{"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=\"3f1579c226\" \/><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  >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_cb68baa216990e162876f6a319d9deaf'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"1\"  id='checkbox_cb68baa216990e162876f6a319d9deaf' 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_0cf65d8c6cf2769fb4fd923fc39721b3'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"2\"  id='checkbox_0cf65d8c6cf2769fb4fd923fc39721b3' 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_0cdd8fbecd039960aa738f61061241a0'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"3\"  id='checkbox_0cdd8fbecd039960aa738f61061241a0' 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_481173d01be700cb2a5d47c94deb0ad1'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"4\"  id='checkbox_481173d01be700cb2a5d47c94deb0ad1' 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_c489ae6720b4cda33dab11b99e0dcd14'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"5\"  id='checkbox_c489ae6720b4cda33dab11b99e0dcd14' 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  >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_f75c0fc2d4cb4493fc01848cae1e48aa'><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_f75c0fc2d4cb4493fc01848cae1e48aa' 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_83b30c41663150c4efc5d60f9a43e719'><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_83b30c41663150c4efc5d60f9a43e719' 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_61facd47c29814b934e977ea9f794f57'><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_61facd47c29814b934e977ea9f794f57' 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_f83e6168339cbe033d0cc350a60ec1d6'><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_f83e6168339cbe033d0cc350a60ec1d6' 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_e2f2a1fa0bc116818b12416a9ac43125'><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_e2f2a1fa0bc116818b12416a9ac43125' 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  >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_1b4cdd2653e8fbc585c966a08e1d8177'><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_1b4cdd2653e8fbc585c966a08e1d8177' 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_5f9306b43cd94df9c6c543fcf6af7847'><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_5f9306b43cd94df9c6c543fcf6af7847' 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_24e3604f2cd4f7ec7dbe281b3d599bc8'><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_24e3604f2cd4f7ec7dbe281b3d599bc8' 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_c5c11b16b5c0545893d290d803f2fa35'><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_c5c11b16b5c0545893d290d803f2fa35' 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_89d5f5a2d51f0314920a4aab2cafe8a1'><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_89d5f5a2d51f0314920a4aab2cafe8a1' 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  >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_b3f79829a23329dee9fc998385c84264'><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_b3f79829a23329dee9fc998385c84264' 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_d319b4692c078e7a64dd3f29310af84a'><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_d319b4692c078e7a64dd3f29310af84a' 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_f077589c4932594d8dede23ba1544135'><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_f077589c4932594d8dede23ba1544135' 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_4ee6a6142071a88cb95ebb2859e9c1c7'><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_4ee6a6142071a88cb95ebb2859e9c1c7' 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_f4f8c0b516c2ba3cc508a766be2acee2'><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_f4f8c0b516c2ba3cc508a766be2acee2' 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  >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_e87bd499f386a0d1272bcf8ad2f539f9'><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_e87bd499f386a0d1272bcf8ad2f539f9' 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_065a3d226da6a1aa228f24c399fd2a41'><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_065a3d226da6a1aa228f24c399fd2a41' 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_71679e68d90e505111d3ba07049d0b95'><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_71679e68d90e505111d3ba07049d0b95' 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_d0159ee3a3a126d8f3285c754a398a49'><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_d0159ee3a3a126d8f3285c754a398a49' 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_2f47cb49ebdc85b6a40af277e8354802'><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_2f47cb49ebdc85b6a40af277e8354802' 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  >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_e0032b94a76f36224a69338d7f6ddef1'><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_e0032b94a76f36224a69338d7f6ddef1' 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_2472355f78125684b01d951f21ada9f9'><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_2472355f78125684b01d951f21ada9f9' 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_8fdb3c34b158938241f3dfe473a3fab6'><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_8fdb3c34b158938241f3dfe473a3fab6' 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_73a81d8ec013637d55736a7c963348e7'><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_73a81d8ec013637d55736a7c963348e7' 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_8a1c5bad8e36bca2434e14f1ae75d6e2'><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_8a1c5bad8e36bca2434e14f1ae75d6e2' 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  >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_ef878212b3762b174c69ce85018b1ef1'><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_ef878212b3762b174c69ce85018b1ef1' 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_566e78b268ca12956e28f8cf5e0ad416'><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_566e78b268ca12956e28f8cf5e0ad416' 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_0ca0409503193d377d4fa486f6053320'><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_0ca0409503193d377d4fa486f6053320' 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_929d7dd3d7cb6f207bdd1a7847d5a95c'><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_929d7dd3d7cb6f207bdd1a7847d5a95c' 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_7f00606265b71f842e8efce5318fd6e7'><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_7f00606265b71f842e8efce5318fd6e7' 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  >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_334bfadfc2cae1ffbe26808b8028acda'><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_334bfadfc2cae1ffbe26808b8028acda' 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_7f29978706f8def650b1d839f0237035'><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_7f29978706f8def650b1d839f0237035' 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_69303a8833d31f1aa8f7770da49c34b1'><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_69303a8833d31f1aa8f7770da49c34b1' 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  >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_a50e554efdd954a9624863231e94b20f'><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_a50e554efdd954a9624863231e94b20f' 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_fffc353382fad9a9b9457a9c66c85d13'><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_fffc353382fad9a9b9457a9c66c85d13' 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_a3a0e772bf7b03e506c6382508d395c9'><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_a3a0e772bf7b03e506c6382508d395c9' 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  >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_6641def8e1aa3b1ddb113c37d80adede'><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_6641def8e1aa3b1ddb113c37d80adede' 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_0d92ae05b20daad193abf021541e829a'><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_0d92ae05b20daad193abf021541e829a' 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'>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'>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  >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_1be124eb16e9a6178bdab68e5e48ce26'><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_1be124eb16e9a6178bdab68e5e48ce26' 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_95b8dca23b1b1e1e97010d77d1709e45'><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_95b8dca23b1b1e1e97010d77d1709e45' 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_80716b736894483d10cbb311f8432e60'><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_80716b736894483d10cbb311f8432e60' 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_3c1843088cf6d04b734dd0afac48e099'><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_3c1843088cf6d04b734dd0afac48e099' 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_03f6afe76baa0ca0572ccfe6233df473'><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_03f6afe76baa0ca0572ccfe6233df473' 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_c35c94be36dadf5ac6ce48d49cea22ad'><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_c35c94be36dadf5ac6ce48d49cea22ad' 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_e65c3e58bf3196103f3f2b36a4f5a79a'><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_e65c3e58bf3196103f3f2b36a4f5a79a' 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  >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_c53a9c7fb4652ba4a16eb832ca2b6898'><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_c53a9c7fb4652ba4a16eb832ca2b6898' 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_9e93e32b698bdf2185a138a05eaf2135'><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_9e93e32b698bdf2185a138a05eaf2135' 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_d3668c99be24f50db0670449e0595399'><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_d3668c99be24f50db0670449e0595399' 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_417c5ec97818d06dd62fcf6c9f69b395'><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_417c5ec97818d06dd62fcf6c9f69b395' 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'>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-form-inline-style' hidden><style>form.fluent_form_7 .ff-btn-submit:not(.ff_btn_no_style) { background-color: var(--fluentform-primary); color: #ffffff; }<\/style><\/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":"","_templately_pack_id":"","_templately_imported_at":"","_templately_source":"","_templately_import_session_id":"","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}]}}