{"id":3363,"date":"2020-09-25T18:20:28","date_gmt":"2020-09-25T18:20:28","guid":{"rendered":"https:\/\/curesz.org\/?page_id=3363"},"modified":"2020-09-30T15:37:31","modified_gmt":"2020-09-30T15:37:31","slug":"csars","status":"publish","type":"page","link":"https:\/\/curesz.org\/zh\/csars\/","title":{"rendered":"C-SARS\u8bc4\u4f30"},"content":{"rendered":"<p><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:0px;--awb-padding-bottom:0px;--awb-margin-top:1%;--awb-margin-bottom:8%;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-center fusion-flex-justify-content-center fusion-flex-content-wrap\" style=\"max-width:1352px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-padding-bottom:74px;--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\"><script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_8' ><div id='gf_8' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data'  id='gform_8'  action='\/zh\/wp-json\/wp\/v2\/pages\/3363#gf_8' data-formid='8' novalidate> \r\n <input type='hidden' class='gforms-pum' value='{\"closepopup\":false,\"closedelay\":0,\"openpopup\":false,\"openpopup_id\":0}' \/>\n        <div id='gf_progressbar_wrapper_8' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<h3 class=\"gf_progressbar_title\">\u6b65\u9aa4 <span class='gf_step_current_page'>1<\/span> \u5b57\uff0c\u6700\u591a <span class='gf_step_page_count'>13<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/h3>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_7' style='width:7%;'><span>7%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_8_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><ul id='gform_fields_8' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_8_97\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_97'>Email<\/label><div class='ginput_container'><input name='input_97' id='input_8_97' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_8_97'>\u8fd9\u4e2a\u5b57\u6bb5\u662f\u7528\u4e8e\u9a8c\u8bc1\u76ee\u7684\uff0c\u5e94\u8be5\u4fdd\u6301\u4e0d\u53d8\u3002<\/div><\/li><li id=\"field_8_43\" class=\"gfield gfield--type-name gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name no_last_name no_suffix gf_name_has_1 ginput_container_name gform-grid-row' id='input_8_43'>\n                            \n                            <span id='input_8_43_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_43.3' id='input_8_43_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_8_43_3' class='gform-field-label gform-field-label--type-sub '>Full Name<\/label>\n                                                <\/span>\n                            \n                            \n                            \n                        <\/div><\/li><li id=\"field_8_5\" class=\"gfield gfield--type-email gf_left_half gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_5'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_5' id='input_8_5' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_8_5\" \/>\n                        <\/div><div class='gfield_description' id='gfield_description_8_5'>A copy of your responses will be sent to this email.<\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_8_6' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_8_2' class='gform_page' data-js='page-field-id-6' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_8_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_8_84\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">1. I have difficulty staying focused on something I am reading or a TV program I am watching<\/h2><\/li><li id=\"field_8_58\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >A. FREQUENCY<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_8_58'>\n\t\t\t<li class='gchoice gchoice_8_58_0'>\n\t\t\t\t<input name='input_58' type='radio' value='0'  id='choice_8_58_0'    \/>\n\t\t\t\t<label for='choice_8_58_0' id='label_8_58_0' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_58_1'>\n\t\t\t\t<input name='input_58' type='radio' value='1'  id='choice_8_58_1'    \/>\n\t\t\t\t<label for='choice_8_58_1' id='label_8_58_1' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_58_2'>\n\t\t\t\t<input name='input_58' type='radio' value='2'  id='choice_8_58_2'    \/>\n\t\t\t\t<label for='choice_8_58_2' id='label_8_58_2' class='gform-field-label gform-field-label--type-inline'>Often<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_58_3'>\n\t\t\t\t<input name='input_58' type='radio' value='3'  id='choice_8_58_3'    \/>\n\t\t\t\t<label for='choice_8_58_3' id='label_8_58_3' class='gform-field-label gform-field-label--type-inline'>All the time<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_8_70\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >B. HOW MUCH IT INTERFERES WITH MY LIFE<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_8_70'>\n\t\t\t<li class='gchoice gchoice_8_70_0'>\n\t\t\t\t<input name='input_70' type='radio' value='0'  id='choice_8_70_0'    \/>\n\t\t\t\t<label for='choice_8_70_0' id='label_8_70_0' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_70_1'>\n\t\t\t\t<input name='input_70' type='radio' value='1'  id='choice_8_70_1'    \/>\n\t\t\t\t<label for='choice_8_70_1' id='label_8_70_1' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_70_2'>\n\t\t\t\t<input name='input_70' type='radio' value='2'  id='choice_8_70_2'    \/>\n\t\t\t\t<label for='choice_8_70_2' id='label_8_70_2' class='gform-field-label gform-field-label--type-inline'>Often<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_70_3'>\n\t\t\t\t<input name='input_70' type='radio' value='3'  id='choice_8_70_3'    \/>\n\t\t\t\t<label for='choice_8_70_3' id='label_8_70_3' class='gform-field-label gform-field-label--type-inline'>All the time<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_8_10' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_8_10' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_8_3' class='gform_page' data-js='page-field-id-10' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_8_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_8_95\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">2. I have difficulty remembering things that happened or what people told me<\/h2><\/li><li id=\"field_8_59\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >A. FREQUENCY<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_8_59'>\n\t\t\t<li class='gchoice gchoice_8_59_0'>\n\t\t\t\t<input name='input_59' type='radio' value='0'  id='choice_8_59_0'    \/>\n\t\t\t\t<label for='choice_8_59_0' id='label_8_59_0' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_59_1'>\n\t\t\t\t<input name='input_59' type='radio' value='1'  id='choice_8_59_1'    \/>\n\t\t\t\t<label for='choice_8_59_1' id='label_8_59_1' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_59_2'>\n\t\t\t\t<input name='input_59' type='radio' value='2'  id='choice_8_59_2'    \/>\n\t\t\t\t<label for='choice_8_59_2' id='label_8_59_2' class='gform-field-label gform-field-label--type-inline'>Often<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_59_3'>\n\t\t\t\t<input name='input_59' type='radio' value='3'  id='choice_8_59_3'    \/>\n\t\t\t\t<label for='choice_8_59_3' id='label_8_59_3' class='gform-field-label gform-field-label--type-inline'>All the time<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_8_71\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >B. HOW MUCH IT INTERFERES WITH MY LIFE<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_8_71'>\n\t\t\t<li class='gchoice gchoice_8_71_0'>\n\t\t\t\t<input name='input_71' type='radio' value='0'  id='choice_8_71_0'    \/>\n\t\t\t\t<label for='choice_8_71_0' id='label_8_71_0' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_71_1'>\n\t\t\t\t<input name='input_71' type='radio' value='1'  id='choice_8_71_1'    \/>\n\t\t\t\t<label for='choice_8_71_1' id='label_8_71_1' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_71_2'>\n\t\t\t\t<input name='input_71' type='radio' value='2'  id='choice_8_71_2'    \/>\n\t\t\t\t<label for='choice_8_71_2' id='label_8_71_2' class='gform-field-label gform-field-label--type-inline'>Often<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_71_3'>\n\t\t\t\t<input name='input_71' type='radio' value='3'  id='choice_8_71_3'    \/>\n\t\t\t\t<label for='choice_8_71_3' id='label_8_71_3' class='gform-field-label gform-field-label--type-inline'>All the time<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_8_12' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_8_12' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_8_4' class='gform_page' data-js='page-field-id-12' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_8_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_8_94\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">3. I forget what I am supposed to do<\/h2><\/li><li id=\"field_8_60\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >A. FREQUENCY<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_8_60'>\n\t\t\t<li class='gchoice gchoice_8_60_0'>\n\t\t\t\t<input name='input_60' type='radio' value='0'  id='choice_8_60_0'    \/>\n\t\t\t\t<label for='choice_8_60_0' id='label_8_60_0' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_60_1'>\n\t\t\t\t<input name='input_60' type='radio' value='1'  id='choice_8_60_1'    \/>\n\t\t\t\t<label for='choice_8_60_1' id='label_8_60_1' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_60_2'>\n\t\t\t\t<input name='input_60' type='radio' value='2'  id='choice_8_60_2'    \/>\n\t\t\t\t<label for='choice_8_60_2' id='label_8_60_2' class='gform-field-label gform-field-label--type-inline'>Often<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_60_3'>\n\t\t\t\t<input name='input_60' type='radio' value='3'  id='choice_8_60_3'    \/>\n\t\t\t\t<label for='choice_8_60_3' id='label_8_60_3' class='gform-field-label gform-field-label--type-inline'>All the time<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_8_72\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >B. HOW MUCH IT INTERFERES WITH MY LIFE<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_8_72'>\n\t\t\t<li class='gchoice gchoice_8_72_0'>\n\t\t\t\t<input name='input_72' type='radio' value='0'  id='choice_8_72_0'    \/>\n\t\t\t\t<label for='choice_8_72_0' id='label_8_72_0' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_72_1'>\n\t\t\t\t<input name='input_72' type='radio' value='1'  id='choice_8_72_1'    \/>\n\t\t\t\t<label for='choice_8_72_1' id='label_8_72_1' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_72_2'>\n\t\t\t\t<input name='input_72' type='radio' value='2'  id='choice_8_72_2'    \/>\n\t\t\t\t<label for='choice_8_72_2' id='label_8_72_2' class='gform-field-label gform-field-label--type-inline'>Often<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_72_3'>\n\t\t\t\t<input name='input_72' type='radio' value='3'  id='choice_8_72_3'    \/>\n\t\t\t\t<label for='choice_8_72_3' id='label_8_72_3' class='gform-field-label gform-field-label--type-inline'>All the time<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_8_15' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_8_15' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_8_5' class='gform_page' data-js='page-field-id-15' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_8_5' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_8_93\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">4. I forget where I put things<\/h2><\/li><li id=\"field_8_61\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >A. FREQUENCY<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_8_61'>\n\t\t\t<li class='gchoice gchoice_8_61_0'>\n\t\t\t\t<input name='input_61' type='radio' value='0'  id='choice_8_61_0'    \/>\n\t\t\t\t<label for='choice_8_61_0' id='label_8_61_0' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_61_1'>\n\t\t\t\t<input name='input_61' type='radio' value='1'  id='choice_8_61_1'    \/>\n\t\t\t\t<label for='choice_8_61_1' id='label_8_61_1' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_61_2'>\n\t\t\t\t<input name='input_61' type='radio' value='2'  id='choice_8_61_2'    \/>\n\t\t\t\t<label for='choice_8_61_2' id='label_8_61_2' class='gform-field-label gform-field-label--type-inline'>Often<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_61_3'>\n\t\t\t\t<input name='input_61' type='radio' value='3'  id='choice_8_61_3'    \/>\n\t\t\t\t<label for='choice_8_61_3' id='label_8_61_3' class='gform-field-label gform-field-label--type-inline'>All the time<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_8_73\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >B. HOW MUCH IT INTERFERES WITH MY LIFE<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_8_73'>\n\t\t\t<li class='gchoice gchoice_8_73_0'>\n\t\t\t\t<input name='input_73' type='radio' value='0'  id='choice_8_73_0'    \/>\n\t\t\t\t<label for='choice_8_73_0' id='label_8_73_0' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_73_1'>\n\t\t\t\t<input name='input_73' type='radio' value='1'  id='choice_8_73_1'    \/>\n\t\t\t\t<label for='choice_8_73_1' id='label_8_73_1' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_73_2'>\n\t\t\t\t<input name='input_73' type='radio' value='2'  id='choice_8_73_2'    \/>\n\t\t\t\t<label for='choice_8_73_2' id='label_8_73_2' class='gform-field-label gform-field-label--type-inline'>Often<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_73_3'>\n\t\t\t\t<input name='input_73' type='radio' value='3'  id='choice_8_73_3'    \/>\n\t\t\t\t<label for='choice_8_73_3' id='label_8_73_3' class='gform-field-label gform-field-label--type-inline'>All the time<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_8_18' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_8_18' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_8_6' class='gform_page' data-js='page-field-id-18' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_8_6' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_8_92\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">5. When I am speaking I forget what I was going to say<\/h2><\/li><li id=\"field_8_62\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >A. FREQUENCY<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_8_62'>\n\t\t\t<li class='gchoice gchoice_8_62_0'>\n\t\t\t\t<input name='input_62' type='radio' value='0'  id='choice_8_62_0'    \/>\n\t\t\t\t<label for='choice_8_62_0' id='label_8_62_0' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_62_1'>\n\t\t\t\t<input name='input_62' type='radio' value='1'  id='choice_8_62_1'    \/>\n\t\t\t\t<label for='choice_8_62_1' id='label_8_62_1' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_62_2'>\n\t\t\t\t<input name='input_62' type='radio' value='2'  id='choice_8_62_2'    \/>\n\t\t\t\t<label for='choice_8_62_2' id='label_8_62_2' class='gform-field-label gform-field-label--type-inline'>Often<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_62_3'>\n\t\t\t\t<input name='input_62' type='radio' value='3'  id='choice_8_62_3'    \/>\n\t\t\t\t<label for='choice_8_62_3' id='label_8_62_3' class='gform-field-label gform-field-label--type-inline'>All the time<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_8_74\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >B. HOW MUCH IT INTERFERES WITH MY LIFE<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_8_74'>\n\t\t\t<li class='gchoice gchoice_8_74_0'>\n\t\t\t\t<input name='input_74' type='radio' value='0'  id='choice_8_74_0'    \/>\n\t\t\t\t<label for='choice_8_74_0' id='label_8_74_0' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_74_1'>\n\t\t\t\t<input name='input_74' type='radio' value='1'  id='choice_8_74_1'    \/>\n\t\t\t\t<label for='choice_8_74_1' id='label_8_74_1' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_74_2'>\n\t\t\t\t<input name='input_74' type='radio' value='2'  id='choice_8_74_2'    \/>\n\t\t\t\t<label for='choice_8_74_2' id='label_8_74_2' class='gform-field-label gform-field-label--type-inline'>Often<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_74_3'>\n\t\t\t\t<input name='input_74' type='radio' value='3'  id='choice_8_74_3'    \/>\n\t\t\t\t<label for='choice_8_74_3' id='label_8_74_3' class='gform-field-label gform-field-label--type-inline'>All the time<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_8_21' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_8_21' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_8_7' class='gform_page' data-js='page-field-id-21' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_8_7' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_8_91\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">6. I have difficulty planning ahead or making decisions<\/h2><\/li><li id=\"field_8_63\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >A. FREQUENCY<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_8_63'>\n\t\t\t<li class='gchoice gchoice_8_63_0'>\n\t\t\t\t<input name='input_63' type='radio' value='0'  id='choice_8_63_0'    \/>\n\t\t\t\t<label for='choice_8_63_0' id='label_8_63_0' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_63_1'>\n\t\t\t\t<input name='input_63' type='radio' value='1'  id='choice_8_63_1'    \/>\n\t\t\t\t<label for='choice_8_63_1' id='label_8_63_1' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_63_2'>\n\t\t\t\t<input name='input_63' type='radio' value='2'  id='choice_8_63_2'    \/>\n\t\t\t\t<label for='choice_8_63_2' id='label_8_63_2' class='gform-field-label gform-field-label--type-inline'>Often<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_63_3'>\n\t\t\t\t<input name='input_63' type='radio' value='3'  id='choice_8_63_3'    \/>\n\t\t\t\t<label for='choice_8_63_3' id='label_8_63_3' class='gform-field-label gform-field-label--type-inline'>All the time<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_8_75\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >B. HOW MUCH IT INTERFERES WITH MY LIFE<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_8_75'>\n\t\t\t<li class='gchoice gchoice_8_75_0'>\n\t\t\t\t<input name='input_75' type='radio' value='0'  id='choice_8_75_0'    \/>\n\t\t\t\t<label for='choice_8_75_0' id='label_8_75_0' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_75_1'>\n\t\t\t\t<input name='input_75' type='radio' value='1'  id='choice_8_75_1'    \/>\n\t\t\t\t<label for='choice_8_75_1' id='label_8_75_1' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_75_2'>\n\t\t\t\t<input name='input_75' type='radio' value='2'  id='choice_8_75_2'    \/>\n\t\t\t\t<label for='choice_8_75_2' id='label_8_75_2' class='gform-field-label gform-field-label--type-inline'>Often<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_75_3'>\n\t\t\t\t<input name='input_75' type='radio' value='3'  id='choice_8_75_3'    \/>\n\t\t\t\t<label for='choice_8_75_3' id='label_8_75_3' class='gform-field-label gform-field-label--type-inline'>All the time<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_8_24' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_8_24' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_8_8' class='gform_page' data-js='page-field-id-24' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_8_8' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_8_90\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">7. I keep doing the same thing even though it does not work<\/h2><\/li><li id=\"field_8_64\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >A. FREQUENCY<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_8_64'>\n\t\t\t<li class='gchoice gchoice_8_64_0'>\n\t\t\t\t<input name='input_64' type='radio' value='0'  id='choice_8_64_0'    \/>\n\t\t\t\t<label for='choice_8_64_0' id='label_8_64_0' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_64_1'>\n\t\t\t\t<input name='input_64' type='radio' value='1'  id='choice_8_64_1'    \/>\n\t\t\t\t<label for='choice_8_64_1' id='label_8_64_1' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_64_2'>\n\t\t\t\t<input name='input_64' type='radio' value='2'  id='choice_8_64_2'    \/>\n\t\t\t\t<label for='choice_8_64_2' id='label_8_64_2' class='gform-field-label gform-field-label--type-inline'>Often<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_64_3'>\n\t\t\t\t<input name='input_64' type='radio' value='3'  id='choice_8_64_3'    \/>\n\t\t\t\t<label for='choice_8_64_3' id='label_8_64_3' class='gform-field-label gform-field-label--type-inline'>All the time<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_8_76\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >B. HOW MUCH IT INTERFERES WITH MY LIFE<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_8_76'>\n\t\t\t<li class='gchoice gchoice_8_76_0'>\n\t\t\t\t<input name='input_76' type='radio' value='0'  id='choice_8_76_0'    \/>\n\t\t\t\t<label for='choice_8_76_0' id='label_8_76_0' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_76_1'>\n\t\t\t\t<input name='input_76' type='radio' value='1'  id='choice_8_76_1'    \/>\n\t\t\t\t<label for='choice_8_76_1' id='label_8_76_1' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_76_2'>\n\t\t\t\t<input name='input_76' type='radio' value='2'  id='choice_8_76_2'    \/>\n\t\t\t\t<label for='choice_8_76_2' id='label_8_76_2' class='gform-field-label gform-field-label--type-inline'>Often<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_76_3'>\n\t\t\t\t<input name='input_76' type='radio' value='3'  id='choice_8_76_3'    \/>\n\t\t\t\t<label for='choice_8_76_3' id='label_8_76_3' class='gform-field-label gform-field-label--type-inline'>All the time<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_8_27' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_8_27' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_8_9' class='gform_page' data-js='page-field-id-27' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_8_9' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_8_89\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">8. I do things without thinking<\/h2><\/li><li id=\"field_8_65\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >A. FREQUENCY<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_8_65'>\n\t\t\t<li class='gchoice gchoice_8_65_0'>\n\t\t\t\t<input name='input_65' type='radio' value='0'  id='choice_8_65_0'    \/>\n\t\t\t\t<label for='choice_8_65_0' id='label_8_65_0' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_65_1'>\n\t\t\t\t<input name='input_65' type='radio' value='1'  id='choice_8_65_1'    \/>\n\t\t\t\t<label for='choice_8_65_1' id='label_8_65_1' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_65_2'>\n\t\t\t\t<input name='input_65' type='radio' value='2'  id='choice_8_65_2'    \/>\n\t\t\t\t<label for='choice_8_65_2' id='label_8_65_2' class='gform-field-label gform-field-label--type-inline'>Often<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_65_3'>\n\t\t\t\t<input name='input_65' type='radio' value='3'  id='choice_8_65_3'    \/>\n\t\t\t\t<label for='choice_8_65_3' id='label_8_65_3' class='gform-field-label gform-field-label--type-inline'>All the time<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_8_77\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >B. HOW MUCH IT INTERFERES WITH MY LIFE<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_8_77'>\n\t\t\t<li class='gchoice gchoice_8_77_0'>\n\t\t\t\t<input name='input_77' type='radio' value='0'  id='choice_8_77_0'    \/>\n\t\t\t\t<label for='choice_8_77_0' id='label_8_77_0' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_77_1'>\n\t\t\t\t<input name='input_77' type='radio' value='1'  id='choice_8_77_1'    \/>\n\t\t\t\t<label for='choice_8_77_1' id='label_8_77_1' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_77_2'>\n\t\t\t\t<input name='input_77' type='radio' value='2'  id='choice_8_77_2'    \/>\n\t\t\t\t<label for='choice_8_77_2' id='label_8_77_2' class='gform-field-label gform-field-label--type-inline'>Often<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_77_3'>\n\t\t\t\t<input name='input_77' type='radio' value='3'  id='choice_8_77_3'    \/>\n\t\t\t\t<label for='choice_8_77_3' id='label_8_77_3' class='gform-field-label gform-field-label--type-inline'>All the time<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_8_30' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_8_30' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_8_10' class='gform_page' data-js='page-field-id-30' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_8_10' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_8_88\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">9. I have difficulty adjusting to changes<\/h2><\/li><li id=\"field_8_66\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >A. FREQUENCY<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_8_66'>\n\t\t\t<li class='gchoice gchoice_8_66_0'>\n\t\t\t\t<input name='input_66' type='radio' value='0'  id='choice_8_66_0'    \/>\n\t\t\t\t<label for='choice_8_66_0' id='label_8_66_0' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_66_1'>\n\t\t\t\t<input name='input_66' type='radio' value='1'  id='choice_8_66_1'    \/>\n\t\t\t\t<label for='choice_8_66_1' id='label_8_66_1' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_66_2'>\n\t\t\t\t<input name='input_66' type='radio' value='2'  id='choice_8_66_2'    \/>\n\t\t\t\t<label for='choice_8_66_2' id='label_8_66_2' class='gform-field-label gform-field-label--type-inline'>Often<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_66_3'>\n\t\t\t\t<input name='input_66' type='radio' value='3'  id='choice_8_66_3'    \/>\n\t\t\t\t<label for='choice_8_66_3' id='label_8_66_3' class='gform-field-label gform-field-label--type-inline'>All the time<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_8_78\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >B. HOW MUCH IT INTERFERES WITH MY LIFE<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_8_78'>\n\t\t\t<li class='gchoice gchoice_8_78_0'>\n\t\t\t\t<input name='input_78' type='radio' value='0'  id='choice_8_78_0'    \/>\n\t\t\t\t<label for='choice_8_78_0' id='label_8_78_0' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_78_1'>\n\t\t\t\t<input name='input_78' type='radio' value='1'  id='choice_8_78_1'    \/>\n\t\t\t\t<label for='choice_8_78_1' id='label_8_78_1' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_78_2'>\n\t\t\t\t<input name='input_78' type='radio' value='2'  id='choice_8_78_2'    \/>\n\t\t\t\t<label for='choice_8_78_2' id='label_8_78_2' class='gform-field-label gform-field-label--type-inline'>Often<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_78_3'>\n\t\t\t\t<input name='input_78' type='radio' value='3'  id='choice_8_78_3'    \/>\n\t\t\t\t<label for='choice_8_78_3' id='label_8_78_3' class='gform-field-label gform-field-label--type-inline'>All the time<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_8_34' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_8_34' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_8_11' class='gform_page' data-js='page-field-id-34' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_8_11' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_8_87\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">10. I tend to be slow in mental or physical tasks<\/h2><\/li><li id=\"field_8_67\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >A. FREQUENCY<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_8_67'>\n\t\t\t<li class='gchoice gchoice_8_67_0'>\n\t\t\t\t<input name='input_67' type='radio' value='0'  id='choice_8_67_0'    \/>\n\t\t\t\t<label for='choice_8_67_0' id='label_8_67_0' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_67_1'>\n\t\t\t\t<input name='input_67' type='radio' value='1'  id='choice_8_67_1'    \/>\n\t\t\t\t<label for='choice_8_67_1' id='label_8_67_1' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_67_2'>\n\t\t\t\t<input name='input_67' type='radio' value='2'  id='choice_8_67_2'    \/>\n\t\t\t\t<label for='choice_8_67_2' id='label_8_67_2' class='gform-field-label gform-field-label--type-inline'>Often<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_67_3'>\n\t\t\t\t<input name='input_67' type='radio' value='3'  id='choice_8_67_3'    \/>\n\t\t\t\t<label for='choice_8_67_3' id='label_8_67_3' class='gform-field-label gform-field-label--type-inline'>All the time<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_8_80\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >B. HOW MUCH IT INTERFERES WITH MY LIFE<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_8_80'>\n\t\t\t<li class='gchoice gchoice_8_80_0'>\n\t\t\t\t<input name='input_80' type='radio' value='0'  id='choice_8_80_0'    \/>\n\t\t\t\t<label for='choice_8_80_0' id='label_8_80_0' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_80_1'>\n\t\t\t\t<input name='input_80' type='radio' value='1'  id='choice_8_80_1'    \/>\n\t\t\t\t<label for='choice_8_80_1' id='label_8_80_1' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_80_2'>\n\t\t\t\t<input name='input_80' type='radio' value='2'  id='choice_8_80_2'    \/>\n\t\t\t\t<label for='choice_8_80_2' id='label_8_80_2' class='gform-field-label gform-field-label--type-inline'>Often<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_80_3'>\n\t\t\t\t<input name='input_80' type='radio' value='3'  id='choice_8_80_3'    \/>\n\t\t\t\t<label for='choice_8_80_3' id='label_8_80_3' class='gform-field-label gform-field-label--type-inline'>All the time<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_8_36' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_8_36' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_8_12' class='gform_page' data-js='page-field-id-36' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_8_12' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_8_86\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">11. I have trouble reading someone&#039;s facial expression or gestures<\/h2><\/li><li id=\"field_8_68\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >A. FREQUENCY<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_8_68'>\n\t\t\t<li class='gchoice gchoice_8_68_0'>\n\t\t\t\t<input name='input_68' type='radio' value='0'  id='choice_8_68_0'    \/>\n\t\t\t\t<label for='choice_8_68_0' id='label_8_68_0' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_68_1'>\n\t\t\t\t<input name='input_68' type='radio' value='1'  id='choice_8_68_1'    \/>\n\t\t\t\t<label for='choice_8_68_1' id='label_8_68_1' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_68_2'>\n\t\t\t\t<input name='input_68' type='radio' value='2'  id='choice_8_68_2'    \/>\n\t\t\t\t<label for='choice_8_68_2' id='label_8_68_2' class='gform-field-label gform-field-label--type-inline'>Often<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_68_3'>\n\t\t\t\t<input name='input_68' type='radio' value='3'  id='choice_8_68_3'    \/>\n\t\t\t\t<label for='choice_8_68_3' id='label_8_68_3' class='gform-field-label gform-field-label--type-inline'>All the time<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_8_81\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >B. HOW MUCH IT INTERFERES WITH MY LIFE<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_8_81'>\n\t\t\t<li class='gchoice gchoice_8_81_0'>\n\t\t\t\t<input name='input_81' type='radio' value='0'  id='choice_8_81_0'    \/>\n\t\t\t\t<label for='choice_8_81_0' id='label_8_81_0' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_81_1'>\n\t\t\t\t<input name='input_81' type='radio' value='1'  id='choice_8_81_1'    \/>\n\t\t\t\t<label for='choice_8_81_1' id='label_8_81_1' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_81_2'>\n\t\t\t\t<input name='input_81' type='radio' value='2'  id='choice_8_81_2'    \/>\n\t\t\t\t<label for='choice_8_81_2' id='label_8_81_2' class='gform-field-label gform-field-label--type-inline'>Often<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_81_3'>\n\t\t\t\t<input name='input_81' type='radio' value='3'  id='choice_8_81_3'    \/>\n\t\t\t\t<label for='choice_8_81_3' id='label_8_81_3' class='gform-field-label gform-field-label--type-inline'>All the time<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_8_40' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_8_40' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_8_13' class='gform_page' data-js='page-field-id-40' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_8_13' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_8_85\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">12. I have difficulty understanding how another person feels<\/h2><\/li><li id=\"field_8_69\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >A. FREQUENCY<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_8_69'>\n\t\t\t<li class='gchoice gchoice_8_69_0'>\n\t\t\t\t<input name='input_69' type='radio' value='0'  id='choice_8_69_0'    \/>\n\t\t\t\t<label for='choice_8_69_0' id='label_8_69_0' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_69_1'>\n\t\t\t\t<input name='input_69' type='radio' value='1'  id='choice_8_69_1'    \/>\n\t\t\t\t<label for='choice_8_69_1' id='label_8_69_1' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_69_2'>\n\t\t\t\t<input name='input_69' type='radio' value='2'  id='choice_8_69_2'    \/>\n\t\t\t\t<label for='choice_8_69_2' id='label_8_69_2' class='gform-field-label gform-field-label--type-inline'>Often<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_69_3'>\n\t\t\t\t<input name='input_69' type='radio' value='3'  id='choice_8_69_3'    \/>\n\t\t\t\t<label for='choice_8_69_3' id='label_8_69_3' class='gform-field-label gform-field-label--type-inline'>All the time<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_8_82\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >B. HOW MUCH IT INTERFERES WITH MY LIFE<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_8_82'>\n\t\t\t<li class='gchoice gchoice_8_82_0'>\n\t\t\t\t<input name='input_82' type='radio' value='0'  id='choice_8_82_0'    \/>\n\t\t\t\t<label for='choice_8_82_0' id='label_8_82_0' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_82_1'>\n\t\t\t\t<input name='input_82' type='radio' value='1'  id='choice_8_82_1'    \/>\n\t\t\t\t<label for='choice_8_82_1' id='label_8_82_1' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_82_2'>\n\t\t\t\t<input name='input_82' type='radio' value='2'  id='choice_8_82_2'    \/>\n\t\t\t\t<label for='choice_8_82_2' id='label_8_82_2' class='gform-field-label gform-field-label--type-inline'>Often<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_8_82_3'>\n\t\t\t\t<input name='input_82' type='radio' value='3'  id='choice_8_82_3'    \/>\n\t\t\t\t<label for='choice_8_82_3' id='label_8_82_3' class='gform-field-label gform-field-label--type-inline'>All the time<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_8_57\" class=\"gfield gfield--type-number gfield_calculation field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_8_57'>Frequency Score<\/label><div class='ginput_container ginput_container_number'><input name='input_57' id='input_8_57' type='text' step='any'   value='' class='medium gform-text-input-reset'  readonly=\"readonly\"    aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_8_96\" class=\"gfield gfield--type-number gfield_calculation field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_8_96'>Severity Score<\/label><div class='ginput_container ginput_container_number'><input name='input_96' id='input_8_96' type='text' step='any'   value='' class='medium gform-text-input-reset'  readonly=\"readonly\"    aria-invalid=\"false\"  \/><\/div><\/li><\/ul><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><input type='submit' id='gform_previous_button_8' class='gform_previous_button 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