{"id":1317,"date":"2026-08-20T18:01:59","date_gmt":"2026-08-20T18:01:59","guid":{"rendered":"https:\/\/chipolahealthystart.org\/?page_id=1317"},"modified":"2026-08-20T18:02:44","modified_gmt":"2026-08-20T18:02:44","slug":"satisfaction-survey","status":"publish","type":"page","link":"https:\/\/chipolahealthystart.org\/index.php\/satisfaction-survey\/","title":{"rendered":"Satisfaction Survey"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1317\" class=\"elementor elementor-1317\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f6d0b20 e-flex e-con-boxed e-con e-parent\" data-id=\"f6d0b20\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-8a7b38c fluent-form-widget-step-header-yes fluent-form-widget-step-progressbar-yes fluentform-widget-submit-button-custom elementor-widget elementor-widget-fluent-form-widget\" data-id=\"8a7b38c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"fluent-form-widget.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\n            <div class=\"fluentform-widget-wrapper fluentform-widget-align-default\">\n\n            \n            <div class='fluentform ff-default fluentform_wrapper_7 ffs_default_wrap'><form data-form_id=\"7\" id=\"fluentform_7\" class=\"frm-fluent-form fluent_form_7 ff-el-form-top ff_form_instance_7_1 ff-form-loading ffs_default\" data-form_instance=\"ff_form_instance_7_1\" method=\"POST\" ><fieldset  style=\"border: none!important;margin: 0!important;padding: 0!important;background-color: transparent!important;box-shadow: none!important;outline: none!important; min-inline-size: 100%;\">\n                    <legend class=\"ff_screen_reader_title\" style=\"display: block; margin: 0!important;padding: 0!important;height: 0!important;text-indent: -999999px;width: 0!important;overflow:hidden;\">Satisfaction Survey<\/legend><input type='hidden' name='__fluent_form_embded_post_id' value='1317' \/><input type=\"hidden\" id=\"_fluentform_7_fluentformnonce\" name=\"_fluentform_7_fluentformnonce\" value=\"4763e0bf34\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index.php\/wp-json\/wp\/v2\/pages\/1317\" \/><div class=\"ff-el-group ff-el-section-break  ff_left\" data-name=\"section_break-7_1\" ><h3 class='ff-el-section-title'><\/h3><div class='ff-section_break_desk'><p>Please score the following questions 1-5, 1 being <strong>Strongly disagree<\/strong> and 5 being\u00a0<strong>Strongly agree.<\/strong><strong><br \/><\/strong><\/p><\/div><hr \/><\/div><div class='ff-el-group ff_list_inline'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"You were offered an appointment time convenient for you.\">You were offered an appointment time convenient for you.<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_dcff5293d967d9ecc412cb6142234335'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"1\"  id='checkbox_dcff5293d967d9ecc412cb6142234335' aria-label='1' aria-invalid='false' aria-required=true> <span>1<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_f7b2db9348af62f7493dfcb5ddd04b3f'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"2\"  id='checkbox_f7b2db9348af62f7493dfcb5ddd04b3f' aria-label='2' aria-invalid='false' aria-required=true> <span>2<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_e03333563b2df43954ca04339e9603f9'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"3\"  id='checkbox_e03333563b2df43954ca04339e9603f9' aria-label='3' aria-invalid='false' aria-required=true> <span>3<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_35b1d53617c32cb5b7db491c0ec9499d'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"4\"  id='checkbox_35b1d53617c32cb5b7db491c0ec9499d' aria-label='4' aria-invalid='false' aria-required=true> <span>4<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_e41609d979d9593b28f39b74f5689c5c'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"5\"  id='checkbox_e41609d979d9593b28f39b74f5689c5c' aria-label='5' aria-invalid='false' aria-required=true> <span>5<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group ff_list_inline'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"The Heathy Start Care Coordinator provided me helpful information.\">The Heathy Start Care Coordinator provided me helpful information.<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_1_acc3727506f9575aedd701f83a99243d'><input  type=\"checkbox\" name=\"checkbox_1[]\" data-name=\"checkbox_1\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"1\"  id='checkbox_1_acc3727506f9575aedd701f83a99243d' aria-label='1' aria-invalid='false' aria-required=true> <span>1<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_1_88a82880b8e3f942e62d1cc1684fd980'><input  type=\"checkbox\" name=\"checkbox_1[]\" data-name=\"checkbox_1\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"2\"  id='checkbox_1_88a82880b8e3f942e62d1cc1684fd980' aria-label='2' aria-invalid='false' aria-required=true> <span>2<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_1_8412ae89d2c483da7156ca6dddb984fd'><input  type=\"checkbox\" name=\"checkbox_1[]\" data-name=\"checkbox_1\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"3\"  id='checkbox_1_8412ae89d2c483da7156ca6dddb984fd' aria-label='3' aria-invalid='false' aria-required=true> <span>3<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_1_17c9962c738987eba088e29a3ed0290b'><input  type=\"checkbox\" name=\"checkbox_1[]\" data-name=\"checkbox_1\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"4\"  id='checkbox_1_17c9962c738987eba088e29a3ed0290b' aria-label='4' aria-invalid='false' aria-required=true> <span>4<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_1_699089271493e621c4fcc61c2a51feb8'><input  type=\"checkbox\" name=\"checkbox_1[]\" data-name=\"checkbox_1\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"5\"  id='checkbox_1_699089271493e621c4fcc61c2a51feb8' aria-label='5' aria-invalid='false' aria-required=true> <span>5<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group ff_list_inline'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"I felt comfortable sharing my concerns with the Healthy Start Care  Coordinator.\">I felt comfortable sharing my concerns with the Healthy Start Care  Coordinator.<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_2_e2742cc2d6a72d1d8ef18b50d071b969'><input  type=\"checkbox\" name=\"checkbox_2[]\" data-name=\"checkbox_2\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"1\"  id='checkbox_2_e2742cc2d6a72d1d8ef18b50d071b969' aria-label='1' aria-invalid='false' aria-required=true> <span>1<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_2_ce21262c2753f987bdeb976805575dfd'><input  type=\"checkbox\" name=\"checkbox_2[]\" data-name=\"checkbox_2\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"2\"  id='checkbox_2_ce21262c2753f987bdeb976805575dfd' aria-label='2' aria-invalid='false' aria-required=true> <span>2<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_2_3d9946dc95121d0b838847333bc44366'><input  type=\"checkbox\" name=\"checkbox_2[]\" data-name=\"checkbox_2\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"3\"  id='checkbox_2_3d9946dc95121d0b838847333bc44366' aria-label='3' aria-invalid='false' aria-required=true> <span>3<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_2_adbaeefed58130faad08c614452087b1'><input  type=\"checkbox\" name=\"checkbox_2[]\" data-name=\"checkbox_2\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"4\"  id='checkbox_2_adbaeefed58130faad08c614452087b1' aria-label='4' aria-invalid='false' aria-required=true> <span>4<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_2_e7f1ba24dc7407dbfb267850a60c1fd8'><input  type=\"checkbox\" name=\"checkbox_2[]\" data-name=\"checkbox_2\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"5\"  id='checkbox_2_e7f1ba24dc7407dbfb267850a60c1fd8' aria-label='5' aria-invalid='false' aria-required=true> <span>5<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group ff_list_inline'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"The Care Coordinator was friendly and supportive.\">The Care Coordinator was friendly and supportive.<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_3_159ffdb6d415a18c1d29bd25373e5365'><input  type=\"checkbox\" name=\"checkbox_3[]\" data-name=\"checkbox_3\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"1\"  id='checkbox_3_159ffdb6d415a18c1d29bd25373e5365' aria-label='1' aria-invalid='false' aria-required=true> <span>1<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_3_30a5b3870d4761cde667a74cc8cc8420'><input  type=\"checkbox\" name=\"checkbox_3[]\" data-name=\"checkbox_3\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"2\"  id='checkbox_3_30a5b3870d4761cde667a74cc8cc8420' aria-label='2' aria-invalid='false' aria-required=true> <span>2<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_3_7f9a5316e8a8644088c015b121e4b9de'><input  type=\"checkbox\" name=\"checkbox_3[]\" data-name=\"checkbox_3\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"3\"  id='checkbox_3_7f9a5316e8a8644088c015b121e4b9de' aria-label='3' aria-invalid='false' aria-required=true> <span>3<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_3_eed29f97d2b041860ac18ef98beb0db7'><input  type=\"checkbox\" name=\"checkbox_3[]\" data-name=\"checkbox_3\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"4\"  id='checkbox_3_eed29f97d2b041860ac18ef98beb0db7' aria-label='4' aria-invalid='false' aria-required=true> <span>4<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_3_52e1ad883c288807c3171fa956990d78'><input  type=\"checkbox\" name=\"checkbox_3[]\" data-name=\"checkbox_3\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"5\"  id='checkbox_3_52e1ad883c288807c3171fa956990d78' aria-label='5' aria-invalid='false' aria-required=true> <span>5<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group ff_list_inline'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"The Care Coordinator explained the Healthy Start program in a way  that I could understand.\">The Care Coordinator explained the Healthy Start program in a way  that I could understand.<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_4_60de8706eccde940ad258b8ab8db1621'><input  type=\"checkbox\" name=\"checkbox_4[]\" data-name=\"checkbox_4\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"1\"  id='checkbox_4_60de8706eccde940ad258b8ab8db1621' aria-label='1' aria-invalid='false' aria-required=true> <span>1<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_4_6a656284f85ed3e901b97445d3bfdf4e'><input  type=\"checkbox\" name=\"checkbox_4[]\" data-name=\"checkbox_4\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"2\"  id='checkbox_4_6a656284f85ed3e901b97445d3bfdf4e' aria-label='2' aria-invalid='false' aria-required=true> <span>2<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_4_9815960671223535a460411b36ad8919'><input  type=\"checkbox\" name=\"checkbox_4[]\" data-name=\"checkbox_4\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"3\"  id='checkbox_4_9815960671223535a460411b36ad8919' aria-label='3' aria-invalid='false' aria-required=true> <span>3<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_4_44f5cbaad19e324d6b348eecb237b51e'><input  type=\"checkbox\" name=\"checkbox_4[]\" data-name=\"checkbox_4\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"4\"  id='checkbox_4_44f5cbaad19e324d6b348eecb237b51e' aria-label='4' aria-invalid='false' aria-required=true> <span>4<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_4_41c025352e7c6b48c3adacb809b6a732'><input  type=\"checkbox\" name=\"checkbox_4[]\" data-name=\"checkbox_4\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"5\"  id='checkbox_4_41c025352e7c6b48c3adacb809b6a732' aria-label='5' aria-invalid='false' aria-required=true> <span>5<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group ff_list_inline'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"While in the Healthy Start Program, I received information about  how to take care of myself and my baby.\">While in the Healthy Start Program, I received information about  how to take care of myself and my baby.<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_6_13df33abf22a9756743d7b374d2228a8'><input  type=\"checkbox\" name=\"checkbox_6[]\" data-name=\"checkbox_6\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"1\"  id='checkbox_6_13df33abf22a9756743d7b374d2228a8' aria-label='1' aria-invalid='false' aria-required=true> <span>1<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_6_9576b1c25b3ee7a883780ae65471b3f9'><input  type=\"checkbox\" name=\"checkbox_6[]\" data-name=\"checkbox_6\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"2\"  id='checkbox_6_9576b1c25b3ee7a883780ae65471b3f9' aria-label='2' aria-invalid='false' aria-required=true> <span>2<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_6_91bb83d5ac5c19b5b1c1c9e266d6abd3'><input  type=\"checkbox\" name=\"checkbox_6[]\" data-name=\"checkbox_6\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"3\"  id='checkbox_6_91bb83d5ac5c19b5b1c1c9e266d6abd3' aria-label='3' aria-invalid='false' aria-required=true> <span>3<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_6_72165df877a049efa8d2149e61e9847d'><input  type=\"checkbox\" name=\"checkbox_6[]\" data-name=\"checkbox_6\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"4\"  id='checkbox_6_72165df877a049efa8d2149e61e9847d' aria-label='4' aria-invalid='false' aria-required=true> <span>4<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_6_5e8d42963149963a058384681130226a'><input  type=\"checkbox\" name=\"checkbox_6[]\" data-name=\"checkbox_6\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"5\"  id='checkbox_6_5e8d42963149963a058384681130226a' aria-label='5' aria-invalid='false' aria-required=true> <span>5<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group ff_list_inline'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"Was the Healthy Start Program useful to you?\">Was the Healthy Start Program useful to you?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_7_c4525c669037bb7658a59c7784cbdff2'><input  type=\"checkbox\" name=\"checkbox_7[]\" data-name=\"checkbox_7\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"1\"  id='checkbox_7_c4525c669037bb7658a59c7784cbdff2' aria-label='1' aria-invalid='false' aria-required=true> <span>1<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_7_697c6631a629cbfbca71882082502f39'><input  type=\"checkbox\" name=\"checkbox_7[]\" data-name=\"checkbox_7\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"2\"  id='checkbox_7_697c6631a629cbfbca71882082502f39' aria-label='2' aria-invalid='false' aria-required=true> <span>2<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_7_981394948dccf74d2cb92d8b7a34480a'><input  type=\"checkbox\" name=\"checkbox_7[]\" data-name=\"checkbox_7\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"3\"  id='checkbox_7_981394948dccf74d2cb92d8b7a34480a' aria-label='3' aria-invalid='false' aria-required=true> <span>3<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_7_dd9a1da4d2d54ecec31ef9888da97c0d'><input  type=\"checkbox\" name=\"checkbox_7[]\" data-name=\"checkbox_7\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"4\"  id='checkbox_7_dd9a1da4d2d54ecec31ef9888da97c0d' aria-label='4' aria-invalid='false' aria-required=true> <span>4<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_7_2cd4546579ee5581c2730bfc6f067ab1'><input  type=\"checkbox\" name=\"checkbox_7[]\" data-name=\"checkbox_7\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"5\"  id='checkbox_7_2cd4546579ee5581c2730bfc6f067ab1' aria-label='5' aria-invalid='false' aria-required=true> <span>5<\/span><\/label><\/div><\/div><\/div><div class=\"ff-el-group ff-el-section-break  ff_left\" data-name=\"section_break-7_2\" ><h3 class='ff-el-section-title'><\/h3><div class='ff-section_break_desk'><\/div><hr \/><\/div><div class='ff-el-group ff_list_inline'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"The Healthy Start Care Coordinator directed me to other agencies  in the community to assist me.\">The Healthy Start Care Coordinator directed me to other agencies  in the community to assist me. <\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_5_cb69c965563c1263a2a63e068c65b8e1'><input  type=\"checkbox\" name=\"checkbox_5[]\" data-name=\"checkbox_5\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Yes\"  id='checkbox_5_cb69c965563c1263a2a63e068c65b8e1' aria-label='Yes' aria-invalid='false' aria-required=true> <span>Yes<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_5_f1c03829a533f9628d9646720a005ffb'><input  type=\"checkbox\" name=\"checkbox_5[]\" data-name=\"checkbox_5\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"No\"  id='checkbox_5_f1c03829a533f9628d9646720a005ffb' aria-label='No' aria-invalid='false' aria-required=true> <span>No<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_5_d1df440a8ab8641c11b0c5eaaed950e6'><input  type=\"checkbox\" name=\"checkbox_5[]\" data-name=\"checkbox_5\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"N\/A\"  id='checkbox_5_d1df440a8ab8641c11b0c5eaaed950e6' aria-label='N\/A' aria-invalid='false' aria-required=true> <span>N\/A<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group ff_list_inline'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"My visit time\/duration was\">My visit time\/duration was <\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_8_f95a96d1092803df84deed791a353f3c'><input  type=\"checkbox\" name=\"checkbox_8[]\" data-name=\"checkbox_8\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Longer than I expected\"  id='checkbox_8_f95a96d1092803df84deed791a353f3c' aria-label='Longer than I expected' aria-invalid='false' aria-required=true> <span>Longer than I expected<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_8_adb51350a4ca6dee3372207cb2c27d5a'><input  type=\"checkbox\" name=\"checkbox_8[]\" data-name=\"checkbox_8\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Duration that I expected\"  id='checkbox_8_adb51350a4ca6dee3372207cb2c27d5a' aria-label='Duration that I expected' aria-invalid='false' aria-required=true> <span>Duration that I expected<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_8_938945edb7eb75a90063d6e8c738ac78'><input  type=\"checkbox\" name=\"checkbox_8[]\" data-name=\"checkbox_8\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Shorter than I expected\"  id='checkbox_8_938945edb7eb75a90063d6e8c738ac78' aria-label='Shorter than I expected' aria-invalid='false' aria-required=true> <span>Shorter than I expected<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group ff_list_inline'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"Would you recommend our services to a friend?\">Would you recommend our services to a friend?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_9_dc3502d0e484f7423f96a97b16ec782b'><input  type=\"checkbox\" name=\"checkbox_9[]\" data-name=\"checkbox_9\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Yes\"  id='checkbox_9_dc3502d0e484f7423f96a97b16ec782b' aria-label='Yes' aria-invalid='false' aria-required=true> <span>Yes<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_9_915615c5d8d0a4e8d30f024c65fd93b3'><input  type=\"checkbox\" name=\"checkbox_9[]\" data-name=\"checkbox_9\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"No\"  id='checkbox_9_915615c5d8d0a4e8d30f024c65fd93b3' aria-label='No' aria-invalid='false' aria-required=true> <span>No<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_7_input_text' id='label_ff_7_input_text' aria-label=\"Why, or why not?\">Why, or why not?<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text\" class=\"ff-el-form-control\" maxlength=\"200\" data-name=\"input_text\" id=\"ff_7_input_text\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_7_input_text_1' id='label_ff_7_input_text_1' aria-label=\"Would you like to share anything else?\">Would you like to share anything else?<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_1\" class=\"ff-el-form-control\" maxlength=\"200\" data-name=\"input_text_1\" id=\"ff_7_input_text_1\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class=\"ff-el-group ff-el-section-break  ff_left\" data-name=\"section_break-7_3\" ><h3 class='ff-el-section-title'><\/h3><div class='ff-section_break_desk'><\/div><hr \/><\/div><div class='ff-el-group ff_list_inline'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"Race\">Race<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_11_c300beb7ba3ff0b7caa560556f24a9c5'><input  type=\"checkbox\" name=\"checkbox_11[]\" data-name=\"checkbox_11\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"White\"  id='checkbox_11_c300beb7ba3ff0b7caa560556f24a9c5' aria-label='White' aria-invalid='false' aria-required=true> <span>White<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_11_52ff2d4e13949daddcfef5391df07d89'><input  type=\"checkbox\" name=\"checkbox_11[]\" data-name=\"checkbox_11\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Black\/African American\"  id='checkbox_11_52ff2d4e13949daddcfef5391df07d89' aria-label='Black\/African American' aria-invalid='false' aria-required=true> <span>Black\/African American<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_11_8bd7cac5c41f2e03a9eb69d0db48a6ec'><input  type=\"checkbox\" name=\"checkbox_11[]\" data-name=\"checkbox_11\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Asian\"  id='checkbox_11_8bd7cac5c41f2e03a9eb69d0db48a6ec' aria-label='Asian' aria-invalid='false' aria-required=true> <span>Asian<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_11_3b35d52782c692b1fa32a3a54b719165'><input  type=\"checkbox\" name=\"checkbox_11[]\" data-name=\"checkbox_11\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Pacific Islander\"  id='checkbox_11_3b35d52782c692b1fa32a3a54b719165' aria-label='Pacific Islander' aria-invalid='false' aria-required=true> <span>Pacific Islander<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_11_0af84ace974d5a4a43a18f045fecac39'><input  type=\"checkbox\" name=\"checkbox_11[]\" data-name=\"checkbox_11\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Native American\/American Indian\"  id='checkbox_11_0af84ace974d5a4a43a18f045fecac39' aria-label='Native American\/American Indian' aria-invalid='false' aria-required=true> <span>Native American\/American Indian<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_11_74d12666c049e276d6720236f0ca1d65'><input  type=\"checkbox\" name=\"checkbox_11[]\" data-name=\"checkbox_11\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Multiracial\"  id='checkbox_11_74d12666c049e276d6720236f0ca1d65' aria-label='Multiracial' aria-invalid='false' aria-required=true> <span>Multiracial<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_11_94975a4d663b1533731f9fd1bf753930'><input  type=\"checkbox\" name=\"checkbox_11[]\" data-name=\"checkbox_11\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Prefer not to share\"  id='checkbox_11_94975a4d663b1533731f9fd1bf753930' aria-label='Prefer not to share' aria-invalid='false' aria-required=true> <span>Prefer not to share<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group ff_list_inline'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"Ethnicity\">Ethnicity<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_12_d4a53f17df0f1c6e7af7c44d95d9986a'><input  type=\"checkbox\" name=\"checkbox_12[]\" data-name=\"checkbox_12\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Hispanic\/Latino\/Spanish origin\"  id='checkbox_12_d4a53f17df0f1c6e7af7c44d95d9986a' aria-label='Hispanic\/Latino\/Spanish origin' aria-invalid='false' aria-required=true> <span>Hispanic\/Latino\/Spanish origin<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_12_305ca2781ea5e5b75b79547cc8765fb3'><input  type=\"checkbox\" name=\"checkbox_12[]\" data-name=\"checkbox_12\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Haitian origin\"  id='checkbox_12_305ca2781ea5e5b75b79547cc8765fb3' aria-label='Haitian origin' aria-invalid='false' aria-required=true> <span>Haitian origin<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_12_21ce8b9d821d0931867d513f201e6922'><input  type=\"checkbox\" name=\"checkbox_12[]\" data-name=\"checkbox_12\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Not Hispanic\/Hatian origin\"  id='checkbox_12_21ce8b9d821d0931867d513f201e6922' aria-label='Not Hispanic\/Hatian origin' aria-invalid='false' aria-required=true> <span>Not Hispanic\/Hatian origin<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_12_1ec246e8c7e5cf1ce6d3c349c41f61a4'><input  type=\"checkbox\" name=\"checkbox_12[]\" data-name=\"checkbox_12\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Prefer not to share\"  id='checkbox_12_1ec246e8c7e5cf1ce6d3c349c41f61a4' aria-label='Prefer not to share' aria-invalid='false' aria-required=true> <span>Prefer not to share<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_7_dropdown' id='label_ff_7_dropdown' aria-label=\"Please select the county you live in.\">Please select the county you live in. <\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown\" id=\"ff_7_dropdown\" class=\"ff-el-form-control\" data-name=\"dropdown\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_7_dropdown\"><option value=\"\">- Select -<\/option><option value=\"Calhoun\"  >Calhoun<\/option><option value=\"Holmes\"  >Holmes<\/option><option value=\"Jackson\"  >Jackson<\/option><option value=\"Liberty\"  >Liberty<\/option><option value=\"Washington\"  >Washington<\/option><\/select><\/div><\/div><div class='ff-el-group ff-text-left ff_submit_btn_wrapper'><button type=\"submit\" class=\"ff-btn ff-btn-submit ff-btn-md ff_btn_style\"  aria-label=\"Submit Form\">Submit Form<\/button><\/div><\/fieldset><\/form><div id='fluentform_7_errors' class='ff-errors-in-stack ff_form_instance_7_1 ff-form-loading_errors ff_form_instance_7_1_errors'><\/div><\/div>            <script type=\"text\/javascript\">\n                window.fluent_form_ff_form_instance_7_1 = {\"id\":\"7\",\"ajaxUrl\":\"https:\\\/\\\/chipolahealthystart.org\\\/wp-admin\\\/admin-ajax.php\",\"settings\":{\"layout\":{\"labelPlacement\":\"top\",\"asteriskPlacement\":\"asterisk-right\",\"helpMessagePlacement\":\"with_label\",\"errorMessagePlacement\":\"inline\",\"cssClassName\":\"\"},\"restrictions\":{\"denyEmptySubmission\":{\"enabled\":false}}},\"form_instance\":\"ff_form_instance_7_1\",\"form_id_selector\":\"fluentform_7\",\"rules\":{\"checkbox\":{\"required\":{\"value\":true,\"message\":\"This field is required\",\"global_message\":\"This field is required\",\"global\":true}},\"checkbox_1\":{\"required\":{\"value\":true,\"message\":\"This field is required\",\"global_message\":\"This field is required\",\"global\":true}},\"checkbox_2\":{\"required\":{\"value\":true,\"message\":\"This field is required\",\"global_message\":\"This field is required\",\"global\":true}},\"checkbox_3\":{\"required\":{\"value\":true,\"message\":\"This field is required\",\"global_message\":\"This field is required\",\"global\":true}},\"checkbox_4\":{\"required\":{\"value\":true,\"message\":\"This field is required\",\"global_message\":\"This field is required\",\"global\":true}},\"checkbox_6\":{\"required\":{\"value\":true,\"message\":\"This field is required\",\"global_message\":\"This field is required\",\"global\":true}},\"checkbox_7\":{\"required\":{\"value\":true,\"message\":\"This field is required\",\"global_message\":\"This field is required\",\"global\":true}},\"checkbox_5\":{\"required\":{\"value\":true,\"message\":\"This field is required\",\"global_message\":\"This field is required\",\"global\":true}},\"checkbox_8\":{\"required\":{\"value\":true,\"message\":\"This field is required\",\"global_message\":\"This field is required\",\"global\":true}},\"checkbox_9\":{\"required\":{\"value\":true,\"message\":\"This field is required\",\"global_message\":\"This field is required\",\"global\":true}},\"input_text\":{\"required\":{\"value\":true,\"message\":\"This field is required\",\"global_message\":\"This field is required\",\"global\":true}},\"input_text_1\":{\"required\":{\"value\":false,\"message\":\"This field is required\",\"global_message\":\"This field is required\",\"global\":true}},\"checkbox_11\":{\"required\":{\"value\":true,\"message\":\"This field is required\",\"global_message\":\"This field is required\",\"global\":true}},\"checkbox_12\":{\"required\":{\"value\":true,\"message\":\"This field is required\",\"global_message\":\"This field is required\",\"global\":true}},\"dropdown\":{\"required\":{\"value\":true,\"message\":\"This field is required\",\"global_message\":\"This field is required\",\"global\":true}}},\"debounce_time\":300,\"file_upload_settings\":[]};\n                            <\/script>\n                        <\/div>\n\n            \t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Satisfaction Survey Please score the following questions 1-5, 1 being Strongly disagree and 5 being\u00a0Strongly agree. You were offered an appointment time convenient for you. 1 2 3 4 5The Heathy Start Care Coordinator provided me helpful information. 1 2 3 4 5I felt comfortable sharing my concerns with the Healthy Start Care Coordinator. 1 [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_eb_attr":"","footnotes":""},"class_list":["post-1317","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/chipolahealthystart.org\/index.php\/wp-json\/wp\/v2\/pages\/1317","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/chipolahealthystart.org\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/chipolahealthystart.org\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/chipolahealthystart.org\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/chipolahealthystart.org\/index.php\/wp-json\/wp\/v2\/comments?post=1317"}],"version-history":[{"count":4,"href":"https:\/\/chipolahealthystart.org\/index.php\/wp-json\/wp\/v2\/pages\/1317\/revisions"}],"predecessor-version":[{"id":1321,"href":"https:\/\/chipolahealthystart.org\/index.php\/wp-json\/wp\/v2\/pages\/1317\/revisions\/1321"}],"wp:attachment":[{"href":"https:\/\/chipolahealthystart.org\/index.php\/wp-json\/wp\/v2\/media?parent=1317"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}