{"id":4274,"date":"2022-02-18T14:42:38","date_gmt":"2022-02-18T14:42:38","guid":{"rendered":"https:\/\/phaxis.com\/?page_id=4274"},"modified":"2022-09-07T19:31:05","modified_gmt":"2022-09-07T19:31:05","slug":"polysomnographer-sleep-tech-skills-checklist","status":"publish","type":"page","link":"https:\/\/phaxis.com\/travel-healthcare\/skills-checklist\/polysomnographer-sleep-tech-skills-checklist\/","title":{"rendered":"Polysomnographer \/ Sleep Tech Skills Checklist"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"4274\" class=\"elementor elementor-4274\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t\t\t\t<section class=\"has_ma_el_bg_slider elementor-section elementor-inner-section elementor-element elementor-element-7004d459 elementor-section-height-min-height elementor-section-boxed elementor-section-height-default jltma-glass-effect-no\" data-id=\"7004d459\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"has_ma_el_bg_slider elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-6c14d29a jltma-glass-effect-no\" data-id=\"6c14d29a\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"has_ma_el_bg_slider elementor-section elementor-top-section elementor-element elementor-element-2c2ad075 elementor-section-height-min-height elementor-section-items-stretch elementor-section-full_width elementor-section-height-default jltma-glass-effect-no\" data-id=\"2c2ad075\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"has_ma_el_bg_slider elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-380339d2 jltma-glass-effect-no\" data-id=\"380339d2\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<section class=\"has_ma_el_bg_slider elementor-section elementor-inner-section elementor-element elementor-element-18e30828 elementor-section-full_width elementor-section-content-top elementor-section-height-default elementor-section-height-default jltma-glass-effect-no\" data-id=\"18e30828\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"has_ma_el_bg_slider elementor-column elementor-col-33 elementor-inner-column elementor-element elementor-element-48d37967 jltma-glass-effect-no\" data-id=\"48d37967\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"has_ma_el_bg_slider elementor-column elementor-col-33 elementor-inner-column elementor-element elementor-element-470c65d4 jltma-glass-effect-no\" data-id=\"470c65d4\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-32c6b543 jltma-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"32c6b543\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.17.0 - 08-11-2023 *\/\n.elementor-heading-title{padding:0;margin:0;line-height:1}.elementor-widget-heading .elementor-heading-title[class*=elementor-size-]>a{color:inherit;font-size:inherit;line-height:inherit}.elementor-widget-heading .elementor-heading-title.elementor-size-small{font-size:15px}.elementor-widget-heading .elementor-heading-title.elementor-size-medium{font-size:19px}.elementor-widget-heading .elementor-heading-title.elementor-size-large{font-size:29px}.elementor-widget-heading .elementor-heading-title.elementor-size-xl{font-size:39px}.elementor-widget-heading .elementor-heading-title.elementor-size-xxl{font-size:59px}<\/style><h2 class=\"elementor-heading-title elementor-size-default\">Polysomnographer \/ Sleep Tech Skills Checklist<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"has_ma_el_bg_slider elementor-column elementor-col-33 elementor-inner-column elementor-element elementor-element-5b860474 jltma-glass-effect-no\" data-id=\"5b860474\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-20c55b85 elementor-view-default jltma-glass-effect-no elementor-widget elementor-widget-icon\" data-id=\"20c55b85\" data-element_type=\"widget\" data-widget_type=\"icon.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-icon-wrapper\">\n\t\t\t<a class=\"elementor-icon\" href=\"#elementor-action%3Aaction%3Dpopup%3Aopen%26settings%3DeyJpZCI6IjUxNiIsInRvZ2dsZSI6ZmFsc2V9\">\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" width=\"27\" height=\"20\" viewBox=\"0 0 27 20\"><g id=\"Group_2\" data-name=\"Group 2\" transform=\"translate(-1840 -60)\"><g id=\"Group_1\" data-name=\"Group 1\"><image id=\"Menu\" width=\"27\" height=\"20\" transform=\"translate(1840 60)\" xlink:href=\"data:image\/png;base64,iVBORw0KGgoAAAANSUhEUgAAABsAAAAUCAYAAAB8gkaAAAAABHNCSVQICAgIfAhkiAAAAJNJREFUSEtj\/P\/\/\/2EGBgYbIKY1OMIItOwt0BYhWtsENP8dyDIVIEOHDpZdAVlGB3sgVoxaRpWgpnsw8gOdrUgVp+M35D7IZ\/eBahToYNkDkGW3gBap0sGy2yDLuKCWMdLQQlBmBltGQztQjR61jCpBTfdgBFUvJlRxOn5DzoB89hGoho8Oln0CWbYNaJEnHSzbDgAo1kxSPzU7mgAAAABJRU5ErkJggg==\"><\/image><\/g><\/g><\/svg>\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"has_ma_el_bg_slider elementor-section elementor-top-section elementor-element elementor-element-18a735c elementor-section-boxed elementor-section-height-default elementor-section-height-default jltma-glass-effect-no\" data-id=\"18a735c\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"has_ma_el_bg_slider elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-aa57110 jltma-glass-effect-no\" data-id=\"aa57110\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<section class=\"has_ma_el_bg_slider elementor-section elementor-inner-section elementor-element elementor-element-a5e135c elementor-section-boxed elementor-section-height-default elementor-section-height-default jltma-glass-effect-no\" data-id=\"a5e135c\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"has_ma_el_bg_slider elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-6575745 jltma-glass-effect-no\" data-id=\"6575745\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-09a385b jltma-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"09a385b\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Polysomnographer \/ Sleep Tech Skills Checklist<\/h1>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"has_ma_el_bg_slider elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-0e502eb jltma-glass-effect-no\" data-id=\"0e502eb\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-9df5989 elementor-align-right jltma-glass-effect-no elementor-widget elementor-widget-button\" data-id=\"9df5989\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm elementor-animation-grow\" href=\"\/skills-checklist\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon elementor-align-icon-left\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"remixicon ri-arrow-left-s-fill\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"elementor-button-text\">Back to Skills Checklist Main<\/span>\n\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<div class=\"elementor-element elementor-element-bf35aea jltma-glass-effect-no elementor-widget elementor-widget-text-editor\" data-id=\"bf35aea\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.17.0 - 08-11-2023 *\/\n.elementor-widget-text-editor.elementor-drop-cap-view-stacked .elementor-drop-cap{background-color:#69727d;color:#fff}.elementor-widget-text-editor.elementor-drop-cap-view-framed .elementor-drop-cap{color:#69727d;border:3px solid;background-color:transparent}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap{margin-top:8px}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap-letter{width:1em;height:1em}.elementor-widget-text-editor .elementor-drop-cap{float:left;text-align:center;line-height:1;font-size:50px}.elementor-widget-text-editor .elementor-drop-cap-letter{display:inline-block}<\/style>\t\t\t\t<p>Please rate your experience \/ frequency (within the last year) using the following scale (check the appropriate boxes below):<\/p><ul><li>0 = No Experience \/ Observed Only<\/li><li>1 = Limited Experience \/ Rarely Done (&lt;6 times\/year)<\/li><li>2 = May Need Some Review \/ Occasionally Done (1 &#8211; 2 times\/month)<\/li><li>3 = Experienced \/ Frequently Done (daily or weekly)<\/li><\/ul>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0595d97 jltma-glass-effect-no elementor-widget elementor-widget-shortcode\" data-id=\"0595d97\" data-element_type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-shortcode\"><script type=\"text\/javascript\">var 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e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_chrome gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_44' ><div id='gf_44' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_44' id='gform_44'  action='\/wp-json\/wp\/v2\/pages\/4274#gf_44' data-formid='44' novalidate><div class='gf_invisible ginput_recaptchav3' data-sitekey='6LdLS5EpAAAAAO0o7fTdC6pgFHgLhNboc1UfgiHJ' data-tabindex='0'><input id=\"input_7944a9ca63011a979f357e1f49c3de4b\" class=\"gfield_recaptcha_response\" type=\"hidden\" name=\"input_7944a9ca63011a979f357e1f49c3de4b\" value=\"\"\/><\/div>\n                        <div class='gform-body gform_body'><ul id='gform_fields_44' class='gform_fields left_label form_sublabel_below description_below'><li id=\"field_44_322\"  class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_322\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_44_322'>\n                            \n                            <span id='input_44_322_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_322.3' id='input_44_322_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_44_322_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_44_322_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_322.6' id='input_44_322_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_44_322_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_44_323\"  class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_323\"><label class='gfield_label gform-field-label' for='input_44_323' >Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_323' id='input_44_323' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_44_491\"  class=\"gfield gfield--type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_491\"><label class='gfield_label gform-field-label' for='input_44_491' >Recruiter&#039;s Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_491' id='input_44_491' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='Bibha Adhikari' >Bibha Adhikari<\/option><option value='Bobby Lutz' >Bobby Lutz<\/option><option value='Brad Donathan' >Brad Donathan<\/option><option value='Bradley Kurtz' >Bradley Kurtz<\/option><option value='Brian Wright' >Brian Wright<\/option><option value='Kaitlin Bockhaus' >Kaitlin Bockhaus<\/option><option value='Kalie DeFillippo' >Kalie DeFillippo<\/option><option value='Kylie Estridge' >Kylie Estridge<\/option><option value='Lauren Courtney' >Lauren Courtney<\/option><option value='Taylor Cunningham' >Taylor Cunningham<\/option><option value='Tripp Mann' >Tripp Mann<\/option><option value='Tyrell Davenport' >Tyrell Davenport<\/option><option value='Whitney Fields' >Whitney Fields<\/option><\/select><\/div><\/li><li id=\"field_44_269\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_269\"><h2 class=\"gsection_title\">AGE OF PATIENTS CARED FOR<\/h2><\/li><li id=\"field_44_2\"  class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_2\"><label class='gfield_label gform-field-label'  >Newborn\/Neonate (birth to 30 days)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_2'>\n\t\t\t<li class='gchoice gchoice_44_2_0'>\n\t\t\t\t<input name='input_2' type='radio' value='0'  id='choice_44_2_0'    \/>\n\t\t\t\t<label for='choice_44_2_0' id='label_44_2_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_2_1'>\n\t\t\t\t<input name='input_2' type='radio' value='1'  id='choice_44_2_1'    \/>\n\t\t\t\t<label for='choice_44_2_1' id='label_44_2_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_2_2'>\n\t\t\t\t<input name='input_2' type='radio' value='2'  id='choice_44_2_2'    \/>\n\t\t\t\t<label for='choice_44_2_2' id='label_44_2_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_2_3'>\n\t\t\t\t<input name='input_2' type='radio' value='3'  id='choice_44_2_3'    \/>\n\t\t\t\t<label for='choice_44_2_3' id='label_44_2_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_3\"  class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_3\"><label class='gfield_label gform-field-label'  >Infant (1 month to 1 year)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_3'>\n\t\t\t<li class='gchoice gchoice_44_3_0'>\n\t\t\t\t<input name='input_3' type='radio' value='0'  id='choice_44_3_0'    \/>\n\t\t\t\t<label for='choice_44_3_0' id='label_44_3_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_3_1'>\n\t\t\t\t<input name='input_3' type='radio' value='1'  id='choice_44_3_1'    \/>\n\t\t\t\t<label for='choice_44_3_1' id='label_44_3_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_3_2'>\n\t\t\t\t<input name='input_3' type='radio' value='2'  id='choice_44_3_2'    \/>\n\t\t\t\t<label for='choice_44_3_2' id='label_44_3_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_3_3'>\n\t\t\t\t<input name='input_3' type='radio' value='3'  id='choice_44_3_3'    \/>\n\t\t\t\t<label for='choice_44_3_3' id='label_44_3_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_4\"  class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_4\"><label class='gfield_label gform-field-label'  >Preschooler (3 years to 5 years)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_4'>\n\t\t\t<li class='gchoice gchoice_44_4_0'>\n\t\t\t\t<input name='input_4' type='radio' value='0'  id='choice_44_4_0'    \/>\n\t\t\t\t<label for='choice_44_4_0' id='label_44_4_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_4_1'>\n\t\t\t\t<input name='input_4' type='radio' value='1'  id='choice_44_4_1'    \/>\n\t\t\t\t<label for='choice_44_4_1' id='label_44_4_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_4_2'>\n\t\t\t\t<input name='input_4' type='radio' value='2'  id='choice_44_4_2'    \/>\n\t\t\t\t<label for='choice_44_4_2' id='label_44_4_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_4_3'>\n\t\t\t\t<input name='input_4' type='radio' value='3'  id='choice_44_4_3'    \/>\n\t\t\t\t<label for='choice_44_4_3' id='label_44_4_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_397\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_397\"><label class='gfield_label gform-field-label'  >School Age Child (5 years to 12 years)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_397'>\n\t\t\t<li class='gchoice gchoice_44_397_0'>\n\t\t\t\t<input name='input_397' type='radio' value='0'  id='choice_44_397_0'    \/>\n\t\t\t\t<label for='choice_44_397_0' id='label_44_397_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_397_1'>\n\t\t\t\t<input name='input_397' type='radio' value='1'  id='choice_44_397_1'    \/>\n\t\t\t\t<label for='choice_44_397_1' id='label_44_397_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_397_2'>\n\t\t\t\t<input name='input_397' type='radio' value='2'  id='choice_44_397_2'    \/>\n\t\t\t\t<label for='choice_44_397_2' id='label_44_397_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_397_3'>\n\t\t\t\t<input name='input_397' type='radio' value='3'  id='choice_44_397_3'    \/>\n\t\t\t\t<label for='choice_44_397_3' id='label_44_397_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_272\"  class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_272\"><label class='gfield_label gform-field-label'  >Adolescents (12 years to 18 years)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_272'>\n\t\t\t<li class='gchoice gchoice_44_272_0'>\n\t\t\t\t<input name='input_272' type='radio' value='0'  id='choice_44_272_0'    \/>\n\t\t\t\t<label for='choice_44_272_0' id='label_44_272_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_272_1'>\n\t\t\t\t<input name='input_272' type='radio' value='1'  id='choice_44_272_1'    \/>\n\t\t\t\t<label for='choice_44_272_1' id='label_44_272_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_272_2'>\n\t\t\t\t<input name='input_272' type='radio' value='2'  id='choice_44_272_2'    \/>\n\t\t\t\t<label for='choice_44_272_2' id='label_44_272_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_272_3'>\n\t\t\t\t<input name='input_272' type='radio' value='3'  id='choice_44_272_3'    \/>\n\t\t\t\t<label for='choice_44_272_3' id='label_44_272_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_398\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_398\"><label class='gfield_label gform-field-label'  >Young Adults (18 years to 39 years)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_398'>\n\t\t\t<li class='gchoice gchoice_44_398_0'>\n\t\t\t\t<input name='input_398' type='radio' value='0'  id='choice_44_398_0'    \/>\n\t\t\t\t<label for='choice_44_398_0' id='label_44_398_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_398_1'>\n\t\t\t\t<input name='input_398' type='radio' value='1'  id='choice_44_398_1'    \/>\n\t\t\t\t<label for='choice_44_398_1' id='label_44_398_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_398_2'>\n\t\t\t\t<input name='input_398' type='radio' value='2'  id='choice_44_398_2'    \/>\n\t\t\t\t<label for='choice_44_398_2' id='label_44_398_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_398_3'>\n\t\t\t\t<input name='input_398' type='radio' value='3'  id='choice_44_398_3'    \/>\n\t\t\t\t<label for='choice_44_398_3' id='label_44_398_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_271\"  class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_271\"><label class='gfield_label gform-field-label'  >Middle Adults (39 years to 64 years)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_271'>\n\t\t\t<li class='gchoice gchoice_44_271_0'>\n\t\t\t\t<input name='input_271' type='radio' value='0'  id='choice_44_271_0'    \/>\n\t\t\t\t<label for='choice_44_271_0' id='label_44_271_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_271_1'>\n\t\t\t\t<input name='input_271' type='radio' value='1'  id='choice_44_271_1'    \/>\n\t\t\t\t<label for='choice_44_271_1' id='label_44_271_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_271_2'>\n\t\t\t\t<input name='input_271' type='radio' value='2'  id='choice_44_271_2'    \/>\n\t\t\t\t<label for='choice_44_271_2' id='label_44_271_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_271_3'>\n\t\t\t\t<input name='input_271' type='radio' value='3'  id='choice_44_271_3'    \/>\n\t\t\t\t<label for='choice_44_271_3' id='label_44_271_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_399\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_399\"><label class='gfield_label gform-field-label'  >Older Adults (64 years to 79 years)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_399'>\n\t\t\t<li class='gchoice gchoice_44_399_0'>\n\t\t\t\t<input name='input_399' type='radio' value='0'  id='choice_44_399_0'    \/>\n\t\t\t\t<label for='choice_44_399_0' id='label_44_399_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_399_1'>\n\t\t\t\t<input name='input_399' type='radio' value='1'  id='choice_44_399_1'    \/>\n\t\t\t\t<label for='choice_44_399_1' id='label_44_399_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_399_2'>\n\t\t\t\t<input name='input_399' type='radio' value='2'  id='choice_44_399_2'    \/>\n\t\t\t\t<label for='choice_44_399_2' id='label_44_399_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_399_3'>\n\t\t\t\t<input name='input_399' type='radio' value='3'  id='choice_44_399_3'    \/>\n\t\t\t\t<label for='choice_44_399_3' id='label_44_399_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_270\"  class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_270\"><label class='gfield_label gform-field-label'  >Elderly Adults (over 79+ years)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_270'>\n\t\t\t<li class='gchoice gchoice_44_270_0'>\n\t\t\t\t<input name='input_270' type='radio' value='0'  id='choice_44_270_0'    \/>\n\t\t\t\t<label for='choice_44_270_0' id='label_44_270_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_270_1'>\n\t\t\t\t<input name='input_270' type='radio' value='1'  id='choice_44_270_1'    \/>\n\t\t\t\t<label for='choice_44_270_1' id='label_44_270_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_270_2'>\n\t\t\t\t<input name='input_270' type='radio' value='2'  id='choice_44_270_2'    \/>\n\t\t\t\t<label for='choice_44_270_2' id='label_44_270_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_270_3'>\n\t\t\t\t<input name='input_270' type='radio' value='3'  id='choice_44_270_3'    \/>\n\t\t\t\t<label for='choice_44_270_3' id='label_44_270_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_447\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_447\"><h2 class=\"gsection_title\">GENERAL SKILLS<\/h2><\/li><li id=\"field_44_400\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_400\"><label class='gfield_label gform-field-label'  >Standard Precautions<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_400'>\n\t\t\t<li class='gchoice gchoice_44_400_0'>\n\t\t\t\t<input name='input_400' type='radio' value='0'  id='choice_44_400_0'    \/>\n\t\t\t\t<label for='choice_44_400_0' id='label_44_400_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_400_1'>\n\t\t\t\t<input name='input_400' type='radio' value='1'  id='choice_44_400_1'    \/>\n\t\t\t\t<label for='choice_44_400_1' id='label_44_400_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_400_2'>\n\t\t\t\t<input name='input_400' type='radio' value='2'  id='choice_44_400_2'    \/>\n\t\t\t\t<label for='choice_44_400_2' id='label_44_400_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_400_3'>\n\t\t\t\t<input name='input_400' type='radio' value='3'  id='choice_44_400_3'    \/>\n\t\t\t\t<label for='choice_44_400_3' id='label_44_400_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_439\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_439\"><label class='gfield_label gform-field-label'  >Isolation Precautions<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_439'>\n\t\t\t<li class='gchoice gchoice_44_439_0'>\n\t\t\t\t<input name='input_439' type='radio' value='0'  id='choice_44_439_0'    \/>\n\t\t\t\t<label for='choice_44_439_0' id='label_44_439_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_439_1'>\n\t\t\t\t<input name='input_439' type='radio' value='1'  id='choice_44_439_1'    \/>\n\t\t\t\t<label for='choice_44_439_1' id='label_44_439_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_439_2'>\n\t\t\t\t<input name='input_439' type='radio' value='2'  id='choice_44_439_2'    \/>\n\t\t\t\t<label for='choice_44_439_2' id='label_44_439_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_439_3'>\n\t\t\t\t<input name='input_439' type='radio' value='3'  id='choice_44_439_3'    \/>\n\t\t\t\t<label for='choice_44_439_3' id='label_44_439_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_440\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_440\"><label class='gfield_label gform-field-label'  >Pediatric Respiratory\/Cardiac Arrest<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_440'>\n\t\t\t<li class='gchoice gchoice_44_440_0'>\n\t\t\t\t<input name='input_440' type='radio' value='0'  id='choice_44_440_0'    \/>\n\t\t\t\t<label for='choice_44_440_0' id='label_44_440_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_440_1'>\n\t\t\t\t<input name='input_440' type='radio' value='1'  id='choice_44_440_1'    \/>\n\t\t\t\t<label for='choice_44_440_1' id='label_44_440_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_440_2'>\n\t\t\t\t<input name='input_440' type='radio' value='2'  id='choice_44_440_2'    \/>\n\t\t\t\t<label for='choice_44_440_2' id='label_44_440_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_440_3'>\n\t\t\t\t<input name='input_440' type='radio' value='3'  id='choice_44_440_3'    \/>\n\t\t\t\t<label for='choice_44_440_3' id='label_44_440_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_441\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_441\"><label class='gfield_label gform-field-label'  >Adult Respiratory\/Cardiac Arrest<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_441'>\n\t\t\t<li class='gchoice gchoice_44_441_0'>\n\t\t\t\t<input name='input_441' type='radio' value='0'  id='choice_44_441_0'    \/>\n\t\t\t\t<label for='choice_44_441_0' id='label_44_441_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_441_1'>\n\t\t\t\t<input name='input_441' type='radio' value='1'  id='choice_44_441_1'    \/>\n\t\t\t\t<label for='choice_44_441_1' id='label_44_441_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_441_2'>\n\t\t\t\t<input name='input_441' type='radio' value='2'  id='choice_44_441_2'    \/>\n\t\t\t\t<label for='choice_44_441_2' id='label_44_441_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_441_3'>\n\t\t\t\t<input name='input_441' type='radio' value='3'  id='choice_44_441_3'    \/>\n\t\t\t\t<label for='choice_44_441_3' id='label_44_441_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_442\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_442\"><label class='gfield_label gform-field-label'  >Crash Carts<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_442'>\n\t\t\t<li class='gchoice gchoice_44_442_0'>\n\t\t\t\t<input name='input_442' type='radio' value='0'  id='choice_44_442_0'    \/>\n\t\t\t\t<label for='choice_44_442_0' id='label_44_442_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_442_1'>\n\t\t\t\t<input name='input_442' type='radio' value='1'  id='choice_44_442_1'    \/>\n\t\t\t\t<label for='choice_44_442_1' id='label_44_442_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_442_2'>\n\t\t\t\t<input name='input_442' type='radio' value='2'  id='choice_44_442_2'    \/>\n\t\t\t\t<label for='choice_44_442_2' id='label_44_442_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_442_3'>\n\t\t\t\t<input name='input_442' type='radio' value='3'  id='choice_44_442_3'    \/>\n\t\t\t\t<label for='choice_44_442_3' id='label_44_442_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_443\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_443\"><label class='gfield_label gform-field-label'  >Defibrillators<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_443'>\n\t\t\t<li class='gchoice gchoice_44_443_0'>\n\t\t\t\t<input name='input_443' type='radio' value='0'  id='choice_44_443_0'    \/>\n\t\t\t\t<label for='choice_44_443_0' id='label_44_443_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_443_1'>\n\t\t\t\t<input name='input_443' type='radio' value='1'  id='choice_44_443_1'    \/>\n\t\t\t\t<label for='choice_44_443_1' id='label_44_443_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_443_2'>\n\t\t\t\t<input name='input_443' type='radio' value='2'  id='choice_44_443_2'    \/>\n\t\t\t\t<label for='choice_44_443_2' id='label_44_443_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_443_3'>\n\t\t\t\t<input name='input_443' type='radio' value='3'  id='choice_44_443_3'    \/>\n\t\t\t\t<label for='choice_44_443_3' id='label_44_443_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_444\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_444\"><label class='gfield_label gform-field-label'  >Electronic Documentation<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_444'>\n\t\t\t<li class='gchoice gchoice_44_444_0'>\n\t\t\t\t<input name='input_444' type='radio' value='0'  id='choice_44_444_0'    \/>\n\t\t\t\t<label for='choice_44_444_0' id='label_44_444_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_444_1'>\n\t\t\t\t<input name='input_444' type='radio' value='1'  id='choice_44_444_1'    \/>\n\t\t\t\t<label for='choice_44_444_1' id='label_44_444_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_444_2'>\n\t\t\t\t<input name='input_444' type='radio' value='2'  id='choice_44_444_2'    \/>\n\t\t\t\t<label for='choice_44_444_2' id='label_44_444_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_444_3'>\n\t\t\t\t<input name='input_444' type='radio' value='3'  id='choice_44_444_3'    \/>\n\t\t\t\t<label for='choice_44_444_3' id='label_44_444_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_448\"  class=\"gfield gfield--type-text gfield--width-full gf_list_inline checklist_input_line field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_448\"><label class='gfield_label gform-field-label' for='input_44_448' >List Types:<\/label><div class='ginput_container ginput_container_text'><input name='input_448' id='input_44_448' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_44_449\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_449\"><label class='gfield_label gform-field-label'  >Automated Med Dispensing Systems<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_449'>\n\t\t\t<li class='gchoice gchoice_44_449_0'>\n\t\t\t\t<input name='input_449' type='radio' value='0'  id='choice_44_449_0'    \/>\n\t\t\t\t<label for='choice_44_449_0' id='label_44_449_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_449_1'>\n\t\t\t\t<input name='input_449' type='radio' value='1'  id='choice_44_449_1'    \/>\n\t\t\t\t<label for='choice_44_449_1' id='label_44_449_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_449_2'>\n\t\t\t\t<input name='input_449' type='radio' value='2'  id='choice_44_449_2'    \/>\n\t\t\t\t<label for='choice_44_449_2' id='label_44_449_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_449_3'>\n\t\t\t\t<input name='input_449' type='radio' value='3'  id='choice_44_449_3'    \/>\n\t\t\t\t<label for='choice_44_449_3' id='label_44_449_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_450\"  class=\"gfield gfield--type-text gfield--width-full gf_list_inline checklist_input_line field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_450\"><label class='gfield_label gform-field-label' for='input_44_450' >List Types:<\/label><div class='ginput_container ginput_container_text'><input name='input_450' id='input_44_450' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_44_359\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_359\"><h2 class=\"gsection_title\">SETTING<\/h2><\/li><li id=\"field_44_274\"  class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_274\"><label class='gfield_label gform-field-label'  >Hospital<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_274'>\n\t\t\t<li class='gchoice gchoice_44_274_0'>\n\t\t\t\t<input name='input_274' type='radio' value='0'  id='choice_44_274_0'    \/>\n\t\t\t\t<label for='choice_44_274_0' id='label_44_274_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_274_1'>\n\t\t\t\t<input name='input_274' type='radio' value='1'  id='choice_44_274_1'    \/>\n\t\t\t\t<label for='choice_44_274_1' id='label_44_274_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_274_2'>\n\t\t\t\t<input name='input_274' type='radio' value='2'  id='choice_44_274_2'    \/>\n\t\t\t\t<label for='choice_44_274_2' id='label_44_274_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_274_3'>\n\t\t\t\t<input name='input_274' type='radio' value='3'  id='choice_44_274_3'    \/>\n\t\t\t\t<label for='choice_44_274_3' id='label_44_274_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_273\"  class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_273\"><label class='gfield_label gform-field-label'  >Independent Lab<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_273'>\n\t\t\t<li class='gchoice gchoice_44_273_0'>\n\t\t\t\t<input name='input_273' type='radio' value='0'  id='choice_44_273_0'    \/>\n\t\t\t\t<label for='choice_44_273_0' id='label_44_273_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_273_1'>\n\t\t\t\t<input name='input_273' type='radio' value='1'  id='choice_44_273_1'    \/>\n\t\t\t\t<label for='choice_44_273_1' id='label_44_273_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_273_2'>\n\t\t\t\t<input name='input_273' type='radio' value='2'  id='choice_44_273_2'    \/>\n\t\t\t\t<label for='choice_44_273_2' id='label_44_273_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_273_3'>\n\t\t\t\t<input name='input_273' type='radio' value='3'  id='choice_44_273_3'    \/>\n\t\t\t\t<label for='choice_44_273_3' id='label_44_273_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_451\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_451\"><label class='gfield_label gform-field-label'  >Patient Home<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_451'>\n\t\t\t<li class='gchoice gchoice_44_451_0'>\n\t\t\t\t<input name='input_451' type='radio' value='0'  id='choice_44_451_0'    \/>\n\t\t\t\t<label for='choice_44_451_0' id='label_44_451_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_451_1'>\n\t\t\t\t<input name='input_451' type='radio' value='1'  id='choice_44_451_1'    \/>\n\t\t\t\t<label for='choice_44_451_1' id='label_44_451_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_451_2'>\n\t\t\t\t<input name='input_451' type='radio' value='2'  id='choice_44_451_2'    \/>\n\t\t\t\t<label for='choice_44_451_2' id='label_44_451_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_451_3'>\n\t\t\t\t<input name='input_451' type='radio' value='3'  id='choice_44_451_3'    \/>\n\t\t\t\t<label for='choice_44_451_3' id='label_44_451_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_445\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_445\"><h2 class=\"gsection_title\">DIAGNOSTIC STUDIES \/ PROCEDURES<\/h2><\/li><li id=\"field_44_329\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_329\"><label class='gfield_label gform-field-label'  >Multiple Sleep Latency Test (MSLT)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_329'>\n\t\t\t<li class='gchoice gchoice_44_329_0'>\n\t\t\t\t<input name='input_329' type='radio' value='0'  id='choice_44_329_0'    \/>\n\t\t\t\t<label for='choice_44_329_0' id='label_44_329_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_329_1'>\n\t\t\t\t<input name='input_329' type='radio' value='1'  id='choice_44_329_1'    \/>\n\t\t\t\t<label for='choice_44_329_1' id='label_44_329_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_329_2'>\n\t\t\t\t<input name='input_329' type='radio' value='2'  id='choice_44_329_2'    \/>\n\t\t\t\t<label for='choice_44_329_2' id='label_44_329_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_329_3'>\n\t\t\t\t<input name='input_329' type='radio' value='3'  id='choice_44_329_3'    \/>\n\t\t\t\t<label for='choice_44_329_3' id='label_44_329_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_328\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_328\"><label class='gfield_label gform-field-label'  >Maintenance of Wakefulness Test (MWT)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_328'>\n\t\t\t<li class='gchoice gchoice_44_328_0'>\n\t\t\t\t<input name='input_328' type='radio' value='0'  id='choice_44_328_0'    \/>\n\t\t\t\t<label for='choice_44_328_0' id='label_44_328_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_328_1'>\n\t\t\t\t<input name='input_328' type='radio' value='1'  id='choice_44_328_1'    \/>\n\t\t\t\t<label for='choice_44_328_1' id='label_44_328_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_328_2'>\n\t\t\t\t<input name='input_328' type='radio' value='2'  id='choice_44_328_2'    \/>\n\t\t\t\t<label for='choice_44_328_2' id='label_44_328_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_328_3'>\n\t\t\t\t<input name='input_328' type='radio' value='3'  id='choice_44_328_3'    \/>\n\t\t\t\t<label for='choice_44_328_3' id='label_44_328_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_327\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_327\"><label class='gfield_label gform-field-label'  >Nocturnal Penile Tumescence<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_327'>\n\t\t\t<li class='gchoice gchoice_44_327_0'>\n\t\t\t\t<input name='input_327' type='radio' value='0'  id='choice_44_327_0'    \/>\n\t\t\t\t<label for='choice_44_327_0' id='label_44_327_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_327_1'>\n\t\t\t\t<input name='input_327' type='radio' value='1'  id='choice_44_327_1'    \/>\n\t\t\t\t<label for='choice_44_327_1' id='label_44_327_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_327_2'>\n\t\t\t\t<input name='input_327' type='radio' value='2'  id='choice_44_327_2'    \/>\n\t\t\t\t<label for='choice_44_327_2' id='label_44_327_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_327_3'>\n\t\t\t\t<input name='input_327' type='radio' value='3'  id='choice_44_327_3'    \/>\n\t\t\t\t<label for='choice_44_327_3' id='label_44_327_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_326\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_326\"><label class='gfield_label gform-field-label'  >Seizure Study<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_326'>\n\t\t\t<li class='gchoice gchoice_44_326_0'>\n\t\t\t\t<input name='input_326' type='radio' value='0'  id='choice_44_326_0'    \/>\n\t\t\t\t<label for='choice_44_326_0' id='label_44_326_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_326_1'>\n\t\t\t\t<input name='input_326' type='radio' value='1'  id='choice_44_326_1'    \/>\n\t\t\t\t<label for='choice_44_326_1' id='label_44_326_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_326_2'>\n\t\t\t\t<input name='input_326' type='radio' value='2'  id='choice_44_326_2'    \/>\n\t\t\t\t<label for='choice_44_326_2' id='label_44_326_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_326_3'>\n\t\t\t\t<input name='input_326' type='radio' value='3'  id='choice_44_326_3'    \/>\n\t\t\t\t<label for='choice_44_326_3' id='label_44_326_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_325\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_325\"><label class='gfield_label gform-field-label'  >Portable Sleep Study<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_325'>\n\t\t\t<li class='gchoice gchoice_44_325_0'>\n\t\t\t\t<input name='input_325' type='radio' value='0'  id='choice_44_325_0'    \/>\n\t\t\t\t<label for='choice_44_325_0' id='label_44_325_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_325_1'>\n\t\t\t\t<input name='input_325' type='radio' value='1'  id='choice_44_325_1'    \/>\n\t\t\t\t<label for='choice_44_325_1' id='label_44_325_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_325_2'>\n\t\t\t\t<input name='input_325' type='radio' value='2'  id='choice_44_325_2'    \/>\n\t\t\t\t<label for='choice_44_325_2' id='label_44_325_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_325_3'>\n\t\t\t\t<input name='input_325' type='radio' value='3'  id='choice_44_325_3'    \/>\n\t\t\t\t<label for='choice_44_325_3' id='label_44_325_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_331\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_331\"><label class='gfield_label gform-field-label'  >Split-Night Polysomnogram<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_331'>\n\t\t\t<li class='gchoice gchoice_44_331_0'>\n\t\t\t\t<input name='input_331' type='radio' value='0'  id='choice_44_331_0'    \/>\n\t\t\t\t<label for='choice_44_331_0' id='label_44_331_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_331_1'>\n\t\t\t\t<input name='input_331' type='radio' value='1'  id='choice_44_331_1'    \/>\n\t\t\t\t<label for='choice_44_331_1' id='label_44_331_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_331_2'>\n\t\t\t\t<input name='input_331' type='radio' value='2'  id='choice_44_331_2'    \/>\n\t\t\t\t<label for='choice_44_331_2' id='label_44_331_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_331_3'>\n\t\t\t\t<input name='input_331' type='radio' value='3'  id='choice_44_331_3'    \/>\n\t\t\t\t<label for='choice_44_331_3' id='label_44_331_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_330\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_330\"><label class='gfield_label gform-field-label'  >EKG Electrode Placement<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_330'>\n\t\t\t<li class='gchoice gchoice_44_330_0'>\n\t\t\t\t<input name='input_330' type='radio' value='0'  id='choice_44_330_0'    \/>\n\t\t\t\t<label for='choice_44_330_0' id='label_44_330_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_330_1'>\n\t\t\t\t<input name='input_330' type='radio' value='1'  id='choice_44_330_1'    \/>\n\t\t\t\t<label for='choice_44_330_1' id='label_44_330_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_330_2'>\n\t\t\t\t<input name='input_330' type='radio' value='2'  id='choice_44_330_2'    \/>\n\t\t\t\t<label for='choice_44_330_2' id='label_44_330_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_330_3'>\n\t\t\t\t<input name='input_330' type='radio' value='3'  id='choice_44_330_3'    \/>\n\t\t\t\t<label for='choice_44_330_3' id='label_44_330_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_334\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_334\"><label class='gfield_label gform-field-label'  >EEG Electrode Placement<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_334'>\n\t\t\t<li class='gchoice gchoice_44_334_0'>\n\t\t\t\t<input name='input_334' type='radio' value='0'  id='choice_44_334_0'    \/>\n\t\t\t\t<label for='choice_44_334_0' id='label_44_334_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_334_1'>\n\t\t\t\t<input name='input_334' type='radio' value='1'  id='choice_44_334_1'    \/>\n\t\t\t\t<label for='choice_44_334_1' id='label_44_334_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_334_2'>\n\t\t\t\t<input name='input_334' type='radio' value='2'  id='choice_44_334_2'    \/>\n\t\t\t\t<label for='choice_44_334_2' id='label_44_334_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_334_3'>\n\t\t\t\t<input name='input_334' type='radio' value='3'  id='choice_44_334_3'    \/>\n\t\t\t\t<label for='choice_44_334_3' id='label_44_334_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_333\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_333\"><label class='gfield_label gform-field-label'  >Seizure Hook-Up<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_333'>\n\t\t\t<li class='gchoice gchoice_44_333_0'>\n\t\t\t\t<input name='input_333' type='radio' value='0'  id='choice_44_333_0'    \/>\n\t\t\t\t<label for='choice_44_333_0' id='label_44_333_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_333_1'>\n\t\t\t\t<input name='input_333' type='radio' value='1'  id='choice_44_333_1'    \/>\n\t\t\t\t<label for='choice_44_333_1' id='label_44_333_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_333_2'>\n\t\t\t\t<input name='input_333' type='radio' value='2'  id='choice_44_333_2'    \/>\n\t\t\t\t<label for='choice_44_333_2' id='label_44_333_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_333_3'>\n\t\t\t\t<input name='input_333' type='radio' value='3'  id='choice_44_333_3'    \/>\n\t\t\t\t<label for='choice_44_333_3' id='label_44_333_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_335\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_335\"><label class='gfield_label gform-field-label'  >Calibration<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_335'>\n\t\t\t<li class='gchoice gchoice_44_335_0'>\n\t\t\t\t<input name='input_335' type='radio' value='0'  id='choice_44_335_0'    \/>\n\t\t\t\t<label for='choice_44_335_0' id='label_44_335_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_335_1'>\n\t\t\t\t<input name='input_335' type='radio' value='1'  id='choice_44_335_1'    \/>\n\t\t\t\t<label for='choice_44_335_1' id='label_44_335_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_335_2'>\n\t\t\t\t<input name='input_335' type='radio' value='2'  id='choice_44_335_2'    \/>\n\t\t\t\t<label for='choice_44_335_2' id='label_44_335_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_335_3'>\n\t\t\t\t<input name='input_335' type='radio' value='3'  id='choice_44_335_3'    \/>\n\t\t\t\t<label for='choice_44_335_3' id='label_44_335_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_403\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_403\"><label class='gfield_label gform-field-label'  >Patient Positioning\/Preparation<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_403'>\n\t\t\t<li class='gchoice gchoice_44_403_0'>\n\t\t\t\t<input name='input_403' type='radio' value='0'  id='choice_44_403_0'    \/>\n\t\t\t\t<label for='choice_44_403_0' id='label_44_403_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_403_1'>\n\t\t\t\t<input name='input_403' type='radio' value='1'  id='choice_44_403_1'    \/>\n\t\t\t\t<label for='choice_44_403_1' id='label_44_403_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_403_2'>\n\t\t\t\t<input name='input_403' type='radio' value='2'  id='choice_44_403_2'    \/>\n\t\t\t\t<label for='choice_44_403_2' id='label_44_403_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_403_3'>\n\t\t\t\t<input name='input_403' type='radio' value='3'  id='choice_44_403_3'    \/>\n\t\t\t\t<label for='choice_44_403_3' id='label_44_403_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_452\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_452\"><label class='gfield_label gform-field-label'  >Drawing Arterial Blood Gases (ABGs)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_452'>\n\t\t\t<li class='gchoice gchoice_44_452_0'>\n\t\t\t\t<input name='input_452' type='radio' value='0'  id='choice_44_452_0'    \/>\n\t\t\t\t<label for='choice_44_452_0' id='label_44_452_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_452_1'>\n\t\t\t\t<input name='input_452' type='radio' value='1'  id='choice_44_452_1'    \/>\n\t\t\t\t<label for='choice_44_452_1' id='label_44_452_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_452_2'>\n\t\t\t\t<input name='input_452' type='radio' value='2'  id='choice_44_452_2'    \/>\n\t\t\t\t<label for='choice_44_452_2' id='label_44_452_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_452_3'>\n\t\t\t\t<input name='input_452' type='radio' value='3'  id='choice_44_452_3'    \/>\n\t\t\t\t<label for='choice_44_452_3' id='label_44_452_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_404\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_404\"><h2 class=\"gsection_title\">MONITORING \/ SCORING<\/h2><\/li><li id=\"field_44_365\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_365\"><label class='gfield_label gform-field-label'  >Periodic Limb Movements<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_365'>\n\t\t\t<li class='gchoice gchoice_44_365_0'>\n\t\t\t\t<input name='input_365' type='radio' value='0'  id='choice_44_365_0'    \/>\n\t\t\t\t<label for='choice_44_365_0' id='label_44_365_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_365_1'>\n\t\t\t\t<input name='input_365' type='radio' value='1'  id='choice_44_365_1'    \/>\n\t\t\t\t<label for='choice_44_365_1' id='label_44_365_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_365_2'>\n\t\t\t\t<input name='input_365' type='radio' value='2'  id='choice_44_365_2'    \/>\n\t\t\t\t<label for='choice_44_365_2' id='label_44_365_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_365_3'>\n\t\t\t\t<input name='input_365' type='radio' value='3'  id='choice_44_365_3'    \/>\n\t\t\t\t<label for='choice_44_365_3' id='label_44_365_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_364\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_364\"><label class='gfield_label gform-field-label'  >Snores<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_364'>\n\t\t\t<li class='gchoice gchoice_44_364_0'>\n\t\t\t\t<input name='input_364' type='radio' value='0'  id='choice_44_364_0'    \/>\n\t\t\t\t<label for='choice_44_364_0' id='label_44_364_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_364_1'>\n\t\t\t\t<input name='input_364' type='radio' value='1'  id='choice_44_364_1'    \/>\n\t\t\t\t<label for='choice_44_364_1' id='label_44_364_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_364_2'>\n\t\t\t\t<input name='input_364' type='radio' value='2'  id='choice_44_364_2'    \/>\n\t\t\t\t<label for='choice_44_364_2' id='label_44_364_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_364_3'>\n\t\t\t\t<input name='input_364' type='radio' value='3'  id='choice_44_364_3'    \/>\n\t\t\t\t<label for='choice_44_364_3' id='label_44_364_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_363\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_363\"><label class='gfield_label gform-field-label'  >Respiratory Events<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_363'>\n\t\t\t<li class='gchoice gchoice_44_363_0'>\n\t\t\t\t<input name='input_363' type='radio' value='0'  id='choice_44_363_0'    \/>\n\t\t\t\t<label for='choice_44_363_0' id='label_44_363_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_363_1'>\n\t\t\t\t<input name='input_363' type='radio' value='1'  id='choice_44_363_1'    \/>\n\t\t\t\t<label for='choice_44_363_1' id='label_44_363_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_363_2'>\n\t\t\t\t<input name='input_363' type='radio' value='2'  id='choice_44_363_2'    \/>\n\t\t\t\t<label for='choice_44_363_2' id='label_44_363_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_363_3'>\n\t\t\t\t<input name='input_363' type='radio' value='3'  id='choice_44_363_3'    \/>\n\t\t\t\t<label for='choice_44_363_3' id='label_44_363_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_362\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_362\"><label class='gfield_label gform-field-label'  >Respiratory Disturbance Index (RDI)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_362'>\n\t\t\t<li class='gchoice gchoice_44_362_0'>\n\t\t\t\t<input name='input_362' type='radio' value='0'  id='choice_44_362_0'    \/>\n\t\t\t\t<label for='choice_44_362_0' id='label_44_362_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_362_1'>\n\t\t\t\t<input name='input_362' type='radio' value='1'  id='choice_44_362_1'    \/>\n\t\t\t\t<label for='choice_44_362_1' id='label_44_362_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_362_2'>\n\t\t\t\t<input name='input_362' type='radio' value='2'  id='choice_44_362_2'    \/>\n\t\t\t\t<label for='choice_44_362_2' id='label_44_362_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_362_3'>\n\t\t\t\t<input name='input_362' type='radio' value='3'  id='choice_44_362_3'    \/>\n\t\t\t\t<label for='choice_44_362_3' id='label_44_362_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_361\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_361\"><label class='gfield_label gform-field-label'  >Apnea-Hypopnea Index (AHI)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_361'>\n\t\t\t<li class='gchoice gchoice_44_361_0'>\n\t\t\t\t<input name='input_361' type='radio' value='0'  id='choice_44_361_0'    \/>\n\t\t\t\t<label for='choice_44_361_0' id='label_44_361_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_361_1'>\n\t\t\t\t<input name='input_361' type='radio' value='1'  id='choice_44_361_1'    \/>\n\t\t\t\t<label for='choice_44_361_1' id='label_44_361_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_361_2'>\n\t\t\t\t<input name='input_361' type='radio' value='2'  id='choice_44_361_2'    \/>\n\t\t\t\t<label for='choice_44_361_2' id='label_44_361_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_361_3'>\n\t\t\t\t<input name='input_361' type='radio' value='3'  id='choice_44_361_3'    \/>\n\t\t\t\t<label for='choice_44_361_3' id='label_44_361_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_386\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_386\"><label class='gfield_label gform-field-label'  >Periodic Breathing<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_386'>\n\t\t\t<li class='gchoice gchoice_44_386_0'>\n\t\t\t\t<input name='input_386' type='radio' value='0'  id='choice_44_386_0'    \/>\n\t\t\t\t<label for='choice_44_386_0' id='label_44_386_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_386_1'>\n\t\t\t\t<input name='input_386' type='radio' value='1'  id='choice_44_386_1'    \/>\n\t\t\t\t<label for='choice_44_386_1' id='label_44_386_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_386_2'>\n\t\t\t\t<input name='input_386' type='radio' value='2'  id='choice_44_386_2'    \/>\n\t\t\t\t<label for='choice_44_386_2' id='label_44_386_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_386_3'>\n\t\t\t\t<input name='input_386' type='radio' value='3'  id='choice_44_386_3'    \/>\n\t\t\t\t<label for='choice_44_386_3' id='label_44_386_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_385\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_385\"><label class='gfield_label gform-field-label'  >Complex Sleep Apnea<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_385'>\n\t\t\t<li class='gchoice gchoice_44_385_0'>\n\t\t\t\t<input name='input_385' type='radio' value='0'  id='choice_44_385_0'    \/>\n\t\t\t\t<label for='choice_44_385_0' id='label_44_385_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_385_1'>\n\t\t\t\t<input name='input_385' type='radio' value='1'  id='choice_44_385_1'    \/>\n\t\t\t\t<label for='choice_44_385_1' id='label_44_385_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_385_2'>\n\t\t\t\t<input name='input_385' type='radio' value='2'  id='choice_44_385_2'    \/>\n\t\t\t\t<label for='choice_44_385_2' id='label_44_385_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_385_3'>\n\t\t\t\t<input name='input_385' type='radio' value='3'  id='choice_44_385_3'    \/>\n\t\t\t\t<label for='choice_44_385_3' id='label_44_385_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_446\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_446\"><label class='gfield_label gform-field-label'  >Cheyne-Stokes<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_446'>\n\t\t\t<li class='gchoice gchoice_44_446_0'>\n\t\t\t\t<input name='input_446' type='radio' value='0'  id='choice_44_446_0'    \/>\n\t\t\t\t<label for='choice_44_446_0' id='label_44_446_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_446_1'>\n\t\t\t\t<input name='input_446' type='radio' value='1'  id='choice_44_446_1'    \/>\n\t\t\t\t<label for='choice_44_446_1' id='label_44_446_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_446_2'>\n\t\t\t\t<input name='input_446' type='radio' value='2'  id='choice_44_446_2'    \/>\n\t\t\t\t<label for='choice_44_446_2' id='label_44_446_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_446_3'>\n\t\t\t\t<input name='input_446' type='radio' value='3'  id='choice_44_446_3'    \/>\n\t\t\t\t<label for='choice_44_446_3' id='label_44_446_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_453\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_453\"><label class='gfield_label gform-field-label'  >Obstructive Sleep Apnea<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_453'>\n\t\t\t<li class='gchoice gchoice_44_453_0'>\n\t\t\t\t<input name='input_453' type='radio' value='0'  id='choice_44_453_0'    \/>\n\t\t\t\t<label for='choice_44_453_0' id='label_44_453_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_453_1'>\n\t\t\t\t<input name='input_453' type='radio' value='1'  id='choice_44_453_1'    \/>\n\t\t\t\t<label for='choice_44_453_1' id='label_44_453_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_453_2'>\n\t\t\t\t<input name='input_453' type='radio' value='2'  id='choice_44_453_2'    \/>\n\t\t\t\t<label for='choice_44_453_2' id='label_44_453_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_453_3'>\n\t\t\t\t<input name='input_453' type='radio' value='3'  id='choice_44_453_3'    \/>\n\t\t\t\t<label for='choice_44_453_3' id='label_44_453_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_454\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_454\"><label class='gfield_label gform-field-label'  >Hypopnea<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_454'>\n\t\t\t<li class='gchoice gchoice_44_454_0'>\n\t\t\t\t<input name='input_454' type='radio' value='0'  id='choice_44_454_0'    \/>\n\t\t\t\t<label for='choice_44_454_0' id='label_44_454_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_454_1'>\n\t\t\t\t<input name='input_454' type='radio' value='1'  id='choice_44_454_1'    \/>\n\t\t\t\t<label for='choice_44_454_1' id='label_44_454_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_454_2'>\n\t\t\t\t<input name='input_454' type='radio' value='2'  id='choice_44_454_2'    \/>\n\t\t\t\t<label for='choice_44_454_2' id='label_44_454_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_454_3'>\n\t\t\t\t<input name='input_454' type='radio' value='3'  id='choice_44_454_3'    \/>\n\t\t\t\t<label for='choice_44_454_3' id='label_44_454_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_455\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_455\"><label class='gfield_label gform-field-label'  >Sleep Log<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_455'>\n\t\t\t<li class='gchoice gchoice_44_455_0'>\n\t\t\t\t<input name='input_455' type='radio' value='0'  id='choice_44_455_0'    \/>\n\t\t\t\t<label for='choice_44_455_0' id='label_44_455_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_455_1'>\n\t\t\t\t<input name='input_455' type='radio' value='1'  id='choice_44_455_1'    \/>\n\t\t\t\t<label for='choice_44_455_1' id='label_44_455_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_455_2'>\n\t\t\t\t<input name='input_455' type='radio' value='2'  id='choice_44_455_2'    \/>\n\t\t\t\t<label for='choice_44_455_2' id='label_44_455_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_455_3'>\n\t\t\t\t<input name='input_455' type='radio' value='3'  id='choice_44_455_3'    \/>\n\t\t\t\t<label for='choice_44_455_3' id='label_44_455_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_456\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_456\"><label class='gfield_label gform-field-label'  >Seizure Recognition and Precaution<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_456'>\n\t\t\t<li class='gchoice gchoice_44_456_0'>\n\t\t\t\t<input name='input_456' type='radio' value='0'  id='choice_44_456_0'    \/>\n\t\t\t\t<label for='choice_44_456_0' id='label_44_456_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_456_1'>\n\t\t\t\t<input name='input_456' type='radio' value='1'  id='choice_44_456_1'    \/>\n\t\t\t\t<label for='choice_44_456_1' id='label_44_456_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_456_2'>\n\t\t\t\t<input name='input_456' type='radio' value='2'  id='choice_44_456_2'    \/>\n\t\t\t\t<label for='choice_44_456_2' id='label_44_456_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_456_3'>\n\t\t\t\t<input name='input_456' type='radio' value='3'  id='choice_44_456_3'    \/>\n\t\t\t\t<label for='choice_44_456_3' id='label_44_456_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_457\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_457\"><label class='gfield_label gform-field-label'  >Transient Arousal Scoring Rules\/Procedures<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_457'>\n\t\t\t<li class='gchoice gchoice_44_457_0'>\n\t\t\t\t<input name='input_457' type='radio' value='0'  id='choice_44_457_0'    \/>\n\t\t\t\t<label for='choice_44_457_0' id='label_44_457_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_457_1'>\n\t\t\t\t<input name='input_457' type='radio' value='1'  id='choice_44_457_1'    \/>\n\t\t\t\t<label for='choice_44_457_1' id='label_44_457_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_457_2'>\n\t\t\t\t<input name='input_457' type='radio' value='2'  id='choice_44_457_2'    \/>\n\t\t\t\t<label for='choice_44_457_2' id='label_44_457_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_457_3'>\n\t\t\t\t<input name='input_457' type='radio' value='3'  id='choice_44_457_3'    \/>\n\t\t\t\t<label for='choice_44_457_3' id='label_44_457_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_458\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_458\"><h2 class=\"gsection_title\">EQUIPMENT<\/h2><\/li><li id=\"field_44_459\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_459\"><label class='gfield_label gform-field-label'  >Oximeters<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_459'>\n\t\t\t<li class='gchoice gchoice_44_459_0'>\n\t\t\t\t<input name='input_459' type='radio' value='0'  id='choice_44_459_0'    \/>\n\t\t\t\t<label for='choice_44_459_0' id='label_44_459_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_459_1'>\n\t\t\t\t<input name='input_459' type='radio' value='1'  id='choice_44_459_1'    \/>\n\t\t\t\t<label for='choice_44_459_1' id='label_44_459_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_459_2'>\n\t\t\t\t<input name='input_459' type='radio' value='2'  id='choice_44_459_2'    \/>\n\t\t\t\t<label for='choice_44_459_2' id='label_44_459_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_459_3'>\n\t\t\t\t<input name='input_459' type='radio' value='3'  id='choice_44_459_3'    \/>\n\t\t\t\t<label for='choice_44_459_3' id='label_44_459_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_460\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_460\"><label class='gfield_label gform-field-label'  >Nasal Cannula<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_460'>\n\t\t\t<li class='gchoice gchoice_44_460_0'>\n\t\t\t\t<input name='input_460' type='radio' value='0'  id='choice_44_460_0'    \/>\n\t\t\t\t<label for='choice_44_460_0' id='label_44_460_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_460_1'>\n\t\t\t\t<input name='input_460' type='radio' value='1'  id='choice_44_460_1'    \/>\n\t\t\t\t<label for='choice_44_460_1' id='label_44_460_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_460_2'>\n\t\t\t\t<input name='input_460' type='radio' value='2'  id='choice_44_460_2'    \/>\n\t\t\t\t<label for='choice_44_460_2' id='label_44_460_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_460_3'>\n\t\t\t\t<input name='input_460' type='radio' value='3'  id='choice_44_460_3'    \/>\n\t\t\t\t<label for='choice_44_460_3' id='label_44_460_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_461\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_461\"><label class='gfield_label gform-field-label'  >Humidified O2<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_461'>\n\t\t\t<li class='gchoice gchoice_44_461_0'>\n\t\t\t\t<input name='input_461' type='radio' value='0'  id='choice_44_461_0'    \/>\n\t\t\t\t<label for='choice_44_461_0' id='label_44_461_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_461_1'>\n\t\t\t\t<input name='input_461' type='radio' value='1'  id='choice_44_461_1'    \/>\n\t\t\t\t<label for='choice_44_461_1' id='label_44_461_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_461_2'>\n\t\t\t\t<input name='input_461' type='radio' value='2'  id='choice_44_461_2'    \/>\n\t\t\t\t<label for='choice_44_461_2' id='label_44_461_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_461_3'>\n\t\t\t\t<input name='input_461' type='radio' value='3'  id='choice_44_461_3'    \/>\n\t\t\t\t<label for='choice_44_461_3' id='label_44_461_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_462\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_462\"><label class='gfield_label gform-field-label'  >Nasal Mask<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_462'>\n\t\t\t<li class='gchoice gchoice_44_462_0'>\n\t\t\t\t<input name='input_462' type='radio' value='0'  id='choice_44_462_0'    \/>\n\t\t\t\t<label for='choice_44_462_0' id='label_44_462_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_462_1'>\n\t\t\t\t<input name='input_462' type='radio' value='1'  id='choice_44_462_1'    \/>\n\t\t\t\t<label for='choice_44_462_1' id='label_44_462_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_462_2'>\n\t\t\t\t<input name='input_462' type='radio' value='2'  id='choice_44_462_2'    \/>\n\t\t\t\t<label for='choice_44_462_2' id='label_44_462_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_462_3'>\n\t\t\t\t<input name='input_462' type='radio' value='3'  id='choice_44_462_3'    \/>\n\t\t\t\t<label for='choice_44_462_3' id='label_44_462_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_463\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_463\"><label class='gfield_label gform-field-label'  >BiPAP<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_463'>\n\t\t\t<li class='gchoice gchoice_44_463_0'>\n\t\t\t\t<input name='input_463' type='radio' value='0'  id='choice_44_463_0'    \/>\n\t\t\t\t<label for='choice_44_463_0' id='label_44_463_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_463_1'>\n\t\t\t\t<input name='input_463' type='radio' value='1'  id='choice_44_463_1'    \/>\n\t\t\t\t<label for='choice_44_463_1' id='label_44_463_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_463_2'>\n\t\t\t\t<input name='input_463' type='radio' value='2'  id='choice_44_463_2'    \/>\n\t\t\t\t<label for='choice_44_463_2' id='label_44_463_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_463_3'>\n\t\t\t\t<input name='input_463' type='radio' value='3'  id='choice_44_463_3'    \/>\n\t\t\t\t<label for='choice_44_463_3' id='label_44_463_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_464\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_464\"><label class='gfield_label gform-field-label'  >CPAP<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_464'>\n\t\t\t<li class='gchoice gchoice_44_464_0'>\n\t\t\t\t<input name='input_464' type='radio' value='0'  id='choice_44_464_0'    \/>\n\t\t\t\t<label for='choice_44_464_0' id='label_44_464_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_464_1'>\n\t\t\t\t<input name='input_464' type='radio' value='1'  id='choice_44_464_1'    \/>\n\t\t\t\t<label for='choice_44_464_1' id='label_44_464_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_464_2'>\n\t\t\t\t<input name='input_464' type='radio' value='2'  id='choice_44_464_2'    \/>\n\t\t\t\t<label for='choice_44_464_2' id='label_44_464_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_464_3'>\n\t\t\t\t<input name='input_464' type='radio' value='3'  id='choice_44_464_3'    \/>\n\t\t\t\t<label for='choice_44_464_3' id='label_44_464_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_465\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_465\"><label class='gfield_label gform-field-label'  >Portable Set-Up<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_465'>\n\t\t\t<li class='gchoice gchoice_44_465_0'>\n\t\t\t\t<input name='input_465' type='radio' value='0'  id='choice_44_465_0'    \/>\n\t\t\t\t<label for='choice_44_465_0' id='label_44_465_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_465_1'>\n\t\t\t\t<input name='input_465' type='radio' value='1'  id='choice_44_465_1'    \/>\n\t\t\t\t<label for='choice_44_465_1' id='label_44_465_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_465_2'>\n\t\t\t\t<input name='input_465' type='radio' value='2'  id='choice_44_465_2'    \/>\n\t\t\t\t<label for='choice_44_465_2' id='label_44_465_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_465_3'>\n\t\t\t\t<input name='input_465' type='radio' value='3'  id='choice_44_465_3'    \/>\n\t\t\t\t<label for='choice_44_465_3' id='label_44_465_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_466\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_466\"><label class='gfield_label gform-field-label'  >Position Sensor<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_466'>\n\t\t\t<li class='gchoice gchoice_44_466_0'>\n\t\t\t\t<input name='input_466' type='radio' value='0'  id='choice_44_466_0'    \/>\n\t\t\t\t<label for='choice_44_466_0' id='label_44_466_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_466_1'>\n\t\t\t\t<input name='input_466' type='radio' value='1'  id='choice_44_466_1'    \/>\n\t\t\t\t<label for='choice_44_466_1' id='label_44_466_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_466_2'>\n\t\t\t\t<input name='input_466' type='radio' value='2'  id='choice_44_466_2'    \/>\n\t\t\t\t<label for='choice_44_466_2' id='label_44_466_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_466_3'>\n\t\t\t\t<input name='input_466' type='radio' value='3'  id='choice_44_466_3'    \/>\n\t\t\t\t<label for='choice_44_466_3' id='label_44_466_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_467\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_467\"><label class='gfield_label gform-field-label'  >Actimeter<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_467'>\n\t\t\t<li class='gchoice gchoice_44_467_0'>\n\t\t\t\t<input name='input_467' type='radio' value='0'  id='choice_44_467_0'    \/>\n\t\t\t\t<label for='choice_44_467_0' id='label_44_467_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_467_1'>\n\t\t\t\t<input name='input_467' type='radio' value='1'  id='choice_44_467_1'    \/>\n\t\t\t\t<label for='choice_44_467_1' id='label_44_467_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_467_2'>\n\t\t\t\t<input name='input_467' type='radio' value='2'  id='choice_44_467_2'    \/>\n\t\t\t\t<label for='choice_44_467_2' id='label_44_467_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_467_3'>\n\t\t\t\t<input name='input_467' type='radio' value='3'  id='choice_44_467_3'    \/>\n\t\t\t\t<label for='choice_44_467_3' id='label_44_467_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_468\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_468\"><label class='gfield_label gform-field-label'  >Thermistor<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_468'>\n\t\t\t<li class='gchoice gchoice_44_468_0'>\n\t\t\t\t<input name='input_468' type='radio' value='0'  id='choice_44_468_0'    \/>\n\t\t\t\t<label for='choice_44_468_0' id='label_44_468_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_468_1'>\n\t\t\t\t<input name='input_468' type='radio' value='1'  id='choice_44_468_1'    \/>\n\t\t\t\t<label for='choice_44_468_1' id='label_44_468_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_468_2'>\n\t\t\t\t<input name='input_468' type='radio' value='2'  id='choice_44_468_2'    \/>\n\t\t\t\t<label for='choice_44_468_2' id='label_44_468_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_468_3'>\n\t\t\t\t<input name='input_468' type='radio' value='3'  id='choice_44_468_3'    \/>\n\t\t\t\t<label for='choice_44_468_3' id='label_44_468_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_469\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_469\"><label class='gfield_label gform-field-label'  >Phillips Respironics<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_469'>\n\t\t\t<li class='gchoice gchoice_44_469_0'>\n\t\t\t\t<input name='input_469' type='radio' value='0'  id='choice_44_469_0'    \/>\n\t\t\t\t<label for='choice_44_469_0' id='label_44_469_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_469_1'>\n\t\t\t\t<input name='input_469' type='radio' value='1'  id='choice_44_469_1'    \/>\n\t\t\t\t<label for='choice_44_469_1' id='label_44_469_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_469_2'>\n\t\t\t\t<input name='input_469' type='radio' value='2'  id='choice_44_469_2'    \/>\n\t\t\t\t<label for='choice_44_469_2' id='label_44_469_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_469_3'>\n\t\t\t\t<input name='input_469' type='radio' value='3'  id='choice_44_469_3'    \/>\n\t\t\t\t<label for='choice_44_469_3' id='label_44_469_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_470\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_470\"><label class='gfield_label gform-field-label'  >Nihon Kohden<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_470'>\n\t\t\t<li class='gchoice gchoice_44_470_0'>\n\t\t\t\t<input name='input_470' type='radio' value='0'  id='choice_44_470_0'    \/>\n\t\t\t\t<label for='choice_44_470_0' id='label_44_470_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_470_1'>\n\t\t\t\t<input name='input_470' type='radio' value='1'  id='choice_44_470_1'    \/>\n\t\t\t\t<label for='choice_44_470_1' id='label_44_470_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_470_2'>\n\t\t\t\t<input name='input_470' type='radio' value='2'  id='choice_44_470_2'    \/>\n\t\t\t\t<label for='choice_44_470_2' id='label_44_470_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_470_3'>\n\t\t\t\t<input name='input_470' type='radio' value='3'  id='choice_44_470_3'    \/>\n\t\t\t\t<label for='choice_44_470_3' id='label_44_470_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_471\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_471\"><label class='gfield_label gform-field-label'  >Grass Technologies<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_471'>\n\t\t\t<li class='gchoice gchoice_44_471_0'>\n\t\t\t\t<input name='input_471' type='radio' value='0'  id='choice_44_471_0'    \/>\n\t\t\t\t<label for='choice_44_471_0' id='label_44_471_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_471_1'>\n\t\t\t\t<input name='input_471' type='radio' value='1'  id='choice_44_471_1'    \/>\n\t\t\t\t<label for='choice_44_471_1' id='label_44_471_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_471_2'>\n\t\t\t\t<input name='input_471' type='radio' value='2'  id='choice_44_471_2'    \/>\n\t\t\t\t<label for='choice_44_471_2' id='label_44_471_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_471_3'>\n\t\t\t\t<input name='input_471' type='radio' value='3'  id='choice_44_471_3'    \/>\n\t\t\t\t<label for='choice_44_471_3' id='label_44_471_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_472\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_472\"><label class='gfield_label gform-field-label'  >Natus<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_472'>\n\t\t\t<li class='gchoice gchoice_44_472_0'>\n\t\t\t\t<input name='input_472' type='radio' value='0'  id='choice_44_472_0'    \/>\n\t\t\t\t<label for='choice_44_472_0' id='label_44_472_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_472_1'>\n\t\t\t\t<input name='input_472' type='radio' value='1'  id='choice_44_472_1'    \/>\n\t\t\t\t<label for='choice_44_472_1' id='label_44_472_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_472_2'>\n\t\t\t\t<input name='input_472' type='radio' value='2'  id='choice_44_472_2'    \/>\n\t\t\t\t<label for='choice_44_472_2' id='label_44_472_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_472_3'>\n\t\t\t\t<input name='input_472' type='radio' value='3'  id='choice_44_472_3'    \/>\n\t\t\t\t<label for='choice_44_472_3' id='label_44_472_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_473\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_473\"><label class='gfield_label gform-field-label'  >ResMed<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_473'>\n\t\t\t<li class='gchoice gchoice_44_473_0'>\n\t\t\t\t<input name='input_473' type='radio' value='0'  id='choice_44_473_0'    \/>\n\t\t\t\t<label for='choice_44_473_0' id='label_44_473_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_473_1'>\n\t\t\t\t<input name='input_473' type='radio' value='1'  id='choice_44_473_1'    \/>\n\t\t\t\t<label for='choice_44_473_1' id='label_44_473_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_473_2'>\n\t\t\t\t<input name='input_473' type='radio' value='2'  id='choice_44_473_2'    \/>\n\t\t\t\t<label for='choice_44_473_2' id='label_44_473_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_473_3'>\n\t\t\t\t<input name='input_473' type='radio' value='3'  id='choice_44_473_3'    \/>\n\t\t\t\t<label for='choice_44_473_3' id='label_44_473_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_474\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_474\"><label class='gfield_label gform-field-label'  >CleveMed<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_474'>\n\t\t\t<li class='gchoice gchoice_44_474_0'>\n\t\t\t\t<input name='input_474' type='radio' value='0'  id='choice_44_474_0'    \/>\n\t\t\t\t<label for='choice_44_474_0' id='label_44_474_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_474_1'>\n\t\t\t\t<input name='input_474' type='radio' value='1'  id='choice_44_474_1'    \/>\n\t\t\t\t<label for='choice_44_474_1' id='label_44_474_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_474_2'>\n\t\t\t\t<input name='input_474' type='radio' value='2'  id='choice_44_474_2'    \/>\n\t\t\t\t<label for='choice_44_474_2' id='label_44_474_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_474_3'>\n\t\t\t\t<input name='input_474' type='radio' value='3'  id='choice_44_474_3'    \/>\n\t\t\t\t<label for='choice_44_474_3' id='label_44_474_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_475\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_475\"><label class='gfield_label gform-field-label'  >CareFusion BD<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_475'>\n\t\t\t<li class='gchoice gchoice_44_475_0'>\n\t\t\t\t<input name='input_475' type='radio' value='0'  id='choice_44_475_0'    \/>\n\t\t\t\t<label for='choice_44_475_0' id='label_44_475_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_475_1'>\n\t\t\t\t<input name='input_475' type='radio' value='1'  id='choice_44_475_1'    \/>\n\t\t\t\t<label for='choice_44_475_1' id='label_44_475_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_475_2'>\n\t\t\t\t<input name='input_475' type='radio' value='2'  id='choice_44_475_2'    \/>\n\t\t\t\t<label for='choice_44_475_2' id='label_44_475_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_475_3'>\n\t\t\t\t<input name='input_475' type='radio' value='3'  id='choice_44_475_3'    \/>\n\t\t\t\t<label for='choice_44_475_3' id='label_44_475_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_476\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_476\"><label class='gfield_label gform-field-label'  >Compumedics<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_476'>\n\t\t\t<li class='gchoice gchoice_44_476_0'>\n\t\t\t\t<input name='input_476' type='radio' value='0'  id='choice_44_476_0'    \/>\n\t\t\t\t<label for='choice_44_476_0' id='label_44_476_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_476_1'>\n\t\t\t\t<input name='input_476' type='radio' value='1'  id='choice_44_476_1'    \/>\n\t\t\t\t<label for='choice_44_476_1' id='label_44_476_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_476_2'>\n\t\t\t\t<input name='input_476' type='radio' value='2'  id='choice_44_476_2'    \/>\n\t\t\t\t<label for='choice_44_476_2' id='label_44_476_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_476_3'>\n\t\t\t\t<input name='input_476' type='radio' value='3'  id='choice_44_476_3'    \/>\n\t\t\t\t<label for='choice_44_476_3' id='label_44_476_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_477\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_477\"><label class='gfield_label gform-field-label'  >Cadwell<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_477'>\n\t\t\t<li class='gchoice gchoice_44_477_0'>\n\t\t\t\t<input name='input_477' type='radio' value='0'  id='choice_44_477_0'    \/>\n\t\t\t\t<label for='choice_44_477_0' id='label_44_477_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_477_1'>\n\t\t\t\t<input name='input_477' type='radio' value='1'  id='choice_44_477_1'    \/>\n\t\t\t\t<label for='choice_44_477_1' id='label_44_477_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_477_2'>\n\t\t\t\t<input name='input_477' type='radio' value='2'  id='choice_44_477_2'    \/>\n\t\t\t\t<label for='choice_44_477_2' id='label_44_477_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_477_3'>\n\t\t\t\t<input name='input_477' type='radio' value='3'  id='choice_44_477_3'    \/>\n\t\t\t\t<label for='choice_44_477_3' id='label_44_477_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_478\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_478\"><label class='gfield_label gform-field-label'  >Somnomedics<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_478'>\n\t\t\t<li class='gchoice gchoice_44_478_0'>\n\t\t\t\t<input name='input_478' type='radio' value='0'  id='choice_44_478_0'    \/>\n\t\t\t\t<label for='choice_44_478_0' id='label_44_478_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_478_1'>\n\t\t\t\t<input name='input_478' type='radio' value='1'  id='choice_44_478_1'    \/>\n\t\t\t\t<label for='choice_44_478_1' id='label_44_478_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_478_2'>\n\t\t\t\t<input name='input_478' type='radio' value='2'  id='choice_44_478_2'    \/>\n\t\t\t\t<label for='choice_44_478_2' id='label_44_478_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_478_3'>\n\t\t\t\t<input name='input_478' type='radio' value='3'  id='choice_44_478_3'    \/>\n\t\t\t\t<label for='choice_44_478_3' id='label_44_478_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_479\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_479\"><label class='gfield_label gform-field-label'  >Other<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_479'>\n\t\t\t<li class='gchoice gchoice_44_479_0'>\n\t\t\t\t<input name='input_479' type='radio' value='0'  id='choice_44_479_0'    \/>\n\t\t\t\t<label for='choice_44_479_0' id='label_44_479_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_479_1'>\n\t\t\t\t<input name='input_479' type='radio' value='1'  id='choice_44_479_1'    \/>\n\t\t\t\t<label for='choice_44_479_1' id='label_44_479_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_479_2'>\n\t\t\t\t<input name='input_479' type='radio' value='2'  id='choice_44_479_2'    \/>\n\t\t\t\t<label for='choice_44_479_2' id='label_44_479_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_479_3'>\n\t\t\t\t<input name='input_479' type='radio' value='3'  id='choice_44_479_3'    \/>\n\t\t\t\t<label for='choice_44_479_3' id='label_44_479_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_480\"  class=\"gfield gfield--type-text gfield--width-full gf_list_inline checklist_input_line field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_480\"><label class='gfield_label gform-field-label' for='input_44_480' >List Types:<\/label><div class='ginput_container ginput_container_text'><input name='input_480' id='input_44_480' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_44_482\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_482\"><h2 class=\"gsection_title\">CREDENTIALS<\/h2><\/li><li id=\"field_44_481\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_481\"><label class='gfield_label gform-field-label'  >CPSGT<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_481'>\n\t\t\t<li class='gchoice gchoice_44_481_0'>\n\t\t\t\t<input name='input_481' type='radio' value='0'  id='choice_44_481_0'    \/>\n\t\t\t\t<label for='choice_44_481_0' id='label_44_481_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_481_1'>\n\t\t\t\t<input name='input_481' type='radio' value='1'  id='choice_44_481_1'    \/>\n\t\t\t\t<label for='choice_44_481_1' id='label_44_481_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_481_2'>\n\t\t\t\t<input name='input_481' type='radio' value='2'  id='choice_44_481_2'    \/>\n\t\t\t\t<label for='choice_44_481_2' id='label_44_481_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_481_3'>\n\t\t\t\t<input name='input_481' type='radio' value='3'  id='choice_44_481_3'    \/>\n\t\t\t\t<label for='choice_44_481_3' id='label_44_481_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_483\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_483\"><label class='gfield_label gform-field-label'  >RST<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_483'>\n\t\t\t<li class='gchoice gchoice_44_483_0'>\n\t\t\t\t<input name='input_483' type='radio' value='0'  id='choice_44_483_0'    \/>\n\t\t\t\t<label for='choice_44_483_0' id='label_44_483_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_483_1'>\n\t\t\t\t<input name='input_483' type='radio' value='1'  id='choice_44_483_1'    \/>\n\t\t\t\t<label for='choice_44_483_1' id='label_44_483_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_483_2'>\n\t\t\t\t<input name='input_483' type='radio' value='2'  id='choice_44_483_2'    \/>\n\t\t\t\t<label for='choice_44_483_2' id='label_44_483_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_483_3'>\n\t\t\t\t<input name='input_483' type='radio' value='3'  id='choice_44_483_3'    \/>\n\t\t\t\t<label for='choice_44_483_3' id='label_44_483_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_484\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_484\"><label class='gfield_label gform-field-label'  >RPSGT<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_484'>\n\t\t\t<li class='gchoice gchoice_44_484_0'>\n\t\t\t\t<input name='input_484' type='radio' value='0'  id='choice_44_484_0'    \/>\n\t\t\t\t<label for='choice_44_484_0' id='label_44_484_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_484_1'>\n\t\t\t\t<input name='input_484' type='radio' value='1'  id='choice_44_484_1'    \/>\n\t\t\t\t<label for='choice_44_484_1' id='label_44_484_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_484_2'>\n\t\t\t\t<input name='input_484' type='radio' value='2'  id='choice_44_484_2'    \/>\n\t\t\t\t<label for='choice_44_484_2' id='label_44_484_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_484_3'>\n\t\t\t\t<input name='input_484' type='radio' value='3'  id='choice_44_484_3'    \/>\n\t\t\t\t<label for='choice_44_484_3' id='label_44_484_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_485\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gf_list_inline checklist_input_line gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_485\"><label class='gfield_label gform-field-label'  >SDS<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_44_485'>\n\t\t\t<li class='gchoice gchoice_44_485_0'>\n\t\t\t\t<input name='input_485' type='radio' value='0'  id='choice_44_485_0'    \/>\n\t\t\t\t<label for='choice_44_485_0' id='label_44_485_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_485_1'>\n\t\t\t\t<input name='input_485' type='radio' value='1'  id='choice_44_485_1'    \/>\n\t\t\t\t<label for='choice_44_485_1' id='label_44_485_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_485_2'>\n\t\t\t\t<input name='input_485' type='radio' value='2'  id='choice_44_485_2'    \/>\n\t\t\t\t<label for='choice_44_485_2' id='label_44_485_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_485_3'>\n\t\t\t\t<input name='input_485' type='radio' value='3'  id='choice_44_485_3'    \/>\n\t\t\t\t<label for='choice_44_485_3' id='label_44_485_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_487\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_487\"><h2 class=\"gsection_title\">OTHER SKILLS<\/h2><\/li><li id=\"field_44_488\"  class=\"gfield gfield--type-text gfield--width-full gf_list_inline checklist_input_line field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_488\"><label class='gfield_label gform-field-label' for='input_44_488' >Please List:<\/label><div class='ginput_container ginput_container_text'><input name='input_488' id='input_44_488' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_44_489\"  class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_489\"><label class='gfield_label gform-field-label' for='input_44_489' >Your Initials<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_489' id='input_44_489' type='text' value='' class='large'  aria-describedby=\"gfield_description_44_489\"   aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><div class='gfield_description' id='gfield_description_44_489'>I hereby certify that all information contained on this application is true and complete. <\/div><\/li><li id=\"field_44_490\"  class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_490\"><label class='gfield_label gform-field-label' for='input_44_490' >Today&#039;s Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_490' id='input_44_490' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_44_492\"  class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_44_492\"><label class='gfield_label gform-field-label' for='input_44_492' >Email<\/label><div class='ginput_container'><input name='input_492' id='input_44_492' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_44_492'>This field is for validation purposes and should be left unchanged.<\/div><\/li><\/ul><\/div>\n        <div class='gform_footer left_label'> <input type='submit' id='gform_submit_button_44' class='gform_button button' value='Submit'  onclick='if(window[\"gf_submitting_44\"]){return false;}  if( !jQuery(\"#gform_44\")[0].checkValidity || jQuery(\"#gform_44\")[0].checkValidity()){window[\"gf_submitting_44\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_44\"]){return false;} if( !jQuery(\"#gform_44\")[0].checkValidity || jQuery(\"#gform_44\")[0].checkValidity()){window[\"gf_submitting_44\"]=true;}  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