other                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_11979\" class=\"form-group\" id=\"fld_11979_2-wrap\">\r\n\t<label id=\"fld_11979Label\" for=\"fld_11979_2\" class=\"control-label\">Reaction before departure:<\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_11979_2_opt1996714\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Unconcerned\"\n                                data-field=\"fld_11979\"\n                                id=\"fld_11979_2_opt1996714\"\n                                class=\"fld_11979_2\"\n                                name=\"fld_11979[opt1996714]\"\n                                value=\"Unconcerned\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_11979_2\"\n                                                                data-calc-value=\"Unconcerned\"\n                            >\n                    Unconcerned                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_11979_2_opt1373358\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Disappointed\"\n                                data-field=\"fld_11979\"\n                                id=\"fld_11979_2_opt1373358\"\n                                class=\"fld_11979_2\"\n                                name=\"fld_11979[opt1373358]\"\n                                value=\"Disappointed\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_11979_2\"\n                                                                data-calc-value=\"Disappointed\"\n                            >\n                    Disappointed                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_11979_2_opt1569938\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Nervous\/anxious\"\n                                data-field=\"fld_11979\"\n                                id=\"fld_11979_2_opt1569938\"\n                                class=\"fld_11979_2\"\n                                name=\"fld_11979[opt1569938]\"\n                                value=\"Nervous\/anxious\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_11979_2\"\n                                                                data-calc-value=\"Nervous\/anxious\"\n                            >\n                    Nervous\/anxious                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_11979_2_opt1441913\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Frantic\"\n                                data-field=\"fld_11979\"\n                                id=\"fld_11979_2_opt1441913\"\n                                class=\"fld_11979_2\"\n                                name=\"fld_11979[opt1441913]\"\n                                value=\"Frantic\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_11979_2\"\n                                                                data-calc-value=\"Frantic\"\n                            >\n                    Frantic                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_11979_2_opt2000557\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Other\"\n                                data-field=\"fld_11979\"\n                                id=\"fld_11979_2_opt2000557\"\n                                class=\"fld_11979_2\"\n                                name=\"fld_11979[opt2000557]\"\n                                value=\"Other\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_11979_2\"\n                                                                data-calc-value=\"Other\"\n                            >\n                    Other                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-35\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_1358608\" class=\"form-group\" id=\"fld_1358608_2-wrap\">\r\n<div class=\"\">\r\n\t<input  class=\"btn btn-default cf-page-btn cf-page-btn-prev\" type=\"button\" name=\"fld_1358608\" id=\"fld_1358608_2\" value=\"Previous\" data-field=\"fld_1358608\" data-page=\"prev\"  >\n<\/div>\r\n<\/div>\r\n\t<input class=\"button_trigger_2\" type=\"hidden\" name=\"fld_1358608\" id=\"fld_1358608_2_btn\" value=\"\" data-field=\"fld_1358608\"  \/>\n<\/div><div  class=\"col-sm-6 \"><div data-field-wrapper=\"fld_182589\" class=\"form-group\" id=\"fld_182589_2-wrap\">\r\n<div class=\"\">\r\n\t<input  class=\"btn btn-default cf-page-btn cf-page-btn-next\" type=\"button\" name=\"fld_182589\" id=\"fld_182589_2\" value=\"Next\" data-field=\"fld_182589\" data-page=\"next\"  >\n<\/div>\r\n<\/div>\r\n\t<input class=\"button_trigger_2\" type=\"hidden\" name=\"fld_182589\" id=\"fld_182589_2_btn\" value=\"\" data-field=\"fld_182589\"  \/>\n<\/div><\/div><\/div><div id=\"form_page_2_pg_5\" data-formpage=\"5\" role=\"region\" aria-labelledby=\"breadcrumb_2_pg_5\" aria-hidden=\"true\" class=\"caldera-form-page\" style=\"display:none;\"><div id=\"CF5bfddec14b5d7_2-row-36\"  class=\"row \"><div  class=\"col-sm-12  single\"><div class=\"\"><h3>Previous Training<\/h3>\n<\/div><\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-37\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_2058101\" class=\"form-group\" id=\"fld_2058101_2-wrap\">\r\n\t<label id=\"fld_2058101Label\" for=\"fld_2058101_2\" class=\"control-label\">Describe any obedience training: <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_2058101_2_opt1985398\"\n                >\n                            <input\n                                data-parsley-required=\"true\" data-parsley-group=\"fld_2058101_2\" data-parsley-multiple=\"fld_2058101_2\"                                type=\"checkbox\"\n                                data-label=\"None\"\n                                data-field=\"fld_2058101\"\n                                id=\"fld_2058101_2_opt1985398\"\n                                class=\"fld_2058101_2 option-required\"\n                                name=\"fld_2058101[opt1985398]\"\n                                value=\"None\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_2058101_2\"\n                                                                data-calc-value=\"None\"\n                            >\n                    None                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_2058101_2_opt1232459\"\n                >\n                            <input\n                                data-parsley-required=\"true\" data-parsley-group=\"fld_2058101_2\" data-parsley-multiple=\"fld_2058101_2\"                                type=\"checkbox\"\n                                data-label=\"Group lessons\"\n                                data-field=\"fld_2058101\"\n                                id=\"fld_2058101_2_opt1232459\"\n                                class=\"fld_2058101_2 option-required\"\n                                name=\"fld_2058101[opt1232459]\"\n                                value=\"Group lessons\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_2058101_2\"\n                                                                data-calc-value=\"Group lessons\"\n                            >\n                    Group lessons                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_2058101_2_opt1534943\"\n                >\n                            <input\n                                data-parsley-required=\"true\" data-parsley-group=\"fld_2058101_2\" data-parsley-multiple=\"fld_2058101_2\"                                type=\"checkbox\"\n                                data-label=\"Private training\"\n                                data-field=\"fld_2058101\"\n                                id=\"fld_2058101_2_opt1534943\"\n                                class=\"fld_2058101_2 option-required\"\n                                name=\"fld_2058101[opt1534943]\"\n                                value=\"Private training\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_2058101_2\"\n                                                                data-calc-value=\"Private training\"\n                            >\n                    Private training                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_2058101_2_opt1232655\"\n                >\n                            <input\n                                data-parsley-required=\"true\" data-parsley-group=\"fld_2058101_2\" data-parsley-multiple=\"fld_2058101_2\"                                type=\"checkbox\"\n                                data-label=\"Other\"\n                                data-field=\"fld_2058101\"\n                                id=\"fld_2058101_2_opt1232655\"\n                                class=\"fld_2058101_2 option-required\"\n                                name=\"fld_2058101[opt1232655]\"\n                                value=\"Other\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_2058101_2\"\n                                                                data-calc-value=\"Other\"\n                            >\n                    Other                <\/label>\n\n                \t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_1730779\" class=\"form-group\" id=\"fld_1730779_2-wrap\">\r\n<label id=\"fld_1730779Label\" for=\"fld_1730779_2\" class=\"control-label\">Are you working with a particular trainer, and if so, please pick which one. <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Angie\" for=\"fld_1730779_2_opt1603655\"><input type=\"radio\" id=\"fld_1730779_2_opt1603655\" data-field=\"fld_1730779\" class=\"fld_1730779_2 option-required\" name=\"fld_1730779\" value=\"Angie\"   required=\"required\" data-radio-field=\"fld_1730779_2\" data-type=\"radio\" data-calc-value=\"Angie\" \/>\n\t\t\tAngie\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Jeri Lynn\" for=\"fld_1730779_2_opt1150846\"><input type=\"radio\" id=\"fld_1730779_2_opt1150846\" data-field=\"fld_1730779\" class=\"fld_1730779_2 option-required\" name=\"fld_1730779\" value=\"Jeri Lynn\"   required=\"required\" data-radio-field=\"fld_1730779_2\" data-type=\"radio\" data-calc-value=\"Jeri Lynn\" \/>\n\t\t\tJeri Lynn\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Joy\" for=\"fld_1730779_2_opt1526492\"><input type=\"radio\" id=\"fld_1730779_2_opt1526492\" data-field=\"fld_1730779\" class=\"fld_1730779_2 option-required\" name=\"fld_1730779\" value=\"Joy\"   required=\"required\" data-radio-field=\"fld_1730779_2\" data-type=\"radio\" data-calc-value=\"Joy\" \/>\n\t\t\tJoy\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Sam\" for=\"fld_1730779_2_opt1895314\"><input type=\"radio\" id=\"fld_1730779_2_opt1895314\" data-field=\"fld_1730779\" class=\"fld_1730779_2 option-required\" name=\"fld_1730779\" value=\"Sam\"   required=\"required\" data-radio-field=\"fld_1730779_2\" data-type=\"radio\" data-calc-value=\"Sam\" \/>\n\t\t\tSam\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"I have not started working with a Positive approach dog trainer.\" for=\"fld_1730779_2_opt1925520\"><input type=\"radio\" id=\"fld_1730779_2_opt1925520\" data-field=\"fld_1730779\" class=\"fld_1730779_2 option-required\" name=\"fld_1730779\" value=\"I have not started working with a Positive approach dog trainer.\"   required=\"required\" data-radio-field=\"fld_1730779_2\" data-type=\"radio\" data-calc-value=\"I have not started working with a Positive approach dog trainer.\" \/>\n\t\t\tI have not started working with a Positive approach dog trainer.\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-38\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_3775659\" class=\"form-group\" id=\"fld_3775659_2-wrap\">\r\n\t<label id=\"fld_3775659Label\" for=\"fld_3775659_2\" class=\"control-label\">Training at what age?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"number\" data-field=\"fld_3775659\" class=\" form-control\" id=\"fld_3775659_2\" name=\"fld_3775659\" value=\"\" data-type=\"number\" min=\"1\" max=\"35\" data-parsley-type=\"number\"   aria-labelledby=\"fld_3775659Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_5410948\" class=\"form-group\" id=\"fld_5410948_2-wrap\">\r\n\t<label id=\"fld_5410948Label\" for=\"fld_5410948_2\" class=\"control-label\">With which family member?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_5410948\" class=\" form-control\" id=\"fld_5410948_2\" name=\"fld_5410948\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_5410948Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-39\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_1807221\" class=\"form-group\" id=\"fld_1807221_2-wrap\">\r\n<label id=\"fld_1807221Label\" for=\"fld_1807221_2\" class=\"control-label\">Success of training:<\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Excellent\" for=\"fld_1807221_2_opt1149311\"><input type=\"radio\" id=\"fld_1807221_2_opt1149311\" data-field=\"fld_1807221\" class=\"fld_1807221_2\" name=\"fld_1807221\" value=\"Excellent\"    data-radio-field=\"fld_1807221_2\" data-type=\"radio\" data-calc-value=\"Excellent\" \/>\n\t\t\tExcellent\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Good\" for=\"fld_1807221_2_opt1979038\"><input type=\"radio\" id=\"fld_1807221_2_opt1979038\" data-field=\"fld_1807221\" class=\"fld_1807221_2\" name=\"fld_1807221\" value=\"Good\"    data-radio-field=\"fld_1807221_2\" data-type=\"radio\" data-calc-value=\"Good\" \/>\n\t\t\tGood\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Fair\" for=\"fld_1807221_2_opt1789434\"><input type=\"radio\" id=\"fld_1807221_2_opt1789434\" data-field=\"fld_1807221\" class=\"fld_1807221_2\" name=\"fld_1807221\" value=\"Fair\"    data-radio-field=\"fld_1807221_2\" data-type=\"radio\" data-calc-value=\"Fair\" \/>\n\t\t\tFair\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Failed\" for=\"fld_1807221_2_opt1548002\"><input type=\"radio\" id=\"fld_1807221_2_opt1548002\" data-field=\"fld_1807221\" class=\"fld_1807221_2\" name=\"fld_1807221\" value=\"Failed\"    data-radio-field=\"fld_1807221_2\" data-type=\"radio\" data-calc-value=\"Failed\" \/>\n\t\t\tFailed\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Did not complete\" for=\"fld_1807221_2_opt1552132\"><input type=\"radio\" id=\"fld_1807221_2_opt1552132\" data-field=\"fld_1807221\" class=\"fld_1807221_2\" name=\"fld_1807221\" value=\"Did not complete\"    data-radio-field=\"fld_1807221_2\" data-type=\"radio\" data-calc-value=\"Did not complete\" \/>\n\t\t\tDid not complete\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-40\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_8300330\" class=\"form-group\" id=\"fld_8300330_2-wrap\">\r\n\t<label id=\"fld_8300330Label\" for=\"fld_8300330_2\" class=\"control-label\">Which commands work best?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_8300330\" class=\" form-control\" id=\"fld_8300330_2\" name=\"fld_8300330\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_8300330Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_3139534\" class=\"form-group\" id=\"fld_3139534_2-wrap\">\r\n\t<label id=\"fld_3139534Label\" for=\"fld_3139534_2\" class=\"control-label\">Which family members have most control?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_3139534\" class=\" form-control\" id=\"fld_3139534_2\" name=\"fld_3139534\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_3139534Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_7730614\" class=\"form-group\" id=\"fld_7730614_2-wrap\">\r\n\t<label id=\"fld_7730614Label\" for=\"fld_7730614_2\" class=\"control-label\">Which commands work poorly?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_7730614\" class=\" form-control\" id=\"fld_7730614_2\" name=\"fld_7730614\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_7730614Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_5786187\" class=\"form-group\" id=\"fld_5786187_2-wrap\">\r\n\t<label id=\"fld_5786187Label\" for=\"fld_5786187_2\" class=\"control-label\">Which family members have least control?<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_5786187\" class=\" form-control\" id=\"fld_5786187_2\" name=\"fld_5786187\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_5786187Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-41\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_2976826\" class=\"form-group\" id=\"fld_2976826_2-wrap\">\r\n<label id=\"fld_2976826Label\" for=\"fld_2976826_2\" class=\"control-label\">Describe your dog's learning ability:<\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Fast\" for=\"fld_2976826_2_opt1714434\"><input type=\"radio\" id=\"fld_2976826_2_opt1714434\" data-field=\"fld_2976826\" class=\"fld_2976826_2\" name=\"fld_2976826\" value=\"Fast\"    data-radio-field=\"fld_2976826_2\" data-type=\"radio\" data-calc-value=\"Fast\" \/>\n\t\t\tFast\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Slow\" for=\"fld_2976826_2_opt1352378\"><input type=\"radio\" id=\"fld_2976826_2_opt1352378\" data-field=\"fld_2976826\" class=\"fld_2976826_2\" name=\"fld_2976826\" value=\"Slow\"    data-radio-field=\"fld_2976826_2\" data-type=\"radio\" data-calc-value=\"Slow\" \/>\n\t\t\tSlow\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Easily distracted\" for=\"fld_2976826_2_opt1170099\"><input type=\"radio\" id=\"fld_2976826_2_opt1170099\" data-field=\"fld_2976826\" class=\"fld_2976826_2\" name=\"fld_2976826\" value=\"Easily distracted\"    data-radio-field=\"fld_2976826_2\" data-type=\"radio\" data-calc-value=\"Easily distracted\" \/>\n\t\t\tEasily distracted\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Other\" for=\"fld_2976826_2_opt1351947\"><input type=\"radio\" id=\"fld_2976826_2_opt1351947\" data-field=\"fld_2976826\" class=\"fld_2976826_2\" name=\"fld_2976826\" value=\"Other\"    data-radio-field=\"fld_2976826_2\" data-type=\"radio\" data-calc-value=\"Other\" \/>\n\t\t\tOther\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_8856752\" class=\"form-group\" id=\"fld_8856752_2-wrap\">\r\n\t<label id=\"fld_8856752Label\" for=\"fld_8856752_2\" class=\"control-label\">Describe<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_8856752\" class=\" form-control\" id=\"fld_8856752_2\" name=\"fld_8856752\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_8856752Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_6142854\" class=\"form-group\" id=\"fld_6142854_2-wrap\">\r\n\t<label id=\"fld_6142854Label\" for=\"fld_6142854_2\" class=\"control-label\">Describe your dog's personality:<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_6142854\" class=\" form-control\" id=\"fld_6142854_2\" name=\"fld_6142854\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_6142854Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-42\"  class=\"row \"><div  class=\"col-sm-5  first_col\"><div data-field-wrapper=\"fld_5284364\" class=\"form-group\" id=\"fld_5284364_2-wrap\">\r\n<label id=\"fld_5284364Label\" for=\"fld_5284364_2\" class=\"control-label\">Does your dog object to being handled or touched?<\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Yes\" for=\"fld_5284364_2_opt1368593\"><input type=\"radio\" id=\"fld_5284364_2_opt1368593\" data-field=\"fld_5284364\" class=\"fld_5284364_2\" name=\"fld_5284364\" value=\"Yes\"    data-radio-field=\"fld_5284364_2\" data-type=\"radio\" data-calc-value=\"Yes\" \/>\n\t\t\tYes\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"No\" for=\"fld_5284364_2_opt1442838\"><input type=\"radio\" id=\"fld_5284364_2_opt1442838\" data-field=\"fld_5284364\" class=\"fld_5284364_2\" name=\"fld_5284364\" value=\"No\"    data-radio-field=\"fld_5284364_2\" data-type=\"radio\" data-calc-value=\"No\" \/>\n\t\t\tNo\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-7  last_col\"><div data-field-wrapper=\"fld_3904545\" class=\"form-group\" id=\"fld_3904545_2-wrap\">\r\n\t<label id=\"fld_3904545Label\" for=\"fld_3904545_2\" class=\"control-label\">If so, describe:<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_3904545\" class=\" form-control\" id=\"fld_3904545_2\" name=\"fld_3904545\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_3904545Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-43\"  class=\"row \"><div  class=\"col-sm-12  single\"><hr id=\"fld_3656906_2\" class=\"\" style=\"width: 100%\" \/><div class=\"\"><p>How does your dog react to:<\/p>\n<\/div><div data-field-wrapper=\"fld_8554068\" class=\"form-group\" id=\"fld_8554068_2-wrap\">\r\n<label id=\"fld_8554068Label\" for=\"fld_8554068_2\" class=\"control-label\">Other dogs on property <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Ignores\" for=\"fld_8554068_2_opt1940580\"><input type=\"radio\" id=\"fld_8554068_2_opt1940580\" data-field=\"fld_8554068\" class=\"fld_8554068_2 option-required\" name=\"fld_8554068\" value=\"Ignores\"   required=\"required\" data-radio-field=\"fld_8554068_2\" data-type=\"radio\" data-calc-value=\"Ignores\" \/>\n\t\t\tIgnores\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Plays\" for=\"fld_8554068_2_opt1240994\"><input type=\"radio\" id=\"fld_8554068_2_opt1240994\" data-field=\"fld_8554068\" class=\"fld_8554068_2 option-required\" name=\"fld_8554068\" value=\"Plays\"   required=\"required\" data-radio-field=\"fld_8554068_2\" data-type=\"radio\" data-calc-value=\"Plays\" \/>\n\t\t\tPlays\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Barks\" for=\"fld_8554068_2_opt1564479\"><input type=\"radio\" id=\"fld_8554068_2_opt1564479\" data-field=\"fld_8554068\" class=\"fld_8554068_2 option-required\" name=\"fld_8554068\" value=\"Barks\"   required=\"required\" data-radio-field=\"fld_8554068_2\" data-type=\"radio\" data-calc-value=\"Barks\" \/>\n\t\t\tBarks\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Attacks\" for=\"fld_8554068_2_opt1881848\"><input type=\"radio\" id=\"fld_8554068_2_opt1881848\" data-field=\"fld_8554068\" class=\"fld_8554068_2 option-required\" name=\"fld_8554068\" value=\"Attacks\"   required=\"required\" data-radio-field=\"fld_8554068_2\" data-type=\"radio\" data-calc-value=\"Attacks\" \/>\n\t\t\tAttacks\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Other\" for=\"fld_8554068_2_opt1900344\"><input type=\"radio\" id=\"fld_8554068_2_opt1900344\" data-field=\"fld_8554068\" class=\"fld_8554068_2 option-required\" name=\"fld_8554068\" value=\"Other\"   required=\"required\" data-radio-field=\"fld_8554068_2\" data-type=\"radio\" data-calc-value=\"Other\" \/>\n\t\t\tOther\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_1493282\" class=\"form-group\" id=\"fld_1493282_2-wrap\">\r\n<label id=\"fld_1493282Label\" for=\"fld_1493282_2\" class=\"control-label\">Other dogs off property? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Ignores\" for=\"fld_1493282_2_opt1940580\"><input type=\"radio\" id=\"fld_1493282_2_opt1940580\" data-field=\"fld_1493282\" class=\"fld_1493282_2 option-required\" name=\"fld_1493282\" value=\"Ignores\"   required=\"required\" data-radio-field=\"fld_1493282_2\" data-type=\"radio\" data-calc-value=\"Ignores\" \/>\n\t\t\tIgnores\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Plays\" for=\"fld_1493282_2_opt1240994\"><input type=\"radio\" id=\"fld_1493282_2_opt1240994\" data-field=\"fld_1493282\" class=\"fld_1493282_2 option-required\" name=\"fld_1493282\" value=\"Plays\"   required=\"required\" data-radio-field=\"fld_1493282_2\" data-type=\"radio\" data-calc-value=\"Plays\" \/>\n\t\t\tPlays\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Barks\" for=\"fld_1493282_2_opt1564479\"><input type=\"radio\" id=\"fld_1493282_2_opt1564479\" data-field=\"fld_1493282\" class=\"fld_1493282_2 option-required\" name=\"fld_1493282\" value=\"Barks\"   required=\"required\" data-radio-field=\"fld_1493282_2\" data-type=\"radio\" data-calc-value=\"Barks\" \/>\n\t\t\tBarks\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Attacks\" for=\"fld_1493282_2_opt1881848\"><input type=\"radio\" id=\"fld_1493282_2_opt1881848\" data-field=\"fld_1493282\" class=\"fld_1493282_2 option-required\" name=\"fld_1493282\" value=\"Attacks\"   required=\"required\" data-radio-field=\"fld_1493282_2\" data-type=\"radio\" data-calc-value=\"Attacks\" \/>\n\t\t\tAttacks\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Other\" for=\"fld_1493282_2_opt1900344\"><input type=\"radio\" id=\"fld_1493282_2_opt1900344\" data-field=\"fld_1493282\" class=\"fld_1493282_2 option-required\" name=\"fld_1493282\" value=\"Other\"   required=\"required\" data-radio-field=\"fld_1493282_2\" data-type=\"radio\" data-calc-value=\"Other\" \/>\n\t\t\tOther\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_1064383\" class=\"form-group\" id=\"fld_1064383_2-wrap\">\r\n<label id=\"fld_1064383Label\" for=\"fld_1064383_2\" class=\"control-label\">Loud noises? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"No reaction\" for=\"fld_1064383_2_opt1940580\"><input type=\"radio\" id=\"fld_1064383_2_opt1940580\" data-field=\"fld_1064383\" class=\"fld_1064383_2 option-required\" name=\"fld_1064383\" value=\"No reaction\"   required=\"required\" data-radio-field=\"fld_1064383_2\" data-type=\"radio\" data-calc-value=\"No reaction\" \/>\n\t\t\tNo reaction\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Startles, recovers quickly\" for=\"fld_1064383_2_opt1240994\"><input type=\"radio\" id=\"fld_1064383_2_opt1240994\" data-field=\"fld_1064383\" class=\"fld_1064383_2 option-required\" name=\"fld_1064383\" value=\"Startles, recovers quickly\"   required=\"required\" data-radio-field=\"fld_1064383_2\" data-type=\"radio\" data-calc-value=\"Startles, recovers quickly\" \/>\n\t\t\tStartles, recovers quickly\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Startles, recovers slowly\" for=\"fld_1064383_2_opt1564479\"><input type=\"radio\" id=\"fld_1064383_2_opt1564479\" data-field=\"fld_1064383\" class=\"fld_1064383_2 option-required\" name=\"fld_1064383\" value=\"Startles, recovers slowly\"   required=\"required\" data-radio-field=\"fld_1064383_2\" data-type=\"radio\" data-calc-value=\"Startles, recovers slowly\" \/>\n\t\t\tStartles, recovers slowly\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Hides\" for=\"fld_1064383_2_opt1881848\"><input type=\"radio\" id=\"fld_1064383_2_opt1881848\" data-field=\"fld_1064383\" class=\"fld_1064383_2 option-required\" name=\"fld_1064383\" value=\"Hides\"   required=\"required\" data-radio-field=\"fld_1064383_2\" data-type=\"radio\" data-calc-value=\"Hides\" \/>\n\t\t\tHides\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_6678952\" class=\"form-group\" id=\"fld_6678952_2-wrap\">\r\n<label id=\"fld_6678952Label\" for=\"fld_6678952_2\" class=\"control-label\">Sudden movements <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"No reaction\" for=\"fld_6678952_2_opt1940580\"><input type=\"radio\" id=\"fld_6678952_2_opt1940580\" data-field=\"fld_6678952\" class=\"fld_6678952_2 option-required\" name=\"fld_6678952\" value=\"No reaction\"   required=\"required\" data-radio-field=\"fld_6678952_2\" data-type=\"radio\" data-calc-value=\"No reaction\" \/>\n\t\t\tNo reaction\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Startles, recovers quickly\" for=\"fld_6678952_2_opt1240994\"><input type=\"radio\" id=\"fld_6678952_2_opt1240994\" data-field=\"fld_6678952\" class=\"fld_6678952_2 option-required\" name=\"fld_6678952\" value=\"Startles, recovers quickly\"   required=\"required\" data-radio-field=\"fld_6678952_2\" data-type=\"radio\" data-calc-value=\"Startles, recovers quickly\" \/>\n\t\t\tStartles, recovers quickly\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Startles, recovers slowly\" for=\"fld_6678952_2_opt1564479\"><input type=\"radio\" id=\"fld_6678952_2_opt1564479\" data-field=\"fld_6678952\" class=\"fld_6678952_2 option-required\" name=\"fld_6678952\" value=\"Startles, recovers slowly\"   required=\"required\" data-radio-field=\"fld_6678952_2\" data-type=\"radio\" data-calc-value=\"Startles, recovers slowly\" \/>\n\t\t\tStartles, recovers slowly\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Defensive\" for=\"fld_6678952_2_opt1881848\"><input type=\"radio\" id=\"fld_6678952_2_opt1881848\" data-field=\"fld_6678952\" class=\"fld_6678952_2 option-required\" name=\"fld_6678952\" value=\"Defensive\"   required=\"required\" data-radio-field=\"fld_6678952_2\" data-type=\"radio\" data-calc-value=\"Defensive\" \/>\n\t\t\tDefensive\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-44\"  class=\"row \"><div  class=\"col-sm-12  single\"><hr id=\"fld_4030648_2\" class=\"\" style=\"width: 100%\" \/><div class=\"\"><p>Has your dog shown any of the following aggressive reactions towards family members in these circumstances:<\/p>\n<\/div><div data-field-wrapper=\"fld_2066547\" class=\"form-group\" id=\"fld_2066547_2-wrap\">\r\n<label id=\"fld_2066547Label\" for=\"fld_2066547_2\" class=\"control-label\">Petting? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Growl\" for=\"fld_2066547_2_opt1940580\"><input type=\"radio\" id=\"fld_2066547_2_opt1940580\" data-field=\"fld_2066547\" class=\"fld_2066547_2 option-required\" name=\"fld_2066547\" value=\"Growl\"   required=\"required\" data-radio-field=\"fld_2066547_2\" data-type=\"radio\" data-calc-value=\"Growl\" \/>\n\t\t\tGrowl\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Bark\" for=\"fld_2066547_2_opt1240994\"><input type=\"radio\" id=\"fld_2066547_2_opt1240994\" data-field=\"fld_2066547\" class=\"fld_2066547_2 option-required\" name=\"fld_2066547\" value=\"Bark\"   required=\"required\" data-radio-field=\"fld_2066547_2\" data-type=\"radio\" data-calc-value=\"Bark\" \/>\n\t\t\tBark\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Snap\" for=\"fld_2066547_2_opt1564479\"><input type=\"radio\" id=\"fld_2066547_2_opt1564479\" data-field=\"fld_2066547\" class=\"fld_2066547_2 option-required\" name=\"fld_2066547\" value=\"Snap\"   required=\"required\" data-radio-field=\"fld_2066547_2\" data-type=\"radio\" data-calc-value=\"Snap\" \/>\n\t\t\tSnap\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Grab\" for=\"fld_2066547_2_opt1881848\"><input type=\"radio\" id=\"fld_2066547_2_opt1881848\" data-field=\"fld_2066547\" class=\"fld_2066547_2 option-required\" name=\"fld_2066547\" value=\"Grab\"   required=\"required\" data-radio-field=\"fld_2066547_2\" data-type=\"radio\" data-calc-value=\"Grab\" \/>\n\t\t\tGrab\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Glare\" for=\"fld_2066547_2_opt1900344\"><input type=\"radio\" id=\"fld_2066547_2_opt1900344\" data-field=\"fld_2066547\" class=\"fld_2066547_2 option-required\" name=\"fld_2066547\" value=\"Glare\"   required=\"required\" data-radio-field=\"fld_2066547_2\" data-type=\"radio\" data-calc-value=\"Glare\" \/>\n\t\t\tGlare\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Bite, breaking skin\" for=\"fld_2066547_2_opt1621093\"><input type=\"radio\" id=\"fld_2066547_2_opt1621093\" data-field=\"fld_2066547\" class=\"fld_2066547_2 option-required\" name=\"fld_2066547\" value=\"Bite, breaking skin\"   required=\"required\" data-radio-field=\"fld_2066547_2\" data-type=\"radio\" data-calc-value=\"Bite, breaking skin\" \/>\n\t\t\tBite, breaking skin\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_5658260\" class=\"form-group\" id=\"fld_5658260_2-wrap\">\r\n<label id=\"fld_5658260Label\" for=\"fld_5658260_2\" class=\"control-label\">Eating or playing with toy? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Growl\" for=\"fld_5658260_2_opt1940580\"><input type=\"radio\" id=\"fld_5658260_2_opt1940580\" data-field=\"fld_5658260\" class=\"fld_5658260_2 option-required\" name=\"fld_5658260\" value=\"Growl\"   required=\"required\" data-radio-field=\"fld_5658260_2\" data-type=\"radio\" data-calc-value=\"Growl\" \/>\n\t\t\tGrowl\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Bark\" for=\"fld_5658260_2_opt1240994\"><input type=\"radio\" id=\"fld_5658260_2_opt1240994\" data-field=\"fld_5658260\" class=\"fld_5658260_2 option-required\" name=\"fld_5658260\" value=\"Bark\"   required=\"required\" data-radio-field=\"fld_5658260_2\" data-type=\"radio\" data-calc-value=\"Bark\" \/>\n\t\t\tBark\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Snap\" for=\"fld_5658260_2_opt1564479\"><input type=\"radio\" id=\"fld_5658260_2_opt1564479\" data-field=\"fld_5658260\" class=\"fld_5658260_2 option-required\" name=\"fld_5658260\" value=\"Snap\"   required=\"required\" data-radio-field=\"fld_5658260_2\" data-type=\"radio\" data-calc-value=\"Snap\" \/>\n\t\t\tSnap\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Grab\" for=\"fld_5658260_2_opt1881848\"><input type=\"radio\" id=\"fld_5658260_2_opt1881848\" data-field=\"fld_5658260\" class=\"fld_5658260_2 option-required\" name=\"fld_5658260\" value=\"Grab\"   required=\"required\" data-radio-field=\"fld_5658260_2\" data-type=\"radio\" data-calc-value=\"Grab\" \/>\n\t\t\tGrab\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Glare\" for=\"fld_5658260_2_opt1900344\"><input type=\"radio\" id=\"fld_5658260_2_opt1900344\" data-field=\"fld_5658260\" class=\"fld_5658260_2 option-required\" name=\"fld_5658260\" value=\"Glare\"   required=\"required\" data-radio-field=\"fld_5658260_2\" data-type=\"radio\" data-calc-value=\"Glare\" \/>\n\t\t\tGlare\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Bite, breaking skin\" for=\"fld_5658260_2_opt1621093\"><input type=\"radio\" id=\"fld_5658260_2_opt1621093\" data-field=\"fld_5658260\" class=\"fld_5658260_2 option-required\" name=\"fld_5658260\" value=\"Bite, breaking skin\"   required=\"required\" data-radio-field=\"fld_5658260_2\" data-type=\"radio\" data-calc-value=\"Bite, breaking skin\" \/>\n\t\t\tBite, breaking skin\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_8964482\" class=\"form-group\" id=\"fld_8964482_2-wrap\">\r\n<label id=\"fld_8964482Label\" for=\"fld_8964482_2\" class=\"control-label\">Being approached when sleeping? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Growl\" for=\"fld_8964482_2_opt1940580\"><input type=\"radio\" id=\"fld_8964482_2_opt1940580\" data-field=\"fld_8964482\" class=\"fld_8964482_2 option-required\" name=\"fld_8964482\" value=\"Growl\"   required=\"required\" data-radio-field=\"fld_8964482_2\" data-type=\"radio\" data-calc-value=\"Growl\" \/>\n\t\t\tGrowl\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Bark\" for=\"fld_8964482_2_opt1240994\"><input type=\"radio\" id=\"fld_8964482_2_opt1240994\" data-field=\"fld_8964482\" class=\"fld_8964482_2 option-required\" name=\"fld_8964482\" value=\"Bark\"   required=\"required\" data-radio-field=\"fld_8964482_2\" data-type=\"radio\" data-calc-value=\"Bark\" \/>\n\t\t\tBark\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Snap\" for=\"fld_8964482_2_opt1564479\"><input type=\"radio\" id=\"fld_8964482_2_opt1564479\" data-field=\"fld_8964482\" class=\"fld_8964482_2 option-required\" name=\"fld_8964482\" value=\"Snap\"   required=\"required\" data-radio-field=\"fld_8964482_2\" data-type=\"radio\" data-calc-value=\"Snap\" \/>\n\t\t\tSnap\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Grab\" for=\"fld_8964482_2_opt1881848\"><input type=\"radio\" id=\"fld_8964482_2_opt1881848\" data-field=\"fld_8964482\" class=\"fld_8964482_2 option-required\" name=\"fld_8964482\" value=\"Grab\"   required=\"required\" data-radio-field=\"fld_8964482_2\" data-type=\"radio\" data-calc-value=\"Grab\" \/>\n\t\t\tGrab\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Glare\" for=\"fld_8964482_2_opt1900344\"><input type=\"radio\" id=\"fld_8964482_2_opt1900344\" data-field=\"fld_8964482\" class=\"fld_8964482_2 option-required\" name=\"fld_8964482\" value=\"Glare\"   required=\"required\" data-radio-field=\"fld_8964482_2\" data-type=\"radio\" data-calc-value=\"Glare\" \/>\n\t\t\tGlare\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Bite, breaking skin\" for=\"fld_8964482_2_opt1621093\"><input type=\"radio\" id=\"fld_8964482_2_opt1621093\" data-field=\"fld_8964482\" class=\"fld_8964482_2 option-required\" name=\"fld_8964482\" value=\"Bite, breaking skin\"   required=\"required\" data-radio-field=\"fld_8964482_2\" data-type=\"radio\" data-calc-value=\"Bite, breaking skin\" \/>\n\t\t\tBite, breaking skin\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_7356658\" class=\"form-group\" id=\"fld_7356658_2-wrap\">\r\n<label id=\"fld_7356658Label\" for=\"fld_7356658_2\" class=\"control-label\">Punishment or discipline? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Growl\" for=\"fld_7356658_2_opt1940580\"><input type=\"radio\" id=\"fld_7356658_2_opt1940580\" data-field=\"fld_7356658\" class=\"fld_7356658_2 option-required\" name=\"fld_7356658\" value=\"Growl\"   required=\"required\" data-radio-field=\"fld_7356658_2\" data-type=\"radio\" data-calc-value=\"Growl\" \/>\n\t\t\tGrowl\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Bark\" for=\"fld_7356658_2_opt1240994\"><input type=\"radio\" id=\"fld_7356658_2_opt1240994\" data-field=\"fld_7356658\" class=\"fld_7356658_2 option-required\" name=\"fld_7356658\" value=\"Bark\"   required=\"required\" data-radio-field=\"fld_7356658_2\" data-type=\"radio\" data-calc-value=\"Bark\" \/>\n\t\t\tBark\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Snap\" for=\"fld_7356658_2_opt1564479\"><input type=\"radio\" id=\"fld_7356658_2_opt1564479\" data-field=\"fld_7356658\" class=\"fld_7356658_2 option-required\" name=\"fld_7356658\" value=\"Snap\"   required=\"required\" data-radio-field=\"fld_7356658_2\" data-type=\"radio\" data-calc-value=\"Snap\" \/>\n\t\t\tSnap\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Grab\" for=\"fld_7356658_2_opt1881848\"><input type=\"radio\" id=\"fld_7356658_2_opt1881848\" data-field=\"fld_7356658\" class=\"fld_7356658_2 option-required\" name=\"fld_7356658\" value=\"Grab\"   required=\"required\" data-radio-field=\"fld_7356658_2\" data-type=\"radio\" data-calc-value=\"Grab\" \/>\n\t\t\tGrab\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Glare\" for=\"fld_7356658_2_opt1900344\"><input type=\"radio\" id=\"fld_7356658_2_opt1900344\" data-field=\"fld_7356658\" class=\"fld_7356658_2 option-required\" name=\"fld_7356658\" value=\"Glare\"   required=\"required\" data-radio-field=\"fld_7356658_2\" data-type=\"radio\" data-calc-value=\"Glare\" \/>\n\t\t\tGlare\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Bite, breaking skin\" for=\"fld_7356658_2_opt1621093\"><input type=\"radio\" id=\"fld_7356658_2_opt1621093\" data-field=\"fld_7356658\" class=\"fld_7356658_2 option-required\" name=\"fld_7356658\" value=\"Bite, breaking skin\"   required=\"required\" data-radio-field=\"fld_7356658_2\" data-type=\"radio\" data-calc-value=\"Bite, breaking skin\" \/>\n\t\t\tBite, breaking skin\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-45\"  class=\"row \"><div  class=\"col-sm-12  single\"><hr id=\"fld_2075418_2\" class=\"\" style=\"width: 100%\" \/><div class=\"\"><p>Has your dog shown any of the following aggressive reactions towards family members in these circumstances:<\/p>\n<\/div><div data-field-wrapper=\"fld_2419117\" class=\"form-group\" id=\"fld_2419117_2-wrap\">\r\n<label id=\"fld_2419117Label\" for=\"fld_2419117_2\" class=\"control-label\">Entering home <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Growl\" for=\"fld_2419117_2_opt1940580\"><input type=\"radio\" id=\"fld_2419117_2_opt1940580\" data-field=\"fld_2419117\" class=\"fld_2419117_2 option-required\" name=\"fld_2419117\" value=\"Growl\"   required=\"required\" data-radio-field=\"fld_2419117_2\" data-type=\"radio\" data-calc-value=\"Growl\" \/>\n\t\t\tGrowl\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Bark\" for=\"fld_2419117_2_opt1240994\"><input type=\"radio\" id=\"fld_2419117_2_opt1240994\" data-field=\"fld_2419117\" class=\"fld_2419117_2 option-required\" name=\"fld_2419117\" value=\"Bark\"   required=\"required\" data-radio-field=\"fld_2419117_2\" data-type=\"radio\" data-calc-value=\"Bark\" \/>\n\t\t\tBark\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Snap\" for=\"fld_2419117_2_opt1564479\"><input type=\"radio\" id=\"fld_2419117_2_opt1564479\" data-field=\"fld_2419117\" class=\"fld_2419117_2 option-required\" name=\"fld_2419117\" value=\"Snap\"   required=\"required\" data-radio-field=\"fld_2419117_2\" data-type=\"radio\" data-calc-value=\"Snap\" \/>\n\t\t\tSnap\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Grab\" for=\"fld_2419117_2_opt1881848\"><input type=\"radio\" id=\"fld_2419117_2_opt1881848\" data-field=\"fld_2419117\" class=\"fld_2419117_2 option-required\" name=\"fld_2419117\" value=\"Grab\"   required=\"required\" data-radio-field=\"fld_2419117_2\" data-type=\"radio\" data-calc-value=\"Grab\" \/>\n\t\t\tGrab\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Glare\" for=\"fld_2419117_2_opt1900344\"><input type=\"radio\" id=\"fld_2419117_2_opt1900344\" data-field=\"fld_2419117\" class=\"fld_2419117_2 option-required\" name=\"fld_2419117\" value=\"Glare\"   required=\"required\" data-radio-field=\"fld_2419117_2\" data-type=\"radio\" data-calc-value=\"Glare\" \/>\n\t\t\tGlare\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Bite, breaking skin\" for=\"fld_2419117_2_opt1621093\"><input type=\"radio\" id=\"fld_2419117_2_opt1621093\" data-field=\"fld_2419117\" class=\"fld_2419117_2 option-required\" name=\"fld_2419117\" value=\"Bite, breaking skin\"   required=\"required\" data-radio-field=\"fld_2419117_2\" data-type=\"radio\" data-calc-value=\"Bite, breaking skin\" \/>\n\t\t\tBite, breaking skin\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_698869\" class=\"form-group\" id=\"fld_698869_2-wrap\">\r\n<label id=\"fld_698869Label\" for=\"fld_698869_2\" class=\"control-label\">Entering yard <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Growl\" for=\"fld_698869_2_opt1940580\"><input type=\"radio\" id=\"fld_698869_2_opt1940580\" data-field=\"fld_698869\" class=\"fld_698869_2 option-required\" name=\"fld_698869\" value=\"Growl\"   required=\"required\" data-radio-field=\"fld_698869_2\" data-type=\"radio\" data-calc-value=\"Growl\" \/>\n\t\t\tGrowl\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Bark\" for=\"fld_698869_2_opt1240994\"><input type=\"radio\" id=\"fld_698869_2_opt1240994\" data-field=\"fld_698869\" class=\"fld_698869_2 option-required\" name=\"fld_698869\" value=\"Bark\"   required=\"required\" data-radio-field=\"fld_698869_2\" data-type=\"radio\" data-calc-value=\"Bark\" \/>\n\t\t\tBark\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Snap\" for=\"fld_698869_2_opt1564479\"><input type=\"radio\" id=\"fld_698869_2_opt1564479\" data-field=\"fld_698869\" class=\"fld_698869_2 option-required\" name=\"fld_698869\" value=\"Snap\"   required=\"required\" data-radio-field=\"fld_698869_2\" data-type=\"radio\" data-calc-value=\"Snap\" \/>\n\t\t\tSnap\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Grab\" for=\"fld_698869_2_opt1881848\"><input type=\"radio\" id=\"fld_698869_2_opt1881848\" data-field=\"fld_698869\" class=\"fld_698869_2 option-required\" name=\"fld_698869\" value=\"Grab\"   required=\"required\" data-radio-field=\"fld_698869_2\" data-type=\"radio\" data-calc-value=\"Grab\" \/>\n\t\t\tGrab\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Glare\" for=\"fld_698869_2_opt1900344\"><input type=\"radio\" id=\"fld_698869_2_opt1900344\" data-field=\"fld_698869\" class=\"fld_698869_2 option-required\" name=\"fld_698869\" value=\"Glare\"   required=\"required\" data-radio-field=\"fld_698869_2\" data-type=\"radio\" data-calc-value=\"Glare\" \/>\n\t\t\tGlare\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"Bite, breaking skin\" for=\"fld_698869_2_opt1621093\"><input type=\"radio\" id=\"fld_698869_2_opt1621093\" data-field=\"fld_698869\" class=\"fld_698869_2 option-required\" name=\"fld_698869\" value=\"Bite, breaking skin\"   required=\"required\" data-radio-field=\"fld_698869_2\" data-type=\"radio\" data-calc-value=\"Bite, breaking skin\" \/>\n\t\t\tBite, breaking skin\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_7480043\" class=\"form-group\" id=\"fld_7480043_2-wrap\">\r\n\t<label id=\"fld_7480043Label\" for=\"fld_7480043_2\" class=\"control-label\">Describe the circumstances of any of the above, including approx dates & severity:<\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_7480043\" value=\"\" data-field=\"fld_7480043\" class=\"form-control\" id=\"fld_7480043_2\" rows=\"4\"    aria-labelledby=\"fld_7480043Label\" ><\/textarea>\n\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_6065865\" class=\"form-group\" id=\"fld_6065865_2-wrap\">\r\n\t<label id=\"fld_6065865Label\" for=\"fld_6065865_2\" class=\"control-label\">Describe any other situations not previously discussed in which your dog has been aggressive:<\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_6065865\" value=\"\" data-field=\"fld_6065865\" class=\"form-control\" id=\"fld_6065865_2\" rows=\"4\"    aria-labelledby=\"fld_6065865Label\" ><\/textarea>\n\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_8341177\" class=\"form-group\" id=\"fld_8341177_2-wrap\">\r\n\t<label id=\"fld_8341177Label\" for=\"fld_8341177_2\" class=\"control-label\">During agressive displays does your dog exhibit any of the following?<\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_8341177_2_opt2042958\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Cowering\"\n                                data-field=\"fld_8341177\"\n                                id=\"fld_8341177_2_opt2042958\"\n                                class=\"fld_8341177_2\"\n                                name=\"fld_8341177[opt2042958]\"\n                                value=\"Cowering\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_8341177_2\"\n                                                                data-calc-value=\"Cowering\"\n                            >\n                    Cowering                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_8341177_2_opt1272526\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Ears back\"\n                                data-field=\"fld_8341177\"\n                                id=\"fld_8341177_2_opt1272526\"\n                                class=\"fld_8341177_2\"\n                                name=\"fld_8341177[opt1272526]\"\n                                value=\"Ears back\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_8341177_2\"\n                                                                data-calc-value=\"Ears back\"\n                            >\n                    Ears back                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_8341177_2_opt1450806\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Tail tucked\"\n                                data-field=\"fld_8341177\"\n                                id=\"fld_8341177_2_opt1450806\"\n                                class=\"fld_8341177_2\"\n                                name=\"fld_8341177[opt1450806]\"\n                                value=\"Tail tucked\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_8341177_2\"\n                                                                data-calc-value=\"Tail tucked\"\n                            >\n                    Tail tucked                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_8341177_2_opt1552972\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Hackles raised\"\n                                data-field=\"fld_8341177\"\n                                id=\"fld_8341177_2_opt1552972\"\n                                class=\"fld_8341177_2\"\n                                name=\"fld_8341177[opt1552972]\"\n                                value=\"Hackles raised\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_8341177_2\"\n                                                                data-calc-value=\"Hackles raised\"\n                            >\n                    Hackles raised                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_8341177_2_opt1534608\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Retreating\"\n                                data-field=\"fld_8341177\"\n                                id=\"fld_8341177_2_opt1534608\"\n                                class=\"fld_8341177_2\"\n                                name=\"fld_8341177[opt1534608]\"\n                                value=\"Retreating\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_8341177_2\"\n                                                                data-calc-value=\"Retreating\"\n                            >\n                    Retreating                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"checkbox\">\n\t\t\t\t\n                <label                         for=\"fld_8341177_2_opt2070539\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Hiding\"\n                                data-field=\"fld_8341177\"\n                                id=\"fld_8341177_2_opt2070539\"\n                                class=\"fld_8341177_2\"\n                                name=\"fld_8341177[opt2070539]\"\n                                value=\"Hiding\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_8341177_2\"\n                                                                data-calc-value=\"Hiding\"\n                            >\n                    Hiding                <\/label>\n\n                \t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-46\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_8811425\" class=\"form-group\" id=\"fld_8811425_2-wrap\">\r\n<label id=\"fld_8811425Label\" for=\"fld_8811425_2\" class=\"control-label\">Aside from the principal problem, does your dog have any other problem behaviors? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"Yes\" for=\"fld_8811425_2_opt1940580\"><input type=\"radio\" id=\"fld_8811425_2_opt1940580\" data-field=\"fld_8811425\" class=\"fld_8811425_2 option-required\" name=\"fld_8811425\" value=\"Yes\"   required=\"required\" data-radio-field=\"fld_8811425_2\" data-type=\"radio\" data-calc-value=\"Yes\" \/>\n\t\t\tYes\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"No\" for=\"fld_8811425_2_opt1240994\"><input type=\"radio\" id=\"fld_8811425_2_opt1240994\" data-field=\"fld_8811425\" class=\"fld_8811425_2 option-required\" name=\"fld_8811425\" value=\"No\"   required=\"required\" data-radio-field=\"fld_8811425_2\" data-type=\"radio\" data-calc-value=\"No\" \/>\n\t\t\tNo\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><div data-field-wrapper=\"fld_6045921\" class=\"form-group\" id=\"fld_6045921_2-wrap\">\r\n\t<label id=\"fld_6045921Label\" for=\"fld_6045921_2\" class=\"control-label\">Describe other problems:<\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_6045921\" value=\"\" data-field=\"fld_6045921\" class=\"form-control\" id=\"fld_6045921_2\" rows=\"4\"    aria-labelledby=\"fld_6045921Label\" ><\/textarea>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-47\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div data-field-wrapper=\"fld_1947916\" class=\"form-group\" id=\"fld_1947916_2-wrap\">\r\n<div class=\"\">\r\n\t<input  class=\"btn btn-default cf-page-btn cf-page-btn-prev\" type=\"button\" name=\"fld_1947916\" id=\"fld_1947916_2\" value=\"Back\" data-field=\"fld_1947916\" data-page=\"prev\"  >\n<\/div>\r\n<\/div>\r\n\t<input class=\"button_trigger_2\" type=\"hidden\" name=\"fld_1947916\" id=\"fld_1947916_2_btn\" value=\"\" data-field=\"fld_1947916\"  \/>\n<\/div><div  class=\"col-sm-6 \"><div data-field-wrapper=\"fld_7586048\" class=\"form-group\" id=\"fld_7586048_2-wrap\">\r\n<div class=\"\">\r\n\t<input  class=\"btn btn-default cf-page-btn cf-page-btn-next\" type=\"button\" name=\"fld_7586048\" id=\"fld_7586048_2\" value=\"Next\" data-field=\"fld_7586048\" data-page=\"next\"  >\n<\/div>\r\n<\/div>\r\n\t<input class=\"button_trigger_2\" type=\"hidden\" name=\"fld_7586048\" id=\"fld_7586048_2_btn\" value=\"\" data-field=\"fld_7586048\"  \/>\n<\/div><\/div><\/div><div id=\"form_page_2_pg_6\" data-formpage=\"6\" role=\"region\" aria-labelledby=\"breadcrumb_2_pg_6\" aria-hidden=\"true\" class=\"caldera-form-page\" style=\"display:none;\"><div id=\"CF5bfddec14b5d7_2-row-48\"  class=\"row \"><div  class=\"col-sm-12  single\"><div class=\"\"><h3>Medical<\/h3>\n<p>Answer the following questions or have your veterinarian send a brief medical history to Positive Approach.<\/p>\n<\/div><\/div><\/div><div id=\"CF5bfddec14b5d7_2-row-49\"  class=\"row  last_row\"><div  class=\"col-sm-12  first_col\"><div data-field-wrapper=\"fld_4096021\" class=\"form-group\" id=\"fld_4096021_2-wrap\">\r\n\t<label id=\"fld_4096021Label\" for=\"fld_4096021_2\" class=\"control-label\">Has your dog had any medical problems? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_4096021_2_opt1288368\"\n                >\n                            <input\n                                data-parsley-required=\"true\" data-parsley-group=\"fld_4096021_2\" data-parsley-multiple=\"fld_4096021_2\"                                type=\"checkbox\"\n                                data-label=\"Ears\"\n                                data-field=\"fld_4096021\"\n                                id=\"fld_4096021_2_opt1288368\"\n                                class=\"fld_4096021_2 option-required\"\n                                name=\"fld_4096021[opt1288368]\"\n                                value=\"Ears\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_4096021_2\"\n                                                                data-calc-value=\"Ears\"\n                            >\n                    Ears                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_4096021_2_opt1935744\"\n                >\n                            <input\n                                data-parsley-required=\"true\" data-parsley-group=\"fld_4096021_2\" data-parsley-multiple=\"fld_4096021_2\"                                type=\"checkbox\"\n                                data-label=\"Back\"\n                                data-field=\"fld_4096021\"\n                                id=\"fld_4096021_2_opt1935744\"\n                                class=\"fld_4096021_2 option-required\"\n                                name=\"fld_4096021[opt1935744]\"\n                                value=\"Back\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_4096021_2\"\n                                                                data-calc-value=\"Back\"\n                            >\n                    Back                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_4096021_2_opt1485990\"\n                >\n                            <input\n                                data-parsley-required=\"true\" data-parsley-group=\"fld_4096021_2\" data-parsley-multiple=\"fld_4096021_2\"                                type=\"checkbox\"\n                                data-label=\"Allergies\"\n                                data-field=\"fld_4096021\"\n                                id=\"fld_4096021_2_opt1485990\"\n                                class=\"fld_4096021_2 option-required\"\n                                name=\"fld_4096021[opt1485990]\"\n                                value=\"Allergies\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_4096021_2\"\n                                                                data-calc-value=\"Allergies\"\n                            >\n                    Allergies                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_4096021_2_opt2071429\"\n                >\n                            <input\n                                data-parsley-required=\"true\" data-parsley-group=\"fld_4096021_2\" data-parsley-multiple=\"fld_4096021_2\"                                type=\"checkbox\"\n                                data-label=\"Hips\"\n                                data-field=\"fld_4096021\"\n                                id=\"fld_4096021_2_opt2071429\"\n                                class=\"fld_4096021_2 option-required\"\n                                name=\"fld_4096021[opt2071429]\"\n                                value=\"Hips\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_4096021_2\"\n                                                                data-calc-value=\"Hips\"\n                            >\n                    Hips                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_4096021_2_opt1852998\"\n                >\n                            <input\n                                data-parsley-required=\"true\" data-parsley-group=\"fld_4096021_2\" data-parsley-multiple=\"fld_4096021_2\"                                type=\"checkbox\"\n                                data-label=\"Skin\"\n                                data-field=\"fld_4096021\"\n                                id=\"fld_4096021_2_opt1852998\"\n                                class=\"fld_4096021_2 option-required\"\n                                name=\"fld_4096021[opt1852998]\"\n                                value=\"Skin\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_4096021_2\"\n                                                                data-calc-value=\"Skin\"\n                            >\n                    Skin                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_4096021_2_opt1688711\"\n                >\n                            <input\n                                data-parsley-required=\"true\" data-parsley-group=\"fld_4096021_2\" data-parsley-multiple=\"fld_4096021_2\"                                type=\"checkbox\"\n                                data-label=\"Other\"\n                                data-field=\"fld_4096021\"\n                                id=\"fld_4096021_2_opt1688711\"\n                                class=\"fld_4096021_2 option-required\"\n                                name=\"fld_4096021[opt1688711]\"\n                                value=\"Other\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_4096021_2\"\n                                                                data-calc-value=\"Other\"\n                            >\n                    Other                <\/label>\n\n                \t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_2324212\" class=\"form-group\" id=\"fld_2324212_2-wrap\">\r\n\t<label id=\"fld_2324212Label\" for=\"fld_2324212_2\" class=\"control-label\">Describe any medications your pet is currently taking, and why: <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_2324212\" value=\"\" data-field=\"fld_2324212\" class=\"form-control\" id=\"fld_2324212_2\" rows=\"4\"  required=\"required\"  aria-labelledby=\"fld_2324212Label\" ><\/textarea>\n\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_5005591\" class=\"form-group\" id=\"fld_5005591_2-wrap\">\r\n\t<label id=\"fld_5005591Label\" for=\"fld_5005591_2\" class=\"control-label\">How does your dog react to nail trimming? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_5005591\" class=\" form-control\" id=\"fld_5005591_2\" name=\"fld_5005591\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_5005591Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_4067479\" class=\"form-group\" id=\"fld_4067479_2-wrap\">\r\n\t<label id=\"fld_4067479Label\" for=\"fld_4067479_2\" class=\"control-label\">How does your dog react to getting medication? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_4067479\" class=\" form-control\" id=\"fld_4067479_2\" name=\"fld_4067479\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_4067479Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_4416855\" class=\"form-group\" id=\"fld_4416855_2-wrap\">\r\n\t<label id=\"fld_4416855Label\" for=\"fld_4416855_2\" class=\"control-label\">How does your dog react to bathing? <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_4416855\" class=\" form-control\" id=\"fld_4416855_2\" name=\"fld_4416855\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_4416855Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<hr id=\"fld_590363_2\" class=\"\" style=\"width: 100%\" \/><div data-field-wrapper=\"fld_7919457\" class=\"form-group\" id=\"fld_7919457_2-wrap\">\r\n<label id=\"fld_7919457Label\" for=\"fld_7919457_2\" class=\"control-label\">I hereby authorize Positive Approach to release any recommendations given as a result of this inquiry to my veterinarian. <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n<div class=\"\">\r\n\t\t\t\t<label class=\"radio-inline\" data-label=\"I Agree\" for=\"fld_7919457_2_opt1694079\"><input type=\"radio\" id=\"fld_7919457_2_opt1694079\" data-field=\"fld_7919457\" class=\"fld_7919457_2 option-required\" name=\"fld_7919457\" value=\"I Agree\"   required=\"required\" data-radio-field=\"fld_7919457_2\" data-type=\"radio\" data-calc-value=\"I Agree\" \/>\n\t\t\tI Agree\t\t<\/label>\n\t\t\t\t\t\t\t\t<label class=\"radio-inline\" data-label=\"I Don&#039;t Agree\" for=\"fld_7919457_2_opt1763310\"><input type=\"radio\" id=\"fld_7919457_2_opt1763310\" data-field=\"fld_7919457\" class=\"fld_7919457_2 option-required\" name=\"fld_7919457\" value=\"I Don&#039;t Agree\"   required=\"required\" data-radio-field=\"fld_7919457_2\" data-type=\"radio\" data-calc-value=\"I Don&#039;t Agree\" \/>\n\t\t\tI Don't Agree\t\t<\/label>\n\t\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_4112120\" class=\"form-group\" id=\"fld_4112120_2-wrap\">\r\n<div class=\"\">\r\n\t<input  class=\"btn btn-default\" type=\"submit\" name=\"fld_4112120\" id=\"fld_4112120_2\" value=\"Submit your Application\" data-field=\"fld_4112120\"  >\n<\/div>\r\n<\/div>\r\n\t<input class=\"button_trigger_2\" type=\"hidden\" name=\"fld_4112120\" id=\"fld_4112120_2_btn\" value=\"\" data-field=\"fld_4112120\"  \/>\n<\/div><\/div><\/div><\/form>\r\n<\/div>\r\n\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"<h1>Behavioral Problems Online Application - Dogs<\/h1>\r\nNote: This form is for Behavioral Problems, and is quite long. If you need a Private Training Session, please go to our Training page.\r\n\r\nBehavior problems can be difficult, frustrating situations to correct. The information you provide on this form is extremely important in finding a solution to the problems you are experiencing. The more thorough you are with your answers here, the less time we will need to spend during your training session dealing with questions.","_et_gb_content_width":"","footnotes":""},"class_list":["post-282","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Behavioral Problems Application - Positive Approach<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.positiveapproachdogtraining.com\/index.php\/behavioral-problems-application\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Behavioral Problems Application - Positive Approach\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.positiveapproachdogtraining.com\/index.php\/behavioral-problems-application\/\" \/>\n<meta property=\"og:site_name\" content=\"Positive Approach\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/PositiveApproachDogTraining\/\" \/>\n<meta property=\"article:modified_time\" content=\"2019-01-31T21:06:02+00:00\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.positiveapproachdogtraining.com\\\/index.php\\\/behavioral-problems-application\\\/\",\"url\":\"https:\\\/\\\/www.positiveapproachdogtraining.com\\\/index.php\\\/behavioral-problems-application\\\/\",\"name\":\"Behavioral Problems Application - 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