{"id":9422,"date":"2023-05-09T11:50:35","date_gmt":"2023-05-09T10:50:35","guid":{"rendered":"https:\/\/www.herbalreality.com\/?page_id=9422"},"modified":"2025-03-19T16:45:51","modified_gmt":"2025-03-19T16:45:51","slug":"health-quiz","status":"publish","type":"page","link":"https:\/\/www.herbalreality.com\/health-quiz\/","title":{"rendered":"Health quiz"},"content":{"rendered":"<script>\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 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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<\/script>\n\n                <div class='gf_browser_unknown gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_2' style='display:none'><form method='post' enctype='multipart\/form-data'  id='gform_2'  action='\/wp-json\/wp\/v2\/pages\/9422' data-formid='2' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_2' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_2_37\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Tell us a bit more about yourself<\/h3><\/div><fieldset id=\"field_2_38\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >What is your age?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_38'>\n\t\t\t<div class='gchoice gchoice_2_38_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='18'  id='choice_2_38_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_38_0' id='label_2_38_0' class='gform-field-label gform-field-label--type-inline'>18 to 24<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_38_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='25'  id='choice_2_38_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_38_1' id='label_2_38_1' class='gform-field-label gform-field-label--type-inline'>25 to 34<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_38_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='35'  id='choice_2_38_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_38_2' id='label_2_38_2' class='gform-field-label gform-field-label--type-inline'>35 to 44<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_38_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='45'  id='choice_2_38_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_38_3' id='label_2_38_3' class='gform-field-label gform-field-label--type-inline'>45 to 54<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_38_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='55'  id='choice_2_38_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_38_4' id='label_2_38_4' class='gform-field-label gform-field-label--type-inline'>55 to 64<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_38_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='65'  id='choice_2_38_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_38_5' id='label_2_38_5' class='gform-field-label gform-field-label--type-inline'>65 to 74<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_38_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='75'  id='choice_2_38_6' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_38_6' id='label_2_38_6' class='gform-field-label gform-field-label--type-inline'>75 and older<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_39\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >What sex were you born with?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_2_39'>Please note that when we refer to \u201cmen\u201d and \u201cwomen\u201d we are referring to biological sex for medical purposes and not gender<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_39'>\n\t\t\t<div class='gchoice gchoice_2_39_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_39' type='radio' value='Male'  id='choice_2_39_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_2_39\"   \/>\n\t\t\t\t\t<label for='choice_2_39_0' id='label_2_39_0' class='gform-field-label gform-field-label--type-inline'>Male<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_39_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_39' type='radio' value='Female'  id='choice_2_39_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_39_1' id='label_2_39_1' class='gform-field-label gform-field-label--type-inline'>Female<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_53\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_53'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_53' id='input_2_53' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><fieldset id=\"field_2_63\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Newsletter<\/legend><div class='ginput_container ginput_container_consent'><input name='input_63.1' id='input_2_63_1' type='checkbox' value='1'    aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_2_63_1' >Sign up to our newsletter and stay up to date with the latest herb news<\/label><input type='hidden' name='input_63.2' value='Sign up to our newsletter and stay up to date with the latest herb news' class='gform_hidden' \/><input type='hidden' name='input_63.3' value='1' class='gform_hidden' \/><\/div><\/fieldset><div id=\"field_2_9\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Your digestion<\/h3><\/div><fieldset id=\"field_2_7\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >How do you feel about your digestion?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_7'>\n\t\t\t<div class='gchoice gchoice_2_7_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='5'  id='choice_2_7_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_7_0' id='label_2_7_0' class='gform-field-label gform-field-label--type-inline'>Very satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_7_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='4'  id='choice_2_7_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_7_1' id='label_2_7_1' class='gform-field-label gform-field-label--type-inline'>Satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_7_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='3'  id='choice_2_7_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_7_2' id='label_2_7_2' class='gform-field-label gform-field-label--type-inline'>Neither satisfied nor dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_7_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='2'  id='choice_2_7_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_7_3' id='label_2_7_3' class='gform-field-label gform-field-label--type-inline'>Dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_7_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='1'  id='choice_2_7_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_7_4' id='label_2_7_4' class='gform-field-label gform-field-label--type-inline'>Very dissatisfied<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_8\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you get bloated?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_8'>\n\t\t\t<div class='gchoice gchoice_2_8_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='1'  id='choice_2_8_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_8_0' id='label_2_8_0' class='gform-field-label gform-field-label--type-inline'>A great deal<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_8_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='2'  id='choice_2_8_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_8_1' id='label_2_8_1' class='gform-field-label gform-field-label--type-inline'>A lot<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_8_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='3'  id='choice_2_8_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_8_2' id='label_2_8_2' class='gform-field-label gform-field-label--type-inline'>A moderate amount<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_8_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='4'  id='choice_2_8_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_8_3' id='label_2_8_3' class='gform-field-label gform-field-label--type-inline'>A little<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_8_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='5'  id='choice_2_8_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_8_4' id='label_2_8_4' class='gform-field-label gform-field-label--type-inline'>None at all<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_14\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you suffer with acidity and heartburn?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_14'>\n\t\t\t<div class='gchoice gchoice_2_14_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='1'  id='choice_2_14_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_14_0' id='label_2_14_0' class='gform-field-label gform-field-label--type-inline'>A great deal<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_14_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='2'  id='choice_2_14_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_14_1' id='label_2_14_1' class='gform-field-label gform-field-label--type-inline'>A lot<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_14_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='3'  id='choice_2_14_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_14_2' id='label_2_14_2' class='gform-field-label gform-field-label--type-inline'>A moderate amount<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_14_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='4'  id='choice_2_14_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_14_3' id='label_2_14_3' class='gform-field-label gform-field-label--type-inline'>A little<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_14_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='5'  id='choice_2_14_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_14_4' id='label_2_14_4' class='gform-field-label gform-field-label--type-inline'>None at all<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_54\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you have regular and healthy bowel movements?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_54'>\n\t\t\t<div class='gchoice gchoice_2_54_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_54' type='radio' value='5'  id='choice_2_54_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_54_0' id='label_2_54_0' class='gform-field-label gform-field-label--type-inline'>Always<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_54_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_54' type='radio' value='4'  id='choice_2_54_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_54_1' id='label_2_54_1' class='gform-field-label gform-field-label--type-inline'>Usually<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_54_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_54' type='radio' value='3'  id='choice_2_54_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_54_2' id='label_2_54_2' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_54_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_54' type='radio' value='2'  id='choice_2_54_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_54_3' id='label_2_54_3' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_54_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_54' type='radio' value='1'  id='choice_2_54_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_54_4' id='label_2_54_4' class='gform-field-label gform-field-label--type-inline'>Never<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_6\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_calculation field_sublabel_below gfield--no-description field_description_above 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_2_6'>Digestion<\/label><div class='ginput_container ginput_container_number'><input name='input_6' id='input_2_6' type='text' step='any'   value='' class='large gform-text-input-reset'  readonly=\"readonly\"    aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_2_10\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Your sleep<\/h3><\/div><fieldset id=\"field_2_11\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >How do you feel about your sleep?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_11'>\n\t\t\t<div class='gchoice gchoice_2_11_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='5'  id='choice_2_11_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_11_0' id='label_2_11_0' class='gform-field-label gform-field-label--type-inline'>Very satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_11_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='4'  id='choice_2_11_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_11_1' id='label_2_11_1' class='gform-field-label gform-field-label--type-inline'>Satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_11_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='3'  id='choice_2_11_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_11_2' id='label_2_11_2' class='gform-field-label gform-field-label--type-inline'>Neither satisfied nor dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_11_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='2'  id='choice_2_11_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_11_3' id='label_2_11_3' class='gform-field-label gform-field-label--type-inline'>Dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_11_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='1'  id='choice_2_11_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_11_4' id='label_2_11_4' class='gform-field-label gform-field-label--type-inline'>Very dissatisfied<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_17\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you rested when you wake up?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_17'>\n\t\t\t<div class='gchoice gchoice_2_17_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='5'  id='choice_2_17_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_17_0' id='label_2_17_0' class='gform-field-label gform-field-label--type-inline'>Well rested<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_17_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='4'  id='choice_2_17_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_17_1' id='label_2_17_1' class='gform-field-label gform-field-label--type-inline'>Not quite fully rested<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_17_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='3'  id='choice_2_17_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_17_2' id='label_2_17_2' class='gform-field-label gform-field-label--type-inline'>Not sure<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_17_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='2'  id='choice_2_17_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_17_3' id='label_2_17_3' class='gform-field-label gform-field-label--type-inline'>Rested with some energy<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_17_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='1'  id='choice_2_17_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_17_4' id='label_2_17_4' class='gform-field-label gform-field-label--type-inline'>Not well rested<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_18\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you find it easy or difficult to fall asleep?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_18'>\n\t\t\t<div class='gchoice gchoice_2_18_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='5'  id='choice_2_18_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_18_0' id='label_2_18_0' class='gform-field-label gform-field-label--type-inline'>Very easy<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_18_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='4'  id='choice_2_18_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_18_1' id='label_2_18_1' class='gform-field-label gform-field-label--type-inline'>Easy<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_18_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='3'  id='choice_2_18_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_18_2' id='label_2_18_2' class='gform-field-label gform-field-label--type-inline'>Neither easy nor difficult<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_18_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='2'  id='choice_2_18_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_18_3' id='label_2_18_3' class='gform-field-label gform-field-label--type-inline'>Difficult<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_18_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='1'  id='choice_2_18_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_18_4' id='label_2_18_4' class='gform-field-label gform-field-label--type-inline'>Very difficult<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_19\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you wake up in the night?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_19'>\n\t\t\t<div class='gchoice gchoice_2_19_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='1'  id='choice_2_19_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_19_0' id='label_2_19_0' class='gform-field-label gform-field-label--type-inline'>A great deal<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_19_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='2'  id='choice_2_19_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_19_1' id='label_2_19_1' class='gform-field-label gform-field-label--type-inline'>A lot<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_19_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='3'  id='choice_2_19_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_19_2' id='label_2_19_2' class='gform-field-label gform-field-label--type-inline'>A moderate amount<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_19_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='4'  id='choice_2_19_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_19_3' id='label_2_19_3' class='gform-field-label gform-field-label--type-inline'>A little<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_19_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='5'  id='choice_2_19_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_19_4' id='label_2_19_4' class='gform-field-label gform-field-label--type-inline'>None at all<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_55\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_calculation field_sublabel_below gfield--no-description field_description_above 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_2_55'>Sleep<\/label><div class='ginput_container ginput_container_number'><input name='input_55' id='input_2_55' type='text' step='any'   value='' class='large gform-text-input-reset'  readonly=\"readonly\"    aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_2_16\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Your mood and mental health<\/h3><\/div><fieldset id=\"field_2_20\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >How do you feel about your mood in general?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_20'>\n\t\t\t<div class='gchoice gchoice_2_20_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='5'  id='choice_2_20_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_20_0' id='label_2_20_0' class='gform-field-label gform-field-label--type-inline'>Very satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_20_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='4'  id='choice_2_20_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_20_1' id='label_2_20_1' class='gform-field-label gform-field-label--type-inline'>Satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_20_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='3'  id='choice_2_20_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_20_2' id='label_2_20_2' class='gform-field-label gform-field-label--type-inline'>Neither satisfied nor dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_20_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='2'  id='choice_2_20_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_20_3' id='label_2_20_3' class='gform-field-label gform-field-label--type-inline'>Dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_20_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='1'  id='choice_2_20_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_20_4' id='label_2_20_4' class='gform-field-label gform-field-label--type-inline'>Very Dissatisfied<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_21\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >How do you feel about your stress levels in general?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_21'>\n\t\t\t<div class='gchoice gchoice_2_21_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='5'  id='choice_2_21_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_21_0' id='label_2_21_0' class='gform-field-label gform-field-label--type-inline'>Very satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_21_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='4'  id='choice_2_21_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_21_1' id='label_2_21_1' class='gform-field-label gform-field-label--type-inline'>Satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_21_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='3'  id='choice_2_21_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_21_2' id='label_2_21_2' class='gform-field-label gform-field-label--type-inline'>Neither satisfied nor dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_21_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='2'  id='choice_2_21_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_21_3' id='label_2_21_3' class='gform-field-label gform-field-label--type-inline'>Dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_21_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='1'  id='choice_2_21_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_21_4' id='label_2_21_4' class='gform-field-label gform-field-label--type-inline'>Very dissatisfied<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_22\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you happy?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_22'>\n\t\t\t<div class='gchoice gchoice_2_22_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='5'  id='choice_2_22_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_22_0' id='label_2_22_0' class='gform-field-label gform-field-label--type-inline'>Yes, I am very happy<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_22_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='4'  id='choice_2_22_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_22_1' id='label_2_22_1' class='gform-field-label gform-field-label--type-inline'>I am happy<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_22_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='3'  id='choice_2_22_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_22_2' id='label_2_22_2' class='gform-field-label gform-field-label--type-inline'>I am okay<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_22_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='2'  id='choice_2_22_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_22_3' id='label_2_22_3' class='gform-field-label gform-field-label--type-inline'>I am unhappy<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_22_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='1'  id='choice_2_22_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_22_4' id='label_2_22_4' class='gform-field-label gform-field-label--type-inline'>I am very unhappy<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_56\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_calculation field_sublabel_below gfield--no-description field_description_above 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_2_56'>Mental Health<\/label><div class='ginput_container ginput_container_number'><input name='input_56' id='input_2_56' type='text' step='any'   value='' class='large gform-text-input-reset'  readonly=\"readonly\"    aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_2_25\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Your seasonal immunity<\/h3><\/div><fieldset id=\"field_2_26\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >How do you feel about your immunity?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_26'>\n\t\t\t<div class='gchoice gchoice_2_26_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='5'  id='choice_2_26_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_26_0' id='label_2_26_0' class='gform-field-label gform-field-label--type-inline'>Very satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_26_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='4'  id='choice_2_26_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_26_1' id='label_2_26_1' class='gform-field-label gform-field-label--type-inline'>Satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_26_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='3'  id='choice_2_26_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_26_2' id='label_2_26_2' class='gform-field-label gform-field-label--type-inline'>Neither satisfied nor dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_26_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='2'  id='choice_2_26_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_26_3' id='label_2_26_3' class='gform-field-label gform-field-label--type-inline'>Dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_26_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='1'  id='choice_2_26_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_26_4' id='label_2_26_4' class='gform-field-label gform-field-label--type-inline'>Very dissatisfied<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_24\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >How often do you get ill (cold and flu)?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_24'>\n\t\t\t<div class='gchoice gchoice_2_24_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='1'  id='choice_2_24_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_24_0' id='label_2_24_0' class='gform-field-label gform-field-label--type-inline'>A great deal<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_24_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='2'  id='choice_2_24_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_24_1' id='label_2_24_1' class='gform-field-label gform-field-label--type-inline'>A lot<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_24_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='3'  id='choice_2_24_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_24_2' id='label_2_24_2' class='gform-field-label gform-field-label--type-inline'>A moderate amount<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_24_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='4'  id='choice_2_24_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_24_3' id='label_2_24_3' class='gform-field-label gform-field-label--type-inline'>A little<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_24_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='5'  id='choice_2_24_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_24_4' id='label_2_24_4' class='gform-field-label gform-field-label--type-inline'>None at all<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_65\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >How is your lymphatic circulation?<\/legend><div class='gfield_description' id='gfield_description_2_65'>If you often feel congested, puffy\/swollen or have enlarged lymph nodes, you may have poor lymph circulation.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_65'>\n\t\t\t<div class='gchoice gchoice_2_65_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_65' type='radio' value='1'  id='choice_2_65_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_2_65\"   \/>\n\t\t\t\t\t<label for='choice_2_65_0' id='label_2_65_0' class='gform-field-label gform-field-label--type-inline'>Very good<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_65_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_65' type='radio' value='2'  id='choice_2_65_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_65_1' id='label_2_65_1' class='gform-field-label gform-field-label--type-inline'>Good<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_65_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_65' type='radio' value='3'  id='choice_2_65_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_65_2' id='label_2_65_2' class='gform-field-label gform-field-label--type-inline'>Neither good nor bad<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_65_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_65' type='radio' value='4'  id='choice_2_65_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_65_3' id='label_2_65_3' class='gform-field-label gform-field-label--type-inline'>Bad<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_65_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_65' type='radio' value='5'  id='choice_2_65_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_65_4' id='label_2_65_4' class='gform-field-label gform-field-label--type-inline'>Very bad<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_57\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_calculation field_sublabel_below gfield--no-description field_description_above 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_2_57'>Seasonal Immunity<\/label><div class='ginput_container ginput_container_number'><input name='input_57' id='input_2_57' type='text' step='any'   value='' class='large gform-text-input-reset'  readonly=\"readonly\"    aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_2_59\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Your muscles and joints<\/h3><\/div><fieldset id=\"field_2_31\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >How do you feel about your flexibility?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_31'>\n\t\t\t<div class='gchoice gchoice_2_31_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='5'  id='choice_2_31_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_31_0' id='label_2_31_0' class='gform-field-label gform-field-label--type-inline'>Very satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_31_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='4'  id='choice_2_31_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_31_1' id='label_2_31_1' class='gform-field-label gform-field-label--type-inline'>Satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_31_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='3'  id='choice_2_31_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_31_2' id='label_2_31_2' class='gform-field-label gform-field-label--type-inline'>Neither satisfied nor dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_31_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='2'  id='choice_2_31_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_31_3' id='label_2_31_3' class='gform-field-label gform-field-label--type-inline'>Dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_31_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='1'  id='choice_2_31_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_31_4' id='label_2_31_4' class='gform-field-label gform-field-label--type-inline'>Very dissatisfied<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_30\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >How do you feel about your joint health?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_30'>\n\t\t\t<div class='gchoice gchoice_2_30_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='5'  id='choice_2_30_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_30_0' id='label_2_30_0' class='gform-field-label gform-field-label--type-inline'>Very satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_30_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='4'  id='choice_2_30_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_30_1' id='label_2_30_1' class='gform-field-label gform-field-label--type-inline'>Satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_30_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='3'  id='choice_2_30_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_30_2' id='label_2_30_2' class='gform-field-label gform-field-label--type-inline'>Neither satisfied nor dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_30_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='2'  id='choice_2_30_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_30_3' id='label_2_30_3' class='gform-field-label gform-field-label--type-inline'>Dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_30_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='1'  id='choice_2_30_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_30_4' id='label_2_30_4' class='gform-field-label gform-field-label--type-inline'>Very dissatisfied<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_29\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you often feel muscle pain?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_29'>\n\t\t\t<div class='gchoice gchoice_2_29_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='1'  id='choice_2_29_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_29_0' id='label_2_29_0' class='gform-field-label gform-field-label--type-inline'>Always<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_29_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='2'  id='choice_2_29_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_29_1' id='label_2_29_1' class='gform-field-label gform-field-label--type-inline'>Usually<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_29_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='3'  id='choice_2_29_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_29_2' id='label_2_29_2' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_29_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='4'  id='choice_2_29_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_29_3' id='label_2_29_3' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_29_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='5'  id='choice_2_29_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_29_4' id='label_2_29_4' class='gform-field-label gform-field-label--type-inline'>Never<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_58\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_calculation field_sublabel_below gfield--no-description field_description_above 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_2_58'>Muscles and Joints<\/label><div class='ginput_container ginput_container_number'><input name='input_58' id='input_2_58' type='text' step='any'   value='' class='large gform-text-input-reset'  readonly=\"readonly\"    aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_2_32\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Metabolic health<\/h3><\/div><fieldset id=\"field_2_64\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >How do you feel about your blood circulation?<\/legend><div class='gfield_description' id='gfield_description_2_64'>If you often have cold hands and feet or pins and needles, you may have poor circulation.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_64'>\n\t\t\t<div class='gchoice gchoice_2_64_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_64' type='radio' value='5'  id='choice_2_64_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_2_64\"   \/>\n\t\t\t\t\t<label for='choice_2_64_0' id='label_2_64_0' class='gform-field-label gform-field-label--type-inline'>Very satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_64_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_64' type='radio' value='4'  id='choice_2_64_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_64_1' id='label_2_64_1' class='gform-field-label gform-field-label--type-inline'>Satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_64_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_64' type='radio' value='3'  id='choice_2_64_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_64_2' id='label_2_64_2' class='gform-field-label gform-field-label--type-inline'>Neither satisfied nor dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_64_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_64' type='radio' value='2'  id='choice_2_64_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_64_3' id='label_2_64_3' class='gform-field-label gform-field-label--type-inline'>Dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_64_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_64' type='radio' value='1'  id='choice_2_64_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_64_4' id='label_2_64_4' class='gform-field-label gform-field-label--type-inline'>Very dissatisfied<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_36\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >How do you feel about your weight?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_36'>\n\t\t\t<div class='gchoice gchoice_2_36_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='5'  id='choice_2_36_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_36_0' id='label_2_36_0' class='gform-field-label gform-field-label--type-inline'>Very satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_36_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='4'  id='choice_2_36_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_36_1' id='label_2_36_1' class='gform-field-label gform-field-label--type-inline'>Satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_36_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='3'  id='choice_2_36_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_36_2' id='label_2_36_2' class='gform-field-label gform-field-label--type-inline'>Neither satisfied nor dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_36_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='2'  id='choice_2_36_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_36_3' id='label_2_36_3' class='gform-field-label gform-field-label--type-inline'>Dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_36_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='1'  id='choice_2_36_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_36_4' id='label_2_36_4' class='gform-field-label gform-field-label--type-inline'>Very dissatisfied<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_35\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >How do you feel about your energy levels?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_35'>\n\t\t\t<div class='gchoice gchoice_2_35_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='5'  id='choice_2_35_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_35_0' id='label_2_35_0' class='gform-field-label gform-field-label--type-inline'>Very satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_35_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='4'  id='choice_2_35_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_35_1' id='label_2_35_1' class='gform-field-label gform-field-label--type-inline'>Satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_35_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='3'  id='choice_2_35_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_35_2' id='label_2_35_2' class='gform-field-label gform-field-label--type-inline'>Neither satisfied nor dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_35_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='2'  id='choice_2_35_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_35_3' id='label_2_35_3' class='gform-field-label gform-field-label--type-inline'>Dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_35_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='1'  id='choice_2_35_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_35_4' id='label_2_35_4' class='gform-field-label gform-field-label--type-inline'>Very dissatisfied<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_33\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you often feel cold no matter the weather?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_33'>\n\t\t\t<div class='gchoice gchoice_2_33_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='1'  id='choice_2_33_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_33_0' id='label_2_33_0' class='gform-field-label gform-field-label--type-inline'>Always<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_33_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='2'  id='choice_2_33_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_33_1' id='label_2_33_1' class='gform-field-label gform-field-label--type-inline'>Usually<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_33_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='3'  id='choice_2_33_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_33_2' id='label_2_33_2' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_33_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='4'  id='choice_2_33_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_33_3' id='label_2_33_3' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_33_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='5'  id='choice_2_33_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_33_4' id='label_2_33_4' class='gform-field-label gform-field-label--type-inline'>Never<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_60\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_calculation field_sublabel_below gfield--no-description field_description_above 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_2_60'>Metabolic Health<\/label><div class='ginput_container ginput_container_number'><input name='input_60' id='input_2_60' type='text' step='any'   value='' class='large gform-text-input-reset'  readonly=\"readonly\"    aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_2_41\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Your hormonal system<\/h3><\/div><fieldset id=\"field_2_42\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you currently menstruate?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_42'>\n\t\t\t<div class='gchoice gchoice_2_42_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='Yes'  id='choice_2_42_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_42_0' id='label_2_42_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_42_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='No'  id='choice_2_42_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_42_1' id='label_2_42_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_52\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Guide<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_52'><div class='gchoice gchoice_2_52_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.1' type='checkbox'  value='yes'  id='choice_2_52_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_52_1' id='label_2_52_1' class='gform-field-label gform-field-label--type-inline'>If you are going through the menopause and want a natural approach to menopause guide please tick here.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_43\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >How do you feel about your menstrual cycle?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_43'>\n\t\t\t<div class='gchoice gchoice_2_43_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='5'  id='choice_2_43_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_43_0' id='label_2_43_0' class='gform-field-label gform-field-label--type-inline'>Very satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_43_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='4'  id='choice_2_43_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_43_1' id='label_2_43_1' class='gform-field-label gform-field-label--type-inline'>Satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_43_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='3'  id='choice_2_43_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_43_2' id='label_2_43_2' class='gform-field-label gform-field-label--type-inline'>Neither satisfied nor dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_43_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='2'  id='choice_2_43_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_43_3' id='label_2_43_3' class='gform-field-label gform-field-label--type-inline'>Dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_43_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='1'  id='choice_2_43_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_43_4' id='label_2_43_4' class='gform-field-label gform-field-label--type-inline'>Very dissatisfied<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_44\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >How do you feel about your hormone balance?<\/legend><div class='gfield_description' id='gfield_description_2_44'>This can include hormones that aren\u2019t reproductive like stress and thyroid hormones.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_44'>\n\t\t\t<div class='gchoice gchoice_2_44_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='5'  id='choice_2_44_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_2_44\"   \/>\n\t\t\t\t\t<label for='choice_2_44_0' id='label_2_44_0' class='gform-field-label gform-field-label--type-inline'>Very satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_44_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='4'  id='choice_2_44_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_44_1' id='label_2_44_1' class='gform-field-label gform-field-label--type-inline'>Satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_44_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='3'  id='choice_2_44_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_44_2' id='label_2_44_2' class='gform-field-label gform-field-label--type-inline'>Neither satisfied nor dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_44_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='2'  id='choice_2_44_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_44_3' id='label_2_44_3' class='gform-field-label gform-field-label--type-inline'>Dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_44_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='1'  id='choice_2_44_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_44_4' id='label_2_44_4' class='gform-field-label gform-field-label--type-inline'>Very dissatisfied<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_46\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >How do you feel about your libido?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_46'>\n\t\t\t<div class='gchoice gchoice_2_46_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='5'  id='choice_2_46_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_46_0' id='label_2_46_0' class='gform-field-label gform-field-label--type-inline'>Very satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_46_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='4'  id='choice_2_46_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_46_1' id='label_2_46_1' class='gform-field-label gform-field-label--type-inline'>Satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_46_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='3'  id='choice_2_46_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_46_2' id='label_2_46_2' class='gform-field-label gform-field-label--type-inline'>Neither satisfied nor dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_46_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='2'  id='choice_2_46_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_46_3' id='label_2_46_3' class='gform-field-label gform-field-label--type-inline'>Dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_46_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='1'  id='choice_2_46_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_46_4' id='label_2_46_4' class='gform-field-label gform-field-label--type-inline'>Very dissatisfied<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_61\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_calculation field_sublabel_below gfield--no-description field_description_above 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_2_61'>Hormonal Health &#8211; Woman<\/label><div class='ginput_container ginput_container_number'><input name='input_61' id='input_2_61' type='text' step='any'   value='' class='large gform-text-input-reset'  readonly=\"readonly\"    aria-invalid=\"false\"  \/><\/div><\/div><fieldset id=\"field_2_50\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you regularly feel tired?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_50'>\n\t\t\t<div class='gchoice gchoice_2_50_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='1'  id='choice_2_50_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_50_0' id='label_2_50_0' class='gform-field-label gform-field-label--type-inline'>A great deal<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_50_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='2'  id='choice_2_50_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_50_1' id='label_2_50_1' class='gform-field-label gform-field-label--type-inline'>A lot<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_50_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='3'  id='choice_2_50_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_50_2' id='label_2_50_2' class='gform-field-label gform-field-label--type-inline'>A moderate amount<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_50_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='4'  id='choice_2_50_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_50_3' id='label_2_50_3' class='gform-field-label gform-field-label--type-inline'>A little<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_50_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='5'  id='choice_2_50_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_50_4' id='label_2_50_4' class='gform-field-label gform-field-label--type-inline'>None at all<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_49\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is your weight stable?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_49'>\n\t\t\t<div class='gchoice gchoice_2_49_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='5'  id='choice_2_49_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_49_0' id='label_2_49_0' class='gform-field-label gform-field-label--type-inline'>Always<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_49_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='4'  id='choice_2_49_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_49_1' id='label_2_49_1' class='gform-field-label gform-field-label--type-inline'>Usually<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_49_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='3'  id='choice_2_49_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_49_2' id='label_2_49_2' class='gform-field-label gform-field-label--type-inline'>Sometimes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_49_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='2'  id='choice_2_49_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_49_3' id='label_2_49_3' class='gform-field-label gform-field-label--type-inline'>Rarely<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_49_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='1'  id='choice_2_49_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_49_4' id='label_2_49_4' class='gform-field-label gform-field-label--type-inline'>Never<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_2_48\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >How do you feel about your libido?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_48'>\n\t\t\t<div class='gchoice gchoice_2_48_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_48' type='radio' value='5'  id='choice_2_48_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_48_0' id='label_2_48_0' class='gform-field-label gform-field-label--type-inline'>Very satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_48_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_48' type='radio' value='4'  id='choice_2_48_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_48_1' id='label_2_48_1' class='gform-field-label gform-field-label--type-inline'>Satisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_48_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_48' type='radio' value='3'  id='choice_2_48_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_48_2' id='label_2_48_2' class='gform-field-label gform-field-label--type-inline'>Neither satisfied nor dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_48_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_48' type='radio' value='2'  id='choice_2_48_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_48_3' id='label_2_48_3' class='gform-field-label gform-field-label--type-inline'>Dissatisfied<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_48_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_48' type='radio' value='1'  id='choice_2_48_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_48_4' id='label_2_48_4' class='gform-field-label gform-field-label--type-inline'>Very dissatisfied<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_62\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_calculation field_sublabel_below gfield--no-description field_description_above 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_2_62'>Hormonal Health &#8211; Male<\/label><div class='ginput_container ginput_container_number'><input name='input_62' id='input_2_62' type='text' step='any'   value='' class='large gform-text-input-reset'  readonly=\"readonly\"    aria-invalid=\"false\"  \/><\/div><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_2' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Submit'  \/> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_2' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_2' id='gform_theme_2' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_2' id='gform_style_settings_2' value='{&quot;inputPrimaryColor&quot;:&quot;#204ce5&quot;}' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_2' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='2' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' 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