{"id":8853,"date":"2020-09-21T11:15:45","date_gmt":"2020-09-21T15:15:45","guid":{"rendered":"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/?page_id=8853"},"modified":"2021-02-18T17:14:02","modified_gmt":"2021-02-18T22:14:02","slug":"ellenor-careplan-edit","status":"publish","type":"page","link":"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/customer\/ellenor-careplan-edit\/","title":{"rendered":"LSQ &#8211; Ellenor Johnson CarePlan \u2013 Edit"},"content":{"rendered":"<p><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 hundred-percent-fullwidth non-hundred-percent-height-scrolling fusion-no-medium-visibility fusion-no-large-visibility\" style=\"background-color: rgba(255,255,255,0);background-position: center center;background-repeat: no-repeat;padding-top:0px;padding-right:0px;padding-bottom:0px;padding-left:0px;margin-bottom: 10px;margin-top: 15px;border-width: 0px 0px 0px 0px;border-color:#eae9e9;border-style:solid;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"margin-top:0px;margin-bottom:0px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 30px;\">\n<div>\n<table border=\"0\" cellspacing=\"0px\">\n<tbody>\n<tr>\n<th style=\"text-align: left; padding-left: 0px;\" align=\"center\"><a href=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/pl\/pl-dashboard\"><img class=\"aligncenter size-full wp-image-575\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/03\/yiayia-mobile-nav-logo.png\" alt=\"\" width=\"26\" height=\"26\" \/><\/a><\/th>\n<th style=\"text-align: left; padding-left: 10px;\" align=\"center\"><a href=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/pl\/search-customers\/\"><img class=\"aligncenter size-full wp-image-575\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/03\/yiayia-customers-icon-blue.png\" alt=\"\" width=\"26\" height=\"26\" \/><\/a><\/th>\n<th style=\"text-align: left; padding-left: 10px;\" align=\"center\"><a href=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/pl\/search-team-members\/\"><img class=\"aligncenter size-full wp-image-575\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/03\/yiayia-team-icon-blue.png\" alt=\"\" width=\"26\" height=\"26\" \/><\/a><\/th>\n<th style=\"text-align: left; padding-left: 10px;\" align=\"center\"><a href=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/pl\/pl-reporting\/\"><img class=\"aligncenter size-full wp-image-575\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/03\/yiayia-reporting-icon-blue.png\" alt=\"\" width=\"26\" height=\"26\" \/><\/a><\/th>\n<th style=\"text-align: left; padding-left: 10px;\" align=\"center\"><a href=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/pl\/my-account\/\"><img class=\"aligncenter size-full wp-image-575\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2019\/10\/robert-brown-icon.png\" alt=\"\" width=\"26\" height=\"26\" \/><\/a><\/th>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"margin-top:0px;margin-bottom:0px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"margin-left: auto;margin-right: auto;margin-top:15px;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"border-color:#d3d3d3;border-top-width:1px;\"><\/div><\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div>\n<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2 p-zero-bottom hundred-percent-fullwidth non-hundred-percent-height-scrolling fusion-equal-height-columns\" style=\"background-color: rgba(255,255,255,0);background-position: center center;background-repeat: no-repeat;padding-top:0px;padding-right:0px;padding-bottom:0px;padding-left:0px;margin-bottom: 0px;margin-top: 0px;border-width: 0px 0px 0px 0px;border-color:#eae9e9;border-style:solid;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_1_6 1_6 fusion-one-sixth fusion-column-first narrow-nav fusion-no-small-visibility\" style=\"width:16.666666666667%;width:calc(16.666666666667% - ( ( 0px + 0px ) * 0.16666666666667 ) );margin-right: 0px;margin-top:0px;margin-bottom:0px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;border-width: 0 1px 0 0;border-color:#cccccc;border-style:solid;padding: 0px 0px 0px 0px;\"><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"margin-left: auto;margin-right: auto;margin-top:25px;width:100%;\"><\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-1 hover-type-none\" style=\"width:100%;max-width:34px;\"><a class=\"fusion-no-lightbox\" href=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/community\/community-dashboard\/\" target=\"_self\"><img width=\"38\" height=\"47\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/03\/yiayia-Icon-Color.png\" class=\"img-responsive wp-image-4378\"\/><\/a><\/span><\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"margin-left: auto;margin-right: auto;margin-top:90px;width:100%;\"><\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-text fusion-text-1\"><p style=\"margin-bottom: 0px;\"><a class=\"yiayia-icon-nav\" title=\"Admin\" href=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/customer\/admin-legacy-at-savannah-quarters\/\"><img class=\"alignleft size-full wp-image-575\" style=\"margin-left: 5px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/03\/yiayia-account-icon-blue.png\" alt=\"\" width=\"26\" height=\"26\" \/><\/a><\/p>\n<\/div><div class=\"fusion-text fusion-text-2\"><p style=\"margin-bottom: 0px;\"><a class=\"yiayia-icon-nav\" title=\"Residents\" href=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/community\/lsq-residents\/\"><img class=\"alignleft size-full wp-image-575\" style=\"margin-left: 5px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/03\/yiayia-residents-icon-blue.png\" alt=\"\" width=\"26\" height=\"26\" \/><\/a><\/p>\n<\/div><div class=\"fusion-text fusion-text-3\"><p style=\"margin-bottom: 0px;\"><a class=\"yiayia-icon-nav\" title=\"Health\" href=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/community\/lsq-health\/\"><img class=\"alignleft size-full wp-image-575\" style=\"margin-left: 5px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/03\/yiayia-health-icon-blue.png\" alt=\"\" width=\"26\" height=\"26\" \/><\/a><\/p>\n<\/div><div class=\"fusion-text fusion-text-4\"><p style=\"margin-bottom: 0px;\"><a class=\"yiayia-icon-nav\" title=\"Documents\" href=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/community\/lsq-documents\/\"><img class=\"alignleft size-full wp-image-575\" style=\"margin-left: 5px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/03\/yiayia-documents-icon-blue.png\" alt=\"\" width=\"26\" height=\"26\" \/><\/a><\/p>\n<\/div><div class=\"fusion-text fusion-text-5\"><p style=\"margin-bottom: 0px;\"><a class=\"yiayia-icon-nav\" title=\"Reporting\" href=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/community\/lsq-reporting\/\"><img class=\"alignleft size-full wp-image-575\" style=\"margin-left: 5px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/03\/yiayia-reporting-icon-blue.png\" alt=\"\" width=\"26\" height=\"26\" \/><\/a><\/p>\n<\/div><div class=\"fusion-text fusion-text-6\"><p style=\"margin-bottom: 0px;\"><a class=\"yiayia-icon-nav\" title=\"Social\" href=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/community\/lsq-social\/\"><img class=\"alignleft size-full wp-image-575\" style=\"margin-left: 5px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/10\/social-calendar-icon.svg\" alt=\"\" width=\"26\" height=\"26\" \/><\/a><\/p>\n<\/div><div class=\"fusion-text fusion-text-7\"><p style=\"margin-bottom: 0px;\"><a class=\"yiayia-icon-nav\" title=\"Building Operations\" href=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/community\/lsq-building-ops\/\"><img class=\"alignleft size-full wp-image-575\" style=\"margin-left: 5px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/10\/building-ops-icon.svg\" alt=\"\" width=\"26\" height=\"26\" \/><\/a><\/p>\n<\/div><div class=\"fusion-text fusion-text-8\"><p style=\"margin-bottom: 0px;\"><a class=\"yiayia-icon-nav\" title=\"Associates\" href=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/community\/lsq-associates\/\"><img class=\"alignleft size-full wp-image-575\" style=\"margin-left: 5px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/03\/yiayia-associates-icon-blue.png\" alt=\"\" width=\"26\" height=\"26\" \/><\/a><\/p>\n<\/div><div class=\"fusion-text fusion-text-9\"><p style=\"margin-bottom: 0px;\"><a class=\"yiayia-icon-nav\" title=\"Corporate\" href=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/community\/lsq-corporate\/\"><img class=\"alignleft size-full wp-image-575\" style=\"margin-left: 5px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/03\/yiayia-corporate-icon-blue.png\" alt=\"\" width=\"26\" height=\"26\" \/><\/a><\/p>\n<\/div><div class=\"fusion-text fusion-text-10\"><p style=\"margin-bottom: 0px;\"><a class=\"yiayia-icon-nav\" title=\"Learning\" href=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/community\/lsq-learning\/\"><img class=\"alignleft size-full wp-image-575\" style=\"margin-left: 5px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/03\/yiayia-learning-icon-blue.png\" alt=\"\" width=\"26\" height=\"26\" \/><\/a><\/p>\n<\/div><div class=\"fusion-text fusion-text-11\"><p style=\"margin-bottom: 0px;\"><a class=\"yiayia-icon-nav\" title=\"Me\" href=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/community\/community-dashboard\/#\"><img class=\"alignleft size-full wp-image-575\" style=\"margin-left: 5px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/10\/jdl-icon-blue-border.png\" alt=\"\" width=\"26\" height=\"26\" \/><\/a><\/p>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-3 fusion_builder_column_2_3 2_3 fusion-two-third middle-width-health\" style=\"width:66.666666666667%;width:calc(66.666666666667% - ( ( 0px + 0px ) * 0.66666666666667 ) );margin-right: 0px;margin-top:0px;margin-bottom:0px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 30px 0px 30px;\"><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-0 fusion_builder_column_inner_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last fusion-no-small-visibility\" style=\"margin-top:20px;margin-bottom:0px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-text fusion-text-12\"><div>\n<table border=\"0\" cellspacing=\"0px\">\n<tbody>\n<tr>\n<th style=\"text-align: left; padding-left: 0px; padding-top: 3px; table-layout: auto;\" align=\"left\"><a  class=\"shiftnav-toggle shiftnav-toggle-health shiftnav-toggle-button\" tabindex=\"0\" data-shiftnav-target=\"health\" ><i class=\"fa fa-bars\"><\/i>  <\/a>\t<\/th>\n<th style=\"text-align: left; padding-left: 0px; padding-right: 15px; padding-top: 8px;\" align=\"center\"><img class=\"aligncenter size-full wp-image-5566\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/04\/ellenor-johnson-circle-white-36.png\" alt=\"\" width=\"36\" height=\"36\" \/><\/th>\n<th align=\"left\">\n<h1 style=\"margin-bottom: 0px; margin-top: 8px; margin-left: 0px; table-layout: auto;\"><a title=\"Dashboard\" href=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/customer\/ellenor-health\/\">Ellenor Johnson<\/a><\/h1>\n<\/th>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"margin-left: auto;margin-right: auto;margin-top:30px;width:100%;\"><\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-text fusion-text-13\"><table style=\"margin: 0px;\" width=\"100%\" cellspacing=\"0px\">\n<tbody>\n<tr>\n<td width=\"25%\"><a class=\"health-button\" href=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/customer\/ellenor-health\/\">CARE<\/a><\/td>\n<td width=\"25%\"><a class=\"health-button-hover\" href=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/customer\/ellenor-careplan\/\">CAREPLAN<\/a><\/td>\n<td width=\"25%\"><a class=\"health-button\" href=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/customer\/ellenor-charting\/\">CHARTING<\/a><\/td>\n<td width=\"25%\"><a class=\"health-button\" href=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/customer\/ellenor-aci\/\">ACI<\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div><div class=\"fusion-text fusion-text-14\"><div style=\"margin-bottom: 15px; border-bottom: 1px solid #bbbbbb;\">\n<table border=\"0\" width=\"100%\" cellspacing=\"0px\">\n<tbody>\n<tr>\n<th style=\"text-align: left; padding-left: 0px;\" align=\"left\" width=\"20%\">\n<h3 style=\"padding: 15px 0 6px 0; margin: 0 0 3px 0; font-size: 18px; line-height: 1; font-family: Roboto Slab,Tahoma,sans-serif; font-weight: 300; color: #005174; background-color: transparent;\">CarePlan<\/h3>\n<\/th>\n<th style=\"text-align: left; padding-left: 0px; margin-top: 20px; margin-bottom: 0px;\" align=\"right\" width=\"41%\"><\/th>\n<th style=\"text-align: left; padding-left: 0px; margin-top: 20px; margin-bottom: 0px;\" align=\"right\" width=\"30%\"><\/th>\n<th style=\"text-align: right; padding-left: 0px;\" align=\"right\" width=\"3%\"><\/th>\n<th style=\"text-align: center; padding-left: 5px;\" align=\"center\" width=\"3%\"><\/th>\n<th style=\"text-align: right; padding-left: 0px;\" align=\"right\" width=\"3%\"><a href=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/customer\/ellenor-careplan\/\"><div class=\"fusion-fa-align-right\"><i class=\"fb-icon-element-1 fb-icon-element fontawesome-icon fa-check fas circle-no\" style=\"font-size:18px;margin-top:10px;margin-right:5px;margin-bottom:6px;\"><\/i><\/div><style>i.fb-icon-element.fontawesome-icon.fb-icon-element-1{ color: #005174;}i.fb-icon-element.fontawesome-icon.fb-icon-element-1:hover { color: #005174;}<\/style><\/a><\/th>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<\/div><div class=\"fusion-text fusion-text-15\"><div class=\"frm_forms  with_frm_style frm_style_health-edit-style\" id=\"frm_form_300_container\" >\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form  frm_pro_form \" id=\"form_ellenor-cp-top-edit\"  >\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_screen_reader\">Ellenor CP Top Edit<\/legend>\r\n\r\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"300\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_300\" id=\"frm_hide_fields_300\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"ellenor-cp-top-edit\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_300\" name=\"frm_submit_entry_300\" value=\"697e471e31\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/staging\/yiayia-web-app\/wp-json\/wp\/v2\/pages\/8853\" \/><input type=\"hidden\" name=\"item_meta[8044]\" id=\"field_4bhhg23dc9637a685e8ebbb015f850a188bd6a0d454e2149cb85a74c559c5b368d3306c1ceb531a7ad7f\" value=\"\"  data-invmsg=\"Create Resident is invalid\"   \/>\n<div id=\"frm_field_8045_container\" class=\"frm_form_field frm_section_heading form-field  frm_hide_section\">\r\n<h3 class=\"frm_pos_none frm_section_spacing\">Top Edit<\/h3>\r\n\r\n\r\n<div id=\"frm_field_8046_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_ul03p11775bf1b0bde0da0eb313584df8a85dc023fba6\" id=\"field_ul03p11775bf1b0bde0da0eb313584df8a85dc023fba6_label\" class=\"frm_primary_label\">Assessment Type\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[8046]\" id=\"field_ul03p11775bf1b0bde0da0eb313584df8a85dc023fba6\"  data-sectionid=\"8045\" data-frmval=\"Quarterly\" data-invmsg=\"Assessment Type is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"14-day\"  class=\"\">\n\t\t\t14-day\t\t<\/option>\n\t\t\t<option value=\"30-day\"  class=\"\">\n\t\t\t30-day\t\t<\/option>\n\t\t\t<option value=\"Interim\"  class=\"\">\n\t\t\tInterim\t\t<\/option>\n\t\t\t<option value=\"Quarterly\"  selected=\"selected\" class=\"\">\n\t\t\tQuarterly\t\t<\/option>\n\t\t\t<option value=\"Significant Change\"  class=\"\">\n\t\t\tSignificant Change\t\t<\/option>\n\t\t\t<option value=\"\"  class=\"\">\n\t\t\t \t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_8047_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth\">\r\n    <label for=\"field_1u5lz71cec44ded\" id=\"field_1u5lz71cec44ded_label\" class=\"frm_primary_label\">Mental Status\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[8047]\" id=\"field_1u5lz71cec44ded\"  data-sectionid=\"8045\" data-frmval=\"Alert and Oriented\" data-invmsg=\"Mental Status is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"(multi-select)\"  class=\"\">\n\t\t\t(multi-select)\t\t<\/option>\n\t\t\t<option value=\"Alert and Oriented\"  selected=\"selected\" class=\"\">\n\t\t\tAlert and Oriented\t\t<\/option>\n\t\t\t<option value=\"Elopement Risk\"  class=\"\">\n\t\t\tElopement Risk\t\t<\/option>\n\t\t\t<option value=\"Aggression \u2013 Physical\"  class=\"\">\n\t\t\tAggression \u2013 Physical\t\t<\/option>\n\t\t\t<option value=\"Aggression \u2013 Verbal\"  class=\"\">\n\t\t\tAggression \u2013 Verbal\t\t<\/option>\n\t\t\t<option value=\"Uncooperative\"  class=\"\">\n\t\t\tUncooperative\t\t<\/option>\n\t\t\t<option value=\"Confused \/ Disoriented\"  class=\"\">\n\t\t\tConfused \/ Disoriented\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_8428_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth\">\n    <label for=\"field_ckcze\" id=\"field_ckcze_label\" class=\"frm_primary_label\">Med Cart Assignment\n        <span class=\"frm_required\"><\/span>\n    <\/label>\n    \t\t<select name=\"item_meta[8428]\" id=\"field_ckcze\"  data-sectionid=\"8045\" data-frmval=\"Cart 1\" data-invmsg=\"Med Cart Assignment is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"Cart 1\"  selected=\"selected\" class=\"\">\n\t\t\tCart 1\t\t<\/option>\n\t\t\t<option value=\"Cart 2\"  class=\"\">\n\t\t\tCart 2\t\t<\/option>\n\t\t\t<option value=\"Cart 3\"  class=\"\">\n\t\t\tCart 3\t\t<\/option>\n\t\t<\/select>\n\t\n    \n    \n<\/div>\n<div id=\"frm_field_8052_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first horizontal_radio\">\n    <div  id=\"field_umd8l_label\" class=\"frm_primary_label\"><a class=\"fusion-modal-text-link\" data-toggle=\"modal\" data-target=\".fusion-modal.add_hospice_provider\" href=\"#\">Hospice<\/a>\n        <span class=\"frm_required\"><\/span>\n    <\/div>\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_umd8l_label\" role=\"group\">\t\t<div class=\"frm_radio\" id=\"frm_radio_8052-8045-0\"><label for=\"field_umd8l-0\">\t\t<input type=\"radio\" name=\"item_meta[8052]\" id=\"field_umd8l-0\" value=\"&lt;a class=&quot;fusion-modal-text-link&quot; data-toggle=&quot;modal&quot; data-target=&quot;.fusion-modal.add_hospice_provider&quot; href=&quot;#&quot;&gt;Yes&lt;\/a&gt;\"\n\t\t   data-sectionid=\"8045\" data-frmval=\"No\" data-invmsg=\"&lt;a class=&quot;fusion-modal-text-link&quot; data-toggle=&quot;modal&quot; data-target=&quot;.fusion-modal.add_hospice_provider&quot; href=&quot;#&quot;&gt;Hospice&lt;\/a&gt; is invalid\" aria-invalid=\"false\"  \/> <a class=\"fusion-modal-text-link\" href=\"#\">Yes<\/a><\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_8052-8045-1\"><label for=\"field_umd8l-1\">\t\t<input type=\"radio\" name=\"item_meta[8052]\" id=\"field_umd8l-1\" value=\"No\"\n\t\tchecked=\"checked\"   data-sectionid=\"8045\" data-frmval=\"No\" data-invmsg=\"&lt;a class=&quot;fusion-modal-text-link&quot; data-toggle=&quot;modal&quot; data-target=&quot;.fusion-modal.add_hospice_provider&quot; href=&quot;#&quot;&gt;Hospice&lt;\/a&gt; is invalid\" aria-invalid=\"false\"  \/> No<\/label><\/div>\n<\/div>\n    \n    \n<\/div>\n<div id=\"frm_field_8101_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth\">\n    <label for=\"field_zui4c\" id=\"field_zui4c_label\" class=\"frm_primary_label\">Hospice Agency\n        <span class=\"frm_required\"><\/span>\n    <\/label>\n    \t\t<select name=\"item_meta[8101]\" id=\"field_zui4c\"  data-sectionid=\"8045\" data-frmval=\"Lowcountry Hospice\" data-invmsg=\"Hospice Agency is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"Lowcountry Hospice\"  selected=\"selected\" class=\"\">\n\t\t\tLowcountry Hospice\t\t<\/option>\n\t\t\t<option value=\"Other Approved Providers...\"  class=\"\">\n\t\t\tOther Approved Providers...\t\t<\/option>\n\t\t<\/select>\n\t\n    \n    \n<\/div>\n<div id=\"frm_field_8050_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth\">\r\n    <label for=\"field_j3w0uc6db61ec49\" id=\"field_j3w0uc6db61ec49_label\" class=\"frm_primary_label\">Hospice Start Date\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_j3w0uc6db61ec49\" name=\"item_meta[8050]\" value=\"09\/18\/20\"  data-sectionid=\"8045\" maxlength=\"10\" data-frmval=\"09\/18\/20\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_8053_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth\">\r\n    <label for=\"field_ohaar\" id=\"field_ohaar_label\" class=\"frm_primary_label\">Date of 1st Hospice CarePlan\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_ohaar\" name=\"item_meta[8053]\" value=\"09\/21\/20\"  data-sectionid=\"8045\" maxlength=\"10\" data-frmval=\"09\/21\/20\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<\/div>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t<div class=\"frm_submit\">\r\n\r\n<button class=\"frm_button_submit frm_final_submit\" type=\"submit\"  >Submit<\/button>\r\n\r\n<\/div><\/div>\n<\/fieldset>\n<\/div>\n<\/form>\n<\/div>\n\n<\/div><div class=\"fusion-text fusion-text-16\"><div class=\"frm_forms  with_frm_style frm_style_health-edit-style\" id=\"frm_form_395_container\" >\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form  frm_pro_form \" id=\"form_careplan-edit-2021\"  >\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_screen_reader\">CarePlan Edit 2021<\/legend>\r\n\r\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"395\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_395\" id=\"frm_hide_fields_395\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"careplan-edit-2021\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_395\" name=\"frm_submit_entry_395\" value=\"697e471e31\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/staging\/yiayia-web-app\/wp-json\/wp\/v2\/pages\/8853\" \/><input type=\"hidden\" name=\"item_meta[11999]\" id=\"field_4bhhg23dc9637a685e8ebbb015f850a188bd6a0d454e64ebfeb406a279b0833\" value=\"\"  data-invmsg=\"Create Resident is invalid\"   \/>\n<div id=\"frm_field_12000_container\" class=\"frm_form_field  frm_html_container form-field\">\n<p style=\"border-bottom: 1px solid #b5b5b5; margin: 15px 0 5px 0; padding: 0;\">&nbsp;<\/p>\n<\/div>\n<div id=\"frm_field_12001_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing frm_trigger\"><i class=\"frm_icon_font frm_arrow_icon\" aria-expanded=\"false\" aria-label=\"Toggle fields\"><\/i> <img style=\"display: inline; margin-right: 10px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-bath-blue.svg\" width=\"30\" height=\"30\" \/>Bathing<\/h3>\r\n\r\n<div class=\"frm_toggle_container frm_grid_container\" style=\"display:none;\">\r\n<div id=\"frm_field_12002_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_vzkl44f5fe812e18f802a17a65b389612b7\" id=\"field_vzkl44f5fe812e18f802a17a65b389612b7_label\" class=\"frm_primary_label\">Level of Assistance\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[12002]\" id=\"field_vzkl44f5fe812e18f802a17a65b389612b7\"  data-sectionid=\"12001\" data-frmval=\"Some Assistance\" data-invmsg=\"Level of Assistance is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"Independent\"  class=\"\">\n\t\t\tIndependent\t\t<\/option>\n\t\t\t<option value=\"Some Assistance\"  selected=\"selected\" class=\"\">\n\t\t\tSome Assistance\t\t<\/option>\n\t\t\t<option value=\"Assisted\"  class=\"\">\n\t\t\tAssisted\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12003_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths horizontal_radio\">\r\n    <div  id=\"field_efjky80a1866bfa4beb1eca16_label\" class=\"frm_primary_label\">Assigned to\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_efjky80a1866bfa4beb1eca16_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12003-12001-0\"><label for=\"field_efjky80a1866bfa4beb1eca16-0\"><input type=\"checkbox\" name=\"item_meta[12003][]\" id=\"field_efjky80a1866bfa4beb1eca16-0\" value=\"Nursing\"  data-sectionid=\"12001\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Nursing<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12003-12001-1\"><label for=\"field_efjky80a1866bfa4beb1eca16-1\"><input type=\"checkbox\" name=\"item_meta[12003][]\" id=\"field_efjky80a1866bfa4beb1eca16-1\" value=\"Med Tech\"  data-sectionid=\"12001\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Med Tech<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12003-12001-2\"><label for=\"field_efjky80a1866bfa4beb1eca16-2\"><input type=\"checkbox\" name=\"item_meta[12003][]\" id=\"field_efjky80a1866bfa4beb1eca16-2\" value=\"Caregivers\" checked=\"checked\"  data-sectionid=\"12001\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Caregivers<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12006_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first frm_three_col\">\r\n    <div  id=\"field_u8vhfe6a52e1f5f_label\" class=\"frm_primary_label\">Frequency\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_u8vhfe6a52e1f5f_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12006-12001-0\"><label for=\"field_u8vhfe6a52e1f5f-0\"><input type=\"checkbox\" name=\"item_meta[12006][]\" id=\"field_u8vhfe6a52e1f5f-0\" value=\"SUN\"  data-sectionid=\"12001\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> SUN<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12006-12001-1\"><label for=\"field_u8vhfe6a52e1f5f-1\"><input type=\"checkbox\" name=\"item_meta[12006][]\" id=\"field_u8vhfe6a52e1f5f-1\" value=\"AM\"  data-sectionid=\"12001\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12006-12001-2\"><label for=\"field_u8vhfe6a52e1f5f-2\"><input type=\"checkbox\" name=\"item_meta[12006][]\" id=\"field_u8vhfe6a52e1f5f-2\" value=\"PM\"  data-sectionid=\"12001\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12006-12001-3\"><label for=\"field_u8vhfe6a52e1f5f-3\"><input type=\"checkbox\" name=\"item_meta[12006][]\" id=\"field_u8vhfe6a52e1f5f-3\" value=\"MON\"  data-sectionid=\"12001\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> MON<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12006-12001-4\"><label for=\"field_u8vhfe6a52e1f5f-4\"><input type=\"checkbox\" name=\"item_meta[12006][]\" id=\"field_u8vhfe6a52e1f5f-4\" value=\"AM\"  data-sectionid=\"12001\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12006-12001-5\"><label for=\"field_u8vhfe6a52e1f5f-5\"><input type=\"checkbox\" name=\"item_meta[12006][]\" id=\"field_u8vhfe6a52e1f5f-5\" value=\"PM\"  data-sectionid=\"12001\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12006-12001-6\"><label for=\"field_u8vhfe6a52e1f5f-6\"><input type=\"checkbox\" name=\"item_meta[12006][]\" id=\"field_u8vhfe6a52e1f5f-6\" value=\"TUE\"  data-sectionid=\"12001\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> TUE<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12006-12001-7\"><label for=\"field_u8vhfe6a52e1f5f-7\"><input type=\"checkbox\" name=\"item_meta[12006][]\" id=\"field_u8vhfe6a52e1f5f-7\" value=\"AM\"  data-sectionid=\"12001\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12006-12001-8\"><label for=\"field_u8vhfe6a52e1f5f-8\"><input type=\"checkbox\" name=\"item_meta[12006][]\" id=\"field_u8vhfe6a52e1f5f-8\" value=\"PM\"  data-sectionid=\"12001\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12006-12001-9\"><label for=\"field_u8vhfe6a52e1f5f-9\"><input type=\"checkbox\" name=\"item_meta[12006][]\" id=\"field_u8vhfe6a52e1f5f-9\" value=\"WED\"  data-sectionid=\"12001\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> WED<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12006-12001-10\"><label for=\"field_u8vhfe6a52e1f5f-10\"><input type=\"checkbox\" name=\"item_meta[12006][]\" id=\"field_u8vhfe6a52e1f5f-10\" value=\"AM\"  data-sectionid=\"12001\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12006-12001-11\"><label for=\"field_u8vhfe6a52e1f5f-11\"><input type=\"checkbox\" name=\"item_meta[12006][]\" id=\"field_u8vhfe6a52e1f5f-11\" value=\"PM\"  data-sectionid=\"12001\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12006-12001-12\"><label for=\"field_u8vhfe6a52e1f5f-12\"><input type=\"checkbox\" name=\"item_meta[12006][]\" id=\"field_u8vhfe6a52e1f5f-12\" value=\"THU\"  data-sectionid=\"12001\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> THU<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12006-12001-13\"><label for=\"field_u8vhfe6a52e1f5f-13\"><input type=\"checkbox\" name=\"item_meta[12006][]\" id=\"field_u8vhfe6a52e1f5f-13\" value=\"AM\"  data-sectionid=\"12001\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12006-12001-14\"><label for=\"field_u8vhfe6a52e1f5f-14\"><input type=\"checkbox\" name=\"item_meta[12006][]\" id=\"field_u8vhfe6a52e1f5f-14\" value=\"PM\"  data-sectionid=\"12001\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12006-12001-15\"><label for=\"field_u8vhfe6a52e1f5f-15\"><input type=\"checkbox\" name=\"item_meta[12006][]\" id=\"field_u8vhfe6a52e1f5f-15\" value=\"FRI\"  data-sectionid=\"12001\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> FRI<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12006-12001-16\"><label for=\"field_u8vhfe6a52e1f5f-16\"><input type=\"checkbox\" name=\"item_meta[12006][]\" id=\"field_u8vhfe6a52e1f5f-16\" value=\"AM\"  data-sectionid=\"12001\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12006-12001-17\"><label for=\"field_u8vhfe6a52e1f5f-17\"><input type=\"checkbox\" name=\"item_meta[12006][]\" id=\"field_u8vhfe6a52e1f5f-17\" value=\"PM\"  data-sectionid=\"12001\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12006-12001-18\"><label for=\"field_u8vhfe6a52e1f5f-18\"><input type=\"checkbox\" name=\"item_meta[12006][]\" id=\"field_u8vhfe6a52e1f5f-18\" value=\"SAT\"  data-sectionid=\"12001\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> SAT<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12006-12001-19\"><label for=\"field_u8vhfe6a52e1f5f-19\"><input type=\"checkbox\" name=\"item_meta[12006][]\" id=\"field_u8vhfe6a52e1f5f-19\" value=\"AM\"  data-sectionid=\"12001\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12006-12001-20\"><label for=\"field_u8vhfe6a52e1f5f-20\"><input type=\"checkbox\" name=\"item_meta[12006][]\" id=\"field_u8vhfe6a52e1f5f-20\" value=\"PM\"  data-sectionid=\"12001\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12005_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_tz9amc12ca2d829d36497d43f\" id=\"field_tz9amc12ca2d829d36497d43f_label\" class=\"frm_primary_label\">Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12005]\" id=\"field_tz9amc12ca2d829d36497d43f\" rows=\"1\"  data-sectionid=\"12001\" data-frmval=\"Notes...\" data-invmsg=\"Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12007_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first horizontal_radio\">\r\n    <div  id=\"field_swr3jb505f79e5a393d35c5e7_label\" class=\"frm_primary_label\">Goal\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_swr3jb505f79e5a393d35c5e7_label\" role=\"group\">\t\t<div class=\"frm_radio\" id=\"frm_radio_12007-12001-0\"><label for=\"field_swr3jb505f79e5a393d35c5e7-0\">\t\t<input type=\"radio\" name=\"item_meta[12007]\" id=\"field_swr3jb505f79e5a393d35c5e7-0\" value=\"Maintain\"\n\t\tchecked=\"checked\"   data-sectionid=\"12001\" data-frmval=\"Maintain\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Maintain<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_12007-12001-1\"><label for=\"field_swr3jb505f79e5a393d35c5e7-1\">\t\t<input type=\"radio\" name=\"item_meta[12007]\" id=\"field_swr3jb505f79e5a393d35c5e7-1\" value=\"Improve\"\n\t\t   data-sectionid=\"12001\" data-frmval=\"Maintain\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Improve<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12008_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_kwu6o74eb67b8f3afb1990a12\" id=\"field_kwu6o74eb67b8f3afb1990a12_label\" class=\"frm_primary_label\">Goal Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12008]\" id=\"field_kwu6o74eb67b8f3afb1990a12\" rows=\"3\"  data-sectionid=\"12001\" data-frmval=\"Notes...\" data-invmsg=\"Goal Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12009_container\" class=\"frm_form_field  frm_html_container form-field\">\n<p  style=\"margin-top: 0px; font-size: 1px; padding-top: 0px;\">&nbsp;<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"frm_field_12011_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing frm_trigger\"><i class=\"frm_icon_font frm_arrow_icon\" aria-expanded=\"false\" aria-label=\"Toggle fields\"><\/i> <img style=\"display: inline; margin-right: 10px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-bed-blue.svg\" width=\"30\" height=\"30\" \/>Bed<\/h3>\r\n\r\n<div class=\"frm_toggle_container frm_grid_container\" style=\"display:none;\">\r\n<div id=\"frm_field_12012_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_12ot3fed6c527f96699060351\" id=\"field_12ot3fed6c527f96699060351_label\" class=\"frm_primary_label\">Level of Assistance\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[12012]\" id=\"field_12ot3fed6c527f96699060351\"  data-sectionid=\"12011\" data-frmval=\"Some Assistance\" data-invmsg=\"Level of Assistance is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"Independent\"  class=\"\">\n\t\t\tIndependent\t\t<\/option>\n\t\t\t<option value=\"Some Assistance\"  selected=\"selected\" class=\"\">\n\t\t\tSome Assistance\t\t<\/option>\n\t\t\t<option value=\"Assisted\"  class=\"\">\n\t\t\tAssisted\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12013_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths horizontal_radio\">\r\n    <div  id=\"field_59zbq580713b08_label\" class=\"frm_primary_label\">Assigned to\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_59zbq580713b08_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12013-12011-0\"><label for=\"field_59zbq580713b08-0\"><input type=\"checkbox\" name=\"item_meta[12013][]\" id=\"field_59zbq580713b08-0\" value=\"Nursing\"  data-sectionid=\"12011\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Nursing<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12013-12011-1\"><label for=\"field_59zbq580713b08-1\"><input type=\"checkbox\" name=\"item_meta[12013][]\" id=\"field_59zbq580713b08-1\" value=\"Med Tech\"  data-sectionid=\"12011\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Med Tech<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12013-12011-2\"><label for=\"field_59zbq580713b08-2\"><input type=\"checkbox\" name=\"item_meta[12013][]\" id=\"field_59zbq580713b08-2\" value=\"Caregivers\" checked=\"checked\"  data-sectionid=\"12011\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Caregivers<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12016_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first frm_three_col\">\r\n    <div  id=\"field_sb3nc546745ccb7_label\" class=\"frm_primary_label\">Frequency\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_sb3nc546745ccb7_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12016-12011-0\"><label for=\"field_sb3nc546745ccb7-0\"><input type=\"checkbox\" name=\"item_meta[12016][]\" id=\"field_sb3nc546745ccb7-0\" value=\"SUN\"  data-sectionid=\"12011\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> SUN<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12016-12011-1\"><label for=\"field_sb3nc546745ccb7-1\"><input type=\"checkbox\" name=\"item_meta[12016][]\" id=\"field_sb3nc546745ccb7-1\" value=\"AM\"  data-sectionid=\"12011\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12016-12011-2\"><label for=\"field_sb3nc546745ccb7-2\"><input type=\"checkbox\" name=\"item_meta[12016][]\" id=\"field_sb3nc546745ccb7-2\" value=\"PM\"  data-sectionid=\"12011\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12016-12011-3\"><label for=\"field_sb3nc546745ccb7-3\"><input type=\"checkbox\" name=\"item_meta[12016][]\" id=\"field_sb3nc546745ccb7-3\" value=\"MON\"  data-sectionid=\"12011\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> MON<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12016-12011-4\"><label for=\"field_sb3nc546745ccb7-4\"><input type=\"checkbox\" name=\"item_meta[12016][]\" id=\"field_sb3nc546745ccb7-4\" value=\"AM\"  data-sectionid=\"12011\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12016-12011-5\"><label for=\"field_sb3nc546745ccb7-5\"><input type=\"checkbox\" name=\"item_meta[12016][]\" id=\"field_sb3nc546745ccb7-5\" value=\"PM\"  data-sectionid=\"12011\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12016-12011-6\"><label for=\"field_sb3nc546745ccb7-6\"><input type=\"checkbox\" name=\"item_meta[12016][]\" id=\"field_sb3nc546745ccb7-6\" value=\"TUE\"  data-sectionid=\"12011\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> TUE<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12016-12011-7\"><label for=\"field_sb3nc546745ccb7-7\"><input type=\"checkbox\" name=\"item_meta[12016][]\" id=\"field_sb3nc546745ccb7-7\" value=\"AM\"  data-sectionid=\"12011\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12016-12011-8\"><label for=\"field_sb3nc546745ccb7-8\"><input type=\"checkbox\" name=\"item_meta[12016][]\" id=\"field_sb3nc546745ccb7-8\" value=\"PM\"  data-sectionid=\"12011\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12016-12011-9\"><label for=\"field_sb3nc546745ccb7-9\"><input type=\"checkbox\" name=\"item_meta[12016][]\" id=\"field_sb3nc546745ccb7-9\" value=\"WED\"  data-sectionid=\"12011\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> WED<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12016-12011-10\"><label for=\"field_sb3nc546745ccb7-10\"><input type=\"checkbox\" name=\"item_meta[12016][]\" id=\"field_sb3nc546745ccb7-10\" value=\"AM\"  data-sectionid=\"12011\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12016-12011-11\"><label for=\"field_sb3nc546745ccb7-11\"><input type=\"checkbox\" name=\"item_meta[12016][]\" id=\"field_sb3nc546745ccb7-11\" value=\"PM\"  data-sectionid=\"12011\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12016-12011-12\"><label for=\"field_sb3nc546745ccb7-12\"><input type=\"checkbox\" name=\"item_meta[12016][]\" id=\"field_sb3nc546745ccb7-12\" value=\"THU\"  data-sectionid=\"12011\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> THU<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12016-12011-13\"><label for=\"field_sb3nc546745ccb7-13\"><input type=\"checkbox\" name=\"item_meta[12016][]\" id=\"field_sb3nc546745ccb7-13\" value=\"AM\"  data-sectionid=\"12011\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12016-12011-14\"><label for=\"field_sb3nc546745ccb7-14\"><input type=\"checkbox\" name=\"item_meta[12016][]\" id=\"field_sb3nc546745ccb7-14\" value=\"PM\"  data-sectionid=\"12011\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12016-12011-15\"><label for=\"field_sb3nc546745ccb7-15\"><input type=\"checkbox\" name=\"item_meta[12016][]\" id=\"field_sb3nc546745ccb7-15\" value=\"FRI\"  data-sectionid=\"12011\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> FRI<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12016-12011-16\"><label for=\"field_sb3nc546745ccb7-16\"><input type=\"checkbox\" name=\"item_meta[12016][]\" id=\"field_sb3nc546745ccb7-16\" value=\"AM\"  data-sectionid=\"12011\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12016-12011-17\"><label for=\"field_sb3nc546745ccb7-17\"><input type=\"checkbox\" name=\"item_meta[12016][]\" id=\"field_sb3nc546745ccb7-17\" value=\"PM\"  data-sectionid=\"12011\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12016-12011-18\"><label for=\"field_sb3nc546745ccb7-18\"><input type=\"checkbox\" name=\"item_meta[12016][]\" id=\"field_sb3nc546745ccb7-18\" value=\"SAT\"  data-sectionid=\"12011\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> SAT<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12016-12011-19\"><label for=\"field_sb3nc546745ccb7-19\"><input type=\"checkbox\" name=\"item_meta[12016][]\" id=\"field_sb3nc546745ccb7-19\" value=\"AM\"  data-sectionid=\"12011\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12016-12011-20\"><label for=\"field_sb3nc546745ccb7-20\"><input type=\"checkbox\" name=\"item_meta[12016][]\" id=\"field_sb3nc546745ccb7-20\" value=\"PM\"  data-sectionid=\"12011\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12015_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_8opaee4d1633a53ddb2b23961\" id=\"field_8opaee4d1633a53ddb2b23961_label\" class=\"frm_primary_label\">Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12015]\" id=\"field_8opaee4d1633a53ddb2b23961\" rows=\"1\"  data-sectionid=\"12011\" data-frmval=\"Sleeps on the side of the bed closer to the bathroom.\" data-invmsg=\"Details is invalid\" aria-invalid=\"false\"  >Sleeps on the side of the bed closer to the bathroom.<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12017_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first horizontal_radio\">\r\n    <div  id=\"field_genxeddba7ce68b319ee07c34_label\" class=\"frm_primary_label\">Goal\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_genxeddba7ce68b319ee07c34_label\" role=\"group\">\t\t<div class=\"frm_radio\" id=\"frm_radio_12017-12011-0\"><label for=\"field_genxeddba7ce68b319ee07c34-0\">\t\t<input type=\"radio\" name=\"item_meta[12017]\" id=\"field_genxeddba7ce68b319ee07c34-0\" value=\"Maintain\"\n\t\tchecked=\"checked\"   data-sectionid=\"12011\" data-frmval=\"Maintain\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Maintain<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_12017-12011-1\"><label for=\"field_genxeddba7ce68b319ee07c34-1\">\t\t<input type=\"radio\" name=\"item_meta[12017]\" id=\"field_genxeddba7ce68b319ee07c34-1\" value=\"Improve\"\n\t\t   data-sectionid=\"12011\" data-frmval=\"Maintain\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Improve<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12018_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_tk9705db630c2bab0c542bbcf\" id=\"field_tk9705db630c2bab0c542bbcf_label\" class=\"frm_primary_label\">Goal Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12018]\" id=\"field_tk9705db630c2bab0c542bbcf\" rows=\"3\"  data-sectionid=\"12011\" data-frmval=\"Notes...\" data-invmsg=\"Goal Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12019_container\" class=\"frm_form_field  frm_html_container form-field\">\n<p  style=\"margin-top: 0px; font-size: 1px; padding-top: 0px;\">&nbsp;<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"frm_field_12021_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing frm_trigger\"><i class=\"frm_icon_font frm_arrow_icon\" aria-expanded=\"false\" aria-label=\"Toggle fields\"><\/i> <img style=\"display: inline; margin-right: 10px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-bp-blue.svg\" width=\"30\" height=\"30\" \/>Blood Pressure<\/h3>\r\n\r\n<div class=\"frm_toggle_container frm_grid_container\" style=\"display:none;\">\r\n<div id=\"frm_field_12022_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_6hz8xe385e6edee8f7737ebfa\" id=\"field_6hz8xe385e6edee8f7737ebfa_label\" class=\"frm_primary_label\">Level of Assistance\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[12022]\" id=\"field_6hz8xe385e6edee8f7737ebfa\"  data-sectionid=\"12021\" data-frmval=\"Some Assistance\" data-invmsg=\"Level of Assistance is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"Independent\"  class=\"\">\n\t\t\tIndependent\t\t<\/option>\n\t\t\t<option value=\"Some Assistance\"  selected=\"selected\" class=\"\">\n\t\t\tSome Assistance\t\t<\/option>\n\t\t\t<option value=\"Assisted\"  class=\"\">\n\t\t\tAssisted\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12023_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths horizontal_radio\">\r\n    <div  id=\"field_kqfq5797cf3a5475eda8141ea_label\" class=\"frm_primary_label\">Assigned to\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_kqfq5797cf3a5475eda8141ea_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12023-12021-0\"><label for=\"field_kqfq5797cf3a5475eda8141ea-0\"><input type=\"checkbox\" name=\"item_meta[12023][]\" id=\"field_kqfq5797cf3a5475eda8141ea-0\" value=\"Nursing\" checked=\"checked\"  data-sectionid=\"12021\" data-frmval=\"[&quot;Nursing&quot;]\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Nursing<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12023-12021-1\"><label for=\"field_kqfq5797cf3a5475eda8141ea-1\"><input type=\"checkbox\" name=\"item_meta[12023][]\" id=\"field_kqfq5797cf3a5475eda8141ea-1\" value=\"Med Tech\"  data-sectionid=\"12021\" data-frmval=\"[&quot;Nursing&quot;]\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Med Tech<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12023-12021-2\"><label for=\"field_kqfq5797cf3a5475eda8141ea-2\"><input type=\"checkbox\" name=\"item_meta[12023][]\" id=\"field_kqfq5797cf3a5475eda8141ea-2\" value=\"Caregivers\"  data-sectionid=\"12021\" data-frmval=\"[&quot;Nursing&quot;]\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Caregivers<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12024_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_v8pvhce597c2584\" id=\"field_v8pvhce597c2584_label\" class=\"frm_primary_label\">Billing Frequency\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[12024]\" id=\"field_v8pvhce597c2584\"  data-sectionid=\"12021\" data-frmval=\"2x \/ Day\" data-invmsg=\"Billing Frequency is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"1x \/ Day\"  class=\"\">\n\t\t\t1x \/ Day\t\t<\/option>\n\t\t\t<option value=\"2x \/ Day\"  selected=\"selected\" class=\"\">\n\t\t\t2x \/ Day\t\t<\/option>\n\t\t\t<option value=\"3x \/ Day +\"  class=\"\">\n\t\t\t3x \/ Day +\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12025_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_rwxlg8179155880cd9e3e6d97\" id=\"field_rwxlg8179155880cd9e3e6d97_label\" class=\"frm_primary_label\">Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12025]\" id=\"field_rwxlg8179155880cd9e3e6d97\" rows=\"1\"  data-sectionid=\"12021\" data-frmval=\"Notes...\" data-invmsg=\"Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12026_container\" class=\"frm_form_field  frm_fourth frm_first frm_html_container form-field\">\n<p class=\"new-label\">Frequency<\/p>\n<div style=\"margin: 0; padding: 0;\">\n<table border=\"0\" width=\"100%\" cellspacing=\"0px\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td width=\"33%\">\n<p style=\"font-size: 14px; color: #000; margin: 2px 0 0 0; padding: 0; font-weight: 200;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-2 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-2{ color: #999999;}i.fb-icon-element.fontawesome-icon.fb-icon-element-2:hover { color: #999999;}<\/style>\n<p>SUN<\/p>\n<\/td>\n<td width=\"33%\">\n<p style=\"font-size: 14px; color: #000; margin: 2px 0 0 0; padding: 0; font-weight: 200;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-3 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-3{ color: #999999;}i.fb-icon-element.fontawesome-icon.fb-icon-element-3:hover { color: #999999;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p style=\"font-size: 14px; color: #000; margin: 2px 0 0 0; padding: 0; font-weight: 200;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-4 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-4{ color: #999999;}i.fb-icon-element.fontawesome-icon.fb-icon-element-4:hover { color: #999999;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-5 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-5{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-5:hover { color: #cccccc;}<\/style>\n<p>12-3<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-6 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-6{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-6:hover { color: #cccccc;}<\/style>\n<p>12-3<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-7 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-7{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-7:hover { color: #cccccc;}<\/style>\n<p>3-6<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-8 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-8{ color: #999999;}i.fb-icon-element.fontawesome-icon.fb-icon-element-8:hover { color: #999999;}<\/style>\n<p>3-6<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-9 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-9{ color: #999999;}i.fb-icon-element.fontawesome-icon.fb-icon-element-9:hover { color: #999999;}<\/style>\n<p>6-9<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-10 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-10{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-10:hover { color: #cccccc;}<\/style>\n<p>6-9<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-11 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-11{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-11:hover { color: #cccccc;}<\/style>\n<p>9-12<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-12 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-12{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-12:hover { color: #cccccc;}<\/style>\n<p>9-12<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-13 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-13{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-13:hover { color: #cccccc;}<\/style>\n<p>MON<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-14 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-14{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-14:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-15 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-15{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-15:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-16 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-16{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-16:hover { color: #cccccc;}<\/style>\n<p>TUE<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-17 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-17{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-17:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-18 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-18{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-18:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-19 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-19{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-19:hover { color: #cccccc;}<\/style>\n<p>WED<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-20 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-20{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-20:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-21 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-21{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-21:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-22 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-22{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-22:hover { color: #cccccc;}<\/style>\n<p>THU<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-23 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-23{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-23:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-24 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-24{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-24:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-25 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-25{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-25:hover { color: #cccccc;}<\/style>\n<p>FRI<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-26 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-26{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-26:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-27 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-27{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-27:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-28 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-28{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-28:hover { color: #cccccc;}<\/style>\n<p>SAT<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-29 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-29{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-29:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-30 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-30{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-30:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<\/div>\n<div id=\"frm_field_12027_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first horizontal_radio\">\r\n    <div  id=\"field_x8zyb25667ca9b954e4fc9b16_label\" class=\"frm_primary_label\">Goal\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_x8zyb25667ca9b954e4fc9b16_label\" role=\"group\">\t\t<div class=\"frm_radio\" id=\"frm_radio_12027-12021-0\"><label for=\"field_x8zyb25667ca9b954e4fc9b16-0\">\t\t<input type=\"radio\" name=\"item_meta[12027]\" id=\"field_x8zyb25667ca9b954e4fc9b16-0\" value=\"Maintain\"\n\t\t   data-sectionid=\"12021\" data-frmval=\"Improve\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Maintain<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_12027-12021-1\"><label for=\"field_x8zyb25667ca9b954e4fc9b16-1\">\t\t<input type=\"radio\" name=\"item_meta[12027]\" id=\"field_x8zyb25667ca9b954e4fc9b16-1\" value=\"Improve\"\n\t\tchecked=\"checked\"   data-sectionid=\"12021\" data-frmval=\"Improve\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Improve<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12028_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_c1pbbb9487cef9d6469f0ba49\" id=\"field_c1pbbb9487cef9d6469f0ba49_label\" class=\"frm_primary_label\">Goal Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12028]\" id=\"field_c1pbbb9487cef9d6469f0ba49\" rows=\"3\"  data-sectionid=\"12021\" data-frmval=\"Checking to see if new medication will help lower blood pressure.\" data-invmsg=\"Goal Details is invalid\" aria-invalid=\"false\"  >Checking to see if new medication will help lower blood pressure.<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12029_container\" class=\"frm_form_field  frm_html_container form-field\">\n<p  style=\"margin-top: 0px; font-size: 1px; padding-top: 0px;\">&nbsp;<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"frm_field_12041_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing frm_trigger\"><i class=\"frm_icon_font frm_arrow_icon\" aria-expanded=\"false\" aria-label=\"Toggle fields\"><\/i> <img style=\"display: inline; margin-right: 10px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-check-in-blue.svg\" width=\"30\" height=\"30\" \/>Check-In<\/h3>\r\n\r\n<div class=\"frm_toggle_container frm_grid_container\" style=\"display:none;\">\r\n<div id=\"frm_field_12042_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_wd3g102c2b8ae63\" id=\"field_wd3g102c2b8ae63_label\" class=\"frm_primary_label\">Level of Assistance\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[12042]\" id=\"field_wd3g102c2b8ae63\"  data-sectionid=\"12041\" data-frmval=\"Assisted\" data-invmsg=\"Level of Assistance is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"Independent\"  class=\"\">\n\t\t\tIndependent\t\t<\/option>\n\t\t\t<option value=\"Assisted\"  selected=\"selected\" class=\"\">\n\t\t\tAssisted\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12043_container\" class=\"frm_form_field form-field  frm_top_container frm_third horizontal_radio\">\r\n    <div  id=\"field_7kfm679fd1d7d35_label\" class=\"frm_primary_label\">Assigned to\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_7kfm679fd1d7d35_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12043-12041-0\"><label for=\"field_7kfm679fd1d7d35-0\"><input type=\"checkbox\" name=\"item_meta[12043][]\" id=\"field_7kfm679fd1d7d35-0\" value=\"Nursing\" checked=\"checked\"  data-sectionid=\"12041\" data-frmval=\"[&quot;Nursing&quot;]\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Nursing<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12043-12041-1\"><label for=\"field_7kfm679fd1d7d35-1\"><input type=\"checkbox\" name=\"item_meta[12043][]\" id=\"field_7kfm679fd1d7d35-1\" value=\"Med Tech\"  data-sectionid=\"12041\" data-frmval=\"[&quot;Nursing&quot;]\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Med Tech<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12043-12041-2\"><label for=\"field_7kfm679fd1d7d35-2\"><input type=\"checkbox\" name=\"item_meta[12043][]\" id=\"field_7kfm679fd1d7d35-2\" value=\"Caregivers\"  data-sectionid=\"12041\" data-frmval=\"[&quot;Nursing&quot;]\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Caregivers<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12044_container\" class=\"frm_form_field form-field  frm_hidden_container frm_fourth horizontal_radio\">\r\n    <div  id=\"field_kvry61716930132_label\" class=\"frm_primary_label\">Do Not Disturb at Night\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_kvry61716930132_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12044-12041-1\"><label for=\"field_kvry61716930132-1\"><input type=\"checkbox\" name=\"item_meta[12044][]\" id=\"field_kvry61716930132-1\" value=\"Do Not Disturb at Night\" checked=\"checked\"  data-sectionid=\"12041\" data-frmval=\"{&quot;1&quot;:&quot;Do Not Disturb at Night&quot;}\" data-invmsg=\"Do Not Disturb at Night is invalid\" aria-invalid=\"false\"   \/> Do Not Disturb at Night<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12045_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_mn2vpd47148bf9e\" id=\"field_mn2vpd47148bf9e_label\" class=\"frm_primary_label\">Frequency\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[12045]\" id=\"field_mn2vpd47148bf9e\"  data-sectionid=\"12041\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  selected=\"selected\" class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"Every 1\/2 Hour\"  class=\"\">\n\t\t\tEvery 1\/2 Hour\t\t<\/option>\n\t\t\t<option value=\"Every Hour\"  class=\"\">\n\t\t\tEvery Hour\t\t<\/option>\n\t\t\t<option value=\"Every 2 Hours\"  class=\"\">\n\t\t\tEvery 2 Hours\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12046_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_eizwo84df681fc1\" id=\"field_eizwo84df681fc1_label\" class=\"frm_primary_label\">Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12046]\" id=\"field_eizwo84df681fc1\" rows=\"3\"  data-sectionid=\"12041\" data-frmval=\"Notes...\" data-invmsg=\"Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12047_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first horizontal_radio\">\r\n    <div  id=\"field_nej3icbaec265af_label\" class=\"frm_primary_label\">Goal\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_nej3icbaec265af_label\" role=\"group\">\t\t<div class=\"frm_radio\" id=\"frm_radio_12047-12041-0\"><label for=\"field_nej3icbaec265af-0\">\t\t<input type=\"radio\" name=\"item_meta[12047]\" id=\"field_nej3icbaec265af-0\" value=\"Maintain\"\n\t\tchecked=\"checked\"   data-sectionid=\"12041\" data-frmval=\"Maintain\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Maintain<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_12047-12041-1\"><label for=\"field_nej3icbaec265af-1\">\t\t<input type=\"radio\" name=\"item_meta[12047]\" id=\"field_nej3icbaec265af-1\" value=\"Improve\"\n\t\t   data-sectionid=\"12041\" data-frmval=\"Maintain\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Improve<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12048_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_33io19a84d08d1c\" id=\"field_33io19a84d08d1c_label\" class=\"frm_primary_label\">Goal Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12048]\" id=\"field_33io19a84d08d1c\" rows=\"3\"  data-sectionid=\"12041\" data-frmval=\"Notes...\" data-invmsg=\"Goal Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12049_container\" class=\"frm_form_field  frm_html_container form-field\">\n<p  style=\"margin-top: 0px; font-size: 1px; padding-top: 0px;\">&nbsp;<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"frm_field_12051_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing frm_trigger\"><i class=\"frm_icon_font frm_arrow_icon\" aria-expanded=\"false\" aria-label=\"Toggle fields\"><\/i> <img style=\"display: inline; margin-right: 10px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-dental-blue.svg\" width=\"30\" height=\"30\" \/>Dental<\/h3>\r\n\r\n<div class=\"frm_toggle_container frm_grid_container\" style=\"display:none;\">\r\n<div id=\"frm_field_12052_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_gcmucd0599654e14a543366a\" id=\"field_gcmucd0599654e14a543366a_label\" class=\"frm_primary_label\">Level of Assistance\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[12052]\" id=\"field_gcmucd0599654e14a543366a\"  data-sectionid=\"12051\" data-frmval=\"Some Assistance\" data-invmsg=\"Level of Assistance is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"Independent\"  class=\"\">\n\t\t\tIndependent\t\t<\/option>\n\t\t\t<option value=\"Some Assistance\"  selected=\"selected\" class=\"\">\n\t\t\tSome Assistance\t\t<\/option>\n\t\t\t<option value=\"Assisted\"  class=\"\">\n\t\t\tAssisted\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12053_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths horizontal_radio\">\r\n    <div  id=\"field_t5u9af132dd9576e5b7bdc559_label\" class=\"frm_primary_label\">Assigned to\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_t5u9af132dd9576e5b7bdc559_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12053-12051-0\"><label for=\"field_t5u9af132dd9576e5b7bdc559-0\"><input type=\"checkbox\" name=\"item_meta[12053][]\" id=\"field_t5u9af132dd9576e5b7bdc559-0\" value=\"Nursing\"  data-sectionid=\"12051\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Nursing<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12053-12051-1\"><label for=\"field_t5u9af132dd9576e5b7bdc559-1\"><input type=\"checkbox\" name=\"item_meta[12053][]\" id=\"field_t5u9af132dd9576e5b7bdc559-1\" value=\"Med Tech\"  data-sectionid=\"12051\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Med Tech<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12053-12051-2\"><label for=\"field_t5u9af132dd9576e5b7bdc559-2\"><input type=\"checkbox\" name=\"item_meta[12053][]\" id=\"field_t5u9af132dd9576e5b7bdc559-2\" value=\"Caregivers\" checked=\"checked\"  data-sectionid=\"12051\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Caregivers<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12056_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first frm_three_col\">\r\n    <div  id=\"field_4iq8w70391b71b5_label\" class=\"frm_primary_label\">Frequency\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_4iq8w70391b71b5_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12056-12051-0\"><label for=\"field_4iq8w70391b71b5-0\"><input type=\"checkbox\" name=\"item_meta[12056][]\" id=\"field_4iq8w70391b71b5-0\" value=\"SUN\"  data-sectionid=\"12051\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> SUN<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12056-12051-1\"><label for=\"field_4iq8w70391b71b5-1\"><input type=\"checkbox\" name=\"item_meta[12056][]\" id=\"field_4iq8w70391b71b5-1\" value=\"AM\"  data-sectionid=\"12051\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12056-12051-2\"><label for=\"field_4iq8w70391b71b5-2\"><input type=\"checkbox\" name=\"item_meta[12056][]\" id=\"field_4iq8w70391b71b5-2\" value=\"PM\"  data-sectionid=\"12051\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12056-12051-3\"><label for=\"field_4iq8w70391b71b5-3\"><input type=\"checkbox\" name=\"item_meta[12056][]\" id=\"field_4iq8w70391b71b5-3\" value=\"MON\"  data-sectionid=\"12051\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> MON<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12056-12051-4\"><label for=\"field_4iq8w70391b71b5-4\"><input type=\"checkbox\" name=\"item_meta[12056][]\" id=\"field_4iq8w70391b71b5-4\" value=\"AM\"  data-sectionid=\"12051\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12056-12051-5\"><label for=\"field_4iq8w70391b71b5-5\"><input type=\"checkbox\" name=\"item_meta[12056][]\" id=\"field_4iq8w70391b71b5-5\" value=\"PM\"  data-sectionid=\"12051\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12056-12051-6\"><label for=\"field_4iq8w70391b71b5-6\"><input type=\"checkbox\" name=\"item_meta[12056][]\" id=\"field_4iq8w70391b71b5-6\" value=\"TUE\"  data-sectionid=\"12051\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> TUE<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12056-12051-7\"><label for=\"field_4iq8w70391b71b5-7\"><input type=\"checkbox\" name=\"item_meta[12056][]\" id=\"field_4iq8w70391b71b5-7\" value=\"AM\"  data-sectionid=\"12051\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12056-12051-8\"><label for=\"field_4iq8w70391b71b5-8\"><input type=\"checkbox\" name=\"item_meta[12056][]\" id=\"field_4iq8w70391b71b5-8\" value=\"PM\"  data-sectionid=\"12051\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12056-12051-9\"><label for=\"field_4iq8w70391b71b5-9\"><input type=\"checkbox\" name=\"item_meta[12056][]\" id=\"field_4iq8w70391b71b5-9\" value=\"WED\"  data-sectionid=\"12051\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> WED<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12056-12051-10\"><label for=\"field_4iq8w70391b71b5-10\"><input type=\"checkbox\" name=\"item_meta[12056][]\" id=\"field_4iq8w70391b71b5-10\" value=\"AM\"  data-sectionid=\"12051\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12056-12051-11\"><label for=\"field_4iq8w70391b71b5-11\"><input type=\"checkbox\" name=\"item_meta[12056][]\" id=\"field_4iq8w70391b71b5-11\" value=\"PM\"  data-sectionid=\"12051\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12056-12051-12\"><label for=\"field_4iq8w70391b71b5-12\"><input type=\"checkbox\" name=\"item_meta[12056][]\" id=\"field_4iq8w70391b71b5-12\" value=\"THU\"  data-sectionid=\"12051\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> THU<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12056-12051-13\"><label for=\"field_4iq8w70391b71b5-13\"><input type=\"checkbox\" name=\"item_meta[12056][]\" id=\"field_4iq8w70391b71b5-13\" value=\"AM\"  data-sectionid=\"12051\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12056-12051-14\"><label for=\"field_4iq8w70391b71b5-14\"><input type=\"checkbox\" name=\"item_meta[12056][]\" id=\"field_4iq8w70391b71b5-14\" value=\"PM\"  data-sectionid=\"12051\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12056-12051-15\"><label for=\"field_4iq8w70391b71b5-15\"><input type=\"checkbox\" name=\"item_meta[12056][]\" id=\"field_4iq8w70391b71b5-15\" value=\"FRI\"  data-sectionid=\"12051\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> FRI<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12056-12051-16\"><label for=\"field_4iq8w70391b71b5-16\"><input type=\"checkbox\" name=\"item_meta[12056][]\" id=\"field_4iq8w70391b71b5-16\" value=\"AM\"  data-sectionid=\"12051\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12056-12051-17\"><label for=\"field_4iq8w70391b71b5-17\"><input type=\"checkbox\" name=\"item_meta[12056][]\" id=\"field_4iq8w70391b71b5-17\" value=\"PM\"  data-sectionid=\"12051\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12056-12051-18\"><label for=\"field_4iq8w70391b71b5-18\"><input type=\"checkbox\" name=\"item_meta[12056][]\" id=\"field_4iq8w70391b71b5-18\" value=\"SAT\"  data-sectionid=\"12051\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> SAT<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12056-12051-19\"><label for=\"field_4iq8w70391b71b5-19\"><input type=\"checkbox\" name=\"item_meta[12056][]\" id=\"field_4iq8w70391b71b5-19\" value=\"AM\"  data-sectionid=\"12051\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12056-12051-20\"><label for=\"field_4iq8w70391b71b5-20\"><input type=\"checkbox\" name=\"item_meta[12056][]\" id=\"field_4iq8w70391b71b5-20\" value=\"PM\"  data-sectionid=\"12051\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12055_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_66c2waa9daf6067eb983231ef\" id=\"field_66c2waa9daf6067eb983231ef_label\" class=\"frm_primary_label\">Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12055]\" id=\"field_66c2waa9daf6067eb983231ef\" rows=\"1\"  data-sectionid=\"12051\" data-frmval=\"Likes just a little toothpaste.\" data-invmsg=\"Details is invalid\" aria-invalid=\"false\"  >Likes just a little toothpaste.<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12057_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first horizontal_radio\">\r\n    <div  id=\"field_lox8428632f623c37ed50f113_label\" class=\"frm_primary_label\">Goal\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_lox8428632f623c37ed50f113_label\" role=\"group\">\t\t<div class=\"frm_radio\" id=\"frm_radio_12057-12051-0\"><label for=\"field_lox8428632f623c37ed50f113-0\">\t\t<input type=\"radio\" name=\"item_meta[12057]\" id=\"field_lox8428632f623c37ed50f113-0\" value=\"Maintain\"\n\t\tchecked=\"checked\"   data-sectionid=\"12051\" data-frmval=\"Maintain\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Maintain<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_12057-12051-1\"><label for=\"field_lox8428632f623c37ed50f113-1\">\t\t<input type=\"radio\" name=\"item_meta[12057]\" id=\"field_lox8428632f623c37ed50f113-1\" value=\"Improve\"\n\t\t   data-sectionid=\"12051\" data-frmval=\"Maintain\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Improve<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12058_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_h40qw92a5b2b9dfaf2e0f519b\" id=\"field_h40qw92a5b2b9dfaf2e0f519b_label\" class=\"frm_primary_label\">Goal Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12058]\" id=\"field_h40qw92a5b2b9dfaf2e0f519b\" rows=\"3\"  data-sectionid=\"12051\" data-frmval=\"Notes...\" data-invmsg=\"Goal Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12059_container\" class=\"frm_form_field  frm_html_container form-field\">\n<p  style=\"margin-top: 0px; font-size: 1px; padding-top: 0px;\">&nbsp;<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"frm_field_12061_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing frm_trigger\"><i class=\"frm_icon_font frm_arrow_icon\" aria-expanded=\"false\" aria-label=\"Toggle fields\"><\/i> <img style=\"display: inline; margin-right: 10px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-dressing-blue.svg\" width=\"30\" height=\"30\" \/>Dressing<\/h3>\r\n\r\n<div class=\"frm_toggle_container frm_grid_container\" style=\"display:none;\">\r\n<div id=\"frm_field_12062_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_m6bhz7961166f2c\" id=\"field_m6bhz7961166f2c_label\" class=\"frm_primary_label\">Level of Assistance\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[12062]\" id=\"field_m6bhz7961166f2c\"  data-sectionid=\"12061\" data-frmval=\"Some Assistance\" data-invmsg=\"Level of Assistance is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"Independent\"  class=\"\">\n\t\t\tIndependent\t\t<\/option>\n\t\t\t<option value=\"Some Assistance\"  selected=\"selected\" class=\"\">\n\t\t\tSome Assistance\t\t<\/option>\n\t\t\t<option value=\"Assisted\"  class=\"\">\n\t\t\tAssisted\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12063_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths horizontal_radio\">\r\n    <div  id=\"field_2299hbfd631bdb0_label\" class=\"frm_primary_label\">Assigned to\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_2299hbfd631bdb0_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12063-12061-0\"><label for=\"field_2299hbfd631bdb0-0\"><input type=\"checkbox\" name=\"item_meta[12063][]\" id=\"field_2299hbfd631bdb0-0\" value=\"Nursing\"  data-sectionid=\"12061\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Nursing<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12063-12061-1\"><label for=\"field_2299hbfd631bdb0-1\"><input type=\"checkbox\" name=\"item_meta[12063][]\" id=\"field_2299hbfd631bdb0-1\" value=\"Med Tech\"  data-sectionid=\"12061\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Med Tech<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12063-12061-2\"><label for=\"field_2299hbfd631bdb0-2\"><input type=\"checkbox\" name=\"item_meta[12063][]\" id=\"field_2299hbfd631bdb0-2\" value=\"Caregivers\" checked=\"checked\"  data-sectionid=\"12061\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Caregivers<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12066_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first frm_three_col\">\r\n    <div  id=\"field_l77jx59fb6fa796_label\" class=\"frm_primary_label\">Frequency\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_l77jx59fb6fa796_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12066-12061-0\"><label for=\"field_l77jx59fb6fa796-0\"><input type=\"checkbox\" name=\"item_meta[12066][]\" id=\"field_l77jx59fb6fa796-0\" value=\"SUN\"  data-sectionid=\"12061\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> SUN<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12066-12061-1\"><label for=\"field_l77jx59fb6fa796-1\"><input type=\"checkbox\" name=\"item_meta[12066][]\" id=\"field_l77jx59fb6fa796-1\" value=\"AM\"  data-sectionid=\"12061\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12066-12061-2\"><label for=\"field_l77jx59fb6fa796-2\"><input type=\"checkbox\" name=\"item_meta[12066][]\" id=\"field_l77jx59fb6fa796-2\" value=\"PM\"  data-sectionid=\"12061\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12066-12061-3\"><label for=\"field_l77jx59fb6fa796-3\"><input type=\"checkbox\" name=\"item_meta[12066][]\" id=\"field_l77jx59fb6fa796-3\" value=\"MON\"  data-sectionid=\"12061\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> MON<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12066-12061-4\"><label for=\"field_l77jx59fb6fa796-4\"><input type=\"checkbox\" name=\"item_meta[12066][]\" id=\"field_l77jx59fb6fa796-4\" value=\"AM\"  data-sectionid=\"12061\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12066-12061-5\"><label for=\"field_l77jx59fb6fa796-5\"><input type=\"checkbox\" name=\"item_meta[12066][]\" id=\"field_l77jx59fb6fa796-5\" value=\"PM\"  data-sectionid=\"12061\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12066-12061-6\"><label for=\"field_l77jx59fb6fa796-6\"><input type=\"checkbox\" name=\"item_meta[12066][]\" id=\"field_l77jx59fb6fa796-6\" value=\"TUE\"  data-sectionid=\"12061\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> TUE<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12066-12061-7\"><label for=\"field_l77jx59fb6fa796-7\"><input type=\"checkbox\" name=\"item_meta[12066][]\" id=\"field_l77jx59fb6fa796-7\" value=\"AM\"  data-sectionid=\"12061\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12066-12061-8\"><label for=\"field_l77jx59fb6fa796-8\"><input type=\"checkbox\" name=\"item_meta[12066][]\" id=\"field_l77jx59fb6fa796-8\" value=\"PM\"  data-sectionid=\"12061\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12066-12061-9\"><label for=\"field_l77jx59fb6fa796-9\"><input type=\"checkbox\" name=\"item_meta[12066][]\" id=\"field_l77jx59fb6fa796-9\" value=\"WED\"  data-sectionid=\"12061\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> WED<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12066-12061-10\"><label for=\"field_l77jx59fb6fa796-10\"><input type=\"checkbox\" name=\"item_meta[12066][]\" id=\"field_l77jx59fb6fa796-10\" value=\"AM\"  data-sectionid=\"12061\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12066-12061-11\"><label for=\"field_l77jx59fb6fa796-11\"><input type=\"checkbox\" name=\"item_meta[12066][]\" id=\"field_l77jx59fb6fa796-11\" value=\"PM\"  data-sectionid=\"12061\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12066-12061-12\"><label for=\"field_l77jx59fb6fa796-12\"><input type=\"checkbox\" name=\"item_meta[12066][]\" id=\"field_l77jx59fb6fa796-12\" value=\"THU\"  data-sectionid=\"12061\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> THU<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12066-12061-13\"><label for=\"field_l77jx59fb6fa796-13\"><input type=\"checkbox\" name=\"item_meta[12066][]\" id=\"field_l77jx59fb6fa796-13\" value=\"AM\"  data-sectionid=\"12061\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12066-12061-14\"><label for=\"field_l77jx59fb6fa796-14\"><input type=\"checkbox\" name=\"item_meta[12066][]\" id=\"field_l77jx59fb6fa796-14\" value=\"PM\"  data-sectionid=\"12061\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12066-12061-15\"><label for=\"field_l77jx59fb6fa796-15\"><input type=\"checkbox\" name=\"item_meta[12066][]\" id=\"field_l77jx59fb6fa796-15\" value=\"FRI\"  data-sectionid=\"12061\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> FRI<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12066-12061-16\"><label for=\"field_l77jx59fb6fa796-16\"><input type=\"checkbox\" name=\"item_meta[12066][]\" id=\"field_l77jx59fb6fa796-16\" value=\"AM\"  data-sectionid=\"12061\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12066-12061-17\"><label for=\"field_l77jx59fb6fa796-17\"><input type=\"checkbox\" name=\"item_meta[12066][]\" id=\"field_l77jx59fb6fa796-17\" value=\"PM\"  data-sectionid=\"12061\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12066-12061-18\"><label for=\"field_l77jx59fb6fa796-18\"><input type=\"checkbox\" name=\"item_meta[12066][]\" id=\"field_l77jx59fb6fa796-18\" value=\"SAT\"  data-sectionid=\"12061\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> SAT<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12066-12061-19\"><label for=\"field_l77jx59fb6fa796-19\"><input type=\"checkbox\" name=\"item_meta[12066][]\" id=\"field_l77jx59fb6fa796-19\" value=\"AM\"  data-sectionid=\"12061\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12066-12061-20\"><label for=\"field_l77jx59fb6fa796-20\"><input type=\"checkbox\" name=\"item_meta[12066][]\" id=\"field_l77jx59fb6fa796-20\" value=\"PM\"  data-sectionid=\"12061\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12065_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_j9kry3dede008c1\" id=\"field_j9kry3dede008c1_label\" class=\"frm_primary_label\">Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12065]\" id=\"field_j9kry3dede008c1\" rows=\"1\"  data-sectionid=\"12061\" data-frmval=\"Notes...\" data-invmsg=\"Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12067_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first horizontal_radio\">\r\n    <div  id=\"field_zihy17dcee1cd50_label\" class=\"frm_primary_label\">Goal\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_zihy17dcee1cd50_label\" role=\"group\">\t\t<div class=\"frm_radio\" id=\"frm_radio_12067-12061-0\"><label for=\"field_zihy17dcee1cd50-0\">\t\t<input type=\"radio\" name=\"item_meta[12067]\" id=\"field_zihy17dcee1cd50-0\" value=\"Maintain\"\n\t\tchecked=\"checked\"   data-sectionid=\"12061\" data-frmval=\"Maintain\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Maintain<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_12067-12061-1\"><label for=\"field_zihy17dcee1cd50-1\">\t\t<input type=\"radio\" name=\"item_meta[12067]\" id=\"field_zihy17dcee1cd50-1\" value=\"Improve\"\n\t\t   data-sectionid=\"12061\" data-frmval=\"Maintain\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Improve<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12068_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_43wy6134ac35ad6\" id=\"field_43wy6134ac35ad6_label\" class=\"frm_primary_label\">Goal Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12068]\" id=\"field_43wy6134ac35ad6\" rows=\"3\"  data-sectionid=\"12061\" data-frmval=\"Notes...\" data-invmsg=\"Goal Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12069_container\" class=\"frm_form_field  frm_html_container form-field\">\n<p  style=\"margin-top: 0px; font-size: 1px; padding-top: 0px;\">&nbsp;<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"frm_field_12071_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing frm_trigger\"><i class=\"frm_icon_font frm_arrow_icon\" aria-expanded=\"false\" aria-label=\"Toggle fields\"><\/i> <img style=\"display: inline; margin-right: 10px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-elopement-blue.svg\" width=\"30\" height=\"30\" \/>Elopement<\/h3>\r\n\r\n<div class=\"frm_toggle_container frm_grid_container\" style=\"display:none;\">\r\n<div id=\"frm_field_12072_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_fiqjj1d0ddebf5404ab9bfb28\" id=\"field_fiqjj1d0ddebf5404ab9bfb28_label\" class=\"frm_primary_label\">Level of Assistance\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[12072]\" id=\"field_fiqjj1d0ddebf5404ab9bfb28\"  data-sectionid=\"12071\" data-frmval=\"Some Assistance\" data-invmsg=\"Level of Assistance is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"Independent\"  class=\"\">\n\t\t\tIndependent\t\t<\/option>\n\t\t\t<option value=\"Some Assistance\"  selected=\"selected\" class=\"\">\n\t\t\tSome Assistance\t\t<\/option>\n\t\t\t<option value=\"Assisted\"  class=\"\">\n\t\t\tAssisted\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12073_container\" class=\"frm_form_field form-field  frm_top_container frm_third horizontal_radio\">\r\n    <div  id=\"field_3tc56c07ea30f49f05d52b5c_label\" class=\"frm_primary_label\">Assigned to\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_3tc56c07ea30f49f05d52b5c_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12073-12071-0\"><label for=\"field_3tc56c07ea30f49f05d52b5c-0\"><input type=\"checkbox\" name=\"item_meta[12073][]\" id=\"field_3tc56c07ea30f49f05d52b5c-0\" value=\"Nursing\"  data-sectionid=\"12071\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Nursing<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12073-12071-1\"><label for=\"field_3tc56c07ea30f49f05d52b5c-1\"><input type=\"checkbox\" name=\"item_meta[12073][]\" id=\"field_3tc56c07ea30f49f05d52b5c-1\" value=\"Med Tech\"  data-sectionid=\"12071\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Med Tech<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12073-12071-2\"><label for=\"field_3tc56c07ea30f49f05d52b5c-2\"><input type=\"checkbox\" name=\"item_meta[12073][]\" id=\"field_3tc56c07ea30f49f05d52b5c-2\" value=\"Caregivers\" checked=\"checked\"  data-sectionid=\"12071\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Caregivers<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12074_container\" class=\"frm_form_field  frm_fourth frm_first frm_html_container form-field\">\n<p style=\"font-size: 12px; color: #70a5cc; margin: 0 0 2px 0; padding: 10px 0 0 0; font-weight: 300;\">&nbsp;<\/p>\n<\/div>\n<div id=\"frm_field_12075_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_jariz1619186ab3f460cfabb3\" id=\"field_jariz1619186ab3f460cfabb3_label\" class=\"frm_primary_label\">Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12075]\" id=\"field_jariz1619186ab3f460cfabb3\" rows=\"3\"  data-sectionid=\"12071\" data-frmval=\"Notes...\" data-invmsg=\"Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12076_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first horizontal_radio\">\r\n    <div  id=\"field_fg4pp9b1ad287f814cfaeb9e8_label\" class=\"frm_primary_label\">Goal\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_fg4pp9b1ad287f814cfaeb9e8_label\" role=\"group\">\t\t<div class=\"frm_radio\" id=\"frm_radio_12076-12071-0\"><label for=\"field_fg4pp9b1ad287f814cfaeb9e8-0\">\t\t<input type=\"radio\" name=\"item_meta[12076]\" id=\"field_fg4pp9b1ad287f814cfaeb9e8-0\" value=\"Maintain\"\n\t\tchecked=\"checked\"   data-sectionid=\"12071\" data-frmval=\"Maintain\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Maintain<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_12076-12071-1\"><label for=\"field_fg4pp9b1ad287f814cfaeb9e8-1\">\t\t<input type=\"radio\" name=\"item_meta[12076]\" id=\"field_fg4pp9b1ad287f814cfaeb9e8-1\" value=\"Improve\"\n\t\t   data-sectionid=\"12071\" data-frmval=\"Maintain\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Improve<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12077_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_9hszib8f66426701c0987463d\" id=\"field_9hszib8f66426701c0987463d_label\" class=\"frm_primary_label\">Goal Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12077]\" id=\"field_9hszib8f66426701c0987463d\" rows=\"3\"  data-sectionid=\"12071\" data-frmval=\"Notes...\" data-invmsg=\"Goal Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12078_container\" class=\"frm_form_field  frm_html_container form-field\">\n<p  style=\"margin-top: 0px; font-size: 1px; padding-top: 0px;\">&nbsp;<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"frm_field_12080_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing frm_trigger\"><i class=\"frm_icon_font frm_arrow_icon\" aria-expanded=\"false\" aria-label=\"Toggle fields\"><\/i> <img style=\"display: inline; margin-right: 10px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-falls-blue.svg\" width=\"30\" height=\"30\" \/>Falls<\/h3>\r\n\r\n<div class=\"frm_toggle_container frm_grid_container\" style=\"display:none;\">\r\n<div id=\"frm_field_12081_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_txjkt764dedf44\" id=\"field_txjkt764dedf44_label\" class=\"frm_primary_label\">Level of Assistance\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[12081]\" id=\"field_txjkt764dedf44\"  data-sectionid=\"12080\" data-frmval=\"Independent\" data-invmsg=\"Level of Assistance is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"Independent\"  selected=\"selected\" class=\"\">\n\t\t\tIndependent\t\t<\/option>\n\t\t\t<option value=\"Some Assistance\"  class=\"\">\n\t\t\tSome Assistance\t\t<\/option>\n\t\t\t<option value=\"Assisted\"  class=\"\">\n\t\t\tAssisted\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12082_container\" class=\"frm_form_field form-field  frm_top_container frm_third horizontal_radio\">\r\n    <div  id=\"field_hhqzu631a8b291fc91e7a8ad9_label\" class=\"frm_primary_label\">Assigned to\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_hhqzu631a8b291fc91e7a8ad9_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12082-12080-0\"><label for=\"field_hhqzu631a8b291fc91e7a8ad9-0\"><input type=\"checkbox\" name=\"item_meta[12082][]\" id=\"field_hhqzu631a8b291fc91e7a8ad9-0\" value=\"Nursing\"  data-sectionid=\"12080\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Nursing<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12082-12080-1\"><label for=\"field_hhqzu631a8b291fc91e7a8ad9-1\"><input type=\"checkbox\" name=\"item_meta[12082][]\" id=\"field_hhqzu631a8b291fc91e7a8ad9-1\" value=\"Med Tech\"  data-sectionid=\"12080\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Med Tech<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12082-12080-2\"><label for=\"field_hhqzu631a8b291fc91e7a8ad9-2\"><input type=\"checkbox\" name=\"item_meta[12082][]\" id=\"field_hhqzu631a8b291fc91e7a8ad9-2\" value=\"Caregivers\"  data-sectionid=\"12080\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Caregivers<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12083_container\" class=\"frm_form_field  frm_fourth frm_first frm_html_container form-field\">\n<p style=\"font-size: 12px; color: #70a5cc; margin: 0 0 2px 0; padding: 10px 0 0 0; font-weight: 300;\">&nbsp;<\/p>\n<\/div>\n<div id=\"frm_field_12084_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_qasydcec14c94ad1014c3f027\" id=\"field_qasydcec14c94ad1014c3f027_label\" class=\"frm_primary_label\">Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12084]\" id=\"field_qasydcec14c94ad1014c3f027\" rows=\"3\"  data-sectionid=\"12080\" data-invmsg=\"Details is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12085_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first horizontal_radio\">\r\n    <div  id=\"field_yhutv3435f1631761afe50d56_label\" class=\"frm_primary_label\">Goal\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_yhutv3435f1631761afe50d56_label\" role=\"group\">\t\t<div class=\"frm_radio\" id=\"frm_radio_12085-12080-0\"><label for=\"field_yhutv3435f1631761afe50d56-0\">\t\t<input type=\"radio\" name=\"item_meta[12085]\" id=\"field_yhutv3435f1631761afe50d56-0\" value=\"Maintain\"\n\t\t   data-sectionid=\"12080\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Maintain<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_12085-12080-1\"><label for=\"field_yhutv3435f1631761afe50d56-1\">\t\t<input type=\"radio\" name=\"item_meta[12085]\" id=\"field_yhutv3435f1631761afe50d56-1\" value=\"Improve\"\n\t\t   data-sectionid=\"12080\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Improve<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12086_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_5ticde441f1773cda1b42fb27\" id=\"field_5ticde441f1773cda1b42fb27_label\" class=\"frm_primary_label\">Goal Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12086]\" id=\"field_5ticde441f1773cda1b42fb27\" rows=\"3\"  data-sectionid=\"12080\" data-invmsg=\"Goal Details is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12087_container\" class=\"frm_form_field  frm_html_container form-field\">\n<p  style=\"margin-top: 0px; font-size: 1px; padding-top: 0px;\">&nbsp;<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"frm_field_12089_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing frm_trigger\"><i class=\"frm_icon_font frm_arrow_icon\" aria-expanded=\"false\" aria-label=\"Toggle fields\"><\/i> <img style=\"display: inline; margin-right: 10px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-blood-sugar-blue.svg\" width=\"30\" height=\"30\" \/>Glucose<\/h3>\r\n\r\n<div class=\"frm_toggle_container frm_grid_container\" style=\"display:none;\">\r\n<div id=\"frm_field_12090_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_4td86eb69508221\" id=\"field_4td86eb69508221_label\" class=\"frm_primary_label\">Level of Assistance\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[12090]\" id=\"field_4td86eb69508221\"  data-sectionid=\"12089\" data-invmsg=\"Level of Assistance is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  selected=\"selected\" class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"Independent\"  class=\"\">\n\t\t\tIndependent\t\t<\/option>\n\t\t\t<option value=\"Some Assistance\"  class=\"\">\n\t\t\tSome Assistance\t\t<\/option>\n\t\t\t<option value=\"Assisted\"  class=\"\">\n\t\t\tAssisted\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12091_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths horizontal_radio\">\r\n    <div  id=\"field_2rys5fc479aaa92_label\" class=\"frm_primary_label\">Assigned to\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_2rys5fc479aaa92_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12091-12089-0\"><label for=\"field_2rys5fc479aaa92-0\"><input type=\"checkbox\" name=\"item_meta[12091][]\" id=\"field_2rys5fc479aaa92-0\" value=\"Nursing\" checked=\"checked\"  data-sectionid=\"12089\" data-frmval=\"[&quot;Nursing&quot;]\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Nursing<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12091-12089-1\"><label for=\"field_2rys5fc479aaa92-1\"><input type=\"checkbox\" name=\"item_meta[12091][]\" id=\"field_2rys5fc479aaa92-1\" value=\"Med Tech\"  data-sectionid=\"12089\" data-frmval=\"[&quot;Nursing&quot;]\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Med Tech<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12091-12089-2\"><label for=\"field_2rys5fc479aaa92-2\"><input type=\"checkbox\" name=\"item_meta[12091][]\" id=\"field_2rys5fc479aaa92-2\" value=\"Caregivers\"  data-sectionid=\"12089\" data-frmval=\"[&quot;Nursing&quot;]\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Caregivers<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12092_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_bny0ad38b81c4a9\" id=\"field_bny0ad38b81c4a9_label\" class=\"frm_primary_label\">Billing Frequency\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[12092]\" id=\"field_bny0ad38b81c4a9\"  data-sectionid=\"12089\" data-frmval=\"2x \/ Day\" data-invmsg=\"Billing Frequency is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"1x \/ Day\"  class=\"\">\n\t\t\t1x \/ Day\t\t<\/option>\n\t\t\t<option value=\"2x \/ Day\"  selected=\"selected\" class=\"\">\n\t\t\t2x \/ Day\t\t<\/option>\n\t\t\t<option value=\"3x \/ Day +\"  class=\"\">\n\t\t\t3x \/ Day +\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12093_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_90pgk68de78789b\" id=\"field_90pgk68de78789b_label\" class=\"frm_primary_label\">Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12093]\" id=\"field_90pgk68de78789b\" rows=\"1\"  data-sectionid=\"12089\" data-frmval=\"Notes...\" data-invmsg=\"Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12094_container\" class=\"frm_form_field  frm_fourth frm_first frm_html_container form-field\">\n<p class=\"blue-label\">Frequency<\/p>\n<div style=\"margin: 0; padding: 0;\">\n<table border=\"0\" width=\"100%\" cellspacing=\"0px\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td width=\"33%\">\n<p style=\"font-size: 14px; color: #000; margin: 2px 0 0 0; padding: 0; font-weight: 200;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-31 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-31{ color: #3b88fd;}i.fb-icon-element.fontawesome-icon.fb-icon-element-31:hover { color: #3b88fd;}<\/style>\n<p>SUN<\/p>\n<\/td>\n<td width=\"33%\">\n<p style=\"font-size: 14px; color: #000; margin: 2px 0 0 0; padding: 0; font-weight: 200;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-32 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-32{ color: #3b88fd;}i.fb-icon-element.fontawesome-icon.fb-icon-element-32:hover { color: #3b88fd;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p style=\"font-size: 14px; color: #000; margin: 2px 0 0 0; padding: 0; font-weight: 200;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-33 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-33{ color: #3b88fd;}i.fb-icon-element.fontawesome-icon.fb-icon-element-33:hover { color: #3b88fd;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-34 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-34{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-34:hover { color: #cccccc;}<\/style>\n<p>12-3<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-35 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-35{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-35:hover { color: #cccccc;}<\/style>\n<p>12-3<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-36 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-36{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-36:hover { color: #cccccc;}<\/style>\n<p>3-6<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-37 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-37{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-37:hover { color: #cccccc;}<\/style>\n<p>3-6<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-38 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-38{ color: #3b88fd;}i.fb-icon-element.fontawesome-icon.fb-icon-element-38:hover { color: #3b88fd;}<\/style>\n<p>6-9<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-39 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-39{ color: #3b88fd;}i.fb-icon-element.fontawesome-icon.fb-icon-element-39:hover { color: #3b88fd;}<\/style>\n<p>6-9<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-40 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-40{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-40:hover { color: #cccccc;}<\/style>\n<p>9-12<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-41 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-41{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-41:hover { color: #cccccc;}<\/style>\n<p>9-12<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-42 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-42{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-42:hover { color: #cccccc;}<\/style>\n<p>MON<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-43 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-43{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-43:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-44 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-44{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-44:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-45 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-45{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-45:hover { color: #cccccc;}<\/style>\n<p>TUE<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-46 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-46{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-46:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-47 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-47{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-47:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-48 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-48{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-48:hover { color: #cccccc;}<\/style>\n<p>WED<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-49 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-49{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-49:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-50 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-50{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-50:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-51 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-51{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-51:hover { color: #cccccc;}<\/style>\n<p>THU<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-52 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-52{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-52:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-53 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-53{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-53:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-54 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-54{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-54:hover { color: #cccccc;}<\/style>\n<p>FRI<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-55 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-55{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-55:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-56 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-56{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-56:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-57 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-57{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-57:hover { color: #cccccc;}<\/style>\n<p>SAT<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-58 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-58{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-58:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-59 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-59{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-59:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<\/div>\n<div id=\"frm_field_12095_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first horizontal_radio\">\r\n    <div  id=\"field_1cyo6501530679_label\" class=\"frm_primary_label\">Goal\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_1cyo6501530679_label\" role=\"group\">\t\t<div class=\"frm_radio\" id=\"frm_radio_12095-12089-0\"><label for=\"field_1cyo6501530679-0\">\t\t<input type=\"radio\" name=\"item_meta[12095]\" id=\"field_1cyo6501530679-0\" value=\"Maintain\"\n\t\t   data-sectionid=\"12089\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Maintain<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_12095-12089-1\"><label for=\"field_1cyo6501530679-1\">\t\t<input type=\"radio\" name=\"item_meta[12095]\" id=\"field_1cyo6501530679-1\" value=\"Improve\"\n\t\t   data-sectionid=\"12089\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Improve<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12096_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_qv6pz516936f6f7\" id=\"field_qv6pz516936f6f7_label\" class=\"frm_primary_label\">Goal Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12096]\" id=\"field_qv6pz516936f6f7\" rows=\"3\"  data-sectionid=\"12089\" data-frmval=\"Checking to see if new medication will help lower blood pressure.\" data-invmsg=\"Goal Details is invalid\" aria-invalid=\"false\"  >Checking to see if new medication will help lower blood pressure.<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12097_container\" class=\"frm_form_field  frm_html_container form-field\">\n<p  style=\"margin-top: 0px; font-size: 1px; padding-top: 0px;\">&nbsp;<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"frm_field_12099_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing frm_trigger\"><i class=\"frm_icon_font frm_arrow_icon\" aria-expanded=\"false\" aria-label=\"Toggle fields\"><\/i> <img style=\"display: inline; margin-right: 10px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-grooming-blue.svg\" width=\"30\" height=\"30\" \/>Grooming<\/h3>\r\n\r\n<div class=\"frm_toggle_container frm_grid_container\" style=\"display:none;\">\r\n<div id=\"frm_field_12100_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_vca3k6a1468b4bd511ef186c0\" id=\"field_vca3k6a1468b4bd511ef186c0_label\" class=\"frm_primary_label\">Level of Assistance\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[12100]\" id=\"field_vca3k6a1468b4bd511ef186c0\"  data-sectionid=\"12099\" data-frmval=\"Some Assistance\" data-invmsg=\"Level of Assistance is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"Independent\"  class=\"\">\n\t\t\tIndependent\t\t<\/option>\n\t\t\t<option value=\"Some Assistance\"  selected=\"selected\" class=\"\">\n\t\t\tSome Assistance\t\t<\/option>\n\t\t\t<option value=\"Assisted\"  class=\"\">\n\t\t\tAssisted\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12101_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths horizontal_radio\">\r\n    <div  id=\"field_zpk8p7810cc572c1c304e8048_label\" class=\"frm_primary_label\">Assigned to\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_zpk8p7810cc572c1c304e8048_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12101-12099-0\"><label for=\"field_zpk8p7810cc572c1c304e8048-0\"><input type=\"checkbox\" name=\"item_meta[12101][]\" id=\"field_zpk8p7810cc572c1c304e8048-0\" value=\"Nursing\"  data-sectionid=\"12099\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Nursing<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12101-12099-1\"><label for=\"field_zpk8p7810cc572c1c304e8048-1\"><input type=\"checkbox\" name=\"item_meta[12101][]\" id=\"field_zpk8p7810cc572c1c304e8048-1\" value=\"Med Tech\"  data-sectionid=\"12099\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Med Tech<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12101-12099-2\"><label for=\"field_zpk8p7810cc572c1c304e8048-2\"><input type=\"checkbox\" name=\"item_meta[12101][]\" id=\"field_zpk8p7810cc572c1c304e8048-2\" value=\"Caregivers\" checked=\"checked\"  data-sectionid=\"12099\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Caregivers<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12104_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first frm_three_col\">\r\n    <div  id=\"field_rlihz04e80983d0_label\" class=\"frm_primary_label\">Frequency\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_rlihz04e80983d0_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12104-12099-0\"><label for=\"field_rlihz04e80983d0-0\"><input type=\"checkbox\" name=\"item_meta[12104][]\" id=\"field_rlihz04e80983d0-0\" value=\"SUN\"  data-sectionid=\"12099\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> SUN<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12104-12099-1\"><label for=\"field_rlihz04e80983d0-1\"><input type=\"checkbox\" name=\"item_meta[12104][]\" id=\"field_rlihz04e80983d0-1\" value=\"AM\"  data-sectionid=\"12099\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12104-12099-2\"><label for=\"field_rlihz04e80983d0-2\"><input type=\"checkbox\" name=\"item_meta[12104][]\" id=\"field_rlihz04e80983d0-2\" value=\"PM\"  data-sectionid=\"12099\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12104-12099-3\"><label for=\"field_rlihz04e80983d0-3\"><input type=\"checkbox\" name=\"item_meta[12104][]\" id=\"field_rlihz04e80983d0-3\" value=\"MON\"  data-sectionid=\"12099\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> MON<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12104-12099-4\"><label for=\"field_rlihz04e80983d0-4\"><input type=\"checkbox\" name=\"item_meta[12104][]\" id=\"field_rlihz04e80983d0-4\" value=\"AM\"  data-sectionid=\"12099\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12104-12099-5\"><label for=\"field_rlihz04e80983d0-5\"><input type=\"checkbox\" name=\"item_meta[12104][]\" id=\"field_rlihz04e80983d0-5\" value=\"PM\"  data-sectionid=\"12099\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12104-12099-6\"><label for=\"field_rlihz04e80983d0-6\"><input type=\"checkbox\" name=\"item_meta[12104][]\" id=\"field_rlihz04e80983d0-6\" value=\"TUE\"  data-sectionid=\"12099\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> TUE<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12104-12099-7\"><label for=\"field_rlihz04e80983d0-7\"><input type=\"checkbox\" name=\"item_meta[12104][]\" id=\"field_rlihz04e80983d0-7\" value=\"AM\"  data-sectionid=\"12099\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12104-12099-8\"><label for=\"field_rlihz04e80983d0-8\"><input type=\"checkbox\" name=\"item_meta[12104][]\" id=\"field_rlihz04e80983d0-8\" value=\"PM\"  data-sectionid=\"12099\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12104-12099-9\"><label for=\"field_rlihz04e80983d0-9\"><input type=\"checkbox\" name=\"item_meta[12104][]\" id=\"field_rlihz04e80983d0-9\" value=\"WED\"  data-sectionid=\"12099\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> WED<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12104-12099-10\"><label for=\"field_rlihz04e80983d0-10\"><input type=\"checkbox\" name=\"item_meta[12104][]\" id=\"field_rlihz04e80983d0-10\" value=\"AM\"  data-sectionid=\"12099\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12104-12099-11\"><label for=\"field_rlihz04e80983d0-11\"><input type=\"checkbox\" name=\"item_meta[12104][]\" id=\"field_rlihz04e80983d0-11\" value=\"PM\"  data-sectionid=\"12099\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12104-12099-12\"><label for=\"field_rlihz04e80983d0-12\"><input type=\"checkbox\" name=\"item_meta[12104][]\" id=\"field_rlihz04e80983d0-12\" value=\"THU\"  data-sectionid=\"12099\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> THU<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12104-12099-13\"><label for=\"field_rlihz04e80983d0-13\"><input type=\"checkbox\" name=\"item_meta[12104][]\" id=\"field_rlihz04e80983d0-13\" value=\"AM\"  data-sectionid=\"12099\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12104-12099-14\"><label for=\"field_rlihz04e80983d0-14\"><input type=\"checkbox\" name=\"item_meta[12104][]\" id=\"field_rlihz04e80983d0-14\" value=\"PM\"  data-sectionid=\"12099\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12104-12099-15\"><label for=\"field_rlihz04e80983d0-15\"><input type=\"checkbox\" name=\"item_meta[12104][]\" id=\"field_rlihz04e80983d0-15\" value=\"FRI\"  data-sectionid=\"12099\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> FRI<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12104-12099-16\"><label for=\"field_rlihz04e80983d0-16\"><input type=\"checkbox\" name=\"item_meta[12104][]\" id=\"field_rlihz04e80983d0-16\" value=\"AM\"  data-sectionid=\"12099\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12104-12099-17\"><label for=\"field_rlihz04e80983d0-17\"><input type=\"checkbox\" name=\"item_meta[12104][]\" id=\"field_rlihz04e80983d0-17\" value=\"PM\"  data-sectionid=\"12099\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12104-12099-18\"><label for=\"field_rlihz04e80983d0-18\"><input type=\"checkbox\" name=\"item_meta[12104][]\" id=\"field_rlihz04e80983d0-18\" value=\"SAT\"  data-sectionid=\"12099\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> SAT<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12104-12099-19\"><label for=\"field_rlihz04e80983d0-19\"><input type=\"checkbox\" name=\"item_meta[12104][]\" id=\"field_rlihz04e80983d0-19\" value=\"AM\"  data-sectionid=\"12099\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12104-12099-20\"><label for=\"field_rlihz04e80983d0-20\"><input type=\"checkbox\" name=\"item_meta[12104][]\" id=\"field_rlihz04e80983d0-20\" value=\"PM\"  data-sectionid=\"12099\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12103_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_h0nufd21dbd11b7cc5ea21e45\" id=\"field_h0nufd21dbd11b7cc5ea21e45_label\" class=\"frm_primary_label\">Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12103]\" id=\"field_h0nufd21dbd11b7cc5ea21e45\" rows=\"1\"  data-sectionid=\"12099\" data-frmval=\"Notes...\" data-invmsg=\"Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12105_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first horizontal_radio\">\r\n    <div  id=\"field_fvi5w463ba437f47984e6f0bf_label\" class=\"frm_primary_label\">Goal\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_fvi5w463ba437f47984e6f0bf_label\" role=\"group\">\t\t<div class=\"frm_radio\" id=\"frm_radio_12105-12099-0\"><label for=\"field_fvi5w463ba437f47984e6f0bf-0\">\t\t<input type=\"radio\" name=\"item_meta[12105]\" id=\"field_fvi5w463ba437f47984e6f0bf-0\" value=\"Maintain\"\n\t\tchecked=\"checked\"   data-sectionid=\"12099\" data-frmval=\"Maintain\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Maintain<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_12105-12099-1\"><label for=\"field_fvi5w463ba437f47984e6f0bf-1\">\t\t<input type=\"radio\" name=\"item_meta[12105]\" id=\"field_fvi5w463ba437f47984e6f0bf-1\" value=\"Improve\"\n\t\t   data-sectionid=\"12099\" data-frmval=\"Maintain\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Improve<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12106_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_c0as9a6179321882f2f401e66\" id=\"field_c0as9a6179321882f2f401e66_label\" class=\"frm_primary_label\">Goal Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12106]\" id=\"field_c0as9a6179321882f2f401e66\" rows=\"3\"  data-sectionid=\"12099\" data-frmval=\"Notes...\" data-invmsg=\"Goal Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12107_container\" class=\"frm_form_field  frm_html_container form-field\">\n<p  style=\"margin-top: 0px; font-size: 1px; padding-top: 0px;\">&nbsp;<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"frm_field_12109_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing frm_trigger\"><i class=\"frm_icon_font frm_arrow_icon\" aria-expanded=\"false\" aria-label=\"Toggle fields\"><\/i> <img style=\"display: inline; margin-right: 10px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-injections-blue.svg\" width=\"30\" height=\"30\" \/>Insulin<\/h3>\r\n\r\n<div class=\"frm_toggle_container frm_grid_container\" style=\"display:none;\">\r\n<div id=\"frm_field_12110_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_pdq5cd66ddd46708b821ae053\" id=\"field_pdq5cd66ddd46708b821ae053_label\" class=\"frm_primary_label\">Level of Assistance\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[12110]\" id=\"field_pdq5cd66ddd46708b821ae053\"  data-sectionid=\"12109\" data-invmsg=\"Level of Assistance is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  selected=\"selected\" class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"Independent\"  class=\"\">\n\t\t\tIndependent\t\t<\/option>\n\t\t\t<option value=\"Some Assistance\"  class=\"\">\n\t\t\tSome Assistance\t\t<\/option>\n\t\t\t<option value=\"Assisted\"  class=\"\">\n\t\t\tAssisted\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12111_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths horizontal_radio\">\r\n    <div  id=\"field_fwzvh73c44859800cae7d9d9e_label\" class=\"frm_primary_label\">Assigned to\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_fwzvh73c44859800cae7d9d9e_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12111-12109-0\"><label for=\"field_fwzvh73c44859800cae7d9d9e-0\"><input type=\"checkbox\" name=\"item_meta[12111][]\" id=\"field_fwzvh73c44859800cae7d9d9e-0\" value=\"Nursing\"  data-sectionid=\"12109\" data-frmval=\"{&quot;1&quot;:&quot;Med Tech&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Nursing<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12111-12109-1\"><label for=\"field_fwzvh73c44859800cae7d9d9e-1\"><input type=\"checkbox\" name=\"item_meta[12111][]\" id=\"field_fwzvh73c44859800cae7d9d9e-1\" value=\"Med Tech\" checked=\"checked\"  data-sectionid=\"12109\" data-frmval=\"{&quot;1&quot;:&quot;Med Tech&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Med Tech<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12111-12109-2\"><label for=\"field_fwzvh73c44859800cae7d9d9e-2\"><input type=\"checkbox\" name=\"item_meta[12111][]\" id=\"field_fwzvh73c44859800cae7d9d9e-2\" value=\"Caregivers\"  data-sectionid=\"12109\" data-frmval=\"{&quot;1&quot;:&quot;Med Tech&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Caregivers<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12112_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_8atho12087c503e\" id=\"field_8atho12087c503e_label\" class=\"frm_primary_label\">Billing Frequency\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[12112]\" id=\"field_8atho12087c503e\"  data-sectionid=\"12109\" data-frmval=\"2x \/ Day\" data-invmsg=\"Billing Frequency is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"1x \/ Day\"  class=\"\">\n\t\t\t1x \/ Day\t\t<\/option>\n\t\t\t<option value=\"2x \/ Day\"  selected=\"selected\" class=\"\">\n\t\t\t2x \/ Day\t\t<\/option>\n\t\t\t<option value=\"3x \/ Day +\"  class=\"\">\n\t\t\t3x \/ Day +\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12113_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_bwkpv461a4662246bd3a02282\" id=\"field_bwkpv461a4662246bd3a02282_label\" class=\"frm_primary_label\">Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12113]\" id=\"field_bwkpv461a4662246bd3a02282\" rows=\"1\"  data-sectionid=\"12109\" data-frmval=\"Notes...\" data-invmsg=\"Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12114_container\" class=\"frm_form_field  frm_fourth frm_first frm_html_container form-field\">\n<p class=\"blue-label\">Frequency<\/p>\n<div style=\"margin: 0; padding: 0;\">\n<table border=\"0\" width=\"100%\" cellspacing=\"0px\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-60 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-60{ color: #3b88fd;}i.fb-icon-element.fontawesome-icon.fb-icon-element-60:hover { color: #3b88fd;}<\/style>\n<p>SUN<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-61 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-61{ color: #3b88fd;}i.fb-icon-element.fontawesome-icon.fb-icon-element-61:hover { color: #3b88fd;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-62 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-62{ color: #3b88fd;}i.fb-icon-element.fontawesome-icon.fb-icon-element-62:hover { color: #3b88fd;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-63 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-63{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-63:hover { color: #cccccc;}<\/style>\n<p>12-3<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-64 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-64{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-64:hover { color: #cccccc;}<\/style>\n<p>12-3<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-65 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-65{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-65:hover { color: #cccccc;}<\/style>\n<p>3-6<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-66 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-66{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-66:hover { color: #cccccc;}<\/style>\n<p>3-6<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-67 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-67{ color: #3b88fd;}i.fb-icon-element.fontawesome-icon.fb-icon-element-67:hover { color: #3b88fd;}<\/style>\n<p>6-9<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-68 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-68{ color: #3b88fd;}i.fb-icon-element.fontawesome-icon.fb-icon-element-68:hover { color: #3b88fd;}<\/style>\n<p>6-9<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-69 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-69{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-69:hover { color: #cccccc;}<\/style>\n<p>9-12<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-70 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-70{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-70:hover { color: #cccccc;}<\/style>\n<p>9-12<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-71 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-71{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-71:hover { color: #cccccc;}<\/style>\n<p>MON<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-72 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-72{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-72:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-73 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-73{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-73:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-74 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-74{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-74:hover { color: #cccccc;}<\/style>\n<p>TUE<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-75 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-75{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-75:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-76 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-76{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-76:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-77 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-77{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-77:hover { color: #cccccc;}<\/style>\n<p>WED<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-78 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-78{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-78:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-79 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-79{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-79:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-80 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-80{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-80:hover { color: #cccccc;}<\/style>\n<p>THU<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-81 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-81{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-81:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-82 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-82{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-82:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-83 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-83{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-83:hover { color: #cccccc;}<\/style>\n<p>FRI<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-84 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-84{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-84:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-85 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-85{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-85:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-86 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-86{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-86:hover { color: #cccccc;}<\/style>\n<p>SAT<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-87 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-87{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-87:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-88 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-88{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-88:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<\/div>\n<div id=\"frm_field_12115_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first horizontal_radio\">\r\n    <div  id=\"field_q894he175372483c64b9c2102_label\" class=\"frm_primary_label\">Goal\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_q894he175372483c64b9c2102_label\" role=\"group\">\t\t<div class=\"frm_radio\" id=\"frm_radio_12115-12109-0\"><label for=\"field_q894he175372483c64b9c2102-0\">\t\t<input type=\"radio\" name=\"item_meta[12115]\" id=\"field_q894he175372483c64b9c2102-0\" value=\"Maintain\"\n\t\tchecked=\"checked\"   data-sectionid=\"12109\" data-frmval=\"Maintain\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Maintain<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_12115-12109-1\"><label for=\"field_q894he175372483c64b9c2102-1\">\t\t<input type=\"radio\" name=\"item_meta[12115]\" id=\"field_q894he175372483c64b9c2102-1\" value=\"Improve\"\n\t\t   data-sectionid=\"12109\" data-frmval=\"Maintain\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Improve<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12116_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_vu0k94b21ab057594a1472b9c\" id=\"field_vu0k94b21ab057594a1472b9c_label\" class=\"frm_primary_label\">Goal Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12116]\" id=\"field_vu0k94b21ab057594a1472b9c\" rows=\"3\"  data-sectionid=\"12109\" data-frmval=\"Notes...\" data-invmsg=\"Goal Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12117_container\" class=\"frm_form_field  frm_html_container form-field\">\n<p  style=\"margin-top: 0px; font-size: 1px; padding-top: 0px;\">&nbsp;<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"frm_field_12119_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing frm_trigger\"><i class=\"frm_icon_font frm_arrow_icon\" aria-expanded=\"false\" aria-label=\"Toggle fields\"><\/i> <img style=\"display: inline; margin-right: 10px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-meals-blue.svg\" width=\"30\" height=\"30\" \/>Meals<\/h3>\r\n\r\n<div class=\"frm_toggle_container frm_grid_container\" style=\"display:none;\">\r\n<div id=\"frm_field_12120_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_afmhkf9d5591716bee3c4915b\" id=\"field_afmhkf9d5591716bee3c4915b_label\" class=\"frm_primary_label\">Level of Assistance\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[12120]\" id=\"field_afmhkf9d5591716bee3c4915b\"  data-sectionid=\"12119\" data-frmval=\"Some Assistance\" data-invmsg=\"Level of Assistance is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"Independent\"  class=\"\">\n\t\t\tIndependent\t\t<\/option>\n\t\t\t<option value=\"Some Assistance\"  selected=\"selected\" class=\"\">\n\t\t\tSome Assistance\t\t<\/option>\n\t\t\t<option value=\"Assisted\"  class=\"\">\n\t\t\tAssisted\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12121_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths horizontal_radio\">\r\n    <div  id=\"field_5obg02991a326ef5003312ada_label\" class=\"frm_primary_label\">Assigned to\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_5obg02991a326ef5003312ada_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12121-12119-0\"><label for=\"field_5obg02991a326ef5003312ada-0\"><input type=\"checkbox\" name=\"item_meta[12121][]\" id=\"field_5obg02991a326ef5003312ada-0\" value=\"Nursing\"  data-sectionid=\"12119\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Nursing<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12121-12119-1\"><label for=\"field_5obg02991a326ef5003312ada-1\"><input type=\"checkbox\" name=\"item_meta[12121][]\" id=\"field_5obg02991a326ef5003312ada-1\" value=\"Med Tech\"  data-sectionid=\"12119\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Med Tech<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12121-12119-2\"><label for=\"field_5obg02991a326ef5003312ada-2\"><input type=\"checkbox\" name=\"item_meta[12121][]\" id=\"field_5obg02991a326ef5003312ada-2\" value=\"Caregivers\" checked=\"checked\"  data-sectionid=\"12119\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Caregivers<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12124_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first frm_four_col\">\r\n    <label for=\"field_u7ytm589cd31a27655b417caf\" id=\"field_u7ytm589cd31a27655b417caf_label\" class=\"frm_primary_label\">Frequency\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-0\"><label for=\"field_u7ytm589cd31a27655b417caf-0\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-0\" value=\"SUN\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> SUN<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-1\"><label for=\"field_u7ytm589cd31a27655b417caf-1\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-1\" value=\"BKS\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> BKS<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-2\"><label for=\"field_u7ytm589cd31a27655b417caf-2\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-2\" value=\"LCH\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> LCH<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-3\"><label for=\"field_u7ytm589cd31a27655b417caf-3\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-3\" value=\"DIN\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> DIN<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-4\"><label for=\"field_u7ytm589cd31a27655b417caf-4\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-4\" value=\"MON\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> MON<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-5\"><label for=\"field_u7ytm589cd31a27655b417caf-5\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-5\" value=\"BKS\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> BKS<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-6\"><label for=\"field_u7ytm589cd31a27655b417caf-6\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-6\" value=\"LCH\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> LCH<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-7\"><label for=\"field_u7ytm589cd31a27655b417caf-7\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-7\" value=\"DIN\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> DIN<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-8\"><label for=\"field_u7ytm589cd31a27655b417caf-8\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-8\" value=\"TUE\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> TUE<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-9\"><label for=\"field_u7ytm589cd31a27655b417caf-9\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-9\" value=\"BKS\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> BKS<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-10\"><label for=\"field_u7ytm589cd31a27655b417caf-10\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-10\" value=\"LCH\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> LCH<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-11\"><label for=\"field_u7ytm589cd31a27655b417caf-11\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-11\" value=\"DIN\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> DIN<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-12\"><label for=\"field_u7ytm589cd31a27655b417caf-12\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-12\" value=\"WED\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> WED<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-13\"><label for=\"field_u7ytm589cd31a27655b417caf-13\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-13\" value=\"BKS\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> BKS<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-14\"><label for=\"field_u7ytm589cd31a27655b417caf-14\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-14\" value=\"LCH\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> LCH<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-15\"><label for=\"field_u7ytm589cd31a27655b417caf-15\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-15\" value=\"DIN\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> DIN<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-16\"><label for=\"field_u7ytm589cd31a27655b417caf-16\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-16\" value=\"THU\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> THU<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-17\"><label for=\"field_u7ytm589cd31a27655b417caf-17\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-17\" value=\"BKS\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> BKS<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-18\"><label for=\"field_u7ytm589cd31a27655b417caf-18\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-18\" value=\"LCH\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> LCH<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-19\"><label for=\"field_u7ytm589cd31a27655b417caf-19\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-19\" value=\"DIN\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> DIN<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-20\"><label for=\"field_u7ytm589cd31a27655b417caf-20\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-20\" value=\"FRI\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> FRI<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-21\"><label for=\"field_u7ytm589cd31a27655b417caf-21\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-21\" value=\"BKS\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> BKS<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-22\"><label for=\"field_u7ytm589cd31a27655b417caf-22\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-22\" value=\"LCH\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> LCH<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-23\"><label for=\"field_u7ytm589cd31a27655b417caf-23\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-23\" value=\"DIN\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> DIN<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-24\"><label for=\"field_u7ytm589cd31a27655b417caf-24\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-24\" value=\"SAT\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> SAT<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-25\"><label for=\"field_u7ytm589cd31a27655b417caf-25\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-25\" value=\"BKS\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> BKS<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-26\"><label for=\"field_u7ytm589cd31a27655b417caf-26\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-26\" value=\"LCH\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> LCH<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12124-12119-27\"><label for=\"field_u7ytm589cd31a27655b417caf-27\"><input type=\"checkbox\" name=\"item_meta[12124][]\" id=\"field_u7ytm589cd31a27655b417caf-27\" value=\"DIN\"  data-sectionid=\"12119\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> DIN<\/label><\/div>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12123_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_lqk50d978e9bb9e5406fa09c9\" id=\"field_lqk50d978e9bb9e5406fa09c9_label\" class=\"frm_primary_label\">Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12123]\" id=\"field_lqk50d978e9bb9e5406fa09c9\" rows=\"1\"  data-sectionid=\"12119\" data-frmval=\"Notes...\" data-invmsg=\"Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12125_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first horizontal_radio\">\r\n    <div  id=\"field_na0r351737396545167000481_label\" class=\"frm_primary_label\">Goal\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_na0r351737396545167000481_label\" role=\"group\">\t\t<div class=\"frm_radio\" id=\"frm_radio_12125-12119-0\"><label for=\"field_na0r351737396545167000481-0\">\t\t<input type=\"radio\" name=\"item_meta[12125]\" id=\"field_na0r351737396545167000481-0\" value=\"Maintain\"\n\t\tchecked=\"checked\"   data-sectionid=\"12119\" data-frmval=\"Maintain\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Maintain<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_12125-12119-1\"><label for=\"field_na0r351737396545167000481-1\">\t\t<input type=\"radio\" name=\"item_meta[12125]\" id=\"field_na0r351737396545167000481-1\" value=\"Improve\"\n\t\t   data-sectionid=\"12119\" data-frmval=\"Maintain\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Improve<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12126_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_ad0mff35650690509c8bcce06\" id=\"field_ad0mff35650690509c8bcce06_label\" class=\"frm_primary_label\">Goal Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12126]\" id=\"field_ad0mff35650690509c8bcce06\" rows=\"3\"  data-sectionid=\"12119\" data-frmval=\"Notes...\" data-invmsg=\"Goal Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12127_container\" class=\"frm_form_field  frm_html_container form-field\">\n<p  style=\"margin-top: 0px; font-size: 1px; padding-top: 0px;\">&nbsp;<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"frm_field_12129_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing frm_trigger\"><i class=\"frm_icon_font frm_arrow_icon\" aria-expanded=\"false\" aria-label=\"Toggle fields\"><\/i> <img style=\"display: inline; margin-right: 10px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-medication-blue.svg\" width=\"30\" height=\"30\" \/>Medication<\/h3>\r\n\r\n<div class=\"frm_toggle_container frm_grid_container\" style=\"display:none;\">\r\n<div id=\"frm_field_12130_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_om6hy018879215bad14612776\" id=\"field_om6hy018879215bad14612776_label\" class=\"frm_primary_label\">Level of Assistance\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[12130]\" id=\"field_om6hy018879215bad14612776\"  data-sectionid=\"12129\" data-frmval=\"Some Assistance\" data-invmsg=\"Level of Assistance is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"Independent\"  class=\"\">\n\t\t\tIndependent\t\t<\/option>\n\t\t\t<option value=\"Some Assistance\"  selected=\"selected\" class=\"\">\n\t\t\tSome Assistance\t\t<\/option>\n\t\t\t<option value=\"Assisted\"  class=\"\">\n\t\t\tAssisted\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12131_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths horizontal_radio\">\r\n    <div  id=\"field_d3w2g17007a3cef0df978e2cc_label\" class=\"frm_primary_label\">Assigned to\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_d3w2g17007a3cef0df978e2cc_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12131-12129-0\"><label for=\"field_d3w2g17007a3cef0df978e2cc-0\"><input type=\"checkbox\" name=\"item_meta[12131][]\" id=\"field_d3w2g17007a3cef0df978e2cc-0\" value=\"Nursing\"  data-sectionid=\"12129\" data-frmval=\"{&quot;1&quot;:&quot;Med Tech&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Nursing<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12131-12129-1\"><label for=\"field_d3w2g17007a3cef0df978e2cc-1\"><input type=\"checkbox\" name=\"item_meta[12131][]\" id=\"field_d3w2g17007a3cef0df978e2cc-1\" value=\"Med Tech\" checked=\"checked\"  data-sectionid=\"12129\" data-frmval=\"{&quot;1&quot;:&quot;Med Tech&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Med Tech<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12131-12129-2\"><label for=\"field_d3w2g17007a3cef0df978e2cc-2\"><input type=\"checkbox\" name=\"item_meta[12131][]\" id=\"field_d3w2g17007a3cef0df978e2cc-2\" value=\"Caregivers\"  data-sectionid=\"12129\" data-frmval=\"{&quot;1&quot;:&quot;Med Tech&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Caregivers<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12132_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_puz0ida4656c15c\" id=\"field_puz0ida4656c15c_label\" class=\"frm_primary_label\">Billing Frequency\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[12132]\" id=\"field_puz0ida4656c15c\"  data-sectionid=\"12129\" data-frmval=\"2x \/ Day\" data-invmsg=\"Billing Frequency is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"1x \/ Day\"  class=\"\">\n\t\t\t1x \/ Day\t\t<\/option>\n\t\t\t<option value=\"2x \/ Day\"  selected=\"selected\" class=\"\">\n\t\t\t2x \/ Day\t\t<\/option>\n\t\t\t<option value=\"3x \/ Day +\"  class=\"\">\n\t\t\t3x \/ Day +\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12133_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_x4iha7e54d4e4b506fcd3987f\" id=\"field_x4iha7e54d4e4b506fcd3987f_label\" class=\"frm_primary_label\">Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12133]\" id=\"field_x4iha7e54d4e4b506fcd3987f\" rows=\"1\"  data-sectionid=\"12129\" data-frmval=\"Notes...\" data-invmsg=\"Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12134_container\" class=\"frm_form_field  frm_fourth frm_first frm_html_container form-field\">\n<p class=\"blue-label\">Frequency<\/p>\n<div style=\"margin: 0; padding: 0;\">\n<table border=\"0\" width=\"100%\" cellspacing=\"0px\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-89 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-89{ color: #3b88fd;}i.fb-icon-element.fontawesome-icon.fb-icon-element-89:hover { color: #3b88fd;}<\/style>\n<p>SUN<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-90 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-90{ color: #3b88fd;}i.fb-icon-element.fontawesome-icon.fb-icon-element-90:hover { color: #3b88fd;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-91 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-91{ color: #3b88fd;}i.fb-icon-element.fontawesome-icon.fb-icon-element-91:hover { color: #3b88fd;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-92 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-92{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-92:hover { color: #cccccc;}<\/style>\n<p>12-3<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-93 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-93{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-93:hover { color: #cccccc;}<\/style>\n<p>12-3<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-94 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-94{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-94:hover { color: #cccccc;}<\/style>\n<p>3-6<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-95 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-95{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-95:hover { color: #cccccc;}<\/style>\n<p>3-6<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-96 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-96{ color: #3b88fd;}i.fb-icon-element.fontawesome-icon.fb-icon-element-96:hover { color: #3b88fd;}<\/style>\n<p>6-9<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-97 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-97{ color: #3b88fd;}i.fb-icon-element.fontawesome-icon.fb-icon-element-97:hover { color: #3b88fd;}<\/style>\n<p>6-9<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-98 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-98{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-98:hover { color: #cccccc;}<\/style>\n<p>9-12<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-99 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-99{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-99:hover { color: #cccccc;}<\/style>\n<p>9-12<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-100 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-100{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-100:hover { color: #cccccc;}<\/style>\n<p>MON<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-101 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-101{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-101:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-102 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-102{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-102:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-103 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-103{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-103:hover { color: #cccccc;}<\/style>\n<p>TUE<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-104 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-104{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-104:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-105 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-105{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-105:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-106 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-106{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-106:hover { color: #cccccc;}<\/style>\n<p>WED<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-107 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-107{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-107:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-108 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-108{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-108:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-109 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-109{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-109:hover { color: #cccccc;}<\/style>\n<p>THU<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-110 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-110{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-110:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-111 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-111{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-111:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-112 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-112{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-112:hover { color: #cccccc;}<\/style>\n<p>FRI<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-113 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-113{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-113:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-114 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-114{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-114:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-115 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-115{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-115:hover { color: #cccccc;}<\/style>\n<p>SAT<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-116 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-116{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-116:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-117 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-117{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-117:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<\/div>\n<div id=\"frm_field_12135_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first horizontal_radio\">\r\n    <div  id=\"field_m1nabbf4e828c3_label\" class=\"frm_primary_label\">Goal\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_m1nabbf4e828c3_label\" role=\"group\">\t\t<div class=\"frm_radio\" id=\"frm_radio_12135-12129-0\"><label for=\"field_m1nabbf4e828c3-0\">\t\t<input type=\"radio\" name=\"item_meta[12135]\" id=\"field_m1nabbf4e828c3-0\" value=\"Maintain\"\n\t\tchecked=\"checked\"   data-sectionid=\"12129\" data-frmval=\"Maintain\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Maintain<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_12135-12129-1\"><label for=\"field_m1nabbf4e828c3-1\">\t\t<input type=\"radio\" name=\"item_meta[12135]\" id=\"field_m1nabbf4e828c3-1\" value=\"Improve\"\n\t\t   data-sectionid=\"12129\" data-frmval=\"Maintain\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Improve<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12136_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_xf1q1f34a15025c29a9f6a069\" id=\"field_xf1q1f34a15025c29a9f6a069_label\" class=\"frm_primary_label\">Goal Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12136]\" id=\"field_xf1q1f34a15025c29a9f6a069\" rows=\"3\"  data-sectionid=\"12129\" data-frmval=\"Notes...\" data-invmsg=\"Goal Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12137_container\" class=\"frm_form_field  frm_html_container form-field\">\n<p  style=\"margin-top: 0px; font-size: 1px; padding-top: 0px;\">&nbsp;<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"frm_field_12139_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing frm_trigger\"><i class=\"frm_icon_font frm_arrow_icon\" aria-expanded=\"false\" aria-label=\"Toggle fields\"><\/i> <img style=\"display: inline; margin-right: 10px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-mobility-blue.svg\" width=\"30\" height=\"30\" \/>Mobility<\/h3>\r\n\r\n<div class=\"frm_toggle_container frm_grid_container\" style=\"display:none;\">\r\n<div id=\"frm_field_12140_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_2cw6qfb9111b1c10908a0952c\" id=\"field_2cw6qfb9111b1c10908a0952c_label\" class=\"frm_primary_label\">Level of Assistance\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[12140]\" id=\"field_2cw6qfb9111b1c10908a0952c\"  data-sectionid=\"12139\" data-frmval=\"Some Assistance\" data-invmsg=\"Level of Assistance is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"Independent\"  class=\"\">\n\t\t\tIndependent\t\t<\/option>\n\t\t\t<option value=\"Some Assistance\"  selected=\"selected\" class=\"\">\n\t\t\tSome Assistance\t\t<\/option>\n\t\t\t<option value=\"Assisted\"  class=\"\">\n\t\t\tAssisted\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12141_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths horizontal_radio\">\r\n    <div  id=\"field_bxvzrec7d9007dbb325c75de2_label\" class=\"frm_primary_label\">Assigned to\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_bxvzrec7d9007dbb325c75de2_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12141-12139-0\"><label for=\"field_bxvzrec7d9007dbb325c75de2-0\"><input type=\"checkbox\" name=\"item_meta[12141][]\" id=\"field_bxvzrec7d9007dbb325c75de2-0\" value=\"Nursing\"  data-sectionid=\"12139\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Nursing<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12141-12139-1\"><label for=\"field_bxvzrec7d9007dbb325c75de2-1\"><input type=\"checkbox\" name=\"item_meta[12141][]\" id=\"field_bxvzrec7d9007dbb325c75de2-1\" value=\"Med Tech\"  data-sectionid=\"12139\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Med Tech<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12141-12139-2\"><label for=\"field_bxvzrec7d9007dbb325c75de2-2\"><input type=\"checkbox\" name=\"item_meta[12141][]\" id=\"field_bxvzrec7d9007dbb325c75de2-2\" value=\"Caregivers\" checked=\"checked\"  data-sectionid=\"12139\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Caregivers<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12144_container\" class=\"frm_form_field  frm_fourth frm_first frm_html_container form-field\">\n<p class=\"blue-label\">Frequency<\/p>\n<div style=\"margin: 0; padding: 0;\">\n<table border=\"0\" width=\"100%\" cellspacing=\"0px\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-118 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-118{ color: #3b88fd;}i.fb-icon-element.fontawesome-icon.fb-icon-element-118:hover { color: #3b88fd;}<\/style>\n<p>SUN<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-119 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-119{ color: #3b88fd;}i.fb-icon-element.fontawesome-icon.fb-icon-element-119:hover { color: #3b88fd;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-120 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-120{ color: #3b88fd;}i.fb-icon-element.fontawesome-icon.fb-icon-element-120:hover { color: #3b88fd;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-121 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-121{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-121:hover { color: #cccccc;}<\/style>\n<p>12-3<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-122 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-122{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-122:hover { color: #cccccc;}<\/style>\n<p>12-3<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-123 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-123{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-123:hover { color: #cccccc;}<\/style>\n<p>3-6<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-124 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-124{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-124:hover { color: #cccccc;}<\/style>\n<p>3-6<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-125 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-125{ color: #3b88fd;}i.fb-icon-element.fontawesome-icon.fb-icon-element-125:hover { color: #3b88fd;}<\/style>\n<p>6-9<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-126 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-126{ color: #3b88fd;}i.fb-icon-element.fontawesome-icon.fb-icon-element-126:hover { color: #3b88fd;}<\/style>\n<p>6-9<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-127 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-127{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-127:hover { color: #cccccc;}<\/style>\n<p>9-12<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-128 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-128{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-128:hover { color: #cccccc;}<\/style>\n<p>9-12<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-129 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-129{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-129:hover { color: #cccccc;}<\/style>\n<p>MON<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-130 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-130{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-130:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-131 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-131{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-131:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-132 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-132{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-132:hover { color: #cccccc;}<\/style>\n<p>TUE<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-133 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-133{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-133:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-134 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-134{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-134:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-135 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-135{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-135:hover { color: #cccccc;}<\/style>\n<p>WED<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-136 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-136{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-136:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-137 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-137{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-137:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-138 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-138{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-138:hover { color: #cccccc;}<\/style>\n<p>THU<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-139 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-139{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-139:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-140 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-140{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-140:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-141 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-141{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-141:hover { color: #cccccc;}<\/style>\n<p>FRI<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-142 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-142{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-142:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-143 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-143{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-143:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-144 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-144{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-144:hover { color: #cccccc;}<\/style>\n<p>SAT<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-145 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-145{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-145:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-146 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-146{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-146:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<\/div>\n<div id=\"frm_field_12143_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_wwx2ec59fa629b\" id=\"field_wwx2ec59fa629b_label\" class=\"frm_primary_label\">Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12143]\" id=\"field_wwx2ec59fa629b\" rows=\"1\"  data-sectionid=\"12139\" data-frmval=\"Notes...\" data-invmsg=\"Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12145_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first horizontal_radio\">\r\n    <div  id=\"field_yndxx5c1f1ca2d_label\" class=\"frm_primary_label\">Goal\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_yndxx5c1f1ca2d_label\" role=\"group\">\t\t<div class=\"frm_radio\" id=\"frm_radio_12145-12139-0\"><label for=\"field_yndxx5c1f1ca2d-0\">\t\t<input type=\"radio\" name=\"item_meta[12145]\" id=\"field_yndxx5c1f1ca2d-0\" value=\"Maintain\"\n\t\tchecked=\"checked\"   data-sectionid=\"12139\" data-frmval=\"Maintain\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Maintain<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_12145-12139-1\"><label for=\"field_yndxx5c1f1ca2d-1\">\t\t<input type=\"radio\" name=\"item_meta[12145]\" id=\"field_yndxx5c1f1ca2d-1\" value=\"Improve\"\n\t\t   data-sectionid=\"12139\" data-frmval=\"Maintain\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Improve<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12146_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_1uc767908934a6612cf01be2c\" id=\"field_1uc767908934a6612cf01be2c_label\" class=\"frm_primary_label\">Goal Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12146]\" id=\"field_1uc767908934a6612cf01be2c\" rows=\"3\"  data-sectionid=\"12139\" data-frmval=\"Notes...\" data-invmsg=\"Goal Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12147_container\" class=\"frm_form_field  frm_html_container form-field\">\n<p  style=\"margin-top: 0px; font-size: 1px; padding-top: 0px;\">&nbsp;<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"frm_field_12149_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing frm_trigger\"><i class=\"frm_icon_font frm_arrow_icon\" aria-expanded=\"false\" aria-label=\"Toggle fields\"><\/i> <img style=\"display: inline; margin-right: 10px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-skin-blue.svg\" width=\"30\" height=\"30\" \/>Skin<\/h3>\r\n\r\n<div class=\"frm_toggle_container frm_grid_container\" style=\"display:none;\">\r\n<div id=\"frm_field_12150_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_gq9tk34d31b722d1e26a85e6e\" id=\"field_gq9tk34d31b722d1e26a85e6e_label\" class=\"frm_primary_label\">Level of Assistance\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[12150]\" id=\"field_gq9tk34d31b722d1e26a85e6e\"  data-sectionid=\"12149\" data-frmval=\"Some Assistance\" data-invmsg=\"Level of Assistance is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"Independent\"  class=\"\">\n\t\t\tIndependent\t\t<\/option>\n\t\t\t<option value=\"Some Assistance\"  selected=\"selected\" class=\"\">\n\t\t\tSome Assistance\t\t<\/option>\n\t\t\t<option value=\"Assisted\"  class=\"\">\n\t\t\tAssisted\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12151_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths horizontal_radio\">\r\n    <div  id=\"field_q9vkx84880be35e4f33d0ff1b_label\" class=\"frm_primary_label\">Assigned to\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_q9vkx84880be35e4f33d0ff1b_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12151-12149-0\"><label for=\"field_q9vkx84880be35e4f33d0ff1b-0\"><input type=\"checkbox\" name=\"item_meta[12151][]\" id=\"field_q9vkx84880be35e4f33d0ff1b-0\" value=\"Nursing\"  data-sectionid=\"12149\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Nursing<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12151-12149-1\"><label for=\"field_q9vkx84880be35e4f33d0ff1b-1\"><input type=\"checkbox\" name=\"item_meta[12151][]\" id=\"field_q9vkx84880be35e4f33d0ff1b-1\" value=\"Med Tech\"  data-sectionid=\"12149\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Med Tech<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12151-12149-2\"><label for=\"field_q9vkx84880be35e4f33d0ff1b-2\"><input type=\"checkbox\" name=\"item_meta[12151][]\" id=\"field_q9vkx84880be35e4f33d0ff1b-2\" value=\"Caregivers\" checked=\"checked\"  data-sectionid=\"12149\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Caregivers<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12154_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first frm_three_col\">\r\n    <div  id=\"field_ob1h070bb77da87_label\" class=\"frm_primary_label\">Frequency\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_ob1h070bb77da87_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12154-12149-0\"><label for=\"field_ob1h070bb77da87-0\"><input type=\"checkbox\" name=\"item_meta[12154][]\" id=\"field_ob1h070bb77da87-0\" value=\"SUN\"  data-sectionid=\"12149\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> SUN<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12154-12149-1\"><label for=\"field_ob1h070bb77da87-1\"><input type=\"checkbox\" name=\"item_meta[12154][]\" id=\"field_ob1h070bb77da87-1\" value=\"AM\"  data-sectionid=\"12149\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12154-12149-2\"><label for=\"field_ob1h070bb77da87-2\"><input type=\"checkbox\" name=\"item_meta[12154][]\" id=\"field_ob1h070bb77da87-2\" value=\"PM\"  data-sectionid=\"12149\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12154-12149-3\"><label for=\"field_ob1h070bb77da87-3\"><input type=\"checkbox\" name=\"item_meta[12154][]\" id=\"field_ob1h070bb77da87-3\" value=\"MON\"  data-sectionid=\"12149\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> MON<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12154-12149-4\"><label for=\"field_ob1h070bb77da87-4\"><input type=\"checkbox\" name=\"item_meta[12154][]\" id=\"field_ob1h070bb77da87-4\" value=\"AM\"  data-sectionid=\"12149\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12154-12149-5\"><label for=\"field_ob1h070bb77da87-5\"><input type=\"checkbox\" name=\"item_meta[12154][]\" id=\"field_ob1h070bb77da87-5\" value=\"PM\"  data-sectionid=\"12149\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12154-12149-6\"><label for=\"field_ob1h070bb77da87-6\"><input type=\"checkbox\" name=\"item_meta[12154][]\" id=\"field_ob1h070bb77da87-6\" value=\"TUE\"  data-sectionid=\"12149\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> TUE<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12154-12149-7\"><label for=\"field_ob1h070bb77da87-7\"><input type=\"checkbox\" name=\"item_meta[12154][]\" id=\"field_ob1h070bb77da87-7\" value=\"AM\"  data-sectionid=\"12149\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12154-12149-8\"><label for=\"field_ob1h070bb77da87-8\"><input type=\"checkbox\" name=\"item_meta[12154][]\" id=\"field_ob1h070bb77da87-8\" value=\"PM\"  data-sectionid=\"12149\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12154-12149-9\"><label for=\"field_ob1h070bb77da87-9\"><input type=\"checkbox\" name=\"item_meta[12154][]\" id=\"field_ob1h070bb77da87-9\" value=\"WED\"  data-sectionid=\"12149\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> WED<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12154-12149-10\"><label for=\"field_ob1h070bb77da87-10\"><input type=\"checkbox\" name=\"item_meta[12154][]\" id=\"field_ob1h070bb77da87-10\" value=\"AM\"  data-sectionid=\"12149\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12154-12149-11\"><label for=\"field_ob1h070bb77da87-11\"><input type=\"checkbox\" name=\"item_meta[12154][]\" id=\"field_ob1h070bb77da87-11\" value=\"PM\"  data-sectionid=\"12149\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12154-12149-12\"><label for=\"field_ob1h070bb77da87-12\"><input type=\"checkbox\" name=\"item_meta[12154][]\" id=\"field_ob1h070bb77da87-12\" value=\"THU\"  data-sectionid=\"12149\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> THU<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12154-12149-13\"><label for=\"field_ob1h070bb77da87-13\"><input type=\"checkbox\" name=\"item_meta[12154][]\" id=\"field_ob1h070bb77da87-13\" value=\"AM\"  data-sectionid=\"12149\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12154-12149-14\"><label for=\"field_ob1h070bb77da87-14\"><input type=\"checkbox\" name=\"item_meta[12154][]\" id=\"field_ob1h070bb77da87-14\" value=\"PM\"  data-sectionid=\"12149\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12154-12149-15\"><label for=\"field_ob1h070bb77da87-15\"><input type=\"checkbox\" name=\"item_meta[12154][]\" id=\"field_ob1h070bb77da87-15\" value=\"FRI\"  data-sectionid=\"12149\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> FRI<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12154-12149-16\"><label for=\"field_ob1h070bb77da87-16\"><input type=\"checkbox\" name=\"item_meta[12154][]\" id=\"field_ob1h070bb77da87-16\" value=\"AM\"  data-sectionid=\"12149\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12154-12149-17\"><label for=\"field_ob1h070bb77da87-17\"><input type=\"checkbox\" name=\"item_meta[12154][]\" id=\"field_ob1h070bb77da87-17\" value=\"PM\"  data-sectionid=\"12149\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12154-12149-18\"><label for=\"field_ob1h070bb77da87-18\"><input type=\"checkbox\" name=\"item_meta[12154][]\" id=\"field_ob1h070bb77da87-18\" value=\"SAT\"  data-sectionid=\"12149\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> SAT<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12154-12149-19\"><label for=\"field_ob1h070bb77da87-19\"><input type=\"checkbox\" name=\"item_meta[12154][]\" id=\"field_ob1h070bb77da87-19\" value=\"AM\"  data-sectionid=\"12149\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12154-12149-20\"><label for=\"field_ob1h070bb77da87-20\"><input type=\"checkbox\" name=\"item_meta[12154][]\" id=\"field_ob1h070bb77da87-20\" value=\"PM\"  data-sectionid=\"12149\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12153_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_7bd8dbaec0db977fb65600910\" id=\"field_7bd8dbaec0db977fb65600910_label\" class=\"frm_primary_label\">Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12153]\" id=\"field_7bd8dbaec0db977fb65600910\" rows=\"1\"  data-sectionid=\"12149\" data-frmval=\"Notes...\" data-invmsg=\"Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12155_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first horizontal_radio\">\r\n    <div  id=\"field_xd5kdc57cf6a49c5c43ea57ac_label\" class=\"frm_primary_label\">Goal\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_xd5kdc57cf6a49c5c43ea57ac_label\" role=\"group\">\t\t<div class=\"frm_radio\" id=\"frm_radio_12155-12149-0\"><label for=\"field_xd5kdc57cf6a49c5c43ea57ac-0\">\t\t<input type=\"radio\" name=\"item_meta[12155]\" id=\"field_xd5kdc57cf6a49c5c43ea57ac-0\" value=\"Maintain\"\n\t\t   data-sectionid=\"12149\" data-frmval=\"Improve\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Maintain<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_12155-12149-1\"><label for=\"field_xd5kdc57cf6a49c5c43ea57ac-1\">\t\t<input type=\"radio\" name=\"item_meta[12155]\" id=\"field_xd5kdc57cf6a49c5c43ea57ac-1\" value=\"Improve\"\n\t\tchecked=\"checked\"   data-sectionid=\"12149\" data-frmval=\"Improve\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Improve<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12156_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_sfdqmedf53804e82c1246e3c6\" id=\"field_sfdqmedf53804e82c1246e3c6_label\" class=\"frm_primary_label\">Goal Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12156]\" id=\"field_sfdqmedf53804e82c1246e3c6\" rows=\"3\"  data-sectionid=\"12149\" data-frmval=\"Notes...\" data-invmsg=\"Goal Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<\/div>\n<div id=\"frm_field_12158_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing frm_trigger\"><i class=\"frm_icon_font frm_arrow_icon\" aria-expanded=\"false\" aria-label=\"Toggle fields\"><\/i> <img style=\"display: inline; margin-right: 10px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-toileting-blue.svg\" width=\"30\" height=\"30\" \/>Toileting<\/h3>\r\n\r\n<div class=\"frm_toggle_container frm_grid_container\" style=\"display:none;\">\r\n<div id=\"frm_field_12159_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_99vxxabf9398edd736f5ae340\" id=\"field_99vxxabf9398edd736f5ae340_label\" class=\"frm_primary_label\">Level of Assistance\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[12159]\" id=\"field_99vxxabf9398edd736f5ae340\"  data-sectionid=\"12158\" data-frmval=\"Some Assistance\" data-invmsg=\"Level of Assistance is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"Independent\"  class=\"\">\n\t\t\tIndependent\t\t<\/option>\n\t\t\t<option value=\"Some Assistance\"  selected=\"selected\" class=\"\">\n\t\t\tSome Assistance\t\t<\/option>\n\t\t\t<option value=\"Assisted\"  class=\"\">\n\t\t\tAssisted\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12160_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths horizontal_radio\">\r\n    <div  id=\"field_pj55d02e1e2d073fde1e51703_label\" class=\"frm_primary_label\">Assigned to\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_pj55d02e1e2d073fde1e51703_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12160-12158-0\"><label for=\"field_pj55d02e1e2d073fde1e51703-0\"><input type=\"checkbox\" name=\"item_meta[12160][]\" id=\"field_pj55d02e1e2d073fde1e51703-0\" value=\"Nursing\"  data-sectionid=\"12158\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Nursing<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12160-12158-1\"><label for=\"field_pj55d02e1e2d073fde1e51703-1\"><input type=\"checkbox\" name=\"item_meta[12160][]\" id=\"field_pj55d02e1e2d073fde1e51703-1\" value=\"Med Tech\"  data-sectionid=\"12158\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Med Tech<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12160-12158-2\"><label for=\"field_pj55d02e1e2d073fde1e51703-2\"><input type=\"checkbox\" name=\"item_meta[12160][]\" id=\"field_pj55d02e1e2d073fde1e51703-2\" value=\"Caregivers\" checked=\"checked\"  data-sectionid=\"12158\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Caregivers<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12163_container\" class=\"frm_form_field  frm_fourth frm_first frm_html_container form-field\">\n<p class=\"blue-label\">Frequency<\/p>\n<div style=\"margin: 0; padding: 0;\">\n<table border=\"0\" width=\"100%\" cellspacing=\"0px\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-147 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-147{ color: #3b88fd;}i.fb-icon-element.fontawesome-icon.fb-icon-element-147:hover { color: #3b88fd;}<\/style>\n<p>SUN<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-148 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-148{ color: #3b88fd;}i.fb-icon-element.fontawesome-icon.fb-icon-element-148:hover { color: #3b88fd;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-149 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-149{ color: #3b88fd;}i.fb-icon-element.fontawesome-icon.fb-icon-element-149:hover { color: #3b88fd;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-150 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-150{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-150:hover { color: #cccccc;}<\/style>\n<p>12-3<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-151 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-151{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-151:hover { color: #cccccc;}<\/style>\n<p>12-3<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-152 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-152{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-152:hover { color: #cccccc;}<\/style>\n<p>3-6<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-153 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-153{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-153:hover { color: #cccccc;}<\/style>\n<p>3-6<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-154 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-154{ color: #3b88fd;}i.fb-icon-element.fontawesome-icon.fb-icon-element-154:hover { color: #3b88fd;}<\/style>\n<p>6-9<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-155 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-155{ color: #3b88fd;}i.fb-icon-element.fontawesome-icon.fb-icon-element-155:hover { color: #3b88fd;}<\/style>\n<p>6-9<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-156 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-156{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-156:hover { color: #cccccc;}<\/style>\n<p>9-12<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-157 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-157{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-157:hover { color: #cccccc;}<\/style>\n<p>9-12<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-158 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-158{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-158:hover { color: #cccccc;}<\/style>\n<p>MON<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-159 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-159{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-159:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-160 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-160{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-160:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-161 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-161{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-161:hover { color: #cccccc;}<\/style>\n<p>TUE<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-162 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-162{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-162:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-163 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-163{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-163:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-164 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-164{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-164:hover { color: #cccccc;}<\/style>\n<p>WED<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-165 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-165{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-165:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-166 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-166{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-166:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-167 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-167{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-167:hover { color: #cccccc;}<\/style>\n<p>THU<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-168 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-168{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-168:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-169 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-169{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-169:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-170 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-170{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-170:hover { color: #cccccc;}<\/style>\n<p>FRI<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-171 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-171{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-171:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-172 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-172{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-172:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-173 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-173{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-173:hover { color: #cccccc;}<\/style>\n<p>SAT<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-174 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-174{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-174:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-175 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-175{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-175:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<\/div>\n<div id=\"frm_field_12162_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_spkuc3c412e32f\" id=\"field_spkuc3c412e32f_label\" class=\"frm_primary_label\">Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12162]\" id=\"field_spkuc3c412e32f\" rows=\"1\"  data-sectionid=\"12158\" data-frmval=\"Notes...\" data-invmsg=\"Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12164_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first horizontal_radio\">\r\n    <div  id=\"field_bkjjn86ceb8f35435fe3466d0_label\" class=\"frm_primary_label\">Goal\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_bkjjn86ceb8f35435fe3466d0_label\" role=\"group\">\t\t<div class=\"frm_radio\" id=\"frm_radio_12164-12158-0\"><label for=\"field_bkjjn86ceb8f35435fe3466d0-0\">\t\t<input type=\"radio\" name=\"item_meta[12164]\" id=\"field_bkjjn86ceb8f35435fe3466d0-0\" value=\"Maintain\"\n\t\tchecked=\"checked\"   data-sectionid=\"12158\" data-frmval=\"Maintain\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Maintain<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_12164-12158-1\"><label for=\"field_bkjjn86ceb8f35435fe3466d0-1\">\t\t<input type=\"radio\" name=\"item_meta[12164]\" id=\"field_bkjjn86ceb8f35435fe3466d0-1\" value=\"Improve\"\n\t\t   data-sectionid=\"12158\" data-frmval=\"Maintain\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Improve<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12165_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_889uj6de6f2260b6841ba1ac2\" id=\"field_889uj6de6f2260b6841ba1ac2_label\" class=\"frm_primary_label\">Goal Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12165]\" id=\"field_889uj6de6f2260b6841ba1ac2\" rows=\"3\"  data-sectionid=\"12158\" data-frmval=\"Notes...\" data-invmsg=\"Goal Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12166_container\" class=\"frm_form_field  frm_html_container form-field\">\n<p  style=\"margin-top: 0px; font-size: 1px; padding-top: 0px;\">&nbsp;<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"frm_field_12168_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing frm_trigger\"><i class=\"frm_icon_font frm_arrow_icon\" aria-expanded=\"false\" aria-label=\"Toggle fields\"><\/i> <img style=\"display: inline; margin-right: 10px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-vision-blue.svg\" width=\"30\" height=\"30\" \/>Vision<\/h3>\r\n\r\n<div class=\"frm_toggle_container frm_grid_container\" style=\"display:none;\">\r\n<div id=\"frm_field_12169_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_qmctb778170b181db53f84eb\" id=\"field_qmctb778170b181db53f84eb_label\" class=\"frm_primary_label\">Level of Assistance\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[12169]\" id=\"field_qmctb778170b181db53f84eb\"  data-sectionid=\"12168\" data-frmval=\"Some Assistance\" data-invmsg=\"Level of Assistance is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"Independent\"  class=\"\">\n\t\t\tIndependent\t\t<\/option>\n\t\t\t<option value=\"Some Assistance\"  selected=\"selected\" class=\"\">\n\t\t\tSome Assistance\t\t<\/option>\n\t\t\t<option value=\"Assisted\"  class=\"\">\n\t\t\tAssisted\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12170_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths horizontal_radio\">\r\n    <div  id=\"field_glxrs80d2bfb72c495edcedda_label\" class=\"frm_primary_label\">Assigned to\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_glxrs80d2bfb72c495edcedda_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12170-12168-0\"><label for=\"field_glxrs80d2bfb72c495edcedda-0\"><input type=\"checkbox\" name=\"item_meta[12170][]\" id=\"field_glxrs80d2bfb72c495edcedda-0\" value=\"Nursing\"  data-sectionid=\"12168\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Nursing<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12170-12168-1\"><label for=\"field_glxrs80d2bfb72c495edcedda-1\"><input type=\"checkbox\" name=\"item_meta[12170][]\" id=\"field_glxrs80d2bfb72c495edcedda-1\" value=\"Med Tech\"  data-sectionid=\"12168\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Med Tech<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12170-12168-2\"><label for=\"field_glxrs80d2bfb72c495edcedda-2\"><input type=\"checkbox\" name=\"item_meta[12170][]\" id=\"field_glxrs80d2bfb72c495edcedda-2\" value=\"Caregivers\" checked=\"checked\"  data-sectionid=\"12168\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Caregivers<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12173_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first frm_three_col\">\r\n    <div  id=\"field_btojf6b49ccc301_label\" class=\"frm_primary_label\">Frequency\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_btojf6b49ccc301_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12173-12168-0\"><label for=\"field_btojf6b49ccc301-0\"><input type=\"checkbox\" name=\"item_meta[12173][]\" id=\"field_btojf6b49ccc301-0\" value=\"SUN\"  data-sectionid=\"12168\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> SUN<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12173-12168-1\"><label for=\"field_btojf6b49ccc301-1\"><input type=\"checkbox\" name=\"item_meta[12173][]\" id=\"field_btojf6b49ccc301-1\" value=\"AM\"  data-sectionid=\"12168\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12173-12168-2\"><label for=\"field_btojf6b49ccc301-2\"><input type=\"checkbox\" name=\"item_meta[12173][]\" id=\"field_btojf6b49ccc301-2\" value=\"PM\"  data-sectionid=\"12168\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12173-12168-3\"><label for=\"field_btojf6b49ccc301-3\"><input type=\"checkbox\" name=\"item_meta[12173][]\" id=\"field_btojf6b49ccc301-3\" value=\"MON\"  data-sectionid=\"12168\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> MON<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12173-12168-4\"><label for=\"field_btojf6b49ccc301-4\"><input type=\"checkbox\" name=\"item_meta[12173][]\" id=\"field_btojf6b49ccc301-4\" value=\"AM\"  data-sectionid=\"12168\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12173-12168-5\"><label for=\"field_btojf6b49ccc301-5\"><input type=\"checkbox\" name=\"item_meta[12173][]\" id=\"field_btojf6b49ccc301-5\" value=\"PM\"  data-sectionid=\"12168\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12173-12168-6\"><label for=\"field_btojf6b49ccc301-6\"><input type=\"checkbox\" name=\"item_meta[12173][]\" id=\"field_btojf6b49ccc301-6\" value=\"TUE\"  data-sectionid=\"12168\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> TUE<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12173-12168-7\"><label for=\"field_btojf6b49ccc301-7\"><input type=\"checkbox\" name=\"item_meta[12173][]\" id=\"field_btojf6b49ccc301-7\" value=\"AM\"  data-sectionid=\"12168\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12173-12168-8\"><label for=\"field_btojf6b49ccc301-8\"><input type=\"checkbox\" name=\"item_meta[12173][]\" id=\"field_btojf6b49ccc301-8\" value=\"PM\"  data-sectionid=\"12168\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12173-12168-9\"><label for=\"field_btojf6b49ccc301-9\"><input type=\"checkbox\" name=\"item_meta[12173][]\" id=\"field_btojf6b49ccc301-9\" value=\"WED\"  data-sectionid=\"12168\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> WED<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12173-12168-10\"><label for=\"field_btojf6b49ccc301-10\"><input type=\"checkbox\" name=\"item_meta[12173][]\" id=\"field_btojf6b49ccc301-10\" value=\"AM\"  data-sectionid=\"12168\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12173-12168-11\"><label for=\"field_btojf6b49ccc301-11\"><input type=\"checkbox\" name=\"item_meta[12173][]\" id=\"field_btojf6b49ccc301-11\" value=\"PM\"  data-sectionid=\"12168\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12173-12168-12\"><label for=\"field_btojf6b49ccc301-12\"><input type=\"checkbox\" name=\"item_meta[12173][]\" id=\"field_btojf6b49ccc301-12\" value=\"THU\"  data-sectionid=\"12168\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> THU<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12173-12168-13\"><label for=\"field_btojf6b49ccc301-13\"><input type=\"checkbox\" name=\"item_meta[12173][]\" id=\"field_btojf6b49ccc301-13\" value=\"AM\"  data-sectionid=\"12168\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12173-12168-14\"><label for=\"field_btojf6b49ccc301-14\"><input type=\"checkbox\" name=\"item_meta[12173][]\" id=\"field_btojf6b49ccc301-14\" value=\"PM\"  data-sectionid=\"12168\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12173-12168-15\"><label for=\"field_btojf6b49ccc301-15\"><input type=\"checkbox\" name=\"item_meta[12173][]\" id=\"field_btojf6b49ccc301-15\" value=\"FRI\"  data-sectionid=\"12168\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> FRI<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12173-12168-16\"><label for=\"field_btojf6b49ccc301-16\"><input type=\"checkbox\" name=\"item_meta[12173][]\" id=\"field_btojf6b49ccc301-16\" value=\"AM\"  data-sectionid=\"12168\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12173-12168-17\"><label for=\"field_btojf6b49ccc301-17\"><input type=\"checkbox\" name=\"item_meta[12173][]\" id=\"field_btojf6b49ccc301-17\" value=\"PM\"  data-sectionid=\"12168\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12173-12168-18\"><label for=\"field_btojf6b49ccc301-18\"><input type=\"checkbox\" name=\"item_meta[12173][]\" id=\"field_btojf6b49ccc301-18\" value=\"SAT\"  data-sectionid=\"12168\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> SAT<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12173-12168-19\"><label for=\"field_btojf6b49ccc301-19\"><input type=\"checkbox\" name=\"item_meta[12173][]\" id=\"field_btojf6b49ccc301-19\" value=\"AM\"  data-sectionid=\"12168\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> AM<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12173-12168-20\"><label for=\"field_btojf6b49ccc301-20\"><input type=\"checkbox\" name=\"item_meta[12173][]\" id=\"field_btojf6b49ccc301-20\" value=\"PM\"  data-sectionid=\"12168\" data-invmsg=\"Frequency is invalid\" aria-invalid=\"false\"   \/> PM<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12172_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_bh7np4bd4cf0fe6775fda602a\" id=\"field_bh7np4bd4cf0fe6775fda602a_label\" class=\"frm_primary_label\">Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12172]\" id=\"field_bh7np4bd4cf0fe6775fda602a\" rows=\"1\"  data-sectionid=\"12168\" data-frmval=\"Notes...\" data-invmsg=\"Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12174_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first horizontal_radio\">\r\n    <div  id=\"field_x2xqvfda34aee5f3dc5e63058_label\" class=\"frm_primary_label\">Goal\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_x2xqvfda34aee5f3dc5e63058_label\" role=\"group\">\t\t<div class=\"frm_radio\" id=\"frm_radio_12174-12168-0\"><label for=\"field_x2xqvfda34aee5f3dc5e63058-0\">\t\t<input type=\"radio\" name=\"item_meta[12174]\" id=\"field_x2xqvfda34aee5f3dc5e63058-0\" value=\"Maintain\"\n\t\tchecked=\"checked\"   data-sectionid=\"12168\" data-frmval=\"Maintain\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Maintain<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_12174-12168-1\"><label for=\"field_x2xqvfda34aee5f3dc5e63058-1\">\t\t<input type=\"radio\" name=\"item_meta[12174]\" id=\"field_x2xqvfda34aee5f3dc5e63058-1\" value=\"Improve\"\n\t\t   data-sectionid=\"12168\" data-frmval=\"Maintain\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Improve<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12175_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_onb80eb144589fed6dd895867\" id=\"field_onb80eb144589fed6dd895867_label\" class=\"frm_primary_label\">Goal Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12175]\" id=\"field_onb80eb144589fed6dd895867\" rows=\"3\"  data-sectionid=\"12168\" data-frmval=\"Notes...\" data-invmsg=\"Goal Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<\/div>\n<div id=\"frm_field_12177_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing frm_trigger\"><i class=\"frm_icon_font frm_arrow_icon\" aria-expanded=\"false\" aria-label=\"Toggle fields\"><\/i> <img style=\"display: inline; margin-right: 10px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-acute-exceptions-blue.svg\" width=\"30\" height=\"30\" \/>Acute \/ Exceptions<\/h3>\r\n\r\n<div class=\"frm_toggle_container frm_grid_container\" style=\"display:none;\">\r\n<div id=\"frm_field_12178_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_3pqj3d490d4a25a1ec3f56b39\" id=\"field_3pqj3d490d4a25a1ec3f56b39_label\" class=\"frm_primary_label\">Acute \/ Exceptions\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[12178]\" id=\"field_3pqj3d490d4a25a1ec3f56b39\"  data-sectionid=\"12177\" data-invmsg=\"Acute \/ Exceptions is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  selected=\"selected\" class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"Chair Stand\"  class=\"\">\n\t\t\tChair Stand\t\t<\/option>\n\t\t\t<option value=\"Grip\"  class=\"\">\n\t\t\tGrip\t\t<\/option>\n\t\t\t<option value=\"Height\"  class=\"\">\n\t\t\tHeight\t\t<\/option>\n\t\t\t<option value=\"Hip\"  class=\"\">\n\t\t\tHip\t\t<\/option>\n\t\t\t<option value=\"Pulse\"  class=\"\">\n\t\t\tPulse\t\t<\/option>\n\t\t\t<option value=\"Pulse Ox\"  class=\"\">\n\t\t\tPulse Ox\t\t<\/option>\n\t\t\t<option value=\"Respirations\"  class=\"\">\n\t\t\tRespirations\t\t<\/option>\n\t\t\t<option value=\"Temp\"  class=\"\">\n\t\t\tTemp\t\t<\/option>\n\t\t\t<option value=\"TUG\"  class=\"\">\n\t\t\tTUG\t\t<\/option>\n\t\t\t<option value=\"Waist\"  class=\"\">\n\t\t\tWaist\t\t<\/option>\n\t\t\t<option value=\"Weight\"  class=\"\">\n\t\t\tWeight\t\t<\/option>\n\t\t\t<option value=\"Other\"  class=\"\">\n\t\t\tOther\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12179_container\" class=\"frm_form_field  frm_eighth frm_html_container form-field\"><img style=\"display: inline; margin: 21px 0 0 0;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-grip-strength-blue.svg\" width=\"35\" height=\"35\" \/><\/div>\n<div id=\"frm_field_12180_container\" class=\"frm_form_field  frm_eighth frm_html_container form-field\"><img style=\"display: inline; margin: 21px 0 0 0;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-height-blue.svg\" width=\"35\" height=\"35\" \/><\/div>\n<div id=\"frm_field_12181_container\" class=\"frm_form_field  frm_eighth frm_html_container form-field\"><img style=\"display: inline; margin: 21px 0 0 0;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-hip-blue.svg\" width=\"35\" height=\"35\" \/><\/div>\n<div id=\"frm_field_12182_container\" class=\"frm_form_field  frm_eighth frm_html_container form-field\"><img style=\"display: inline; margin: 21px 0 0 0;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-pulse-blue.svg\" width=\"35\" height=\"35\" \/><\/div>\n<div id=\"frm_field_12183_container\" class=\"frm_form_field  frm_eighth frm_html_container form-field\"><img style=\"display: inline; margin: 21px 0 0 0;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-pulse-ox-blue.svg\" width=\"35\" height=\"35\" \/><\/div>\n<div id=\"frm_field_12184_container\" class=\"frm_form_field  frm_eighth frm_html_container form-field\"><img style=\"display: inline; margin: 21px 0 0 0;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-respirations-blue.svg\" width=\"35\" height=\"35\" \/><\/div>\n<div id=\"frm_field_12185_container\" class=\"frm_form_field  frm_eighth frm_html_container form-field\"><img style=\"display: inline; margin: 21px 0 0 0;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-temp-blue.svg\" width=\"35\" height=\"35\" \/><\/div>\n<div id=\"frm_field_12186_container\" class=\"frm_form_field  frm_eighth frm_html_container form-field\"><img style=\"display: inline; margin: 21px 0 0 0;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-tug-blue.svg\" width=\"35\" height=\"35\" \/><\/div>\n<div id=\"frm_field_12187_container\" class=\"frm_form_field  frm_eighth frm_html_container form-field\"><img style=\"display: inline; margin: 21px 0 0 0;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-waist-blue.svg\" width=\"35\" height=\"35\" \/><\/div>\n<div id=\"frm_field_12188_container\" class=\"frm_form_field  frm_eighth frm_html_container form-field\"><img style=\"display: inline; margin: 21px 0 0 0;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-weight-blue.svg\" width=\"35\" height=\"35\" \/><\/div>\n<div id=\"frm_field_12189_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth\">\r\n    <label for=\"field_p6pqu0be5e348ba17bc9d2ccd\" id=\"field_p6pqu0be5e348ba17bc9d2ccd_label\" class=\"frm_primary_label\">Other\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_p6pqu0be5e348ba17bc9d2ccd\" name=\"item_meta[12189]\" value=\"\"  data-sectionid=\"12177\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12190_container\" class=\"frm_form_field  frm_fourth frm_html_container form-field\"><img style=\"display: inline; margin: 21px 0 0 0;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-acute-exceptions-blue.svg\" width=\"35\" height=\"35\" \/><\/div>\n<div id=\"frm_field_12191_container\" class=\"frm_form_field  frm_fourth frm_alignright frm_html_container form-field\">\n<div class=\"fusion-fa-align-right\"><a class=\"fb-icon-element-176 fb-icon-element fontawesome-icon fa-plus fas circle-no fusion-link\" style=\"font-size:18px;margin-top:25px;margin-right:3px;margin-bottom:0px;\" href=\"#\" aria-label=\"Link to #\" target=\"_self\"><\/a><\/div>\n<style>a.fb-icon-element.fontawesome-icon.fb-icon-element-176{ color: #005174;}a.fb-icon-element.fontawesome-icon.fb-icon-element-176:hover { color: #005174;}<\/style>\n<\/div>\n<div id=\"frm_field_12192_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_32lit36f044abea157150dfc\" id=\"field_32lit36f044abea157150dfc_label\" class=\"frm_primary_label\">Level of Assistance\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[12192]\" id=\"field_32lit36f044abea157150dfc\"  data-sectionid=\"12177\" data-invmsg=\"Level of Assistance is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  selected=\"selected\" class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"Independent\"  class=\"\">\n\t\t\tIndependent\t\t<\/option>\n\t\t\t<option value=\"Some Assistance\"  class=\"\">\n\t\t\tSome Assistance\t\t<\/option>\n\t\t\t<option value=\"Assisted\"  class=\"\">\n\t\t\tAssisted\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12193_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths horizontal_radio\">\r\n    <div  id=\"field_eq0cd28735d69abdb9e3a890_label\" class=\"frm_primary_label\">Assigned to\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_eq0cd28735d69abdb9e3a890_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12193-12177-0\"><label for=\"field_eq0cd28735d69abdb9e3a890-0\"><input type=\"checkbox\" name=\"item_meta[12193][]\" id=\"field_eq0cd28735d69abdb9e3a890-0\" value=\"Nursing\"  data-sectionid=\"12177\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Nursing<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12193-12177-1\"><label for=\"field_eq0cd28735d69abdb9e3a890-1\"><input type=\"checkbox\" name=\"item_meta[12193][]\" id=\"field_eq0cd28735d69abdb9e3a890-1\" value=\"Med Tech\"  data-sectionid=\"12177\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Med Tech<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12193-12177-2\"><label for=\"field_eq0cd28735d69abdb9e3a890-2\"><input type=\"checkbox\" name=\"item_meta[12193][]\" id=\"field_eq0cd28735d69abdb9e3a890-2\" value=\"Caregivers\"  data-sectionid=\"12177\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Caregivers<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12194_container\" class=\"frm_form_field  frm_fourth frm_first frm_html_container form-field\">\n<p class=\"blue-label\">Frequency<\/p>\n<div style=\"margin: 0; padding: 0;\">\n<table border=\"0\" width=\"100%\" cellspacing=\"0px\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-177 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-177{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-177:hover { color: #cccccc;}<\/style>\n<p>SUN<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-178 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-178{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-178:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-179 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-179{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-179:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-180 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-180{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-180:hover { color: #cccccc;}<\/style>\n<p>12-3<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-181 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-181{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-181:hover { color: #cccccc;}<\/style>\n<p>12-3<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-182 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-182{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-182:hover { color: #cccccc;}<\/style>\n<p>3-6<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-183 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-183{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-183:hover { color: #cccccc;}<\/style>\n<p>3-6<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-184 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-184{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-184:hover { color: #cccccc;}<\/style>\n<p>6-9<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-185 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-185{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-185:hover { color: #cccccc;}<\/style>\n<p>6-9<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-186 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-186{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-186:hover { color: #cccccc;}<\/style>\n<p>9-12<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-187 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-187{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-187:hover { color: #cccccc;}<\/style>\n<p>9-12<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-188 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-188{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-188:hover { color: #cccccc;}<\/style>\n<p>MON<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-189 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-189{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-189:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-190 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-190{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-190:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-191 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-191{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-191:hover { color: #cccccc;}<\/style>\n<p>TUE<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-192 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-192{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-192:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-193 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-193{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-193:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-194 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-194{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-194:hover { color: #cccccc;}<\/style>\n<p>WED<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-195 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-195{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-195:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-196 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-196{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-196:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-197 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-197{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-197:hover { color: #cccccc;}<\/style>\n<p>THU<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-198 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-198{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-198:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-199 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-199{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-199:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-200 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-200{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-200:hover { color: #cccccc;}<\/style>\n<p>FRI<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-201 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-201{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-201:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-202 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-202{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-202:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-203 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-203{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-203:hover { color: #cccccc;}<\/style>\n<p>SAT<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-204 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-204{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-204:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-205 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-205{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-205:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<\/div>\n<div id=\"frm_field_12195_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_pxdwl99bfc246381144da1373\" id=\"field_pxdwl99bfc246381144da1373_label\" class=\"frm_primary_label\">Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12195]\" id=\"field_pxdwl99bfc246381144da1373\" rows=\"3\"  data-sectionid=\"12177\" data-invmsg=\"Details is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12196_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first horizontal_radio\">\r\n    <div  id=\"field_uaga3b3970d5a6092471ab988_label\" class=\"frm_primary_label\">Goal\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_uaga3b3970d5a6092471ab988_label\" role=\"group\">\t\t<div class=\"frm_radio\" id=\"frm_radio_12196-12177-0\"><label for=\"field_uaga3b3970d5a6092471ab988-0\">\t\t<input type=\"radio\" name=\"item_meta[12196]\" id=\"field_uaga3b3970d5a6092471ab988-0\" value=\"Maintain\"\n\t\t   data-sectionid=\"12177\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Maintain<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_12196-12177-1\"><label for=\"field_uaga3b3970d5a6092471ab988-1\">\t\t<input type=\"radio\" name=\"item_meta[12196]\" id=\"field_uaga3b3970d5a6092471ab988-1\" value=\"Improve\"\n\t\t   data-sectionid=\"12177\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Improve<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12197_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_r6gxb200a0726ab6bbd3c60bd\" id=\"field_r6gxb200a0726ab6bbd3c60bd_label\" class=\"frm_primary_label\">Goal Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12197]\" id=\"field_r6gxb200a0726ab6bbd3c60bd\" rows=\"3\"  data-sectionid=\"12177\" data-invmsg=\"Goal Details is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<\/div>\n<div id=\"frm_field_12199_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing frm_trigger\"><i class=\"frm_icon_font frm_arrow_icon\" aria-expanded=\"false\" aria-label=\"Toggle fields\"><\/i> <img style=\"display: inline; margin-right: 10px;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-acute-exceptions-blue.svg\" width=\"30\" height=\"30\" \/>Broken Arm<\/h3>\r\n\r\n<div class=\"frm_toggle_container frm_grid_container\" style=\"display:none;\">\r\n<div id=\"frm_field_12200_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_givng938606aa83\" id=\"field_givng938606aa83_label\" class=\"frm_primary_label\">Acute \/ Exceptions\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[12200]\" id=\"field_givng938606aa83\"  data-sectionid=\"12199\" data-frmval=\"Other\" data-invmsg=\"Acute \/ Exceptions is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"Grip\"  class=\"\">\n\t\t\tGrip\t\t<\/option>\n\t\t\t<option value=\"Height\"  class=\"\">\n\t\t\tHeight\t\t<\/option>\n\t\t\t<option value=\"Hip\"  class=\"\">\n\t\t\tHip\t\t<\/option>\n\t\t\t<option value=\"Pulse\"  class=\"\">\n\t\t\tPulse\t\t<\/option>\n\t\t\t<option value=\"Pulse Ox\"  class=\"\">\n\t\t\tPulse Ox\t\t<\/option>\n\t\t\t<option value=\"Respirations\"  class=\"\">\n\t\t\tRespirations\t\t<\/option>\n\t\t\t<option value=\"Temp\"  class=\"\">\n\t\t\tTemp\t\t<\/option>\n\t\t\t<option value=\"TUG\"  class=\"\">\n\t\t\tTUG\t\t<\/option>\n\t\t\t<option value=\"Waist\"  class=\"\">\n\t\t\tWaist\t\t<\/option>\n\t\t\t<option value=\"Weight\"  class=\"\">\n\t\t\tWeight\t\t<\/option>\n\t\t\t<option value=\"Other\"  selected=\"selected\" class=\"\">\n\t\t\tOther\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12201_container\" class=\"frm_form_field  frm_eighth frm_html_container form-field\"><img style=\"display: inline; margin: 21px 0 0 0;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-grip-strength-blue.svg\" width=\"35\" height=\"35\" \/><\/div>\n<div id=\"frm_field_12202_container\" class=\"frm_form_field  frm_eighth frm_html_container form-field\"><img style=\"display: inline; margin: 21px 0 0 0;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-height-blue.svg\" width=\"35\" height=\"35\" \/><\/div>\n<div id=\"frm_field_12203_container\" class=\"frm_form_field  frm_eighth frm_html_container form-field\"><img style=\"display: inline; margin: 21px 0 0 0;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-hip-blue.svg\" width=\"35\" height=\"35\" \/><\/div>\n<div id=\"frm_field_12204_container\" class=\"frm_form_field  frm_eighth frm_html_container form-field\"><img style=\"display: inline; margin: 21px 0 0 0;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-pulse-blue.svg\" width=\"35\" height=\"35\" \/><\/div>\n<div id=\"frm_field_12205_container\" class=\"frm_form_field  frm_eighth frm_html_container form-field\"><img style=\"display: inline; margin: 21px 0 0 0;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-pulse-ox-blue.svg\" width=\"35\" height=\"35\" \/><\/div>\n<div id=\"frm_field_12206_container\" class=\"frm_form_field  frm_eighth frm_html_container form-field\"><img style=\"display: inline; margin: 21px 0 0 0;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-respirations-blue.svg\" width=\"35\" height=\"35\" \/><\/div>\n<div id=\"frm_field_12207_container\" class=\"frm_form_field  frm_eighth frm_html_container form-field\"><img style=\"display: inline; margin: 21px 0 0 0;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-temp-blue.svg\" width=\"35\" height=\"35\" \/><\/div>\n<div id=\"frm_field_12208_container\" class=\"frm_form_field  frm_eighth frm_html_container form-field\"><img style=\"display: inline; margin: 21px 0 0 0;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-tug-blue.svg\" width=\"35\" height=\"35\" \/><\/div>\n<div id=\"frm_field_12209_container\" class=\"frm_form_field  frm_eighth frm_html_container form-field\"><img style=\"display: inline; margin: 21px 0 0 0;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-waist-blue.svg\" width=\"35\" height=\"35\" \/><\/div>\n<div id=\"frm_field_12210_container\" class=\"frm_form_field  frm_eighth frm_html_container form-field\"><img style=\"display: inline; margin: 21px 0 0 0;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-weight-blue.svg\" width=\"35\" height=\"35\" \/><\/div>\n<div id=\"frm_field_12211_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth\">\r\n    <label for=\"field_gu3ov1aeef21cdb\" id=\"field_gu3ov1aeef21cdb_label\" class=\"frm_primary_label\">Other\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_gu3ov1aeef21cdb\" name=\"item_meta[12211]\" value=\"Broken Arm\"  data-sectionid=\"12199\" data-frmval=\"Broken Arm\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12212_container\" class=\"frm_form_field  frm_fourth frm_html_container form-field\"><img style=\"display: inline; margin: 21px 0 0 0;\" src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/adl-acute-exceptions-blue.svg\" width=\"35\" height=\"35\" \/><\/div>\n<div id=\"frm_field_12213_container\" class=\"frm_form_field  frm_fourth frm_alignright frm_html_container form-field\">\n<div class=\"fusion-fa-align-right\"><a class=\"fb-icon-element-206 fb-icon-element fontawesome-icon fa-minus fas circle-no fusion-link\" style=\"font-size:18px;margin-top:25px;margin-right:3px;margin-bottom:0px;\" href=\"#\" aria-label=\"Link to #\" target=\"_self\"><\/a><\/div>\n<style>a.fb-icon-element.fontawesome-icon.fb-icon-element-206{ color: #005174;}a.fb-icon-element.fontawesome-icon.fb-icon-element-206:hover { color: #005174;}<\/style>\n<\/div>\n<div id=\"frm_field_12214_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_phf0g67a4f6934c\" id=\"field_phf0g67a4f6934c_label\" class=\"frm_primary_label\">Level of Assistance\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[12214]\" id=\"field_phf0g67a4f6934c\"  data-sectionid=\"12199\" data-frmval=\"Assisted\" data-invmsg=\"Level of Assistance is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"Independent\"  class=\"\">\n\t\t\tIndependent\t\t<\/option>\n\t\t\t<option value=\"Some Assistance\"  class=\"\">\n\t\t\tSome Assistance\t\t<\/option>\n\t\t\t<option value=\"Assisted\"  selected=\"selected\" class=\"\">\n\t\t\tAssisted\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12215_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths horizontal_radio\">\r\n    <div  id=\"field_1ipai4a75d6e309_label\" class=\"frm_primary_label\">Assigned to\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_1ipai4a75d6e309_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12215-12199-0\"><label for=\"field_1ipai4a75d6e309-0\"><input type=\"checkbox\" name=\"item_meta[12215][]\" id=\"field_1ipai4a75d6e309-0\" value=\"Nursing\"  data-sectionid=\"12199\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Nursing<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12215-12199-1\"><label for=\"field_1ipai4a75d6e309-1\"><input type=\"checkbox\" name=\"item_meta[12215][]\" id=\"field_1ipai4a75d6e309-1\" value=\"Med Tech\"  data-sectionid=\"12199\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Med Tech<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_12215-12199-2\"><label for=\"field_1ipai4a75d6e309-2\"><input type=\"checkbox\" name=\"item_meta[12215][]\" id=\"field_1ipai4a75d6e309-2\" value=\"Caregivers\" checked=\"checked\"  data-sectionid=\"12199\" data-frmval=\"{&quot;2&quot;:&quot;Caregivers&quot;}\" data-invmsg=\"Assigned to is invalid\" aria-invalid=\"false\"   \/> Caregivers<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12216_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first\">\r\n    <label for=\"field_nywo43af550e11f\" id=\"field_nywo43af550e11f_label\" class=\"frm_primary_label\">Frequency per Day\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[12216]\" id=\"field_nywo43af550e11f\"  data-sectionid=\"12199\" data-frmval=\"2x \/ Day\" data-invmsg=\"Frequency per Day is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t<option value=\"\"  class=\"\">\n\t\t\t \t\t<\/option>\n\t\t\t<option value=\"1x \/ Day\"  class=\"\">\n\t\t\t1x \/ Day\t\t<\/option>\n\t\t\t<option value=\"2x \/ Day\"  selected=\"selected\" class=\"\">\n\t\t\t2x \/ Day\t\t<\/option>\n\t\t\t<option value=\"3x \/ Day +\"  class=\"\">\n\t\t\t3x \/ Day +\t\t<\/option>\n\t\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12217_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_ncoyw102619ee15\" id=\"field_ncoyw102619ee15_label\" class=\"frm_primary_label\">Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12217]\" id=\"field_ncoyw102619ee15\" rows=\"1\"  data-sectionid=\"12199\" data-frmval=\"Notes...\" data-invmsg=\"Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12218_container\" class=\"frm_form_field  frm_fourth frm_first frm_html_container form-field\">\n<p class=\"blue-label\">Frequency<\/p>\n<div style=\"margin: 0; padding: 0;\">\n<table border=\"0\" width=\"100%\" cellspacing=\"0px\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-207 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-207{ color: #999999;}i.fb-icon-element.fontawesome-icon.fb-icon-element-207:hover { color: #999999;}<\/style>\n<p>SUN<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-208 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-208{ color: #999999;}i.fb-icon-element.fontawesome-icon.fb-icon-element-208:hover { color: #999999;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-209 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-209{ color: #999999;}i.fb-icon-element.fontawesome-icon.fb-icon-element-209:hover { color: #999999;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-210 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-210{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-210:hover { color: #cccccc;}<\/style>\n<p>12-3<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-211 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-211{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-211:hover { color: #cccccc;}<\/style>\n<p>12-3<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-212 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-212{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-212:hover { color: #cccccc;}<\/style>\n<p>3-6<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-213 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-213{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-213:hover { color: #cccccc;}<\/style>\n<p>3-6<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-214 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-214{ color: #999999;}i.fb-icon-element.fontawesome-icon.fb-icon-element-214:hover { color: #999999;}<\/style>\n<p>6-9<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-215 fb-icon-element fontawesome-icon fa-check-square fas circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-215{ color: #999999;}i.fb-icon-element.fontawesome-icon.fb-icon-element-215:hover { color: #999999;}<\/style>\n<p>6-9<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-216 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-216{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-216:hover { color: #cccccc;}<\/style>\n<p>9-12<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-217 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-217{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-217:hover { color: #cccccc;}<\/style>\n<p>9-12<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-218 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-218{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-218:hover { color: #cccccc;}<\/style>\n<p>MON<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-219 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-219{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-219:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-220 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-220{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-220:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-221 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-221{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-221:hover { color: #cccccc;}<\/style>\n<p>TUE<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-222 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-222{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-222:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-223 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-223{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-223:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-224 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-224{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-224:hover { color: #cccccc;}<\/style>\n<p>WED<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-225 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-225{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-225:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-226 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-226{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-226:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-227 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-227{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-227:hover { color: #cccccc;}<\/style>\n<p>THU<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-228 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-228{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-228:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-229 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-229{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-229:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-230 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-230{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-230:hover { color: #cccccc;}<\/style>\n<p>FRI<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-231 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-231{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-231:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-232 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-232{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-232:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-233 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-233{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-233:hover { color: #cccccc;}<\/style>\n<p>SAT<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-234 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-234{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-234:hover { color: #cccccc;}<\/style>\n<p>AM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\" style=\"margin-bottom: 0;\">\n<div class=\"fusion-fa-align-left\"><i class=\"fb-icon-element-235 fb-icon-element fontawesome-icon fa-square far circle-no\" style=\"font-size:14px;margin-top:4px;margin-right:5px;\"><\/i><\/div>\n<style>i.fb-icon-element.fontawesome-icon.fb-icon-element-235{ color: #cccccc;}i.fb-icon-element.fontawesome-icon.fb-icon-element-235:hover { color: #cccccc;}<\/style>\n<p>PM<\/p>\n<\/td>\n<td width=\"33%\">\n<p class=\"new-view-frequency\">\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<\/div>\n<div id=\"frm_field_12219_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_first horizontal_radio\">\r\n    <div  id=\"field_3vb6l28c0dfca50_label\" class=\"frm_primary_label\">Goal\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_3vb6l28c0dfca50_label\" role=\"group\">\t\t<div class=\"frm_radio\" id=\"frm_radio_12219-12199-0\"><label for=\"field_3vb6l28c0dfca50-0\">\t\t<input type=\"radio\" name=\"item_meta[12219]\" id=\"field_3vb6l28c0dfca50-0\" value=\"Maintain\"\n\t\t   data-sectionid=\"12199\" data-frmval=\"Improve\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Maintain<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_12219-12199-1\"><label for=\"field_3vb6l28c0dfca50-1\">\t\t<input type=\"radio\" name=\"item_meta[12219]\" id=\"field_3vb6l28c0dfca50-1\" value=\"Improve\"\n\t\tchecked=\"checked\"   data-sectionid=\"12199\" data-frmval=\"Improve\" data-invmsg=\"Goal is invalid\" aria-invalid=\"false\"  \/> Improve<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_12220_container\" class=\"frm_form_field form-field  frm_top_container frm_three_fourths\">\r\n    <label for=\"field_9qq2p0b50f16385\" id=\"field_9qq2p0b50f16385_label\" class=\"frm_primary_label\">Goal Details\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12220]\" id=\"field_9qq2p0b50f16385\" rows=\"3\"  data-sectionid=\"12199\" data-frmval=\"Notes...\" data-invmsg=\"Goal Details is invalid\" aria-invalid=\"false\"  >Notes...<\/textarea>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<\/div>\n<div id=\"frm_field_12222_container\" class=\"frm_form_field  frm_html_container form-field\">\n<p  style=\"margin-top: 0px; padding-top: 0px;\">&nbsp;<\/p>\n<\/div>\n<div id=\"frm_field_12223_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">Meeting Minutes \/ Signatures<\/h3>\r\n\r\n\r\n<div id=\"frm_field_12224_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_1cbqk42d6030610793568aaf72c6a71c7d3\" id=\"field_1cbqk42d6030610793568aaf72c6a71c7d3_label\" class=\"frm_primary_label\">Meeting Minutes\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12224]\" id=\"field_1cbqk42d6030610793568aaf72c6a71c7d3\" rows=\"5\"  data-sectionid=\"12223\" data-invmsg=\"Meeting Minutes is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<\/div>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t<div class=\"frm_submit\">\r\n\r\n<button class=\"frm_button_submit frm_final_submit\" type=\"submit\"  >Submit<\/button>\r\n\r\n<\/div><\/div>\n<\/fieldset>\n<\/div>\n<\/form>\n<\/div>\n\n<\/div><div class=\"fusion-text fusion-text-17\"><div style=\"border-top: 1px solid #b5b5b5; margin-top: 20px;\"><a href=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/customer\/ellenor-careplan\/\"><div class=\"fusion-fa-align-right\"><i class=\"fb-icon-element-236 fb-icon-element fontawesome-icon fa-check fas circle-no\" style=\"font-size:20px;margin-top:15px;margin-right:2px;margin-bottom:0px;\"><\/i><\/div><style>i.fb-icon-element.fontawesome-icon.fb-icon-element-236{ color: #005174;}i.fb-icon-element.fontawesome-icon.fb-icon-element-236:hover { color: #005174;}<\/style><\/a><\/div>\n<\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"margin-left: auto;margin-right: auto;margin-top:30%;width:100%;\"><\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-modal modal fade modal-1 add_hospice_provider\" tabindex=\"-1\" role=\"dialog\" aria-labelledby=\"modal-heading-1\" aria-hidden=\"true\"><style type=\"text\/css\">.modal-1 .modal-header, .modal-1 .modal-footer{border-color:#ebebeb;}<\/style><div class=\"modal-dialog modal-lg\" role=\"document\"><div class=\"modal-content fusion-modal-content\" style=\"background-color:#f6f6f6\"><div class=\"modal-header\"><button class=\"close\" type=\"button\" data-dismiss=\"modal\" aria-hidden=\"true\" aria-label=\"Close\">&times;<\/button><h3 class=\"modal-title\" id=\"modal-heading-1\" data-dismiss=\"modal\" aria-hidden=\"true\">Add Hospice Provider<\/h3><\/div><div class=\"modal-body fusion-clearfix\">\n<div style=\"color: #000000; font-size: 16px;\" align=\"center\">\n<p>Please add Hospice Provider to (Resident name)&#8217;s Medical page to continue.<\/p>\n<p><a class=\"fusion-button button-default button-medium button default medium\" data-dismiss=\"modal\">Cancel<\/a> \u00a0 <a class=\"fusion-button button-default button-medium button default medium\" title=\"Go to Medical\" href=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/customer\/lsq-ellenor-johnson-medical-edit\/\">Go to Medical<\/a><\/p>\n<\/div>\n<\/div><\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-4 fusion_builder_column_1_6 1_6 fusion-one-sixth fusion-column-last insights-display fusion-no-small-visibility\" style=\"width:16.666666666667%;width:calc(16.666666666667% - ( ( 0px + 0px ) * 0.16666666666667 ) );margin-top:0px;margin-bottom:0px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;border-width: 0 0 0 1px;border-color:#cccccc;border-style:solid;padding: 0px 0px 0px 20px;\"><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-separator fusion-no-small-visibility fusion-full-width-sep\" style=\"margin-left: auto;margin-right: auto;margin-top:120px;width:100%;\"><\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-text fusion-text-18\"><p style=\"margin-bottom: 4px;\"><img src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/happy-icon.svg\" alt=\"Smile\" width=\"32\" height=\"32\" \/><\/p>\n<h2 style=\"font-weight: 100; font-size: 1.5em; margin-top: 0px;\">Weekly lunch date with daughter today.<\/h2>\n<\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-separator fusion-no-small-visibility fusion-full-width-sep\" style=\"margin-left: auto;margin-right: auto;margin-top:0px;margin-bottom:20px;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"border-color:#005174;border-top-width:1px;\"><\/div><\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-text fusion-text-19\"><p style=\"margin-bottom: 4px;\"><img src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/happy-icon.svg\" alt=\"Smile\" width=\"32\" height=\"32\" \/><\/p>\n<h2 style=\"font-weight: 100; font-size: 1.5em;\">Poker champ last night.<\/h2>\n<\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-separator fusion-no-small-visibility fusion-full-width-sep\" style=\"margin-left: auto;margin-right: auto;margin-top:0px;margin-bottom:20px;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"border-color:#005174;border-top-width:1px;\"><\/div><\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-text fusion-text-20\"><p style=\"margin-bottom: 4px;\"><img src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/frown-icon.svg\" alt=\"Smile\" width=\"32\" height=\"32\" \/><\/p>\n<h2 style=\"font-weight: 100; font-size: 1.5em;\">Her dog, Chloe, isn't feeling well.<\/h2>\n<\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-separator fusion-no-small-visibility fusion-full-width-sep\" style=\"margin-left: auto;margin-right: auto;margin-top:0px;margin-bottom:20px;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"border-color:#005174;border-top-width:1px;\"><\/div><\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-text fusion-text-21\"><p style=\"margin-bottom: 4px;\"><img src=\"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-content\/uploads\/2020\/09\/happy-icon.svg\" alt=\"Smile\" width=\"32\" height=\"32\" \/><\/p>\n<h2 style=\"font-weight: 100; font-size: 1.5em;\">Ask about her new friend, Susie.<\/h2>\n<\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-separator fusion-no-small-visibility fusion-full-width-sep\" style=\"margin-left: auto;margin-right: auto;margin-top:0px;margin-bottom:20px;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"border-color:#005174;border-top-width:1px;\"><\/div><\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":789,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":[],"_links":{"self":[{"href":"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-json\/wp\/v2\/pages\/8853"}],"collection":[{"href":"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-json\/wp\/v2\/comments?post=8853"}],"version-history":[{"count":29,"href":"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-json\/wp\/v2\/pages\/8853\/revisions"}],"predecessor-version":[{"id":11712,"href":"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-json\/wp\/v2\/pages\/8853\/revisions\/11712"}],"up":[{"embeddable":true,"href":"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-json\/wp\/v2\/pages\/789"}],"wp:attachment":[{"href":"https:\/\/bluesouthcreative.com\/staging\/yiayia-web-app\/wp-json\/wp\/v2\/media?parent=8853"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}