{"id":22,"date":"2020-08-14T17:37:26","date_gmt":"2020-08-14T17:37:26","guid":{"rendered":"https:\/\/communityforcaregivers.com\/assessments\/?page_id=22"},"modified":"2021-11-06T16:36:24","modified_gmt":"2021-11-06T16:36:24","slug":"caregiver-health-checkup","status":"publish","type":"page","link":"https:\/\/communityforcaregivers.com\/checkup\/","title":{"rendered":"The Caregiver Health Check-up"},"content":{"rendered":"<p>This check-up is designed to assess these four distinct areas of Caregiver Health: Physical Health, Mental &amp; Emotional Health, Social &amp; Family Health, and Financial &amp; Career Health.<\/p>\n<p>Getting stronger in these four areas helps caregivers on their path to becoming healthier, experiencing a greater sense of wellness, and building resilience for the days ahead.<\/p>\n<p>Please allow for 5-10 minutes to complete this check-up.\u00a0 A copy of your answers will be emailed to you when you are finished.<\/p>\n<p>&nbsp;<\/p>\n\r\n<style type=\"text\/css\">\r\n@import url('https:\/\/fonts.googleapis.com\/css?family=Lato');\r\n\r\n\r\nbody #wpforms-62 {\r\n\t\tmargin:5px 10px  ;padding:30px ;border-width:.5 ;border-color:#54aab7 ;border-radius:11px ;-web-border-radius:11px ;-moz-border-radius:11px ;\r\n\t\t\tfont-family:Lato;border-style: solid;}\r\n\r\n\t\r\n\r\n\r\n\tbody #wpforms-62 .wpforms-head-container .wpforms-description {\r\n\t\tline-height:24px ;font-size:18px;\t\tdisplay:block;\r\n\t}\r\n\r\n\r\n\tbody #wpforms-62 .wpforms-submit-container .wpforms-submit, body #wpforms-62 .wpforms-field-pagebreak button.wpforms-page-button {\r\n\t\ttext-align:right ;color:#ffffff ;background-color:#00808e ;margin:10px ;padding:10px 30px ;border-radius:20px ;-web-border-radius:20px ;-moz-border-radius:20px ;\t\tborder-width: 0px;\t}\r\n\r\n\tbody #wpforms-62 .wpforms-submit-container .wpforms-submit:hover, body #wpforms-62 .wpforms-field-pagebreak button.wpforms-page-button:hover {\r\n\tbackground-color:#74b551;\t\t}\r\n\r\n\tbody #wpforms-62 .wpforms-submit-container,\r\n\tbody #wpforms-62 .wpforms-field-pagebreak .wpforms-pagebreak-left{\r\n\ttext-align:right;\t}\r\n\r\n\r\n\tbody #wpforms-62 .wpforms-form .wpforms-field input[type=text],\r\n\tbody #wpforms-62 .wpforms-form .wpforms-field input[type=email],\r\n\tbody #wpforms-62 .wpforms-form .wpforms-field input[type=tel],\r\n\tbody #wpforms-62 .wpforms-form .wpforms-field input[type=url],\r\n\tbody #wpforms-62 .wpforms-form .wpforms-field input[type=password],\r\n\tbody #wpforms-62 .wpforms-form .wpforms-field input[type=number]\r\n\t{\r\n\t\tcolor:#0f2f54 ;font-size:18px;border-radius:5px ;-web-border-radius:5px ;-moz-border-radius:5px ;\t\tborder-width: 1px;\t}\r\n\r\n\tbody #wpforms-62 .wpforms-form .wpforms-field .wpforms-field-row\r\n\t{\r\n\t\t\t}\r\n\r\n\tbody #wpforms-62 .wpforms-form .wpforms-field-layout.wpforms-field input[type=text],\r\n\tbody #wpforms-62 .wpforms-form .wpforms-field-layout.wpforms-field input[type=email],\r\n\tbody #wpforms-62 .wpforms-form .wpforms-field-layout.wpforms-field input[type=tel],\r\n\tbody #wpforms-62 .wpforms-form .wpforms-field-layout.wpforms-field input[type=url],\r\n\tbody #wpforms-62 .wpforms-form .wpforms-field-layout.wpforms-field input[type=password],\r\n\tbody #wpforms-62 .wpforms-form .wpforms-field-layout.wpforms-field input[type=number]{\r\n\t\twidth: 100%;\r\n\t}\r\n\r\n\tbody #wpforms-62 .wpforms-form .wpforms-field .wpforms-field-row input[type=text]{\r\n\t\twidth: 100%;\r\n\t}\r\n\r\n\r\n\r\n\r\n\r\n\r\n \r\n\r\n\tbody #wpforms-62 .wpforms-form .wpforms-field select {\r\n\r\n\t\tcolor:#0a8896 ;font-size:18px;\r\n\t\tborder-width: 1px;\t}\r\n\r\n\t\/* dropdown styles on modern background *\/\r\n\tbody #wpforms-62 .wpforms-form .wpforms-field-select-style-modern .choices__inner{\r\n\t\tcolor:#0a8896 ;font-size:18px;\t\t\r\n\t}\r\n\r\n\t\/* background color on modern dropdown *\/\r\n\t\t\tbody #wpforms-62 .wpforms-form .wpforms-field-select-style-modern .choices__item{\r\n\t\t\tcolor: #0a8896;\r\n\t\t}\r\n\t\t\r\n\t\t\r\n \r\n\tbody #wpforms-62 .wpforms-form .wpforms-field-radio li label,\r\n\tbody #wpforms-62 .wpforms-form .wpforms-field-payment-multiple li label {\r\n\t\tcolor:#008291 ;\t}\r\n \r\n\tbody #wpforms-62 .wpforms-form .wpforms-field-checkbox li label {\r\n\t\tcolor:#006f91 ;\t}\r\n \r\n\tbody #wpforms-62 .wpforms-form .wpforms-field .wpforms-field-description {\r\n\r\n\t\tcolor:#4f4f4f ;font-size:18px;\t}\r\n\r\n \r\n\tbody #wpforms-62 .wpforms-form .wpforms-field label.wpforms-field-label,\r\n\tbody #wpforms-62 .wpforms-form .wpforms-field .wpforms-field-label {\r\n\t\tcolor:#0c5975 ;line-height:22px ;font-size:18px;\t}\r\n\r\n\r\n\/* Styling for Tablets *\/\r\n@media only screen and (max-width: 800px) and (min-width:481px) {\r\n\t\r\n\r\n\r\n\r\n\tbody #wpforms-62 .wpforms-form .wpforms-field input[type=text],\r\n\t\tbody #wpforms-62 .wpforms-form .wpforms-field input[type=email],\r\n\t\tbody #wpforms-62 .wpforms-form .wpforms-field input[type=tel],\r\n\t\tbody #wpforms-62 .wpforms-form .wpforms-field input[type=url],\r\n\t\tbody #wpforms-62 .wpforms-form .wpforms-field input[type=password],\r\n\t\tbody #wpforms-62 .wpforms-form .wpforms-field input[type=number]{\r\n\t\t\tfont-size:16px ;\t\t\t}\r\n\tbody #wpforms-62 .wpforms-form .wpforms-field .wpforms-field-row{\r\n\t\t\t\r\n\t}\t\r\n\r\n\tbody #wpforms-62 .wpforms-form .wpforms-field .wpforms-field-row input{\r\n\t\twidth: 100%;\r\n\t}\r\n\t\t\r\n\t\tbody #wpforms-62 .wpforms-form .wpforms-field select{\r\n\t\tfont-size:16px ;\t\t\t\t}       \r\n\r\n\t\tbody #wpforms-62 .wpforms-form .wpforms-field label.wpforms-field-label,\r\n\t\tbody #wpforms-62 .wpforms-form .wpforms-field .wpforms-field-label{\r\n\t\tfont-size:16px ;line-height:20px;\t\t}       \r\n\t\tbody #wpforms-62 .wpforms-form .wpforms-field .wpforms-field-description {\r\n\t\tfont-size:16px ;\t\t}      \r\n\r\n\r\n}\r\n\r\n@media only screen and (max-width: 480px){\r\n\t\r\n\r\n\r\n\r\n\tbody #wpforms-62 .wpforms-form .wpforms-field input[type=text],\r\n\t\tbody #wpforms-62 .wpforms-form .wpforms-field input[type=email],\r\n\t\tbody #wpforms-62 .wpforms-form .wpforms-field input[type=tel],\r\n\t\tbody #wpforms-62 .wpforms-form .wpforms-field input[type=url],\r\n\t\tbody #wpforms-62 .wpforms-form .wpforms-field input[type=password],\r\n\t\tbody #wpforms-62 .wpforms-form .wpforms-field input[type=number]{\r\n\t\t\tfont-size:16px ;\t\t\t\t\t} \r\n\r\n\t\tbody #wpforms-62 .wpforms-form .wpforms-field .wpforms-field-row{\r\n\t\t\t\t\t}\r\n\tbody #wpforms-62 .wpforms-form .wpforms-field select{\r\n\t\tfont-size:16px ;\t\t\t\t}\r\n\r\n\t\tbody #wpforms-62 .wpforms-form .wpforms-field label.wpforms-field-label,\r\n\t\tbody #wpforms-62 .wpforms-form .wpforms-field .wpforms-field-label{\r\n\t\tfont-size:16px ;line-height:20px;\t\t}       \r\n\t\tbody #wpforms-62 .wpforms-form .wpforms-field .wpforms-field-description {\r\n\t\tfont-size:16px ;\t\t}       \r\n\r\n}\r\n\/*Option to add custom CSS *\/\r\n\r\n\r\n\r\n\t\t<\/style>\r\n\t\t<div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-62\"><form id=\"wpforms-form-62\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"62\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/checkup\/wp-json\/wp\/v2\/pages\/22\" data-token=\"4e16b68607abea1ddf5cfc0a8527c557\"><div class=\"wpforms-head-container\"><\/div><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-page-indicator none\" data-indicator=\"none\" data-indicator-color=\"#72b239\" data-scroll=\"1\"><\/div><div class=\"wpforms-field-container\"><div class=\"wpforms-page wpforms-page-1 \"><div id=\"wpforms-62-field_13-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-id=\"13\"><\/div><div id=\"wpforms-62-field_4-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"4\"><h3 id=\"wpforms-62-field_4\" name=\"wpforms[fields][4]\">Caregiver Physical Health<\/h3><div class=\"wpforms-field-description\">This section of the checkup explores your physical health, including your diet, exercise, sleep, care for existing conditions, doctor visits, etc. <\/div><\/div><div id=\"wpforms-62-field_38-container\" class=\"wpforms-field wpforms-field-hidden\" data-field-id=\"38\"><input type=\"hidden\" id=\"wpforms-62-field_38\" name=\"wpforms[fields][38]\" value=\".\"><\/div><div id=\"wpforms-62-field_8-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_8\">I consider the food choices I make overall to be\u2026<\/label><ul id=\"wpforms-62-field_8\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_8_1\" name=\"wpforms[fields][8]\" value=\"Terrible\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_8_1\">Terrible<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_8_2\" name=\"wpforms[fields][8]\" value=\"Poor\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_8_2\">Poor<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_8_3\" name=\"wpforms[fields][8]\" value=\"Fair\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_8_3\">Fair<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_8_4\" name=\"wpforms[fields][8]\" value=\"Good\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_8_4\">Good<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_8_5\" name=\"wpforms[fields][8]\" value=\"Excellent\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_8_5\">Excellent<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_11-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"11\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_11\">I exercise _____ days in an average week.<\/label><ul id=\"wpforms-62-field_11\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_11_1\" name=\"wpforms[fields][11]\" value=\"0\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_11_1\">0<\/label><\/li><li class=\"choice-7 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_11_7\" name=\"wpforms[fields][11]\" value=\"1 - 2\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_11_7\">1 - 2<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_11_3\" name=\"wpforms[fields][11]\" value=\"3 - 4\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_11_3\">3 - 4<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_11_4\" name=\"wpforms[fields][11]\" value=\"5 - 6\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_11_4\">5 - 6<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_11_5\" name=\"wpforms[fields][11]\" value=\"7\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_11_5\">7<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_20-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"20\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_20\">Across one week, I average _____ hours of sleep  per night.<\/label><ul id=\"wpforms-62-field_20\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_20_1\" name=\"wpforms[fields][20]\" value=\"0 - 2\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_20_1\">0 - 2<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_20_2\" name=\"wpforms[fields][20]\" value=\"2 - 4\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_20_2\">2 - 4<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_20_3\" name=\"wpforms[fields][20]\" value=\"4 - 6\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_20_3\">4 - 6<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_20_4\" name=\"wpforms[fields][20]\" value=\"6 - 8\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_20_4\">6 - 8<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_20_5\" name=\"wpforms[fields][20]\" value=\"8+\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_20_5\">8+<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_31-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"31\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_31\">The importance I assign to my physical health is best described as... <\/label><ul id=\"wpforms-62-field_31\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_31_1\" name=\"wpforms[fields][31]\" value=\"Not important\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_31_1\">Not important<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_31_2\" name=\"wpforms[fields][31]\" value=\"Somewhat important\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_31_2\">Somewhat important<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_31_3\" name=\"wpforms[fields][31]\" value=\"Moderately important\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_31_3\">Moderately important<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_31_4\" name=\"wpforms[fields][31]\" value=\"Quite important\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_31_4\">Quite important<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_31_5\" name=\"wpforms[fields][31]\" value=\"Extremely important\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_31_5\">Extremely important<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_32-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"32\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_32\">I consider my overall physical health to be... <\/label><ul id=\"wpforms-62-field_32\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_32_1\" name=\"wpforms[fields][32]\" value=\"Terrible\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_32_1\">Terrible<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_32_2\" name=\"wpforms[fields][32]\" value=\"Poor\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_32_2\">Poor<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_32_3\" name=\"wpforms[fields][32]\" value=\"Fair\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_32_3\">Fair<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_32_4\" name=\"wpforms[fields][32]\" value=\"Good\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_32_4\">Good<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_32_5\" name=\"wpforms[fields][32]\" value=\"Excellent\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_32_5\">Excellent<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_34-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"34\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_34\">The degree to which my overall physical health has been negatively affected by my role as a caregiver is... <\/label><ul id=\"wpforms-62-field_34\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_34_1\" name=\"wpforms[fields][34]\" value=\"Not at all\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_34_1\">Not at all<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_34_2\" name=\"wpforms[fields][34]\" value=\"Some\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_34_2\">Some<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_34_3\" name=\"wpforms[fields][34]\" value=\"Moderately\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_34_3\">Moderately<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_34_4\" name=\"wpforms[fields][34]\" value=\"Quite a bit\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_34_4\">Quite a bit<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_34_5\" name=\"wpforms[fields][34]\" value=\"Extremely\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_34_5\">Extremely<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_36-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-id=\"36\"><div class=\"wpforms-clear wpforms-pagebreak-left\"><button class=\"wpforms-page-button wpforms-page-next\" data-action=\"next\" data-page=\"1\" data-formid=\"62\" disabled>Next --&gt; Mental and Emotional Health<\/button><\/div><\/div><\/div><div class=\"wpforms-page wpforms-page-2  \" style=\"display:none;\"><div id=\"wpforms-62-field_37-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"37\"><h3 id=\"wpforms-62-field_37\" name=\"wpforms[fields][37]\">Caregiver Mental and Emotional Health<\/h3><div class=\"wpforms-field-description\">This section of the checkup explores your mental and emotional health, including questions that examine stress, guilt, respite, depression, resilience, coping skills, spiritual practices, etc.<\/div><\/div><div id=\"wpforms-62-field_39-container\" class=\"wpforms-field wpforms-field-hidden\" data-field-id=\"39\"><input type=\"hidden\" id=\"wpforms-62-field_39\" name=\"wpforms[fields][39]\" value=\".\"><\/div><div id=\"wpforms-62-field_41-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"41\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_41\">How would you describe your life\u2019s current stress level?  <\/label><ul id=\"wpforms-62-field_41\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_41_1\" name=\"wpforms[fields][41]\" value=\"Not at all Stressful\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_41_1\">Not at all Stressful<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_41_2\" name=\"wpforms[fields][41]\" value=\"Somewhat Stressful\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_41_2\">Somewhat Stressful<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_41_3\" name=\"wpforms[fields][41]\" value=\"Moderately Stressful\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_41_3\">Moderately Stressful<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_41_4\" name=\"wpforms[fields][41]\" value=\"Quite Stressful\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_41_4\">Quite Stressful<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_41_5\" name=\"wpforms[fields][41]\" value=\"Extremely Stressful\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_41_5\">Extremely Stressful<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_44-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"44\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_44\">Describe the level of irritation, anger, or resentment you feel.<\/label><ul id=\"wpforms-62-field_44\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_44_1\" name=\"wpforms[fields][44]\" value=\"Not at all Angry\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_44_1\">Not at all Angry<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_44_2\" name=\"wpforms[fields][44]\" value=\"Somewhat Angry\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_44_2\">Somewhat Angry<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_44_3\" name=\"wpforms[fields][44]\" value=\"Moderately Angry\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_44_3\">Moderately Angry<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_44_4\" name=\"wpforms[fields][44]\" value=\"Quite Angry\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_44_4\">Quite Angry<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_44_5\" name=\"wpforms[fields][44]\" value=\"Extremely Angry\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_44_5\">Extremely Angry<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_45-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"45\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_45\">Describe the level of sadness\/depression you experience (this includes feelings of hopelessness\/worthlessness).<\/label><ul id=\"wpforms-62-field_45\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_45_1\" name=\"wpforms[fields][45]\" value=\"Not at all Sad\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_45_1\">Not at all Sad<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_45_2\" name=\"wpforms[fields][45]\" value=\"Somewhat Sad\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_45_2\">Somewhat Sad<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_45_3\" name=\"wpforms[fields][45]\" value=\"Moderately Sad\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_45_3\">Moderately Sad<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_45_4\" name=\"wpforms[fields][45]\" value=\"Quite Sad\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_45_4\">Quite Sad<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_45_5\" name=\"wpforms[fields][45]\" value=\"Extremely Sad\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_45_5\">Extremely Sad<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_47-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"47\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_47\">How much worry\/anxiety do you feel for your life as a whole (not just the caregiving situation you are in)?<\/label><ul id=\"wpforms-62-field_47\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_47_1\" name=\"wpforms[fields][47]\" value=\"No\/Very Little Worry\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_47_1\">No\/Very Little Worry<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_47_2\" name=\"wpforms[fields][47]\" value=\"Some Worry\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_47_2\">Some Worry<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_47_3\" name=\"wpforms[fields][47]\" value=\"Moderate Worry\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_47_3\">Moderate Worry<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_47_4\" name=\"wpforms[fields][47]\" value=\"Quite a bit of Worry\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_47_4\">Quite a bit of Worry<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_47_5\" name=\"wpforms[fields][47]\" value=\"Extreme Worry\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_47_5\">Extreme Worry<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_52-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"52\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_52\">How would you describe your ability and skills to cope and\/or manage your thoughts and feelings?<\/label><ul id=\"wpforms-62-field_52\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_52_1\" name=\"wpforms[fields][52]\" value=\"Terrible\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_52_1\">Terrible<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_52_2\" name=\"wpforms[fields][52]\" value=\"Poor\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_52_2\">Poor<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_52_3\" name=\"wpforms[fields][52]\" value=\"Fair\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_52_3\">Fair<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_52_4\" name=\"wpforms[fields][52]\" value=\"Good\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_52_4\">Good<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_52_5\" name=\"wpforms[fields][52]\" value=\"Excellent\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_52_5\">Excellent<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_55-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"55\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_55\">The importance I assign to my mental\/emotional health is best described as:<\/label><ul id=\"wpforms-62-field_55\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_55_1\" name=\"wpforms[fields][55]\" value=\"Not Important\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_55_1\">Not Important<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_55_2\" name=\"wpforms[fields][55]\" value=\"Somewhat Important\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_55_2\">Somewhat Important<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_55_3\" name=\"wpforms[fields][55]\" value=\"Moderately Important\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_55_3\">Moderately Important<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_55_4\" name=\"wpforms[fields][55]\" value=\"Quite Important\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_55_4\">Quite Important<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_55_5\" name=\"wpforms[fields][55]\" value=\"Extremely Important\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_55_5\">Extremely Important<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_56-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"56\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_56\">I consider my overall mental\/emotional health to be\u2026<\/label><ul id=\"wpforms-62-field_56\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_56_1\" name=\"wpforms[fields][56]\" value=\"Terrible\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_56_1\">Terrible<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_56_2\" name=\"wpforms[fields][56]\" value=\"Poor\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_56_2\">Poor<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_56_3\" name=\"wpforms[fields][56]\" value=\"Fair\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_56_3\">Fair<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_56_4\" name=\"wpforms[fields][56]\" value=\"Good\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_56_4\">Good<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_56_5\" name=\"wpforms[fields][56]\" value=\"Excellent\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_56_5\">Excellent<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_57-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"57\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_57\">The degree to which my overall mental\/emotional health has been negatively affected\/disrupted by my role as a caregiver is... <\/label><ul id=\"wpforms-62-field_57\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_57_1\" name=\"wpforms[fields][57]\" value=\"Not at All\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_57_1\">Not at All<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_57_2\" name=\"wpforms[fields][57]\" value=\"Some\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_57_2\">Some<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_57_3\" name=\"wpforms[fields][57]\" value=\"Moderately\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_57_3\">Moderately<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_57_4\" name=\"wpforms[fields][57]\" value=\"Quite a Bit\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_57_4\">Quite a Bit<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_57_5\" name=\"wpforms[fields][57]\" value=\"Extremely\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_57_5\">Extremely<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_59-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-id=\"59\"><div class=\"wpforms-clear wpforms-pagebreak-left\"><button class=\"wpforms-page-button wpforms-page-next\" data-action=\"next\" data-page=\"2\" data-formid=\"62\" disabled>Next --&gt; Social and Family Health<\/button><\/div><\/div><\/div><div class=\"wpforms-page wpforms-page-3  \" style=\"display:none;\"><div id=\"wpforms-62-field_60-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"60\"><h3 id=\"wpforms-62-field_60\" name=\"wpforms[fields][60]\">Caregiver Social and Family Health<\/h3><div class=\"wpforms-field-description\">This section of the checkup explores the health of your social interactions and family relationships.<\/div><\/div><div id=\"wpforms-62-field_77-container\" class=\"wpforms-field wpforms-field-hidden\" data-field-id=\"77\"><input type=\"hidden\" id=\"wpforms-62-field_77\" name=\"wpforms[fields][77]\" value=\".\"><\/div><div id=\"wpforms-62-field_61-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"61\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_61\">How would you describe your level of loneliness\/isolation in your caregiving role?<\/label><ul id=\"wpforms-62-field_61\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_61_1\" name=\"wpforms[fields][61]\" value=\"Not at all Lonely\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_61_1\">Not at all Lonely<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_61_2\" name=\"wpforms[fields][61]\" value=\"Somewhat Lonely\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_61_2\">Somewhat Lonely<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_61_3\" name=\"wpforms[fields][61]\" value=\"Moderately Lonely\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_61_3\">Moderately Lonely<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_61_4\" name=\"wpforms[fields][61]\" value=\"Quite a Bit Lonely\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_61_4\">Quite a Bit Lonely<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_61_5\" name=\"wpforms[fields][61]\" value=\"Extremely Lonely\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_61_5\">Extremely Lonely<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_65-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"65\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_65\">What is the quality of your current relationship with your significant other\/spouse\/partner.<\/label><ul id=\"wpforms-62-field_65\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_65_1\" name=\"wpforms[fields][65]\" value=\"Terrible--We constantly fight and bitterly disagree about decisions and issues.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_65_1\">Terrible--We constantly fight and bitterly disagree about decisions and issues.<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_65_2\" name=\"wpforms[fields][65]\" value=\"Poor--We are not close, we disagree, but it is not constant\/bitter.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_65_2\">Poor--We are not close, we disagree, but it is not constant\/bitter.<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_65_3\" name=\"wpforms[fields][65]\" value=\"Fair--We make it work, but it\u2019s neither warm nor cold. \"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_65_3\">Fair--We make it work, but it\u2019s neither warm nor cold. <\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_65_4\" name=\"wpforms[fields][65]\" value=\"Good--We are mostly aligned and work well together, but it\u2019s not overly warm.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_65_4\">Good--We are mostly aligned and work well together, but it\u2019s not overly warm.<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_65_5\" name=\"wpforms[fields][65]\" value=\"Excellent--The relationship is incredibly warm and loving, we are almost always aligned.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_65_5\">Excellent--The relationship is incredibly warm and loving, we are almost always aligned.<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_65_6\" name=\"wpforms[fields][65]\" value=\"N\/A - No significant other\/spouse\/partner.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_65_6\">N\/A - No significant other\/spouse\/partner.<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_63-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"63\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_63\">What is the \u201caverage level\u201d relationship you have with your family members?<\/label><ul id=\"wpforms-62-field_63\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_63_1\" name=\"wpforms[fields][63]\" value=\"Terrible--We constantly fight and bitterly disagree about decisions and issues.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_63_1\">Terrible--We constantly fight and bitterly disagree about decisions and issues.<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_63_2\" name=\"wpforms[fields][63]\" value=\"Poor--We are not close, we disagree, but it is not constant\/bitter.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_63_2\">Poor--We are not close, we disagree, but it is not constant\/bitter.<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_63_3\" name=\"wpforms[fields][63]\" value=\"Fair--We make it work, but it\u2019s neither warm nor cold. \"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_63_3\">Fair--We make it work, but it\u2019s neither warm nor cold. <\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_63_4\" name=\"wpforms[fields][63]\" value=\"Good--We are mostly aligned and work well together, but it\u2019s not overly warm.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_63_4\">Good--We are mostly aligned and work well together, but it\u2019s not overly warm.<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_63_5\" name=\"wpforms[fields][63]\" value=\"Excellent--The relationship is incredibly warm and loving, we are almost always aligned.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_63_5\">Excellent--The relationship is incredibly warm and loving, we are almost always aligned.<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_63_6\" name=\"wpforms[fields][63]\" value=\"N\/A - No other family members are directly engaged in this caregiving situation.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_63_6\">N\/A - No other family members are directly engaged in this caregiving situation.<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_69-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"69\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_69\">Considering your total level of social interactions across all groups--family, co-workers, friends, and others--what amount of social interaction do you have? <\/label><ul id=\"wpforms-62-field_69\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_69_1\" name=\"wpforms[fields][69]\" value=\"Less than I need\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_69_1\">Less than I need<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_69_2\" name=\"wpforms[fields][69]\" value=\"Just what I need\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_69_2\">Just what I need<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_69_3\" name=\"wpforms[fields][69]\" value=\"More than I need\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_69_3\">More than I need<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_70-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"70\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_70\">The importance I assign to my social and family health is best described as\u2026<\/label><ul id=\"wpforms-62-field_70\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_70_1\" name=\"wpforms[fields][70]\" value=\"Not Important\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_70_1\">Not Important<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_70_2\" name=\"wpforms[fields][70]\" value=\"Somewhat Important\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_70_2\">Somewhat Important<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_70_3\" name=\"wpforms[fields][70]\" value=\"Moderately Important\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_70_3\">Moderately Important<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_70_4\" name=\"wpforms[fields][70]\" value=\"Quite Important\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_70_4\">Quite Important<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_70_5\" name=\"wpforms[fields][70]\" value=\"Extremely Important\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_70_5\">Extremely Important<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_71-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"71\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_71\">I consider my overall social interactions\/health to be\u2026<\/label><ul id=\"wpforms-62-field_71\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_71_1\" name=\"wpforms[fields][71]\" value=\"Terrible\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_71_1\">Terrible<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_71_2\" name=\"wpforms[fields][71]\" value=\"Poor\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_71_2\">Poor<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_71_3\" name=\"wpforms[fields][71]\" value=\"Fair\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_71_3\">Fair<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_71_4\" name=\"wpforms[fields][71]\" value=\"Good\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_71_4\">Good<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_71_5\" name=\"wpforms[fields][71]\" value=\"Excellent\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_71_5\">Excellent<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_72-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"72\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_72\">The degree to which my overall social interactions\/health has been negatively affected\/disrupted by my role as a caregiver is\u2026<\/label><ul id=\"wpforms-62-field_72\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_72_1\" name=\"wpforms[fields][72]\" value=\"Not at All\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_72_1\">Not at All<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_72_2\" name=\"wpforms[fields][72]\" value=\"Some\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_72_2\">Some<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_72_3\" name=\"wpforms[fields][72]\" value=\"Moderately\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_72_3\">Moderately<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_72_4\" name=\"wpforms[fields][72]\" value=\"Quite a Bit\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_72_4\">Quite a Bit<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_72_5\" name=\"wpforms[fields][72]\" value=\"Extremely\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_72_5\">Extremely<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_74-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-id=\"74\"><div class=\"wpforms-clear wpforms-pagebreak-left\"><button class=\"wpforms-page-button wpforms-page-next\" data-action=\"next\" data-page=\"3\" data-formid=\"62\" disabled>Next --&gt; Financial and Career Health<\/button><\/div><\/div><\/div><div class=\"wpforms-page wpforms-page-4  \" style=\"display:none;\"><div id=\"wpforms-62-field_75-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"75\"><h3 id=\"wpforms-62-field_75\" name=\"wpforms[fields][75]\">Caregiver Financial and Career Health<\/h3><div class=\"wpforms-field-description\">This section of the checkup explores your financial\/employment health, including how much time is spent in your caregiving role.<\/div><\/div><div id=\"wpforms-62-field_76-container\" class=\"wpforms-field wpforms-field-hidden\" data-field-id=\"76\"><input type=\"hidden\" id=\"wpforms-62-field_76\" name=\"wpforms[fields][76]\" value=\".\"><\/div><div id=\"wpforms-62-field_80-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"80\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_80\">As objectively as you can, select which statement best describes the amount of TIME you spend as a caregiver:<\/label><ul id=\"wpforms-62-field_80\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_80_1\" name=\"wpforms[fields][80]\" value=\"I spend entirely too much time as a caregiver and my life is out of control because of it. \"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_80_1\">I spend entirely too much time as a caregiver and my life is out of control because of it. <\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_80_2\" name=\"wpforms[fields][80]\" value=\"I spend more time than I likely need to spend as a caregiver and would like to reduce those hours.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_80_2\">I spend more time than I likely need to spend as a caregiver and would like to reduce those hours.<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_80_3\" name=\"wpforms[fields][80]\" value=\"I think I spend just about the right amount of time as a caregiver--it\u2019s in balance and I am satisfied.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_80_3\">I think I spend just about the right amount of time as a caregiver--it\u2019s in balance and I am satisfied.<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_80_4\" name=\"wpforms[fields][80]\" value=\"I should spend more time than I do as a caregiver and would like to increase those hours.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_80_4\">I should spend more time than I do as a caregiver and would like to increase those hours.<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_80_5\" name=\"wpforms[fields][80]\" value=\"I spend entirely too little time as a caregiver--and have a strong desire to spend more time.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_80_5\">I spend entirely too little time as a caregiver--and have a strong desire to spend more time.<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_82-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"82\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_82\">As objectively as you can, select which statement best describes the amount of MONEY you spend on this caregiving situation:<\/label><ul id=\"wpforms-62-field_82\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_82_1\" name=\"wpforms[fields][82]\" value=\"I spend entirely too much money on this caregiving situation and my finances and financial future are in  great danger.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_82_1\">I spend entirely too much money on this caregiving situation and my finances and financial future are in  great danger.<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_82_2\" name=\"wpforms[fields][82]\" value=\"I spend more money than I likely should be spending on this caregiving situation and would like to  reduce that spend.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_82_2\">I spend more money than I likely should be spending on this caregiving situation and would like to  reduce that spend.<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_82_3\" name=\"wpforms[fields][82]\" value=\"I think I spend just about the right amount of money on this caregiving situation; I\u2019m satisfied.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_82_3\">I think I spend just about the right amount of money on this caregiving situation; I\u2019m satisfied.<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_82_4\" name=\"wpforms[fields][82]\" value=\"I should spend more money on this caregiving situation than I do, and I\u2019d like to increase that spend.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_82_4\">I should spend more money on this caregiving situation than I do, and I\u2019d like to increase that spend.<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_82_5\" name=\"wpforms[fields][82]\" value=\"I spend entirely too little money on this caregiving situation and have a strong desire to spend more.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_82_5\">I spend entirely too little money on this caregiving situation and have a strong desire to spend more.<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_83-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"83\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_83\">Choose the statement below that best characterizes how you think about your career and your caregiving responsibilities:<\/label><ul id=\"wpforms-62-field_83\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_83_1\" name=\"wpforms[fields][83]\" value=\"My caregiving responsibilities have affected my career by 0 - 5%.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_83_1\">My caregiving responsibilities have affected my career by 0 - 5%.<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_83_2\" name=\"wpforms[fields][83]\" value=\"My caregiving responsibilities have affected my career by 5 - 25%.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_83_2\">My caregiving responsibilities have affected my career by 5 - 25%.<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_83_3\" name=\"wpforms[fields][83]\" value=\"My caregiving responsibilities have affected my career by 25 - 50%.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_83_3\">My caregiving responsibilities have affected my career by 25 - 50%.<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_83_4\" name=\"wpforms[fields][83]\" value=\"My caregiving responsibilities have affected my career by 50 - 75%.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_83_4\">My caregiving responsibilities have affected my career by 50 - 75%.<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_83_5\" name=\"wpforms[fields][83]\" value=\"My caregiving responsibilities have affected my career by 75 - 100%.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_83_5\">My caregiving responsibilities have affected my career by 75 - 100%.<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_90-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"90\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_90\">The degree to which my overall financial\/career health has been negatively affected\/disrupted by my role as a caregiver is\u2026<\/label><ul id=\"wpforms-62-field_90\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_90_1\" name=\"wpforms[fields][90]\" value=\"Not at All\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_90_1\">Not at All<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_90_2\" name=\"wpforms[fields][90]\" value=\"Some\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_90_2\">Some<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_90_3\" name=\"wpforms[fields][90]\" value=\"Moderately\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_90_3\">Moderately<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_90_4\" name=\"wpforms[fields][90]\" value=\"Quite a Bit\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_90_4\">Quite a Bit<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_90_5\" name=\"wpforms[fields][90]\" value=\"Extremely\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_90_5\">Extremely<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_92-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-id=\"92\"><div class=\"wpforms-clear wpforms-pagebreak-left\"><button class=\"wpforms-page-button wpforms-page-next\" data-action=\"next\" data-page=\"4\" data-formid=\"62\" disabled>Next --&gt; Caregiving Landscape<\/button><\/div><\/div><\/div><div class=\"wpforms-page wpforms-page-5  \" style=\"display:none;\"><div id=\"wpforms-62-field_93-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"93\"><h3 id=\"wpforms-62-field_93\" name=\"wpforms[fields][93]\">Health of the Caregiving Landscape<\/h3><div class=\"wpforms-field-description\">This section of the checkup explores the health of your \u201cCaregiving Landscape.\u201d  The health of the care situation you are managing, including your recipient of care\u2019s health, their housing, and the collaboration of others--as it has a direct impact on your health. The below questions explore areas of that Landscape at a general level. <\/div><\/div><div id=\"wpforms-62-field_94-container\" class=\"wpforms-field wpforms-field-hidden\" data-field-id=\"94\"><input type=\"hidden\" id=\"wpforms-62-field_94\" name=\"wpforms[fields][94]\" value=\".\"><\/div><div id=\"wpforms-62-field_95-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"95\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_95\">The physical health, including mobility, of my care recipient is....<\/label><ul id=\"wpforms-62-field_95\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_95_1\" name=\"wpforms[fields][95]\" value=\"Terrible\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_95_1\">Terrible<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_95_2\" name=\"wpforms[fields][95]\" value=\"Poor\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_95_2\">Poor<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_95_3\" name=\"wpforms[fields][95]\" value=\"Fair\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_95_3\">Fair<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_95_4\" name=\"wpforms[fields][95]\" value=\"Good\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_95_4\">Good<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_95_5\" name=\"wpforms[fields][95]\" value=\"Excellent\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_95_5\">Excellent<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_96-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"96\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_96\">The mental and emotional  health of my care recipient (including their cognitive\/thinking abilities) is....<\/label><ul id=\"wpforms-62-field_96\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_96_1\" name=\"wpforms[fields][96]\" value=\"Terrible\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_96_1\">Terrible<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_96_2\" name=\"wpforms[fields][96]\" value=\"Poor\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_96_2\">Poor<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_96_3\" name=\"wpforms[fields][96]\" value=\"Fair\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_96_3\">Fair<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_96_4\" name=\"wpforms[fields][96]\" value=\"Good\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_96_4\">Good<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_96_5\" name=\"wpforms[fields][96]\" value=\"Excellent\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_96_5\">Excellent<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_97-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"97\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_97\">The health of my care recipient\u2019s relationships with their family and other social connections is\u2026.<\/label><ul id=\"wpforms-62-field_97\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_97_1\" name=\"wpforms[fields][97]\" value=\"Terrible\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_97_1\">Terrible<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_97_2\" name=\"wpforms[fields][97]\" value=\"Poor\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_97_2\">Poor<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_97_3\" name=\"wpforms[fields][97]\" value=\"Fair\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_97_3\">Fair<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_97_4\" name=\"wpforms[fields][97]\" value=\"Good\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_97_4\">Good<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_97_5\" name=\"wpforms[fields][97]\" value=\"Excellent\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_97_5\">Excellent<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_98-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"98\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_98\">My care recipient\u2019s sense of identity and purpose is\u2026.<\/label><ul id=\"wpforms-62-field_98\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_98_1\" name=\"wpforms[fields][98]\" value=\"Terrible\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_98_1\">Terrible<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_98_2\" name=\"wpforms[fields][98]\" value=\"Poor\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_98_2\">Poor<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_98_3\" name=\"wpforms[fields][98]\" value=\"Fair\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_98_3\">Fair<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_98_4\" name=\"wpforms[fields][98]\" value=\"Good\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_98_4\">Good<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_98_5\" name=\"wpforms[fields][98]\" value=\"Excellent\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_98_5\">Excellent<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_99-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"99\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_99\">The financial and legal health of my care recipient is....<\/label><ul id=\"wpforms-62-field_99\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_99_1\" name=\"wpforms[fields][99]\" value=\"Terrible\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_99_1\">Terrible<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_99_2\" name=\"wpforms[fields][99]\" value=\"Poor\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_99_2\">Poor<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_99_3\" name=\"wpforms[fields][99]\" value=\"Fair\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_99_3\">Fair<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_99_4\" name=\"wpforms[fields][99]\" value=\"Good\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_99_4\">Good<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_99_5\" name=\"wpforms[fields][99]\" value=\"Excellent\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_99_5\">Excellent<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_100-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"100\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_100\">The condition of my care recipient\u2019s housing and transportation is\u2026.<\/label><ul id=\"wpforms-62-field_100\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_100_1\" name=\"wpforms[fields][100]\" value=\"Terrible\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_100_1\">Terrible<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_100_2\" name=\"wpforms[fields][100]\" value=\"Poor\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_100_2\">Poor<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_100_3\" name=\"wpforms[fields][100]\" value=\"Fair\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_100_3\">Fair<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_100_4\" name=\"wpforms[fields][100]\" value=\"Good\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_100_4\">Good<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_100_5\" name=\"wpforms[fields][100]\" value=\"Excellent\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_100_5\">Excellent<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_101-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"101\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_101\">The availability, balance, and quality of my care recipient\u2019s external services and outside help is\u2026.<\/label><ul id=\"wpforms-62-field_101\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_101_1\" name=\"wpforms[fields][101]\" value=\"Terrible\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_101_1\">Terrible<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_101_2\" name=\"wpforms[fields][101]\" value=\"Poor\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_101_2\">Poor<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_101_3\" name=\"wpforms[fields][101]\" value=\"Fair\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_101_3\">Fair<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_101_4\" name=\"wpforms[fields][101]\" value=\"Good\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_101_4\">Good<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_101_5\" name=\"wpforms[fields][101]\" value=\"Excellent\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_101_5\">Excellent<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_102-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"102\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_102\">The degree to which my care recipient\u2019s situation is planned, monitored, and coordinated is\u2026. <\/label><ul id=\"wpforms-62-field_102\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_102_1\" name=\"wpforms[fields][102]\" value=\"Terrible\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_102_1\">Terrible<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_102_2\" name=\"wpforms[fields][102]\" value=\"Poor\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_102_2\">Poor<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_102_3\" name=\"wpforms[fields][102]\" value=\"Fair\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_102_3\">Fair<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_102_4\" name=\"wpforms[fields][102]\" value=\"Good\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_102_4\">Good<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_102_5\" name=\"wpforms[fields][102]\" value=\"Excellent\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_102_5\">Excellent<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_103-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-id=\"103\"><div class=\"wpforms-clear wpforms-pagebreak-left\"><button class=\"wpforms-page-button wpforms-page-next\" data-action=\"next\" data-page=\"5\" data-formid=\"62\" disabled>Next --&gt; Demographics (Optional Information)<\/button><\/div><\/div><\/div><div class=\"wpforms-page wpforms-page-6 last \" style=\"display:none;\"><div id=\"wpforms-62-field_104-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"104\"><h3 id=\"wpforms-62-field_104\" name=\"wpforms[fields][104]\">DEMOGRAPHICS<\/h3><div class=\"wpforms-field-description\">(Optional -- Please fill out all fields that you are comfortable sharing with us; we will use this information to guide course and service creation.)<\/div><\/div><div id=\"wpforms-62-field_123-container\" class=\"wpforms-field wpforms-field-hidden\" data-field-id=\"123\"><input type=\"hidden\" id=\"wpforms-62-field_123\" name=\"wpforms[fields][123]\" value=\".\"><\/div><div id=\"wpforms-62-field_105-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"105\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_105\">Name<\/label><input type=\"text\" id=\"wpforms-62-field_105\" class=\"wpforms-field-medium\" name=\"wpforms[fields][105]\" ><\/div><div id=\"wpforms-62-field_106-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"106\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_106\">Age<\/label><input type=\"text\" id=\"wpforms-62-field_106\" class=\"wpforms-field-medium\" name=\"wpforms[fields][106]\" ><\/div><div id=\"wpforms-62-field_108-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-modern\" data-field-id=\"108\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_108\">Gender<\/label><select id=\"wpforms-62-field_108\" class=\"wpforms-field-medium choicesjs-select\" data-size-class=\"wpforms-field-row wpforms-field-medium\" data-search-enabled=\"\" name=\"wpforms[fields][108]\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>Male<\/option><option value=\"Male\" >Male<\/option><option value=\"Female\" >Female<\/option><option value=\"Non-Binary\" >Non-Binary<\/option><option value=\"Prefer not to say\" >Prefer not to say<\/option><\/select><\/div><div id=\"wpforms-62-field_109-container\" class=\"wpforms-field wpforms-field-address\" data-field-id=\"109\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_109\">Address<\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div ><input type=\"text\" id=\"wpforms-62-field_109\" class=\"wpforms-field-address-address1\" name=\"wpforms[fields][109][address1]\" ><label for=\"wpforms-62-field_109\" class=\"wpforms-field-sublabel after \">Address Line 1<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div ><input type=\"text\" id=\"wpforms-62-field_109-address2\" class=\"wpforms-field-address-address2\" name=\"wpforms[fields][109][address2]\" ><label for=\"wpforms-62-field_109-address2\" class=\"wpforms-field-sublabel after \">Address Line 2<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-62-field_109-city\" class=\"wpforms-field-address-city\" name=\"wpforms[fields][109][city]\" ><label for=\"wpforms-62-field_109-city\" class=\"wpforms-field-sublabel after \">City<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><select id=\"wpforms-62-field_109-state\" class=\"wpforms-field-address-state\" name=\"wpforms[fields][109][state]\" ><option value=\"AL\" >Alabama<\/option><option value=\"AK\" >Alaska<\/option><option value=\"AZ\" >Arizona<\/option><option value=\"AR\" >Arkansas<\/option><option value=\"CA\" >California<\/option><option value=\"CO\" >Colorado<\/option><option value=\"CT\" >Connecticut<\/option><option value=\"DE\" >Delaware<\/option><option value=\"DC\" >District of Columbia<\/option><option value=\"FL\" >Florida<\/option><option value=\"GA\" >Georgia<\/option><option value=\"HI\" >Hawaii<\/option><option value=\"ID\" >Idaho<\/option><option value=\"IL\" >Illinois<\/option><option value=\"IN\" >Indiana<\/option><option value=\"IA\" >Iowa<\/option><option value=\"KS\" >Kansas<\/option><option value=\"KY\" >Kentucky<\/option><option value=\"LA\" >Louisiana<\/option><option value=\"ME\" >Maine<\/option><option value=\"MD\" >Maryland<\/option><option value=\"MA\" >Massachusetts<\/option><option value=\"MI\" >Michigan<\/option><option value=\"MN\" >Minnesota<\/option><option value=\"MS\" >Mississippi<\/option><option value=\"MO\" >Missouri<\/option><option value=\"MT\" >Montana<\/option><option value=\"NE\" >Nebraska<\/option><option value=\"NV\" >Nevada<\/option><option value=\"NH\" >New Hampshire<\/option><option value=\"NJ\" >New Jersey<\/option><option value=\"NM\" >New Mexico<\/option><option value=\"NY\" >New York<\/option><option value=\"NC\" >North Carolina<\/option><option value=\"ND\" >North Dakota<\/option><option value=\"OH\" >Ohio<\/option><option value=\"OK\" >Oklahoma<\/option><option value=\"OR\" >Oregon<\/option><option value=\"PA\" >Pennsylvania<\/option><option value=\"RI\" >Rhode Island<\/option><option value=\"SC\" >South Carolina<\/option><option value=\"SD\" >South Dakota<\/option><option value=\"TN\" >Tennessee<\/option><option value=\"TX\" >Texas<\/option><option value=\"UT\" >Utah<\/option><option value=\"VT\" >Vermont<\/option><option value=\"VA\" >Virginia<\/option><option value=\"WA\" >Washington<\/option><option value=\"WV\" >West Virginia<\/option><option value=\"WI\" >Wisconsin<\/option><option value=\"WY\" >Wyoming<\/option><\/select><label for=\"wpforms-62-field_109-state\" class=\"wpforms-field-sublabel after \">State<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-62-field_109-postal\" class=\"wpforms-field-address-postal wpforms-masked-input\" data-inputmask-mask=\"99999[-9999]\" data-inputmask-greedy=\"false\" data-rule-empty-blanks=\"1\" name=\"wpforms[fields][109][postal]\" ><label for=\"wpforms-62-field_109-postal\" class=\"wpforms-field-sublabel after \">Zip Code<\/label><\/div><\/div><\/div><div id=\"wpforms-62-field_110-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-modern\" data-field-id=\"110\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_110\">Level of Education<\/label><select id=\"wpforms-62-field_110\" class=\"wpforms-field-medium choicesjs-select\" data-size-class=\"wpforms-field-row wpforms-field-medium\" data-search-enabled=\"\" name=\"wpforms[fields][110]\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>High School<\/option><option value=\"High School\" >High School<\/option><option value=\"Some College\" >Some College<\/option><option value=\"Associate&#039;s\" >Associate&#039;s<\/option><option value=\"Bachelor&#039;s\" >Bachelor&#039;s<\/option><option value=\"Master&#039;s\" >Master&#039;s<\/option><option value=\"PhD\" >PhD<\/option><\/select><\/div><div id=\"wpforms-62-field_111-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"111\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_111\">Employment:<\/label><ul id=\"wpforms-62-field_111\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_111_1\" name=\"wpforms[fields][111]\" value=\"Part-Time\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_111_1\">Part-Time<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_111_2\" name=\"wpforms[fields][111]\" value=\"Full-Time\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_111_2\">Full-Time<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_111_3\" name=\"wpforms[fields][111]\" value=\"Self-Employed\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_111_3\">Self-Employed<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_111_4\" name=\"wpforms[fields][111]\" value=\"No Work\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_111_4\">No Work<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_112-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"112\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_112\">Number of Children<\/label><input type=\"number\" pattern=\"\\d*\" id=\"wpforms-62-field_112\" class=\"wpforms-field-small\" name=\"wpforms[fields][112]\" ><\/div><div id=\"wpforms-62-field_113-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"113\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_113\">Children&#039;s Ages, if applicable:<\/label><input type=\"text\" id=\"wpforms-62-field_113\" class=\"wpforms-field-medium\" name=\"wpforms[fields][113]\" ><\/div><div id=\"wpforms-62-field_114-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"114\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_114\">Do children live with you? <\/label><ul id=\"wpforms-62-field_114\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_114_1\" name=\"wpforms[fields][114]\" value=\"Yes\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_114_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_114_2\" name=\"wpforms[fields][114]\" value=\"No\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_114_2\">No<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_114_3\" name=\"wpforms[fields][114]\" value=\"N\/A\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_114_3\">N\/A<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_115-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-modern\" data-field-id=\"115\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_115\">Recipient of Care Gender:<\/label><select id=\"wpforms-62-field_115\" class=\"wpforms-field-medium choicesjs-select\" data-size-class=\"wpforms-field-row wpforms-field-medium\" data-search-enabled=\"\" name=\"wpforms[fields][115]\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>Male<\/option><option value=\"Male\" >Male<\/option><option value=\"Female\" >Female<\/option><option value=\"Prefer not to say\" >Prefer not to say<\/option><\/select><\/div><div id=\"wpforms-62-field_116-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"116\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_116\">Recipient of Care Age:<\/label><input type=\"number\" pattern=\"\\d*\" id=\"wpforms-62-field_116\" class=\"wpforms-field-small\" name=\"wpforms[fields][116]\" ><\/div><div id=\"wpforms-62-field_117-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-modern\" data-field-id=\"117\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_117\">Recipient of Care Relationship -- The recipient of care is my: <\/label><select id=\"wpforms-62-field_117\" class=\"wpforms-field-medium choicesjs-select\" data-size-class=\"wpforms-field-row wpforms-field-medium\" data-search-enabled=\"1\" name=\"wpforms[fields][117]\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>Mother<\/option><option value=\"Mother\" >Mother<\/option><option value=\"Father\" >Father<\/option><option value=\"Grandmother\" >Grandmother<\/option><option value=\"Grandfather\" >Grandfather<\/option><option value=\"Spouse\/Significant Other\" >Spouse\/Significant Other<\/option><option value=\"Brother\" >Brother<\/option><option value=\"Sister\" >Sister<\/option><option value=\"Aunt\" >Aunt<\/option><option value=\"Uncle\" >Uncle<\/option><option value=\"Son\" >Son<\/option><option value=\"Daughter\" >Daughter<\/option><option value=\"Other\" >Other<\/option><\/select><\/div><div id=\"wpforms-62-field_118-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"118\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_118\">Do you live with the recipient of care?<\/label><ul id=\"wpforms-62-field_118\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_118_1\" name=\"wpforms[fields][118]\" value=\"Yes\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_118_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_118_2\" name=\"wpforms[fields][118]\" value=\"No\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_118_2\">No<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_120-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"120\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_120\">If yes:<\/label><ul id=\"wpforms-62-field_120\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_120_1\" name=\"wpforms[fields][120]\" value=\"Your Home\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_120_1\">Your Home<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-62-field_120_2\" name=\"wpforms[fields][120]\" value=\"Other\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-62-field_120_2\">Other<\/label><\/li><\/ul><\/div><div id=\"wpforms-62-field_121-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"121\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-62-field_121\">Other Location<\/label><input type=\"text\" id=\"wpforms-62-field_121\" class=\"wpforms-field-large\" name=\"wpforms[fields][121]\" placeholder=\"Other location description\" ><\/div><div id=\"wpforms-62-field_3-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-62-field_3\">Email - Please enter your best email for sending a copy of your check-up. <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-62-field_3\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][3]\" required><\/div><div id=\"wpforms-62-field_14-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-id=\"14\"><div class=\"wpforms-clear wpforms-pagebreak-left\"><\/div><\/div><\/div><\/div><div class=\"wpforms-submit-container\" style=\"display:none;\"><input type=\"hidden\" name=\"wpforms[id]\" value=\"62\"><input type=\"hidden\" name=\"wpforms[author]\" value=\"1\"><button type=\"submit\" name=\"wpforms[submit]\" class=\"wpforms-submit \" id=\"wpforms-submit-62\" value=\"wpforms-submit\" aria-live=\"assertive\" data-alt-text=\"Processing...\" data-submit-text=\"Submit\">Submit<\/button><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/communityforcaregivers.com\/checkup\/wp-content\/plugins\/wpforms\/assets\/images\/submit-spin.svg\" class=\"wpforms-submit-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"\"><\/div><\/form><\/div>  <!-- .wpforms-container -->\n","protected":false},"excerpt":{"rendered":"<p>This check-up is designed to assess these four distinct areas of Caregiver Health: Physical Health, Mental &amp; Emotional Health, Social &amp; Family Health, and Financial &amp; Career Health. Getting stronger in these four areas helps caregivers on their path to becoming healthier, experiencing a greater sense of wellness, and building resilience for the days ahead. [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-22","page","type-page","status-publish","hentry","post"],"_links":{"self":[{"href":"https:\/\/communityforcaregivers.com\/checkup\/wp-json\/wp\/v2\/pages\/22","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/communityforcaregivers.com\/checkup\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/communityforcaregivers.com\/checkup\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/communityforcaregivers.com\/checkup\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/communityforcaregivers.com\/checkup\/wp-json\/wp\/v2\/comments?post=22"}],"version-history":[{"count":14,"href":"https:\/\/communityforcaregivers.com\/checkup\/wp-json\/wp\/v2\/pages\/22\/revisions"}],"predecessor-version":[{"id":185,"href":"https:\/\/communityforcaregivers.com\/checkup\/wp-json\/wp\/v2\/pages\/22\/revisions\/185"}],"wp:attachment":[{"href":"https:\/\/communityforcaregivers.com\/checkup\/wp-json\/wp\/v2\/media?parent=22"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}