{"id":4088,"date":"2020-08-26T23:30:37","date_gmt":"2020-08-26T23:30:37","guid":{"rendered":"http:\/\/kidsandco.eu\/enrollment\/"},"modified":"2023-08-19T13:08:43","modified_gmt":"2023-08-19T12:08:43","slug":"enrollment","status":"publish","type":"page","link":"https:\/\/kidsandco.eu\/en\/enrollment\/","title":{"rendered":"Enrollment"},"content":{"rendered":"<p>[vc_row css_animation=&#8221;fadeInDown&#8221;][vc_column][vc_custom_heading text=&#8221;Request for enrollment&#8221; font_container=&#8221;tag:h1|text_align:center&#8221; use_theme_fonts=&#8221;yes&#8221; css_animation=&#8221;none&#8221; el_class=&#8221;kidsco-h1-40&#8243;][vc_raw_html]PGhyIGNsYXNzPSJraWRzLWNvLXNlcGFyYXRvci1uby1tYXJnaW4iPg==[\/vc_raw_html][\/vc_column][\/vc_row][vc_row content_placement=&#8221;middle&#8221; css_animation=&#8221;none&#8221; disable_element=&#8221;yes&#8221;][vc_column width=&#8221;1\/3&#8243; css=&#8221;.vc_custom_1684922181225{padding-right: 10% !important;padding-left: 10% !important;}&#8221;][\/vc_column][vc_column width=&#8221;1\/3&#8243;][vc_column_text]<\/p>\n<h3>Dear visitors,<\/h3>\n<p>Thank you for your interest in KIDS&#038;CO. concept of preschool education and care. Unfortunately, we have to inform you that we are currently unable to process enrolment requests until the end of June 2023 due to full capacity of all groups.[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/3&#8243;][\/vc_column][\/vc_row][vc_row content_placement=&#8221;middle&#8221; css_animation=&#8221;none&#8221;][vc_column][vc_column_text]<\/p>\n<link rel=\"stylesheet\" property=\"stylesheet\" href=\"https:\/\/kidsandco.eu\/wp-content\/plugins\/happyforms-upgrade\/inc\/assets\/css\/frontend\/color.css?ver=1.38.9\" \/><link rel=\"stylesheet\" property=\"stylesheet\" href=\"https:\/\/kidsandco.eu\/wp-content\/plugins\/happyforms-upgrade\/inc\/assets\/css\/frontend\/steps.css\" \/><link rel=\"stylesheet\" property=\"stylesheet\" href=\"https:\/\/kidsandco.eu\/wp-content\/plugins\/happyforms-upgrade\/inc\/assets\/css\/frontend\/layout.css?ver=1.38.9\" \/>\t\t<style type=\"text\/css\" id=\"happyforms-conditional-styles\">\n\t\t#happyforms-4087_checkbox_42-part { display: none; }\n#happyforms-4087_single_line_text_67-part { display: none; }\n#happyforms-4087_single_line_text_71-part { display: none; }\n#happyforms-4087_single_line_text_72-part { display: none; }\n#happyforms-4087_single_line_text_73-part { display: none; }\n#happyforms-4087_checkbox_75-part { display: none; }\n#happyforms-4087_single_line_text_85-part { display: none; }\n#happyforms-4087_single_line_text_87-part { display: none; }\n#happyforms-4087_single_line_text_89-part { display: none; }\n#happyforms-4087_checkbox_101-part { display: none; }\n#happyforms-4087_narrative_103-part { display: none; }\n#happyforms-4087_single_line_text_110-part { display: none; }\n#happyforms-4087_single_line_text_112-part { display: none; }\n#happyforms-4087_single_line_text_114-part { display: none; }\n#happyforms-4087_single_line_text_127-part { display: none; }\n#happyforms-4087_single_line_text_131-part { display: none; }\n#happyforms-4087_single_line_text_136-part { display: none; }\n#happyforms-4087_single_line_text_138-part { display: none; }\n\t\t<\/style>\n\t\t\t<!-- HappyForms CSS variables -->\n\t<style>\n\t#kidsco-razgovor {\n\t\t--happyforms-form-width: 90%;\n--happyforms-part-title-font-size: 14px;\n--happyforms-part-description-font-size: 14px;\n--happyforms-part-value-font-size: 16px;\n--happyforms-submit-button-font-size: 16px;\n--happyforms-color-primary: #777777;\n--happyforms-color-success-notice: #ebf9f0;\n--happyforms-color-success-notice-text: #1eb452;\n--happyforms-color-error: #f23000;\n--happyforms-color-error-notice: #ffeeea;\n--happyforms-color-error-notice-text: #f23000;\n--happyforms-color-part-title: #888888;\n--happyforms-color-part-value: #000000;\n--happyforms-color-part-placeholder: #888888;\n--happyforms-color-part-description: #454545;\n--happyforms-color-part-border: #dbdbdb;\n--happyforms-color-part-border-focus: #009f6d;\n--happyforms-color-part-background: #f4f3f1;\n--happyforms-color-part-background-focus: #ffffff;\n--happyforms-color-submit-background: #000000;\n--happyforms-color-submit-background-hover: #000000;\n--happyforms-color-submit-border: transparent;\n--happyforms-color-submit-text: #ffffff;\n--happyforms-color-submit-text-hover: #ffffff;\n--happyforms-color-table-row-odd: #fcfcfc;\n--happyforms-color-table-row-even: #efefef;\n--happyforms-color-table-row-odd-text: #000000;\n--happyforms-color-table-row-even-text: #000000;\n--happyforms-color-dropdown-item-bg: #ffffff;\n--happyforms-color-dropdown-item-text: #000000;\n--happyforms-color-dropdown-item-bg-hover: #f4f4f5;\n--happyforms-color-dropdown-item-text-hover: #000000;\n--happyforms-color-divider-hr: #cccccc;\n--happyforms-color-choice-checkmark-bg: #f4f3f1;\n--happyforms-color-choice-checkmark-bg-focus: #000000;\n--happyforms-color-choice-checkmark-color: #ffffff;\n--happyforms-color-rating: #cccccc;\n--happyforms-color-rating-hover: #ffbf00;\n--happyforms-color-multistep-info-text-color: #000000;\n--happyforms-color-multistep-info-back-color: #000000;\n--happyforms-color-multistep-info-back-color-hover: #000000;\n--happyforms-poll-bar-color: #407fff;\n--happyforms-poll-link-color: #407fff;\n--happyforms-poll-winner-color: #ffffff;\n\t}\n\t<\/style>\n\t<!-- End of HappyForms CSS variables -->\n\t\t<!-- HappyForms Additional CSS -->\n\t<style data-happyforms-additional-css>\n\t\t<\/style>\n\t<!-- End of HappyForms Additional CSS -->\n\t\t\t<link rel=\"stylesheet\" type=\"text\/css\" href=\"https:\/\/kidsandco.eu\/wp-content\/plugins\/happyforms-upgrade\/core\/assets\/css\/no-interaction.css\">\n\t\t<div class=\"happyforms-form happyforms-styles 1 happyforms-form--part-borders-bottom-only happyforms-form--part-inner-padding-narrow happyforms-form--multistep\" id=\"kidsco-razgovor\">\n\t\t\n\t<form action=\"\" id=\"happyforms-form-4087\" method=\"post\" novalidate=\"true\" autocomplete=\"off\" data-happyforms-resumable=\"\" data-happyforms-conditionable=\"\">\n\t\t\t\t<input type=\"hidden\" name=\"happyforms_random_seed\" value=\"1114901218\" \/>\n\t\t\t\t<div data-happyforms-type=\"session\">\n\t\t\t<input type=\"hidden\" name=\"happyforms_session_id\" value=\"5906856a3f30365d488139ca8219450c\" \/>\n\t\t<\/div>\n\t\t\t<div class=\"happyforms-form__progress happyforms-form-progress\">\n\t\t\n\t\t<div class=\"happyforms-flex happyforms-step_information_wrapper\">\n\t\t\t<div class=\"happyforms-message-notice happyforms-step-wrapper-notice\">\n\t\t\t\t\t\t\t\t<span class=\"happyforms-form-progress__step-index happyforms-form-progress__step-title\">Step 1\/9: General information about the child<\/span>\n\t\t\t<\/div>\n\t\t<\/div>\n\n\t<\/div>\n\n\t\t\t<input type=\"hidden\" name=\"action\" value=\"happyforms_message\">\n\t\t\t\t<input type=\"hidden\" name=\"client_referer\" value=\"\">\n\t\t\t\t<input type=\"hidden\" name=\"current_post_id\" value=\"\">\n\t\t\t\t<input type=\"hidden\" name=\"happyforms_form_id\" value=\"4087\" \/>\n\t\t\t\t<input type=\"hidden\" name=\"happyforms_step\" value=\"0\" \/>\n\t\n\t\t<div class=\"happyforms-flex\">\n\t\t\t\t<label for=\"4087-single_line_text\" class=\"screen-reader-text\">Leave this field blank<\/label>\n\t<input type=\"text\" id=\"4087-single_line_text\" name=\"4087-single_line_text\" style=\"display: none;\" tabindex=\"-1\" autocomplete=\"off\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-step\">\n\t\t<div class=\"happyforms-form__part happyforms-part happyforms-part--page_break happyforms-part--label-show\" id=\"happyforms-4087_page_break_44-part\" data-happyforms-type=\"page_break\" data-happyforms-id=\"page_break_44\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--layout_title happyforms-part--width-full\" id=\"happyforms-4087_layout_title_18-part\" data-happyforms-type=\"layout_title\" data-happyforms-id=\"layout_title_18\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t<h3 class=\"happyforms-layout-title\">General information about the child<\/h3>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-half happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_1-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_1\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_1\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Name of child<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_1\" type=\"text\" name=\"4087_single_line_text_1\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-half happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_16-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_16\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_16\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Last name (surname)<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_16\" type=\"text\" name=\"4087_single_line_text_16\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--date happyforms-part--width-third happyforms-part--label-below happyforms-part-date--required happyforms-part-date--date happyforms-part-date--12\" id=\"happyforms-4087_date_17-part\" data-happyforms-type=\"date\" data-happyforms-id=\"date_17\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_date_17\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Date of birth<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\n<div class=\"happyforms-part-date__date-input happyforms-part--date__input-wrap happyforms-part-date-input--date\">\n\t<div class=\"happyforms-custom-date\" data-searchable=\"true\">\n\t\t<div class=\"happyforms-part__date-wrap\">\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t<input type=\"date\" min=\"2013-01-01\" max=\"2040-12-31\" value=\"\" name=\"4087_date_17[date]\" data-serialize required class=\"happyforms-date-field\" \/>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--radio happyforms-part--width-third happyforms-part--label-below\" id=\"happyforms-4087_radio_4-part\" data-happyforms-type=\"radio\" data-happyforms-id=\"radio_4\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_radio_4\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Sex<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_4_option_1592427321238\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_4\" value=\"0\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">M<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_4_option_1592427326024\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_4\" value=\"1\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">F<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-third happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_6-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_6\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_6\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Personal Identification Number<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_6\" type=\"text\" name=\"4087_single_line_text_6\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-third happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_5-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_5\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_5\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Registered Residence - City<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_5\" type=\"text\" name=\"4087_single_line_text_5\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-auto happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_7-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_7\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_7\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Registered residence - Street, number, subnumber<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_7\" type=\"text\" name=\"4087_single_line_text_7\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--date happyforms-part--width-third happyforms-part--label-show happyforms-part-date--required happyforms-part-date--month_year happyforms-part-date--12\" id=\"happyforms-4087_date_149-part\" data-happyforms-type=\"date\" data-happyforms-id=\"date_149\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_date_149\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Planned month for enrollment<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\n<div class=\"happyforms-part-date__date-input happyforms-part--date__input-wrap happyforms-part-date-input--date\" id=\"happyforms-4087_date_149-part\">\n\t<div class=\"happyforms-custom-date\" data-searchable=\"true\">\n\t\t<div class=\"happyforms-part__date-wrap\">\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t<input type=\"month\" min=\"2021-01\" max=\"2031-12\" value=\"2026-05\" name=\"4087_date_149[date]\" data-serialize required class=\"happyforms-date-field\" \/>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"happyforms-step\" style=\"display: none;\">\n\t\t<div class=\"happyforms-form__part happyforms-part happyforms-part--page_break happyforms-part--label-show\" id=\"happyforms-4087_page_break_43-part\" data-happyforms-type=\"page_break\" data-happyforms-id=\"page_break_43\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--layout_title happyforms-part--width-full\" id=\"happyforms-4087_layout_title_19-part\" data-happyforms-type=\"layout_title\" data-happyforms-id=\"layout_title_19\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t<h3 class=\"happyforms-layout-title\">Information about parents\/guardians<\/h3>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-third happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_20-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_20\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_20\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Relation to the child<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t<span class=\"happyforms-part__description\">please write mother, father, ...<\/span>\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_20\" type=\"text\" name=\"4087_single_line_text_20\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-third happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_21-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_21\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_21\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Name of parent\/guardian<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_21\" type=\"text\" name=\"4087_single_line_text_21\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-third happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_22-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_22\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_22\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Last name (surname) of parent\/guardian<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_22\" type=\"text\" name=\"4087_single_line_text_22\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--phone happyforms-part--width-third happyforms-part--label-below happyforms-phone--plain\" id=\"happyforms-4087_phone_33-part\" data-happyforms-type=\"phone\" data-happyforms-id=\"phone_33\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_phone_33\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Telephone number<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t<div class=\"happyforms-part-phone-wrap\">\n\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\t\t\t\t\t\t<input id=\"happyforms-4087_phone_33\" type=\"tel\" value=\"\" name=\"4087_phone_33[number]\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\" \/>\n\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--phone happyforms-part--width-third happyforms-part--label-below happyforms-phone--plain\" id=\"happyforms-4087_phone_36-part\" data-happyforms-type=\"phone\" data-happyforms-id=\"phone_36\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_phone_36\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Mobile number<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t<div class=\"happyforms-part-phone-wrap\">\n\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\t\t\t\t\t\t<input id=\"happyforms-4087_phone_36\" type=\"tel\" value=\"\" name=\"4087_phone_36[number]\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\" \/>\n\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--with-autocomplete happyforms-form__part happyforms-part happyforms-part--email happyforms-part--width-third happyforms-part--label-below\" id=\"happyforms-4087_email_25-part\" data-happyforms-type=\"email\" data-happyforms-id=\"email_25\" data-happyforms-required=\"\">\n\t\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_email_25\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Email adress<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t<input type=\"email\" name=\"4087_email_25\" id=\"happyforms-4087_email_25\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--divider happyforms-part--width-full\" id=\"happyforms-4087_divider_46-part\" data-happyforms-type=\"divider\" data-happyforms-id=\"divider_46\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t<hr \/>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-third happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_26-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_26\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_26\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Relation to the child<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t<span class=\"happyforms-part__description\">please write mother, father, ...<\/span>\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_26\" type=\"text\" name=\"4087_single_line_text_26\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-third happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_27-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_27\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_27\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Name of parent\/guardian<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_27\" type=\"text\" name=\"4087_single_line_text_27\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-third happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_28-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_28\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_28\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Last name (surname) of parent\/guardian<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_28\" type=\"text\" name=\"4087_single_line_text_28\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--phone happyforms-part--width-third happyforms-part--label-below happyforms-phone--plain\" id=\"happyforms-4087_phone_35-part\" data-happyforms-type=\"phone\" data-happyforms-id=\"phone_35\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_phone_35\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Telelphone number<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t<div class=\"happyforms-part-phone-wrap\">\n\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\t\t\t\t\t\t<input id=\"happyforms-4087_phone_35\" type=\"tel\" value=\"\" name=\"4087_phone_35[number]\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\" \/>\n\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--phone happyforms-part--width-third happyforms-part--label-below happyforms-phone--plain\" id=\"happyforms-4087_phone_37-part\" data-happyforms-type=\"phone\" data-happyforms-id=\"phone_37\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_phone_37\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Mobile number<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t<div class=\"happyforms-part-phone-wrap\">\n\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\t\t\t\t\t\t<input id=\"happyforms-4087_phone_37\" type=\"tel\" value=\"\" name=\"4087_phone_37[number]\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\" \/>\n\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--with-autocomplete happyforms-form__part happyforms-part happyforms-part--email happyforms-part--width-third happyforms-part--label-below\" id=\"happyforms-4087_email_31-part\" data-happyforms-type=\"email\" data-happyforms-id=\"email_31\" data-happyforms-required=\"\">\n\t\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_email_31\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Email adress<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t<input type=\"email\" name=\"4087_email_31\" id=\"happyforms-4087_email_31\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"happyforms-step\" style=\"display: none;\">\n\t\t<div class=\"happyforms-form__part happyforms-part happyforms-part--page_break happyforms-part--label-show\" id=\"happyforms-4087_page_break_45-part\" data-happyforms-type=\"page_break\" data-happyforms-id=\"page_break_45\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--layout_title happyforms-part--width-full\" id=\"happyforms-4087_layout_title_32-part\" data-happyforms-type=\"layout_title\" data-happyforms-id=\"layout_title_32\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t<h3 class=\"happyforms-layout-title\">Information about the family<\/h3>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-quarter happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_38-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_38\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_38\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">With whom does the child live with<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t<span class=\"happyforms-part__description\">Please state<\/span>\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_38\" type=\"text\" name=\"4087_single_line_text_38\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--radio happyforms-part--width-auto happyforms-part--label-left\" id=\"happyforms-4087_radio_54-part\" data-happyforms-type=\"radio\" data-happyforms-id=\"radio_54\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_radio_54\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">How long hasn&#039;t the child lived with both parents\/guardians?<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_54_option_1595536524221\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_54\" value=\"0\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">residing in another city<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_54_option_1595536579368\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_54\" value=\"1\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">divorce<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_54_option_1595536579385\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_54\" value=\"2\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">dissolved our of wedlock union<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_54_option_1595536579402\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_54\" value=\"3\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">restraining order<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_54_option_1595536579435\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_54\" value=\"4\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">fostering<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_54_option_1595536579463\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_54\" value=\"5\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">guardianship<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t<div class=\"happyforms-part__option happyforms-part-option happyforms-part-option--other\" id=\"radio_54_other\">\n\t<label class=\"option-label\">\n\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_54\" value=\"999\"  autocomplete=\"off\" spellcheck=\"false\">\n\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t<span class=\"label\" id=\"hf-label-4087_radio_54\">other<\/span>\n\t<\/label>\n\t<input type=\"text\" name=\"4087_radio_54\" placeholder=\"please state\" aria-labelledby=\"hf-label-4087_radio_54\" value=\"\" class=\"\" autocomplete=\"off\" spellcheck=\"false\" autocorrect=\"off\" \/>\n<\/div>\n\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--radio happyforms-part--width-third happyforms-part--label-below\" id=\"happyforms-4087_radio_41-part\" data-happyforms-type=\"radio\" data-happyforms-id=\"radio_41\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_radio_41\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Is family in counseling with the center of social welfare<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_41_option_1595458524341\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_41\" value=\"0\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">Yes<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_41_option_1595458527716\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_41\" value=\"1\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">No<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice display-type--block happyforms-form__part happyforms-part happyforms-part--checkbox happyforms-part--width-half happyforms-part--label-below\" id=\"happyforms-4087_checkbox_42-part\" data-happyforms-type=\"checkbox\" data-happyforms-id=\"checkbox_42\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_checkbox_42\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Navesti koje vrste<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_42_option_1595458740579\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_42[]\" value=\"0\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">supervision of parental rights<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_42_option_1595458743019\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_42[]\" value=\"1\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">Litigation of divorce<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_42_option_1595458752840\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_42[]\" value=\"2\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">welfare services<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t<div class=\"happyforms-part__option happyforms-part-option happyforms-part-option--other\" id=\"checkbox_42_other\">\n\t<label class=\"option-label\">\n\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden\" name=\"4087_checkbox_42[]\"  value=\"999\" data-serialize autocomplete=\"off\" spellcheck=\"false\">\n\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t<span class=\"label\" id=\"hf-label-4087_checkbox_42\">ostalo<\/span>\n\t<\/label>\n\t<input  type=\"text\" aria-labelledby=\"hf-label-4087_checkbox_42\" placeholder=\"navesti\" value=\"\" autocomplete=\"off\" spellcheck=\"false\" autocorrect=\"off\" \/>\n<\/div>\n\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--layout_title happyforms-part--width-full\" id=\"happyforms-4087_layout_title_50-part\" data-happyforms-type=\"layout_title\" data-happyforms-id=\"layout_title_50\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t<h3 class=\"happyforms-layout-title\"><\/h3>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--placeholder happyforms-part--width-third happyforms-part--label-above\" id=\"happyforms-4087_placeholder_48-part\" data-happyforms-type=\"placeholder\" data-happyforms-id=\"placeholder_48\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_placeholder_48\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Please state the times your child would be at the preschool during the year<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--narrative happyforms-part--width-third happyforms-part--label-above\" id=\"happyforms-4087_narrative_47-part\" data-happyforms-type=\"narrative\" data-happyforms-id=\"narrative_47\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_narrative_47\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Child woulld arrive at<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t<p><p>\t\t\t\t<input id=\"happyforms-4087_narrative_47\" type=\"text\" name=\"4087_narrative_47[]\"  value=\"\" autocomplete=\"off\" spellcheck=\"false\" \/> hours<\/p><\/p>\n\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--narrative happyforms-part--width-third happyforms-part--label-above\" id=\"happyforms-4087_narrative_49-part\" data-happyforms-type=\"narrative\" data-happyforms-id=\"narrative_49\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_narrative_49\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Child would leave at<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t<p><p>\t\t\t\t<input id=\"happyforms-4087_narrative_49\" type=\"text\" name=\"4087_narrative_49[]\"  value=\"\" autocomplete=\"off\" spellcheck=\"false\" \/> hours<\/p><\/p>\n\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"happyforms-step\" style=\"display: none;\">\n\t\t<div class=\"happyforms-form__part happyforms-part happyforms-part--page_break happyforms-part--label-show\" id=\"happyforms-4087_page_break_51-part\" data-happyforms-type=\"page_break\" data-happyforms-id=\"page_break_51\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--layout_title happyforms-part--width-full\" id=\"happyforms-4087_layout_title_52-part\" data-happyforms-type=\"layout_title\" data-happyforms-id=\"layout_title_52\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t<h3 class=\"happyforms-layout-title\">Information of health and developmental status of child<\/h3>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--radio happyforms-part--width-third happyforms-part--label-above\" id=\"happyforms-4087_radio_53-part\" data-happyforms-type=\"radio\" data-happyforms-id=\"radio_53\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_radio_53\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Pregnancy<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_53_option_1595461333736\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_53\" value=\"0\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">normal<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_53_option_1595461352852\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_53\" value=\"1\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">high risk<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t<div class=\"happyforms-part__option happyforms-part-option happyforms-part-option--other\" id=\"radio_53_other\">\n\t<label class=\"option-label\">\n\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_53\" value=\"999\"  autocomplete=\"off\" spellcheck=\"false\">\n\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t<span class=\"label\" id=\"hf-label-4087_radio_53\">other<\/span>\n\t<\/label>\n\t<input type=\"text\" name=\"4087_radio_53\" placeholder=\"please state\" aria-labelledby=\"hf-label-4087_radio_53\" value=\"\" class=\"\" autocomplete=\"off\" spellcheck=\"false\" autocorrect=\"off\" \/>\n<\/div>\n\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part-select--required happyforms-form__part happyforms-part happyforms-part--select happyforms-part--width-third happyforms-part--label-above\" id=\"happyforms-4087_select_55-part\" data-happyforms-type=\"select\" data-happyforms-id=\"select_55\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_select_55\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Type of birth<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t<div class=\"happyforms-custom-select\">\n\t\t\t\t<div class=\"happyforms-part__select-wrap\">\n\t\t\t\t\t\t\t\t\t\t<select name=\"4087_select_55\" data-serialize class='happyforms-select' required>\n\t\t\t\t\t\t\t<option disabled hidden  selected value='' class=\"happyforms-placeholder-option\">Choose<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"0\"   id=\"select_55_option_1595537015684\">natural <\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"1\"   id=\"select_55_option_1595537015758\">caesarean <\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"2\"   id=\"select_55_option_1595537015772\">vaccum <\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/select>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--narrative happyforms-part--width-third happyforms-part--label-above\" id=\"happyforms-4087_narrative_56-part\" data-happyforms-type=\"narrative\" data-happyforms-id=\"narrative_56\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_narrative_56\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Birth<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t<p><p>at \t\t\t\t<input id=\"happyforms-4087_narrative_56\" type=\"text\" name=\"4087_narrative_56[]\"  value=\"\" autocomplete=\"off\" spellcheck=\"false\" \/> weeks<\/p><\/p>\n\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-third happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_57-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_57\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_57\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Birth weight\/height<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_57\" type=\"text\" name=\"4087_single_line_text_57\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-third happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_58-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_58\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_58\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Apgar score<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_58\" type=\"text\" name=\"4087_single_line_text_58\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-third happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_59-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_59\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_59\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Days spent in hospital<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_59\" type=\"text\" name=\"4087_single_line_text_59\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--checkbox happyforms-part--width-half happyforms-part--label-left\" id=\"happyforms-4087_checkbox_60-part\" data-happyforms-type=\"checkbox\" data-happyforms-id=\"checkbox_60\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_checkbox_60\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Condition of child before and after birth<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_60_option_1595539465679\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_60[]\" value=\"0\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">normal<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_60_option_1595539465776\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_60[]\" value=\"1\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">infection<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_60_option_1595539465791\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_60[]\" value=\"2\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">wrapped umbilical cord<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_60_option_1595539465807\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_60[]\" value=\"3\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">intracranial bleeding<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_60_option_1595539465824\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_60[]\" value=\"4\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">given oxygen<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_60_option_1595539465852\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_60[]\" value=\"5\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">incubator<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t<div class=\"happyforms-part__option happyforms-part-option happyforms-part-option--other\" id=\"checkbox_60_other\">\n\t<label class=\"option-label\">\n\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden\" name=\"4087_checkbox_60[]\"  value=\"999\" data-serialize autocomplete=\"off\" spellcheck=\"false\">\n\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t<span class=\"label\" id=\"hf-label-4087_checkbox_60\">other<\/span>\n\t<\/label>\n\t<input  type=\"text\" aria-labelledby=\"hf-label-4087_checkbox_60\" placeholder=\"please state\" value=\"\" autocomplete=\"off\" spellcheck=\"false\" autocorrect=\"off\" \/>\n<\/div>\n\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-half happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_61-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_61\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_61\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Frequent acute and\/or chronic sickness and condition<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_61\" type=\"text\" name=\"4087_single_line_text_61\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--layout_title happyforms-part--width-full\" id=\"happyforms-4087_layout_title_62-part\" data-happyforms-type=\"layout_title\" data-happyforms-id=\"layout_title_62\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t<h3 class=\"happyforms-layout-title\">Please write if the child stayed in the hospital<\/h3>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-half happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_63-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_63\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_63\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Name of hospital<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_63\" type=\"text\" name=\"4087_single_line_text_63\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-quarter happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_64-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_64\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_64\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">How many days<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_64\" type=\"text\" name=\"4087_single_line_text_64\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-quarter happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_65-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_65\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_65\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Reason for the stay<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_65\" type=\"text\" name=\"4087_single_line_text_65\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--radio happyforms-part--width-auto happyforms-part--label-left\" id=\"happyforms-4087_radio_66-part\" data-happyforms-type=\"radio\" data-happyforms-id=\"radio_66\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_radio_66\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Difficulties due to separation<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_66_option_1595540522588\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_66\" value=\"0\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">Yes<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_66_option_1595540532242\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_66\" value=\"1\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">No<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-full happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_67-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_67\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_67\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Navesti koje vrste<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_67\" type=\"text\" name=\"4087_single_line_text_67\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--layout_title happyforms-part--width-full\" id=\"happyforms-4087_layout_title_68-part\" data-happyforms-type=\"layout_title\" data-happyforms-id=\"layout_title_68\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t<h3 class=\"happyforms-layout-title\"><\/h3>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--radio happyforms-part--width-full happyforms-part--label-above\" id=\"happyforms-4087_radio_70-part\" data-happyforms-type=\"radio\" data-happyforms-id=\"radio_70\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_radio_70\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Child is being monitored or receiving therapy by specialist<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t<span class=\"happyforms-part__description\">ex: physical therapist, speech therapist, rehabilitator, psychologist, neuro pediatrician and others (please note: for the initial interview, it is necessary to bring all medical documentation)<\/span>\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_70_option_1595540906341\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_70\" value=\"0\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">Yes<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_70_option_1595540909491\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_70\" value=\"1\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">No<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-third happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_71-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_71\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_71\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">What institution<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_71\" type=\"text\" name=\"4087_single_line_text_71\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-third happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_72-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_72\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_72\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">What type of experts<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_72\" type=\"text\" name=\"4087_single_line_text_72\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-third happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_73-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_73\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_73\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">What type of therapy was given<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_73\" type=\"text\" name=\"4087_single_line_text_73\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--radio happyforms-part--width-full happyforms-part--label-above\" id=\"happyforms-4087_radio_74-part\" data-happyforms-type=\"radio\" data-happyforms-id=\"radio_74\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_radio_74\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Child with special educational needs<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t<span class=\"happyforms-part__description\">(developmental disability, health difficulties and neurological damage, chronic sickness, elimination of nutrition, risk behavior, and so forth...) Pplease note , on the initial interview it is necessary to bring all relevant documentation to confirm the status and needs of the child<\/span>\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_70_option_1595540906341\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_74\" value=\"0\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">Yes<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_70_option_1595540909491\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_74\" value=\"1\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">No<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--checkbox happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_checkbox_75-part\" data-happyforms-type=\"checkbox\" data-happyforms-id=\"checkbox_75\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_checkbox_75\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Which<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_75_option_1595542382975\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_75[]\" value=\"0\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">impaired vision<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_75_option_1595542383102\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_75[]\" value=\"1\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">hearing impairment<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_75_option_1595542383129\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_75[]\" value=\"2\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">Intellectual disabilities<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_75_option_1595542383164\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_75[]\" value=\"3\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">disabilities from the spectrum of autism<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_75_option_1595542383191\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_75[]\" value=\"4\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">motor skill disorders<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_75_option_1595542383231\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_75[]\" value=\"5\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">language\/speech disabilities<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_75_option_1595542383259\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_75[]\" value=\"6\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">specific disability in learning<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_75_option_1595542383300\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_75[]\" value=\"7\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">Chronic illness<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_75_option_1595542383331\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_75[]\" value=\"8\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">risk behaviour<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_75_option_1595542383375\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_75[]\" value=\"9\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">special health needs<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_75_option_1595542383408\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_75[]\" value=\"10\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">attention deficiency - hyperactive disorder<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t<div class=\"happyforms-part__option happyforms-part-option happyforms-part-option--other\" id=\"checkbox_75_other\">\n\t<label class=\"option-label\">\n\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden\" name=\"4087_checkbox_75[]\"  value=\"999\" data-serialize autocomplete=\"off\" spellcheck=\"false\">\n\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t<span class=\"label\" id=\"hf-label-4087_checkbox_75\">None of the mentioned above<\/span>\n\t<\/label>\n\t<input  type=\"text\" aria-labelledby=\"hf-label-4087_checkbox_75\" placeholder=\"please state\" value=\"\" autocomplete=\"off\" spellcheck=\"false\" autocorrect=\"off\" \/>\n<\/div>\n\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--checkbox happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_checkbox_76-part\" data-happyforms-type=\"checkbox\" data-happyforms-id=\"checkbox_76\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_checkbox_76\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">If there is documentation which the child has<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_76_option_1595542605425\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_76[]\" value=\"0\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">results and opinions of a sole expert<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_76_option_1595542605551\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_76[]\" value=\"1\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">decision from social welfare<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_76_option_1595542605574\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_76[]\" value=\"2\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">results and opinion of a specialized institution<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_76_option_1595542605600\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_76[]\" value=\"3\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">opinion from the professional team of the preschool<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_76_option_1595542605639\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_76[]\" value=\"4\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">medical and other results<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"happyforms-step\" style=\"display: none;\">\n\t\t<div class=\"happyforms-form__part happyforms-part happyforms-part--page_break happyforms-part--label-show\" id=\"happyforms-4087_page_break_77-part\" data-happyforms-type=\"page_break\" data-happyforms-id=\"page_break_77\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--layout_title happyforms-part--width-full\" id=\"happyforms-4087_layout_title_78-part\" data-happyforms-type=\"layout_title\" data-happyforms-id=\"layout_title_78\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t<h3 class=\"happyforms-layout-title\">Needs and habits of a child<\/h3>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice display-type--block happyforms-form__part happyforms-part happyforms-part--radio happyforms-part--width-half happyforms-part--label-above\" id=\"happyforms-4087_radio_79-part\" data-happyforms-type=\"radio\" data-happyforms-id=\"radio_79\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_radio_79\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Child is still breastfeeding<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_79_option_1595542887132\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_79\" value=\"0\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">Yes<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_79_option_1595542889298\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_79\" value=\"1\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">No<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--checkbox happyforms-part--width-half happyforms-part--label-above\" id=\"happyforms-4087_checkbox_80-part\" data-happyforms-type=\"checkbox\" data-happyforms-id=\"checkbox_80\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_checkbox_80\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Form of consuming liquids<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_80_option_1595543073320\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_80[]\" value=\"0\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">bottle<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_80_option_1595543073469\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_80[]\" value=\"1\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">use of cup with help<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_80_option_1595543073500\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_80[]\" value=\"2\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">use of cup independently<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice display-type--block happyforms-form__part happyforms-part happyforms-part--checkbox happyforms-part--width-third happyforms-part--label-above\" id=\"happyforms-4087_checkbox_81-part\" data-happyforms-type=\"checkbox\" data-happyforms-id=\"checkbox_81\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_checkbox_81\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Form of consuming food<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_81_option_1595544086051\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_81[]\" value=\"0\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">mushy<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_81_option_1595544086212\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_81[]\" value=\"1\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">small pieces<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_81_option_1595544086249\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_81[]\" value=\"2\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">solid<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice display-type--block happyforms-form__part happyforms-part happyforms-part--checkbox happyforms-part--width-third happyforms-part--label-above\" id=\"happyforms-4087_checkbox_82-part\" data-happyforms-type=\"checkbox\" data-happyforms-id=\"checkbox_82\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_checkbox_82\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Feeding<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_82_option_1595544219573\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_82[]\" value=\"0\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">independently<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_82_option_1595544219716\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_82[]\" value=\"1\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">not independently<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_82_option_1595544219757\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_82[]\" value=\"2\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">needs to be fed<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice display-type--block happyforms-form__part happyforms-part happyforms-part--checkbox happyforms-part--width-third happyforms-part--label-above\" id=\"happyforms-4087_checkbox_83-part\" data-happyforms-type=\"checkbox\" data-happyforms-id=\"checkbox_83\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_checkbox_83\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Apetite<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_83_option_1595544306437\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_83[]\" value=\"0\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">good<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_83_option_1595544306601\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_83[]\" value=\"1\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">bad<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_83_option_1595544306644\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_83[]\" value=\"2\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">selective<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_83_option_1595544306701\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_83[]\" value=\"3\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">depends<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_83_option_1595544306747\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_83[]\" value=\"4\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">excessive<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--radio happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_radio_84-part\" data-happyforms-type=\"radio\" data-happyforms-id=\"radio_84\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_radio_84\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Child has\/had difficulties with chewing and swallowing<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_84_option_1597101022129\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_84\" value=\"0\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">Yes<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_84_option_1597101052200\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_84\" value=\"1\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">No<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-full happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_85-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_85\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_85\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">State what kind<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_85\" type=\"text\" name=\"4087_single_line_text_85\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--radio happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_radio_86-part\" data-happyforms-type=\"radio\" data-happyforms-id=\"radio_86\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_radio_86\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Does child reject some types of foods<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_86_option_1597101429598\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_86\" value=\"0\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">Yes<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_86_option_1597101432881\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_86\" value=\"1\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">No<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-full happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_87-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_87\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_87\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">State which types<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_87\" type=\"text\" name=\"4087_single_line_text_87\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--radio happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_radio_88-part\" data-happyforms-type=\"radio\" data-happyforms-id=\"radio_88\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_radio_88\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Elimination of nutrition<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t<span class=\"happyforms-part__description\">allergic on certain foods, celiac disease, intolerance, nutrition conditioned by metabolic disorders and other (Please note: on initial interview, necessary to provide medical documentation)<\/span>\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_88_option_1597101741578\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_88\" value=\"0\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">Yes<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_88_option_1597101744828\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_88\" value=\"1\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">No<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-full happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_89-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_89\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_89\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">State which foods<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_89\" type=\"text\" name=\"4087_single_line_text_89\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-full happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_90-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_90\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_90\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Special note related to nutrition<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t<span class=\"happyforms-part__description\">Please state<\/span>\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_90\" type=\"text\" name=\"4087_single_line_text_90\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--layout_title happyforms-part--width-full\" id=\"happyforms-4087_layout_title_91-part\" data-happyforms-type=\"layout_title\" data-happyforms-id=\"layout_title_91\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t<h3 class=\"happyforms-layout-title\">Sleep pattern times<\/h3>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--narrative happyforms-part--width-full happyforms-part--label-above\" id=\"happyforms-4087_narrative_92-part\" data-happyforms-type=\"narrative\" data-happyforms-id=\"narrative_92\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_narrative_92\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Night times<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t<p><p>from \t\t\t\t<input id=\"happyforms-4087_narrative_92\" type=\"text\" name=\"4087_narrative_92[]\"  value=\"\" autocomplete=\"off\" spellcheck=\"false\" \/> to \t\t\t\t<input id=\"happyforms-4087_narrative_92\" type=\"text\" name=\"4087_narrative_92[]\"  value=\"\" autocomplete=\"off\" spellcheck=\"false\" \/> hours<\/p><\/p>\n\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--narrative happyforms-part--width-full happyforms-part--label-above\" id=\"happyforms-4087_narrative_93-part\" data-happyforms-type=\"narrative\" data-happyforms-id=\"narrative_93\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_narrative_93\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Day time<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t<p><p>first nap - from \t\t\t\t<input id=\"happyforms-4087_narrative_93\" type=\"text\" name=\"4087_narrative_93[]\"  value=\"\" autocomplete=\"off\" spellcheck=\"false\" \/> to \t\t\t\t<input id=\"happyforms-4087_narrative_93\" type=\"text\" name=\"4087_narrative_93[]\"  value=\"\" autocomplete=\"off\" spellcheck=\"false\" \/> hours<\/p><\/p>\n\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--narrative happyforms-part--width-full happyforms-part--label-hidden\" id=\"happyforms-4087_narrative_94-part\" data-happyforms-type=\"narrative\" data-happyforms-id=\"narrative_94\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t<p><p>second nap - from \t\t\t\t<input id=\"happyforms-4087_narrative_94\" type=\"text\" name=\"4087_narrative_94[]\"  value=\"\" autocomplete=\"off\" spellcheck=\"false\" \/> to \t\t\t\t<input id=\"happyforms-4087_narrative_94\" type=\"text\" name=\"4087_narrative_94[]\"  value=\"\" autocomplete=\"off\" spellcheck=\"false\" \/> hours<\/p><\/p>\n\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--checkbox happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_checkbox_95-part\" data-happyforms-type=\"checkbox\" data-happyforms-id=\"checkbox_95\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_checkbox_95\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">How does child fall asleep<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_95_option_1597103239032\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_95[]\" value=\"0\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">falls asleep independently<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_95_option_1597103239240\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_95[]\" value=\"1\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">with pacifier<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_95_option_1597103239299\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_95[]\" value=\"2\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">with bottle<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_95_option_1597103239345\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_95[]\" value=\"3\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">breat fed<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_95_option_1597103239407\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_95[]\" value=\"4\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">with toy<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t<div class=\"happyforms-part__option happyforms-part-option happyforms-part-option--other\" id=\"checkbox_95_other\">\n\t<label class=\"option-label\">\n\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden\" name=\"4087_checkbox_95[]\"  value=\"999\" data-serialize autocomplete=\"off\" spellcheck=\"false\">\n\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t<span class=\"label\" id=\"hf-label-4087_checkbox_95\">other<\/span>\n\t<\/label>\n\t<input  type=\"text\" aria-labelledby=\"hf-label-4087_checkbox_95\" placeholder=\"\" value=\"\" autocomplete=\"off\" spellcheck=\"false\" autocorrect=\"off\" \/>\n<\/div>\n\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--radio happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_radio_96-part\" data-happyforms-type=\"radio\" data-happyforms-id=\"radio_96\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_radio_96\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Child falls asleep<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_96_option_1597103458087\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_96\" value=\"0\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">easy<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_96_option_1597103473326\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_96\" value=\"1\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">with difficulty<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--checkbox happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_checkbox_97-part\" data-happyforms-type=\"checkbox\" data-happyforms-id=\"checkbox_97\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_checkbox_97\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Child sleeps<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_97_option_1597103693278\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_97[]\" value=\"0\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">peaceful<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_97_option_1597103693470\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_97[]\" value=\"1\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">restless<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_97_option_1597103693534\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_97[]\" value=\"2\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">cries in sleep<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_97_option_1597103693597\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_97[]\" value=\"3\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">screams<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_97_option_1597103693670\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_97[]\" value=\"4\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">wakes up many times<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--number happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_number_98-part\" data-happyforms-type=\"number\" data-happyforms-id=\"number_98\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_number_98\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">On average how many times<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\t\t\t\t<input id=\"happyforms-4087_number_98\" type=\"number\" value=\"\" name=\"4087_number_98\" placeholder=\"\" min=\"0\" max=\"10\" step=\"1\" autocomplete=\"off\" spellcheck=\"false\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-full happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_99-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_99\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_99\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Special note related to sleeping<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t<span class=\"happyforms-part__description\">Please state<\/span>\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_99\" type=\"text\" name=\"4087_single_line_text_99\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--radio happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_radio_100-part\" data-happyforms-type=\"radio\" data-happyforms-id=\"radio_100\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_radio_100\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Child needs diapers<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_100_option_1597104135899\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_100\" value=\"0\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">Yes<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_100_option_1597104138743\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_100\" value=\"1\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">No<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice display-type--block happyforms-form__part happyforms-part happyforms-part--checkbox happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_checkbox_101-part\" data-happyforms-type=\"checkbox\" data-happyforms-id=\"checkbox_101\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_checkbox_101\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">When does the child use them<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_101_option_1597104385877\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_101[]\" value=\"0\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">all the time<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_101_option_1597104390090\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_101[]\" value=\"1\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">during day sleep (nap)<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_101_option_1597104407056\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_101[]\" value=\"2\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">during night sleep<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--radio happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_radio_102-part\" data-happyforms-type=\"radio\" data-happyforms-id=\"radio_102\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_radio_102\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Is child potty-trained<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_102_option_1597104539273\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_102\" value=\"0\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">Yes<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_102_option_1597104542333\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_102\" value=\"1\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">No<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--narrative happyforms-part--width-full happyforms-part--label-hidden\" id=\"happyforms-4087_narrative_103-part\" data-happyforms-type=\"narrative\" data-happyforms-id=\"narrative_103\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t<p><p>started with \t\t\t\t<input id=\"happyforms-4087_narrative_103\" type=\"text\" name=\"4087_narrative_103[]\"  value=\"\" autocomplete=\"off\" spellcheck=\"false\" \/> months<\/p><\/p>\n\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--checkbox happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_checkbox_104-part\" data-happyforms-type=\"checkbox\" data-happyforms-id=\"checkbox_104\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_checkbox_104\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Now child<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_104_option_1597104934635\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_104[]\" value=\"0\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">goes independently to the toilet or potty<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_104_option_1597104934869\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_104[]\" value=\"1\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">asks to be taken to the toilet<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_104_option_1597104934952\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_104[]\" value=\"2\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">needs to be reminded<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_104_option_1597104935060\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_104[]\" value=\"3\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">sits and doesn&#039;t defecate<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_104_option_1597104935171\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_104[]\" value=\"4\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">refuses to go<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_104_option_1597104935279\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_104[]\" value=\"5\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">does not independently defecate<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t<div class=\"happyforms-part__option happyforms-part-option happyforms-part-option--other\" id=\"checkbox_104_other\">\n\t<label class=\"option-label\">\n\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden\" name=\"4087_checkbox_104[]\"  value=\"999\" data-serialize autocomplete=\"off\" spellcheck=\"false\">\n\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t<span class=\"label\" id=\"hf-label-4087_checkbox_104\">other<\/span>\n\t<\/label>\n\t<input  type=\"text\" aria-labelledby=\"hf-label-4087_checkbox_104\" placeholder=\"please state\" value=\"\" autocomplete=\"off\" spellcheck=\"false\" autocorrect=\"off\" \/>\n<\/div>\n\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--checkbox happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_checkbox_105-part\" data-happyforms-type=\"checkbox\" data-happyforms-id=\"checkbox_105\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_checkbox_105\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">If child is weaned off from diapers, does it happen<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_105_option_1597105091067\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_105[]\" value=\"0\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">wets underwear in conscience state<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_105_option_1597105091357\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_105[]\" value=\"1\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">wets underwear when sleeping<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_105_option_1597105091474\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_105[]\" value=\"2\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">defecates in underwear<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_105_option_1597105091614\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_105[]\" value=\"3\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">retention of bowel<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_105_option_1598393738915\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_105[]\" value=\"4\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">none of the above<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-full happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_106-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_106\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_106\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Special note related to diapers and defecation<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_106\" type=\"text\" name=\"4087_single_line_text_106\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"happyforms-step\" style=\"display: none;\">\n\t\t<div class=\"happyforms-form__part happyforms-part happyforms-part--page_break happyforms-part--label-show\" id=\"happyforms-4087_page_break_107-part\" data-happyforms-type=\"page_break\" data-happyforms-id=\"page_break_107\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--layout_title happyforms-part--width-full\" id=\"happyforms-4087_layout_title_108-part\" data-happyforms-type=\"layout_title\" data-happyforms-id=\"layout_title_108\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t<h3 class=\"happyforms-layout-title\">Motor and sensory development of child<\/h3>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--radio happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_radio_109-part\" data-happyforms-type=\"radio\" data-happyforms-id=\"radio_109\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_radio_109\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Child sits independently<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_109_option_1597175787486\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_109\" value=\"0\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">Yes<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_109_option_1597175789918\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_109\" value=\"1\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">No<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-full happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_110-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_110\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_110\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">How many months it started<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_110\" type=\"text\" name=\"4087_single_line_text_110\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--radio happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_radio_111-part\" data-happyforms-type=\"radio\" data-happyforms-id=\"radio_111\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_radio_111\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Child has crawled<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_111_option_1597176041638\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_111\" value=\"0\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">Yes<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_111_option_1597176044111\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_111\" value=\"1\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">No<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-full happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_112-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_112\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_112\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">with how many months started<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_112\" type=\"text\" name=\"4087_single_line_text_112\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--radio happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_radio_113-part\" data-happyforms-type=\"radio\" data-happyforms-id=\"radio_113\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_radio_113\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Child walks independently<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_113_option_1597176261998\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_113\" value=\"0\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">Yes<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_113_option_1597176265153\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_113\" value=\"1\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">No<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-full happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_114-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_114\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_114\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">with how many months started<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_114\" type=\"text\" name=\"4087_single_line_text_114\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--checkbox happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_checkbox_115-part\" data-happyforms-type=\"checkbox\" data-happyforms-id=\"checkbox_115\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_checkbox_115\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Have you noticed any specific motor skill developments of your child from the following<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_115_option_1597176975089\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_115[]\" value=\"0\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">clumsiness<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_115_option_1597176975306\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_115[]\" value=\"1\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">falling frequently<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_115_option_1597176975345\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_115[]\" value=\"2\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">stumbling<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_115_option_1597176975384\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_115[]\" value=\"3\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">colliding into objects<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_115_option_1597176975417\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_115[]\" value=\"4\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">tendency to injury<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_115_option_1597176975465\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_115[]\" value=\"5\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">increased motor movement (lively)<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_115_option_1597176975499\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_115[]\" value=\"6\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">walks on toes<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_115_option_1597176975544\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_115[]\" value=\"7\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">doesn&#039;t like to move<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t<div class=\"happyforms-part__option happyforms-part-option happyforms-part-option--other\" id=\"checkbox_115_other\">\n\t<label class=\"option-label\">\n\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden\" name=\"4087_checkbox_115[]\"  value=\"999\" data-serialize autocomplete=\"off\" spellcheck=\"false\">\n\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t<span class=\"label\" id=\"hf-label-4087_checkbox_115\">None of the above - other<\/span>\n\t<\/label>\n\t<input  type=\"text\" aria-labelledby=\"hf-label-4087_checkbox_115\" placeholder=\"please state\" value=\"\" autocomplete=\"off\" spellcheck=\"false\" autocorrect=\"off\" \/>\n<\/div>\n\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--checkbox happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_checkbox_116-part\" data-happyforms-type=\"checkbox\" data-happyforms-id=\"checkbox_116\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_checkbox_116\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Does the child show hypersensitivity to environmental stimuli?<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_116_option_1597177133477\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_116[]\" value=\"0\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">sound<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_116_option_1597177133717\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_116[]\" value=\"1\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">touch<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_116_option_1597177133765\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_116[]\" value=\"2\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">light changes<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_116_option_1597177133820\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_116[]\" value=\"3\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">smell<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_116_option_1597177133868\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_116[]\" value=\"4\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">taste<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_116_option_1597177133925\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_116[]\" value=\"5\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">spinning<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_116_option_1597177133986\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_116[]\" value=\"6\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">swaying (back-forth, side to side)<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t<div class=\"happyforms-part__option happyforms-part-option happyforms-part-option--other\" id=\"checkbox_116_other\">\n\t<label class=\"option-label\">\n\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden\" name=\"4087_checkbox_116[]\"  value=\"999\" data-serialize autocomplete=\"off\" spellcheck=\"false\">\n\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t<span class=\"label\" id=\"hf-label-4087_checkbox_116\">none of the above - other<\/span>\n\t<\/label>\n\t<input  type=\"text\" aria-labelledby=\"hf-label-4087_checkbox_116\" placeholder=\"please state\" value=\"\" autocomplete=\"off\" spellcheck=\"false\" autocorrect=\"off\" \/>\n<\/div>\n\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"happyforms-step\" style=\"display: none;\">\n\t\t<div class=\"happyforms-form__part happyforms-part happyforms-part--page_break happyforms-part--label-show\" id=\"happyforms-4087_page_break_117-part\" data-happyforms-type=\"page_break\" data-happyforms-id=\"page_break_117\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--layout_title happyforms-part--width-full\" id=\"happyforms-4087_layout_title_118-part\" data-happyforms-type=\"layout_title\" data-happyforms-id=\"layout_title_118\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t<h3 class=\"happyforms-layout-title\">Communication and language speaking development of child<\/h3>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--checkbox happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_checkbox_119-part\" data-happyforms-type=\"checkbox\" data-happyforms-id=\"checkbox_119\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_checkbox_119\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Expression of child<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_119_option_1597177321782\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_119[]\" value=\"0\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">gesture<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_119_option_1597177322050\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_119[]\" value=\"1\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">cooing, babbling<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_119_option_1597177322126\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_119[]\" value=\"2\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">with words<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_119_option_1597177322206\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_119[]\" value=\"3\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">with sentences<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--checkbox happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_checkbox_120-part\" data-happyforms-type=\"checkbox\" data-happyforms-id=\"checkbox_120\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_checkbox_120\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">You notice in your child<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_120_option_1597177510614\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_120[]\" value=\"0\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">responds to their name<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_120_option_1597177510918\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_120[]\" value=\"1\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">brings and shows interesting thing, toys<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_120_option_1597177511011\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_120[]\" value=\"2\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">looks into your eyes<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_120_option_1597177511110\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_120[]\" value=\"3\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">looks at you and checks how you will react<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_120_option_1597177511208\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_120[]\" value=\"4\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">laughs when you laugh<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_120_option_1597177511309\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_120[]\" value=\"5\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">imitates your moments, grimace, clapping<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_120_option_1597177511414\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_120[]\" value=\"6\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">waves &quot;bye-bye&quot;<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_120_option_1597177511516\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_120[]\" value=\"7\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">uses gestures to show<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--narrative happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_narrative_121-part\" data-happyforms-type=\"narrative\" data-happyforms-id=\"narrative_121\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_narrative_121\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">How many months old did the child say first word with meaning<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t<p><p>\t\t\t\t<input id=\"happyforms-4087_narrative_121\" type=\"text\" name=\"4087_narrative_121[]\"  value=\"\" autocomplete=\"off\" spellcheck=\"false\" \/> months<\/p><\/p>\n\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--narrative happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_narrative_122-part\" data-happyforms-type=\"narrative\" data-happyforms-id=\"narrative_122\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_narrative_122\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">How old was child when he\/she said a full sentence<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t<span class=\"happyforms-part__description\">ex: car broom-broom, bear drinks...<\/span>\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t<p><p>\t\t\t\t<input id=\"happyforms-4087_narrative_122\" type=\"text\" name=\"4087_narrative_122[]\"  value=\"\" autocomplete=\"off\" spellcheck=\"false\" \/> months<\/p><\/p>\n\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--radio happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_radio_123-part\" data-happyforms-type=\"radio\" data-happyforms-id=\"radio_123\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_radio_123\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Does child understand when others speak?<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_123_option_1597177762825\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_123\" value=\"0\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">Yes<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_123_option_1597177766056\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_123\" value=\"1\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">No<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--radio happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_radio_124-part\" data-happyforms-type=\"radio\" data-happyforms-id=\"radio_124\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_radio_124\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Does child pronounce correctly grammar sounds of the croatian language<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t<span class=\"happyforms-part__description\">only applies to child 3 years old and older<\/span>\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_124_option_1597177825455\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_124\" value=\"0\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">Yes<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_124_option_1597177829009\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_124\" value=\"1\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">No<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--radio happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_radio_125-part\" data-happyforms-type=\"radio\" data-happyforms-id=\"radio_125\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_radio_125\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Does the child have a change in tempo and rhythm when speaking?<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t<span class=\"happyforms-part__description\">repeating, pausing, talking too fast...<\/span>\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_125_option_1597178039159\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_125\" value=\"0\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">Yes<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_125_option_1597178041900\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_125\" value=\"1\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">No<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--radio happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_radio_126-part\" data-happyforms-type=\"radio\" data-happyforms-id=\"radio_126\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_radio_126\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Does the child live in a multilingual environment?<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_126_option_1597178105896\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_126\" value=\"0\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">Yes<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_126_option_1597178108178\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_126\" value=\"1\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">No<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-full happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_127-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_127\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_127\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">What is the primary language spoken at home?<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_127\" type=\"text\" name=\"4087_single_line_text_127\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"happyforms-step\" style=\"display: none;\">\n\t\t<div class=\"happyforms-form__part happyforms-part happyforms-part--page_break happyforms-part--label-show\" id=\"happyforms-4087_page_break_128-part\" data-happyforms-type=\"page_break\" data-happyforms-id=\"page_break_128\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--layout_title happyforms-part--width-full\" id=\"happyforms-4087_layout_title_129-part\" data-happyforms-type=\"layout_title\" data-happyforms-id=\"layout_title_129\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t<h3 class=\"happyforms-layout-title\">Social - emotional development of child<\/h3>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--radio happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_radio_130-part\" data-happyforms-type=\"radio\" data-happyforms-id=\"radio_130\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_radio_130\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Child has attended preschool, babysitting service, been to a playroom<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_130_option_1597178367814\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_130\" value=\"0\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">Yes<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_130_option_1597178369571\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_130\" value=\"1\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">No<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-full happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_131-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_131\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_131\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">How did the child adjust<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_131\" type=\"text\" name=\"4087_single_line_text_131\" value=\"\" placeholder=\"please state\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--checkbox happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_checkbox_132-part\" data-happyforms-type=\"checkbox\" data-happyforms-id=\"checkbox_132\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_checkbox_132\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Separation from a close person is for the child<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_132_option_1597178619005\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_132[]\" value=\"0\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">hard<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_132_option_1597178619375\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_132[]\" value=\"1\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">no problem<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_132_option_1597178619557\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_132[]\" value=\"2\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">has never been separated<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--radio happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_radio_133-part\" data-happyforms-type=\"radio\" data-happyforms-id=\"radio_133\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_radio_133\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Child has had contact with other children<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_133_option_1597178726139\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_133\" value=\"0\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">rarely<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_133_option_1597178726517\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_133\" value=\"1\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">occasionally<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_133_option_1597178726665\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_133\" value=\"2\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">often<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--checkbox happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_checkbox_134-part\" data-happyforms-type=\"checkbox\" data-happyforms-id=\"checkbox_134\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_checkbox_134\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">In contact with other children<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_134_option_1597178886499\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_134[]\" value=\"0\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">observes other children<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_134_option_1597178886925\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_134[]\" value=\"1\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">plays close to them<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_134_option_1597178887140\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_134[]\" value=\"2\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">is shy<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_134_option_1597178887351\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_134[]\" value=\"3\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">withdrawn<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_134_option_1597178887568\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_134[]\" value=\"4\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">shows very little interest to play with other children<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_134_option_1597178887791\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_134[]\" value=\"5\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">tries to include in play<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_134_option_1597178888009\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_134[]\" value=\"6\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">cooperates well with other children<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_134_option_1597178888221\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_134[]\" value=\"7\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">sometimes shows rudeness towards children (biting, pushing, fighting)<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_134_option_1597178888445\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_134[]\" value=\"8\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">compassion<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_134_option_1597178888662\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_134[]\" value=\"9\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">comforst<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_134_option_1597178888886\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_134[]\" value=\"10\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">helps<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_134_option_1597178889104\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_134[]\" value=\"11\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">willing to share, donate<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--checkbox happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_checkbox_135-part\" data-happyforms-type=\"checkbox\" data-happyforms-id=\"checkbox_135\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_checkbox_135\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">In emotions, moods and habits of child<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_135_option_1597179397738\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_135[]\" value=\"0\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">very disturbed when separated from parents<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_135_option_1597179398205\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_135[]\" value=\"1\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">complains on stomach pain, headache similar<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_135_option_1597179398447\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_135[]\" value=\"2\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">often resists requests<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_135_option_1597179398667\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_135[]\" value=\"3\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">often says &quot;no&quot;<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_135_option_1597179398892\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_135[]\" value=\"4\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">is angry, has outbursts of anger<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_135_option_1597179399111\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_135[]\" value=\"5\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">shows jealousy<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_135_option_1597179399341\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_135[]\" value=\"6\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">cries frequently<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_135_option_1597179399564\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_135[]\" value=\"7\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">has respiratory affective crisis<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_135_option_1597179399787\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_135[]\" value=\"8\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">shows sign of ticks<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_135_option_1597179400009\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_135[]\" value=\"9\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">shaking of hands<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_135_option_1597179400241\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_135[]\" value=\"10\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">unusual motion of hands near the face<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_135_option_1597179400468\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_135[]\" value=\"11\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">nail biting<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_135_option_1597179400694\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_135[]\" value=\"12\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">biting one self<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_135_option_1597179400924\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_135[]\" value=\"13\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">swaying<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_135_option_1597179401150\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_135[]\" value=\"14\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">hair twirling<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_135_option_1597179401374\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_135[]\" value=\"15\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">hopping in place<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_135_option_1597179401547\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_135[]\" value=\"16\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">spinning around one self<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_135_option_1597179401723\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_135[]\" value=\"17\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">walking in a circle<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_135_option_1597179582991\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_135[]\" value=\"18\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">shows fear of (please state)<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t<div class=\"happyforms-part__option happyforms-part-option happyforms-part-option--other\" id=\"checkbox_135_other\">\n\t<label class=\"option-label\">\n\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden\" name=\"4087_checkbox_135[]\"  value=\"999\" data-serialize autocomplete=\"off\" spellcheck=\"false\">\n\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t<span class=\"label\" id=\"hf-label-4087_checkbox_135\">none of the above - other<\/span>\n\t<\/label>\n\t<input  type=\"text\" aria-labelledby=\"hf-label-4087_checkbox_135\" placeholder=\"please state\" value=\"\" autocomplete=\"off\" spellcheck=\"false\" autocorrect=\"off\" \/>\n<\/div>\n\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-full happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_136-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_136\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_136\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">shows fear of:<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_136\" type=\"text\" name=\"4087_single_line_text_136\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--radio happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_radio_137-part\" data-happyforms-type=\"radio\" data-happyforms-id=\"radio_137\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_radio_137\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Child usually carries an object<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_137_option_1597179776473\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_137\" value=\"0\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">Yes<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"radio_137_option_1597179778582\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"radio\" class=\"happyforms-visuallyhidden\" name=\"4087_radio_137\" value=\"1\"  autocomplete=\"off\" spellcheck=\"false\" >\n\t\t\t\t\t<span class=\"checkmark\"><span class=\"happyforms-radio-circle\"><\/span><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">No<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_single_line_text_138-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_138\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_138\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Which<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t<span class=\"happyforms-part__description\">ex: pacifier, bottle, toy<\/span>\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_138\" type=\"text\" name=\"4087_single_line_text_138\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-full happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_139-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_139\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_139\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">What is the easiest way to comfort child?<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_139\" type=\"text\" name=\"4087_single_line_text_139\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"happyforms-step\" style=\"display: none;\">\n\t\t<div class=\"happyforms-form__part happyforms-part happyforms-part--page_break happyforms-part--label-show\" id=\"happyforms-4087_page_break_140-part\" data-happyforms-type=\"page_break\" data-happyforms-id=\"page_break_140\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--layout_title happyforms-part--width-full\" id=\"happyforms-4087_layout_title_141-part\" data-happyforms-type=\"layout_title\" data-happyforms-id=\"layout_title_141\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t<h3 class=\"happyforms-layout-title\">Characteristics of child\u2019s play, attention and knowledge<\/h3>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-full happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_142-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_142\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_142\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Child, most often, likes to play with<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t<span class=\"happyforms-part__description\">person, object ...<\/span>\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_142\" type=\"text\" name=\"4087_single_line_text_142\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--checkbox happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_checkbox_143-part\" data-happyforms-type=\"checkbox\" data-happyforms-id=\"checkbox_143\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_checkbox_143\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Child&#039;s attention span in play or activity<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_143_option_1597181119453\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_143[]\" value=\"0\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">short time - often doesn&#039;t finish one game<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_143_option_1597181119995\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_143[]\" value=\"1\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">short time - transitions to another game<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_143_option_1597181120548\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_143[]\" value=\"2\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">easily interrupted by sounds or stimuli from the side<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_143_option_1597181120824\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_143[]\" value=\"3\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">plays with one game for a long time<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_143_option_1597181121089\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_143[]\" value=\"4\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">repeats same activity many times in a row<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_143_option_1597181121336\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_143[]\" value=\"5\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">sometimes wanders in thoughts (daydreaming)<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_143_option_1597181121615\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_143[]\" value=\"6\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">cannot evaluate<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--checkbox happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_checkbox_144-part\" data-happyforms-type=\"checkbox\" data-happyforms-id=\"checkbox_144\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_checkbox_144\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Precautions in behaviour<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_144_option_1597181252723\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_144[]\" value=\"0\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">has no precaution<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_144_option_1597181253282\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_144[]\" value=\"1\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">carelessly distances one self from parents and other familiar people<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_144_option_1597181253554\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_144[]\" value=\"2\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">poorly estimates danger<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_144_option_1597181253816\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_144[]\" value=\"3\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">climbs<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_144_option_1597181254102\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_144[]\" value=\"4\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">puts small and inedible things in mouth<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_144_option_1597181254386\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_144[]\" value=\"5\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">fearless<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t<div class=\"happyforms-part__option happyforms-part-option happyforms-part-option--other\" id=\"checkbox_144_other\">\n\t<label class=\"option-label\">\n\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden\" name=\"4087_checkbox_144[]\"  value=\"999\" data-serialize autocomplete=\"off\" spellcheck=\"false\">\n\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t<span class=\"label\" id=\"hf-label-4087_checkbox_144\">none of the above - other<\/span>\n\t<\/label>\n\t<input  type=\"text\" aria-labelledby=\"hf-label-4087_checkbox_144\" placeholder=\"\" value=\"\" autocomplete=\"off\" spellcheck=\"false\" autocorrect=\"off\" \/>\n<\/div>\n\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-part--choice happyforms-form__part happyforms-part happyforms-part--checkbox happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_checkbox_145-part\" data-happyforms-type=\"checkbox\" data-happyforms-id=\"checkbox_145\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_checkbox_145\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Child spends time in front of screens watching<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\n\t\t<span class=\"happyforms-part__description\">TV, cartoons, movies, playing video games ...<\/span>\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_145_option_1597181496011\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_145[]\" value=\"0\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">doesn&#039;t spend time in front of screens<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_145_option_1597181496560\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_145[]\" value=\"1\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">television<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_145_option_1597181496803\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_145[]\" value=\"2\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">mobile phone<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"happyforms-part__option happyforms-part-option\" id=\"checkbox_145_option_1597181497042\">\n\t\t\t\t<label class=\"option-label\">\n\t\t\t\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden happyforms-checkbox\" name=\"4087_checkbox_145[]\" value=\"3\" data-serialize  autocomplete=\"off\" spellcheck=\"false\"  >\n\t\t\t\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t\t\t\t<span class=\"label-wrap\">\n\t\t\t\t\t\t<span class=\"label\">personal computer, laptop, tablet<\/span>\t\t\t\t\t<\/span>\n\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\n\t\t\t<div class=\"happyforms-part__option happyforms-part-option happyforms-part-option--other\" id=\"checkbox_145_other\">\n\t<label class=\"option-label\">\n\t\t<input type=\"checkbox\" class=\"happyforms-visuallyhidden\" name=\"4087_checkbox_145[]\"  value=\"999\" data-serialize autocomplete=\"off\" spellcheck=\"false\">\n\t\t<span class=\"checkmark\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" viewBox=\"0 0 24 24\"><path fill=\"currentColor\" d=\"M20.285 2l-11.285 11.567-5.286-5.011-3.714 3.716 9 8.728 15-15.285z\"\/><\/svg><\/span>\n\t\t<span class=\"label\" id=\"hf-label-4087_checkbox_145\">none of the above - other<\/span>\n\t<\/label>\n\t<input  type=\"text\" aria-labelledby=\"hf-label-4087_checkbox_145\" placeholder=\"\" value=\"\" autocomplete=\"off\" spellcheck=\"false\" autocorrect=\"off\" \/>\n<\/div>\n\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--narrative happyforms-part--width-full happyforms-part--label-left\" id=\"happyforms-4087_narrative_146-part\" data-happyforms-type=\"narrative\" data-happyforms-id=\"narrative_146\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_narrative_146\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">Average time spent in front of screens<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t<p><p>\t\t\t\t<input id=\"happyforms-4087_narrative_146\" type=\"text\" name=\"4087_narrative_146[]\"  value=\"\" autocomplete=\"off\" spellcheck=\"false\" \/> minutes<\/p><\/p>\n\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-full happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_147-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_147\" data-happyforms-required=\"\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_147\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">What is your child good at, what are your child\u2019s strengths?<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_147\" type=\"text\" name=\"4087_single_line_text_147\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"happyforms-form__part happyforms-part happyforms-part--single_line_text happyforms-part--width-full happyforms-part--label-below\" id=\"happyforms-4087_single_line_text_148-part\" data-happyforms-type=\"single_line_text\" data-happyforms-id=\"single_line_text_148\">\n\t<div class=\"happyforms-part-wrap\">\n\t\t\n\t\t\t\t\t\t<div class=\"happyforms-part__label-container\">\n\t\t\t\t<label for=\"happyforms-4087_single_line_text_148\" class=\"happyforms-part__label\">\n\t\t\t<span class=\"label\">are you concerned with something related to the development and behavior of your child? If yes, what is the concern?<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-required\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"happyforms-optional\"><\/span>\n\t\t\t\t\t<\/label>\n\t\t\t<\/div>\n\t\t\t\n\t\t\n\t\t<div class=\"happyforms-part__el\">\n\t\t\t\n\t\t\t\n\t\t\t<div class=\"happyforms-input\">\n\t\t\t\t\n\t\t\t\t<input id=\"happyforms-4087_single_line_text_148\" type=\"text\" name=\"4087_single_line_text_148\" value=\"\" placeholder=\"\" autocomplete=\"off\" spellcheck=\"false\"  autocorrect=\"off\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\t\t\t<\/div>\t\t\t<div class=\"happyforms-form__part happyforms-part happyforms-part--submit\">\n\t\t\t<button type=\"submit\" class=\"happyforms-submit happyforms-button--submit \">next<\/button>\n\t<button type=\"button\" class=\"happyforms-text-button happyforms-save-session disabled\" data-happyforms-form-id=\"4087\">save and continue later<\/button>\n<\/div>\n\t\t<\/div>\n\n\t\t\t<\/form>\n\n\t<\/div>\n\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>[vc_row css_animation=&#8221;fadeInDown&#8221;][vc_column][vc_custom_heading text=&#8221;Request for enrollment&#8221; font_container=&#8221;tag:h1|text_align:center&#8221; use_theme_fonts=&#8221;yes&#8221; css_animation=&#8221;none&#8221; el_class=&#8221;kidsco-h1-40&#8243;][vc_raw_html]PGhyIGNsYXNzPSJraWRzLWNvLXNlcGFyYXRvci1uby1tYXJnaW4iPg==[\/vc_raw_html][\/vc_column][\/vc_row][vc_row content_placement=&#8221;middle&#8221; css_animation=&#8221;none&#8221; disable_element=&#8221;yes&#8221;][vc_column width=&#8221;1\/3&#8243; css=&#8221;.vc_custom_1684922181225{padding-right: 10% !important;padding-left: 10% !important;}&#8221;][\/vc_column][vc_column width=&#8221;1\/3&#8243;][vc_column_text] Dear visitors, Thank you for your interest in KIDS&#038;CO. concept of preschool education and care. Unfortunately, we have to inform you that we are currently unable to process enrolment requests until the end of June 2023 [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-4088","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Enrollment - Kids&amp;Co.<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/kidsandco.eu\/en\/enrollment\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Enrollment - Kids&amp;Co.\" \/>\n<meta property=\"og:description\" content=\"[vc_row css_animation=&#8221;fadeInDown&#8221;][vc_column][vc_custom_heading text=&#8221;Request for enrollment&#8221; font_container=&#8221;tag:h1|text_align:center&#8221; use_theme_fonts=&#8221;yes&#8221; css_animation=&#8221;none&#8221; el_class=&#8221;kidsco-h1-40&#8243;][vc_raw_html]PGhyIGNsYXNzPSJraWRzLWNvLXNlcGFyYXRvci1uby1tYXJnaW4iPg==[\/vc_raw_html][\/vc_column][\/vc_row][vc_row content_placement=&#8221;middle&#8221; css_animation=&#8221;none&#8221; disable_element=&#8221;yes&#8221;][vc_column width=&#8221;1\/3&#8243; css=&#8221;.vc_custom_1684922181225{padding-right: 10% !important;padding-left: 10% !important;}&#8221;][\/vc_column][vc_column width=&#8221;1\/3&#8243;][vc_column_text] Dear visitors, Thank you for your interest in KIDS&#038;CO. concept of preschool education and care. Unfortunately, we have to inform you that we are currently unable to process enrolment requests until the end of June 2023 [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/kidsandco.eu\/en\/enrollment\/\" \/>\n<meta property=\"og:site_name\" content=\"Kids&amp;Co.\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/Kidsandcozg\" \/>\n<meta property=\"article:modified_time\" content=\"2023-08-19T12:08:43+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/kidsandco.eu\/wp-content\/uploads\/2020\/07\/kids-and-co-gallery-05.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1920\" \/>\n\t<meta property=\"og:image:height\" content=\"1280\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/kidsandco.eu\\\/en\\\/enrollment\\\/\",\"url\":\"https:\\\/\\\/kidsandco.eu\\\/en\\\/enrollment\\\/\",\"name\":\"Enrollment - Kids&amp;Co.\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/kidsandco.eu\\\/#website\"},\"datePublished\":\"2020-08-26T23:30:37+00:00\",\"dateModified\":\"2023-08-19T12:08:43+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/kidsandco.eu\\\/en\\\/enrollment\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/kidsandco.eu\\\/en\\\/enrollment\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/kidsandco.eu\\\/en\\\/enrollment\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/kidsandco.eu\\\/en\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Enrollment\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/kidsandco.eu\\\/#website\",\"url\":\"https:\\\/\\\/kidsandco.eu\\\/\",\"name\":\"Kids&amp;Co.\",\"description\":\"\",\"publisher\":{\"@id\":\"https:\\\/\\\/kidsandco.eu\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/kidsandco.eu\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/kidsandco.eu\\\/#organization\",\"name\":\"Kids&Co.\",\"url\":\"https:\\\/\\\/kidsandco.eu\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/kidsandco.eu\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/kidsandco.eu\\\/wp-content\\\/uploads\\\/2020\\\/02\\\/kidsco_logo.png\",\"contentUrl\":\"https:\\\/\\\/kidsandco.eu\\\/wp-content\\\/uploads\\\/2020\\\/02\\\/kidsco_logo.png\",\"width\":204,\"height\":55,\"caption\":\"Kids&Co.\"},\"image\":{\"@id\":\"https:\\\/\\\/kidsandco.eu\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/Kidsandcozg\",\"https:\\\/\\\/www.instagram.com\\\/dv_kreativni_dani\\\/\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Enrollment - Kids&amp;Co.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/kidsandco.eu\/en\/enrollment\/","og_locale":"en_US","og_type":"article","og_title":"Enrollment - Kids&amp;Co.","og_description":"[vc_row css_animation=&#8221;fadeInDown&#8221;][vc_column][vc_custom_heading text=&#8221;Request for enrollment&#8221; font_container=&#8221;tag:h1|text_align:center&#8221; use_theme_fonts=&#8221;yes&#8221; css_animation=&#8221;none&#8221; el_class=&#8221;kidsco-h1-40&#8243;][vc_raw_html]PGhyIGNsYXNzPSJraWRzLWNvLXNlcGFyYXRvci1uby1tYXJnaW4iPg==[\/vc_raw_html][\/vc_column][\/vc_row][vc_row content_placement=&#8221;middle&#8221; css_animation=&#8221;none&#8221; disable_element=&#8221;yes&#8221;][vc_column width=&#8221;1\/3&#8243; css=&#8221;.vc_custom_1684922181225{padding-right: 10% !important;padding-left: 10% !important;}&#8221;][\/vc_column][vc_column width=&#8221;1\/3&#8243;][vc_column_text] Dear visitors, Thank you for your interest in KIDS&#038;CO. concept of preschool education and care. 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