{"id":223,"date":"2019-01-16T15:30:38","date_gmt":"2019-01-16T15:30:38","guid":{"rendered":"http:\/\/djcareservices.com\/?page_id=223"},"modified":"2019-01-16T15:35:59","modified_gmt":"2019-01-16T15:35:59","slug":"quality-assurance-questionnaire","status":"publish","type":"page","link":"http:\/\/djcareservices.com\/quality-assurance-questionnaire\/","title":{"rendered":"Quality Assurance: Questionnaire"},"content":{"rendered":"<style type='text\/css'>\n\t\t@import url('http:\/\/fonts.googleapis.com\/css?family=Roboto+Slab%3A700');\r\n@import url('http:\/\/fonts.googleapis.com\/css?family=Roboto+Slab%3A300');\r\n@import url('http:\/\/fonts.googleapis.com\/css?family=Roboto+Condensed');\r\n@import url('http:\/\/fonts.googleapis.com\/css?family=Roboto+Slab');\r\n\t\t.language_direction_contact_bank_2765\t\t{\n\t\t\t\tdirection:ltr !important;\n\t\t}\n\t\tlabel.custom-error\n\t\t{\n\t\t\t\t\t\t\t\t\t\tbackground: rgba(255,255,255,0.5) !important;\n\t\t\t\t\t\t\/*        display: inline-block;*\/\n\t\t\t\tfont-size: 12px !important;\n\t\t\t\tcolor: #ff2c38 !important;\n\t\t\t\tmargin: 0px 0px 0px 0px !important;\n\t\t\t\tpadding: 5px 0px 0px 0px !important;\n\t\t\t\tfont-family: 'Roboto Slab' !important;\t\t}\n\t\t.cb-limit-input\n\t\t{\n\t\t\t\t\t\t\t\t\t\tbackground: rgba(255,255,255,0.5) !important;\n\t\t\t\t\t\t\t\t\t\tfont-size: 12px !important;\n\t\t\t\tfont-family: 'Roboto Slab' !important;;\n\t\t\t\tpadding: 5px 0px 0px 0px !important;\n\t\t}\n\t\t.divider-line-seperator_2765\t\t{\n\t\t\t\theight: 1px;\n\t\t\t\tbackground: #717171;\n\t\t\t\tborder-bottom: 1px solid #DDD;\n\t\t\t\tmargin-bottom: 20px;\n\t\t}\n\t\t.main_container_contact_bank_2765\t\t{\n\t\t\t\t\t\t\t\t\t\tfloat: left !important;\n\t\t\t\t\t\t\t\t\t\twidth: 100% !important;\n\t\t\t\tclear: both;\n\t\t}\n\t\t.form-layout-main-container-contact-bank_2765\t\t{\n\t\t\t\t\t\t\t\t\t\tbackground: rgba(255,255,255,1) !important;\n\t\t\t\t\t\t\t\t\t\tmargin: 0px 0px 0px 0px !important;\n\t\t\t\tpadding: 10px 10px 10px 10px !important;\n\t\t}\n\t\t.form-layout-title-contact-bank_2765 h1\t\t{\n\t\t\t\ttext-align: left !important;\n\t\t\t\tfont-size: 24px !important;\n\t\t\t\tcolor: #000000 !important;\n\t\t\t\tmargin: 0px 0px 5px 0px !important;\n\t\t\t\tpadding: 5px 0px 0px 0px !important;\n\t\t\t\tfont-family: 'Roboto Slab' !important;\r\n\tfont-weight: 700 !important;\t\t}\n\t\t.form-layout-description-contact-bank_2765 p\t\t{\n\t\t\t\ttext-align: left !important;\n\t\t\t\tfont-size: 12px !important;\n\t\t\t\tcolor: #000000 !important;\n\t\t\t\tmargin: 0px 0px 5px 0px !important;\n\t\t\t\tpadding: 0px 0px 5px 0px !important;\n\t\t\t\tfont-family: 'Roboto Slab' !important;\r\n\tfont-weight: 300 !important;\t\t}\n\t\t\t\t\t\t.input_radio_button_label_contact_bank_2765\t\t\t\t{\n\t\t\t\t\t\tfont-size: 14px !important;\n\t\t\t\t\t\tcolor: #000000 !important;\n\t\t\t\t\t\tdisplay:inline-block !important;\n\t\t\t\t\t\tmargin-left: 8px !important;\n\t\t\t\t\t\tfont-family: 'Roboto Condensed' !important;\t\t\t\t}\n\t\t\t\t.input_radio_button_contact_bank_2765\t\t\t\t{\n           margin-left: 9px !important;\n\t\t\t\t}\n\t\t\t\t\t\t\t\t.input_chk_button_label_contact_bank_2765\t\t\t\t{\n\t\t\t\t\t\tfont-size: 14px !important;\n\t\t\t\t\t\tcolor: #000000 !important;\n\t\t\t\t\t\tfont-family: 'Roboto Condensed' !important;;\n\t\t\t\t\t\tdisplay:inline-block !important;\n\t\t\t\t\t\tmargin-left: 8px !important;\n\t\t\t\t}\n\t\t\t\t.input_chk_button_contact_bank_2765\t\t\t\t{\n\/*            margin-left: 9px !important;*\/\n\t\t\t\t}\n\t\t\t\t\t\t.right-placement-input-contact-bank_2765::-webkit-input-placeholder {\n\t\t\t\tfont-family: 'Roboto Condensed' !important;;\n\t\t}\n\t\t.right-placement-input-contact-bank_2765::-moz-placeholder {\n\t\t\t\tfont-family: 'Roboto Condensed' !important;;\n\t\t}\n\t\t.right-placement-input-contact-bank_2765\t\t{\n\t\t\t\twidth: 60% !important;\n\t\t\t\tfloat: left !important;\n\t\t\t\theight: 100% !important;\n\t\t\t\ttext-align: left !important;\n\t\t\t\tfont-size: 14px !important;\n\t\t\t\tcolor: #000000 !important;\n\t\t\t\tborder: 1px solid #d1d1d1 !important;\n\t\t\t\t-webkit-border: 1px solid #d1d1d1 !important;\n\t\t\t\t-moz-border: 1px solid #d1d1d1 !important;\n\t\t\t\tborder-radius: 2px !important;\n\t\t\t\t-webkit-border-radius: 2px !important;\n\t\t\t\t-moz-border-radius: 2px !important;\n\t\t\t\tpadding: 10px 10px 10px 10px !important;\n\t\t\t\tfont-family: 'Roboto Condensed' !important;;\n\t\t}\n\t\t.right-placement-input-contact-bank_credit_card_2765::-webkit-input-placeholder{\n\t\t\t\tfont-family: 'Roboto Condensed' !important;;\n\t\t}\n\t\t.right-placement-input-contact-bank_credit_card_2765::-moz-placeholder {\n\t\t\t\tfont-family: 'Roboto Condensed' !important;;\n\t\t}\n\t\t.right-placement-input-contact-bank_credit_card_2765\t\t{\n\t\t\t\twidth: 60% !important;\n\t\t\t\theight: 100% !important;\n\t\t\t\ttext-align: left !important;\n\t\t\t\tfont-size: 14px !important;\n\t\t\t\tcolor: #000000 !important;\n\t\t\t\tborder: 1px solid #d1d1d1 !important;\n\t\t\t\t-webkit-border: 1px solid #d1d1d1 !important;\n\t\t\t\t-moz-border: 1px solid #d1d1d1 !important;\n\t\t\t\tborder-radius: 2px !important;\n\t\t\t\t-webkit-border-radius: 2px !important;\n\t\t\t\t-moz-border-radius: 2px !important;\n\t\t\t\tpadding: 10px 10px 10px 10px !important;\n\t\t\t\tfont-family: 'Roboto Condensed' !important;;\n\t\t}\n\t\t.left-placement-input-contact-bank_2765::-webkit-input-placeholder {\n\t\t\t\tfont-family: 'Roboto Condensed' !important;;\n\t\t}\n\t\t.left-placement-input-contact-bank_2765::-moz-placeholder {\n\t\t\t\tfont-family: 'Roboto Condensed' !important;;\n\t\t}\n\t\t.left-placement-input-contact-bank_2765\t\t{\n\t\t\t\twidth: 60% !important;\n\t\t\t\t\t\t\t\t\t\t\tbackground-color: rgba(247,247,247,1) !important;\n\t\t\t\t\t\t\t\t\theight: 100% !important;\n\t\t\t\ttext-align: left !important;\n\t\t\t\tfont-size: 14px !important;\n\t\t\t\tcolor: #000000 !important;\n\t\t\t\tborder: 1px solid #d1d1d1 !important;\n\t\t\t\t-webkit-border: 1px solid #d1d1d1 !important;\n\t\t\t\t-moz-border: 1px solid #d1d1d1 !important;\n\t\t\t\tborder-radius: 2px !important;\n\t\t\t\t-webkit-border-radius: 2px !important;\n\t\t\t\t-moz-border-radius: 2px !important;\n\t\t\t\tmargin: 5px 0px 5px 0px !important;\n\t\t\t\tpadding: 10px 10px 10px 10px !important;\n\t\t\t\tfont-family: 'Roboto Condensed' !important;;\n\t\t\t}\n\t\t.left-placement-input-contact-bank_credit_card_2765::-webkit-input-placeholder {\n\t\t\t\tfont-family: 'Roboto Condensed' !important;;\n\t\t\t}\n\t\t.left-placement-input-contact-bank_credit_card_2765::-moz-placeholder{\n\t\t\t\tfont-family: 'Roboto Condensed' !important;;\n\t\t}\n\t\t.left-placement-input-contact-bank_credit_card_2765\t\t{\n\t\t\t\twidth: 60% !important;\n\t\t\t\t\t\t\t\tbackground-color: rgba(247,247,247,1) !important;\n\t\t\t\t\t\t\t\theight: 100% !important;\n\t\t\t\tdisplay: inline-block;\n\t\t\t\tvertical-align: middle;\n\t\t\t\ttext-align: left !important;\n\t\t\t\tfont-size: 14px !important;\n\t\t\t\tcolor: #000000 !important;\n\t\t\t\tborder: 1px solid #d1d1d1 !important;\n\t\t\t\t-webkit-border: 1px solid #d1d1d1 !important;\n\t\t\t\t-moz-border: 1px solid #d1d1d1 !important;\n\t\t\t\tborder-radius: 2px !important;\n\t\t\t\t-webkit-border-radius: 2px !important;\n\t\t\t\t-moz-border-radius: 2px !important;\n\t\t\t\tmargin: 5px 0px 5px 0px !important;\n\t\t\t\tpadding: 10px 10px 10px 10px !important;\n\t\t\t\tfont-family: 'Roboto Condensed' !important;;\n\t\t\t}\n\t\t.input-layout-field-contact-bank_2765\t\t{\n\t\t\t\t\t\t\t\t\t\t\t\tbackground-color: rgba(247,247,247,1) !important;\n\t\t\t\t\t\t\t\t\t\t\t\theight: 100% !important;\n\t\t\t\t\t\ttext-align: left !important;\n\t\t\t\t\t\tfont-size: 14px !important;\n\t\t\t\t\t\tcolor: #000000 !important;\n\t\t\t\t\t\tborder: 1px solid #d1d1d1 !important;\n\t\t\t\t\t\t-webkit-border: 1px solid #d1d1d1 !important;\n\t\t\t\t\t\t-moz-border: 1px solid #d1d1d1 !important;\n\t\t\t\t\t\tborder-radius: 2px !important;\n\t\t\t\t\t\t-webkit-border-radius: 2px !important;\n\t\t\t\t\t\t-moz-border-radius: 2px !important;\n\t\t\t\t\t\tmargin: 5px 0px 5px 0px !important;\n\t\t\t\t\t\tpadding: 10px 10px 10px 10px !important;\n\t\t\t\t\t\twidth: 90% !important;\n\t\t\t\t\t\tfont-family: 'Roboto Condensed' !important;;\n\t\t}\n\t\t.input-layout-field-contact-bank_2765::-webkit-input-placeholder {\n\t\t\t\tfont-family: 'Roboto Condensed' !important;;\n\t\t}\n\t\t.input-layout-field-contact-bank_2765::-moz-placeholder {\n\t\t\t\tfont-family: 'Roboto Condensed' !important;;\n\t\t}\n\t\t.label_left_placement_2765\t\t{\n\t\t\t\tposition: relative;\n\t\t\t\tdisplay: inline-block;\n\t\t\t\tbottom: 2px;\n\t\t\t\twidth: 30% !important;\n\t\t\t\tfloat: left !important;\n\t\t\t\ttext-align: left !important;\n\t\t\t\theight: 100% !important;\n\t\t\t\tfont-size: 16px !important;\n\t\t\t\tcolor: #000000 !important;\n\t\t\t\tmargin: 0px 0px 0px 0px !important;\n\t\t\t\tpadding: 10px 10px 10px 0px !important;\n\t\t\t\tfont-family: 'Roboto Condensed' !important;\t\t}\n\t\t.radio_list_label_right_placement_2765\t\t{\n\t\t\t\tfloat: left;\n\t\t\t\twidth: 60%;\n\t\t\t\tdisplay: inline-block;\n\t\t\t\tposition: relative;\n\t\t}\n\t\t.radio_list_label_2765\t\t{\n\t\t\t\ttext-align: left !important;\n\t\t\t\tvertical-align: middle;\n\t\t\t\tposition: relative;\n\t\t\t\tbottom: 0px;\n\t\t\t\tfont-family: 'Roboto Condensed' !important;\t\t\t\tfont-size: 16px !important;\n\t\t}\n\t\t.checkbox_label_right_placement_2765\t\t{\n\t\t\t\tfloat: right;\n\t\t\t\twidth: 60%;\n\t\t\t\tbottom: 10px;\n\t\t\t\tposition: relative;\n\t\t}\n\t\t.checkbox_input_right_placement_2765\t\t{\n\t\t\t\tdisplay: inline-block;\n\t\t\t\tposition: relative;\n\t\t\t\twidth: 30%;\n\t\t}\n\t\t.label-gdrp-compliance-style\n\t\t{\n\t\t\t\tfont-size: 16px !important;\n\t\t\t\tcolor: #000000 !important;\n\t\t\t\tmargin: 0px 0px 0px 0px !important;\n\t\t\t\tpadding: 10px 10px 10px 0px !important;\n\t\t\t\tfont-family: 'Roboto Condensed' !important;\t\t}\n\t\t.label_left_placement_credit_card_2765\t\t{\n\t\t\t\twidth: 30% !important;\n\t\t\t\tdisplay: inline-block;\n\t\t\t\tvertical-align: middle;\n\t\t\t\ttext-align: left !important;\n\t\t\t\theight: 100% !important;\n\t\t\t\tfont-size: 16px !important;\n\t\t\t\tcolor: #000000 !important;\n\t\t\t\tmargin: 0px 0px 0px 0px !important;\n\t\t\t\tpadding: 10px 10px 10px 0px !important;\n\t\t\t\tfont-family: 'Roboto Condensed' !important;\t\t}\n\t\t.label-layout-field-contact-bank_2765\t\t{\n\t\t\t\t\t\t\t\t\t\tbackground: rgba(255,255,255,0) !important;\n\t\t\t\t\t\t\t\t\t\ttext-align: left !important;\n\t\t\t\twidth: 100% !important;\n\t\t\t\theight: 100% !important;\n\t\t\t\tfont-size: 16px !important;\n\t\t\t\tcolor: #000000 !important;\n\t\t\t\tmargin: 0px 0px 0px 0px !important;\n\t\t\t\tpadding: 10px 10px 10px 0px !important;\n\t\t\t\tfont-family: 'Roboto Condensed' !important;\t\t}\n\t\t.label-gdrp-compliance-style\n\t\t{\n\t\t\t\tfont-size: 16px !important;\n\t\t\t\tcolor: #000000 !important;\n\t\t\t\tmargin: 0px 0px 0px 0px !important;\n\t\t\t\tpadding: 10px 10px 10px 0px !important;\n\t\t\t\tfont-family: 'Roboto Condensed' !important;\t\t}\n\t\t.label_tooltip_contact_bank\n\t\t{\n\t\t\t\tfont-size: 12px !important;\n\t\t}\n\t\t.button-layout-contact-bank_2765\t\t{\n\t\t\t\t\t\t\t\t\t\tbackground: rgba(82,76,82,1) !important;\n\t\t\t\t\t\t\t\t\t\ttext-align: center !important;\n\t\t\t\twidth: 100px !important;\n\t\t\t\theight: 100% !important;\n\t\t\t\tfont-size: 16px !important;\n\t\t\t\tcolor: #ffffff !important;\n\t\t\t\tborder: 1px solid #524c52 !important;\n\t\t\t\t-webkit-border: 1px solid #524c52 !important;\n\t\t\t\t-moz-border: 1px solid #524c52 !important;\n\t\t\t\tborder-radius: 4px !important;\n\t\t\t\t-webkit-border-radius: 4px !important;\n\t\t\t\t-moz-border-radius: 4px !important;\n\t\t\t\tmargin: 10px 0px 0px 0px !important;\n\t\t\t\tpadding: 15px 20px 15px 20px !important;\n\t\t\t\tfont-family: 'Roboto Slab' !important;;\n\t\t\t\tdisplay: inline-block !important;\n\t\t\t\ttext-transform: none !important;\n\t\t}\n\t\t.button-layout-contact-bank_2765:hover\n\t\t{\n\t\t\t\t\t\t\t\t\t\tbackground: rgba(112,108,112,1) !important;\n\t\t\t\t\t\tborder-color: #706c70 !important;\n\t\t\t\t\t\t\t\t}\n\t\t.file-upload-button-style-contact-bank_2765\t\t{\n\t\t\t\t\t\t\t\t\t\tbackground: rgba(82,76,82,1) !important;\n\t\t\t\t\t\t\t\t\t\tcolor: #ffffff !important;\n\t\t\t\tpadding: 5px 10px 5px 10px !important;\n\t\t\t\tborder: 1px solid #524c52 !important;\n\t\t\t\t-webkit-border: 1px solid #524c52 !important;\n\t\t\t\t-moz-border: 1px solid #524c52 !important;\n\t\t\t\tfont-size: 12px !important;\n\t\t}\n\t\t.file-upload-button-style-contact-bank_2765:hover\n\t\t{\n\t\t\t\t\t\t\t\t\t\tbackground: rgba(112,108,112,1) !important;\n\t\t\t\t\t\tborder-color: #706c70 !important;\n\t\t\t\t\t\tpadding: 5px 10px 5px 10px !important;\n\t\t\t\t\t\tfont-size: 12px !important;\n\t\t\t\t\t\t\t\t}\n\t\t.message-layout-contact-bank_2765\t\t{\n\t\t\t\ttext-align: left !important;\n\t\t\t\tdirection: inherit !important;\n\t\t\t\tbackground: url(http:\/\/djcareservices.com\/wp-content\/plugins\/contact-bank\/user-views\/assets\/img\/icon-succes.png) no-repeat 8px 3px  rgba( 229,255,213,0.5 ) !important;\n\t\t}\n\t\t.custom-message\n\t\t{\n\t\t\t\tposition: relative;\n\t\t\t\tdisplay: inline-block;\n\t\t\t\tmargin: 20px 0 0 0;\n\t\t\t\tmargin-bottom: 0px;\n\t\t\t\tpadding: 0 0 0 35px;\n\t\t}\n\t\t#success_message_text_2765\t\t{\n\t\t\t\tfont-size: 18px !important;\n\t\t\t\tcolor: #6aa500 !important;\n\t\t\t\tmargin: 0px 0px 0px 0px !important;\n\t\t\t\tpadding: 0px 0px 0px 0px !important;\n\t\t\t\tfont-family: 'Roboto Slab' !important;\t\t}\n\t\t.error-message\n\t\t{\n\t\t\t\ttext-align: left !important;\n\t\t\t\tbackground: url(http:\/\/djcareservices.com\/wp-content\/plugins\/contact-bank\/user-views\/assets\/img\/no.png) no-repeat 8px 6px #FFBABA !important;\n\t\t}\n\t\t.error_message_text\n\t\t{\n\t\t\t\tfont-size: 18px !important;\n\t\t\t\tcolor: #D8000C !important;\n\t\t\t\tmargin: 0px 0px 0px 0px !important;\n\t\t\t\tpadding: 0px 0px 0px 0px !important;\n\t\t\t\tfont-family: 'Roboto Slab' !important;\t\t}\n\t\t.cb-pricing-control\n\t\t{\n\t\t\t\tborder: 0px none #000000 !important;\n\t\t\t\tbackground-color: transparent !important;\n\t\t\t\tbox-shadow: none !important;\n\t\t}\n\t\t<\/style>\n\t<div class=\"main_container_contact_bank_2765 form-layout-main-container-contact-bank_2765 language_direction_contact_bank_2765\">\n\t\t<form name=\"ux_frm_main_container_2765\" id=\"ux_frm_main_container_2765\">\n\t\t\t<div id=\"form_error_message_frontend_2765\" class=\"custom-message error-message\" style=\"display: none; margin-bottom: 10px;\">\n\t\t\t\t<span class=\"error_message_text\">\n\t\t\t\t\t<strong><\/strong>\n\t\t\t\t<\/span>\n\t\t\t<\/div>\n\t\t\t<div id=\"form_success_message_frontend_2765\" class=\"custom-message message-layout-contact-bank_2765\" style=\"display: none; margin-bottom: 10px;\">\n\t\t\t\t<div id=\"success_message_text_2765\"><\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"form-layout-title-contact-bank_2765\">\n\t\t\t\t\t<h1>QUALITY ASSURANCE: QUESTIONNAIRE (Annual) (Domiciliary)<\/h1>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"form-layout-description-contact-bank_2765\">\n\t\t\t\t\t<p><p>This quality assurance questionnaire is our way of gathering feedback from our service users, their family or representatives. If you need any assistance in the completion of this survey, please contact the office where we will be happy to assist.<br \/>Thank you for your cooperation<\/p> <\/p>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547640163229\" id=\"ux_sub_div_1547640163229\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547640163229\" id=\"field_label_1547640163229\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547640163229\" id=\"ux_label_title_1547640163229\" value=\"Name of Person Completing the Form:\">Name of Person Completing the Form:<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547640163229\" id=\"ux_tooltip_title_1547640163229\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:\" aria-required=\"true\" name=\"ux_required_1547640163229\" id=\"ux_required_1547640163229\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input style=\"\"  placeholder=\"\" name=\"ux_txt_singal_line_text_1547640163229\" onkeyup=\"only_characters_contact_bank_2765(event,1547640163229,'50','Characters Left');\" id=\"ux_txt_singal_line_text_1547640163229\" class='input-layout-field-contact-bank_2765 untitled_control ' type=\"text\" value=\"\" autocomplete=\"off\"  >\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547640163229\" id=\"ux_txt_hidden_label_1547640163229\" value=\"Name of Person Completing the Form:\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547640163229\" id=\"ux_text_appear_after_counter_1547640163229\">Characters Left<\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547640163229\" id=\"ux_txt_hidden_control_type_1547640163229\" value=\"text\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547640215176\" id=\"ux_sub_div_1547640215176\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547640215176\" id=\"field_label_1547640215176\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547640215176\" id=\"ux_label_title_1547640215176\" value=\"Name of Service User:\">Name of Service User:<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547640215176\" id=\"ux_tooltip_title_1547640215176\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:\" aria-required=\"true\" name=\"ux_required_1547640215176\" id=\"ux_required_1547640215176\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input style=\"\"  placeholder=\"\" name=\"ux_txt_singal_line_text_1547640215176\" onkeyup=\"only_characters_contact_bank_2765(event,1547640215176,'50','Characters Left');\" id=\"ux_txt_singal_line_text_1547640215176\" class='input-layout-field-contact-bank_2765 untitled_control ' type=\"text\" value=\"\" autocomplete=\"off\"  >\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547640215176\" id=\"ux_txt_hidden_label_1547640215176\" value=\"Name of Service User:\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547640215176\" id=\"ux_text_appear_after_counter_1547640215176\">Characters Left<\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547640215176\" id=\"ux_txt_hidden_control_type_1547640215176\" value=\"text\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547640264768\" id=\"ux_sub_div_1547640264768\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547640264768\" id=\"field_label_1547640264768\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547640264768\" id=\"ux_label_title_1547640264768\" value=\"Relationship to Service User:\">Relationship to Service User:<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547640264768\" id=\"ux_tooltip_title_1547640264768\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:\" aria-required=\"true\" name=\"ux_required_1547640264768\" id=\"ux_required_1547640264768\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input style=\"\"  placeholder=\"\" name=\"ux_txt_singal_line_text_1547640264768\" onkeyup=\"only_characters_contact_bank_2765(event,1547640264768,'50','Characters Left');\" id=\"ux_txt_singal_line_text_1547640264768\" class='input-layout-field-contact-bank_2765 untitled_control ' type=\"text\" value=\"\" autocomplete=\"off\"  >\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547640264768\" id=\"ux_txt_hidden_label_1547640264768\" value=\"Relationship to Service User:\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547640264768\" id=\"ux_text_appear_after_counter_1547640264768\">Characters Left<\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547640264768\" id=\"ux_txt_hidden_control_type_1547640264768\" value=\"text\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547643275584\" id=\"ux_sub_div_1547643275584\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547643275584\" id=\"field_label_1547643275584\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547643275584\" id=\"ux_label_title_1547643275584\" value=\"Have you received a copy of the service user guide?\">Have you received a copy of the service user guide?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547643275584\" id=\"ux_tooltip_title_1547643275584\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:\" aria-required=\"true\" name=\"ux_required_1547643275584\" id=\"ux_required_1547643275584\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547643275584\" id=\"ux_txt_check_box_1547643275584\" class=\"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547643275584\" name=\"field_labels_1547643275584\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_chk_button_contact_bank_2765\" type=\"checkbox\" name=\"ux_txt_check_box_lists_1547643275584[]\" id=\"ux_txt_check_box_lists_1547643275584\" value=\"Yes\" class='checkbox_class_1547643275584 '><label name=\"ux_chk_label_lists_1547643275584\" class=\"input_chk_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547643275584\" value=\"Yes\">Yes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_chk_button_contact_bank_2765\" type=\"checkbox\" name=\"ux_txt_check_box_lists_1547643275584[]\" id=\"ux_txt_check_box_lists_1547643275584\" value=\"No\" class='checkbox_class_1547643275584 '><label name=\"ux_chk_label_lists_1547643275584\" class=\"input_chk_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547643275584\" value=\"No\">No<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547643275584\" id=\"ux_txt_hidden_label_1547643275584\" value=\"Have you received a copy of the service user guide?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547643275584\" id=\"ux_text_appear_after_counter_1547643275584\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547643275584\" id=\"ux_txt_hidden_control_type_1547643275584\" value=\"checkbox-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547643804784\" id=\"ux_sub_div_1547643804784\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547643804784\" id=\"field_label_1547643804784\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547643804784\" id=\"ux_label_title_1547643804784\" value=\"Have you read this information?\">Have you read this information?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547643804784\" id=\"ux_tooltip_title_1547643804784\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:\" aria-required=\"true\" name=\"ux_required_1547643804784\" id=\"ux_required_1547643804784\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547643804784\" id=\"ux_txt_check_box_1547643804784\" class=\"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547643804784\" name=\"field_labels_1547643804784\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_chk_button_contact_bank_2765\" type=\"checkbox\" name=\"ux_txt_check_box_lists_1547643804784[]\" id=\"ux_txt_check_box_lists_1547643804784\" value=\"Yes\" class='checkbox_class_1547643804784 '><label name=\"ux_chk_label_lists_1547643804784\" class=\"input_chk_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547643804784\" value=\"Yes\">Yes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_chk_button_contact_bank_2765\" type=\"checkbox\" name=\"ux_txt_check_box_lists_1547643804784[]\" id=\"ux_txt_check_box_lists_1547643804784\" value=\"No\" class='checkbox_class_1547643804784 '><label name=\"ux_chk_label_lists_1547643804784\" class=\"input_chk_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547643804784\" value=\"No\">No<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547643804784\" id=\"ux_txt_hidden_label_1547643804784\" value=\"Have you read this information?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547643804784\" id=\"ux_text_appear_after_counter_1547643804784\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547643804784\" id=\"ux_txt_hidden_control_type_1547643804784\" value=\"checkbox-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547643833442\" id=\"ux_sub_div_1547643833442\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547643833442\" id=\"field_label_1547643833442\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547643833442\" id=\"ux_label_title_1547643833442\" value=\"Was it helpful in informing you about our services?\">Was it helpful in informing you about our services?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547643833442\" id=\"ux_tooltip_title_1547643833442\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:\" aria-required=\"true\" name=\"ux_required_1547643833442\" id=\"ux_required_1547643833442\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547643833442\" id=\"ux_txt_check_box_1547643833442\" class=\"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547643833442\" name=\"field_labels_1547643833442\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_chk_button_contact_bank_2765\" type=\"checkbox\" name=\"ux_txt_check_box_lists_1547643833442[]\" id=\"ux_txt_check_box_lists_1547643833442\" value=\"Yes\" class='checkbox_class_1547643833442 '><label name=\"ux_chk_label_lists_1547643833442\" class=\"input_chk_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547643833442\" value=\"Yes\">Yes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_chk_button_contact_bank_2765\" type=\"checkbox\" name=\"ux_txt_check_box_lists_1547643833442[]\" id=\"ux_txt_check_box_lists_1547643833442\" value=\"No\" class='checkbox_class_1547643833442 '><label name=\"ux_chk_label_lists_1547643833442\" class=\"input_chk_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547643833442\" value=\"No\">No<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547643833442\" id=\"ux_txt_hidden_label_1547643833442\" value=\"Was it helpful in informing you about our services?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547643833442\" id=\"ux_text_appear_after_counter_1547643833442\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547643833442\" id=\"ux_txt_hidden_control_type_1547643833442\" value=\"checkbox-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547643853353\" id=\"ux_sub_div_1547643853353\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547643853353\" id=\"field_label_1547643853353\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547643853353\" id=\"ux_label_title_1547643853353\" value=\"Is there anything that you did not understand?\">Is there anything that you did not understand?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547643853353\" id=\"ux_tooltip_title_1547643853353\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:\" aria-required=\"true\" name=\"ux_required_1547643853353\" id=\"ux_required_1547643853353\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547643853353\" id=\"ux_txt_check_box_1547643853353\" class=\"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547643853353\" name=\"field_labels_1547643853353\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_chk_button_contact_bank_2765\" type=\"checkbox\" name=\"ux_txt_check_box_lists_1547643853353[]\" id=\"ux_txt_check_box_lists_1547643853353\" value=\"Yes\" class='checkbox_class_1547643853353 '><label name=\"ux_chk_label_lists_1547643853353\" class=\"input_chk_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547643853353\" value=\"Yes\">Yes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_chk_button_contact_bank_2765\" type=\"checkbox\" name=\"ux_txt_check_box_lists_1547643853353[]\" id=\"ux_txt_check_box_lists_1547643853353\" value=\"No\" class='checkbox_class_1547643853353 '><label name=\"ux_chk_label_lists_1547643853353\" class=\"input_chk_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547643853353\" value=\"No\">No<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547643853353\" id=\"ux_txt_hidden_label_1547643853353\" value=\"Is there anything that you did not understand?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547643853353\" id=\"ux_text_appear_after_counter_1547643853353\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547643853353\" id=\"ux_txt_hidden_control_type_1547643853353\" value=\"checkbox-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547643887777\" id=\"ux_sub_div_1547643887777\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547643887777\" id=\"field_label_1547643887777\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547643887777\" id=\"ux_label_title_1547643887777\" value=\"Is there anything we seem to have missed?\">Is there anything we seem to have missed?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547643887777\" id=\"ux_tooltip_title_1547643887777\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:\" aria-required=\"true\" name=\"ux_required_1547643887777\" id=\"ux_required_1547643887777\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547643887777\" id=\"ux_txt_check_box_1547643887777\" class=\"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547643887777\" name=\"field_labels_1547643887777\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_chk_button_contact_bank_2765\" type=\"checkbox\" name=\"ux_txt_check_box_lists_1547643887777[]\" id=\"ux_txt_check_box_lists_1547643887777\" value=\"Yes\" class='checkbox_class_1547643887777 '><label name=\"ux_chk_label_lists_1547643887777\" class=\"input_chk_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547643887777\" value=\"Yes\">Yes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_chk_button_contact_bank_2765\" type=\"checkbox\" name=\"ux_txt_check_box_lists_1547643887777[]\" id=\"ux_txt_check_box_lists_1547643887777\" value=\"No\" class='checkbox_class_1547643887777 '><label name=\"ux_chk_label_lists_1547643887777\" class=\"input_chk_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547643887777\" value=\"No\">No<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547643887777\" id=\"ux_txt_hidden_label_1547643887777\" value=\"Is there anything we seem to have missed?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547643887777\" id=\"ux_text_appear_after_counter_1547643887777\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547643887777\" id=\"ux_txt_hidden_control_type_1547643887777\" value=\"checkbox-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547646408078\" id=\"ux_sub_div_1547646408078\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547646408078\" id=\"field_label_1547646408078\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547646408078\" id=\"ux_label_title_1547646408078\" value=\"Do you have any suggestions of how it could be improved?\">Do you have any suggestions of how it could be improved?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547646408078\" id=\"ux_tooltip_title_1547646408078\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:\" aria-required=\"true\" name=\"ux_required_1547646408078\" id=\"ux_required_1547646408078\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547646408078\" id=\"ux_txt_check_box_1547646408078\" class=\"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547646408078\" name=\"field_labels_1547646408078\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_chk_button_contact_bank_2765\" type=\"checkbox\" name=\"ux_txt_check_box_lists_1547646408078[]\" id=\"ux_txt_check_box_lists_1547646408078\" value=\"Yes\" class='checkbox_class_1547646408078 '><label name=\"ux_chk_label_lists_1547646408078\" class=\"input_chk_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547646408078\" value=\"Yes\">Yes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_chk_button_contact_bank_2765\" type=\"checkbox\" name=\"ux_txt_check_box_lists_1547646408078[]\" id=\"ux_txt_check_box_lists_1547646408078\" value=\"No\" class='checkbox_class_1547646408078 '><label name=\"ux_chk_label_lists_1547646408078\" class=\"input_chk_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547646408078\" value=\"No\">No<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547646408078\" id=\"ux_txt_hidden_label_1547646408078\" value=\"Do you have any suggestions of how it could be improved?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547646408078\" id=\"ux_text_appear_after_counter_1547646408078\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547646408078\" id=\"ux_txt_hidden_control_type_1547646408078\" value=\"checkbox-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547646429380\" id=\"ux_sub_div_1547646429380\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547646429380\" id=\"field_label_1547646429380\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547646429380\" id=\"ux_label_title_1547646429380\" value=\"Please comment on any improvement\">Please comment on any improvement<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547646429380\" id=\"ux_tooltip_title_1547646429380\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:\" aria-required=\"true\" name=\"ux_required_1547646429380\" id=\"ux_required_1547646429380\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<textarea rows=\"6\" style=\"\" placeholder=\"\" name=\"ux_txt_singal_line_text_1547646429380\" onkeyup=\"only_characters_contact_bank_2765(event,1547646429380,'200','Characters Left');\" id=\"ux_txt_singal_line_text_1547646429380\"class='input-layout-field-contact-bank_2765 untitled_control ' type=\"text\" autocomplete=\"off\" ><\/textarea>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547646429380\" id=\"ux_txt_hidden_label_1547646429380\" value=\"Please comment on any improvement\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547646429380\" id=\"ux_text_appear_after_counter_1547646429380\">Characters Left<\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547646429380\" id=\"ux_txt_hidden_control_type_1547646429380\" value=\"paragraph\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547646628078\" id=\"ux_sub_div_1547646628078\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547646628078\" id=\"field_label_1547646628078\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547646628078\" id=\"ux_label_title_1547646628078\" value=\"Do you have a completed care needs assessment?\">Do you have a completed care needs assessment?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547646628078\" id=\"ux_tooltip_title_1547646628078\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:\" aria-required=\"true\" name=\"ux_required_1547646628078\" id=\"ux_required_1547646628078\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547646628078\" id=\"ux_txt_check_box_1547646628078\" class=\"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547646628078\" name=\"field_labels_1547646628078\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_chk_button_contact_bank_2765\" type=\"checkbox\" name=\"ux_txt_check_box_lists_1547646628078[]\" id=\"ux_txt_check_box_lists_1547646628078\" value=\"Yes\" class='checkbox_class_1547646628078 '><label name=\"ux_chk_label_lists_1547646628078\" class=\"input_chk_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547646628078\" value=\"Yes\">Yes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_chk_button_contact_bank_2765\" type=\"checkbox\" name=\"ux_txt_check_box_lists_1547646628078[]\" id=\"ux_txt_check_box_lists_1547646628078\" value=\"No\" class='checkbox_class_1547646628078 '><label name=\"ux_chk_label_lists_1547646628078\" class=\"input_chk_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547646628078\" value=\"No\">No<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547646628078\" id=\"ux_txt_hidden_label_1547646628078\" value=\"Do you have a completed care needs assessment?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547646628078\" id=\"ux_text_appear_after_counter_1547646628078\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547646628078\" id=\"ux_txt_hidden_control_type_1547646628078\" value=\"checkbox-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547646671118\" id=\"ux_sub_div_1547646671118\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547646671118\" id=\"field_label_1547646671118\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547646671118\" id=\"ux_label_title_1547646671118\" value=\"Is there a care plan within your home?\">Is there a care plan within your home?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547646671118\" id=\"ux_tooltip_title_1547646671118\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:\" aria-required=\"true\" name=\"ux_required_1547646671118\" id=\"ux_required_1547646671118\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547646671118\" id=\"ux_txt_check_box_1547646671118\" class=\"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547646671118\" name=\"field_labels_1547646671118\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_chk_button_contact_bank_2765\" type=\"checkbox\" name=\"ux_txt_check_box_lists_1547646671118[]\" id=\"ux_txt_check_box_lists_1547646671118\" value=\"Yes\" class='checkbox_class_1547646671118 '><label name=\"ux_chk_label_lists_1547646671118\" class=\"input_chk_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547646671118\" value=\"Yes\">Yes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_chk_button_contact_bank_2765\" type=\"checkbox\" name=\"ux_txt_check_box_lists_1547646671118[]\" id=\"ux_txt_check_box_lists_1547646671118\" value=\"No\" class='checkbox_class_1547646671118 '><label name=\"ux_chk_label_lists_1547646671118\" class=\"input_chk_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547646671118\" value=\"No\">No<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547646671118\" id=\"ux_txt_hidden_label_1547646671118\" value=\"Is there a care plan within your home?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547646671118\" id=\"ux_text_appear_after_counter_1547646671118\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547646671118\" id=\"ux_txt_hidden_control_type_1547646671118\" value=\"checkbox-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547646708982\" id=\"ux_sub_div_1547646708982\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547646708982\" id=\"field_label_1547646708982\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547646708982\" id=\"ux_label_title_1547646708982\" value=\"Did you sign a contract for services?\">Did you sign a contract for services?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547646708982\" id=\"ux_tooltip_title_1547646708982\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:\" aria-required=\"true\" name=\"ux_required_1547646708982\" id=\"ux_required_1547646708982\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547646708982\" id=\"ux_txt_check_box_1547646708982\" class=\"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547646708982\" name=\"field_labels_1547646708982\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_chk_button_contact_bank_2765\" type=\"checkbox\" name=\"ux_txt_check_box_lists_1547646708982[]\" id=\"ux_txt_check_box_lists_1547646708982\" value=\"Yes\" class='checkbox_class_1547646708982 '><label name=\"ux_chk_label_lists_1547646708982\" class=\"input_chk_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547646708982\" value=\"Yes\">Yes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_chk_button_contact_bank_2765\" type=\"checkbox\" name=\"ux_txt_check_box_lists_1547646708982[]\" id=\"ux_txt_check_box_lists_1547646708982\" value=\"No\" class='checkbox_class_1547646708982 '><label name=\"ux_chk_label_lists_1547646708982\" class=\"input_chk_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547646708982\" value=\"No\">No<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547646708982\" id=\"ux_txt_hidden_label_1547646708982\" value=\"Did you sign a contract for services?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547646708982\" id=\"ux_text_appear_after_counter_1547646708982\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547646708982\" id=\"ux_txt_hidden_control_type_1547646708982\" value=\"checkbox-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547646740150\" id=\"ux_sub_div_1547646740150\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547646740150\" id=\"field_label_1547646740150\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547646740150\" id=\"ux_label_title_1547646740150\" value=\"Are we providing the services detailed on the care plan?\">Are we providing the services detailed on the care plan?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547646740150\" id=\"ux_tooltip_title_1547646740150\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:\" aria-required=\"true\" name=\"ux_required_1547646740150\" id=\"ux_required_1547646740150\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547646740150\" id=\"ux_txt_check_box_1547646740150\" class=\"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547646740150\" name=\"field_labels_1547646740150\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_chk_button_contact_bank_2765\" type=\"checkbox\" name=\"ux_txt_check_box_lists_1547646740150[]\" id=\"ux_txt_check_box_lists_1547646740150\" value=\"Yes\" class='checkbox_class_1547646740150 '><label name=\"ux_chk_label_lists_1547646740150\" class=\"input_chk_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547646740150\" value=\"Yes\">Yes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_chk_button_contact_bank_2765\" type=\"checkbox\" name=\"ux_txt_check_box_lists_1547646740150[]\" id=\"ux_txt_check_box_lists_1547646740150\" value=\"No\" class='checkbox_class_1547646740150 '><label name=\"ux_chk_label_lists_1547646740150\" class=\"input_chk_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547646740150\" value=\"No\">No<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547646740150\" id=\"ux_txt_hidden_label_1547646740150\" value=\"Are we providing the services detailed on the care plan?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547646740150\" id=\"ux_text_appear_after_counter_1547646740150\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547646740150\" id=\"ux_txt_hidden_control_type_1547646740150\" value=\"checkbox-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547646764583\" id=\"ux_sub_div_1547646764583\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547646764583\" id=\"field_label_1547646764583\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547646764583\" id=\"ux_label_title_1547646764583\" value=\"Does the service meet your expectations?\">Does the service meet your expectations?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547646764583\" id=\"ux_tooltip_title_1547646764583\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:\" aria-required=\"true\" name=\"ux_required_1547646764583\" id=\"ux_required_1547646764583\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547646764583\" id=\"ux_txt_check_box_1547646764583\" class=\"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547646764583\" name=\"field_labels_1547646764583\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_chk_button_contact_bank_2765\" type=\"checkbox\" name=\"ux_txt_check_box_lists_1547646764583[]\" id=\"ux_txt_check_box_lists_1547646764583\" value=\"Yes\" class='checkbox_class_1547646764583 '><label name=\"ux_chk_label_lists_1547646764583\" class=\"input_chk_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547646764583\" value=\"Yes\">Yes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_chk_button_contact_bank_2765\" type=\"checkbox\" name=\"ux_txt_check_box_lists_1547646764583[]\" id=\"ux_txt_check_box_lists_1547646764583\" value=\"No\" class='checkbox_class_1547646764583 '><label name=\"ux_chk_label_lists_1547646764583\" class=\"input_chk_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547646764583\" value=\"No\">No<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547646764583\" id=\"ux_txt_hidden_label_1547646764583\" value=\"Does the service meet your expectations?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547646764583\" id=\"ux_text_appear_after_counter_1547646764583\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547646764583\" id=\"ux_txt_hidden_control_type_1547646764583\" value=\"checkbox-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547646803765\" id=\"ux_sub_div_1547646803765\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547646803765\" id=\"field_label_1547646803765\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547646803765\" id=\"ux_label_title_1547646803765\" value=\"Please detail any \u201cYes\u201d answers\">Please detail any \u201cYes\u201d answers<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547646803765\" id=\"ux_tooltip_title_1547646803765\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:\" aria-required=\"true\" name=\"ux_required_1547646803765\" id=\"ux_required_1547646803765\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<textarea rows=\"2\" style=\"\" placeholder=\"\" name=\"ux_txt_singal_line_text_1547646803765\" onkeyup=\"only_characters_contact_bank_2765(event,1547646803765,'50','Characters Left');\" id=\"ux_txt_singal_line_text_1547646803765\"class='input-layout-field-contact-bank_2765 untitled_control ' type=\"text\" autocomplete=\"off\" ><\/textarea>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547646803765\" id=\"ux_txt_hidden_label_1547646803765\" value=\"Please detail any \u201cYes\u201d answers\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547646803765\" id=\"ux_text_appear_after_counter_1547646803765\">Characters Left<\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547646803765\" id=\"ux_txt_hidden_control_type_1547646803765\" value=\"paragraph\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547647487469\" id=\"ux_sub_div_1547647487469\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547647487469\" id=\"field_label_1547647487469\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547647487469\" id=\"ux_label_title_1547647487469\" value=\"Are they polite, courteous and respectful?\">Are they polite, courteous and respectful?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547647487469\" id=\"ux_tooltip_title_1547647487469\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547647487469\" id=\"ux_required_1547647487469\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547647487469\" id=\"ux_txt_check_box_1547647487469\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547647487469\" name=\"field_labels_1547647487469\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647487469\" id=\"ux_txt_check_box_lists_1547647487469\" value=\"Not at all\" checked=checked  class='checkbox_class_1547647487469 '><label name=\"ux_chk_label_lists_1547647487469\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647487469\" value=\"Not at all\">Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647487469\" id=\"ux_txt_check_box_lists_1547647487469\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547647487469 '><label name=\"ux_chk_label_lists_1547647487469\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647487469\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647487469\" id=\"ux_txt_check_box_lists_1547647487469\" value=\"Most of the time\" checked=checked  class='checkbox_class_1547647487469 '><label name=\"ux_chk_label_lists_1547647487469\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647487469\" value=\"Most of the time\">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647487469\" id=\"ux_txt_check_box_lists_1547647487469\" value=\"Always\" checked=checked  class='checkbox_class_1547647487469 '><label name=\"ux_chk_label_lists_1547647487469\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647487469\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547647487469\" id=\"ux_txt_hidden_label_1547647487469\" value=\"Are they polite, courteous and respectful?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547647487469\" id=\"ux_text_appear_after_counter_1547647487469\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547647487469\" id=\"ux_txt_hidden_control_type_1547647487469\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547647056746\" id=\"ux_sub_div_1547647056746\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547647056746\" id=\"field_label_1547647056746\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547647056746\" id=\"ux_label_title_1547647056746\" value=\"Do you think our carers understand your needs?\">Do you think our carers understand your needs?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547647056746\" id=\"ux_tooltip_title_1547647056746\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547647056746\" id=\"ux_required_1547647056746\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547647056746\" id=\"ux_txt_check_box_1547647056746\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547647056746\" name=\"field_labels_1547647056746\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647056746\" id=\"ux_txt_check_box_lists_1547647056746\" value=\"Not at all\" checked=checked  class='checkbox_class_1547647056746 '><label name=\"ux_chk_label_lists_1547647056746\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647056746\" value=\"Not at all\">Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647056746\" id=\"ux_txt_check_box_lists_1547647056746\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547647056746 '><label name=\"ux_chk_label_lists_1547647056746\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647056746\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647056746\" id=\"ux_txt_check_box_lists_1547647056746\" value=\"Most of the time\" checked=checked  class='checkbox_class_1547647056746 '><label name=\"ux_chk_label_lists_1547647056746\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647056746\" value=\"Most of the time\">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647056746\" id=\"ux_txt_check_box_lists_1547647056746\" value=\"Always\" checked=checked  class='checkbox_class_1547647056746 '><label name=\"ux_chk_label_lists_1547647056746\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647056746\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547647056746\" id=\"ux_txt_hidden_label_1547647056746\" value=\"Do you think our carers understand your needs?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547647056746\" id=\"ux_text_appear_after_counter_1547647056746\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547647056746\" id=\"ux_txt_hidden_control_type_1547647056746\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547647630685\" id=\"ux_sub_div_1547647630685\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547647630685\" id=\"field_label_1547647630685\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547647630685\" id=\"ux_label_title_1547647630685\" value=\"Do you find them helpful?\">Do you find them helpful?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547647630685\" id=\"ux_tooltip_title_1547647630685\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547647630685\" id=\"ux_required_1547647630685\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547647630685\" id=\"ux_txt_check_box_1547647630685\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547647630685\" name=\"field_labels_1547647630685\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647630685\" id=\"ux_txt_check_box_lists_1547647630685\" value=\"Always\" checked=checked  class='checkbox_class_1547647630685 '><label name=\"ux_chk_label_lists_1547647630685\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647630685\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647630685\" id=\"ux_txt_check_box_lists_1547647630685\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547647630685 '><label name=\"ux_chk_label_lists_1547647630685\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647630685\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647630685\" id=\"ux_txt_check_box_lists_1547647630685\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547647630685 '><label name=\"ux_chk_label_lists_1547647630685\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647630685\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647630685\" id=\"ux_txt_check_box_lists_1547647630685\" value=\"Not at all\" checked=checked  class='checkbox_class_1547647630685 '><label name=\"ux_chk_label_lists_1547647630685\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647630685\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547647630685\" id=\"ux_txt_hidden_label_1547647630685\" value=\"Do you find them helpful?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547647630685\" id=\"ux_text_appear_after_counter_1547647630685\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547647630685\" id=\"ux_txt_hidden_control_type_1547647630685\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547647651036\" id=\"ux_sub_div_1547647651036\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547647651036\" id=\"field_label_1547647651036\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547647651036\" id=\"ux_label_title_1547647651036\" value=\"Do you find them friendly and interested in you?\">Do you find them friendly and interested in you?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547647651036\" id=\"ux_tooltip_title_1547647651036\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547647651036\" id=\"ux_required_1547647651036\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547647651036\" id=\"ux_txt_check_box_1547647651036\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547647651036\" name=\"field_labels_1547647651036\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647651036\" id=\"ux_txt_check_box_lists_1547647651036\" value=\"Always\" checked=checked  class='checkbox_class_1547647651036 '><label name=\"ux_chk_label_lists_1547647651036\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647651036\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647651036\" id=\"ux_txt_check_box_lists_1547647651036\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547647651036 '><label name=\"ux_chk_label_lists_1547647651036\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647651036\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647651036\" id=\"ux_txt_check_box_lists_1547647651036\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547647651036 '><label name=\"ux_chk_label_lists_1547647651036\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647651036\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647651036\" id=\"ux_txt_check_box_lists_1547647651036\" value=\"Not at all\" checked=checked  class='checkbox_class_1547647651036 '><label name=\"ux_chk_label_lists_1547647651036\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647651036\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547647651036\" id=\"ux_txt_hidden_label_1547647651036\" value=\"Do you find them friendly and interested in you?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547647651036\" id=\"ux_text_appear_after_counter_1547647651036\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547647651036\" id=\"ux_txt_hidden_control_type_1547647651036\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547647680956\" id=\"ux_sub_div_1547647680956\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547647680956\" id=\"field_label_1547647680956\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547647680956\" id=\"ux_label_title_1547647680956\" value=\"Do they listen when you ask them to do something?\">Do they listen when you ask them to do something?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547647680956\" id=\"ux_tooltip_title_1547647680956\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547647680956\" id=\"ux_required_1547647680956\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547647680956\" id=\"ux_txt_check_box_1547647680956\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547647680956\" name=\"field_labels_1547647680956\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647680956\" id=\"ux_txt_check_box_lists_1547647680956\" value=\"Always\" checked=checked  class='checkbox_class_1547647680956 '><label name=\"ux_chk_label_lists_1547647680956\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647680956\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647680956\" id=\"ux_txt_check_box_lists_1547647680956\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547647680956 '><label name=\"ux_chk_label_lists_1547647680956\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647680956\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647680956\" id=\"ux_txt_check_box_lists_1547647680956\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547647680956 '><label name=\"ux_chk_label_lists_1547647680956\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647680956\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647680956\" id=\"ux_txt_check_box_lists_1547647680956\" value=\"Not at all\" checked=checked  class='checkbox_class_1547647680956 '><label name=\"ux_chk_label_lists_1547647680956\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647680956\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547647680956\" id=\"ux_txt_hidden_label_1547647680956\" value=\"Do they listen when you ask them to do something?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547647680956\" id=\"ux_text_appear_after_counter_1547647680956\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547647680956\" id=\"ux_txt_hidden_control_type_1547647680956\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547647714949\" id=\"ux_sub_div_1547647714949\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547647714949\" id=\"field_label_1547647714949\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547647714949\" id=\"ux_label_title_1547647714949\" value=\"Do they listen when you ask them to do something?\">Do they listen when you ask them to do something?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547647714949\" id=\"ux_tooltip_title_1547647714949\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547647714949\" id=\"ux_required_1547647714949\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547647714949\" id=\"ux_txt_check_box_1547647714949\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547647714949\" name=\"field_labels_1547647714949\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647714949\" id=\"ux_txt_check_box_lists_1547647714949\" value=\"Always\" checked=checked  class='checkbox_class_1547647714949 '><label name=\"ux_chk_label_lists_1547647714949\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647714949\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647714949\" id=\"ux_txt_check_box_lists_1547647714949\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547647714949 '><label name=\"ux_chk_label_lists_1547647714949\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647714949\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647714949\" id=\"ux_txt_check_box_lists_1547647714949\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547647714949 '><label name=\"ux_chk_label_lists_1547647714949\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647714949\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647714949\" id=\"ux_txt_check_box_lists_1547647714949\" value=\"Not at all\" checked=checked  class='checkbox_class_1547647714949 '><label name=\"ux_chk_label_lists_1547647714949\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647714949\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547647714949\" id=\"ux_txt_hidden_label_1547647714949\" value=\"Do they listen when you ask them to do something?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547647714949\" id=\"ux_text_appear_after_counter_1547647714949\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547647714949\" id=\"ux_txt_hidden_control_type_1547647714949\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547647796084\" id=\"ux_sub_div_1547647796084\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547647796084\" id=\"field_label_1547647796084\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547647796084\" id=\"ux_label_title_1547647796084\" value=\"Do they follow the Care Plan?\">Do they follow the Care Plan?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547647796084\" id=\"ux_tooltip_title_1547647796084\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547647796084\" id=\"ux_required_1547647796084\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547647796084\" id=\"ux_txt_check_box_1547647796084\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547647796084\" name=\"field_labels_1547647796084\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647796084\" id=\"ux_txt_check_box_lists_1547647796084\" value=\"Always\" checked=checked  class='checkbox_class_1547647796084 '><label name=\"ux_chk_label_lists_1547647796084\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647796084\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647796084\" id=\"ux_txt_check_box_lists_1547647796084\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547647796084 '><label name=\"ux_chk_label_lists_1547647796084\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647796084\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647796084\" id=\"ux_txt_check_box_lists_1547647796084\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547647796084 '><label name=\"ux_chk_label_lists_1547647796084\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647796084\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647796084\" id=\"ux_txt_check_box_lists_1547647796084\" value=\"Not at all\" checked=checked  class='checkbox_class_1547647796084 '><label name=\"ux_chk_label_lists_1547647796084\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647796084\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547647796084\" id=\"ux_txt_hidden_label_1547647796084\" value=\"Do they follow the Care Plan?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547647796084\" id=\"ux_text_appear_after_counter_1547647796084\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547647796084\" id=\"ux_txt_hidden_control_type_1547647796084\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547647830308\" id=\"ux_sub_div_1547647830308\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547647830308\" id=\"field_label_1547647830308\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547647830308\" id=\"ux_label_title_1547647830308\" value=\"Do they follow the Care Plan?\">Do they follow the Care Plan?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547647830308\" id=\"ux_tooltip_title_1547647830308\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:\" aria-required=\"true\" name=\"ux_required_1547647830308\" id=\"ux_required_1547647830308\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547647830308\" id=\"ux_txt_check_box_1547647830308\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547647830308\" name=\"field_labels_1547647830308\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647830308\" id=\"ux_txt_check_box_lists_1547647830308\" value=\"Always\" checked=checked  class='checkbox_class_1547647830308 '><label name=\"ux_chk_label_lists_1547647830308\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647830308\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647830308\" id=\"ux_txt_check_box_lists_1547647830308\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547647830308 '><label name=\"ux_chk_label_lists_1547647830308\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647830308\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647830308\" id=\"ux_txt_check_box_lists_1547647830308\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547647830308 '><label name=\"ux_chk_label_lists_1547647830308\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647830308\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547647830308\" id=\"ux_txt_check_box_lists_1547647830308\" value=\"Not at all\" checked=checked  class='checkbox_class_1547647830308 '><label name=\"ux_chk_label_lists_1547647830308\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547647830308\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547647830308\" id=\"ux_txt_hidden_label_1547647830308\" value=\"Do they follow the Care Plan?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547647830308\" id=\"ux_text_appear_after_counter_1547647830308\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547647830308\" id=\"ux_txt_hidden_control_type_1547647830308\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547648045636\" id=\"ux_sub_div_1547648045636\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547648045636\" id=\"field_label_1547648045636\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547648045636\" id=\"ux_label_title_1547648045636\" value=\"Please detail any \u201cC and D\u201d answers\">Please detail any \u201cC and D\u201d answers<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547648045636\" id=\"ux_tooltip_title_1547648045636\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:\" aria-required=\"true\" name=\"ux_required_1547648045636\" id=\"ux_required_1547648045636\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<textarea rows=\"2\" style=\"\" placeholder=\"\" name=\"ux_txt_singal_line_text_1547648045636\" onkeyup=\"only_characters_contact_bank_2765(event,1547648045636,'50','Characters Left');\" id=\"ux_txt_singal_line_text_1547648045636\"class='input-layout-field-contact-bank_2765 untitled_control ' type=\"text\" autocomplete=\"off\" ><\/textarea>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547648045636\" id=\"ux_txt_hidden_label_1547648045636\" value=\"Please detail any \u201cC and D\u201d answers\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547648045636\" id=\"ux_text_appear_after_counter_1547648045636\">Characters Left<\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547648045636\" id=\"ux_txt_hidden_control_type_1547648045636\" value=\"paragraph\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547649045283\" id=\"ux_sub_div_1547649045283\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547649045283\" id=\"field_label_1547649045283\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547649045283\" id=\"ux_label_title_1547649045283\" value=\"Do the care-workers come at times that suit you?\">Do the care-workers come at times that suit you?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547649045283\" id=\"ux_tooltip_title_1547649045283\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547649045283\" id=\"ux_required_1547649045283\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547649045283\" id=\"ux_txt_check_box_1547649045283\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547649045283\" name=\"field_labels_1547649045283\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649045283\" id=\"ux_txt_check_box_lists_1547649045283\" value=\"Always\" checked=checked  class='checkbox_class_1547649045283 '><label name=\"ux_chk_label_lists_1547649045283\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649045283\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649045283\" id=\"ux_txt_check_box_lists_1547649045283\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547649045283 '><label name=\"ux_chk_label_lists_1547649045283\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649045283\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649045283\" id=\"ux_txt_check_box_lists_1547649045283\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547649045283 '><label name=\"ux_chk_label_lists_1547649045283\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649045283\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649045283\" id=\"ux_txt_check_box_lists_1547649045283\" value=\"Not at all\" checked=checked  class='checkbox_class_1547649045283 '><label name=\"ux_chk_label_lists_1547649045283\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649045283\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547649045283\" id=\"ux_txt_hidden_label_1547649045283\" value=\"Do the care-workers come at times that suit you?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547649045283\" id=\"ux_text_appear_after_counter_1547649045283\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547649045283\" id=\"ux_txt_hidden_control_type_1547649045283\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547649073019\" id=\"ux_sub_div_1547649073019\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547649073019\" id=\"field_label_1547649073019\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547649073019\" id=\"ux_label_title_1547649073019\" value=\"Do the care-workers arrive on time at the agreed time?\">Do the care-workers arrive on time at the agreed time?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547649073019\" id=\"ux_tooltip_title_1547649073019\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547649073019\" id=\"ux_required_1547649073019\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547649073019\" id=\"ux_txt_check_box_1547649073019\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547649073019\" name=\"field_labels_1547649073019\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649073019\" id=\"ux_txt_check_box_lists_1547649073019\" value=\"Always\" checked=checked  class='checkbox_class_1547649073019 '><label name=\"ux_chk_label_lists_1547649073019\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649073019\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649073019\" id=\"ux_txt_check_box_lists_1547649073019\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547649073019 '><label name=\"ux_chk_label_lists_1547649073019\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649073019\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649073019\" id=\"ux_txt_check_box_lists_1547649073019\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547649073019 '><label name=\"ux_chk_label_lists_1547649073019\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649073019\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649073019\" id=\"ux_txt_check_box_lists_1547649073019\" value=\"Not at all\" checked=checked  class='checkbox_class_1547649073019 '><label name=\"ux_chk_label_lists_1547649073019\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649073019\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547649073019\" id=\"ux_txt_hidden_label_1547649073019\" value=\"Do the care-workers arrive on time at the agreed time?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547649073019\" id=\"ux_text_appear_after_counter_1547649073019\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547649073019\" id=\"ux_txt_hidden_control_type_1547649073019\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547649225378\" id=\"ux_sub_div_1547649225378\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547649225378\" id=\"field_label_1547649225378\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547649225378\" id=\"ux_label_title_1547649225378\" value=\"Have they ever not turned up?\">Have they ever not turned up?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547649225378\" id=\"ux_tooltip_title_1547649225378\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547649225378\" id=\"ux_required_1547649225378\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547649225378\" id=\"ux_txt_check_box_1547649225378\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547649225378\" name=\"field_labels_1547649225378\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649225378\" id=\"ux_txt_check_box_lists_1547649225378\" value=\"Always\" checked=checked  class='checkbox_class_1547649225378 '><label name=\"ux_chk_label_lists_1547649225378\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649225378\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649225378\" id=\"ux_txt_check_box_lists_1547649225378\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547649225378 '><label name=\"ux_chk_label_lists_1547649225378\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649225378\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649225378\" id=\"ux_txt_check_box_lists_1547649225378\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547649225378 '><label name=\"ux_chk_label_lists_1547649225378\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649225378\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649225378\" id=\"ux_txt_check_box_lists_1547649225378\" value=\"Not at all\" checked=checked  class='checkbox_class_1547649225378 '><label name=\"ux_chk_label_lists_1547649225378\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649225378\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547649225378\" id=\"ux_txt_hidden_label_1547649225378\" value=\"Have they ever not turned up?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547649225378\" id=\"ux_text_appear_after_counter_1547649225378\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547649225378\" id=\"ux_txt_hidden_control_type_1547649225378\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547649247172\" id=\"ux_sub_div_1547649247172\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547649247172\" id=\"field_label_1547649247172\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547649247172\" id=\"ux_label_title_1547649247172\" value=\"When they have been delayed, have you been informed?\">When they have been delayed, have you been informed?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547649247172\" id=\"ux_tooltip_title_1547649247172\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547649247172\" id=\"ux_required_1547649247172\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547649247172\" id=\"ux_txt_check_box_1547649247172\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547649247172\" name=\"field_labels_1547649247172\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649247172\" id=\"ux_txt_check_box_lists_1547649247172\" value=\"Always\" checked=checked  class='checkbox_class_1547649247172 '><label name=\"ux_chk_label_lists_1547649247172\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649247172\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649247172\" id=\"ux_txt_check_box_lists_1547649247172\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547649247172 '><label name=\"ux_chk_label_lists_1547649247172\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649247172\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649247172\" id=\"ux_txt_check_box_lists_1547649247172\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547649247172 '><label name=\"ux_chk_label_lists_1547649247172\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649247172\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649247172\" id=\"ux_txt_check_box_lists_1547649247172\" value=\"Not at all\" checked=checked  class='checkbox_class_1547649247172 '><label name=\"ux_chk_label_lists_1547649247172\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649247172\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547649247172\" id=\"ux_txt_hidden_label_1547649247172\" value=\"When they have been delayed, have you been informed?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547649247172\" id=\"ux_text_appear_after_counter_1547649247172\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547649247172\" id=\"ux_txt_hidden_control_type_1547649247172\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547649270907\" id=\"ux_sub_div_1547649270907\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547649270907\" id=\"field_label_1547649270907\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547649270907\" id=\"ux_label_title_1547649270907\" value=\"Do they have enough time to complete the tasks?\">Do they have enough time to complete the tasks?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547649270907\" id=\"ux_tooltip_title_1547649270907\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547649270907\" id=\"ux_required_1547649270907\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547649270907\" id=\"ux_txt_check_box_1547649270907\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547649270907\" name=\"field_labels_1547649270907\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649270907\" id=\"ux_txt_check_box_lists_1547649270907\" value=\"Always\" checked=checked  class='checkbox_class_1547649270907 '><label name=\"ux_chk_label_lists_1547649270907\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649270907\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649270907\" id=\"ux_txt_check_box_lists_1547649270907\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547649270907 '><label name=\"ux_chk_label_lists_1547649270907\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649270907\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649270907\" id=\"ux_txt_check_box_lists_1547649270907\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547649270907 '><label name=\"ux_chk_label_lists_1547649270907\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649270907\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649270907\" id=\"ux_txt_check_box_lists_1547649270907\" value=\"Not at all\" checked=checked  class='checkbox_class_1547649270907 '><label name=\"ux_chk_label_lists_1547649270907\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649270907\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547649270907\" id=\"ux_txt_hidden_label_1547649270907\" value=\"Do they have enough time to complete the tasks?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547649270907\" id=\"ux_text_appear_after_counter_1547649270907\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547649270907\" id=\"ux_txt_hidden_control_type_1547649270907\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547649301204\" id=\"ux_sub_div_1547649301204\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547649301204\" id=\"field_label_1547649301204\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547649301204\" id=\"ux_label_title_1547649301204\" value=\"Do they seem to be in too much of a rush?\">Do they seem to be in too much of a rush?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547649301204\" id=\"ux_tooltip_title_1547649301204\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547649301204\" id=\"ux_required_1547649301204\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547649301204\" id=\"ux_txt_check_box_1547649301204\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547649301204\" name=\"field_labels_1547649301204\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649301204\" id=\"ux_txt_check_box_lists_1547649301204\" value=\"Always\" checked=checked  class='checkbox_class_1547649301204 '><label name=\"ux_chk_label_lists_1547649301204\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649301204\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649301204\" id=\"ux_txt_check_box_lists_1547649301204\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547649301204 '><label name=\"ux_chk_label_lists_1547649301204\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649301204\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649301204\" id=\"ux_txt_check_box_lists_1547649301204\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547649301204 '><label name=\"ux_chk_label_lists_1547649301204\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649301204\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649301204\" id=\"ux_txt_check_box_lists_1547649301204\" value=\"Not at all\" checked=checked  class='checkbox_class_1547649301204 '><label name=\"ux_chk_label_lists_1547649301204\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649301204\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547649301204\" id=\"ux_txt_hidden_label_1547649301204\" value=\"Do they seem to be in too much of a rush?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547649301204\" id=\"ux_text_appear_after_counter_1547649301204\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547649301204\" id=\"ux_txt_hidden_control_type_1547649301204\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547649335379\" id=\"ux_sub_div_1547649335379\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547649335379\" id=\"field_label_1547649335379\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547649335379\" id=\"ux_label_title_1547649335379\" value=\"Do they spend less time than they should?\">Do they spend less time than they should?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547649335379\" id=\"ux_tooltip_title_1547649335379\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547649335379\" id=\"ux_required_1547649335379\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547649335379\" id=\"ux_txt_check_box_1547649335379\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547649335379\" name=\"field_labels_1547649335379\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649335379\" id=\"ux_txt_check_box_lists_1547649335379\" value=\"Always\" checked=checked  class='checkbox_class_1547649335379 '><label name=\"ux_chk_label_lists_1547649335379\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649335379\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649335379\" id=\"ux_txt_check_box_lists_1547649335379\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547649335379 '><label name=\"ux_chk_label_lists_1547649335379\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649335379\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649335379\" id=\"ux_txt_check_box_lists_1547649335379\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547649335379 '><label name=\"ux_chk_label_lists_1547649335379\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649335379\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649335379\" id=\"ux_txt_check_box_lists_1547649335379\" value=\"Not at all\" checked=checked  class='checkbox_class_1547649335379 '><label name=\"ux_chk_label_lists_1547649335379\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649335379\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547649335379\" id=\"ux_txt_hidden_label_1547649335379\" value=\"Do they spend less time than they should?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547649335379\" id=\"ux_text_appear_after_counter_1547649335379\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547649335379\" id=\"ux_txt_hidden_control_type_1547649335379\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547649353418\" id=\"ux_sub_div_1547649353418\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547649353418\" id=\"field_label_1547649353418\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547649353418\" id=\"ux_label_title_1547649353418\" value=\"Are they thorough in what they do for you?\">Are they thorough in what they do for you?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547649353418\" id=\"ux_tooltip_title_1547649353418\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547649353418\" id=\"ux_required_1547649353418\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547649353418\" id=\"ux_txt_check_box_1547649353418\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547649353418\" name=\"field_labels_1547649353418\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649353418\" id=\"ux_txt_check_box_lists_1547649353418\" value=\"Always\" checked=checked  class='checkbox_class_1547649353418 '><label name=\"ux_chk_label_lists_1547649353418\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649353418\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649353418\" id=\"ux_txt_check_box_lists_1547649353418\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547649353418 '><label name=\"ux_chk_label_lists_1547649353418\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649353418\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649353418\" id=\"ux_txt_check_box_lists_1547649353418\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547649353418 '><label name=\"ux_chk_label_lists_1547649353418\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649353418\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649353418\" id=\"ux_txt_check_box_lists_1547649353418\" value=\"Not at all\" checked=checked  class='checkbox_class_1547649353418 '><label name=\"ux_chk_label_lists_1547649353418\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649353418\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547649353418\" id=\"ux_txt_hidden_label_1547649353418\" value=\"Are they thorough in what they do for you?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547649353418\" id=\"ux_text_appear_after_counter_1547649353418\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547649353418\" id=\"ux_txt_hidden_control_type_1547649353418\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547649384050\" id=\"ux_sub_div_1547649384050\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547649384050\" id=\"field_label_1547649384050\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547649384050\" id=\"ux_label_title_1547649384050\" value=\"Do they encourage you to do as much as possible?\">Do they encourage you to do as much as possible?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547649384050\" id=\"ux_tooltip_title_1547649384050\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547649384050\" id=\"ux_required_1547649384050\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547649384050\" id=\"ux_txt_check_box_1547649384050\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547649384050\" name=\"field_labels_1547649384050\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649384050\" id=\"ux_txt_check_box_lists_1547649384050\" value=\"Always\" checked=checked  class='checkbox_class_1547649384050 '><label name=\"ux_chk_label_lists_1547649384050\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649384050\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649384050\" id=\"ux_txt_check_box_lists_1547649384050\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547649384050 '><label name=\"ux_chk_label_lists_1547649384050\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649384050\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649384050\" id=\"ux_txt_check_box_lists_1547649384050\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547649384050 '><label name=\"ux_chk_label_lists_1547649384050\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649384050\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649384050\" id=\"ux_txt_check_box_lists_1547649384050\" value=\"Not at all\" checked=checked  class='checkbox_class_1547649384050 '><label name=\"ux_chk_label_lists_1547649384050\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649384050\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547649384050\" id=\"ux_txt_hidden_label_1547649384050\" value=\"Do they encourage you to do as much as possible?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547649384050\" id=\"ux_text_appear_after_counter_1547649384050\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547649384050\" id=\"ux_txt_hidden_control_type_1547649384050\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547649453043\" id=\"ux_sub_div_1547649453043\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547649453043\" id=\"field_label_1547649453043\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547649453043\" id=\"ux_label_title_1547649453043\" value=\"If they assist with medication, do they follow correct procedures?\">If they assist with medication, do they follow correct procedures?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547649453043\" id=\"ux_tooltip_title_1547649453043\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547649453043\" id=\"ux_required_1547649453043\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547649453043\" id=\"ux_txt_check_box_1547649453043\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547649453043\" name=\"field_labels_1547649453043\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649453043\" id=\"ux_txt_check_box_lists_1547649453043\" value=\"Always\" checked=checked  class='checkbox_class_1547649453043 '><label name=\"ux_chk_label_lists_1547649453043\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649453043\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649453043\" id=\"ux_txt_check_box_lists_1547649453043\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547649453043 '><label name=\"ux_chk_label_lists_1547649453043\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649453043\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649453043\" id=\"ux_txt_check_box_lists_1547649453043\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547649453043 '><label name=\"ux_chk_label_lists_1547649453043\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649453043\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649453043\" id=\"ux_txt_check_box_lists_1547649453043\" value=\"Not at all\" checked=checked  class='checkbox_class_1547649453043 '><label name=\"ux_chk_label_lists_1547649453043\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649453043\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547649453043\" id=\"ux_txt_hidden_label_1547649453043\" value=\"If they assist with medication, do they follow correct procedures?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547649453043\" id=\"ux_text_appear_after_counter_1547649453043\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547649453043\" id=\"ux_txt_hidden_control_type_1547649453043\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547649474315\" id=\"ux_sub_div_1547649474315\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547649474315\" id=\"field_label_1547649474315\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547649474315\" id=\"ux_label_title_1547649474315\" value=\"Do they work well as a team where appropriate?\">Do they work well as a team where appropriate?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547649474315\" id=\"ux_tooltip_title_1547649474315\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547649474315\" id=\"ux_required_1547649474315\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547649474315\" id=\"ux_txt_check_box_1547649474315\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547649474315\" name=\"field_labels_1547649474315\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649474315\" id=\"ux_txt_check_box_lists_1547649474315\" value=\"Always\" checked=checked  class='checkbox_class_1547649474315 '><label name=\"ux_chk_label_lists_1547649474315\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649474315\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649474315\" id=\"ux_txt_check_box_lists_1547649474315\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547649474315 '><label name=\"ux_chk_label_lists_1547649474315\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649474315\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649474315\" id=\"ux_txt_check_box_lists_1547649474315\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547649474315 '><label name=\"ux_chk_label_lists_1547649474315\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649474315\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649474315\" id=\"ux_txt_check_box_lists_1547649474315\" value=\"Not at all\" checked=checked  class='checkbox_class_1547649474315 '><label name=\"ux_chk_label_lists_1547649474315\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649474315\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547649474315\" id=\"ux_txt_hidden_label_1547649474315\" value=\"Do they work well as a team where appropriate?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547649474315\" id=\"ux_text_appear_after_counter_1547649474315\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547649474315\" id=\"ux_txt_hidden_control_type_1547649474315\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547649580155\" id=\"ux_sub_div_1547649580155\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547649580155\" id=\"field_label_1547649580155\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547649580155\" id=\"ux_label_title_1547649580155\" value=\"Do they treat your home in a respectful manner?\">Do they treat your home in a respectful manner?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547649580155\" id=\"ux_tooltip_title_1547649580155\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547649580155\" id=\"ux_required_1547649580155\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547649580155\" id=\"ux_txt_check_box_1547649580155\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547649580155\" name=\"field_labels_1547649580155\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649580155\" id=\"ux_txt_check_box_lists_1547649580155\" value=\"Always\" checked=checked  class='checkbox_class_1547649580155 '><label name=\"ux_chk_label_lists_1547649580155\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649580155\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649580155\" id=\"ux_txt_check_box_lists_1547649580155\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547649580155 '><label name=\"ux_chk_label_lists_1547649580155\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649580155\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649580155\" id=\"ux_txt_check_box_lists_1547649580155\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547649580155 '><label name=\"ux_chk_label_lists_1547649580155\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649580155\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649580155\" id=\"ux_txt_check_box_lists_1547649580155\" value=\"Not at all\" checked=checked  class='checkbox_class_1547649580155 '><label name=\"ux_chk_label_lists_1547649580155\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649580155\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547649580155\" id=\"ux_txt_hidden_label_1547649580155\" value=\"Do they treat your home in a respectful manner?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547649580155\" id=\"ux_text_appear_after_counter_1547649580155\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547649580155\" id=\"ux_txt_hidden_control_type_1547649580155\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547649623155\" id=\"ux_sub_div_1547649623155\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547649623155\" id=\"field_label_1547649623155\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547649623155\" id=\"ux_label_title_1547649623155\" value=\"If you have had a change of worker, do they always know what to do?\">If you have had a change of worker, do they always know what to do?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547649623155\" id=\"ux_tooltip_title_1547649623155\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547649623155\" id=\"ux_required_1547649623155\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547649623155\" id=\"ux_txt_check_box_1547649623155\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547649623155\" name=\"field_labels_1547649623155\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649623155\" id=\"ux_txt_check_box_lists_1547649623155\" value=\"Always\" checked=checked  class='checkbox_class_1547649623155 '><label name=\"ux_chk_label_lists_1547649623155\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649623155\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649623155\" id=\"ux_txt_check_box_lists_1547649623155\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547649623155 '><label name=\"ux_chk_label_lists_1547649623155\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649623155\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649623155\" id=\"ux_txt_check_box_lists_1547649623155\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547649623155 '><label name=\"ux_chk_label_lists_1547649623155\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649623155\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649623155\" id=\"ux_txt_check_box_lists_1547649623155\" value=\"Not at all\" checked=checked  class='checkbox_class_1547649623155 '><label name=\"ux_chk_label_lists_1547649623155\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649623155\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547649623155\" id=\"ux_txt_hidden_label_1547649623155\" value=\"If you have had a change of worker, do they always know what to do?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547649623155\" id=\"ux_text_appear_after_counter_1547649623155\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547649623155\" id=\"ux_txt_hidden_control_type_1547649623155\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547649655170\" id=\"ux_sub_div_1547649655170\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547649655170\" id=\"field_label_1547649655170\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547649655170\" id=\"ux_label_title_1547649655170\" value=\"Are you confident that they will not harm you and keep you safe?\">Are you confident that they will not harm you and keep you safe?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547649655170\" id=\"ux_tooltip_title_1547649655170\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547649655170\" id=\"ux_required_1547649655170\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547649655170\" id=\"ux_txt_check_box_1547649655170\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547649655170\" name=\"field_labels_1547649655170\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649655170\" id=\"ux_txt_check_box_lists_1547649655170\" value=\"Always\" checked=checked  class='checkbox_class_1547649655170 '><label name=\"ux_chk_label_lists_1547649655170\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649655170\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649655170\" id=\"ux_txt_check_box_lists_1547649655170\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547649655170 '><label name=\"ux_chk_label_lists_1547649655170\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649655170\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649655170\" id=\"ux_txt_check_box_lists_1547649655170\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547649655170 '><label name=\"ux_chk_label_lists_1547649655170\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649655170\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649655170\" id=\"ux_txt_check_box_lists_1547649655170\" value=\"Not at all\" checked=checked  class='checkbox_class_1547649655170 '><label name=\"ux_chk_label_lists_1547649655170\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649655170\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547649655170\" id=\"ux_txt_hidden_label_1547649655170\" value=\"Are you confident that they will not harm you and keep you safe?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547649655170\" id=\"ux_text_appear_after_counter_1547649655170\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547649655170\" id=\"ux_txt_hidden_control_type_1547649655170\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547649669363\" id=\"ux_sub_div_1547649669363\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547649669363\" id=\"field_label_1547649669363\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547649669363\" id=\"ux_label_title_1547649669363\" value=\"Do you agree that they are well trained?\">Do you agree that they are well trained?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547649669363\" id=\"ux_tooltip_title_1547649669363\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547649669363\" id=\"ux_required_1547649669363\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547649669363\" id=\"ux_txt_check_box_1547649669363\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547649669363\" name=\"field_labels_1547649669363\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649669363\" id=\"ux_txt_check_box_lists_1547649669363\" value=\"Always\" checked=checked  class='checkbox_class_1547649669363 '><label name=\"ux_chk_label_lists_1547649669363\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649669363\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649669363\" id=\"ux_txt_check_box_lists_1547649669363\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547649669363 '><label name=\"ux_chk_label_lists_1547649669363\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649669363\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649669363\" id=\"ux_txt_check_box_lists_1547649669363\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547649669363 '><label name=\"ux_chk_label_lists_1547649669363\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649669363\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649669363\" id=\"ux_txt_check_box_lists_1547649669363\" value=\"Not at all\" checked=checked  class='checkbox_class_1547649669363 '><label name=\"ux_chk_label_lists_1547649669363\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649669363\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547649669363\" id=\"ux_txt_hidden_label_1547649669363\" value=\"Do you agree that they are well trained?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547649669363\" id=\"ux_text_appear_after_counter_1547649669363\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547649669363\" id=\"ux_txt_hidden_control_type_1547649669363\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547649685482\" id=\"ux_sub_div_1547649685482\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547649685482\" id=\"field_label_1547649685482\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547649685482\" id=\"ux_label_title_1547649685482\" value=\"Do you agree that all information about you is handled in confidence?\">Do you agree that all information about you is handled in confidence?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547649685482\" id=\"ux_tooltip_title_1547649685482\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547649685482\" id=\"ux_required_1547649685482\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547649685482\" id=\"ux_txt_check_box_1547649685482\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547649685482\" name=\"field_labels_1547649685482\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649685482\" id=\"ux_txt_check_box_lists_1547649685482\" value=\"Always\" checked=checked  class='checkbox_class_1547649685482 '><label name=\"ux_chk_label_lists_1547649685482\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649685482\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649685482\" id=\"ux_txt_check_box_lists_1547649685482\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547649685482 '><label name=\"ux_chk_label_lists_1547649685482\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649685482\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649685482\" id=\"ux_txt_check_box_lists_1547649685482\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547649685482 '><label name=\"ux_chk_label_lists_1547649685482\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649685482\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649685482\" id=\"ux_txt_check_box_lists_1547649685482\" value=\"Not at all\" checked=checked  class='checkbox_class_1547649685482 '><label name=\"ux_chk_label_lists_1547649685482\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649685482\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547649685482\" id=\"ux_txt_hidden_label_1547649685482\" value=\"Do you agree that all information about you is handled in confidence?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547649685482\" id=\"ux_text_appear_after_counter_1547649685482\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547649685482\" id=\"ux_txt_hidden_control_type_1547649685482\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547649713001\" id=\"ux_sub_div_1547649713001\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547649713001\" id=\"field_label_1547649713001\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547649713001\" id=\"ux_label_title_1547649713001\" value=\"Are you satisfied that carers will not breach confidentiality?\">Are you satisfied that carers will not breach confidentiality?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547649713001\" id=\"ux_tooltip_title_1547649713001\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547649713001\" id=\"ux_required_1547649713001\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547649713001\" id=\"ux_txt_check_box_1547649713001\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547649713001\" name=\"field_labels_1547649713001\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649713001\" id=\"ux_txt_check_box_lists_1547649713001\" value=\"Always\" checked=checked  class='checkbox_class_1547649713001 '><label name=\"ux_chk_label_lists_1547649713001\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649713001\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649713001\" id=\"ux_txt_check_box_lists_1547649713001\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547649713001 '><label name=\"ux_chk_label_lists_1547649713001\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649713001\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649713001\" id=\"ux_txt_check_box_lists_1547649713001\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547649713001 '><label name=\"ux_chk_label_lists_1547649713001\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649713001\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649713001\" id=\"ux_txt_check_box_lists_1547649713001\" value=\"Not at all\" checked=checked  class='checkbox_class_1547649713001 '><label name=\"ux_chk_label_lists_1547649713001\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649713001\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547649713001\" id=\"ux_txt_hidden_label_1547649713001\" value=\"Are you satisfied that carers will not breach confidentiality?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547649713001\" id=\"ux_text_appear_after_counter_1547649713001\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547649713001\" id=\"ux_txt_hidden_control_type_1547649713001\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547649724794\" id=\"ux_sub_div_1547649724794\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547649724794\" id=\"field_label_1547649724794\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547649724794\" id=\"ux_label_title_1547649724794\" value=\"Do you agree that our carers seem to know what they are doing?\">Do you agree that our carers seem to know what they are doing?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547649724794\" id=\"ux_tooltip_title_1547649724794\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:\" aria-required=\"true\" name=\"ux_required_1547649724794\" id=\"ux_required_1547649724794\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547649724794\" id=\"ux_txt_check_box_1547649724794\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547649724794\" name=\"field_labels_1547649724794\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649724794\" id=\"ux_txt_check_box_lists_1547649724794\" value=\"Always\" checked=checked  class='checkbox_class_1547649724794 '><label name=\"ux_chk_label_lists_1547649724794\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649724794\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649724794\" id=\"ux_txt_check_box_lists_1547649724794\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547649724794 '><label name=\"ux_chk_label_lists_1547649724794\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649724794\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649724794\" id=\"ux_txt_check_box_lists_1547649724794\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547649724794 '><label name=\"ux_chk_label_lists_1547649724794\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649724794\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547649724794\" id=\"ux_txt_check_box_lists_1547649724794\" value=\"Not at all\" checked=checked  class='checkbox_class_1547649724794 '><label name=\"ux_chk_label_lists_1547649724794\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547649724794\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547649724794\" id=\"ux_txt_hidden_label_1547649724794\" value=\"Do you agree that our carers seem to know what they are doing?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547649724794\" id=\"ux_text_appear_after_counter_1547649724794\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547649724794\" id=\"ux_txt_hidden_control_type_1547649724794\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547650039841\" id=\"ux_sub_div_1547650039841\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547650039841\" id=\"field_label_1547650039841\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547650039841\" id=\"ux_label_title_1547650039841\" value=\"Are you confident in their abilities?\">Are you confident in their abilities?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547650039841\" id=\"ux_tooltip_title_1547650039841\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547650039841\" id=\"ux_required_1547650039841\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547650039841\" id=\"ux_txt_check_box_1547650039841\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547650039841\" name=\"field_labels_1547650039841\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650039841\" id=\"ux_txt_check_box_lists_1547650039841\" value=\"Always\" checked=checked  class='checkbox_class_1547650039841 '><label name=\"ux_chk_label_lists_1547650039841\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650039841\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650039841\" id=\"ux_txt_check_box_lists_1547650039841\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547650039841 '><label name=\"ux_chk_label_lists_1547650039841\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650039841\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650039841\" id=\"ux_txt_check_box_lists_1547650039841\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547650039841 '><label name=\"ux_chk_label_lists_1547650039841\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650039841\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650039841\" id=\"ux_txt_check_box_lists_1547650039841\" value=\"Not at all\" checked=checked  class='checkbox_class_1547650039841 '><label name=\"ux_chk_label_lists_1547650039841\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650039841\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547650039841\" id=\"ux_txt_hidden_label_1547650039841\" value=\"Are you confident in their abilities?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547650039841\" id=\"ux_text_appear_after_counter_1547650039841\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547650039841\" id=\"ux_txt_hidden_control_type_1547650039841\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547650082690\" id=\"ux_sub_div_1547650082690\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547650082690\" id=\"field_label_1547650082690\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547650082690\" id=\"ux_label_title_1547650082690\" value=\"Do you agree that they are given clear instruction about what to do?\">Do you agree that they are given clear instruction about what to do?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547650082690\" id=\"ux_tooltip_title_1547650082690\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547650082690\" id=\"ux_required_1547650082690\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547650082690\" id=\"ux_txt_check_box_1547650082690\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547650082690\" name=\"field_labels_1547650082690\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650082690\" id=\"ux_txt_check_box_lists_1547650082690\" value=\"Always\" checked=checked  class='checkbox_class_1547650082690 '><label name=\"ux_chk_label_lists_1547650082690\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650082690\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650082690\" id=\"ux_txt_check_box_lists_1547650082690\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547650082690 '><label name=\"ux_chk_label_lists_1547650082690\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650082690\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650082690\" id=\"ux_txt_check_box_lists_1547650082690\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547650082690 '><label name=\"ux_chk_label_lists_1547650082690\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650082690\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650082690\" id=\"ux_txt_check_box_lists_1547650082690\" value=\"Not at all\" checked=checked  class='checkbox_class_1547650082690 '><label name=\"ux_chk_label_lists_1547650082690\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650082690\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547650082690\" id=\"ux_txt_hidden_label_1547650082690\" value=\"Do you agree that they are given clear instruction about what to do?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547650082690\" id=\"ux_text_appear_after_counter_1547650082690\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547650082690\" id=\"ux_txt_hidden_control_type_1547650082690\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547650166553\" id=\"ux_sub_div_1547650166553\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547650166553\" id=\"field_label_1547650166553\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547650166553\" id=\"ux_label_title_1547650166553\" value=\"Are you confident that any complaint you make will be investigated?\">Are you confident that any complaint you make will be investigated?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547650166553\" id=\"ux_tooltip_title_1547650166553\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547650166553\" id=\"ux_required_1547650166553\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547650166553\" id=\"ux_txt_check_box_1547650166553\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547650166553\" name=\"field_labels_1547650166553\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650166553\" id=\"ux_txt_check_box_lists_1547650166553\" value=\"Always\" checked=checked  class='checkbox_class_1547650166553 '><label name=\"ux_chk_label_lists_1547650166553\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650166553\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650166553\" id=\"ux_txt_check_box_lists_1547650166553\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547650166553 '><label name=\"ux_chk_label_lists_1547650166553\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650166553\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650166553\" id=\"ux_txt_check_box_lists_1547650166553\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547650166553 '><label name=\"ux_chk_label_lists_1547650166553\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650166553\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650166553\" id=\"ux_txt_check_box_lists_1547650166553\" value=\"Not at all\" checked=checked  class='checkbox_class_1547650166553 '><label name=\"ux_chk_label_lists_1547650166553\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650166553\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547650166553\" id=\"ux_txt_hidden_label_1547650166553\" value=\"Are you confident that any complaint you make will be investigated?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547650166553\" id=\"ux_text_appear_after_counter_1547650166553\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547650166553\" id=\"ux_txt_hidden_control_type_1547650166553\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547650188122\" id=\"ux_sub_div_1547650188122\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547650188122\" id=\"field_label_1547650188122\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547650188122\" id=\"ux_label_title_1547650188122\" value=\"Do carers record accurately in the attendance record?\">Do carers record accurately in the attendance record?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547650188122\" id=\"ux_tooltip_title_1547650188122\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547650188122\" id=\"ux_required_1547650188122\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547650188122\" id=\"ux_txt_check_box_1547650188122\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547650188122\" name=\"field_labels_1547650188122\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650188122\" id=\"ux_txt_check_box_lists_1547650188122\" value=\"Always\" checked=checked  class='checkbox_class_1547650188122 '><label name=\"ux_chk_label_lists_1547650188122\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650188122\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650188122\" id=\"ux_txt_check_box_lists_1547650188122\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547650188122 '><label name=\"ux_chk_label_lists_1547650188122\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650188122\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650188122\" id=\"ux_txt_check_box_lists_1547650188122\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547650188122 '><label name=\"ux_chk_label_lists_1547650188122\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650188122\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650188122\" id=\"ux_txt_check_box_lists_1547650188122\" value=\"Not at all\" checked=checked  class='checkbox_class_1547650188122 '><label name=\"ux_chk_label_lists_1547650188122\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650188122\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547650188122\" id=\"ux_txt_hidden_label_1547650188122\" value=\"Do carers record accurately in the attendance record?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547650188122\" id=\"ux_text_appear_after_counter_1547650188122\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547650188122\" id=\"ux_txt_hidden_control_type_1547650188122\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547650205370\" id=\"ux_sub_div_1547650205370\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547650205370\" id=\"field_label_1547650205370\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547650205370\" id=\"ux_label_title_1547650205370\" value=\"When you have had to make contact with us have you been dealt with promptly?\">When you have had to make contact with us have you been dealt with promptly?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547650205370\" id=\"ux_tooltip_title_1547650205370\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547650205370\" id=\"ux_required_1547650205370\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547650205370\" id=\"ux_txt_check_box_1547650205370\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547650205370\" name=\"field_labels_1547650205370\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650205370\" id=\"ux_txt_check_box_lists_1547650205370\" value=\"Always\" checked=checked  class='checkbox_class_1547650205370 '><label name=\"ux_chk_label_lists_1547650205370\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650205370\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650205370\" id=\"ux_txt_check_box_lists_1547650205370\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547650205370 '><label name=\"ux_chk_label_lists_1547650205370\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650205370\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650205370\" id=\"ux_txt_check_box_lists_1547650205370\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547650205370 '><label name=\"ux_chk_label_lists_1547650205370\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650205370\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650205370\" id=\"ux_txt_check_box_lists_1547650205370\" value=\"Not at all\" checked=checked  class='checkbox_class_1547650205370 '><label name=\"ux_chk_label_lists_1547650205370\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650205370\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547650205370\" id=\"ux_txt_hidden_label_1547650205370\" value=\"When you have had to make contact with us have you been dealt with promptly?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547650205370\" id=\"ux_text_appear_after_counter_1547650205370\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547650205370\" id=\"ux_txt_hidden_control_type_1547650205370\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547650228098\" id=\"ux_sub_div_1547650228098\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547650228098\" id=\"field_label_1547650228098\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547650228098\" id=\"ux_label_title_1547650228098\" value=\"Are phone calls returned quickly?\">Are phone calls returned quickly?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547650228098\" id=\"ux_tooltip_title_1547650228098\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547650228098\" id=\"ux_required_1547650228098\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547650228098\" id=\"ux_txt_check_box_1547650228098\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547650228098\" name=\"field_labels_1547650228098\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650228098\" id=\"ux_txt_check_box_lists_1547650228098\" value=\"Always\" checked=checked  class='checkbox_class_1547650228098 '><label name=\"ux_chk_label_lists_1547650228098\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650228098\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650228098\" id=\"ux_txt_check_box_lists_1547650228098\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547650228098 '><label name=\"ux_chk_label_lists_1547650228098\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650228098\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650228098\" id=\"ux_txt_check_box_lists_1547650228098\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547650228098 '><label name=\"ux_chk_label_lists_1547650228098\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650228098\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650228098\" id=\"ux_txt_check_box_lists_1547650228098\" value=\"Not at all\" checked=checked  class='checkbox_class_1547650228098 '><label name=\"ux_chk_label_lists_1547650228098\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650228098\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547650228098\" id=\"ux_txt_hidden_label_1547650228098\" value=\"Are phone calls returned quickly?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547650228098\" id=\"ux_text_appear_after_counter_1547650228098\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547650228098\" id=\"ux_txt_hidden_control_type_1547650228098\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547650297154\" id=\"ux_sub_div_1547650297154\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547650297154\" id=\"field_label_1547650297154\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547650297154\" id=\"ux_label_title_1547650297154\" value=\"Are office staff polite and courteous?\">Are office staff polite and courteous?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547650297154\" id=\"ux_tooltip_title_1547650297154\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547650297154\" id=\"ux_required_1547650297154\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547650297154\" id=\"ux_txt_check_box_1547650297154\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547650297154\" name=\"field_labels_1547650297154\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650297154\" id=\"ux_txt_check_box_lists_1547650297154\" value=\"Always\" checked=checked  class='checkbox_class_1547650297154 '><label name=\"ux_chk_label_lists_1547650297154\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650297154\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650297154\" id=\"ux_txt_check_box_lists_1547650297154\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547650297154 '><label name=\"ux_chk_label_lists_1547650297154\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650297154\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650297154\" id=\"ux_txt_check_box_lists_1547650297154\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547650297154 '><label name=\"ux_chk_label_lists_1547650297154\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650297154\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650297154\" id=\"ux_txt_check_box_lists_1547650297154\" value=\"Not at all\" checked=checked  class='checkbox_class_1547650297154 '><label name=\"ux_chk_label_lists_1547650297154\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650297154\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547650297154\" id=\"ux_txt_hidden_label_1547650297154\" value=\"Are office staff polite and courteous?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547650297154\" id=\"ux_text_appear_after_counter_1547650297154\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547650297154\" id=\"ux_txt_hidden_control_type_1547650297154\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547650315842\" id=\"ux_sub_div_1547650315842\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547650315842\" id=\"field_label_1547650315842\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547650315842\" id=\"ux_label_title_1547650315842\" value=\"Do we make the changes to your service as required?\">Do we make the changes to your service as required?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547650315842\" id=\"ux_tooltip_title_1547650315842\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547650315842\" id=\"ux_required_1547650315842\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547650315842\" id=\"ux_txt_check_box_1547650315842\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547650315842\" name=\"field_labels_1547650315842\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650315842\" id=\"ux_txt_check_box_lists_1547650315842\" value=\"Always\" checked=checked  class='checkbox_class_1547650315842 '><label name=\"ux_chk_label_lists_1547650315842\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650315842\" value=\"Always\">Always<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650315842\" id=\"ux_txt_check_box_lists_1547650315842\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547650315842 '><label name=\"ux_chk_label_lists_1547650315842\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650315842\" value=\"Most of the time \">Most of the time<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650315842\" id=\"ux_txt_check_box_lists_1547650315842\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547650315842 '><label name=\"ux_chk_label_lists_1547650315842\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650315842\" value=\"Sometimes\">Sometimes<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650315842\" id=\"ux_txt_check_box_lists_1547650315842\" value=\"Not at all\" checked=checked  class='checkbox_class_1547650315842 '><label name=\"ux_chk_label_lists_1547650315842\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650315842\" value=\"Not at all\">D Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547650315842\" id=\"ux_txt_hidden_label_1547650315842\" value=\"Do we make the changes to your service as required?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547650315842\" id=\"ux_text_appear_after_counter_1547650315842\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547650315842\" id=\"ux_txt_hidden_control_type_1547650315842\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547650340897\" id=\"ux_sub_div_1547650340897\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547650340897\" id=\"field_label_1547650340897\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547650340897\" id=\"ux_label_title_1547650340897\" value=\"Please detail any \u201cC and D\u201d answers\">Please detail any \u201cC and D\u201d answers<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547650340897\" id=\"ux_tooltip_title_1547650340897\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:\" aria-required=\"true\" name=\"ux_required_1547650340897\" id=\"ux_required_1547650340897\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<textarea rows=\"2\" style=\"\" placeholder=\"\" name=\"ux_txt_singal_line_text_1547650340897\" onkeyup=\"only_characters_contact_bank_2765(event,1547650340897,'50','Characters Left');\" id=\"ux_txt_singal_line_text_1547650340897\"class='input-layout-field-contact-bank_2765 untitled_control ' type=\"text\" autocomplete=\"off\" ><\/textarea>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547650340897\" id=\"ux_txt_hidden_label_1547650340897\" value=\"Please detail any \u201cC and D\u201d answers\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547650340897\" id=\"ux_text_appear_after_counter_1547650340897\">Characters Left<\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547650340897\" id=\"ux_txt_hidden_control_type_1547650340897\" value=\"paragraph\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547650430210\" id=\"ux_sub_div_1547650430210\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547650430210\" id=\"field_label_1547650430210\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547650430210\" id=\"ux_label_title_1547650430210\" value=\"Does it help you to keep your independence?\">Does it help you to keep your independence?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547650430210\" id=\"ux_tooltip_title_1547650430210\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547650430210\" id=\"ux_required_1547650430210\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547650430210\" id=\"ux_txt_check_box_1547650430210\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547650430210\" name=\"field_labels_1547650430210\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650430210\" id=\"ux_txt_check_box_lists_1547650430210\" value=\"Always\" checked=checked  class='checkbox_class_1547650430210 '><label name=\"ux_chk_label_lists_1547650430210\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650430210\" value=\"Always\">It helps a lot<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650430210\" id=\"ux_txt_check_box_lists_1547650430210\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547650430210 '><label name=\"ux_chk_label_lists_1547650430210\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650430210\" value=\"Most of the time \">It helps a little<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650430210\" id=\"ux_txt_check_box_lists_1547650430210\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547650430210 '><label name=\"ux_chk_label_lists_1547650430210\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650430210\" value=\"Sometimes\">It doesn\u2019t help at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547650430210\" id=\"ux_txt_hidden_label_1547650430210\" value=\"Does it help you to keep your independence?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547650430210\" id=\"ux_text_appear_after_counter_1547650430210\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547650430210\" id=\"ux_txt_hidden_control_type_1547650430210\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547650515944\" id=\"ux_sub_div_1547650515944\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547650515944\" id=\"field_label_1547650515944\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547650515944\" id=\"ux_label_title_1547650515944\" value=\"Does it help you to be clean and comfortable?\">Does it help you to be clean and comfortable?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547650515944\" id=\"ux_tooltip_title_1547650515944\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547650515944\" id=\"ux_required_1547650515944\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547650515944\" id=\"ux_txt_check_box_1547650515944\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547650515944\" name=\"field_labels_1547650515944\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650515944\" id=\"ux_txt_check_box_lists_1547650515944\" value=\"Always\" checked=checked  class='checkbox_class_1547650515944 '><label name=\"ux_chk_label_lists_1547650515944\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650515944\" value=\"Always\">It helps a lot<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650515944\" id=\"ux_txt_check_box_lists_1547650515944\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547650515944 '><label name=\"ux_chk_label_lists_1547650515944\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650515944\" value=\"Most of the time \">It helps a little<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650515944\" id=\"ux_txt_check_box_lists_1547650515944\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547650515944 '><label name=\"ux_chk_label_lists_1547650515944\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650515944\" value=\"Sometimes\">It doesn\u2019t help at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547650515944\" id=\"ux_txt_hidden_label_1547650515944\" value=\"Does it help you to be clean and comfortable?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547650515944\" id=\"ux_text_appear_after_counter_1547650515944\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547650515944\" id=\"ux_txt_hidden_control_type_1547650515944\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547650730944\" id=\"ux_sub_div_1547650730944\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547650730944\" id=\"field_label_1547650730944\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547650730944\" id=\"ux_label_title_1547650730944\" value=\"Does it help you to feel safe in your own home?\">Does it help you to feel safe in your own home?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547650730944\" id=\"ux_tooltip_title_1547650730944\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547650730944\" id=\"ux_required_1547650730944\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547650730944\" id=\"ux_txt_check_box_1547650730944\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547650730944\" name=\"field_labels_1547650730944\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650730944\" id=\"ux_txt_check_box_lists_1547650730944\" value=\"Always\" checked=checked  class='checkbox_class_1547650730944 '><label name=\"ux_chk_label_lists_1547650730944\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650730944\" value=\"Always\">It helps a lot<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650730944\" id=\"ux_txt_check_box_lists_1547650730944\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547650730944 '><label name=\"ux_chk_label_lists_1547650730944\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650730944\" value=\"Most of the time \">It helps a little<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650730944\" id=\"ux_txt_check_box_lists_1547650730944\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547650730944 '><label name=\"ux_chk_label_lists_1547650730944\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650730944\" value=\"Sometimes\">It doesn\u2019t help at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547650730944\" id=\"ux_txt_hidden_label_1547650730944\" value=\"Does it help you to feel safe in your own home?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547650730944\" id=\"ux_text_appear_after_counter_1547650730944\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547650730944\" id=\"ux_txt_hidden_control_type_1547650730944\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547650749922\" id=\"ux_sub_div_1547650749922\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547650749922\" id=\"field_label_1547650749922\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547650749922\" id=\"ux_label_title_1547650749922\" value=\"Does it assist in keeping contacts with other people as you want?\">Does it assist in keeping contacts with other people as you want?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547650749922\" id=\"ux_tooltip_title_1547650749922\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547650749922\" id=\"ux_required_1547650749922\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547650749922\" id=\"ux_txt_check_box_1547650749922\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547650749922\" name=\"field_labels_1547650749922\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650749922\" id=\"ux_txt_check_box_lists_1547650749922\" value=\"Always\" checked=checked  class='checkbox_class_1547650749922 '><label name=\"ux_chk_label_lists_1547650749922\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650749922\" value=\"Always\">It helps a lot<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650749922\" id=\"ux_txt_check_box_lists_1547650749922\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547650749922 '><label name=\"ux_chk_label_lists_1547650749922\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650749922\" value=\"Most of the time \">It helps a little<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547650749922\" id=\"ux_txt_check_box_lists_1547650749922\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547650749922 '><label name=\"ux_chk_label_lists_1547650749922\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547650749922\" value=\"Sometimes\">It doesn\u2019t help at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547650749922\" id=\"ux_txt_hidden_label_1547650749922\" value=\"Does it assist in keeping contacts with other people as you want?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547650749922\" id=\"ux_text_appear_after_counter_1547650749922\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547650749922\" id=\"ux_txt_hidden_control_type_1547650749922\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547651018161\" id=\"ux_sub_div_1547651018161\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547651018161\" id=\"field_label_1547651018161\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547651018161\" id=\"ux_label_title_1547651018161\" value=\"Does it assist with your leisure and interest activities?\">Does it assist with your leisure and interest activities?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547651018161\" id=\"ux_tooltip_title_1547651018161\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547651018161\" id=\"ux_required_1547651018161\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547651018161\" id=\"ux_txt_check_box_1547651018161\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547651018161\" name=\"field_labels_1547651018161\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547651018161\" id=\"ux_txt_check_box_lists_1547651018161\" value=\"Always\" checked=checked  class='checkbox_class_1547651018161 '><label name=\"ux_chk_label_lists_1547651018161\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547651018161\" value=\"Always\">It helps a lot<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547651018161\" id=\"ux_txt_check_box_lists_1547651018161\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547651018161 '><label name=\"ux_chk_label_lists_1547651018161\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547651018161\" value=\"Most of the time \">It helps a little<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547651018161\" id=\"ux_txt_check_box_lists_1547651018161\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547651018161 '><label name=\"ux_chk_label_lists_1547651018161\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547651018161\" value=\"Sometimes\">It doesn\u2019t help at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547651018161\" id=\"ux_txt_hidden_label_1547651018161\" value=\"Does it assist with your leisure and interest activities?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547651018161\" id=\"ux_text_appear_after_counter_1547651018161\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547651018161\" id=\"ux_txt_hidden_control_type_1547651018161\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547651037801\" id=\"ux_sub_div_1547651037801\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547651037801\" id=\"field_label_1547651037801\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547651037801\" id=\"ux_label_title_1547651037801\" value=\"Does it help you to get up and go to bed at times which suit you?\">Does it help you to get up and go to bed at times which suit you?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547651037801\" id=\"ux_tooltip_title_1547651037801\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547651037801\" id=\"ux_required_1547651037801\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547651037801\" id=\"ux_txt_check_box_1547651037801\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547651037801\" name=\"field_labels_1547651037801\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547651037801\" id=\"ux_txt_check_box_lists_1547651037801\" value=\"Always\" checked=checked  class='checkbox_class_1547651037801 '><label name=\"ux_chk_label_lists_1547651037801\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547651037801\" value=\"Always\">It helps a lot<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547651037801\" id=\"ux_txt_check_box_lists_1547651037801\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547651037801 '><label name=\"ux_chk_label_lists_1547651037801\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547651037801\" value=\"Most of the time \">It helps a little<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547651037801\" id=\"ux_txt_check_box_lists_1547651037801\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547651037801 '><label name=\"ux_chk_label_lists_1547651037801\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547651037801\" value=\"Sometimes\">It doesn\u2019t help at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547651037801\" id=\"ux_txt_hidden_label_1547651037801\" value=\"Does it help you to get up and go to bed at times which suit you?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547651037801\" id=\"ux_text_appear_after_counter_1547651037801\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547651037801\" id=\"ux_txt_hidden_control_type_1547651037801\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547651053600\" id=\"ux_sub_div_1547651053600\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547651053600\" id=\"field_label_1547651053600\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547651053600\" id=\"ux_label_title_1547651053600\" value=\"Does the service enable you to remain at home?\">Does the service enable you to remain at home?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547651053600\" id=\"ux_tooltip_title_1547651053600\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547651053600\" id=\"ux_required_1547651053600\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547651053600\" id=\"ux_txt_check_box_1547651053600\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547651053600\" name=\"field_labels_1547651053600\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547651053600\" id=\"ux_txt_check_box_lists_1547651053600\" value=\"Always\" checked=checked  class='checkbox_class_1547651053600 '><label name=\"ux_chk_label_lists_1547651053600\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547651053600\" value=\"Always\">It helps a lot<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547651053600\" id=\"ux_txt_check_box_lists_1547651053600\" value=\"Most of the time \" checked=checked  class='checkbox_class_1547651053600 '><label name=\"ux_chk_label_lists_1547651053600\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547651053600\" value=\"Most of the time \">It helps a little<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547651053600\" id=\"ux_txt_check_box_lists_1547651053600\" value=\"Sometimes\" checked=checked  class='checkbox_class_1547651053600 '><label name=\"ux_chk_label_lists_1547651053600\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547651053600\" value=\"Sometimes\">It doesn\u2019t help at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547651053600\" id=\"ux_txt_hidden_label_1547651053600\" value=\"Does the service enable you to remain at home?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547651053600\" id=\"ux_text_appear_after_counter_1547651053600\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547651053600\" id=\"ux_txt_hidden_control_type_1547651053600\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547651234625\" id=\"ux_sub_div_1547651234625\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547651234625\" id=\"field_label_1547651234625\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547651234625\" id=\"ux_label_title_1547651234625\" value=\"Please detail any \u201cC\u201d answers\">Please detail any \u201cC\u201d answers<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547651234625\" id=\"ux_tooltip_title_1547651234625\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:\" aria-required=\"true\" name=\"ux_required_1547651234625\" id=\"ux_required_1547651234625\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<textarea rows=\"2\" style=\"\" placeholder=\"\" name=\"ux_txt_singal_line_text_1547651234625\" onkeyup=\"only_characters_contact_bank_2765(event,1547651234625,'50','Characters Left');\" id=\"ux_txt_singal_line_text_1547651234625\"class='input-layout-field-contact-bank_2765 untitled_control ' type=\"text\" autocomplete=\"off\" ><\/textarea>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547651234625\" id=\"ux_txt_hidden_label_1547651234625\" value=\"Please detail any \u201cC\u201d answers\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547651234625\" id=\"ux_text_appear_after_counter_1547651234625\">Characters Left<\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547651234625\" id=\"ux_txt_hidden_control_type_1547651234625\" value=\"paragraph\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547651307601\" id=\"ux_sub_div_1547651307601\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547651307601\" id=\"field_label_1547651307601\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547651307601\" id=\"ux_label_title_1547651307601\" value=\"How satisfied are you in general with the services provided?\">How satisfied are you in general with the services provided?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547651307601\" id=\"ux_tooltip_title_1547651307601\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547651307601\" id=\"ux_required_1547651307601\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547651307601\" id=\"ux_txt_check_box_1547651307601\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547651307601\" name=\"field_labels_1547651307601\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547651307601\" id=\"ux_txt_check_box_lists_1547651307601\" value=\"Completely satisfied \" checked=checked  class='checkbox_class_1547651307601 '><label name=\"ux_chk_label_lists_1547651307601\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547651307601\" value=\"Completely satisfied \">Completely satisfied<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547651307601\" id=\"ux_txt_check_box_lists_1547651307601\" value=\"Nearly Satisfied       \" checked=checked  class='checkbox_class_1547651307601 '><label name=\"ux_chk_label_lists_1547651307601\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547651307601\" value=\"Nearly Satisfied       \">Nearly Satisfied<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547651307601\" id=\"ux_txt_check_box_lists_1547651307601\" value=\" Partly Satisfied      \" checked=checked  class='checkbox_class_1547651307601 '><label name=\"ux_chk_label_lists_1547651307601\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547651307601\" value=\" Partly Satisfied      \">Partly Satisfied<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547651307601\" id=\"ux_txt_check_box_lists_1547651307601\" value=\"Unsatisfied\" checked=checked  class='checkbox_class_1547651307601 '><label name=\"ux_chk_label_lists_1547651307601\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547651307601\" value=\"Unsatisfied\">Unsatisfied<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547651307601\" id=\"ux_txt_hidden_label_1547651307601\" value=\"How satisfied are you in general with the services provided?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547651307601\" id=\"ux_text_appear_after_counter_1547651307601\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547651307601\" id=\"ux_txt_hidden_control_type_1547651307601\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547651692791\" id=\"ux_sub_div_1547651692791\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547651692791\" id=\"field_label_1547651692791\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547651692791\" id=\"ux_label_title_1547651692791\" value=\"How satisfied are you in general with the services provided?\">How satisfied are you in general with the services provided?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547651692791\" id=\"ux_tooltip_title_1547651692791\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547651692791\" id=\"ux_required_1547651692791\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547651692791\" id=\"ux_txt_check_box_1547651692791\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547651692791\" name=\"field_labels_1547651692791\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547651692791\" id=\"ux_txt_check_box_lists_1547651692791\" value=\"Excellent \" checked=checked  class='checkbox_class_1547651692791 '><label name=\"ux_chk_label_lists_1547651692791\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547651692791\" value=\"Excellent \">Excellent<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547651692791\" id=\"ux_txt_check_box_lists_1547651692791\" value=\" Very Good       \" checked=checked  class='checkbox_class_1547651692791 '><label name=\"ux_chk_label_lists_1547651692791\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547651692791\" value=\" Very Good       \">Very Good<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547651692791\" id=\"ux_txt_check_box_lists_1547651692791\" value=\"Good       \" checked=checked  class='checkbox_class_1547651692791 '><label name=\"ux_chk_label_lists_1547651692791\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547651692791\" value=\"Good       \">Good<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547651692791\" id=\"ux_txt_check_box_lists_1547651692791\" value=\"Satisfactory \" checked=checked  class='checkbox_class_1547651692791 '><label name=\"ux_chk_label_lists_1547651692791\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547651692791\" value=\"Satisfactory \">Satisfactory<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547651692791\" id=\"ux_txt_check_box_lists_1547651692791\" value=\"Poor\" checked=checked  class='checkbox_class_1547651692791 '><label name=\"ux_chk_label_lists_1547651692791\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547651692791\" value=\"Poor\">Poor<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547651692791\" id=\"ux_txt_hidden_label_1547651692791\" value=\"How satisfied are you in general with the services provided?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547651692791\" id=\"ux_text_appear_after_counter_1547651692791\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547651692791\" id=\"ux_txt_hidden_control_type_1547651692791\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547651958695\" id=\"ux_sub_div_1547651958695\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547651958695\" id=\"field_label_1547651958695\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547651958695\" id=\"ux_label_title_1547651958695\" value=\"If you had a friend or neighbour needing support, would you recommend us?\">If you had a friend or neighbour needing support, would you recommend us?<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547651958695\" id=\"ux_tooltip_title_1547651958695\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:none\" aria-required=\"true\" name=\"ux_required_1547651958695\" id=\"ux_required_1547651958695\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span name=\"ux_txt_check_box_1547651958695\" id=\"ux_txt_check_box_1547651958695\" class= \"checkbox-label\">\n\t\t\t\t\t\t\t\t\t\t\t<label id=\"field_labels_1547651958695\" name=\"field_labels_1547651958695\"  style=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547651958695\" id=\"ux_txt_check_box_lists_1547651958695\" value=\"Definitely \" checked=checked  class='checkbox_class_1547651958695 '><label name=\"ux_chk_label_lists_1547651958695\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547651958695\" value=\"Definitely \">Definitely<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547651958695\" id=\"ux_txt_check_box_lists_1547651958695\" value=\"Probably \" checked=checked  class='checkbox_class_1547651958695 '><label name=\"ux_chk_label_lists_1547651958695\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547651958695\" value=\"Probably \">Probably<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547651958695\" id=\"ux_txt_check_box_lists_1547651958695\" value=\" Not certain\" checked=checked  class='checkbox_class_1547651958695 '><label name=\"ux_chk_label_lists_1547651958695\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547651958695\" value=\" Not certain\">Not certain<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input class=\"input_radio_button_contact_bank_2765\" type=\"radio\" name=\"ux_txt_check_box_lists_1547651958695\" id=\"ux_txt_check_box_lists_1547651958695\" value=\" Not at all\" checked=checked  class='checkbox_class_1547651958695 '><label name=\"ux_chk_label_lists_1547651958695\" class=\"input_radio_button_label_contact_bank_2765\" id=\"ux_chk_label_lists_1547651958695\" value=\" Not at all\">Not at all<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547651958695\" id=\"ux_txt_hidden_label_1547651958695\" value=\"If you had a friend or neighbour needing support, would you recommend us?\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547651958695\" id=\"ux_text_appear_after_counter_1547651958695\"><\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547651958695\" id=\"ux_txt_hidden_control_type_1547651958695\" value=\"radio-list\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547652188532\" id=\"ux_sub_div_1547652188532\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547652188532\" id=\"field_label_1547652188532\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547652188532\" id=\"ux_label_title_1547652188532\" value=\"Print Name to Sign\">Print Name to Sign<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547652188532\" id=\"ux_tooltip_title_1547652188532\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:\" aria-required=\"true\" name=\"ux_required_1547652188532\" id=\"ux_required_1547652188532\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input style=\"\"  placeholder=\"\" name=\"ux_txt_singal_line_text_1547652188532\" onkeyup=\"only_characters_contact_bank_2765(event,1547652188532,'50','Characters Left');\" id=\"ux_txt_singal_line_text_1547652188532\" class='input-layout-field-contact-bank_2765 untitled_control ' type=\"text\" value=\"\" autocomplete=\"off\"  >\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547652188532\" id=\"ux_txt_hidden_label_1547652188532\" value=\"Print Name to Sign\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547652188532\" id=\"ux_text_appear_after_counter_1547652188532\">Characters Left<\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547652188532\" id=\"ux_txt_hidden_control_type_1547652188532\" value=\"text\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div style=\"clear:both;\"class='sub_div ' name=\"ux_sub_div_1547652344678\" id=\"ux_sub_div_1547652344678\">\n\t\t\t\t\t\t\t\t\t<label style=\"\" class='label-layout-field-contact-bank_2765 control-label field_label' name=\"field_label_1547652344678\" id=\"field_label_1547652344678\">\n\t\t\t\t\t\t\t\t\t\t<span name=\"ux_label_title_1547652344678\" id=\"ux_label_title_1547652344678\" value=\"Date\">Date<\/span> :\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<i class=\"icon-custom-question tooltips label_tooltip_contact_bank\" name=\"ux_tooltip_title_1547652344678\" id=\"ux_tooltip_title_1547652344678\" data-original-title=\"\" data-placement=\"right\"><\/i>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"required\" style=\"display:\" aria-required=\"true\" name=\"ux_required_1547652344678\" id=\"ux_required_1547652344678\">*<\/span>\n\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input style=\"\"  placeholder=\"\" name=\"ux_txt_singal_line_text_1547652344678\" onkeyup=\"only_characters_contact_bank_2765(event,1547652344678,'50','Characters Left');\" id=\"ux_txt_singal_line_text_1547652344678\" class='input-layout-field-contact-bank_2765 untitled_control ' type=\"text\" value=\"\" autocomplete=\"off\"  >\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_label_1547652344678\" id=\"ux_txt_hidden_label_1547652344678\" value=\"Date\">\n\t\t\t\t\t\t\t\t\t<span class=\"cb-limit-input control-label field_label\" style=\"display:none;position:relative;\" name=\"ux_text_appear_after_counter_1547652344678\" id=\"ux_text_appear_after_counter_1547652344678\">Characters Left<\/span>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<input type=\"hidden\" name=\"ux_txt_hidden_control_type_1547652344678\" id=\"ux_txt_hidden_control_type_1547652344678\" value=\"text\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"col-md-12\" style=\"margin-top:2%;\">\n\t\t\t\t\t<input style=\"margin-left:-3%\" type=\"checkbox\" name=\"ux_chk_gdpr_compliance_agree_form_2765\" id=\"ux_chk_gdpr_compliance_agree_form_2765\" value=\"1\">\n\t\t\t\t\t<span id=\"gdpr_agree_text_form_contact_bank\" class=\"label-gdrp-compliance-style\">By using this form you agree with the storage and handling of your data by this website<\/span>\n\t\t\t\t\t<span id=\"ux_chk_validation_gdpr_form_contact_bank\" style=\"display:none\">*<\/span>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div style=\"clear: both;\">\n\t\t\t\t<input type=\"submit\" class=\"button-layout-contact-bank_2765\" name=\"ux_btn_save_changes\" id=\"ux_btn_save_changes\" onclick=\"submit_form_contact_bank_2765([1547640163229,1547640215176,1547640264768,1547643275584,1547643804784,1547643833442,1547643853353,1547643887777,1547646408078,1547646429380,1547646628078,1547646671118,1547646708982,1547646740150,1547646764583,1547646803765,1547647487469,1547647056746,1547647630685,1547647651036,1547647680956,1547647714949,1547647796084,1547647830308,1547648045636,1547649045283,1547649073019,1547649225378,1547649247172,1547649270907,1547649301204,1547649335379,1547649353418,1547649384050,1547649453043,1547649474315,1547649580155,1547649623155,1547649655170,1547649669363,1547649685482,1547649713001,1547649724794,1547650039841,1547650082690,1547650166553,1547650188122,1547650205370,1547650228098,1547650297154,1547650315842,1547650340897,1547650430210,1547650515944,1547650730944,1547650749922,1547651018161,1547651037801,1547651053600,1547651234625,1547651307601,1547651692791,1547651958695,1547652188532,1547652344678], '#ux_frm_main_container_2765', 'enable', 'http:\/\/djcareservices.com\/home\/', 'disable', '10', 'page', '', '')\" value=\"Submit\">\n\t\t\t<\/div>\n\t\t<\/form>\n\t<\/div>\n\t<script type=\"text\/javascript\">\n\tvar ajaxurl = \"http:\/\/djcareservices.com\/wp-admin\/admin-ajax.php\";\n\tjQuery(\".tooltips\").tooltip_tip({placement: \"right\"});\n\tif (typeof (base64_encode_contact_bank) != \"function\")\n\t{\n\t\tfunction base64_encode_contact_bank(data) {\n\t\t\tvar b64 = \"ABCDEFGHIJKLMNOPQRSTUVWXYZabcdefghijklmnopqrstuvwxyz0123456789+\/=\";\n\t\t\tvar o1, o2, o3, h1, h2, h3, h4, bits, i = 0,\n\t\t\t\t\tac = 0,\n\t\t\t\t\tenc = \"\",\n\t\t\t\t\ttmp_arr = [];\n\t\t\tif (!data) {\n\t\t\t\treturn data;\n\t\t\t}\n\t\t\tdo {\n\t\t\t\to1 = data.charCodeAt(i++);\n\t\t\t\to2 = data.charCodeAt(i++);\n\t\t\t\to3 = data.charCodeAt(i++);\n\t\t\t\tbits = o1 << 16 | o2 << 8 | o3;\n\t\t\t\th1 = bits >> 18 & 0x3f;\n\t\t\t\th2 = bits >> 12 & 0x3f;\n\t\t\t\th3 = bits >> 6 & 0x3f;\n\t\t\t\th4 = bits & 0x3f;\n\t\t\t\ttmp_arr[ac++] = b64.charAt(h1) + b64.charAt(h2) + b64.charAt(h3) + b64.charAt(h4);\n\t\t\t} while (i < data.length);\n\t\t\tenc = tmp_arr.join(\"\");\n\t\t\tvar r = data.length % 3;\n\t\t\treturn(r ? enc.slice(0, r - 3) : enc) + \"===\".slice(r || 3);\n\t\t}\n\t}\n\tif (typeof (overlay_loading_contact_bank_2765) !== \"function\")\n\t{\n\t\tfunction overlay_loading_contact_bank_2765(message) {\n\t\t\tvar overlay_opacity = jQuery(\"<div class=\\\"opacity_overlay\\\"><\/div>\");\n\t\t\tjQuery(\"body\").append(overlay_opacity);\n\t\t\tvar overlay = jQuery(\"<div class=\\\"loader_opacity\\\"><div class=\\\"processing_overlay\\\"><\/div><\/div>\");\n\t\t\tjQuery(\"body\").append(overlay);\n\t\t}\n\t}\n\tif (typeof (remove_overlay_contact_bank_2765) !== \"function\")\n\t{\n\t\tfunction remove_overlay_contact_bank_2765() {\n\t\t\tjQuery(\".loader_opacity\").remove();\n\t\t\tjQuery(\".opacity_overlay\").remove();\n\t\t}\n\t}\n\tif (typeof (only_characters_contact_bank_2765) !== \"function\")\n\t{\n\t\tfunction only_characters_contact_bank_2765(event, timestamp, max_limit, value) {\n\t\t\tvar content = jQuery(\"#ux_txt_singal_line_text_\" + timestamp).val();\n\t\t\tvar characters_length = content.length;\n\t\t\tmax_limit !== \"\" ? jQuery(\"#ux_txt_singal_line_text_\" + timestamp).attr(\"maxlength\", max_limit) : \"\";\n\t\t\tif (max_limit === \"\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_text_appear_after_counter_\" + timestamp).css(\"display\", \"none\");\n\t\t\t} else if (characters_length > max_limit) {\n\t\t\t\tvar lastIndex = content.lastIndexOf(\" \");\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(content.substring(0, lastIndex));\n\t\t\t\tjQuery(\"#ux_text_appear_after_counter_\" + timestamp).css(\"display\", \"block\").addClass(\"field_label\");\n\t\t\t\tjQuery(\"#ux_text_appear_after_counter_\" + timestamp).text(max_limit - characters_length + \" \" + value);\n\t\t\t} else {\n\t\t\t\tjQuery(\"#ux_text_appear_after_counter_\" + timestamp).css(\"display\", \"block\").addClass(\"field_label\");\n\t\t\t\tjQuery(\"#ux_text_appear_after_counter_\" + timestamp).text(max_limit - characters_length + \" \" + value);\n\t\t\t}\n\t\t}\n\t}\n\tif (typeof (only_digits_contact_bank_2765) !== \"function\")\n\t{\n\t\tfunction only_digits_contact_bank_2765(event, timestamp, max_limit, text_appear)\n\t\t{\n\t\t\tvar content = jQuery(\"#ux_txt_singal_line_text_\" + timestamp).val();\n\t\t\tvar words = content.split(\/\\s+\/);\n\t\t\tvar words_length = words.length;\n\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).removeAttr(\"maxlength\", \"\");\n\t\t\tvar value = text_appear;\n\t\t\tif (words_length > max_limit) {\n\t\t\t\tevent.preventDefault();\n\t\t\t\tvar lastIndex = content.lastIndexOf(\" \");\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(content.substring(0, lastIndex));\n\t\t\t\tjQuery(\"#ux_text_appear_after_counter_\" + timestamp).css(\"display\", \"block\").addClass(\"field_label\");\n\t\t\t\tif (max_limit > words_length)\n\t\t\t\t{\n\t\t\t\t\tjQuery(\"#ux_text_appear_after_counter_\" + timestamp).text(max_limit - words_length + \" \" + value);\n\t\t\t\t}\n\t\t\t}\n\t\t\telse\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_text_appear_after_counter_\" + timestamp).css(\"display\", \"block\").addClass(\"field_label\");\n\t\t\t\tjQuery(\"#ux_text_appear_after_counter_\" + timestamp).text(max_limit - words_length + \" \" + value);\n\t\t\t}\n\t\t}\n\t}\n\tif (typeof (apply_input_masking_contact_bank_2765) !== \"function\")\n\t{\n\t\tfunction apply_input_masking_contact_bank_2765(input_id, timestamp, input_mask_type, custom_mask_value) {\n\t\t\tswitch (input_mask_type) {\n\t\t\t\tcase \"none\":\n\t\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).unmask();\n\t\t\t\tbreak;\n\t\t\t\tcase \"us_phone\":\n\t\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).unmask();\n\t\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).mask(\"(999)999-9999\");\n\t\t\t\tbreak;\n\t\t\t\tcase \"date\":\n\t\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).unmask();\n\t\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).mask(\"99\/99\/9999\");\n\t\t\t\tbreak;\n\t\t\t\tcase \"custom\":\n\t\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).unmask();\n\t\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).mask(custom_mask_value);\n\t\t\t\tbreak;\n\t\t\t}\n\t\t}\n\t}\n\tif (typeof (change_label_placement_contact_bank_2765) !== \"function\")\n\t{\n\t\tfunction change_label_placement_contact_bank_2765(input_id, timestamp, label_placement_type, control_name)\n\t\t{\n\t\t\tswitch (label_placement_type)\n\t\t\t{\n\t\t\t\tcase \"above\":\n\t\t\t\t\tjQuery(\"#field_label_\" + timestamp).css(\"display\", \"block\");\n\t\t\t\t\tif (control_name == \"radio-list\" || control_name == \"checkbox-list\")\n\t\t\t\t\t{\n\t\t\t\t\t\tjQuery(\"#ux_txt_check_box_\" + timestamp).insertAfter(\"#field_label_\" + timestamp);\n\t\t\t\t\t}\n\t\t\t\t\telse\n\t\t\t\t\t{\n\t\t\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).insertAfter(\"#field_label_\" + timestamp);\n\t\t\t\t\t}\n\t\t\t\t\tjQuery(\"#ux_text_appear_after_counter_\" + timestamp).css({\"position\": \"\", \"margin-top\": \"\", \"margin-left\": \"\"});\n\t\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).css({\"display\": \"block\", \"margin-left\": \"9px\", \"margin-right\": \"0\"});\n\t\t\t\t\tjQuery(\"#ux_sub_div_\" + timestamp).removeClass(\"field_label\").removeClass(\"control-label\");\n\t\t\t\tbreak;\n\t\t\t\tcase \"below\":\n\t\t\t\t\tjQuery(\"#field_label_\" + timestamp).css(\"display\", \"block\");\n\t\t\t\t\tif (control_name == \"radio-list\" || control_name == \"checkbox-list\")\n\t\t\t\t\t{\n\t\t\t\t\t\tjQuery(\"#ux_txt_check_box_\" + timestamp).insertBefore(jQuery(\"#field_label_\" + timestamp).addClass(\"field_label\").addClass(\"control-label\"));\n\t\t\t\t\t}\n\t\t\t\t\telse\n\t\t\t\t\t{\n\t\t\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).insertBefore(jQuery(\"#field_label_\" + timestamp).addClass(\"field_label\").addClass(\"control-label\")).css({\"margin-right\": \"0\", \"margin-bottom\": \"-8% !important\"});\n\t\t\t\t\t}\n\t\t\t\t\tjQuery(\"#ux_text_appear_after_counter_\" + timestamp).css({\"position\": \"\"});\n\t\t\t\t\tjQuery(\"#ux_sub_div_\" + timestamp).addClass(\"field_label\").addClass(\"control-label\").css(\"padding-bottom\", \"10px\");\n\t\t\t\tbreak;\n\t\t\t\tcase \"left\":\n\t\t\t\t\tjQuery(\"#field_label_\" + timestamp).css(\"display\", \"\");\n\t\t\t\t\tif(control_name == \"radio-list\" || control_name == \"checkbox-list\")\n\t\t\t\t\t{\n\t\t\t\t\t\tjQuery(\"#ux_txt_check_box_\" + timestamp);\n\t\t\t\t\t}\n\t\t\t\t\tjQuery(\"#ux_text_appear_after_counter_\" + timestamp).css({\"position\": \"relative\", \"margin-top\": \"\", \"margin-left\": \"30%\"});\n\t\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).css({\"display\": \"inline-block\", \"margin-left\": \"0px\", \"margin-right\": \"0\"});\n\t\t\t\t\tjQuery(\"#ux_sub_div_\" + timestamp).addClass(\"field_label\").addClass(\"control-label\");\n\t\t\t\tbreak;\n\t\t\t\tcase \"right\":\n\t\t\t\t\tjQuery(\"#field_label_\" + timestamp).css(\"display\", \"\");\n\t\t\t\t\tif(control_name == \"radio-list\" || control_name == \"checkbox-list\")\n\t\t\t\t\t{\n\t\t\t\t\t\tjQuery(\"#ux_txt_check_box_\" + timestamp).prependTo(\"#field_label_\" + timestamp);\n\t\t\t\t\t}\n\t\t\t\t\tjQuery(\"#ux_text_appear_after_counter_\" + timestamp).css({\"position\": \"\", \"margin-top\": \"\", \"margin-left\": \"\"});\n\t\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).css({\"display\": \"inline-block\", \"margin-left\": \"0px\", \"margin-right\": \"5%\"});\n\t\t\t\t\tjQuery(\"#ux_sub_div_\" + timestamp).addClass(\"field_label\").addClass(\"control-label\");\n\t\t\t\tbreak;\n\t\t\t\tcase \"hidden\":\n\t\t\t\t\tjQuery(\"#field_label_\" + timestamp).addClass(\"field_label\").addClass(\"control-label\");\n\t\t\t\t\tjQuery(\"#ux_text_appear_after_counter_\" + timestamp).css({\"position\": \"\", \"margin-top\": \"\", \"margin-left\": \"\"});\n\t\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).css({\"display\": \"block\", \"margin-left\": \"9px\"});\n\t\t\t\t\tif(control_name == \"radio-list\" || control_name == \"checkbox-list\")\n\t\t\t\t\t{\n\t\t\t\t\t\tjQuery(\"#ux_txt_check_box_\" + timestamp).insertAfter(\"#field_label_\" + timestamp);\n\t\t\t\t\t}\n\t\t\t\t\telse\n\t\t\t\t\t{\n\t\t\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).insertAfter(\"#field_label_\" + timestamp).css({\"margin-right\": \"0\"});\n\t\t\t\t\t}\n\t\t\t\t\tjQuery(\"#field_label_\" + timestamp).css(\"display\", \"none\");\n\t\t\t\tbreak;\n\t\t\t}\n\t\t}\n\t}\n\tif (typeof (number_settings_contact_bank_2765) !== \"function\")\n\t{\n\t\tfunction number_settings_contact_bank_2765(timestamp, event, step_number_cb, min_number, max_number)\n\t\t{\n\t\t\tvar count = 0;\n\t\t\tvar step_count = 0;\n\t\t\tstep_number_cb = parseInt(step_number_cb);\n\t\t\tmin_number = parseInt(min_number);\n\t\t\tmax_number = parseInt(max_number);\n\t\t\tvar input_number = parseInt(jQuery(\"#ux_txt_singal_line_text_\" + timestamp).val());\n\t\t\tjQuery(\"#ux_text_appear_after_counter_\" + timestamp).css(\"display\", \"none\");\n\t\t\tif (min_number !== \"\" && max_number !== \"\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_btn_save_changes\").removeAttr(\"disabled\",\"disabled\");\n\t\t\t\tif (input_number > max_number)\n\t\t\t\t{\n\t\t\t\t\tcount = 1;\n\t\t\t\t}\n\t\t\t\telse if (jQuery.trim(input_number) < min_number)\n\t\t\t\t{\n\t\t\t\t\tcount = 1;\n\t\t\t\t}\n\t\t\t}\n\t\t\tif (input_number % step_number_cb !== 0 && step_number_cb !== \"\") {\n\t\t\t\tstep_count = 1;\n\t\t\t}\n\t\t\tif (count === 1 && step_count === 1) {\n\t\t\t\tjQuery(\"#ux_text_appear_after_counter_\" + timestamp).css(\"display\", \"block\").html(\"Please enter number between \" + min_number + \" and \" + max_number + \" Please Increment By \" + step_number_cb).addClass(\"field_label\");\n\t\t\t\tjQuery(\"#ux_btn_save_changes\").attr(\"disabled\",\"disabled\");\n\t\t\t}\n\t\t\telse if (step_count === 1)\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_text_appear_after_counter_\" + timestamp).css(\"display\", \"block\").html(\"Please Increment By \" + step_number_cb).addClass(\"field_label\");\n\t\t\t\tjQuery(\"#ux_btn_save_changes\").attr(\"disabled\",\"disabled\");\n\t\t\t}\n\t\t\telse if (count === 1)\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_text_appear_after_counter_\" + timestamp).css(\"display\", \"block\").html(\"Please enter number between \" + min_number + \" and \" + max_number + \"\").addClass(\"field_label\");\n\t\t\t\tjQuery(\"#ux_btn_save_changes\").attr(\"disabled\",\"disabled\");\n\t\t\t}\n\t\t\tif (input_number === \"\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_text_appear_after_counter_\" + timestamp).css(\"display\", \"none\");\n\t\t\t\tjQuery(\"#ux_btn_save_changes\").attr(\"disabled\",\"disabled\");\n\t\t\t}\n\t\t}\n\t}\n\tif (typeof (submit_form_contact_bank_2765) !== \"function\")\n\t{\n\t\tfunction submit_form_contact_bank_2765(controls_ids, form_name, save_submssion, page_url, submission_enable_disable, submission_limit, redirect_type, redirect_url,form_success_message)\n\t\t{\n\t\t\t\t\t\t\t\tvar form_id = \"10\";\n\t\t\t\t\t\t\tvar id_count = \"2\";\n\t\t\tvar url_redirect_after_submit = redirect_type == \"page\" ? page_url : redirect_url;\n\t\t\tjQuery(\"#ux_frm_main_container_2765\").validate({\n\t\t\t\terrorClass: \"custom-error\",\n\t\t\t\trules:\n\t\t\t\t{\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tux_txt_singal_line_text_1547640163229 :\n\t\t\t\t\t\t\t\t\t\t\t\t{\n\t\t\t\t\t\t\t\t\t\t\t\t\trequired: true\n\t\t\t\t\t\t\t\t\t\t\t\t},\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tux_txt_singal_line_text_1547640215176 :\n\t\t\t\t\t\t\t\t\t\t\t\t{\n\t\t\t\t\t\t\t\t\t\t\t\t\trequired: true\n\t\t\t\t\t\t\t\t\t\t\t\t},\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tux_txt_singal_line_text_1547640264768 :\n\t\t\t\t\t\t\t\t\t\t\t\t{\n\t\t\t\t\t\t\t\t\t\t\t\t\trequired: true\n\t\t\t\t\t\t\t\t\t\t\t\t},\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"ux_txt_check_box_lists_1547643275584[]\" :\n\t\t\t\t\t\t\t\t\t\t\t\t{\n\t\t\t\t\t\t\t\t\t\t\t\t\trequired: true\n\t\t\t\t\t\t\t\t\t\t\t\t},\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"ux_txt_check_box_lists_1547643804784[]\" :\n\t\t\t\t\t\t\t\t\t\t\t\t{\n\t\t\t\t\t\t\t\t\t\t\t\t\trequired: true\n\t\t\t\t\t\t\t\t\t\t\t\t},\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"ux_txt_check_box_lists_1547643833442[]\" :\n\t\t\t\t\t\t\t\t\t\t\t\t{\n\t\t\t\t\t\t\t\t\t\t\t\t\trequired: true\n\t\t\t\t\t\t\t\t\t\t\t\t},\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"ux_txt_check_box_lists_1547643853353[]\" :\n\t\t\t\t\t\t\t\t\t\t\t\t{\n\t\t\t\t\t\t\t\t\t\t\t\t\trequired: true\n\t\t\t\t\t\t\t\t\t\t\t\t},\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"ux_txt_check_box_lists_1547643887777[]\" :\n\t\t\t\t\t\t\t\t\t\t\t\t{\n\t\t\t\t\t\t\t\t\t\t\t\t\trequired: true\n\t\t\t\t\t\t\t\t\t\t\t\t},\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"ux_txt_check_box_lists_1547646408078[]\" :\n\t\t\t\t\t\t\t\t\t\t\t\t{\n\t\t\t\t\t\t\t\t\t\t\t\t\trequired: true\n\t\t\t\t\t\t\t\t\t\t\t\t},\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tux_txt_singal_line_text_1547646429380 :\n\t\t\t\t\t\t\t\t\t\t\t\t{\n\t\t\t\t\t\t\t\t\t\t\t\t\trequired: true\n\t\t\t\t\t\t\t\t\t\t\t\t},\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"ux_txt_check_box_lists_1547646628078[]\" :\n\t\t\t\t\t\t\t\t\t\t\t\t{\n\t\t\t\t\t\t\t\t\t\t\t\t\trequired: true\n\t\t\t\t\t\t\t\t\t\t\t\t},\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"ux_txt_check_box_lists_1547646671118[]\" :\n\t\t\t\t\t\t\t\t\t\t\t\t{\n\t\t\t\t\t\t\t\t\t\t\t\t\trequired: true\n\t\t\t\t\t\t\t\t\t\t\t\t},\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"ux_txt_check_box_lists_1547646708982[]\" :\n\t\t\t\t\t\t\t\t\t\t\t\t{\n\t\t\t\t\t\t\t\t\t\t\t\t\trequired: true\n\t\t\t\t\t\t\t\t\t\t\t\t},\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"ux_txt_check_box_lists_1547646740150[]\" :\n\t\t\t\t\t\t\t\t\t\t\t\t{\n\t\t\t\t\t\t\t\t\t\t\t\t\trequired: true\n\t\t\t\t\t\t\t\t\t\t\t\t},\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"ux_txt_check_box_lists_1547646764583[]\" :\n\t\t\t\t\t\t\t\t\t\t\t\t{\n\t\t\t\t\t\t\t\t\t\t\t\t\trequired: true\n\t\t\t\t\t\t\t\t\t\t\t\t},\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tux_txt_singal_line_text_1547646803765 :\n\t\t\t\t\t\t\t\t\t\t\t\t{\n\t\t\t\t\t\t\t\t\t\t\t\t\trequired: true\n\t\t\t\t\t\t\t\t\t\t\t\t},\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tux_txt_singal_line_text_1547647830308 :\n\t\t\t\t\t\t\t\t\t\t\t\t{\n\t\t\t\t\t\t\t\t\t\t\t\t\trequired: true\n\t\t\t\t\t\t\t\t\t\t\t\t},\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tux_txt_singal_line_text_1547648045636 :\n\t\t\t\t\t\t\t\t\t\t\t\t{\n\t\t\t\t\t\t\t\t\t\t\t\t\trequired: true\n\t\t\t\t\t\t\t\t\t\t\t\t},\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tux_txt_singal_line_text_1547649724794 :\n\t\t\t\t\t\t\t\t\t\t\t\t{\n\t\t\t\t\t\t\t\t\t\t\t\t\trequired: true\n\t\t\t\t\t\t\t\t\t\t\t\t},\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tux_txt_singal_line_text_1547650340897 :\n\t\t\t\t\t\t\t\t\t\t\t\t{\n\t\t\t\t\t\t\t\t\t\t\t\t\trequired: true\n\t\t\t\t\t\t\t\t\t\t\t\t},\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tux_txt_singal_line_text_1547651234625 :\n\t\t\t\t\t\t\t\t\t\t\t\t{\n\t\t\t\t\t\t\t\t\t\t\t\t\trequired: true\n\t\t\t\t\t\t\t\t\t\t\t\t},\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tux_txt_singal_line_text_1547652188532 :\n\t\t\t\t\t\t\t\t\t\t\t\t{\n\t\t\t\t\t\t\t\t\t\t\t\t\trequired: true\n\t\t\t\t\t\t\t\t\t\t\t\t},\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tux_txt_singal_line_text_1547652344678 :\n\t\t\t\t\t\t\t\t\t\t\t\t{\n\t\t\t\t\t\t\t\t\t\t\t\t\trequired: true\n\t\t\t\t\t\t\t\t\t\t\t\t},\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tux_chk_gdpr_compliance_agree_form_2765:\n\t\t\t\t\t{\n\t\t\t\t\trequired: true\n\t\t\t\t\t},\n\t\t\t\t},\n\t\t\t\tmessages:\n\t\t\t\t{\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tux_txt_singal_line_text_1547640163229: \"This field is required\",\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tux_txt_singal_line_text_1547640215176: \"This field is required\",\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tux_txt_singal_line_text_1547640264768: \"This field is required\",\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"ux_txt_check_box_lists_1547643275584[]\" : \"This field is required\",\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"ux_txt_check_box_lists_1547643804784[]\" : \"This field is required\",\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"ux_txt_check_box_lists_1547643833442[]\" : \"This field is required\",\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"ux_txt_check_box_lists_1547643853353[]\" : \"This field is required\",\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"ux_txt_check_box_lists_1547643887777[]\" : \"This field is required\",\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"ux_txt_check_box_lists_1547646408078[]\" : \"This field is required\",\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tux_txt_singal_line_text_1547646429380: \"This field is required\",\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"ux_txt_check_box_lists_1547646628078[]\" : \"This field is required\",\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"ux_txt_check_box_lists_1547646671118[]\" : \"This field is required\",\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"ux_txt_check_box_lists_1547646708982[]\" : \"This field is required\",\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"ux_txt_check_box_lists_1547646740150[]\" : \"This field is required\",\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"ux_txt_check_box_lists_1547646764583[]\" : \"This field is required\",\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tux_txt_singal_line_text_1547646803765: \"This field is required\",\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tux_txt_singal_line_text_1547647830308: \"This field is Required!\",\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tux_txt_singal_line_text_1547648045636: \"This field is required\",\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tux_txt_singal_line_text_1547649724794: \"This field is Required!\",\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tux_txt_singal_line_text_1547650340897: \"This field is required\",\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tux_txt_singal_line_text_1547651234625: \"This field is required\",\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tux_txt_singal_line_text_1547652188532: \"This field is required\",\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tux_txt_singal_line_text_1547652344678: \"This field is required\",\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tux_chk_gdpr_compliance_agree_form_2765: \"This field is Required!\",\n\t\t\t\t},\n\t\t\t\terrorPlacement: function(error, element)\n\t\t\t\t{\n\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent());\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent());\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent());\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent());\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent());\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent());\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent());\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent());\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent().children(\"label:last-child\"));\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent());\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\terror.insertAfter(element.parent());\n\t\t\t\t\t\t\t\t\t\t\t\t},\n\t\t\t\tsubmitHandler: function ()\n\t\t\t\t{\n\t\t\t\t\tjQuery(\"html, body\").animate({ scrollTop: 0 }, \"slow\");\n\t\t\t\t\tif ((submission_enable_disable == \"disable\") || (submission_enable_disable == \"enable\" && id_count < submission_limit))\n\t\t\t\t\t{\n\t\t\t\t\t\tjQuery(\"#form_error_message_frontend_2765\").css(\"display\", \"none\");\n\t\t\t\t\t\tjQuery(\"#form_success_message_frontend_2765\").css(\"display\", \"block\");\n\t\t\t\t\t\tjQuery(\"#success_message_text_2765\").text(\"Kindly wait until the form is submitted.\");\n\t\t\t\t\t}\n\t\t\t\t\tjQuery.post(ajaxurl, {\n\t\t\t\t\t\tform_id : form_id,\n\t\t\t\t\t\tsave_submssion : save_submssion,\n\t\t\t\t\t\tsubmission_limit : submission_limit,\n\t\t\t\t\t\tsubmission_enable_disable : submission_enable_disable,\n\t\t\t\t\t\tdata : base64_encode_contact_bank(jQuery(form_name).serialize()),\n\t\t\t\t\t\tcontrols_ids : JSON.stringify(controls_ids),\n\t\t\t\t\t\tparam : \"frontend_form_module\",\n\t\t\t\t\t\taction : \"contact_bank_frontend_ajax_call\"\n\t\t\t\t\t},\n\t\t\t\t\tfunction(data)\n\t\t\t\t\t{\n\t\t\t\t\t\tif ((submission_enable_disable == \"disable\") || (submission_enable_disable == \"enable\" && id_count < submission_limit))\n\t\t\t\t\t\t{\n\t\t\t\t\t\t\tjQuery(\"#form_success_message_frontend_2765\").css(\"display\", \"block\");\n\t\t\t\t\t\t\toverlay_loading_contact_bank_2765();\n\t\t\t\t\t\t\tjQuery(\"#success_message_text_2765\").text(form_success_message);\n\t\t\t\t\t\t\tsetTimeout(function ()\n\t\t\t\t\t\t\t{\n\t\t\t\t\t\t\t\tremove_overlay_contact_bank_2765();\n\t\t\t\t\t\t\t\twindow.location.href = url_redirect_after_submit;\n\t\t\t\t\t\t\t}, 3000);\n\t\t\t\t\t\t}\n\t\t\t\t\t\telse\n\t\t\t\t\t\t{\n\t\t\t\t\t\t\tjQuery(\"#form_error_message_frontend_2765\").css(\"display\", \"block\");\n\t\t\t\t\t\t}\n\t\t\t\t\t});\n\t\t\t\t}\n\t\t\t});\n\t\t}\n\t}\n\tvar price_arr = [];\n\tjQuery(document).ready(function () {\n\t\t\t\tvar timestamp = 1547640163229;\n\t\t\tvar control_name = 'text';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"none\";\n\t\t\tvar custom_mask = \"999,999,999,999\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547640215176;\n\t\t\tvar control_name = 'text';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"none\";\n\t\t\tvar custom_mask = \"999,999,999,999\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547640264768;\n\t\t\tvar control_name = 'text';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"none\";\n\t\t\tvar custom_mask = \"999,999,999,999\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547643275584;\n\t\t\tvar control_name = 'checkbox-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547643804784;\n\t\t\tvar control_name = 'checkbox-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547643833442;\n\t\t\tvar control_name = 'checkbox-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547643853353;\n\t\t\tvar control_name = 'checkbox-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547643887777;\n\t\t\tvar control_name = 'checkbox-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547646408078;\n\t\t\tvar control_name = 'checkbox-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547646429380;\n\t\t\tvar control_name = 'paragraph';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547646628078;\n\t\t\tvar control_name = 'checkbox-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547646671118;\n\t\t\tvar control_name = 'checkbox-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547646708982;\n\t\t\tvar control_name = 'checkbox-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547646740150;\n\t\t\tvar control_name = 'checkbox-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547646764583;\n\t\t\tvar control_name = 'checkbox-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547646803765;\n\t\t\tvar control_name = 'paragraph';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547647487469;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547647056746;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547647630685;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547647651036;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547647680956;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547647714949;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547647796084;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547647830308;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"none\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547648045636;\n\t\t\tvar control_name = 'paragraph';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547649045283;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547649073019;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547649225378;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547649247172;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547649270907;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547649301204;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547649335379;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547649353418;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547649384050;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547649453043;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547649474315;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547649580155;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547649623155;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547649655170;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547649669363;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547649685482;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547649713001;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547649724794;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"none\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547650039841;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547650082690;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547650166553;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547650188122;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547650205370;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547650228098;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547650297154;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547650315842;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547650340897;\n\t\t\tvar control_name = 'paragraph';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547650430210;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547650515944;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547650730944;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547650749922;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547651018161;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547651037801;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547651053600;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547651234625;\n\t\t\tvar control_name = 'paragraph';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547651307601;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547651692791;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547651958695;\n\t\t\tvar control_name = 'radio-list';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"\";\n\t\t\tvar custom_mask = \"\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547652188532;\n\t\t\tvar control_name = 'text';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"none\";\n\t\t\tvar custom_mask = \"999,999,999,999\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t\t\tvar timestamp = 1547652344678;\n\t\t\tvar control_name = 'text';\n\t\t\tvar label_placement_type = \"above\";\n\t\t\tvar input_mask_type = \"none\";\n\t\t\tvar custom_mask = \"999,999,999,999\";\n\t\t\tchange_label_placement_contact_bank_2765(\"ux_ddl_label_placement_\" + timestamp, timestamp, label_placement_type, control_name);\n\t\t\tapply_input_masking_contact_bank_2765(\"ux_txt_singal_line_text_\" + timestamp, timestamp, input_mask_type, custom_mask);\n\t\t\tif(control_name == \"select\")\n\t\t\t{\n\t\t\t\tjQuery(\"#ux_txt_singal_line_text_\" + timestamp).val(\"\");\n\t\t\t}\n\t\t\t});\n<\/script>\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v14.4.1 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Quality Assurance: Questionnaire - DJ Care Services<\/title>\n<meta name=\"robots\" content=\"index, follow\" \/>\n<meta name=\"googlebot\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta name=\"bingbot\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"http:\/\/djcareservices.com\/quality-assurance-questionnaire\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Quality Assurance: Questionnaire - DJ Care Services\" \/>\n<meta property=\"og:url\" content=\"http:\/\/djcareservices.com\/quality-assurance-questionnaire\/\" \/>\n<meta property=\"og:site_name\" content=\"DJ Care Services\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/DJCareservices\/\" \/>\n<meta property=\"article:modified_time\" content=\"2019-01-16T15:35:59+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary\" \/>\n<meta name=\"twitter:creator\" content=\"@DJCareServices\" \/>\n<meta name=\"twitter:site\" content=\"@DJCareServices\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebSite\",\"@id\":\"http:\/\/djcareservices.com\/#website\",\"url\":\"http:\/\/djcareservices.com\/\",\"name\":\"DJ Care Services\",\"description\":\"\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":\"http:\/\/djcareservices.com\/?s={search_term_string}\",\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-GB\"},{\"@type\":\"WebPage\",\"@id\":\"http:\/\/djcareservices.com\/quality-assurance-questionnaire\/#webpage\",\"url\":\"http:\/\/djcareservices.com\/quality-assurance-questionnaire\/\",\"name\":\"Quality Assurance: Questionnaire - DJ Care Services\",\"isPartOf\":{\"@id\":\"http:\/\/djcareservices.com\/#website\"},\"datePublished\":\"2019-01-16T15:30:38+00:00\",\"dateModified\":\"2019-01-16T15:35:59+00:00\",\"inLanguage\":\"en-GB\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"http:\/\/djcareservices.com\/quality-assurance-questionnaire\/\"]}]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","_links":{"self":[{"href":"http:\/\/djcareservices.com\/wp-json\/wp\/v2\/pages\/223"}],"collection":[{"href":"http:\/\/djcareservices.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/djcareservices.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/djcareservices.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/djcareservices.com\/wp-json\/wp\/v2\/comments?post=223"}],"version-history":[{"count":2,"href":"http:\/\/djcareservices.com\/wp-json\/wp\/v2\/pages\/223\/revisions"}],"predecessor-version":[{"id":227,"href":"http:\/\/djcareservices.com\/wp-json\/wp\/v2\/pages\/223\/revisions\/227"}],"wp:attachment":[{"href":"http:\/\/djcareservices.com\/wp-json\/wp\/v2\/media?parent=223"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}