{"id":622,"date":"2026-02-11T07:09:17","date_gmt":"2026-02-11T07:09:17","guid":{"rendered":"http:\/\/www.avonleaclinic.com.au\/upgrade\/?page_id=622"},"modified":"2026-02-11T07:10:45","modified_gmt":"2026-02-11T07:10:45","slug":"take-our-survey","status":"publish","type":"page","link":"http:\/\/www.avonleaclinic.com.au\/upgrade\/take-our-survey\/","title":{"rendered":"Take Our Survey"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row row_height_percent=&#8221;80&#8243; back_color=&#8221;color-wayh&#8221; overlay_alpha=&#8221;50&#8243; gutter_size=&#8221;3&#8243; column_width_percent=&#8221;100&#8243; shift_y=&#8221;0&#8243; z_index=&#8221;0&#8243; content_parallax=&#8221;0&#8243; uncode_shortcode_id=&#8221;191419&#8243; back_color_type=&#8221;uncode-palette&#8221;][vc_column width=&#8221;1\/1&#8243;][uncode_slider slider_type=&#8221;fade&#8221; slider_interval=&#8221;5000&#8243; slider_navspeed=&#8221;400&#8243; slider_loop=&#8221;yes&#8221;][vc_row_inner 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animation_delay=&#8221;400&#8243; uncode_shortcode_id=&#8221;787655&#8243; heading_custom_size=&#8221;100&#8243;]Take Our Survey[\/vc_custom_heading][vc_column_text text_lead=&#8221;yes&#8221; css_animation=&#8221;bottom-t-top&#8221; animation_delay=&#8221;600&#8243; uncode_shortcode_id=&#8221;184109&#8243;]We have a few questions we\u2019d love you to answer.[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/uncode_slider][\/vc_column][\/vc_row][vc_row row_height_percent=&#8221;0&#8243; override_padding=&#8221;yes&#8221; h_padding=&#8221;2&#8243; top_padding=&#8221;5&#8243; bottom_padding=&#8221;2&#8243; overlay_alpha=&#8221;50&#8243; gutter_size=&#8221;3&#8243; column_width_percent=&#8221;100&#8243; shift_y=&#8221;0&#8243; z_index=&#8221;0&#8243; content_parallax=&#8221;0&#8243; uncode_shortcode_id=&#8221;188425&#8243;][vc_column width=&#8221;1\/1&#8243;][vc_custom_heading text_color=&#8221;accent&#8221; heading_semantic=&#8221;h6&#8243; text_size=&#8221;h6&#8243; text_transform=&#8221;uppercase&#8221; text_space=&#8221;fontspace-184360&#8243; uncode_shortcode_id=&#8221;192155&#8243; text_color_type=&#8221;uncode-palette&#8221;]Take our survey[\/vc_custom_heading][vc_custom_heading text_size=&#8221;h1&#8243; uncode_shortcode_id=&#8221;200045&#8243;]It\u2019ll help us continue to provide a great experience for everyone.[\/vc_custom_heading][vc_column_text text_lead=&#8221;yes&#8221; uncode_shortcode_id=&#8221;214061&#8243;]Your responses will be kept anonymous.[\/vc_column_text][\/vc_column][\/vc_row][vc_row row_height_percent=&#8221;0&#8243; override_padding=&#8221;yes&#8221; h_padding=&#8221;2&#8243; top_padding=&#8221;2&#8243; bottom_padding=&#8221;4&#8243; back_image=&#8221;575&#8243; back_repeat=&#8221;no-repeat&#8221; back_attachment=&#8221;scroll&#8221; back_position=&#8221;left bottom&#8221; parallax=&#8221;yes&#8221; kburns=&#8221;yes&#8221; overlay_alpha=&#8221;50&#8243; gutter_size=&#8221;3&#8243; column_width_percent=&#8221;100&#8243; 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novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_3' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_3_44\" class=\"gfield gfield--type-select gf_left_half gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_44'>Doctor you consulted with.<\/label><div class='ginput_container ginput_container_select'><select name='input_44' id='input_3_44' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select<\/option><option value='Dr Tony Ma' >Dr Tony Ma<\/option><option value='Dr Marilla Druitt' >Dr Marilla Druitt<\/option><option value='Dr Anne Hotchin' >Dr Anne Hotchin<\/option><\/select><\/div><\/div><div id=\"field_3_46\" class=\"gfield gfield--type-html gfield_html 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for='choice_3_2_0' id='label_3_2_0' class='gform-field-label gform-field-label--type-inline'>Obstetric<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_2_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_2' type='radio' value='Gynaecological'  id='choice_3_2_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_2_1' id='label_3_2_1' class='gform-field-label gform-field-label--type-inline'>Gynaecological<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_2_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_2' type='radio' value='Both'  id='choice_3_2_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_2_2' id='label_3_2_2' class='gform-field-label gform-field-label--type-inline'>Both<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_3_1\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gf_right_third gfield--width-third field_sublabel_below 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gform-field-label--type-inline'>Strongly Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_4_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_4' type='radio' value='Agree'  id='choice_3_4_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_4_1' id='label_3_4_1' class='gform-field-label gform-field-label--type-inline'>Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_4_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_4' type='radio' value='Disagree'  id='choice_3_4_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_4_2' id='label_3_4_2' class='gform-field-label gform-field-label--type-inline'>Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_4_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_4' type='radio' value='Strongly Disagree'  id='choice_3_4_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_4_3' id='label_3_4_3' class='gform-field-label gform-field-label--type-inline'>Strongly Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_4_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_4' type='radio' value='Not Applicable'  id='choice_3_4_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_4_4' id='label_3_4_4' class='gform-field-label gform-field-label--type-inline'>Not Applicable<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_3_5\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gf_right_half gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >I found staff at the practice welcoming and friendly.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_5'>\n\t\t\t<div class='gchoice gchoice_3_5_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_5' type='radio' value='Strongly Agree'  id='choice_3_5_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_5_0' id='label_3_5_0' class='gform-field-label gform-field-label--type-inline'>Strongly Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_5_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_5' type='radio' value='Agree'  id='choice_3_5_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_5_1' id='label_3_5_1' class='gform-field-label gform-field-label--type-inline'>Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_5_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_5' type='radio' value='Disagree'  id='choice_3_5_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_5_2' id='label_3_5_2' class='gform-field-label gform-field-label--type-inline'>Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_5_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_5' type='radio' value='Strongly Disagree'  id='choice_3_5_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_5_3' id='label_3_5_3' class='gform-field-label gform-field-label--type-inline'>Strongly Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_5_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_5' type='radio' value='Not Applicable'  id='choice_3_5_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_5_4' id='label_3_5_4' class='gform-field-label gform-field-label--type-inline'>Not Applicable<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3_35\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_3_6\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gf_left_half gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >You were made aware of our fee schedule prior to attending your appointment.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_6'>\n\t\t\t<div class='gchoice gchoice_3_6_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='Strongly Agree'  id='choice_3_6_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_6_0' id='label_3_6_0' class='gform-field-label gform-field-label--type-inline'>Strongly Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_6_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='Agree'  id='choice_3_6_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_6_1' id='label_3_6_1' class='gform-field-label gform-field-label--type-inline'>Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_6_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='Disagree'  id='choice_3_6_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_6_2' id='label_3_6_2' class='gform-field-label gform-field-label--type-inline'>Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_6_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='Strongly Disagree'  id='choice_3_6_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_6_3' id='label_3_6_3' class='gform-field-label gform-field-label--type-inline'>Strongly Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_6_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='Not Applicable'  id='choice_3_6_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_6_4' id='label_3_6_4' class='gform-field-label gform-field-label--type-inline'>Not Applicable<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_3_7\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gf_right_half gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >The staff were helpful and assisted me with my queries.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_7'>\n\t\t\t<div class='gchoice gchoice_3_7_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='Strongly Agree'  id='choice_3_7_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_7_0' id='label_3_7_0' class='gform-field-label gform-field-label--type-inline'>Strongly Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_7_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='Agree'  id='choice_3_7_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_7_1' id='label_3_7_1' class='gform-field-label gform-field-label--type-inline'>Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_7_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='Disagree'  id='choice_3_7_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_7_2' id='label_3_7_2' class='gform-field-label gform-field-label--type-inline'>Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_7_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='Strongly Disagree'  id='choice_3_7_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_7_3' id='label_3_7_3' class='gform-field-label gform-field-label--type-inline'>Strongly Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_7_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='Not Applicable'  id='choice_3_7_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_7_4' id='label_3_7_4' class='gform-field-label gform-field-label--type-inline'>Not Applicable<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3_32\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_3_8\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gf_left_half gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >You received information on COVID guidelines from our staff prior to your appointment.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_8'>\n\t\t\t<div class='gchoice gchoice_3_8_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='Strongly Agree'  id='choice_3_8_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_8_0' id='label_3_8_0' class='gform-field-label gform-field-label--type-inline'>Strongly Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_8_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='Agree'  id='choice_3_8_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_8_1' id='label_3_8_1' class='gform-field-label gform-field-label--type-inline'>Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_8_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='Disagree'  id='choice_3_8_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_8_2' id='label_3_8_2' class='gform-field-label gform-field-label--type-inline'>Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_8_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='Strongly Disagree'  id='choice_3_8_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_8_3' id='label_3_8_3' class='gform-field-label gform-field-label--type-inline'>Strongly Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_8_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='Not Applicable'  id='choice_3_8_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_8_4' id='label_3_8_4' class='gform-field-label gform-field-label--type-inline'>Not Applicable<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_3_9\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gf_right_half gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >You feel the guidelines were appropriate.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_9'>\n\t\t\t<div class='gchoice gchoice_3_9_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Strongly Agree'  id='choice_3_9_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_9_0' id='label_3_9_0' class='gform-field-label gform-field-label--type-inline'>Strongly Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_9_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Agree'  id='choice_3_9_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_9_1' id='label_3_9_1' class='gform-field-label gform-field-label--type-inline'>Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_9_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Disagree'  id='choice_3_9_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_9_2' id='label_3_9_2' class='gform-field-label gform-field-label--type-inline'>Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_9_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Strongly Disagree'  id='choice_3_9_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_9_3' id='label_3_9_3' class='gform-field-label gform-field-label--type-inline'>Strongly Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_9_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Not Applicable'  id='choice_3_9_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_9_4' id='label_3_9_4' class='gform-field-label gform-field-label--type-inline'>Not Applicable<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3_36\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_3_10\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gf_left_half gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Did you view the Avonlea website prior to booking your appointment?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_10'>\n\t\t\t<div class='gchoice gchoice_3_10_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='Yes'  id='choice_3_10_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_10_0' id='label_3_10_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_10_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='No'  id='choice_3_10_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_10_1' id='label_3_10_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_3_11\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gf_right_half gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >The website was helpful.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_11'>\n\t\t\t<div class='gchoice gchoice_3_11_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='Strongly Agree'  id='choice_3_11_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_11_0' id='label_3_11_0' class='gform-field-label gform-field-label--type-inline'>Strongly Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_11_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='Agree'  id='choice_3_11_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_11_1' id='label_3_11_1' class='gform-field-label gform-field-label--type-inline'>Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_11_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='Disagree'  id='choice_3_11_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_11_2' id='label_3_11_2' class='gform-field-label gform-field-label--type-inline'>Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_11_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='Strongly Disagree'  id='choice_3_11_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_11_3' id='label_3_11_3' class='gform-field-label gform-field-label--type-inline'>Strongly Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_11_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='Not Applicable'  id='choice_3_11_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_11_4' id='label_3_11_4' class='gform-field-label gform-field-label--type-inline'>Not Applicable<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3_37\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_3_14\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >On arrival I found the waiting time to see the specialist reasonable.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_14'>\n\t\t\t<div class='gchoice gchoice_3_14_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='Strongly Agree'  id='choice_3_14_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_14_0' id='label_3_14_0' class='gform-field-label gform-field-label--type-inline'>Strongly Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_14_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='Agree'  id='choice_3_14_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_14_1' id='label_3_14_1' class='gform-field-label gform-field-label--type-inline'>Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_14_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='Disagree'  id='choice_3_14_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_14_2' id='label_3_14_2' class='gform-field-label gform-field-label--type-inline'>Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_14_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='Strongly Disagree'  id='choice_3_14_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_14_3' id='label_3_14_3' class='gform-field-label gform-field-label--type-inline'>Strongly Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_14_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='Not Applicable'  id='choice_3_14_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_14_4' id='label_3_14_4' class='gform-field-label gform-field-label--type-inline'>Not Applicable<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3_13\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_13'>Approximately how many minutes after your scheduled appointment time did your consultation begin?<\/label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_3_13' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_38\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_3_12\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gf_right_half gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >The doctor was professional and respectful towards me at all times.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_12'>\n\t\t\t<div class='gchoice gchoice_3_12_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Strongly Agree'  id='choice_3_12_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_12_0' id='label_3_12_0' class='gform-field-label gform-field-label--type-inline'>Strongly Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_12_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Agree'  id='choice_3_12_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_12_1' id='label_3_12_1' class='gform-field-label gform-field-label--type-inline'>Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_12_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Disagree'  id='choice_3_12_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_12_2' id='label_3_12_2' class='gform-field-label gform-field-label--type-inline'>Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_12_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Strongly Disagree'  id='choice_3_12_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_12_3' id='label_3_12_3' class='gform-field-label gform-field-label--type-inline'>Strongly Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_12_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Not Applicable'  id='choice_3_12_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_12_4' id='label_3_12_4' class='gform-field-label gform-field-label--type-inline'>Not Applicable<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_3_15\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gf_left_half gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >I felt the doctor listened to me and valued my opinion.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_15'>\n\t\t\t<div class='gchoice gchoice_3_15_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='Strongly Agree'  id='choice_3_15_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_15_0' id='label_3_15_0' class='gform-field-label gform-field-label--type-inline'>Strongly Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_15_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='Agree'  id='choice_3_15_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_15_1' id='label_3_15_1' class='gform-field-label gform-field-label--type-inline'>Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_15_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='Disagree'  id='choice_3_15_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_15_2' id='label_3_15_2' class='gform-field-label gform-field-label--type-inline'>Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_15_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='Strongly Disagree'  id='choice_3_15_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_15_3' id='label_3_15_3' class='gform-field-label gform-field-label--type-inline'>Strongly Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_15_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='Not Applicable'  id='choice_3_15_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_15_4' id='label_3_15_4' class='gform-field-label gform-field-label--type-inline'>Not Applicable<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3_39\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_3_16\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gf_right_half gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >I felt the doctor made me feel as comfortable as possible during my examination.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_16'>\n\t\t\t<div class='gchoice gchoice_3_16_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='Strongly Agree'  id='choice_3_16_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_16_0' id='label_3_16_0' class='gform-field-label gform-field-label--type-inline'>Strongly Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_16_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='Agree'  id='choice_3_16_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_16_1' id='label_3_16_1' class='gform-field-label gform-field-label--type-inline'>Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_16_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='Disagree'  id='choice_3_16_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_16_2' id='label_3_16_2' class='gform-field-label gform-field-label--type-inline'>Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_16_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='Strongly Disagree'  id='choice_3_16_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_16_3' id='label_3_16_3' class='gform-field-label gform-field-label--type-inline'>Strongly Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_16_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='Not Applicable'  id='choice_3_16_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_16_4' id='label_3_16_4' class='gform-field-label gform-field-label--type-inline'>Not Applicable<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_3_17\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gf_left_half gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >I felt confident in the knowledge and expertise of the doctor.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_17'>\n\t\t\t<div class='gchoice gchoice_3_17_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='Strongly Agree'  id='choice_3_17_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_17_0' id='label_3_17_0' class='gform-field-label gform-field-label--type-inline'>Strongly Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_17_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='Agree'  id='choice_3_17_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_17_1' id='label_3_17_1' class='gform-field-label gform-field-label--type-inline'>Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_17_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='Disagree'  id='choice_3_17_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_17_2' id='label_3_17_2' class='gform-field-label gform-field-label--type-inline'>Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_17_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='Strongly Disagree'  id='choice_3_17_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_17_3' id='label_3_17_3' class='gform-field-label gform-field-label--type-inline'>Strongly Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_17_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='Not Applicable'  id='choice_3_17_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_17_4' id='label_3_17_4' class='gform-field-label gform-field-label--type-inline'>Not Applicable<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3_40\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_3_18\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gf_right_half gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >I felt able to talk to the doctor about private and personal issues relating to the reason for my visit.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_18'>\n\t\t\t<div class='gchoice gchoice_3_18_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='Strongly Agree'  id='choice_3_18_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_18_0' id='label_3_18_0' class='gform-field-label gform-field-label--type-inline'>Strongly Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_18_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='Agree'  id='choice_3_18_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_18_1' id='label_3_18_1' class='gform-field-label gform-field-label--type-inline'>Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_18_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='Disagree'  id='choice_3_18_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_18_2' id='label_3_18_2' class='gform-field-label gform-field-label--type-inline'>Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_18_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='Strongly Disagree'  id='choice_3_18_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_18_3' id='label_3_18_3' class='gform-field-label gform-field-label--type-inline'>Strongly Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_18_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='Not Applicable'  id='choice_3_18_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_18_4' id='label_3_18_4' class='gform-field-label gform-field-label--type-inline'>Not Applicable<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_3_29\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gf_right_half gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >The doctor answered my questions in a way that was clear to me.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_29'>\n\t\t\t<div class='gchoice gchoice_3_29_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='Strongly Agree'  id='choice_3_29_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_29_0' id='label_3_29_0' class='gform-field-label gform-field-label--type-inline'>Strongly Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_29_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='Agree'  id='choice_3_29_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_29_1' id='label_3_29_1' class='gform-field-label gform-field-label--type-inline'>Agree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_29_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='Disagree'  id='choice_3_29_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_29_2' id='label_3_29_2' class='gform-field-label gform-field-label--type-inline'>Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_29_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='Strongly Disagree'  id='choice_3_29_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_29_3' id='label_3_29_3' class='gform-field-label gform-field-label--type-inline'>Strongly Disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_29_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='Not Applicable'  id='choice_3_29_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_29_4' id='label_3_29_4' class='gform-field-label gform-field-label--type-inline'>Not Applicable<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3_41\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_3_20\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >During this consultation, did the doctor order any pathology (e.g. blood test, urine test, etc.) or imaging (e.g. ultrasound, MRI, CT, X-ray etc.) for you to have done?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_20'>\n\t\t\t<div class='gchoice gchoice_3_20_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='Yes'  id='choice_3_20_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_20_0' id='label_3_20_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_20_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='No'  id='choice_3_20_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_20_1' id='label_3_20_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_3_23\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gf_left_half gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >The reason for the pathology\/imaging was made clear to me.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_23'>\n\t\t\t<div class='gchoice gchoice_3_23_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='Yes'  id='choice_3_23_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_23_0' id='label_3_23_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_23_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='No'  id='choice_3_23_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_23_1' id='label_3_23_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_3_24\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gf_left_half gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >The cost of the pathology\/imaging was made clear to me.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_24'>\n\t\t\t<div class='gchoice gchoice_3_24_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='Yes'  id='choice_3_24_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_24_0' id='label_3_24_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_24_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='No'  id='choice_3_24_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_24_1' id='label_3_24_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3_42\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_3_25\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >During this consultation, did the doctor prescribe you any medication?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_25'>\n\t\t\t<div class='gchoice gchoice_3_25_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='Yes'  id='choice_3_25_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_25_0' id='label_3_25_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_25_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='No'  id='choice_3_25_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_25_1' id='label_3_25_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_3_26\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gf_left_third gfield--width-third field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >The reason for the medication was made clear to me.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_26'>\n\t\t\t<div class='gchoice gchoice_3_26_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='Yes'  id='choice_3_26_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_26_0' id='label_3_26_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_26_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='No'  id='choice_3_26_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_26_1' id='label_3_26_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_3_27\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gf_middle_third gfield--width-third field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >The cost of the medication was made clear to me.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_27'>\n\t\t\t<div class='gchoice gchoice_3_27_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='Yes'  id='choice_3_27_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_27_0' id='label_3_27_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_27_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='No'  id='choice_3_27_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_27_1' id='label_3_27_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_3_28\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gf_right_third gfield--width-third field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >The side effects of the medication were made clear to me.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_28'>\n\t\t\t<div class='gchoice gchoice_3_28_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='Yes'  id='choice_3_28_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_28_0' id='label_3_28_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_28_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='No'  id='choice_3_28_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_28_1' id='label_3_28_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3_43\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_3_19\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gf_right_half gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >By the end of my consultation I felt better able to understand and\/or manage my condition and care.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_19'>\n\t\t\t<div class='gchoice gchoice_3_19_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='Yes'  id='choice_3_19_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_19_0' id='label_3_19_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_19_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='No'  id='choice_3_19_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_19_1' id='label_3_19_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_3_30\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline gf_left_half gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >I would recommend this doctor to others.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_30'>\n\t\t\t<div class='gchoice gchoice_3_30_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='Yes'  id='choice_3_30_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_30_0' id='label_3_30_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_30_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='No'  id='choice_3_30_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_30_1' id='label_3_30_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3_34\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_3_31\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_31'>Based on your experience at your most recent consultation, do you have any comments you would like to add regarding you what LIKED, or what could be IMPROVED ON, about the doctor or staff, their communication, provision of information, people skills, or some other aspect of the 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