{"id":4031,"date":"2021-09-23T15:45:26","date_gmt":"2021-09-23T21:45:26","guid":{"rendered":"https:\/\/idahoreproductive.com\/?page_id=4031"},"modified":"2025-02-20T05:58:14","modified_gmt":"2025-02-20T12:58:14","slug":"patient-survey","status":"publish","type":"page","link":"https:\/\/idahoreproductive.com\/fr\/patient-survey\/","title":{"rendered":"Sondage aupr\u00e8s des patients"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"4031\" class=\"elementor elementor-4031\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-48a3a8b elementor-section-height-min-height elementor-section-boxed elementor-section-height-default elementor-section-items-middle\" data-id=\"48a3a8b\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-0e8f371\" data-id=\"0e8f371\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6abcf12 elementor-widget elementor-widget-heading\" data-id=\"6abcf12\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-xxl\">PATIENT SURVEY<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-09c0632 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"09c0632\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-e97ba86\" data-id=\"e97ba86\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6826939 elementor-widget elementor-widget-heading\" data-id=\"6826939\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Patient Survey<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-af0cf27 elementor-widget elementor-widget-text-editor\" data-id=\"af0cf27\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Your experience with ICRM is very important to us. Please take a moment to fill out the form below with your feedback.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9956d1f elementor-widget elementor-widget-shortcode\" data-id=\"9956d1f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><div class=\"frm_forms  with_frm_style frm_style_formidable-style\" id=\"frm_form_2_container\" data-token=\"1ce256c00449975a801861c739a3ba73\">\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form  frm_pro_form \" id=\"form_patientsurvey\" data-frm-error-config=\"{&quot;includeAlertRole&quot;:false,&quot;focusFirstError&quot;:false,&quot;focusErrorSummary&quot;:true}\" data-token=\"1ce256c00449975a801861c739a3ba73\">\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_screen_reader\">Patient Survey<\/legend>\r\n\r\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"2\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_2\" id=\"frm_hide_fields_2\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"patientsurvey\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_2\" name=\"frm_submit_entry_2\" value=\"2228f76d33\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/fr\/wp-json\/wp\/v2\/pages\/4031\" \/><div id=\"frm_field_21_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12\">\r\n    <div  id=\"field_zpd8b_label\" class=\"frm_primary_label\">Name\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/div>\r\n    <fieldset aria-labelledby=\"field_zpd8b_label\">\n\t<legend class=\"frm_screen_reader frm_hidden\">\n\t\tName\t<\/legend>\n\n\t<div  class=\"frm_combo_inputs_container\" id=\"frm_combo_inputs_container_21\" data-reqmsg=\"Name cannot be blank.\" data-name-layout=\"first_last\">\n\t\t\t\t\t<div\n\t\t\t\tid=\"frm_field_21-first_container\"\n\t\t\t\tclass=\"frm_form_field form-field frm_form_subfield-first  frm6\"\n\t\t\t\tdata-sub-field-name=\"first\"\n\t\t\t>\n\t\t\t\t<label for=\"field_zpd8b_first\" class=\"frm_screen_reader frm_hidden\">\n\t\t\t\t\tFirst Name\t\t\t\t<\/label>\n\n\t\t\t\t<input  type=\"text\" id=\"field_zpd8b_first\" value=\"\" name=\"item_meta[21][first]\" autocomplete=\"given-name\" data-reqmsg=\"First Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Name est non valide\" aria-invalid=\"false\"  \/><div class=\"frm_description\" id=\"frm_field_21_first_desc\">First Name<\/div>\t\t\t<\/div>\n\t\t\t\t\t\t<div\n\t\t\t\tid=\"frm_field_21-last_container\"\n\t\t\t\tclass=\"frm_form_field form-field frm_form_subfield-last  frm6\"\n\t\t\t\tdata-sub-field-name=\"last\"\n\t\t\t>\n\t\t\t\t<label for=\"field_zpd8b_last\" class=\"frm_screen_reader frm_hidden\">\n\t\t\t\t\tLast Name\t\t\t\t<\/label>\n\n\t\t\t\t<input  type=\"text\" id=\"field_zpd8b_last\" value=\"\" name=\"item_meta[21][last]\" autocomplete=\"family-name\" data-reqmsg=\"Last Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Name est non valide\" aria-invalid=\"false\"  \/><div class=\"frm_description\" id=\"frm_field_21_last_desc\">Last Name<\/div>\t\t\t<\/div>\n\t\t\t\t<\/div>\n<\/fieldset>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_22_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_half\">\r\n    <label for=\"field_uqs9b\" id=\"field_uqs9b_label\" class=\"frm_primary_label\">Email\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_uqs9b\" name=\"item_meta[22]\" value=\"\"  data-reqmsg=\"Email cannot be blank.\" aria-required=\"true\" data-invmsg=\"Enter a valid email address, like name@example.com\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_23_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_half\">\r\n    <label for=\"field_zj63c\" id=\"field_zj63c_label\" class=\"frm_primary_label\">Phone Number\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"tel\" id=\"field_zj63c\" name=\"item_meta[23]\" value=\"\"  data-reqmsg=\"Phone Number cannot be blank.\" aria-required=\"true\" data-invmsg=\"Phone is invalid\" aria-invalid=\"false\" pattern=\"((\\+\\d{1,3}(-|.| )?\\(?\\d\\)?(-| |.)?\\d{1,5})|(\\(?\\d{2,6}\\)?))(-|.| )?(\\d{3,4})(-|.| )?(\\d{4})(( x| ext)\\d{1,5}){0,1}$\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_24_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12 frm_other_container\">\r\n    <label for=\"field_37b2l\" id=\"field_37b2l_label\" class=\"frm_primary_label\">Who was your doctor?\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[24]\" id=\"field_37b2l\"  data-reqmsg=\"Who was your doctor? cannot be blank.\" aria-required=\"true\" data-invmsg=\"Who was your doctor? est non valide\" class=\"auto_width\" aria-invalid=\"false\"  >\n\t\t<option  value=\"Select Your Doctor\">Select Your Doctor<\/option><option  value=\"Dr. Kevin Maas\">Dr. Kevin Maas<\/option><option  value=\"Dr. Cristin Slater\">Dr. Cristin Slater<\/option><option  value=\"Dr. Kyle Tobler\">Dr. Kyle Tobler<\/option>\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_25_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12 frm_first\">\r\n    <label for=\"field_zn1cw\" id=\"field_zn1cw_label\" class=\"frm_primary_label\">How would rate the overall care you received from your physician provider?\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_zn1cw_label\" role=\"group\"><div class=\"frm-star-group\">\n\t\t<input type=\"radio\" name=\"item_meta[25]\" id=\"field_zn1cw-0\" value=\"1\"  data-reqmsg=\"How would rate the overall care you received from your physician provider? cannot be blank.\" aria-required=\"true\" data-invmsg=\"How would rate the overall care you received from your physician provider? est non valide\" aria-invalid=\"false\"   \/><label  for=\"field_zn1cw-0\" class=\"star-rating\">\n\t\t\t\t<svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><g clip-path=\"url(#frm-star-clip-path)\"><path fill=\"#EAECF0\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/><\/g><defs><clipPath id=\"frm-star-clip-path\"><path fill=\"#fff\" d=\"M0 0h20v20H0z\"\/><\/clipPath><\/defs>\n<\/svg><svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><path fill=\"#FDB022\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/>\n<\/svg>\t\t\t\t<span class=\"frm_screen_reader\">1 \u00c9toile<\/span>\n\t\t\t<\/label>\n\t\t<input type=\"radio\" name=\"item_meta[25]\" id=\"field_zn1cw-1\" value=\"2\"  data-reqmsg=\"How would rate the overall care you received from your physician provider? cannot be blank.\" aria-required=\"true\" data-invmsg=\"How would rate the overall care you received from your physician provider? est non valide\" aria-invalid=\"false\"   \/><label  for=\"field_zn1cw-1\" class=\"star-rating\">\n\t\t\t\t<svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><g clip-path=\"url(#frm-star-clip-path)\"><path fill=\"#EAECF0\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/><\/g><defs><clipPath id=\"frm-star-clip-path\"><path fill=\"#fff\" d=\"M0 0h20v20H0z\"\/><\/clipPath><\/defs>\n<\/svg><svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><path fill=\"#FDB022\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/>\n<\/svg>\t\t\t\t<span class=\"frm_screen_reader\">2 \u00c9toiles<\/span>\n\t\t\t<\/label>\n\t\t<input type=\"radio\" name=\"item_meta[25]\" id=\"field_zn1cw-2\" value=\"3\"  data-reqmsg=\"How would rate the overall care you received from your physician provider? cannot be blank.\" aria-required=\"true\" data-invmsg=\"How would rate the overall care you received from your physician provider? est non valide\" aria-invalid=\"false\"   \/><label  for=\"field_zn1cw-2\" class=\"star-rating\">\n\t\t\t\t<svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><g clip-path=\"url(#frm-star-clip-path)\"><path fill=\"#EAECF0\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/><\/g><defs><clipPath id=\"frm-star-clip-path\"><path fill=\"#fff\" d=\"M0 0h20v20H0z\"\/><\/clipPath><\/defs>\n<\/svg><svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><path fill=\"#FDB022\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/>\n<\/svg>\t\t\t\t<span class=\"frm_screen_reader\">3 \u00c9toiles<\/span>\n\t\t\t<\/label>\n\t\t<input type=\"radio\" name=\"item_meta[25]\" id=\"field_zn1cw-3\" value=\"4\"  data-reqmsg=\"How would rate the overall care you received from your physician provider? cannot be blank.\" aria-required=\"true\" data-invmsg=\"How would rate the overall care you received from your physician provider? est non valide\" aria-invalid=\"false\"   \/><label  for=\"field_zn1cw-3\" class=\"star-rating\">\n\t\t\t\t<svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><g clip-path=\"url(#frm-star-clip-path)\"><path fill=\"#EAECF0\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/><\/g><defs><clipPath id=\"frm-star-clip-path\"><path fill=\"#fff\" d=\"M0 0h20v20H0z\"\/><\/clipPath><\/defs>\n<\/svg><svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><path fill=\"#FDB022\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/>\n<\/svg>\t\t\t\t<span class=\"frm_screen_reader\">4 \u00c9toiles<\/span>\n\t\t\t<\/label>\n\t\t<input type=\"radio\" name=\"item_meta[25]\" id=\"field_zn1cw-4\" value=\"5\"  data-reqmsg=\"How would rate the overall care you received from your physician provider? cannot be blank.\" aria-required=\"true\" data-invmsg=\"How would rate the overall care you received from your physician provider? est non valide\" aria-invalid=\"false\"   \/><label  for=\"field_zn1cw-4\" class=\"star-rating\">\n\t\t\t\t<svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><g clip-path=\"url(#frm-star-clip-path)\"><path fill=\"#EAECF0\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/><\/g><defs><clipPath id=\"frm-star-clip-path\"><path fill=\"#fff\" d=\"M0 0h20v20H0z\"\/><\/clipPath><\/defs>\n<\/svg><svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><path fill=\"#FDB022\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/>\n<\/svg>\t\t\t\t<span class=\"frm_screen_reader\">5 \u00c9toiles<\/span>\n\t\t\t<\/label>\n<div style=\"clear:both;\"><\/div>\n<\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_26_container\" class=\"frm_form_field form-field  frm_top_container frm12\">\r\n    <label for=\"field_w1nn8\" id=\"field_w1nn8_label\" class=\"frm_primary_label\">Comments\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[26]\" id=\"field_w1nn8\"  data-invmsg=\"Comments est non valide\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_27_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12\">\r\n    <label for=\"field_f7wmx\" id=\"field_f7wmx_label\" class=\"frm_primary_label\">Please rate the overall cleanliness and appearance of our clinic.\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_f7wmx_label\" role=\"group\"><div class=\"frm-star-group\">\n\t\t<input type=\"radio\" name=\"item_meta[27]\" id=\"field_f7wmx-0\" value=\"1\"  data-reqmsg=\"Please rate the overall cleanliness and appearance of our clinic. cannot be blank.\" aria-required=\"true\" data-invmsg=\"Please rate the overall cleanliness and appearance of our clinic. est non valide\" aria-invalid=\"false\"   \/><label  for=\"field_f7wmx-0\" class=\"star-rating\">\n\t\t\t\t<svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><g clip-path=\"url(#frm-star-clip-path)\"><path fill=\"#EAECF0\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/><\/g><defs><clipPath id=\"frm-star-clip-path\"><path fill=\"#fff\" d=\"M0 0h20v20H0z\"\/><\/clipPath><\/defs>\n<\/svg><svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><path fill=\"#FDB022\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/>\n<\/svg>\t\t\t\t<span class=\"frm_screen_reader\">1 \u00c9toile<\/span>\n\t\t\t<\/label>\n\t\t<input type=\"radio\" name=\"item_meta[27]\" id=\"field_f7wmx-1\" value=\"2\"  data-reqmsg=\"Please rate the overall cleanliness and appearance of our clinic. cannot be blank.\" aria-required=\"true\" data-invmsg=\"Please rate the overall cleanliness and appearance of our clinic. est non valide\" aria-invalid=\"false\"   \/><label  for=\"field_f7wmx-1\" class=\"star-rating\">\n\t\t\t\t<svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><g clip-path=\"url(#frm-star-clip-path)\"><path fill=\"#EAECF0\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/><\/g><defs><clipPath id=\"frm-star-clip-path\"><path fill=\"#fff\" d=\"M0 0h20v20H0z\"\/><\/clipPath><\/defs>\n<\/svg><svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><path fill=\"#FDB022\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/>\n<\/svg>\t\t\t\t<span class=\"frm_screen_reader\">2 \u00c9toiles<\/span>\n\t\t\t<\/label>\n\t\t<input type=\"radio\" name=\"item_meta[27]\" id=\"field_f7wmx-2\" value=\"3\"  data-reqmsg=\"Please rate the overall cleanliness and appearance of our clinic. cannot be blank.\" aria-required=\"true\" data-invmsg=\"Please rate the overall cleanliness and appearance of our clinic. est non valide\" aria-invalid=\"false\"   \/><label  for=\"field_f7wmx-2\" class=\"star-rating\">\n\t\t\t\t<svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><g clip-path=\"url(#frm-star-clip-path)\"><path fill=\"#EAECF0\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/><\/g><defs><clipPath id=\"frm-star-clip-path\"><path fill=\"#fff\" d=\"M0 0h20v20H0z\"\/><\/clipPath><\/defs>\n<\/svg><svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><path fill=\"#FDB022\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/>\n<\/svg>\t\t\t\t<span class=\"frm_screen_reader\">3 \u00c9toiles<\/span>\n\t\t\t<\/label>\n\t\t<input type=\"radio\" name=\"item_meta[27]\" id=\"field_f7wmx-3\" value=\"4\"  data-reqmsg=\"Please rate the overall cleanliness and appearance of our clinic. cannot be blank.\" aria-required=\"true\" data-invmsg=\"Please rate the overall cleanliness and appearance of our clinic. est non valide\" aria-invalid=\"false\"   \/><label  for=\"field_f7wmx-3\" class=\"star-rating\">\n\t\t\t\t<svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><g clip-path=\"url(#frm-star-clip-path)\"><path fill=\"#EAECF0\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/><\/g><defs><clipPath id=\"frm-star-clip-path\"><path fill=\"#fff\" d=\"M0 0h20v20H0z\"\/><\/clipPath><\/defs>\n<\/svg><svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><path fill=\"#FDB022\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/>\n<\/svg>\t\t\t\t<span class=\"frm_screen_reader\">4 \u00c9toiles<\/span>\n\t\t\t<\/label>\n\t\t<input type=\"radio\" name=\"item_meta[27]\" id=\"field_f7wmx-4\" value=\"5\"  data-reqmsg=\"Please rate the overall cleanliness and appearance of our clinic. cannot be blank.\" aria-required=\"true\" data-invmsg=\"Please rate the overall cleanliness and appearance of our clinic. est non valide\" aria-invalid=\"false\"   \/><label  for=\"field_f7wmx-4\" class=\"star-rating\">\n\t\t\t\t<svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><g clip-path=\"url(#frm-star-clip-path)\"><path fill=\"#EAECF0\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/><\/g><defs><clipPath id=\"frm-star-clip-path\"><path fill=\"#fff\" d=\"M0 0h20v20H0z\"\/><\/clipPath><\/defs>\n<\/svg><svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><path fill=\"#FDB022\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/>\n<\/svg>\t\t\t\t<span class=\"frm_screen_reader\">5 \u00c9toiles<\/span>\n\t\t\t<\/label>\n<div style=\"clear:both;\"><\/div>\n<\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_28_container\" class=\"frm_form_field form-field  frm_top_container frm12\">\r\n    <label for=\"field_6ycqj\" id=\"field_6ycqj_label\" class=\"frm_primary_label\">Comments\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[28]\" id=\"field_6ycqj\"  data-invmsg=\"Comments est non valide\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_29_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12\">\r\n    <label for=\"field_9a8pj\" id=\"field_9a8pj_label\" class=\"frm_primary_label\">How satisfied were you with the communication and care provided to you from your clinical coordinator(s)? \r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_9a8pj_label\" role=\"group\"><div class=\"frm-star-group\">\n\t\t<input type=\"radio\" name=\"item_meta[29]\" id=\"field_9a8pj-0\" value=\"1\"  data-reqmsg=\"How satisfied were you with the communication and care provided to you from your clinical coordinator(s)?  cannot be blank.\" aria-required=\"true\" data-invmsg=\"How satisfied were you with the communication and care provided to you from your clinical coordinator(s)?  est non valide\" aria-invalid=\"false\"   \/><label  for=\"field_9a8pj-0\" class=\"star-rating\">\n\t\t\t\t<svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><g clip-path=\"url(#frm-star-clip-path)\"><path fill=\"#EAECF0\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/><\/g><defs><clipPath id=\"frm-star-clip-path\"><path fill=\"#fff\" d=\"M0 0h20v20H0z\"\/><\/clipPath><\/defs>\n<\/svg><svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><path fill=\"#FDB022\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/>\n<\/svg>\t\t\t\t<span class=\"frm_screen_reader\">1 \u00c9toile<\/span>\n\t\t\t<\/label>\n\t\t<input type=\"radio\" name=\"item_meta[29]\" id=\"field_9a8pj-1\" value=\"2\"  data-reqmsg=\"How satisfied were you with the communication and care provided to you from your clinical coordinator(s)?  cannot be blank.\" aria-required=\"true\" data-invmsg=\"How satisfied were you with the communication and care provided to you from your clinical coordinator(s)?  est non valide\" aria-invalid=\"false\"   \/><label  for=\"field_9a8pj-1\" class=\"star-rating\">\n\t\t\t\t<svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><g clip-path=\"url(#frm-star-clip-path)\"><path fill=\"#EAECF0\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/><\/g><defs><clipPath id=\"frm-star-clip-path\"><path fill=\"#fff\" d=\"M0 0h20v20H0z\"\/><\/clipPath><\/defs>\n<\/svg><svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><path fill=\"#FDB022\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/>\n<\/svg>\t\t\t\t<span class=\"frm_screen_reader\">2 \u00c9toiles<\/span>\n\t\t\t<\/label>\n\t\t<input type=\"radio\" name=\"item_meta[29]\" id=\"field_9a8pj-2\" value=\"3\"  data-reqmsg=\"How satisfied were you with the communication and care provided to you from your clinical coordinator(s)?  cannot be blank.\" aria-required=\"true\" data-invmsg=\"How satisfied were you with the communication and care provided to you from your clinical coordinator(s)?  est non valide\" aria-invalid=\"false\"   \/><label  for=\"field_9a8pj-2\" class=\"star-rating\">\n\t\t\t\t<svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><g clip-path=\"url(#frm-star-clip-path)\"><path fill=\"#EAECF0\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/><\/g><defs><clipPath id=\"frm-star-clip-path\"><path fill=\"#fff\" d=\"M0 0h20v20H0z\"\/><\/clipPath><\/defs>\n<\/svg><svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><path fill=\"#FDB022\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/>\n<\/svg>\t\t\t\t<span class=\"frm_screen_reader\">3 \u00c9toiles<\/span>\n\t\t\t<\/label>\n\t\t<input type=\"radio\" name=\"item_meta[29]\" id=\"field_9a8pj-3\" value=\"4\"  data-reqmsg=\"How satisfied were you with the communication and care provided to you from your clinical coordinator(s)?  cannot be blank.\" aria-required=\"true\" data-invmsg=\"How satisfied were you with the communication and care provided to you from your clinical coordinator(s)?  est non valide\" aria-invalid=\"false\"   \/><label  for=\"field_9a8pj-3\" class=\"star-rating\">\n\t\t\t\t<svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><g clip-path=\"url(#frm-star-clip-path)\"><path fill=\"#EAECF0\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/><\/g><defs><clipPath id=\"frm-star-clip-path\"><path fill=\"#fff\" d=\"M0 0h20v20H0z\"\/><\/clipPath><\/defs>\n<\/svg><svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><path fill=\"#FDB022\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/>\n<\/svg>\t\t\t\t<span class=\"frm_screen_reader\">4 \u00c9toiles<\/span>\n\t\t\t<\/label>\n\t\t<input type=\"radio\" name=\"item_meta[29]\" id=\"field_9a8pj-4\" value=\"5\"  data-reqmsg=\"How satisfied were you with the communication and care provided to you from your clinical coordinator(s)?  cannot be blank.\" aria-required=\"true\" data-invmsg=\"How satisfied were you with the communication and care provided to you from your clinical coordinator(s)?  est non valide\" aria-invalid=\"false\"   \/><label  for=\"field_9a8pj-4\" class=\"star-rating\">\n\t\t\t\t<svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><g clip-path=\"url(#frm-star-clip-path)\"><path fill=\"#EAECF0\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/><\/g><defs><clipPath id=\"frm-star-clip-path\"><path fill=\"#fff\" d=\"M0 0h20v20H0z\"\/><\/clipPath><\/defs>\n<\/svg><svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><path fill=\"#FDB022\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/>\n<\/svg>\t\t\t\t<span class=\"frm_screen_reader\">5 \u00c9toiles<\/span>\n\t\t\t<\/label>\n<div style=\"clear:both;\"><\/div>\n<\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_30_container\" class=\"frm_form_field form-field  frm_top_container frm12\">\r\n    <label for=\"field_19xi5\" id=\"field_19xi5_label\" class=\"frm_primary_label\">Comments\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[30]\" id=\"field_19xi5\"  data-invmsg=\"Comments est non valide\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_31_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12\">\r\n    <label for=\"field_xmsf8\" id=\"field_xmsf8_label\" class=\"frm_primary_label\">How would you rate your interactions with our administrative staff (ie: front desk, check out, billing, financial counselor)?\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_xmsf8_label\" role=\"group\"><div class=\"frm-star-group\">\n\t\t<input type=\"radio\" name=\"item_meta[31]\" id=\"field_xmsf8-0\" value=\"1\"  data-reqmsg=\"How would you rate your interactions with our administrative staff (ie: front desk, check out, billing, financial counselor)? cannot be blank.\" aria-required=\"true\" data-invmsg=\"How would you rate your interactions with our administrative staff (ie: front desk, check out, billing, financial counselor)? est non valide\" aria-invalid=\"false\"   \/><label  for=\"field_xmsf8-0\" class=\"star-rating\">\n\t\t\t\t<svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><g clip-path=\"url(#frm-star-clip-path)\"><path fill=\"#EAECF0\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/><\/g><defs><clipPath id=\"frm-star-clip-path\"><path fill=\"#fff\" d=\"M0 0h20v20H0z\"\/><\/clipPath><\/defs>\n<\/svg><svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><path fill=\"#FDB022\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/>\n<\/svg>\t\t\t\t<span class=\"frm_screen_reader\">1 \u00c9toile<\/span>\n\t\t\t<\/label>\n\t\t<input type=\"radio\" name=\"item_meta[31]\" id=\"field_xmsf8-1\" value=\"2\"  data-reqmsg=\"How would you rate your interactions with our administrative staff (ie: front desk, check out, billing, financial counselor)? cannot be blank.\" aria-required=\"true\" data-invmsg=\"How would you rate your interactions with our administrative staff (ie: front desk, check out, billing, financial counselor)? est non valide\" aria-invalid=\"false\"   \/><label  for=\"field_xmsf8-1\" class=\"star-rating\">\n\t\t\t\t<svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><g clip-path=\"url(#frm-star-clip-path)\"><path fill=\"#EAECF0\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/><\/g><defs><clipPath id=\"frm-star-clip-path\"><path fill=\"#fff\" d=\"M0 0h20v20H0z\"\/><\/clipPath><\/defs>\n<\/svg><svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><path fill=\"#FDB022\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/>\n<\/svg>\t\t\t\t<span class=\"frm_screen_reader\">2 \u00c9toiles<\/span>\n\t\t\t<\/label>\n\t\t<input type=\"radio\" name=\"item_meta[31]\" id=\"field_xmsf8-2\" value=\"3\"  data-reqmsg=\"How would you rate your interactions with our administrative staff (ie: front desk, check out, billing, financial counselor)? cannot be blank.\" aria-required=\"true\" data-invmsg=\"How would you rate your interactions with our administrative staff (ie: front desk, check out, billing, financial counselor)? est non valide\" aria-invalid=\"false\"   \/><label  for=\"field_xmsf8-2\" class=\"star-rating\">\n\t\t\t\t<svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><g clip-path=\"url(#frm-star-clip-path)\"><path fill=\"#EAECF0\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/><\/g><defs><clipPath id=\"frm-star-clip-path\"><path fill=\"#fff\" d=\"M0 0h20v20H0z\"\/><\/clipPath><\/defs>\n<\/svg><svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><path fill=\"#FDB022\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/>\n<\/svg>\t\t\t\t<span class=\"frm_screen_reader\">3 \u00c9toiles<\/span>\n\t\t\t<\/label>\n\t\t<input type=\"radio\" name=\"item_meta[31]\" id=\"field_xmsf8-3\" value=\"4\"  data-reqmsg=\"How would you rate your interactions with our administrative staff (ie: front desk, check out, billing, financial counselor)? cannot be blank.\" aria-required=\"true\" data-invmsg=\"How would you rate your interactions with our administrative staff (ie: front desk, check out, billing, financial counselor)? est non valide\" aria-invalid=\"false\"   \/><label  for=\"field_xmsf8-3\" class=\"star-rating\">\n\t\t\t\t<svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><g clip-path=\"url(#frm-star-clip-path)\"><path fill=\"#EAECF0\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/><\/g><defs><clipPath id=\"frm-star-clip-path\"><path fill=\"#fff\" d=\"M0 0h20v20H0z\"\/><\/clipPath><\/defs>\n<\/svg><svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><path fill=\"#FDB022\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/>\n<\/svg>\t\t\t\t<span class=\"frm_screen_reader\">4 \u00c9toiles<\/span>\n\t\t\t<\/label>\n\t\t<input type=\"radio\" name=\"item_meta[31]\" id=\"field_xmsf8-4\" value=\"5\"  data-reqmsg=\"How would you rate your interactions with our administrative staff (ie: front desk, check out, billing, financial counselor)? cannot be blank.\" aria-required=\"true\" data-invmsg=\"How would you rate your interactions with our administrative staff (ie: front desk, check out, billing, financial counselor)? est non valide\" aria-invalid=\"false\"   \/><label  for=\"field_xmsf8-4\" class=\"star-rating\">\n\t\t\t\t<svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><g clip-path=\"url(#frm-star-clip-path)\"><path fill=\"#EAECF0\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/><\/g><defs><clipPath id=\"frm-star-clip-path\"><path fill=\"#fff\" d=\"M0 0h20v20H0z\"\/><\/clipPath><\/defs>\n<\/svg><svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><path fill=\"#FDB022\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/>\n<\/svg>\t\t\t\t<span class=\"frm_screen_reader\">5 \u00c9toiles<\/span>\n\t\t\t<\/label>\n<div style=\"clear:both;\"><\/div>\n<\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_32_container\" class=\"frm_form_field form-field  frm_top_container frm12\">\r\n    <label for=\"field_b1mkf\" id=\"field_b1mkf_label\" class=\"frm_primary_label\">Comments\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[32]\" id=\"field_b1mkf\"  data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_33_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12 frm_first\">\r\n    <label for=\"field_9pdj5\" id=\"field_9pdj5_label\" class=\"frm_primary_label\">Based on your complete experience with our clinic, how likely are you to recommend us to a friend or colleague?\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_9pdj5_label\" role=\"group\"><div class=\"frm-star-group\">\n\t\t<input type=\"radio\" name=\"item_meta[33]\" id=\"field_9pdj5-0\" value=\"1\"  data-reqmsg=\"Based on your complete experience with our clinic, how likely are you to recommend us to a friend or colleague? cannot be blank.\" aria-required=\"true\" data-invmsg=\"Based on your complete experience with our clinic, how likely are you to recommend us to a friend or colleague? est non valide\" aria-invalid=\"false\"   \/><label  for=\"field_9pdj5-0\" class=\"star-rating\">\n\t\t\t\t<svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><g clip-path=\"url(#frm-star-clip-path)\"><path fill=\"#EAECF0\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/><\/g><defs><clipPath id=\"frm-star-clip-path\"><path fill=\"#fff\" d=\"M0 0h20v20H0z\"\/><\/clipPath><\/defs>\n<\/svg><svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><path fill=\"#FDB022\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/>\n<\/svg>\t\t\t\t<span class=\"frm_screen_reader\">1 \u00c9toile<\/span>\n\t\t\t<\/label>\n\t\t<input type=\"radio\" name=\"item_meta[33]\" id=\"field_9pdj5-1\" value=\"2\"  data-reqmsg=\"Based on your complete experience with our clinic, how likely are you to recommend us to a friend or colleague? cannot be blank.\" aria-required=\"true\" data-invmsg=\"Based on your complete experience with our clinic, how likely are you to recommend us to a friend or colleague? est non valide\" aria-invalid=\"false\"   \/><label  for=\"field_9pdj5-1\" class=\"star-rating\">\n\t\t\t\t<svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><g clip-path=\"url(#frm-star-clip-path)\"><path fill=\"#EAECF0\" d=\"m10 .5 2.64 6.36 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est non valide\" aria-invalid=\"false\"   \/><label  for=\"field_9pdj5-4\" class=\"star-rating\">\n\t\t\t\t<svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><g clip-path=\"url(#frm-star-clip-path)\"><path fill=\"#EAECF0\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/><\/g><defs><clipPath id=\"frm-star-clip-path\"><path fill=\"#fff\" d=\"M0 0h20v20H0z\"\/><\/clipPath><\/defs>\n<\/svg><svg  viewBox=\"0 0 20 20\" class=\"frmsvg\"><path fill=\"#FDB022\" d=\"m10 .5 2.64 6.36 6.87.55-5.23 4.48 1.6 6.7L10 15l-5.88 3.59 1.6-6.7L.49 7.41l6.86-.55L10 .5Z\"\/>\n<\/svg>\t\t\t\t<span class=\"frm_screen_reader\">5 \u00c9toiles<\/span>\n\t\t\t<\/label>\n<div style=\"clear:both;\"><\/div>\n<\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_34_container\" class=\"frm_form_field form-field  frm_top_container frm12\">\r\n    <label for=\"field_ims94\" id=\"field_ims94_label\" class=\"frm_primary_label\">Comments\r\n        <span 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id=\"frm_field_65_container\" class=\"frm_form_field form-field \">\n\t<div class=\"frm_submit\">\r\n\r\n<button class=\"frm_button_submit frm_final_submit\" type=\"submit\"   formnovalidate=\"formnovalidate\">Submit<\/button>\r\n\r\n<\/div>\n<\/div>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t\t\t<div id=\"frm_field_130_container\">\n\t\t\t<label for=\"field_6114r\" >\n\t\t\t\tSi vous \u00eates un humain, ne remplissez pas ce champ.\t\t\t<\/label>\n\t\t\t<input  id=\"field_6114r\" type=\"text\" class=\"frm_form_field form-field frm_verify\" name=\"item_meta[130]\" value=\"\"  \/>\n\t\t<\/div>\n\t\t<input name=\"frm_state\" type=\"hidden\" value=\"c0nBPMcz6gMCqtX\/TUV1E3PXAN+Vkxlc9X0\/M0K7la9kStlsQs4q2Js6yA4ZLSSP\" \/><\/div>\n<\/fieldset>\n<\/div>\n\n<\/form>\n<\/div>\n<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>ENQU\u00caTE PATIENT Enqu\u00eate patient Votre exp\u00e9rience avec l&#039;ICRM est tr\u00e8s importante pour nous. Veuillez prendre un moment pour remplir le formulaire ci-dessous avec vos commentaires.<\/p>","protected":false},"author":9,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-4031","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Patient Survey - Idaho Center for Reproductive Medicine<\/title>\n<meta name=\"description\" content=\"Your experience with ICRM is very important to us. 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