[{"id":259548,"date":"2026-04-14T15:04:15","date_gmt":"2026-04-14T19:04:15","guid":{"rendered":"https:\/\/screening.mhanational.org\/?post_type=screen&#038;p=259548"},"modified":"2026-04-14T15:04:15","modified_gmt":"2026-04-14T19:04:15","slug":"ai-mental-health-survey-theresa-sandbox","status":"publish","type":"screen","link":"https:\/\/screening.mhanational.org\/es\/screening-tools\/ai-mental-health-survey-theresa-sandbox\/","title":{"rendered":"AI &#038; Mental Health Survey &#8211; Theresa sandbox"},"content":{"rendered":"<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_chrome gform_wrapper gravity-theme gform-theme--no-framework full-pager_wrapper' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_94' style='display:none'>\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_94' class='full-pager' class='clearfix' action='\/es\/wp-json\/wp\/v2\/screen' data-formid='94' novalidate><ol class=\"full-progress-bar clearfix step-1-of-3\"><li class=\"step-1 active\"><span>Survey Questions<\/span><\/li><li class=\"step-2 empty\"><span>Optional Questions<\/span><\/li><\/ol>\n                        <div class='gform-body gform_body'><div id='gform_page_94_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_94' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_94_158\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_94_158'><span class='gform-field-label__text'>Facebook<\/span><\/label><div class='gfield_description' id='gfield_description_94_158'>This field is for validation purposes and should be left unchanged.<\/div><div class='ginput_container'><input name='input_158' id='input_94_158' type='text' value='' autocomplete='new-password'\/><\/div><\/div><div id=\"field_94_4\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p>This survey was developed to help us explore your opinions about artificial intelligence (AI) and mental mealth.<\/p><p>Sharing these thoughts will help us understand what resources and policies to consider when thinking about the future of AI in mental health. Thank you for participating!<\/p><\/div><div id=\"field_94_38\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_38' id='input_94_38' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_94_39\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><input name=\"input_39\" id=\"input_94_39\" type=\"hidden\" class=\"gform_hidden\" aria-invalid=\"false\" value=\"259548\"><\/div><div id=\"field_94_40\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below 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\/><\/div><\/div><div id=\"field_94_81\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_81' id='input_94_81' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_94_82\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_82' id='input_94_82' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_94_83\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_83' id='input_94_83' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_94_93\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_93' id='input_94_93' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_94_157\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_157' id='input_94_157' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='lang--es' \/><\/div><\/div><fieldset id=\"field_94_103\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio traditional gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Which of the following <strong>best<\/strong> describes your use of AI?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_94_103'>\n\t\t\t<div class='gchoice gchoice_94_103_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_103' type='radio' value='I have never used AI, but I would like to'  id='choice_94_103_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_103_0' id='label_94_103_0' class='gform-field-label gform-field-label--type-inline'>I have never used AI, but I would like to<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_103_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_103' type='radio' value='I will never use AI if I can avoid it'  id='choice_94_103_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_103_1' id='label_94_103_1' class='gform-field-label gform-field-label--type-inline'>I will never use AI if I can avoid it<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_103_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_103' type='radio' value='I have only used AI when forced to'  id='choice_94_103_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_103_2' id='label_94_103_2' class='gform-field-label gform-field-label--type-inline'>I have only used AI when forced to<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_103_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_103' type='radio' value='I only use AI when it\u2019s included in another product (ex: Zoom, Office, Google)'  id='choice_94_103_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_103_3' id='label_94_103_3' class='gform-field-label gform-field-label--type-inline'>I only use AI when it\u2019s included in another product (ex: Zoom, Office, Google)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_103_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_103' type='radio' value='I use AI less than once a month'  id='choice_94_103_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_103_4' id='label_94_103_4' class='gform-field-label gform-field-label--type-inline'>I use AI less than once a month<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_103_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_103' type='radio' value='I use AI once a month'  id='choice_94_103_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_103_5' id='label_94_103_5' class='gform-field-label gform-field-label--type-inline'>I use AI once a month<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_103_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_103' type='radio' value='I use AI once or twice a week'  id='choice_94_103_6' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_103_6' id='label_94_103_6' class='gform-field-label gform-field-label--type-inline'>I use AI once or twice a week<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_103_7'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_103' type='radio' value='I use AI every day'  id='choice_94_103_7' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_103_7' id='label_94_103_7' class='gform-field-label gform-field-label--type-inline'>I use AI every day<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_94_110\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-3 gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>What prevents you from using AI?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_94_110'>Select your top 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_94_110'><div class='gchoice gchoice_94_110_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_110.1' type='checkbox'  value='AI doesn\u2019t seem interesting or useful to me'  id='choice_94_110_1'   aria-describedby=\"gfield_description_94_110\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_94_110_1' id='label_94_110_1' class='gform-field-label gform-field-label--type-inline'>AI doesn\u2019t seem interesting or useful to me<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_110_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_110.2' type='checkbox'  value='I don\u2019t know how to use AI'  id='choice_94_110_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_110_2' id='label_94_110_2' class='gform-field-label gform-field-label--type-inline'>I don\u2019t know how to use AI<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_110_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_110.3' type='checkbox'  value='I don\u2019t have access to AI'  id='choice_94_110_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_110_3' id='label_94_110_3' class='gform-field-label gform-field-label--type-inline'>I don\u2019t have access to AI<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_110_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_110.4' type='checkbox'  value='AI can\u2019t do anything for me that I can\u2019t do for myself'  id='choice_94_110_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_110_4' id='label_94_110_4' class='gform-field-label gform-field-label--type-inline'>AI can\u2019t do anything for me that I can\u2019t do for myself<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_110_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_110.5' type='checkbox'  value='I don\u2019t trust AI to give me good advice or accurate information'  id='choice_94_110_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_110_5' id='label_94_110_5' class='gform-field-label gform-field-label--type-inline'>I don\u2019t trust AI to give me good advice or accurate information<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_110_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_110.6' type='checkbox'  value='I don\u2019t want my personal information to be tracked'  id='choice_94_110_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_110_6' id='label_94_110_6' class='gform-field-label gform-field-label--type-inline'>I don\u2019t want my personal information to be tracked<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_110_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_110.7' type='checkbox'  value='I don\u2019t trust the companies behind AI'  id='choice_94_110_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_110_7' id='label_94_110_7' class='gform-field-label gform-field-label--type-inline'>I don\u2019t trust the companies behind AI<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_110_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_110.8' type='checkbox'  value='I am opposed to using AI because of its negative impact on society'  id='choice_94_110_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_110_8' id='label_94_110_8' class='gform-field-label gform-field-label--type-inline'>I am opposed to using AI because of its negative impact on society<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_110_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_110.9' type='checkbox'  value='The technology isn\u2019t good enough yet'  id='choice_94_110_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_110_9' id='label_94_110_9' class='gform-field-label gform-field-label--type-inline'>The technology isn\u2019t good enough yet<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_94_140\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full traditional gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Which AI system do you use <strong>the most<\/strong>?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_94_140'>\n\t\t\t<div class='gchoice gchoice_94_140_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_140' type='radio' value='ChatGPT'  id='choice_94_140_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_140_0' id='label_94_140_0' class='gform-field-label gform-field-label--type-inline'>ChatGPT<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_140_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_140' type='radio' value='Claude (Anthropic)'  id='choice_94_140_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_140_1' id='label_94_140_1' class='gform-field-label gform-field-label--type-inline'>Claude (Anthropic)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_140_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_140' type='radio' value='Gemini (Google)'  id='choice_94_140_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_140_2' id='label_94_140_2' class='gform-field-label gform-field-label--type-inline'>Gemini (Google)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_140_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_140' type='radio' value='Character AI'  id='choice_94_140_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_140_3' id='label_94_140_3' class='gform-field-label gform-field-label--type-inline'>Character AI<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_140_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_140' type='radio' value='Grok'  id='choice_94_140_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_140_4' id='label_94_140_4' class='gform-field-label gform-field-label--type-inline'>Grok<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_140_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_140' type='radio' value='Microsoft Copilot'  id='choice_94_140_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_140_5' id='label_94_140_5' class='gform-field-label gform-field-label--type-inline'>Microsoft Copilot<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_140_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_140' type='radio' value='Meta AI'  id='choice_94_140_6' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_140_6' id='label_94_140_6' class='gform-field-label gform-field-label--type-inline'>Meta AI<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_140_7'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_140' type='radio' value='Other (examples: Perplexity, Snapchat AI)'  id='choice_94_140_7' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_140_7' id='label_94_140_7' class='gform-field-label gform-field-label--type-inline'>Other (examples: Perplexity, Snapchat AI)<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_94_141\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_94_141'><span class='gform-field-label__text'>What other AI system do you use the most?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_141' id='input_94_141' type='text' value='' class='medium'    placeholder='Tell us more...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_94_132\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_94_114\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-3 gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Imagine the future 5 years from now. What do you hope AI will help you do?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_94_114'>Select your top 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_94_114'><div class='gchoice gchoice_94_114_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_114.1' type='checkbox'  value='Save time and effort by doing tasks for me'  id='choice_94_114_1'   aria-describedby=\"gfield_description_94_114\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_94_114_1' id='label_94_114_1' class='gform-field-label gform-field-label--type-inline'>Save time and effort by doing tasks for me<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_114_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_114.2' type='checkbox'  value='Organizing my life \u2014 reminders, to-do lists, calendars, files, and photos'  id='choice_94_114_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_114_2' id='label_94_114_2' class='gform-field-label gform-field-label--type-inline'>Organizing my life \u2014 reminders, to-do lists, calendars, files, and photos<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_114_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_114.3' type='checkbox'  value='Easier access to information'  id='choice_94_114_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_114_3' id='label_94_114_3' class='gform-field-label gform-field-label--type-inline'>Easier access to information<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_114_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_114.4' type='checkbox'  value='Improve my problem solving or decision making'  id='choice_94_114_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_114_4' id='label_94_114_4' class='gform-field-label gform-field-label--type-inline'>Improve my problem solving or decision making<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_114_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_114.5' type='checkbox'  value='Learning new skills'  id='choice_94_114_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_114_5' id='label_94_114_5' class='gform-field-label gform-field-label--type-inline'>Learning new skills<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_114_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_114.6' type='checkbox'  value='Find new ways to express myself creatively'  id='choice_94_114_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_114_6' id='label_94_114_6' class='gform-field-label gform-field-label--type-inline'>Find new ways to express myself creatively<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_114_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_114.7' type='checkbox'  value='Support my health and wellness'  id='choice_94_114_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_114_7' id='label_94_114_7' class='gform-field-label gform-field-label--type-inline'>Support my health and wellness<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_114_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_114.8' type='checkbox'  value='Enhance my communication with other people'  id='choice_94_114_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_114_8' id='label_94_114_8' class='gform-field-label gform-field-label--type-inline'>Enhance my communication with other people<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_114_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_114.9' type='checkbox'  value='Help me feel less lonely'  id='choice_94_114_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_114_9' id='label_94_114_9' class='gform-field-label gform-field-label--type-inline'>Help me feel less lonely<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_114_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_114.11' type='checkbox'  value='Other people will use AI to make new inventions or discoveries that will improve my life'  id='choice_94_114_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_114_11' id='label_94_114_11' class='gform-field-label gform-field-label--type-inline'>Other people will use AI to make new inventions or discoveries that will improve my life<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_114_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_114.12' type='checkbox'  value='Nothing. I don&#039;t like AI and don&#039;t want it to affect my life in any way'  id='choice_94_114_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_114_12' id='label_94_114_12' class='gform-field-label gform-field-label--type-inline'>Nothing. I don't like AI and don't want it to affect my life in any way<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_114_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_114.13' type='checkbox'  value='Other...'  id='choice_94_114_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_114_13' id='label_94_114_13' class='gform-field-label gform-field-label--type-inline'>Other...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_94_117\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_94_117'><span class='gform-field-label__text'>What else do you hope AI will help you do?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_117' id='input_94_117' type='text' value='' class='medium'    placeholder='Tell us more...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_94_118\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-3 gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Imagine the future 5 years from now. What scares you the most about the impact of AI?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_94_118'>Select your top 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_94_118'><div class='gchoice gchoice_94_118_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_118.1' type='checkbox'  value='Losing human skills (social, reading, writing, creating)'  id='choice_94_118_1'   aria-describedby=\"gfield_description_94_118\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_94_118_1' id='label_94_118_1' class='gform-field-label gform-field-label--type-inline'>Losing human skills (social, reading, writing, creating)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_118_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_118.2' type='checkbox'  value='Being monitored and tracked online'  id='choice_94_118_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_118_2' id='label_94_118_2' class='gform-field-label gform-field-label--type-inline'>Being monitored and tracked online<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_118_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_118.3' type='checkbox'  value='Companies stealing my information or work to train AI models'  id='choice_94_118_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_118_3' id='label_94_118_3' class='gform-field-label gform-field-label--type-inline'>Companies stealing my information or work to train AI models<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_118_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_118.4' type='checkbox'  value='Job loss or being replaced by AI'  id='choice_94_118_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_118_4' id='label_94_118_4' class='gform-field-label gform-field-label--type-inline'>Job loss or being replaced by AI<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_118_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_118.5' type='checkbox'  value='AI making biased decisions about me (what healthcare or jobs I can get, where I can live, etc.)'  id='choice_94_118_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_118_5' id='label_94_118_5' class='gform-field-label gform-field-label--type-inline'>AI making biased decisions about me (what healthcare or jobs I can get, where I can live, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_118_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_118.6' type='checkbox'  value='Replacing in-person connection with other people'  id='choice_94_118_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_118_6' id='label_94_118_6' class='gform-field-label gform-field-label--type-inline'>Replacing in-person connection with other people<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_118_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_118.7' type='checkbox'  value='Can cause brain changes that are harmful (addiction, attention problems)'  id='choice_94_118_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_118_7' id='label_94_118_7' class='gform-field-label gform-field-label--type-inline'>Can cause brain changes that are harmful (addiction, attention problems)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_118_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_118.8' type='checkbox'  value='Becoming dependent on AI (can\u2019t make decisions without AI)'  id='choice_94_118_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_118_8' id='label_94_118_8' class='gform-field-label gform-field-label--type-inline'>Becoming dependent on AI (can\u2019t make decisions without AI)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_118_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_118.9' type='checkbox'  value='Providing bad information (bad advice, wrong answers, deep fakes)'  id='choice_94_118_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_118_9' id='label_94_118_9' class='gform-field-label gform-field-label--type-inline'>Providing bad information (bad advice, wrong answers, deep fakes)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_118_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_118.11' type='checkbox'  value='Flooding the internet with junk and making it harder to find quality content'  id='choice_94_118_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_118_11' id='label_94_118_11' class='gform-field-label gform-field-label--type-inline'>Flooding the internet with junk and making it harder to find quality content<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_118_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_118.12' type='checkbox'  value='Nothing. I think AI will only have positive effects.'  id='choice_94_118_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_118_12' id='label_94_118_12' class='gform-field-label gform-field-label--type-inline'>Nothing. I think AI will only have positive effects.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_118_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_118.13' type='checkbox'  value='Other...'  id='choice_94_118_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_118_13' id='label_94_118_13' class='gform-field-label gform-field-label--type-inline'>Other...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_94_119\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_94_119'><span class='gform-field-label__text'>What else scares you about the impact of AI?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_119' id='input_94_119' type='text' value='' class='medium'    placeholder='Tell us more...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_94_105\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio traditional gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Have you used AI for emotional support?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_94_105'>\n\t\t\t<div class='gchoice gchoice_94_105_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_105' type='radio' value='No, never'  id='choice_94_105_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_105_0' id='label_94_105_0' class='gform-field-label gform-field-label--type-inline'>No, never<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_105_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_105' type='radio' value='Yes, a few times'  id='choice_94_105_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_105_1' id='label_94_105_1' class='gform-field-label gform-field-label--type-inline'>Yes, a few times<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_105_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_105' type='radio' value='Yes, regularly \/ often'  id='choice_94_105_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_105_2' id='label_94_105_2' class='gform-field-label gform-field-label--type-inline'>Yes, regularly \/ often<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_94_120\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-3 gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>What is preventing you from using AI for emotional support more often?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_94_120'>Select your top 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_94_120'><div class='gchoice gchoice_94_120_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.1' type='checkbox'  value='I don\u2019t trust AI to give me good advice or accurate information'  id='choice_94_120_1'   aria-describedby=\"gfield_description_94_120\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_94_120_1' id='label_94_120_1' class='gform-field-label gform-field-label--type-inline'>I don\u2019t trust AI to give me good advice or accurate information<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_120_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.2' type='checkbox'  value='I\u2019m worried that my personal information could be tracked'  id='choice_94_120_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_120_2' id='label_94_120_2' class='gform-field-label gform-field-label--type-inline'>I\u2019m worried that my personal information could be tracked<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_120_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.3' type='checkbox'  value='I don\u2019t trust the companies behind AI'  id='choice_94_120_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_120_3' id='label_94_120_3' class='gform-field-label gform-field-label--type-inline'>I don\u2019t trust the companies behind AI<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_120_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.4' type='checkbox'  value='I don\u2019t know how to use it for this purpose'  id='choice_94_120_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_120_4' id='label_94_120_4' class='gform-field-label gform-field-label--type-inline'>I don\u2019t know how to use it for this purpose<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_120_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.5' type='checkbox'  value='I prefer to talk to a human'  id='choice_94_120_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_120_5' id='label_94_120_5' class='gform-field-label gform-field-label--type-inline'>I prefer to talk to a human<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_120_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.6' type='checkbox'  value='The technology isn\u2019t good enough yet'  id='choice_94_120_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_120_6' id='label_94_120_6' class='gform-field-label gform-field-label--type-inline'>The technology isn\u2019t good enough yet<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_120_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.7' type='checkbox'  value='I am opposed to using AI because of its negative impact on society'  id='choice_94_120_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_120_7' id='label_94_120_7' class='gform-field-label gform-field-label--type-inline'>I am opposed to using AI because of its negative impact on society<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_120_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.8' type='checkbox'  value='I don\u2019t need it because I am already receiving treatment or support another way'  id='choice_94_120_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_120_8' id='label_94_120_8' class='gform-field-label gform-field-label--type-inline'>I don\u2019t need it because I am already receiving treatment or support another way<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_120_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.9' type='checkbox'  value='I already got what I needed from it'  id='choice_94_120_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_120_9' id='label_94_120_9' class='gform-field-label gform-field-label--type-inline'>I already got what I needed from it<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_94_133\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full traditional gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>How positive or negative was your experience?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_94_133'>\n\t\t\t<div class='gchoice gchoice_94_133_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_133' type='radio' value='Very positive'  id='choice_94_133_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_133_0' id='label_94_133_0' class='gform-field-label gform-field-label--type-inline'>Very positive<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_133_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_133' type='radio' value='Positive'  id='choice_94_133_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_133_1' id='label_94_133_1' class='gform-field-label gform-field-label--type-inline'>Positive<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_133_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_133' type='radio' value='Negative'  id='choice_94_133_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_133_2' id='label_94_133_2' class='gform-field-label gform-field-label--type-inline'>Negative<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_133_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_133' type='radio' value='Very negative'  id='choice_94_133_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_133_3' id='label_94_133_3' class='gform-field-label gform-field-label--type-inline'>Very negative<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_94_123\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_94_123'><span class='gform-field-label__text'>Can you tell us more about why your experience was positive?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_123' id='input_94_123' type='text' value='' class='large'    placeholder='Tell us more...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_94_124\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_94_124'><span class='gform-field-label__text'>Can you tell us more about why your experience was negative?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_124' id='input_94_124' type='text' value='' class='large'    placeholder='Tell us more...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_94_125\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Would you ever consider using AI for emotional support?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_94_125'>\n\t\t\t<div class='gchoice gchoice_94_125_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_125' type='radio' value='Yes'  id='choice_94_125_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_125_0' id='label_94_125_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_125_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_125' type='radio' value='No'  id='choice_94_125_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_125_1' id='label_94_125_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_94_127\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-3 gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>What would prevent you from using AI for emotional support?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_94_127'>Select your top 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_94_127'><div class='gchoice gchoice_94_127_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.1' type='checkbox'  value='I don\u2019t trust AI to give me good advice or accurate information'  id='choice_94_127_1'   aria-describedby=\"gfield_description_94_127\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_94_127_1' id='label_94_127_1' class='gform-field-label gform-field-label--type-inline'>I don\u2019t trust AI to give me good advice or accurate information<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_127_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.2' type='checkbox'  value='I\u2019m worried that my personal information could be tracked'  id='choice_94_127_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_127_2' id='label_94_127_2' class='gform-field-label gform-field-label--type-inline'>I\u2019m worried that my personal information could be tracked<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_127_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.3' type='checkbox'  value='I don\u2019t trust the companies behind AI'  id='choice_94_127_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_127_3' id='label_94_127_3' class='gform-field-label gform-field-label--type-inline'>I don\u2019t trust the companies behind AI<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_127_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.4' type='checkbox'  value='I don\u2019t know how to use it for this purpose'  id='choice_94_127_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_127_4' id='label_94_127_4' class='gform-field-label gform-field-label--type-inline'>I don\u2019t know how to use it for this purpose<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_127_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.5' type='checkbox'  value='I prefer to talk to a human'  id='choice_94_127_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_127_5' id='label_94_127_5' class='gform-field-label gform-field-label--type-inline'>I prefer to talk to a human<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_127_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.6' type='checkbox'  value='The technology isn\u2019t good enough yet'  id='choice_94_127_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_127_6' id='label_94_127_6' class='gform-field-label gform-field-label--type-inline'>The technology isn\u2019t good enough yet<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_127_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.7' type='checkbox'  value='I am opposed to using AI because of its negative impact on society'  id='choice_94_127_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_127_7' id='label_94_127_7' class='gform-field-label gform-field-label--type-inline'>I am opposed to using AI because of its negative impact on society<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_127_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.8' type='checkbox'  value='I don\u2019t need it because I am already receiving treatment or support another way'  id='choice_94_127_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_127_8' id='label_94_127_8' class='gform-field-label gform-field-label--type-inline'>I don\u2019t need it because I am already receiving treatment or support another way<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_127_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.9' type='checkbox'  value='I already got what I needed from it'  id='choice_94_127_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_127_9' id='label_94_127_9' class='gform-field-label gform-field-label--type-inline'>I already got what I needed from it<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_94_139\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-3 gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Why would you consider using AI for mental or emotional support?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_94_139'>Select your top 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_94_139'><div class='gchoice gchoice_94_139_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_139.1' type='checkbox'  value='I feel more comfortable talking to a bot than to a human'  id='choice_94_139_1'   aria-describedby=\"gfield_description_94_139\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_94_139_1' id='label_94_139_1' class='gform-field-label gform-field-label--type-inline'>I feel more comfortable talking to a bot than to a human<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_139_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_139.2' type='checkbox'  value='It\u2019s convenient\/available 24\/7'  id='choice_94_139_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_139_2' id='label_94_139_2' class='gform-field-label gform-field-label--type-inline'>It\u2019s convenient\/available 24\/7<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_139_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_139.3' type='checkbox'  value='It\u2019s free'  id='choice_94_139_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_139_3' id='label_94_139_3' class='gform-field-label gform-field-label--type-inline'>It\u2019s free<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_139_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_139.4' type='checkbox'  value='Traditional therapy isn\u2019t available to me'  id='choice_94_139_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_139_4' id='label_94_139_4' class='gform-field-label gform-field-label--type-inline'>Traditional therapy isn\u2019t available to me<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_139_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_139.5' type='checkbox'  value='It\u2019s safer. It lets me stay anonymous'  id='choice_94_139_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_139_5' id='label_94_139_5' class='gform-field-label gform-field-label--type-inline'>It\u2019s safer. It lets me stay anonymous<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_139_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_139.6' type='checkbox'  value='It lets me get help without telling my family'  id='choice_94_139_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_139_6' id='label_94_139_6' class='gform-field-label gform-field-label--type-inline'>It lets me get help without telling my family<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_139_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_139.7' type='checkbox'  value='Therapy or help I\u2019ve received from people has not helped'  id='choice_94_139_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_139_7' id='label_94_139_7' class='gform-field-label gform-field-label--type-inline'>Therapy or help I\u2019ve received from people has not helped<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_139_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_139.8' type='checkbox'  value='It\u2019s entertaining\/engaging'  id='choice_94_139_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_139_8' id='label_94_139_8' class='gform-field-label gform-field-label--type-inline'>It\u2019s entertaining\/engaging<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_94_137\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-3 gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>In what ways have you <strong>used AI the most<\/strong> for emotional support?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_94_137'>Select your top 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_94_137'><div class='gchoice gchoice_94_137_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_137.1' type='checkbox'  value='Help me answer questions about mental health'  id='choice_94_137_1'   aria-describedby=\"gfield_description_94_137\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_94_137_1' id='label_94_137_1' class='gform-field-label gform-field-label--type-inline'>Help me answer questions about mental health<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_137_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_137.2' type='checkbox'  value='Help me with a mental health diagnosis'  id='choice_94_137_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_137_2' id='label_94_137_2' class='gform-field-label gform-field-label--type-inline'>Help me with a mental health diagnosis<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_137_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_137.3' type='checkbox'  value='Help me get treatment options'  id='choice_94_137_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_137_3' id='label_94_137_3' class='gform-field-label gform-field-label--type-inline'>Help me get treatment options<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_137_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_137.4' type='checkbox'  value='Tracking my mood or habits (logs, reminders)'  id='choice_94_137_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_137_4' id='label_94_137_4' class='gform-field-label gform-field-label--type-inline'>Tracking my mood or habits (logs, reminders)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_137_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_137.5' type='checkbox'  value='A structured tool or app that uses AI in the activity (worksheets, exercises, journaling prompts)'  id='choice_94_137_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_137_5' id='label_94_137_5' class='gform-field-label gform-field-label--type-inline'>A structured tool or app that uses AI in the activity (worksheets, exercises, journaling prompts)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_137_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_137.6' type='checkbox'  value='A conversation with AI (learns your habits\/needs over time, provides listening and advice, helps me make decisions, helps me deal with hard issues)'  id='choice_94_137_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_137_6' id='label_94_137_6' class='gform-field-label gform-field-label--type-inline'>A conversation with AI (learns your habits\/needs over time, provides listening and advice, helps me make decisions, helps me deal with hard issues)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_94_128\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-3 gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>In what ways are you <strong>most interested in using AI<\/strong> for emotional support?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_94_128'>Select your top 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_94_128'><div class='gchoice gchoice_94_128_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.1' type='checkbox'  value='Help me answer questions about mental health'  id='choice_94_128_1'   aria-describedby=\"gfield_description_94_128\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_94_128_1' id='label_94_128_1' class='gform-field-label gform-field-label--type-inline'>Help me answer questions about mental health<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_128_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.2' type='checkbox'  value='Help me with a mental health diagnosis'  id='choice_94_128_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_128_2' id='label_94_128_2' class='gform-field-label gform-field-label--type-inline'>Help me with a mental health diagnosis<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_128_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.3' type='checkbox'  value='Help me get treatment options'  id='choice_94_128_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_128_3' id='label_94_128_3' class='gform-field-label gform-field-label--type-inline'>Help me get treatment options<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_128_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.4' type='checkbox'  value='Tracking my mood or habits (logs, reminders)'  id='choice_94_128_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_128_4' id='label_94_128_4' class='gform-field-label gform-field-label--type-inline'>Tracking my mood or habits (logs, reminders)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_128_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.5' type='checkbox'  value='A structured tool or app that uses AI in the activity (worksheets, exercises, journaling prompts)'  id='choice_94_128_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_128_5' id='label_94_128_5' class='gform-field-label gform-field-label--type-inline'>A structured tool or app that uses AI in the activity (worksheets, exercises, journaling prompts)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_128_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.6' type='checkbox'  value='A conversation with AI (learns your habits\/needs over time, provides listening and advice, helps me make decisions, helps me deal with hard issues)'  id='choice_94_128_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_128_6' id='label_94_128_6' class='gform-field-label gform-field-label--type-inline'>A conversation with AI (learns your habits\/needs over time, provides listening and advice, helps me make decisions, helps me deal with hard issues)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_94_149\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-3 gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>When people use AI for emotional support, what is the best thing the AI can do to respond to their needs?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_94_149'>Select your top 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_94_149'><div class='gchoice gchoice_94_149_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_149.1' type='checkbox'  value='Ask them directly about risk of harm (hurting yourself or others)'  id='choice_94_149_1'   aria-describedby=\"gfield_description_94_149\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_94_149_1' id='label_94_149_1' class='gform-field-label gform-field-label--type-inline'>Ask them directly about risk of harm (hurting yourself or others)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_149_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_149.2' type='checkbox'  value='Listen and support their emotional concerns'  id='choice_94_149_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_149_2' id='label_94_149_2' class='gform-field-label gform-field-label--type-inline'>Listen and support their emotional concerns<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_149_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_149.3' type='checkbox'  value='Help them figure out how to feel better (e.g making a plan, learning some skils)'  id='choice_94_149_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_149_3' id='label_94_149_3' class='gform-field-label gform-field-label--type-inline'>Help them figure out how to feel better (e.g making a plan, learning some skils)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_149_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_149.4' type='checkbox'  value='Give them information about mental health'  id='choice_94_149_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_149_4' id='label_94_149_4' class='gform-field-label gform-field-label--type-inline'>Give them information about mental health<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_149_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_149.5' type='checkbox'  value='Explore all the different support systems they have'  id='choice_94_149_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_149_5' id='label_94_149_5' class='gform-field-label gform-field-label--type-inline'>Explore all the different support systems they have<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_149_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_149.6' type='checkbox'  value='Help them figure out how to talk to someone'  id='choice_94_149_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_149_6' id='label_94_149_6' class='gform-field-label gform-field-label--type-inline'>Help them figure out how to talk to someone<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_149_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_149.7' type='checkbox'  value='Send them resources, including how to connect to a person'  id='choice_94_149_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_149_7' id='label_94_149_7' class='gform-field-label gform-field-label--type-inline'>Send them resources, including how to connect to a person<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_94_138\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_94_138'><span class='gform-field-label__text'><strong>Optional:<\/strong> Think back to a time when you used AI for emotional support. Can you share anything about how that conversation went? What did you talk about? How did you feel?<\/span><\/label><div class='gfield_description' id='gfield_description_94_138'><em><strong>Share as much or as little as you like.<\/strong> For example, you could just describe your experience in one sentence, share prompts you've used that have been particularly effective, or anything in between.<\/em><\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_138' id='input_94_138' class='textarea medium'  aria-describedby=\"gfield_description_94_138\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_94_142\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full limit-3 traditional question gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Who do you think are the top 3 groups who should be most responsible for implementing mental health protections for people who use AI?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_94_142'>Select up to 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_94_142'><div class='gchoice gchoice_94_142_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_142.1' type='checkbox'  value='Myself \/ individual users'  id='choice_94_142_1'   aria-describedby=\"gfield_description_94_142\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_94_142_1' id='label_94_142_1' class='gform-field-label gform-field-label--type-inline'>Myself \/ individual users<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_142_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_142.2' type='checkbox'  value='Parents \/ guardians'  id='choice_94_142_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_142_2' id='label_94_142_2' class='gform-field-label gform-field-label--type-inline'>Parents \/ guardians<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_142_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_142.3' type='checkbox'  value='Technology companies'  id='choice_94_142_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_142_3' id='label_94_142_3' class='gform-field-label gform-field-label--type-inline'>Technology companies<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_142_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_142.4' type='checkbox'  value='Companies using AI software (employers, healthcare, schools)'  id='choice_94_142_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_142_4' id='label_94_142_4' class='gform-field-label gform-field-label--type-inline'>Companies using AI software (employers, healthcare, schools)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_142_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_142.5' type='checkbox'  value='Government'  id='choice_94_142_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_142_5' id='label_94_142_5' class='gform-field-label gform-field-label--type-inline'>Government<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_142_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_142.6' type='checkbox'  value='Other...'  id='choice_94_142_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_142_6' id='label_94_142_6' class='gform-field-label gform-field-label--type-inline'>Other...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_94_143\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_94_143'><span class='gform-field-label__text'>Who else do you think is the most responsible for implementing mental health protections?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_143' id='input_94_143' type='text' value='' class='large'    placeholder='Tell us more...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_94_144\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full limit-3 traditional question gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>What are the top 3 things that technology companies can do to protect people from harm when they\u2019re getting mental health support from AI?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_94_144'>Select up to 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_94_144'><div class='gchoice gchoice_94_144_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_144.1' type='checkbox'  value='Refer me to a mental health professional instead of providing direct advice'  id='choice_94_144_1'   aria-describedby=\"gfield_description_94_144\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_94_144_1' id='label_94_144_1' class='gform-field-label gform-field-label--type-inline'>Refer me to a mental health professional instead of providing direct advice<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_144_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_144.2' type='checkbox'  value='Remind me that I\u2019m talking to a machine and not a human'  id='choice_94_144_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_144_2' id='label_94_144_2' class='gform-field-label gform-field-label--type-inline'>Remind me that I\u2019m talking to a machine and not a human<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_144_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_144.3' type='checkbox'  value='Make the AI less like a human'  id='choice_94_144_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_144_3' id='label_94_144_3' class='gform-field-label gform-field-label--type-inline'>Make the AI less like a human<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_144_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_144.4' type='checkbox'  value='Make the AI more like a human'  id='choice_94_144_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_144_4' id='label_94_144_4' class='gform-field-label gform-field-label--type-inline'>Make the AI more like a human<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_144_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_144.5' type='checkbox'  value='Tell me about my emotional risks when I\u2019m using AI'  id='choice_94_144_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_144_5' id='label_94_144_5' class='gform-field-label gform-field-label--type-inline'>Tell me about my emotional risks when I\u2019m using AI<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_144_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_144.6' type='checkbox'  value='Guarantee that my conversations won\u2019t be used to train the AI'  id='choice_94_144_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_144_6' id='label_94_144_6' class='gform-field-label gform-field-label--type-inline'>Guarantee that my conversations won\u2019t be used to train the AI<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_144_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_144.7' type='checkbox'  value='Make sure no one else can ever see the conversations I have with AI'  id='choice_94_144_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_144_7' id='label_94_144_7' class='gform-field-label gform-field-label--type-inline'>Make sure no one else can ever see the conversations I have with AI<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_144_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_144.8' type='checkbox'  value='Develop industry standards for measuring impact on communities of users'  id='choice_94_144_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_144_8' id='label_94_144_8' class='gform-field-label gform-field-label--type-inline'>Develop industry standards for measuring impact on communities of users<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_144_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_144.9' type='checkbox'  value='Other...'  id='choice_94_144_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_144_9' id='label_94_144_9' class='gform-field-label gform-field-label--type-inline'>Other...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_94_145\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_94_145'><span class='gform-field-label__text'>What else can technology companies do to protect the mental health of people who use their AI?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_145' id='input_94_145' type='text' value='' class='large'    placeholder='Tell us more...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_94_146\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full limit-3 traditional question gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>What are the top 3 things that the government can do to protect the mental health of people who use AI?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_94_146'>Select up to 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_94_146'><div class='gchoice gchoice_94_146_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_146.1' type='checkbox'  value='Set policies\/laws that tech companies have to follow'  id='choice_94_146_1'   aria-describedby=\"gfield_description_94_146\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_94_146_1' id='label_94_146_1' class='gform-field-label gform-field-label--type-inline'>Set policies\/laws that tech companies have to follow<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_146_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_146.2' type='checkbox'  value='Create a group of people responsible for reviewing and giving limitations on safety'  id='choice_94_146_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_146_2' id='label_94_146_2' class='gform-field-label gform-field-label--type-inline'>Create a group of people responsible for reviewing and giving limitations on safety<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_146_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_146.3' type='checkbox'  value='Create guidelines and incentives for safety'  id='choice_94_146_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_146_3' id='label_94_146_3' class='gform-field-label gform-field-label--type-inline'>Create guidelines and incentives for safety<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_146_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_146.4' type='checkbox'  value='Incentivize research on potential harms or positive impacts of AI'  id='choice_94_146_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_146_4' id='label_94_146_4' class='gform-field-label gform-field-label--type-inline'>Incentivize research on potential harms or positive impacts of AI<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_146_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_146.5' type='checkbox'  value='Fine technology companies for harm towards people'  id='choice_94_146_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_146_5' id='label_94_146_5' class='gform-field-label gform-field-label--type-inline'>Fine technology companies for harm towards people<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_146_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_146.6' type='checkbox'  value='Invest in public education on using AIsafely'  id='choice_94_146_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_146_6' id='label_94_146_6' class='gform-field-label gform-field-label--type-inline'>Invest in public education on using AIsafely<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_146_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_146.7' type='checkbox'  value='Other...'  id='choice_94_146_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_146_7' id='label_94_146_7' class='gform-field-label gform-field-label--type-inline'>Other...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_94_147\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_94_147'><span class='gform-field-label__text'>What else can the government do to protect the mental health of people who use AI?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_147' id='input_94_147' type='text' value='' class='large'    placeholder='Tell us more...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_94_152\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full traditional field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>When you use AI tools, which mode do you use most often?<\/span><\/legend><div class='gfield_description' id='gfield_description_94_152'>Select 1.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_94_152'>\n\t\t\t<div class='gchoice gchoice_94_152_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_152' type='radio' value='Text-based chat (typing)'  id='choice_94_152_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_94_152\"   \/>\n\t\t\t\t\t<label for='choice_94_152_0' id='label_94_152_0' class='gform-field-label gform-field-label--type-inline'>Text-based chat (typing)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_152_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_152' type='radio' value='Voice-based conversation (speaking\/listening)'  id='choice_94_152_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_152_1' id='label_94_152_1' class='gform-field-label gform-field-label--type-inline'>Voice-based conversation (speaking\/listening)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_152_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_152' type='radio' value='Both equally'  id='choice_94_152_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_152_2' id='label_94_152_2' class='gform-field-label gform-field-label--type-inline'>Both equally<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_152_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_152' type='radio' value='Other...'  id='choice_94_152_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_152_3' id='label_94_152_3' class='gform-field-label gform-field-label--type-inline'>Other...<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_152_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_152' type='radio' value='I don&#039;t know \/ not sure'  id='choice_94_152_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_152_4' id='label_94_152_4' class='gform-field-label gform-field-label--type-inline'>I don't know \/ not sure<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_94_153\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_94_153'><span class='gform-field-label__text'>What other way do you interact with AI tools most often?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_153' id='input_94_153' type='text' value='' class='medium'    placeholder='Tell us more...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_94_154\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>When you interact with AI tools using text-based chat, how natural or human-like does the interaction feel?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_94_154'>\n\t\t\t<div class='gchoice gchoice_94_154_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_154' type='radio' value='Not natural at all'  id='choice_94_154_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_154_0' id='label_94_154_0' class='gform-field-label gform-field-label--type-inline'>Not natural at all<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_154_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_154' type='radio' value='Somewhat natural'  id='choice_94_154_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_154_1' id='label_94_154_1' class='gform-field-label gform-field-label--type-inline'>Somewhat natural<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_154_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_154' type='radio' value='Very natural'  id='choice_94_154_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_154_2' id='label_94_154_2' class='gform-field-label gform-field-label--type-inline'>Very natural<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_94_155\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>When you interact with AI tools using voice-based conversation, how natural or human-like does the interaction feel?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_94_155'>\n\t\t\t<div class='gchoice gchoice_94_155_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_155' type='radio' value='Not natural at all'  id='choice_94_155_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_155_0' id='label_94_155_0' class='gform-field-label gform-field-label--type-inline'>Not natural at all<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_155_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_155' type='radio' value='Somewhat natural'  id='choice_94_155_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_155_1' id='label_94_155_1' class='gform-field-label gform-field-label--type-inline'>Somewhat natural<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_155_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_155' type='radio' value='Very natural'  id='choice_94_155_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_155_2' id='label_94_155_2' class='gform-field-label gform-field-label--type-inline'>Very natural<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_94_151\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><hr \/><\/div><fieldset id=\"field_94_129\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>We sometimes run paid research studies on topics like AI and mental health. Would you like to hear about future opportunities?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_94_129'>\n\t\t\t<div class='gchoice gchoice_94_129_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_129' type='radio' value='Yes, I&#039;m interested!'  id='choice_94_129_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_129_0' id='label_94_129_0' class='gform-field-label gform-field-label--type-inline'>Yes, I'm interested!<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_129_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_129' type='radio' value='No, thank you.'  id='choice_94_129_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_129_1' id='label_94_129_1' class='gform-field-label gform-field-label--type-inline'>No, thank you.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_94_131\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  >Great! Drop your email below so we can reach out when something comes up:<\/div><div id=\"field_94_130\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_94_130'><span class='gform-field-label__text'>Email<\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_130' id='input_94_130' type='email' value='' class='small'   placeholder='Enter your email address...'  aria-invalid=\"false\"  \/>\n                        <\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <button type='button' id='gform_next_button_94_17' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Next<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_94_2' class='gform_page demographics' data-js='page-field-id-17' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_94_2' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_94_53\" class=\"gfield gfield--type-html gfield--input-type-html section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>About You<\/h2><\/div><div id=\"field_94_54\" class=\"gfield gfield--type-select gfield--input-type-select optional taxonomy field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_94_54'><span class='gform-field-label__text'>Age Range<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_54' id='input_94_54' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='8-10' >8-10<\/option><option value='11-13' >11-13<\/option><option value='14-15' >14-15<\/option><option value='16-17' >16-17<\/option><option value='18-24' >18-24<\/option><option value='25-34' >25-34<\/option><option value='35-44' >35-44<\/option><option value='45-54' >45-54<\/option><option value='55-64' >55-64<\/option><option value='65+' >65+<\/option><option value='Prefer not to answer' >Prefer not to answer<\/option><\/select><\/div><\/div><fieldset id=\"field_94_55\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional mb-2 short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Gender<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_94_55'>\n\t\t\t<div class='gchoice gchoice_94_55_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='Female'  id='choice_94_55_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_55_0' id='label_94_55_0' class='gform-field-label gform-field-label--type-inline'>Female<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_55_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='Male'  id='choice_94_55_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_55_1' id='label_94_55_1' class='gform-field-label gform-field-label--type-inline'>Male<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_55_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='Non-Binary'  id='choice_94_55_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_55_2' id='label_94_55_2' class='gform-field-label gform-field-label--type-inline'>Non-Binary<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_55_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='Prefer not to answer'  id='choice_94_55_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_55_3' id='label_94_55_3' class='gform-field-label gform-field-label--type-inline'>Prefer not to answer<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_94_156\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you identify as transgender?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_94_156'>\n\t\t\t<div class='gchoice gchoice_94_156_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_156' type='radio' value='Yes'  id='choice_94_156_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_156_0' id='label_94_156_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_156_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_156' type='radio' value='No'  id='choice_94_156_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_156_1' id='label_94_156_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_94_135\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_94_135'><span class='gform-field-label__text'>How would you describe your gender?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_135' id='input_94_135' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_94_58\" class=\"gfield gfield--type-select gfield--input-type-select optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_94_58'><span class='gform-field-label__text'>Race\/Ethnicity<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_58' id='input_94_58' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='American Indian or Alaska Native' >American Indian or Alaska Native<\/option><option value='Asian' >Asian<\/option><option value='Black or African American (non-Hispanic)' >Black or African American (non-Hispanic)<\/option><option value='Hispanic or Latino' >Hispanic or Latino<\/option><option value='Middle Eastern or North African' >Middle Eastern or North African<\/option><option value='Native Hawaiian or other Pacific Islander' >Native Hawaiian or other Pacific Islander<\/option><option value='White (non-Hispanic)' >White (non-Hispanic)<\/option><option value='More than one of the above' >More than one of the above<\/option><option value='Other...' >Other...<\/option><\/select><\/div><\/div><div id=\"field_94_134\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_94_134'><span class='gform-field-label__text'>How would you describe your race\/ethnicity?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_134' id='input_94_134' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_94_59\" class=\"gfield gfield--type-select gfield--input-type-select optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_94_59'><span class='gform-field-label__text'>Household Income<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_59' id='input_94_59' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Less than $20,000' >Less than $20,000<\/option><option value='$20,000 - $39,999' >$20,000 - $39,999<\/option><option value='$40,000 - $59,999' >$40,000 - $59,999<\/option><option value='$60,000 - $79,999' >$60,000 - $79,999<\/option><option value='$80,000 - $99,999' >$80,000 - $99,999<\/option><option value='$100,000 - $149,999' >$100,000 - $149,999<\/option><option value='$150,000+' >$150,000+<\/option><\/select><\/div><\/div><fieldset id=\"field_94_87\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you live in the United States or another country?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_94_87'>\n\t\t\t<div class='gchoice gchoice_94_87_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_87' type='radio' value='I live in the United States'  id='choice_94_87_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_87_0' id='label_94_87_0' class='gform-field-label gform-field-label--type-inline'>I live in the United States<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_94_87_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_87' type='radio' value='I live in another country'  id='choice_94_87_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_94_87_1' id='label_94_87_1' class='gform-field-label gform-field-label--type-inline'>I live in another country<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_94_78\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_94_78'><span class='gform-field-label__text'>State<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_78' id='input_94_78' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='I live in a U.S. Territory' >I live in a U.S. Territory<\/option><\/select><\/div><\/div><div id=\"field_94_80\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_94_80'><span class='gform-field-label__text'>What country do you live in?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_80' id='input_94_80' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cape Verde' >Cape Verde<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Congo, Republic of the' >Congo, Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czech Republic' >Czech Republic<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini (Swaziland)' >Eswatini (Swaziland)<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard and McDonald Islands' >Heard and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macau' >Macau<\/option><option value='Macedonia' >Macedonia<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Korea' >North Korea<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russia' >Russia<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena' >Saint Helena<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia' >South Georgia<\/option><option value='South Korea' >South Korea<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen Islands' >Svalbard and Jan Mayen Islands<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria' >Syria<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania' >Tanzania<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkey' >Turkey<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' >United Kingdom<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Vietnam' >Vietnam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option><\/select><\/div><\/div><fieldset id=\"field_94_109\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Do you live with any of the following disabilities or conditions?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_94_109'>Select all that apply.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_94_109'><div class='gchoice gchoice_94_109_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.1' type='checkbox'  value='Blind\/Low vision'  id='choice_94_109_1'   aria-describedby=\"gfield_description_94_109\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_94_109_1' id='label_94_109_1' class='gform-field-label gform-field-label--type-inline'>Blind\/Low vision<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_109_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.2' type='checkbox'  value='Hearing impairment'  id='choice_94_109_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_109_2' id='label_94_109_2' class='gform-field-label gform-field-label--type-inline'>Hearing impairment<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_109_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.3' type='checkbox'  value='Limited Mobility'  id='choice_94_109_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_109_3' id='label_94_109_3' class='gform-field-label gform-field-label--type-inline'>Limited Mobility<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_109_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.4' type='checkbox'  value='Arthritis or other chronic pain'  id='choice_94_109_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_109_4' id='label_94_109_4' class='gform-field-label gform-field-label--type-inline'>Arthritis or other chronic pain<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_109_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.5' type='checkbox'  value='Anxiety'  id='choice_94_109_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_109_5' id='label_94_109_5' class='gform-field-label gform-field-label--type-inline'>Anxiety<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_109_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.6' type='checkbox'  value='Mood conditions: depression or bipolar'  id='choice_94_109_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_109_6' id='label_94_109_6' class='gform-field-label gform-field-label--type-inline'>Mood conditions: depression or bipolar<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_109_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.7' type='checkbox'  value='Autism spectrum and\/or ADHD'  id='choice_94_109_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_109_7' id='label_94_109_7' class='gform-field-label gform-field-label--type-inline'>Autism spectrum and\/or ADHD<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_94_109_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.8' type='checkbox'  value='Intellectual or learning disability'  id='choice_94_109_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_94_109_8' id='label_94_109_8' class='gform-field-label 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No es un test de salud mental.<\/p>","protected":false},"template":"","tags":[],"age_group":[],"condition":[],"class_list":["post-259548","screen","type-screen","status-publish","hentry"],"acf":[],"yoast_head":"<title>AI &amp; Mental Health Survey - Theresa sandbox &#8211; Mental Health America<\/title>\n<meta name=\"description\" content=\"This survey was developed to help us explore your opinions about artificial intelligence (AI) and mental health.\" \/>\n<meta name=\"robots\" content=\"noindex, nofollow\" \/>\n<meta property=\"og:locale\" content=\"es_MX\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"AI &amp; Mental Health Survey - Theresa sandbox &#8211; Mental Health America\" \/>\n<meta property=\"og:description\" content=\"This survey was developed to help us explore your opinions about artificial intelligence (AI) and mental health.\" \/>\n<meta property=\"og:url\" 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&#038; Schizophrenia Test (staging)"},"content":{"rendered":"<div class='gf_browser_chrome gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_9' style='display:none'>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Test de psicosis<\/h2>\n                            <p class='gform_description'><\/p>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>\"<span class=\"gfield_required gfield_required_asterisk\">*<\/span>\"indica campos obligatorios<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_9'  class='clearfix' action='\/es\/wp-json\/wp\/v2\/screen' data-formid='9' novalidate data-trp-original-action=\"\/es\/wp-json\/wp\/v2\/screen\"><ol class=\"screen-progress-bar clearfix step-1-of-3\">\n\t\t\t\t\t<li class=\"step-1 translation-block\"><span>Preguntas<br>del Test<\/span><\/li>\n\t\t\t\t\t<li class=\"step-2 translation-block\"><span>Preguntas<br>Opcionales<\/span><\/li>\n\t\t\t\t\t<li class=\"step-3 translation-block\"><span>Tus<br>Resultados<\/span><\/li>\n\t\t\t\t<\/ol>\n                        <div class='gform-body gform_body'><div id='gform_page_9_1' class='gform_page' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_9' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_9_157\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_157'><span class='gform-field-label__text'>Facebook<\/span><\/label><div class='gfield_description' id='gfield_description_9_157'>Este campo es para fines de validaci\u00f3n y no debe modificarse.<\/div><div class='ginput_container'><input name='input_157' id='input_9_157' type='text' value='' autocomplete='new-password'\/><\/div><\/div><div id=\"field_9_38\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_38' id='input_9_38' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_9_39\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><input name=\"input_39\" id=\"input_9_39\" type=\"hidden\" class=\"gform_hidden\" aria-invalid=\"false\" value=\"256835\"><\/div><div id=\"field_9_40\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><input name=\"input_40\" id=\"input_9_40\" type=\"hidden\" class=\"gform_hidden\" aria-invalid=\"false\" value=\"e875158b42d4e2ab407c8e264f11f752\"><\/div><div id=\"field_9_41\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_41' id='input_9_41' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_9_89\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_89' id='input_9_89' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='http:\/\/screening.mhanational.org' \/><\/div><\/div><div id=\"field_9_119\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_119' id='input_9_119' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_9_120\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_120' id='input_9_120' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_9_121\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_121' id='input_9_121' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_9_133\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_133' id='input_9_133' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_9_134\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_134' id='input_9_134' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='https:\/\/screening.mhanational.org\/es\/wp-json\/wp\/v2\/screen' \/><\/div><\/div><div id=\"field_9_156\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_156' id='input_9_156' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='lang--es' \/><\/div><\/div><div id=\"field_9_4\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p>\u00bfHas tenido recientemente los siguientes pensamientos, sensaciones o experiencias? Marque \u201cs\u00ed\u201d o \u201cno\u201d para pregunta.<\/p>\n\n<p>No incluyas experiencias que solo ocurran bajo la influencia del alcohol, las drogas o los medicamentos que no te hayan sido recetados.<\/p>\n\n<p>Si respondes \u201cS\u00cd\u201d a alguna pregunta, indica tambi\u00e9n qu\u00e9 malestar te ha producido dicha experiencia.<\/p>\n\n<p>Ten en cuenta: todos los campos son obligatorios.<\/p><\/div><div id=\"field_9_145\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2 class=\"section-title\">En los \u00faltimos 3 meses...<\/h2><\/div><fieldset id=\"field_9_135\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'><strong>En los \u00faltimos tres meses<\/strong>, \u00bfAlguna vez has escuchado la voz de alguien hablando que otras personas no pueden o\u00edr?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_135'>\n\t\t\t<div class='gchoice gchoice_9_135_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_135' type='radio' value='Yes'  id='choice_9_135_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_135_0' id='label_9_135_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_135_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_135' type='radio' value='No'  id='choice_9_135_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_135_1' id='label_9_135_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_136\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'><strong>En los \u00faltimos tres meses<\/strong>, \u00bfAlguna vez has sentido que alguien estaba jugando con tu mente?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_136'>\n\t\t\t<div class='gchoice gchoice_9_136_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_136' type='radio' value='Yes'  id='choice_9_136_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_136_0' id='label_9_136_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_136_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_136' type='radio' value='No'  id='choice_9_136_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_136_1' id='label_9_136_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_137\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'><strong>En los \u00faltimos tres meses<\/strong>, \u00bfAlguna vez te ha parecido irreal un entorno que te resulta familiar?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_137'>\n\t\t\t<div class='gchoice gchoice_9_137_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_137' type='radio' value='Yes'  id='choice_9_137_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_137_0' id='label_9_137_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_137_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_137' type='radio' value='No'  id='choice_9_137_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_137_1' id='label_9_137_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_138\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'><strong>En los \u00faltimos tres meses<\/strong>, \u00bfHas visto cosas que otras personas no pueden ver o parecen no ver?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_138'>\n\t\t\t<div class='gchoice gchoice_9_138_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_138' type='radio' value='Yes'  id='choice_9_138_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_138_0' id='label_9_138_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_138_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_138' type='radio' value='No'  id='choice_9_138_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_138_1' id='label_9_138_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_143\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2 class=\"section-title\">En el \u00faltimo mes...<\/h2><\/div><fieldset id=\"field_9_47\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>1. \u00bfLos ambientes conocidos te parecen a veces extra\u00f1os, confusos, amenazantes o irreales?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_47'>\n\t\t\t<div class='gchoice gchoice_9_47_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_47' type='radio' value='No'  id='choice_9_47_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_47_0' id='label_9_47_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_47_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_47' type='radio' value='Yes'  id='choice_9_47_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_47_1' id='label_9_47_1' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_48\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Si contestaste S\u00cd: Cuando esto sucede, me siento asustado\/a, preocupado\/a o me causa problemas (P1):<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_48'>\n\t\t\t<div class='gchoice gchoice_9_48_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_48' type='radio' value='1'  id='choice_9_48_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_48_0' id='label_9_48_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_48_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_48' type='radio' value='2'  id='choice_9_48_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_48_1' id='label_9_48_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_48_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_48' type='radio' value='3'  id='choice_9_48_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_48_2' id='label_9_48_2' class='gform-field-label gform-field-label--type-inline'>Neutral<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_48_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_48' type='radio' value='4'  id='choice_9_48_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_48_3' id='label_9_48_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_48_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_48' type='radio' value='5'  id='choice_9_48_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_48_4' id='label_9_48_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_49\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>2. \u00bfAlguna vez has percibido sonidos inusuales como golpes, chasquidos, silbidos, aplausos o timbres en tus o\u00eddos?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_49'>\n\t\t\t<div class='gchoice gchoice_9_49_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='No'  id='choice_9_49_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_49_0' id='label_9_49_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_49_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='Yes'  id='choice_9_49_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_49_1' id='label_9_49_1' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_50\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Si contestaste S\u00cd: Cuando esto sucede, me siento asustado\/a, preocupado\/a o me causa problemas (P2):<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_50'>\n\t\t\t<div class='gchoice gchoice_9_50_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='1'  id='choice_9_50_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_50_0' id='label_9_50_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_50_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='2'  id='choice_9_50_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_50_1' id='label_9_50_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_50_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='3'  id='choice_9_50_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_50_2' id='label_9_50_2' class='gform-field-label gform-field-label--type-inline'>Neutral<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_50_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='4'  id='choice_9_50_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_50_3' id='label_9_50_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_50_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='5'  id='choice_9_50_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_50_4' id='label_9_50_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_51\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>3. \u00bfLas cosas que ves te parecen diferentes a como normalmente son?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_51'>\n\t\t\t<div class='gchoice gchoice_9_51_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_51' type='radio' value='No'  id='choice_9_51_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_51_0' id='label_9_51_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_51_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_51' type='radio' value='Yes'  id='choice_9_51_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_51_1' id='label_9_51_1' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_52\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Si contestaste S\u00cd: Cuando esto sucede, me siento asustado\/a, preocupado\/a o me causa problemas (P3):<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_52'>\n\t\t\t<div class='gchoice gchoice_9_52_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_52' type='radio' value='1'  id='choice_9_52_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_52_0' id='label_9_52_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_52_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_52' type='radio' value='2'  id='choice_9_52_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_52_1' id='label_9_52_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_52_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_52' type='radio' value='3'  id='choice_9_52_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_52_2' id='label_9_52_2' class='gform-field-label gform-field-label--type-inline'>Neutral<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_52_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_52' type='radio' value='4'  id='choice_9_52_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_52_3' id='label_9_52_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_52_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_52' type='radio' value='5'  id='choice_9_52_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_52_4' id='label_9_52_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_55\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>4. \u00bfHas tenido experiencias de telepat\u00eda, poderes de vidente o de adivino?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_55'>\n\t\t\t<div class='gchoice gchoice_9_55_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='No'  id='choice_9_55_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_55_0' id='label_9_55_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_55_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='Yes'  id='choice_9_55_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_55_1' id='label_9_55_1' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_54\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Si contestaste S\u00cd: Cuando esto sucede, me siento asustado\/a, preocupado\/a o me causa problemas (P4):<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_54'>\n\t\t\t<div class='gchoice gchoice_9_54_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_54' type='radio' value='1'  id='choice_9_54_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_54_0' id='label_9_54_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_54_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_54' type='radio' value='2'  id='choice_9_54_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_54_1' id='label_9_54_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_54_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_54' type='radio' value='3'  id='choice_9_54_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_54_2' id='label_9_54_2' class='gform-field-label gform-field-label--type-inline'>Neutral<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_54_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_54' type='radio' value='4'  id='choice_9_54_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_54_3' id='label_9_54_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_54_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_54' type='radio' value='5'  id='choice_9_54_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_54_4' id='label_9_54_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_53\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>5. \u00bfAlguna vez te has sentido como si no tuvieras control de tus propias ideas o pensamientos?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_53'>\n\t\t\t<div class='gchoice gchoice_9_53_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_53' type='radio' value='No'  id='choice_9_53_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_53_0' id='label_9_53_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_53_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_53' type='radio' value='Yes'  id='choice_9_53_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_53_1' id='label_9_53_1' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_56\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Si contestaste S\u00cd: Cuando esto sucede, me siento asustado\/a, preocupado\/a o me causa problemas (P5):<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_56'>\n\t\t\t<div class='gchoice gchoice_9_56_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_56' type='radio' value='1'  id='choice_9_56_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_56_0' id='label_9_56_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_56_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_56' type='radio' value='2'  id='choice_9_56_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_56_1' id='label_9_56_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_56_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_56' type='radio' value='3'  id='choice_9_56_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_56_2' id='label_9_56_2' class='gform-field-label gform-field-label--type-inline'>Neutral<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_56_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_56' type='radio' value='4'  id='choice_9_56_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_56_3' id='label_9_56_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_56_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_56' type='radio' value='5'  id='choice_9_56_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_56_4' id='label_9_56_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_57\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>6. \u00bfTienes dificultad para seguir tu propio tema, debido a que divagas o pierdes\nmucho la pista cuando hablas?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_57'>\n\t\t\t<div class='gchoice gchoice_9_57_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_57' type='radio' value='No'  id='choice_9_57_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_57_0' id='label_9_57_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_57_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_57' type='radio' value='Yes'  id='choice_9_57_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_57_1' id='label_9_57_1' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_58\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Si contestaste S\u00cd: Cuando esto sucede, me siento asustado\/a, preocupado\/a o me causa problemas (P6):<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_58'>\n\t\t\t<div class='gchoice gchoice_9_58_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_58' type='radio' value='1'  id='choice_9_58_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_58_0' id='label_9_58_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_58_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_58' type='radio' value='2'  id='choice_9_58_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_58_1' id='label_9_58_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_58_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_58' type='radio' value='3'  id='choice_9_58_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_58_2' id='label_9_58_2' class='gform-field-label gform-field-label--type-inline'>Neutral<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_58_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_58' type='radio' value='4'  id='choice_9_58_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_58_3' id='label_9_58_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_58_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_58' type='radio' value='5'  id='choice_9_58_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_58_4' id='label_9_58_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_59\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>7. \u00bfTienes la fuerte sensaci\u00f3n o la creencia de que posees alguna clase de dones o\ntalentos inusuales?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_59'>\n\t\t\t<div class='gchoice gchoice_9_59_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_59' type='radio' value='No'  id='choice_9_59_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_59_0' id='label_9_59_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_59_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_59' type='radio' value='Yes'  id='choice_9_59_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_59_1' id='label_9_59_1' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_60\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Si contestaste S\u00cd: Cuando esto sucede, me siento asustado\/a, preocupado\/a o me causa problemas (P7):<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_60'>\n\t\t\t<div class='gchoice gchoice_9_60_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_60' type='radio' value='1'  id='choice_9_60_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_60_0' id='label_9_60_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_60_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_60' type='radio' value='2'  id='choice_9_60_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_60_1' id='label_9_60_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_60_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_60' type='radio' value='3'  id='choice_9_60_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_60_2' id='label_9_60_2' class='gform-field-label gform-field-label--type-inline'>Neutral<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_60_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_60' type='radio' value='4'  id='choice_9_60_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_60_3' id='label_9_60_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_60_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_60' type='radio' value='5'  id='choice_9_60_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_60_4' id='label_9_60_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_61\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>8. \u00bfTienes la sensaci\u00f3n de que otras personas te observan o hablan de ti?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_61'>\n\t\t\t<div class='gchoice gchoice_9_61_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_61' type='radio' value='No'  id='choice_9_61_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_61_0' id='label_9_61_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_61_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_61' type='radio' value='Yes'  id='choice_9_61_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_61_1' id='label_9_61_1' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_62\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Si contestaste S\u00cd: Cuando esto sucede, me siento asustado\/a, preocupado\/a o me causa problemas (P8):<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_62'>\n\t\t\t<div class='gchoice gchoice_9_62_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_62' type='radio' value='1'  id='choice_9_62_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_62_0' id='label_9_62_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_62_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_62' type='radio' value='2'  id='choice_9_62_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_62_1' id='label_9_62_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_62_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_62' type='radio' value='3'  id='choice_9_62_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_62_2' id='label_9_62_2' class='gform-field-label gform-field-label--type-inline'>Neutral<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_62_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_62' type='radio' value='4'  id='choice_9_62_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_62_3' id='label_9_62_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_62_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_62' type='radio' value='5'  id='choice_9_62_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_62_4' id='label_9_62_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_63\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>9. \u00bfNotas a veces extra\u00f1as sensaciones en la piel o debajo de ella, como bichos reptando?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_63'>\n\t\t\t<div class='gchoice gchoice_9_63_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_63' type='radio' value='No'  id='choice_9_63_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_63_0' id='label_9_63_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_63_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_63' type='radio' value='Yes'  id='choice_9_63_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_63_1' id='label_9_63_1' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_64\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Si contestaste S\u00cd: Cuando esto sucede, me siento asustado\/a, preocupado\/a o me causa problemas (P9):<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_64'>\n\t\t\t<div class='gchoice gchoice_9_64_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_64' type='radio' value='1'  id='choice_9_64_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_64_0' id='label_9_64_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_64_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_64' type='radio' value='2'  id='choice_9_64_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_64_1' id='label_9_64_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_64_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_64' type='radio' value='3'  id='choice_9_64_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_64_2' id='label_9_64_2' class='gform-field-label gform-field-label--type-inline'>Neutral<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_64_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_64' type='radio' value='4'  id='choice_9_64_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_64_3' id='label_9_64_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_64_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_64' type='radio' value='5'  id='choice_9_64_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_64_4' id='label_9_64_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_65\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>10. \u00bfTe sientes a veces rependinamente distra\u00eddo\/a por sonidos distantes de los que normalmente no te das cuenta?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_65'>\n\t\t\t<div class='gchoice gchoice_9_65_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_65' type='radio' value='No'  id='choice_9_65_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_65_0' id='label_9_65_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_65_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_65' type='radio' value='Yes'  id='choice_9_65_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_65_1' id='label_9_65_1' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_66\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Si contestaste S\u00cd: Cuando esto sucede, me siento asustado\/a, preocupado\/a o me causa problemas (P10):<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_66'>\n\t\t\t<div class='gchoice gchoice_9_66_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_66' type='radio' value='1'  id='choice_9_66_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_66_0' id='label_9_66_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_66_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_66' type='radio' value='2'  id='choice_9_66_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_66_1' id='label_9_66_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_66_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_66' type='radio' value='3'  id='choice_9_66_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_66_2' id='label_9_66_2' class='gform-field-label gform-field-label--type-inline'>Neutral<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_66_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_66' type='radio' value='4'  id='choice_9_66_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_66_3' id='label_9_66_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_66_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_66' type='radio' value='5'  id='choice_9_66_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_66_4' id='label_9_66_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_67\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>11. \u00bfAlguna vez has tenido la sensaci\u00f3n de que hab\u00eda alguna persona o fuerza a tu alrededor, aunque no pod\u00edas ver a nadie?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_67'>\n\t\t\t<div class='gchoice gchoice_9_67_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_67' type='radio' value='No'  id='choice_9_67_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_67_0' id='label_9_67_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_67_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_67' type='radio' value='Yes'  id='choice_9_67_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_67_1' id='label_9_67_1' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_68\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Si contestaste S\u00cd: Cuando esto sucede, me siento asustado\/a, preocupado\/a o me causa problemas (P11):<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_68'>\n\t\t\t<div class='gchoice gchoice_9_68_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_68' type='radio' value='1'  id='choice_9_68_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_68_0' id='label_9_68_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_68_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_68' type='radio' value='2'  id='choice_9_68_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_68_1' id='label_9_68_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_68_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_68' type='radio' value='3'  id='choice_9_68_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_68_2' id='label_9_68_2' class='gform-field-label gform-field-label--type-inline'>Neutral<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_68_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_68' type='radio' value='4'  id='choice_9_68_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_68_3' id='label_9_68_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_68_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_68' type='radio' value='5'  id='choice_9_68_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_68_4' id='label_9_68_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_69\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>12. \u00bfTe preocupa a veces que algo pueda ir mal en tu mente?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_69'>\n\t\t\t<div class='gchoice gchoice_9_69_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='No'  id='choice_9_69_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_69_0' id='label_9_69_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_69_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='Yes'  id='choice_9_69_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_69_1' id='label_9_69_1' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_70\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Si contestaste S\u00cd: Cuando esto sucede, me siento asustado\/a, preocupado\/a o me causa problemas (P12):<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_70'>\n\t\t\t<div class='gchoice gchoice_9_70_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_70' type='radio' value='1'  id='choice_9_70_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_70_0' id='label_9_70_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_70_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_70' type='radio' value='2'  id='choice_9_70_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_70_1' id='label_9_70_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_70_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_70' type='radio' value='3'  id='choice_9_70_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_70_2' id='label_9_70_2' class='gform-field-label gform-field-label--type-inline'>Neutral<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_70_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_70' type='radio' value='4'  id='choice_9_70_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_70_3' id='label_9_70_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_70_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_70' type='radio' value='5'  id='choice_9_70_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_70_4' id='label_9_70_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_71\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>13. \u00bfHas sentido alguna vez que no exist\u00eda, que el mundo no exist\u00eda o que estabas muerto?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_71'>\n\t\t\t<div class='gchoice gchoice_9_71_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_71' type='radio' value='No'  id='choice_9_71_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_71_0' id='label_9_71_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_71_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_71' type='radio' value='Yes'  id='choice_9_71_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_71_1' id='label_9_71_1' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_72\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Si contestaste S\u00cd: Cuando esto sucede, me siento asustado\/a, preocupado\/a o me causa problemas (P13):<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_72'>\n\t\t\t<div class='gchoice gchoice_9_72_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='1'  id='choice_9_72_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_72_0' id='label_9_72_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_72_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='2'  id='choice_9_72_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_72_1' id='label_9_72_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_72_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='3'  id='choice_9_72_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_72_2' id='label_9_72_2' class='gform-field-label gform-field-label--type-inline'>Neutral<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_72_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='4'  id='choice_9_72_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_72_3' id='label_9_72_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_72_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='5'  id='choice_9_72_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_72_4' id='label_9_72_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_73\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>14. \u00bfTe has sentido a veces confuso\/a sobre si algo de lo que te pasaba era real o imaginario?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_73'>\n\t\t\t<div class='gchoice gchoice_9_73_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_73' type='radio' value='No'  id='choice_9_73_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_73_0' id='label_9_73_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_73_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_73' type='radio' value='Yes'  id='choice_9_73_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_73_1' id='label_9_73_1' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_74\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Si contestaste S\u00cd: Cuando esto sucede, me siento asustado\/a, preocupado\/a o me causa problemas (P14):<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_74'>\n\t\t\t<div class='gchoice gchoice_9_74_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_74' type='radio' value='1'  id='choice_9_74_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_74_0' id='label_9_74_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_74_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_74' type='radio' value='2'  id='choice_9_74_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_74_1' id='label_9_74_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_74_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_74' type='radio' value='3'  id='choice_9_74_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_74_2' id='label_9_74_2' class='gform-field-label gform-field-label--type-inline'>Neutral<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_74_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_74' type='radio' value='4'  id='choice_9_74_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_74_3' id='label_9_74_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_74_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_74' type='radio' value='5'  id='choice_9_74_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_74_4' id='label_9_74_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_75\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>15. \u00bfTienes creencias que a otras personas les parecer\u00edan extra\u00f1as o inusuales?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_75'>\n\t\t\t<div class='gchoice gchoice_9_75_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_75' type='radio' value='No'  id='choice_9_75_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_75_0' id='label_9_75_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_75_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_75' type='radio' value='Yes'  id='choice_9_75_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_75_1' id='label_9_75_1' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_76\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Si contestaste S\u00cd: Cuando esto sucede, me siento asustado\/a, preocupado\/a o me causa problemas (P15):<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_76'>\n\t\t\t<div class='gchoice gchoice_9_76_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_76' type='radio' value='1'  id='choice_9_76_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_76_0' id='label_9_76_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_76_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_76' type='radio' value='2'  id='choice_9_76_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_76_1' id='label_9_76_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_76_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_76' type='radio' value='3'  id='choice_9_76_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_76_2' id='label_9_76_2' class='gform-field-label gform-field-label--type-inline'>Neutral<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_76_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_76' type='radio' value='4'  id='choice_9_76_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_76_3' id='label_9_76_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_76_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_76' type='radio' value='5'  id='choice_9_76_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_76_4' id='label_9_76_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_77\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>16. \u00bfSientes que partes de tu cuerpo han cambiado de alguna manera, o que partes de tu cuerpo est\u00e1n funcionando de manera diferente?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_77'>\n\t\t\t<div class='gchoice gchoice_9_77_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_77' type='radio' value='No'  id='choice_9_77_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_77_0' id='label_9_77_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_77_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_77' type='radio' value='Yes'  id='choice_9_77_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_77_1' id='label_9_77_1' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_78\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Si contestaste S\u00cd: Cuando esto sucede, me siento asustado\/a, preocupado\/a o me causa problemas (P16):<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_78'>\n\t\t\t<div class='gchoice gchoice_9_78_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_78' type='radio' value='1'  id='choice_9_78_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_78_0' id='label_9_78_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_78_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_78' type='radio' value='2'  id='choice_9_78_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_78_1' id='label_9_78_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_78_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_78' type='radio' value='3'  id='choice_9_78_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_78_2' id='label_9_78_2' class='gform-field-label gform-field-label--type-inline'>Neutral<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_78_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_78' type='radio' value='4'  id='choice_9_78_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_78_3' id='label_9_78_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_78_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_78' type='radio' value='5'  id='choice_9_78_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_78_4' id='label_9_78_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_79\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>17. \u00bfTus pensamientos son a veces tan intensos que casi puedes o\u00edrlos?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_79'>\n\t\t\t<div class='gchoice gchoice_9_79_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_79' type='radio' value='No'  id='choice_9_79_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_79_0' id='label_9_79_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_79_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_79' type='radio' value='Yes'  id='choice_9_79_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_79_1' id='label_9_79_1' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_80\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Si contestaste S\u00cd: Cuando esto sucede, me siento asustado\/a, preocupado\/a o me causa problemas (P17):<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_80'>\n\t\t\t<div class='gchoice gchoice_9_80_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_80' type='radio' value='1'  id='choice_9_80_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_80_0' id='label_9_80_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_80_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_80' type='radio' value='2'  id='choice_9_80_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_80_1' id='label_9_80_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_80_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_80' type='radio' value='3'  id='choice_9_80_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_80_2' id='label_9_80_2' class='gform-field-label gform-field-label--type-inline'>Neutral<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_80_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_80' type='radio' value='4'  id='choice_9_80_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_80_3' id='label_9_80_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_80_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_80' type='radio' value='5'  id='choice_9_80_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_80_4' id='label_9_80_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_81\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>18. \u00bfExperimentas sentimientos de recelo y desconfianza hacia otras personas?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_81'>\n\t\t\t<div class='gchoice gchoice_9_81_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_81' type='radio' value='No'  id='choice_9_81_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_81_0' id='label_9_81_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_81_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_81' type='radio' value='Yes'  id='choice_9_81_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_81_1' id='label_9_81_1' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_82\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Si contestaste S\u00cd: Cuando esto sucede, me siento asustado\/a, preocupado\/a o me causa problemas (P18):<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_82'>\n\t\t\t<div class='gchoice gchoice_9_82_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_82' type='radio' value='1'  id='choice_9_82_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_82_0' id='label_9_82_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_82_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_82' type='radio' value='2'  id='choice_9_82_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_82_1' id='label_9_82_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_82_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_82' type='radio' value='3'  id='choice_9_82_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_82_2' id='label_9_82_2' class='gform-field-label gform-field-label--type-inline'>Neutral<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_82_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_82' type='radio' value='4'  id='choice_9_82_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_82_3' id='label_9_82_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_82_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_82' type='radio' value='5'  id='choice_9_82_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_82_4' id='label_9_82_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_83\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>19. \u00bfAlguna vez has visto cosas inusuales como destellos, llamas, luces deslumbrantes, o figuras geom\u00e9tricas?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_83'>\n\t\t\t<div class='gchoice gchoice_9_83_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_83' type='radio' value='No'  id='choice_9_83_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_83_0' id='label_9_83_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_83_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_83' type='radio' value='Yes'  id='choice_9_83_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_83_1' id='label_9_83_1' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_84\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Si contestaste S\u00cd: Cuando esto sucede, me siento asustado\/a, preocupado\/a o me causa problemas (P19):<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_84'>\n\t\t\t<div class='gchoice gchoice_9_84_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_84' type='radio' value='1'  id='choice_9_84_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_84_0' id='label_9_84_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_84_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_84' type='radio' value='2'  id='choice_9_84_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_84_1' id='label_9_84_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_84_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_84' type='radio' value='3'  id='choice_9_84_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_84_2' id='label_9_84_2' class='gform-field-label gform-field-label--type-inline'>Neutral<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_84_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_84' type='radio' value='4'  id='choice_9_84_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_84_3' id='label_9_84_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_84_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_84' type='radio' value='5'  id='choice_9_84_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_84_4' id='label_9_84_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_85\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>20. \u00bfAlguna vez has visto cosas que otras personas no pueden ver o no parecen ver?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_85'>\n\t\t\t<div class='gchoice gchoice_9_85_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_85' type='radio' value='No'  id='choice_9_85_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_85_0' id='label_9_85_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_85_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_85' type='radio' value='Yes'  id='choice_9_85_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_85_1' id='label_9_85_1' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_86\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Si contestaste S\u00cd: Cuando esto sucede, me siento asustado\/a, preocupado\/a o me causa problemas (P20):<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_86'>\n\t\t\t<div class='gchoice gchoice_9_86_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_86' type='radio' value='1'  id='choice_9_86_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_86_0' id='label_9_86_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_86_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_86' type='radio' value='2'  id='choice_9_86_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_86_1' id='label_9_86_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_86_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_86' type='radio' value='3'  id='choice_9_86_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_86_2' id='label_9_86_2' class='gform-field-label gform-field-label--type-inline'>Neutral<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_86_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_86' type='radio' value='4'  id='choice_9_86_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_86_3' id='label_9_86_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_86_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_86' type='radio' value='5'  id='choice_9_86_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_86_4' id='label_9_86_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_87\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>21. \u00bfA veces a la gente le cuesta entender lo que est\u00e1s diciendo?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_87'>\n\t\t\t<div class='gchoice gchoice_9_87_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_87' type='radio' value='No'  id='choice_9_87_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_87_0' id='label_9_87_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_87_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_87' type='radio' value='Yes'  id='choice_9_87_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_87_1' id='label_9_87_1' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_88\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Si contestaste S\u00cd: Cuando esto sucede, me siento asustado\/a, preocupado\/a o me causa problemas (P21):<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_88'>\n\t\t\t<div class='gchoice gchoice_9_88_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_88' type='radio' value='1'  id='choice_9_88_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_88_0' id='label_9_88_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_88_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_88' type='radio' value='2'  id='choice_9_88_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_88_1' id='label_9_88_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_88_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_88' type='radio' value='3'  id='choice_9_88_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_88_2' id='label_9_88_2' class='gform-field-label gform-field-label--type-inline'>Neutral<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_88_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_88' type='radio' value='4'  id='choice_9_88_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_88_3' id='label_9_88_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_88_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_88' type='radio' value='5'  id='choice_9_88_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_88_4' id='label_9_88_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_144\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2 class=\"section-title\">En los \u00faltimos 3 meses...<\/h2><\/div><fieldset id=\"field_9_139\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'><strong>En los \u00faltimos tres meses<\/strong>, \u00bfAlguna vez has escuchado la voz de alguien hablando que otras personas no pueden o\u00edr?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_139'>\n\t\t\t<div class='gchoice gchoice_9_139_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_139' type='radio' value='Yes'  id='choice_9_139_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_139_0' id='label_9_139_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_139_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_139' type='radio' value='No'  id='choice_9_139_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_139_1' id='label_9_139_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_140\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'><strong>En los \u00faltimos tres meses<\/strong>, \u00bfAlguna vez has sentido que alguien estaba jugando con tu mente?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_140'>\n\t\t\t<div class='gchoice gchoice_9_140_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_140' type='radio' value='Yes'  id='choice_9_140_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_140_0' id='label_9_140_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_140_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_140' type='radio' value='No'  id='choice_9_140_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_140_1' id='label_9_140_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_141\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'><strong>En los \u00faltimos tres meses<\/strong>, \u00bfAlguna vez te ha parecido irreal un entorno que te resulta familiar?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_141'>\n\t\t\t<div class='gchoice gchoice_9_141_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_141' type='radio' value='Yes'  id='choice_9_141_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_141_0' id='label_9_141_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_141_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_141' type='radio' value='No'  id='choice_9_141_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_141_1' id='label_9_141_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_142\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'><strong>En los \u00faltimos tres meses<\/strong>, \u00bfHas visto cosas que otras personas no pueden ver o parecen no ver?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_142'>\n\t\t\t<div class='gchoice gchoice_9_142_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_142' type='radio' value='Yes'  id='choice_9_142_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_142_0' id='label_9_142_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_142_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_142' type='radio' value='No'  id='choice_9_142_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_142_1' id='label_9_142_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <button type='button' id='gform_next_button_9_17' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Siguiente<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_2' class='gform_page demographics' data-js='page-field-id-17' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_2' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_9_90\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p class=\"translation-block\">Por favor, toma un momento para responder a las siguientes preguntas <strong>opcionales<\/strong>. Tus respuestas son totalmente an\u00f3nimas: no podremos identificarte a partir de esta informaci\u00f3n. Tus respuestas nos ayudan a proporcionar mejor informaci\u00f3n y apoyo a personas como t\u00fa.<\/p>\n\n<p>Puedes responder a tantas preguntas como desees. Cuando hayas terminado, despl\u00e1zate hasta la parte inferior de la encuesta y haz clic en \"ver resultados\" para recibir los resultados de la evaluaci\u00f3n.<\/p><\/div><div id=\"field_9_122\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><hr \/><\/div><fieldset id=\"field_9_146\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfCrees que necesitas hacer algo para mejorar tu salud emocional o mental?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_146'>\n\t\t\t<div class='gchoice gchoice_9_146_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_146' type='radio' value='Yes'  id='choice_9_146_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_146_0' id='label_9_146_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_146_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_146' type='radio' value='No'  id='choice_9_146_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_146_1' id='label_9_146_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_146_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_146' type='radio' value='I&#039;m not sure'  id='choice_9_146_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_146_2' id='label_9_146_2' class='gform-field-label gform-field-label--type-inline'>No estoy seguro.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_147\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-3 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfQu\u00e9 pasos te interesar\u00eda m\u00e1s dar en el pr\u00f3ximo mes para sentirte mejor?<\/span><\/legend><div class='gfield_description' id='gfield_description_9_147'>Selecciona hasta 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_9_147'><div class='gchoice gchoice_9_147_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_147.1' type='checkbox'  value='Learn more about my mental health (material to read or watch)'  id='choice_9_147_1'   aria-describedby=\"gfield_description_9_147\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_9_147_1' id='label_9_147_1' class='gform-field-label gform-field-label--type-inline'>Aprender m\u00e1s sobre mi salud mental (material para leer o ver)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_147_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_147.2' type='checkbox'  value='Share how I&#039;m feeling with someone in my life (friend or relative)'  id='choice_9_147_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_147_2' id='label_9_147_2' class='gform-field-label gform-field-label--type-inline'>Compartir c\u00f3mo me siento con alguien cercano (amigo o familiar)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_147_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_147.3' type='checkbox'  value='Talk to someone who&#039;s been through a similar experience (peer supporter or mentor)'  id='choice_9_147_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_147_3' id='label_9_147_3' class='gform-field-label gform-field-label--type-inline'>Hablar con alguien que haya pasado por una experiencia similar (un compa\u00f1ero de apoyo o un mentor)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_147_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_147.4' type='checkbox'  value='Learn about therapy or treatment options'  id='choice_9_147_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_147_4' id='label_9_147_4' class='gform-field-label gform-field-label--type-inline'>Informarme sobre las opciones de ter\u00e1pia o tratamiento.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_147_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_147.5' type='checkbox'  value='Obtain a diagnosis\/understand what I\u2019ve been experiencing'  id='choice_9_147_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_147_5' id='label_9_147_5' class='gform-field-label gform-field-label--type-inline'>Obtener un diagn\u00f3stico\/entender lo que he estado experimentando.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_147_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_147.6' type='checkbox'  value='Learn and practice skills to manage mental health on my own'  id='choice_9_147_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_147_6' id='label_9_147_6' class='gform-field-label gform-field-label--type-inline'>Aprender y practicar habilidades para manejar mi salud mental por mi cuenta.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_147_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_147.7' type='checkbox'  value='None'  id='choice_9_147_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_147_7' id='label_9_147_7' class='gform-field-label gform-field-label--type-inline'>Ninguno<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_147_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_147.8' type='checkbox'  value='Other...'  id='choice_9_147_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_147_8' id='label_9_147_8' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_148\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_148'><span class='gform-field-label__text'><strong>\u00bfQu\u00e9 otros pasos<\/strong> te interesar\u00edan dar en el pr\u00f3ximo mes para sentirte mejor?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_148' id='input_9_148' type='text' value='' class='large'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_154\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-3 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfQu\u00e9 te podr\u00eda prevenir de dar estos pasos si lo quisieras hacer?<\/span><\/legend><div class='gfield_description' id='gfield_description_9_154'>Selecciona hasta 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_9_154'><div class='gchoice gchoice_9_154_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_154.1' type='checkbox'  value='I am concerned about what others might think about me'  id='choice_9_154_1'   aria-describedby=\"gfield_description_9_154\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_9_154_1' id='label_9_154_1' class='gform-field-label gform-field-label--type-inline'>Me preocupa lo que los dem\u00e1s puedan pensar sobre m\u00ed<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_154_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_154.2' type='checkbox'  value='I&#039;m worried about what my experiences mean for me and my future'  id='choice_9_154_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_154_2' id='label_9_154_2' class='gform-field-label gform-field-label--type-inline'>Me preocupa qu\u00e9 signifiquen mis experiencias para mi y para mi futuro<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_154_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_154.3' type='checkbox'  value='I feel I can help myself well enough without treatment'  id='choice_9_154_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_154_3' id='label_9_154_3' class='gform-field-label gform-field-label--type-inline'>Creo que me puedo ayudar a m\u00ed mismo lo suficiente sin tratamiento<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_154_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_154.4' type='checkbox'  value='I can&#039;t afford it'  id='choice_9_154_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_154_4' id='label_9_154_4' class='gform-field-label gform-field-label--type-inline'>No puedo pagarlo<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_154_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_154.5' type='checkbox'  value='I am concerned about my privacy\/confidentiality'  id='choice_9_154_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_154_5' id='label_9_154_5' class='gform-field-label gform-field-label--type-inline'>Me preocupa mi privacis\/confidencialidad<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_154_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_154.6' type='checkbox'  value='I don&#039;t know if I can trust a professional'  id='choice_9_154_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_154_6' id='label_9_154_6' class='gform-field-label gform-field-label--type-inline'>No s\u00e9 si puedo confiar a un profesional<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_154_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_154.7' type='checkbox'  value='I am concerned about getting parental\/caregiver consent or involvement'  id='choice_9_154_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_154_7' id='label_9_154_7' class='gform-field-label gform-field-label--type-inline'>Me preocupa tener que obtener autorizaci\u00f3n paterna o de mi guardi\u00e1n<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_154_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_154.8' type='checkbox'  value='I don&#039;t have time'  id='choice_9_154_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_154_8' id='label_9_154_8' class='gform-field-label gform-field-label--type-inline'>No tengo tiempo<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_154_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_154.9' type='checkbox'  value='It&#039;s too big of an effort\/I don&#039;t have the energy'  id='choice_9_154_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_154_9' id='label_9_154_9' class='gform-field-label gform-field-label--type-inline'>Es demasiado dif\u00edcil\/No tengo la energ\u00eda<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_154_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_154.11' type='checkbox'  value='Logistical problems (transportation, wi-fi access, private space to talk)'  id='choice_9_154_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_154_11' id='label_9_154_11' class='gform-field-label gform-field-label--type-inline'>Problemas log\u00edsticos (la transportaci\u00f3n, la conectividad wi-fi, un espacio privado para hablar)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_154_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_154.12' type='checkbox'  value='I don&#039;t think it will work\/make me feel better'  id='choice_9_154_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_154_12' id='label_9_154_12' class='gform-field-label gform-field-label--type-inline'>No creo que funcione\/que me haga sentir mejor<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_154_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_154.13' type='checkbox'  value='I&#039;m confused about what to do next'  id='choice_9_154_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_154_13' id='label_9_154_13' class='gform-field-label gform-field-label--type-inline'>Estoy confuso sobre qu\u00e9 hacer despu\u00e9s<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_154_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_154.14' type='checkbox'  value='Other...'  id='choice_9_154_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_154_14' id='label_9_154_14' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_155\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_155'><span class='gform-field-label__text'><strong>\u00bfQu\u00e9 m\u00e1s<\/strong> te podr\u00eda prevenir de dar estos pasos?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_155' id='input_9_155' type='text' value='' class='large'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_123\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfEst\u00e1s haciendo este test por ti o en lugar de otra persona?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_123'>\n\t\t\t<div class='gchoice gchoice_9_123_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_123' type='radio' value='For myself'  id='choice_9_123_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_123_0' id='label_9_123_0' class='gform-field-label gform-field-label--type-inline'>Por m\u00ed mismo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_123_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_123' type='radio' value='For someone else'  id='choice_9_123_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_123_1' id='label_9_123_1' class='gform-field-label gform-field-label--type-inline'>En lugar de otra persona<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_124\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  >Si est\u00e1s haciendo este test en lugar de otra persona, <strong>Por favor, utilice la informaci\u00f3n de esa persona.<\/strong> para las preguntas siguientes, o d\u00e9jalas en blanco si no sabes la respuesta. Recuerda que, <em>estas preguntas son opcionales<\/em>.<\/div><div id=\"field_9_91\" class=\"gfield gfield--type-html gfield--input-type-html section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>Acerca de ti<\/h2><\/div><div id=\"field_9_92\" class=\"gfield gfield--type-select gfield--input-type-select optional taxonomy field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_92'><span class='gform-field-label__text'>Rango de edades<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_92' id='input_9_92' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='8-10' >8-10<\/option><option value='11-13' >11-13<\/option><option value='14-15' >14-15<\/option><option value='16-17' >16-17<\/option><option value='18-24' >18-24<\/option><option value='25-34' >25-34<\/option><option value='35-44' >35-44<\/option><option value='45-54' >45-54<\/option><option value='55-64' >55-64<\/option><option value='65+' >65+<\/option><\/select><\/div><\/div><fieldset id=\"field_9_93\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>G\u00e9nero<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_93'>\n\t\t\t<div class='gchoice gchoice_9_93_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_93' type='radio' value='Female'  id='choice_9_93_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_93_0' id='label_9_93_0' class='gform-field-label gform-field-label--type-inline'>Femenino<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_93_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_93' type='radio' value='Male'  id='choice_9_93_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_93_1' id='label_9_93_1' class='gform-field-label gform-field-label--type-inline'>Masculino<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_93_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_93' type='radio' value='Non-Binary'  id='choice_9_93_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_93_2' id='label_9_93_2' class='gform-field-label gform-field-label--type-inline'>No binario<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_151\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTe identificas como transg\u00e9nero?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_151'>\n\t\t\t<div class='gchoice gchoice_9_151_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_151' type='radio' value='Yes'  id='choice_9_151_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_151_0' id='label_9_151_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_151_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_151' type='radio' value='No'  id='choice_9_151_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_151_1' id='label_9_151_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_94\" class=\"gfield gfield--type-text gfield--input-type-text optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_94'><span class='gform-field-label__text'>\u00bfC\u00f3mo describir\u00edas tu g\u00e9nero?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_94' id='input_9_94' type='text' value='' class='small'    placeholder='Ingresa el g\u00e9nero...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_96\" class=\"gfield gfield--type-select gfield--input-type-select optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_96'><span class='gform-field-label__text'>Raza\/etnia<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_96' id='input_9_96' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='American Indian or Alaska Native' >Amerindio o nativo de Alaska<\/option><option value='Asian' >Asi\u00e1tico<\/option><option value='Black or African American (non-Hispanic)' >Negro o afroamericano (no hispano)<\/option><option value='Hispanic or Latino' >Hispano o latino<\/option><option value='Middle Eastern or North African' >Del medio oriente o norteafricano<\/option><option value='Native Hawaiian or other Pacific Islander' >Isle\u00f1o nativo hawaiano o pac\u00edfico<\/option><option value='White (non-Hispanic)' >Blanco (no hispano)<\/option><option value='More than one of the above' >M\u00e1s de uno de los anteriores<\/option><option value='Other' >Otros<\/option><\/select><\/div><\/div><div id=\"field_9_97\" class=\"gfield gfield--type-select gfield--input-type-select optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_97'><span class='gform-field-label__text'>Ingresos familiares (USD)<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_97' id='input_9_97' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Less than $20,000' >Menos de $20,000<\/option><option value='$20,000 - $39,999' >$20,000 - $39,999<\/option><option value='$40,000 - $59,999' >$40,000 - $59,999<\/option><option value='$60,000 - $79,999' >$60,000 - $79,999<\/option><option value='$80,000 - $99,999' >$80,000 - $99,999<\/option><option value='$100,000 - $149,999' >$100,000 - $149,999<\/option><option value='$150,000+' >$150,000+<\/option><\/select><\/div><\/div><fieldset id=\"field_9_125\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfVives en los Estados Unidos de Am\u00e9rica o en otro pa\u00eds?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_125'>\n\t\t\t<div class='gchoice gchoice_9_125_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_125' type='radio' value='I live in the United States'  id='choice_9_125_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_125_0' id='label_9_125_0' class='gform-field-label gform-field-label--type-inline'>Vivo en los Estados Unidos de Am\u00e9rica.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_125_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_125' type='radio' value='I live in another country'  id='choice_9_125_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_125_1' id='label_9_125_1' class='gform-field-label gform-field-label--type-inline'>Vivo en otro pa\u00eds.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_116\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_116'><span class='gform-field-label__text'>Estado<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_116' id='input_9_116' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >Distrito de Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Hawaii' >Haw\u00e1i<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Luisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >M\u00edchigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Misisipi<\/option><option value='Missouri' >Misuri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >Nuevo Hampshire<\/option><option value='New Jersey' >Nueva Jersey<\/option><option value='New Mexico' >Nuevo M\u00e9xico<\/option><option value='New York' >Nueva York<\/option><option value='North Carolina' >Carolina del Norte<\/option><option value='North Dakota' >Dakota del Norte<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oreg\u00f3n<\/option><option value='Pennsylvania' >Pensilvania<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >Carolina del Sur<\/option><option value='South Dakota' >Dakota del Sur<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >Virginia Occidental<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='I live in a U.S. Territory' >Vivo en un territorio de los Estados Unidos.<\/option><\/select><\/div><\/div><div id=\"field_9_118\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_118'><span class='gform-field-label__text'>\u00bfEn qu\u00e9 pa\u00eds vives?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_118' id='input_9_118' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Afghanistan' >Afganist\u00e1n<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Argelia<\/option><option value='American Samoa' >Samoa Americana<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguila<\/option><option value='Antarctica' >Ant\u00e1rtida<\/option><option value='Antigua and Barbuda' >Antigua y Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaiy\u00e1n<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrein<\/option><option value='Bangladesh' >Banglad\u00e9s<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Bielorrusia<\/option><option value='Belgium' >B\u00e9lgica<\/option><option value='Belize' >Belice<\/option><option value='Benin' >Ben\u00edn<\/option><option value='Bermuda' >Bermudas<\/option><option value='Bhutan' >But\u00e1n<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, San Eustaquio y Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia y Herzegovina<\/option><option value='Botswana' >Botsuana<\/option><option value='Bouvet Island' >Isla Bouvet<\/option><option value='Brazil' >Brasil<\/option><option value='British Indian Ocean Territory' >Territorio Brit\u00e1nico del Oc\u00e9ano \u00cdndico<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cambodia' >Camboya<\/option><option value='Cameroon' >Camer\u00fan<\/option><option value='Canada' >Canad\u00e1<\/option><option value='Cape Verde' >Cabo Verde<\/option><option value='Cayman Islands' >Islas Caim\u00e1n<\/option><option value='Central African Republic' >Rep\u00fablica Centroafricana<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Isla de Navidad<\/option><option value='Cocos Islands' >Islas Cocos<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoras<\/option><option value='Congo, Democratic Republic of the' >Rep\u00fablica Democr\u00e1tica del Congo<\/option><option value='Congo, Republic of the' >Rep\u00fablica del Congo<\/option><option value='Cook Islands' >Islas Cook<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croacia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Curazao<\/option><option value='Cyprus' >Chipre<\/option><option value='Czech Republic' >Rep\u00fablica Checa<\/option><option value='C\u00f4te d&#039;Ivoire' >Costa de Marfil<\/option><option value='Denmark' >Dinamarca<\/option><option value='Djibouti' >Yibuti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Rep\u00fablica Dominicana<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egipto<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Guinea Ecuatorial<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini (Swaziland)' >Esuatini (Suazilandia)<\/option><option value='Ethiopia' >Etiop\u00eda<\/option><option value='Falkland Islands' >Islas Malvinas<\/option><option value='Faroe Islands' >Islas Feroe<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finlandia<\/option><option value='France' >Francia<\/option><option value='French Guiana' >Guayana Francesa<\/option><option value='French Polynesia' >Polinesia Francesa<\/option><option value='French Southern Territories' >Territorios Australes Franceses<\/option><option value='Gabon' >Gab\u00f3n<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Alemania<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Grecia<\/option><option value='Greenland' >Groenlandia<\/option><option value='Grenada' >Granada<\/option><option value='Guadeloupe' >Guadalupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Hait\u00ed<\/option><option value='Heard and McDonald Islands' >Islas Heard y McDonald<\/option><option value='Holy See' >Santa Sede<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungr\u00eda<\/option><option value='Iceland' >Islandia<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Ir\u00e1n<\/option><option value='Iraq' >Irak<\/option><option value='Ireland' >Irlanda<\/option><option value='Isle of Man' >Isla de Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italia<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Jap\u00f3n<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordania<\/option><option value='Kazakhstan' >Kazajist\u00e1n<\/option><option value='Kenya' >Kenia<\/option><option value='Kiribati' >Kiribati<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kirguist\u00e1n<\/option><option value='Lao People&#039;s Democratic Republic' >Rep\u00fablica Democr\u00e1tica Popular Lao<\/option><option value='Latvia' >Letonia<\/option><option value='Lebanon' >L\u00edbano<\/option><option value='Lesotho' >Lesoto<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libia<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lituania<\/option><option value='Luxembourg' >Luxemburgo<\/option><option value='Macau' >Macao<\/option><option value='Macedonia' >Macedonia<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malaui<\/option><option value='Malaysia' >Malasia<\/option><option value='Maldives' >Maldivas<\/option><option value='Mali' >Mal\u00ed<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Islas Marshall<\/option><option value='Martinique' >Martinica<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauricio<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >M\u00e9xico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldavia<\/option><option value='Monaco' >M\u00f3naco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Marruecos<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Pa\u00edses Bajos<\/option><option value='New Caledonia' >Nueva Caledonia<\/option><option value='New Zealand' >Nueva Zelanda<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >N\u00edger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Isla Norfolk<\/option><option value='North Korea' >Corea del Norte<\/option><option value='Northern Mariana Islands' >Islas Marianas del Norte<\/option><option value='Norway' >Noruega<\/option><option value='Oman' >Om\u00e1n<\/option><option value='Pakistan' >Pakist\u00e1n<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestina, Estado de<\/option><option value='Panama' >Panam\u00e1<\/option><option value='Papua New Guinea' >Pap\u00faa Nueva Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Per\u00fa<\/option><option value='Philippines' >Filipinas<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Polonia<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Rumania<\/option><option value='Russia' >Rusia<\/option><option value='Rwanda' >Ruanda<\/option><option value='R\u00e9union' >Reuni\u00f3n<\/option><option value='Saint Barth\u00e9lemy' >San Bartolom\u00e9<\/option><option value='Saint Helena' >Santa Elena<\/option><option value='Saint Kitts and Nevis' >San Crist\u00f3bal y Nieves<\/option><option value='Saint Lucia' >Santa Luc\u00eda<\/option><option value='Saint Martin' >San Mart\u00edn<\/option><option value='Saint Pierre and Miquelon' >San Pedro y Miquel\u00f3n<\/option><option value='Saint Vincent and the Grenadines' >San Vicente y las Granadinas<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Santo Tom\u00e9 y Pr\u00edncipe<\/option><option value='Saudi Arabia' >Arabia Saudita<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leona<\/option><option value='Singapore' >Singapur<\/option><option value='Sint Maarten' >San Mart\u00edn<\/option><option value='Slovakia' >Eslovaquia<\/option><option value='Slovenia' >Eslovenia<\/option><option value='Solomon Islands' >Islas Salom\u00f3n<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >Sud\u00e1frica<\/option><option value='South Georgia' >Georgia del Sur<\/option><option value='South Korea' >Corea del Sur<\/option><option value='South Sudan' >Sud\u00e1n del Sur<\/option><option value='Spain' >Espa\u00f1a<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sud\u00e1n<\/option><option value='Suriname' >Surinam<\/option><option value='Svalbard and Jan Mayen Islands' >Islas Svalbard y Jan Mayen<\/option><option value='Sweden' >Suecia<\/option><option value='Switzerland' >Suiza<\/option><option value='Syria' >Siria<\/option><option value='Taiwan' >Taiw\u00e1n<\/option><option value='Tajikistan' >Tayikist\u00e1n<\/option><option value='Tanzania' >Tanzania<\/option><option value='Thailand' >Tailandia<\/option><option value='Timor-Leste' >Timor Oriental<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad y Tobago<\/option><option value='Tunisia' >T\u00fanez<\/option><option value='Turkey' >Turqu\u00eda<\/option><option value='Turkmenistan' >Turkmenist\u00e1n<\/option><option value='Turks and Caicos Islands' >Islas Turcas y Caicos<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='US Minor Outlying Islands' >Islas menores alejadas de los Estados Unidos<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ucrania<\/option><option value='United Arab Emirates' >Emiratos \u00c1rabes Unidos<\/option><option value='United Kingdom' >Reino Unido<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekist\u00e1n<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Vietnam' >Vietnam<\/option><option value='Virgin Islands, British' >Islas V\u00edrgenes Brit\u00e1nicas<\/option><option value='Virgin Islands, U.S.' >Islas V\u00edrgenes de los Estados Unidos.<\/option><option value='Wallis and Futuna' >Wallis y Futuna<\/option><option value='Western Sahara' >S\u00e1hara Occidental<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabue<\/option><option value='\u00c5land Islands' >Islas \u00c5land<\/option><\/select><\/div><\/div><div id=\"field_9_117\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_117'><span class='gform-field-label__text'>C\u00f3digo postal<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_117' id='input_9_117' type='text' value='' class='small'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_98\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox optional traditional field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfCu\u00e1l de las siguientes poblaciones te describe?<\/span><\/legend><div class='gfield_description' id='gfield_description_9_98'>Selecciona todas las opciones que apliquen.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_9_98'><div class='gchoice gchoice_9_98_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_98.1' type='checkbox'  value='Veteran or active-duty military'  id='choice_9_98_1'   aria-describedby=\"gfield_description_9_98\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_9_98_1' id='label_9_98_1' class='gform-field-label gform-field-label--type-inline'>Militar veterano(a) o en servicio activo<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_98_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_98.2' type='checkbox'  value='Caregiver of someone living with emotional or physical illness'  id='choice_9_98_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_98_2' id='label_9_98_2' class='gform-field-label gform-field-label--type-inline'>Cuidador(a) de una persona que padece una enfermedad emocional o f\u00edsica.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_98_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_98.3' type='checkbox'  value='LGBTQ+'  id='choice_9_98_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_98_3' id='label_9_98_3' class='gform-field-label gform-field-label--type-inline'>LGBTQ+<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_98_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_98.4' type='checkbox'  value='Student'  id='choice_9_98_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_98_4' id='label_9_98_4' class='gform-field-label gform-field-label--type-inline'>Estudiante<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_98_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_98.5' type='checkbox'  value='Trauma survivor'  id='choice_9_98_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_98_5' id='label_9_98_5' class='gform-field-label gform-field-label--type-inline'>Sobrevivente de un trauma<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_98_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_98.6' type='checkbox'  value='New or expecting parent'  id='choice_9_98_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_98_6' id='label_9_98_6' class='gform-field-label gform-field-label--type-inline'>Madre primeriza, padre primerizo, futura madre, o futuro padre<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_98_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_98.7' type='checkbox'  value='Healthcare worker'  id='choice_9_98_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_98_7' id='label_9_98_7' class='gform-field-label gform-field-label--type-inline'>Trabajador(a) de la salud<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_126\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full traditional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfCuidas a alguien con una enfermedad mental o f\u00edsica?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_126'>\n\t\t\t<div class='gchoice gchoice_9_126_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_126' type='radio' value='Mental health condition'  id='choice_9_126_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_126_0' id='label_9_126_0' class='gform-field-label gform-field-label--type-inline'>Condici\u00f3n de salud mental<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_126_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_126' type='radio' value='Physical health condition'  id='choice_9_126_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_126_1' id='label_9_126_1' class='gform-field-label gform-field-label--type-inline'>Condici\u00f3n f\u00edsica<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_126_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_126' type='radio' value='Both mental and physical health conditions'  id='choice_9_126_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_126_2' id='label_9_126_2' class='gform-field-label gform-field-label--type-inline'>Tanto las condiciones de salud mental como las f\u00edsicas.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_127\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_127'><span class='gform-field-label__text'>\u00bfCu\u00e1l de las siguientes opciones describe mejor tu orientaci\u00f3n sexual?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_127' id='input_9_127' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Lesbian or Gay' >Lesbiana o gay<\/option><option value='Bisexual' >Bisexual<\/option><option value='Queer' >Queer<\/option><option value='Pansexual' >Pansexual<\/option><option value='Asexual' >Asexual<\/option><option value='Straight' >Heterosexual<\/option><option value='Other...' >Otros...<\/option><\/select><\/div><\/div><div id=\"field_9_104\" class=\"gfield gfield--type-text gfield--input-type-text optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_104'><span class='gform-field-label__text'>\u00bfCu\u00e1l es tu orientaci\u00f3n sexual?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_104' id='input_9_104' type='text' value='' class='small'    placeholder='Ingresa la orientaci\u00f3n sexual...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_128\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfCu\u00e1l de las siguientes opciones describe tu experiencia con el trauma?<\/span><\/legend><div class='gfield_description' id='gfield_description_9_128'>Selecciona todas las opciones que apliquen.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_9_128'><div class='gchoice gchoice_9_128_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.1' type='checkbox'  value='Child abuse\/violence'  id='choice_9_128_1'   aria-describedby=\"gfield_description_9_128\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_9_128_1' id='label_9_128_1' class='gform-field-label gform-field-label--type-inline'>Maltrato infantil\/violencia<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_128_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.2' type='checkbox'  value='Intimate partner violence'  id='choice_9_128_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_128_2' id='label_9_128_2' class='gform-field-label gform-field-label--type-inline'>Violencia de pareja<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_128_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.3' type='checkbox'  value='Sexual assault\/violence'  id='choice_9_128_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_128_3' id='label_9_128_3' class='gform-field-label gform-field-label--type-inline'>Agresi\u00f3n\/violencia sexual<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_128_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.4' type='checkbox'  value='Serious illness\/injury\/assault'  id='choice_9_128_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_128_4' id='label_9_128_4' class='gform-field-label gform-field-label--type-inline'>Enfermedad\/lesi\u00f3n\/agresi\u00f3n grave<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_128_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.5' type='checkbox'  value='Family conflict (identity acceptance\/separation\/divorce)'  id='choice_9_128_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_128_5' id='label_9_128_5' class='gform-field-label gform-field-label--type-inline'>Conflicto familiar (aceptaci\u00f3n de la identidad\/separaci\u00f3n\/divorcio)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_128_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.6' type='checkbox'  value='Traumatic event (natural disaster, accident, witnessing violence, etc.)'  id='choice_9_128_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_128_6' id='label_9_128_6' class='gform-field-label gform-field-label--type-inline'>Evento traum\u00e1tico (desastre natural, accidente, presenciar violencia, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_128_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.7' type='checkbox'  value='Death of a loved one'  id='choice_9_128_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_128_7' id='label_9_128_7' class='gform-field-label gform-field-label--type-inline'>Muerte de un ser querido<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_128_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_128.8' type='checkbox'  value='Other and\/or tell us more about your trauma'  id='choice_9_128_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_128_8' id='label_9_128_8' class='gform-field-label gform-field-label--type-inline'>Otros y\/o cu\u00e9ntenos m\u00e1s sobre tu trauma.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_129\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_129'><span class='gform-field-label__text'>Cu\u00e9ntanos m\u00e1s sobre tu experiencia con el trauma:<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_129' id='input_9_129' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_105\" class=\"gfield gfield--type-html gfield--input-type-html section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>Acerca de tu salud mental<\/h2><\/div><fieldset id=\"field_9_107\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfAlguna vez has recibido tratamiento o apoyo por un problema de salud mental?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_107'>\n\t\t\t<div class='gchoice gchoice_9_107_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_107' type='radio' value='Yes'  id='choice_9_107_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_107_0' id='label_9_107_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_107_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_107' type='radio' value='No'  id='choice_9_107_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_107_1' id='label_9_107_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_108\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfEst\u00e1s recibiendo tratamiento o apoyo actualmente?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_108'>\n\t\t\t<div class='gchoice gchoice_9_108_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_108' type='radio' value='Yes'  id='choice_9_108_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_108_0' id='label_9_108_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_108_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_108' type='radio' value='No'  id='choice_9_108_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_108_1' id='label_9_108_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_152\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full optional traditional limit-3 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfQu\u00e9 te ha impedido buscar tratamiento en el pasado?<\/span><\/legend><div class='gfield_description' id='gfield_description_9_152'>Selecciona hasta 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_9_152'><div class='gchoice gchoice_9_152_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_152.1' type='checkbox'  value='I wanted to handle my mental health on my own'  id='choice_9_152_1'   aria-describedby=\"gfield_description_9_152\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_9_152_1' id='label_9_152_1' class='gform-field-label gform-field-label--type-inline'>Quer\u00eda manejar mi salud mental por mi cuenta.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_152_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_152.2' type='checkbox'  value='I didn\u2019t know how or where to start'  id='choice_9_152_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_152_2' id='label_9_152_2' class='gform-field-label gform-field-label--type-inline'>No sab\u00eda c\u00f3mo ni por d\u00f3nde empezar.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_152_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_152.3' type='checkbox'  value='I thought it would cost too much'  id='choice_9_152_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_152_3' id='label_9_152_3' class='gform-field-label gform-field-label--type-inline'>Pensaba que costar\u00eda demasiado.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_152_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_152.4' type='checkbox'  value='I didn\u2019t have time'  id='choice_9_152_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_152_4' id='label_9_152_4' class='gform-field-label gform-field-label--type-inline'>No ten\u00eda tiempo.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_152_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_152.5' type='checkbox'  value='I didn\u2019t think it would help me'  id='choice_9_152_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_152_5' id='label_9_152_5' class='gform-field-label gform-field-label--type-inline'>No cre\u00eda que me fuera a ayudar.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_152_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_152.6' type='checkbox'  value='I didn&#039;t feel ready to start treatment'  id='choice_9_152_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_152_6' id='label_9_152_6' class='gform-field-label gform-field-label--type-inline'>No me sent\u00eda preparado para comenzar el tratamiento.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_152_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_152.7' type='checkbox'  value='I was worried about what people would think or say if I got treatment'  id='choice_9_152_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_152_7' id='label_9_152_7' class='gform-field-label gform-field-label--type-inline'>Me preocupaba lo que la gente fuera a pensar o decir si me sometiera al tratamiento.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_152_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_152.8' type='checkbox'  value='I was afraid of being forced into a hospital or forced to take medication'  id='choice_9_152_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_152_8' id='label_9_152_8' class='gform-field-label gform-field-label--type-inline'>Ten\u00eda miedo de que me internaran en un hospital o me obligaran a tomar medicamentos.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_152_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_152.9' type='checkbox'  value='I tried, but couldn\u2019t find available treatment (no openings, wouldn\u2019t take insurance, etc.)'  id='choice_9_152_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_152_9' id='label_9_152_9' class='gform-field-label gform-field-label--type-inline'>Lo intent\u00e9, pero no pude encontrar un tratamiento disponible (no hab\u00eda plazas, no aceptaban el seguro, etc.).<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_152_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_152.11' type='checkbox'  value='My parent(s) or guardian wouldn&#039;t let me, or I didn&#039;t want to ask'  id='choice_9_152_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_152_11' id='label_9_152_11' class='gform-field-label gform-field-label--type-inline'>Mis pap\u00e1s o mi tutor no me dejaron, o no quer\u00eda pedir permiso.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_152_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_152.12' type='checkbox'  value='Other...'  id='choice_9_152_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_152_12' id='label_9_152_12' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_153\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_153'><span class='gform-field-label__text'>\u00bfQu\u00e9 otras cosas te han impedido buscar tratamiento en el pasado?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_153' id='input_9_153' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_109\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox optional traditional limit-3 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Piensa en tu prueba de salud mental. \u00bfCu\u00e1les son los principales factores que contribuyen a tus problemas de salud mental en este momento?<\/span><\/legend><div class='gfield_description' id='gfield_description_9_109'>Selecciona hasta 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_9_109'><div class='gchoice gchoice_9_109_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.1' type='checkbox'  value='Abuse or violence'  id='choice_9_109_1'   aria-describedby=\"gfield_description_9_109\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_9_109_1' id='label_9_109_1' class='gform-field-label gform-field-label--type-inline'>Abuso o violencia<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_109_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.2' type='checkbox'  value='Relationship problems (friends, family, or significant other)'  id='choice_9_109_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_109_2' id='label_9_109_2' class='gform-field-label gform-field-label--type-inline'>Problemas de relaci\u00f3n (amigos, familia o pareja)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_109_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.3' type='checkbox'  value='Body image'  id='choice_9_109_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_109_3' id='label_9_109_3' class='gform-field-label gform-field-label--type-inline'>Imagen corporal<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_109_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.4' type='checkbox'  value='Low self-esteem or self-image'  id='choice_9_109_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_109_4' id='label_9_109_4' class='gform-field-label gform-field-label--type-inline'>Baja autoestima o imagen de uno mismo<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_109_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.5' type='checkbox'  value='School or work problems'  id='choice_9_109_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_109_5' id='label_9_109_5' class='gform-field-label gform-field-label--type-inline'>Problemas en la escuela o en el trabajo<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_109_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.6' type='checkbox'  value='Financial problems'  id='choice_9_109_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_109_6' id='label_9_109_6' class='gform-field-label gform-field-label--type-inline'>Problemas financieros<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_109_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.7' type='checkbox'  value='Loneliness or isolation'  id='choice_9_109_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_109_7' id='label_9_109_7' class='gform-field-label gform-field-label--type-inline'>Soledad o aislamiento<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_109_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.8' type='checkbox'  value='Grief or loss of someone or something'  id='choice_9_109_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_109_8' id='label_9_109_8' class='gform-field-label gform-field-label--type-inline'>Dolor o p\u00e9rdida de alguien o algo.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_109_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.9' type='checkbox'  value='Experiencing hate\/bullying (including racism, homophobia, transphobia, or discrimination)'  id='choice_9_109_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_109_9' id='label_9_109_9' class='gform-field-label gform-field-label--type-inline'>Sufrir odio o acoso (incluido el racismo, la homofobia, la transfobia o la discriminaci\u00f3n)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_109_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.11' type='checkbox'  value='State of the world (war, climate, politics, immigration)'  id='choice_9_109_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_109_11' id='label_9_109_11' class='gform-field-label gform-field-label--type-inline'>Situaci\u00f3n mundial (guerra, clima, pol\u00edtica, inmigraci\u00f3n)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_109_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.12' type='checkbox'  value='I don\u2019t know (something just feels wrong)'  id='choice_9_109_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_109_12' id='label_9_109_12' class='gform-field-label gform-field-label--type-inline'>No lo s\u00e9 (s\u00f3lo que algo no va bien)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_109_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.13' type='checkbox'  value='Other...'  id='choice_9_109_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_109_13' id='label_9_109_13' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_110\" class=\"gfield gfield--type-text gfield--input-type-text optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_110'><span class='gform-field-label__text'>\u00bfQu\u00e9 m\u00e1s est\u00e1 contribuyendo a tus problemas de salud mental en este momento?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_110' id='input_9_110' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_132\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_132'><span class='gform-field-label__text'>\u00bfQu\u00e9 aspecto de la situaci\u00f3n mundial te afecta m\u00e1s?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_132' id='input_9_132' type='text' value='' class='large'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_111\" class=\"gfield gfield--type-html gfield--input-type-html section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>Acerca de tu salud<\/h2><\/div><fieldset id=\"field_9_112\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTienes actualmente un seguro m\u00e9dico?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_112'>\n\t\t\t<div class='gchoice gchoice_9_112_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_112' type='radio' value='Yes'  id='choice_9_112_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_112_0' id='label_9_112_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_112_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_112' type='radio' value='No'  id='choice_9_112_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_112_1' id='label_9_112_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_112_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_112' type='radio' value='I don&#039;t know'  id='choice_9_112_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_112_2' id='label_9_112_2' class='gform-field-label gform-field-label--type-inline'>No lo s\u00e9<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_113\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox optional traditional field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfTienes alguna de las siguientes condiciones f\u00edsicas?<\/span><\/legend><div class='gfield_description' id='gfield_description_9_113'>Selecciona todas las opciones que apliquen.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_9_113'><div class='gchoice gchoice_9_113_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_113.1' type='checkbox'  value='Heart disease'  id='choice_9_113_1'   aria-describedby=\"gfield_description_9_113\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_9_113_1' id='label_9_113_1' class='gform-field-label gform-field-label--type-inline'>Enfermedad card\u00edaca<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_113_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_113.2' type='checkbox'  value='Reproductive health concerns (PCOS, endometriosis, infertility, etc.)'  id='choice_9_113_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_113_2' id='label_9_113_2' class='gform-field-label gform-field-label--type-inline'>Problemas de salud reproductiva (s\u00edndrome de ovario poliqu\u00edstico, endometriosis, infertilidad, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_113_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_113.3' type='checkbox'  value='Diabetes'  id='choice_9_113_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_113_3' id='label_9_113_3' class='gform-field-label gform-field-label--type-inline'>Diabetes<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_113_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_113.4' type='checkbox'  value='Cancer'  id='choice_9_113_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_113_4' id='label_9_113_4' class='gform-field-label gform-field-label--type-inline'>C\u00e1ncer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_113_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_113.5' type='checkbox'  value='Arthritis or other chronic pain'  id='choice_9_113_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_113_5' id='label_9_113_5' class='gform-field-label gform-field-label--type-inline'>Artritis u otros dolores cr\u00f3nicos<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_113_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_113.6' type='checkbox'  value='Asthma, COPD or other lung conditions'  id='choice_9_113_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_113_6' id='label_9_113_6' class='gform-field-label gform-field-label--type-inline'>Asma, EPOC u otras afecciones pulmonares<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_113_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_113.7' type='checkbox'  value='Movement Disorders (involuntary tics, tardive dyskinesia, etc.)'  id='choice_9_113_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_113_7' id='label_9_113_7' class='gform-field-label gform-field-label--type-inline'>Trastornos del movimiento (tics involuntarios, discinesia tard\u00eda, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_113_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_113.8' type='checkbox'  value='Digestive problems (Crohn\u2019s, colitis, IBS, etc.)'  id='choice_9_113_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_113_8' id='label_9_113_8' class='gform-field-label gform-field-label--type-inline'>Problemas digestivos (enfermedad de Crohn, colitis, s\u00edndrome del intestino irritable, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_113_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_113.9' type='checkbox'  value='Neurological conditions (epilepsy, etc.) or traumatic brain injury (TBI)'  id='choice_9_113_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_113_9' id='label_9_113_9' class='gform-field-label gform-field-label--type-inline'>Afecciones neurol\u00f3gicas (epilepsia, etc.) o traumatismo craneoencef\u00e1lico (TCE)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_113_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_113.11' type='checkbox'  value='Other...'  id='choice_9_113_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_113_11' id='label_9_113_11' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_114\" class=\"gfield gfield--type-text gfield--input-type-text optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_114'><span class='gform-field-label__text'>\u00bfQu\u00e9 otras condiciones f\u00edsicas tienes?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_114' id='input_9_114' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_149\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTienes una mascota que te ayuda a cuidar tu salud mental?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_149'>\n\t\t\t<div class='gchoice gchoice_9_149_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_149' type='radio' value='Yes'  id='choice_9_149_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_149_0' id='label_9_149_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_149_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_149' type='radio' value='No'  id='choice_9_149_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_149_1' id='label_9_149_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_150\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTe interesa tener una mascota que te ayude a cuidar tu salud mental?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_150'>\n\t\t\t<div class='gchoice gchoice_9_150_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_150' type='radio' value='Yes'  id='choice_9_150_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_150_0' id='label_9_150_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_150_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_150' type='radio' value='No'  id='choice_9_150_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_150_1' id='label_9_150_1' class='gform-field-label 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\/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_9' id='gform_target_page_number_9' value='2' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_9' id='gform_source_page_number_9' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n             <\/div><\/div>\n                        <input type=\"hidden\" name=\"trp-form-language\" value=\"es\"\/><\/form>\n                        <\/div>\n<p>&nbsp;<\/p>\n<hr \/>\n<h2 class=\"smaller\">Fuente:<\/h2>\n<div class=\"references\">\n<p>Loewy, Rachel L., et al. (2011). Detecci\u00f3n del riesgo de psicosis con el Cuestionario Prodr\u00f3mico \u2014 Versi\u00f3n Breve (PQ-B). <em>Investigaci\u00f3n sobre la esquizofrenia 12<\/em>(1) pp. 42-46. <a href=\"https:\/\/doi.org\/10.1016\/j.schres.2011.03.029\">DOI: 10.1016\/j.schres.2011.03.029<\/a><\/p>\n<p>Savill, M., D\u2019Ambrosio, J., Cannon, T. D., Loewy, R. (2017). Detecci\u00f3n del riesgo de psicosis en diferentes poblaciones mediante el Cuestionario Prodr\u00f3mico: una revisi\u00f3n sistem\u00e1tica. <em>Intervenci\u00f3n temprana en psiquiatr\u00eda 12<\/em>(1), pp. 3-14. <a href=\"https:\/\/doi.org\/10.1111\/eip.12446\">DOI: 10.1111\/eip.12446<\/a><\/p>\n<p>Una puntuaci\u00f3n positiva en el Cuestionario Prodr\u00f3mico - Versi\u00f3n Breve (PQ-B) sugiere la necesidad de una evaluaci\u00f3n m\u00e1s profunda por parte de un profesional de la salud (M.D., R.N.) o de la salud mental (Ph.D., Psy.D., LCSW) cualificado y formado en el reconocimiento de los primeros signos de psicosis.  El PQ-B est\u00e1 dise\u00f1ado para detectar el pr\u00f3dromo o el riesgo ultraalto de psicosis y se considera el primer paso de un proceso de detecci\u00f3n en dos etapas.<\/p>\n<p><a href=\"https:\/\/screening.mhanational.org\/es\/about-our-mental-health-tests\/\" target=\"_blank\" rel=\"noopener\">Para aprender m\u00e1s sobre nuestras herramientas de detecci\u00f3n, haz clic aqu\u00ed.<\/a><\/p>\n<p><strong><em>Ten en cuenta:<\/em><\/strong><span style=\"font-style: normal !msorm;\"><em> Las herramientas de evaluaci\u00f3n en l\u00ednea no son instrumentos de diagn\u00f3stico. Te recomendamos que compartas tus resultados con un m\u00e9dico o profesional de la salud. Mental Health America Inc., sus patrocinadores, socios y anunciantes no se hacen responsables de ninguna responsabilidad, p\u00e9rdida o riesgo que se derive, directa o indirectamente, del uso y la aplicaci\u00f3n de estas evaluaciones.<\/em><\/span><\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Para personas que sienten que su cerebro les juega malas pasadas (ven, oyen o creen cosas que no parecen reales o del todo correctas).<\/p>","protected":false},"template":"","tags":[],"age_group":[],"condition":[89],"class_list":["post-256835","screen","type-screen","status-publish","hentry","condition-psychosis"],"acf":[],"yoast_head":"<title>Psychosis &amp; Schizophrenia Test (staging) &#8211; Free, quick, &amp; confidential<\/title>\n<meta name=\"description\" content=\"Is your brain playing tricks on you? 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Mental Health Treatments Survey"},"content":{"rendered":"<div class='gf_browser_chrome gform_wrapper gravity-theme gform-theme--no-framework full-pager_wrapper' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_93' style='display:none'><form method='post' enctype='multipart\/form-data'  id='gform_93' class='full-pager' action='\/es\/wp-json\/wp\/v2\/screen' data-formid='93' novalidate data-trp-original-action=\"\/es\/wp-json\/wp\/v2\/screen\"><input id=\"partial_entry_id_93\" class=\"partial_entry_id\" type=\"hidden\" name=\"partial_entry_id\" value=\"pending\" data-form_id=\"93\"\/><ol class=\"full-progress-bar clearfix step-1-of-3\"><li class=\"step-1 active\"><span>Preguntas de la encuesta<\/span><\/li><li class=\"step-2 empty\"><span>Preguntas opcionales<\/span><\/li><\/ol>\n                        <div class='gform-body gform_body'><div id='gform_page_93_1' class='gform_page' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_93' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_93_144\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_93_144'><span class='gform-field-label__text'>Instagram<\/span><\/label><div class='gfield_description' id='gfield_description_93_144'>Este campo es para fines de validaci\u00f3n y no debe modificarse.<\/div><div class='ginput_container'><input name='input_144' id='input_93_144' type='text' value='' autocomplete='new-password'\/><\/div><\/div><div id=\"field_93_38\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_38' id='input_93_38' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_93_39\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><input name=\"input_39\" id=\"input_93_39\" type=\"hidden\" class=\"gform_hidden\" aria-invalid=\"false\" value=\"256450\"><\/div><div id=\"field_93_40\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><input name=\"input_40\" id=\"input_93_40\" type=\"hidden\" class=\"gform_hidden\" aria-invalid=\"false\" value=\"e875158b42d4e2ab407c8e264f11f752\"><\/div><div id=\"field_93_41\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_41' id='input_93_41' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_93_51\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_51' id='input_93_51' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='http:\/\/screening.mhanational.org' \/><\/div><\/div><div id=\"field_93_81\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_81' id='input_93_81' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_93_82\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_82' id='input_93_82' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_93_83\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_83' id='input_93_83' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_93_93\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_93' id='input_93_93' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_93_143\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_143' id='input_93_143' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='lang--es' \/><\/div><\/div><div id=\"field_93_4\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p>In this survey, we'll ask you about digital treatments for depression. Your answers will help us understand what people know and feel about their options.<\/p><p>Thank you for participating!<\/p>\n<hr \/><\/div><fieldset id=\"field_93_106\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional question-optional show-only-value hide-score question field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_unchanged gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Are you currently receiving any treatment for depression?<\/span><\/legend><div class='gfield_description' id='gfield_description_93_106'>Selecciona todas las opciones que apliquen.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_93_106'><div class='gchoice gchoice_93_106_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_106.1' type='checkbox'  value='Medication'  id='choice_93_106_1'   aria-describedby=\"gfield_description_93_106\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_93_106_1' id='label_93_106_1' class='gform-field-label gform-field-label--type-inline'>Medicamentos<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_106_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_106.2' type='checkbox'  value='Therapy\/counseling'  id='choice_93_106_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_106_2' id='label_93_106_2' class='gform-field-label gform-field-label--type-inline'>Therapy\/counseling<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_106_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_106.3' type='checkbox'  value='Prescription digital therapeutic'  id='choice_93_106_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_106_3' id='label_93_106_3' class='gform-field-label gform-field-label--type-inline'>Prescription digital therapeutic<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_106_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_106.4' type='checkbox'  value='Other digital tool'  id='choice_93_106_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_106_4' id='label_93_106_4' class='gform-field-label gform-field-label--type-inline'>Other digital tool<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_106_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_106.5' type='checkbox'  value='Not currently in treatment'  id='choice_93_106_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_106_5' id='label_93_106_5' class='gform-field-label gform-field-label--type-inline'>Not currently in treatment<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_93_107\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional question-optional show-only-value hide-score question field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_unchanged gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Have you ever received treatment for depression in the past?<\/span><\/legend><div class='gfield_description' id='gfield_description_93_107'>Selecciona todas las opciones que apliquen.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_93_107'><div class='gchoice gchoice_93_107_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_107.1' type='checkbox'  value='Medication'  id='choice_93_107_1'   aria-describedby=\"gfield_description_93_107\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_93_107_1' id='label_93_107_1' class='gform-field-label gform-field-label--type-inline'>Medicamentos<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_107_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_107.2' type='checkbox'  value='Therapy\/counseling'  id='choice_93_107_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_107_2' id='label_93_107_2' class='gform-field-label gform-field-label--type-inline'>Therapy\/counseling<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_107_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_107.3' type='checkbox'  value='Prescription digital therapeutic'  id='choice_93_107_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_107_3' id='label_93_107_3' class='gform-field-label gform-field-label--type-inline'>Prescription digital therapeutic<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_107_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_107.4' type='checkbox'  value='Other digital tool'  id='choice_93_107_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_107_4' id='label_93_107_4' class='gform-field-label gform-field-label--type-inline'>Other digital tool<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_107_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_107.5' type='checkbox'  value='No past treatment'  id='choice_93_107_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_107_5' id='label_93_107_5' class='gform-field-label gform-field-label--type-inline'>No past treatment<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_93_108\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional question-optional show-only-value hide-score question field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_unchanged gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Have you ever been diagnosed with a mental health condition?<\/span><\/legend><div class='gfield_description' id='gfield_description_93_108'>Selecciona todas las opciones que apliquen.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_93_108'><div class='gchoice gchoice_93_108_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.1' type='checkbox'  value='Depression'  id='choice_93_108_1'   aria-describedby=\"gfield_description_93_108\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_93_108_1' id='label_93_108_1' class='gform-field-label gform-field-label--type-inline'>Depresi\u00f3n<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_108_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.2' type='checkbox'  value='Anxiety'  id='choice_93_108_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_108_2' id='label_93_108_2' class='gform-field-label gform-field-label--type-inline'>Ansiedad<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_108_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.3' type='checkbox'  value='Bipolar disorder'  id='choice_93_108_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_108_3' id='label_93_108_3' class='gform-field-label gform-field-label--type-inline'>Trastorno bipolar<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_108_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.4' type='checkbox'  value='PTSD'  id='choice_93_108_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_108_4' id='label_93_108_4' class='gform-field-label gform-field-label--type-inline'>trastorno por estr\u00e9s postraum\u00e1tico<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_108_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.5' type='checkbox'  value='Other'  id='choice_93_108_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_108_5' id='label_93_108_5' class='gform-field-label gform-field-label--type-inline'>Otros<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_108_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_108.6' type='checkbox'  value='No diagnosis'  id='choice_93_108_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_108_6' id='label_93_108_6' class='gform-field-label gform-field-label--type-inline'>No diagnosis<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_93_119\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><hr \/>\n<strong>\u00bfQu\u00e9 tan de acuerdo o en desacuerdo est\u00e1s con las siguientes afirmaciones?<\/strong><\/div><fieldset id=\"field_93_120\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question-optional show-only-value hide-score question field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_unchanged gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>I know what health resources are available about depression.<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_93_120'>\n\t\t\t<div class='gchoice gchoice_93_120_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_120' type='radio' value='-2'  id='choice_93_120_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_120_0' id='label_93_120_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_120_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_120' type='radio' value='-1'  id='choice_93_120_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_120_1' id='label_93_120_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_120_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_120' type='radio' value='0'  id='choice_93_120_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_120_2' id='label_93_120_2' class='gform-field-label gform-field-label--type-inline'>No estoy seguro\/a<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_120_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_120' type='radio' value='1'  id='choice_93_120_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_120_3' id='label_93_120_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_120_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_120' type='radio' value='2'  id='choice_93_120_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_120_4' id='label_93_120_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_93_121\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question-optional show-only-value hide-score question field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_unchanged gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>I know how to find helpful information about depression online.<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_93_121'>\n\t\t\t<div class='gchoice gchoice_93_121_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_121' type='radio' value='-2'  id='choice_93_121_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_121_0' id='label_93_121_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_121_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_121' type='radio' value='-1'  id='choice_93_121_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_121_1' id='label_93_121_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_121_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_121' type='radio' value='0'  id='choice_93_121_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_121_2' id='label_93_121_2' class='gform-field-label gform-field-label--type-inline'>No estoy seguro\/a<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_121_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_121' type='radio' value='1'  id='choice_93_121_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_121_3' id='label_93_121_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_121_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_121' type='radio' value='2'  id='choice_93_121_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_121_4' id='label_93_121_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_93_122\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question-optional show-only-value hide-score question field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_unchanged gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>I know how to use information I find to help manage depression.<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_93_122'>\n\t\t\t<div class='gchoice gchoice_93_122_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_122' type='radio' value='-2'  id='choice_93_122_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_122_0' id='label_93_122_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_122_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_122' type='radio' value='-1'  id='choice_93_122_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_122_1' id='label_93_122_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_122_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_122' type='radio' value='0'  id='choice_93_122_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_122_2' id='label_93_122_2' class='gform-field-label gform-field-label--type-inline'>No estoy seguro\/a<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_122_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_122' type='radio' value='1'  id='choice_93_122_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_122_3' id='label_93_122_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_122_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_122' type='radio' value='2'  id='choice_93_122_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_122_4' id='label_93_122_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_93_123\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question-optional show-only-value hide-score question field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_unchanged gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>I know how to tell if information about depression is trustworthy.<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_93_123'>\n\t\t\t<div class='gchoice gchoice_93_123_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_123' type='radio' value='-2'  id='choice_93_123_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_123_0' id='label_93_123_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_123_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_123' type='radio' value='-1'  id='choice_93_123_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_123_1' id='label_93_123_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_123_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_123' type='radio' value='0'  id='choice_93_123_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_123_2' id='label_93_123_2' class='gform-field-label gform-field-label--type-inline'>No estoy seguro\/a<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_123_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_123' type='radio' value='1'  id='choice_93_123_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_123_3' id='label_93_123_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_123_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_123' type='radio' value='2'  id='choice_93_123_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_123_4' id='label_93_123_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_93_124\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question-optional show-only-value hide-score question field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_unchanged gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>I have the skills needed to evaluate online information about depression.<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_93_124'>\n\t\t\t<div class='gchoice gchoice_93_124_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_124' type='radio' value='-2'  id='choice_93_124_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_124_0' id='label_93_124_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_124_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_124' type='radio' value='-1'  id='choice_93_124_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_124_1' id='label_93_124_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_124_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_124' type='radio' value='0'  id='choice_93_124_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_124_2' id='label_93_124_2' class='gform-field-label gform-field-label--type-inline'>No estoy seguro\/a<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_124_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_124' type='radio' value='1'  id='choice_93_124_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_124_3' id='label_93_124_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_124_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_124' type='radio' value='2'  id='choice_93_124_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_124_4' id='label_93_124_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_93_125\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question-optional show-only-value hide-score question field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_unchanged gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>I feel confident using online information to make decisions about depression care.<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_93_125'>\n\t\t\t<div class='gchoice gchoice_93_125_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_125' type='radio' value='-2'  id='choice_93_125_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_125_0' id='label_93_125_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_125_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_125' type='radio' value='-1'  id='choice_93_125_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_125_1' id='label_93_125_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_125_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_125' type='radio' value='0'  id='choice_93_125_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_125_2' id='label_93_125_2' class='gform-field-label gform-field-label--type-inline'>No estoy seguro\/a<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_125_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_125' type='radio' value='1'  id='choice_93_125_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_125_3' id='label_93_125_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_125_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_125' type='radio' value='2'  id='choice_93_125_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_125_4' id='label_93_125_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_93_126\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question-optional show-only-value hide-score question field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_unchanged gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Online information helps me understand my depression treatment options.<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_93_126'>\n\t\t\t<div class='gchoice gchoice_93_126_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_126' type='radio' value='-2'  id='choice_93_126_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_126_0' id='label_93_126_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_126_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_126' type='radio' value='-1'  id='choice_93_126_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_126_1' id='label_93_126_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_126_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_126' type='radio' value='0'  id='choice_93_126_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_126_2' id='label_93_126_2' class='gform-field-label gform-field-label--type-inline'>No estoy seguro\/a<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_126_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_126' type='radio' value='1'  id='choice_93_126_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_126_3' id='label_93_126_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_126_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_126' type='radio' value='2'  id='choice_93_126_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_126_4' id='label_93_126_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_93_127\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question-optional show-only-value hide-score question field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_unchanged gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>I feel informed about digital treatment options for depression.<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_93_127'>\n\t\t\t<div class='gchoice gchoice_93_127_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_127' type='radio' value='-2'  id='choice_93_127_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_127_0' id='label_93_127_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_127_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_127' type='radio' value='-1'  id='choice_93_127_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_127_1' id='label_93_127_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_127_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_127' type='radio' value='0'  id='choice_93_127_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_127_2' id='label_93_127_2' class='gform-field-label gform-field-label--type-inline'>No estoy seguro\/a<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_127_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_127' type='radio' value='1'  id='choice_93_127_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_127_3' id='label_93_127_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_127_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_127' type='radio' value='2'  id='choice_93_127_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_127_4' id='label_93_127_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_93_142\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><hr \/>\n<strong>\u00bfQu\u00e9 tan de acuerdo o en desacuerdo est\u00e1s con las siguientes afirmaciones?<\/strong><\/div><fieldset id=\"field_93_129\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question-optional show-only-value hide-score question field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_unchanged gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>A digital tool for treating depression must be tested in clinical trials for me to trust that it works.<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_93_129'>\n\t\t\t<div class='gchoice gchoice_93_129_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_129' type='radio' value='-2'  id='choice_93_129_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_129_0' id='label_93_129_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_129_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_129' type='radio' value='-1'  id='choice_93_129_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_129_1' id='label_93_129_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_129_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_129' type='radio' value='0'  id='choice_93_129_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_129_2' id='label_93_129_2' class='gform-field-label gform-field-label--type-inline'>Neither agree nor disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_129_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_129' type='radio' value='1'  id='choice_93_129_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_129_3' id='label_93_129_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_129_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_129' type='radio' value='2'  id='choice_93_129_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_129_4' id='label_93_129_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_93_130\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question-optional show-only-value hide-score question field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_unchanged gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>I would only use a digital tool to treat depression if my doctor or clinician recommended it.<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_93_130'>\n\t\t\t<div class='gchoice gchoice_93_130_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_130' type='radio' value='-2'  id='choice_93_130_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_130_0' id='label_93_130_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_130_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_130' type='radio' value='-1'  id='choice_93_130_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_130_1' id='label_93_130_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_130_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_130' type='radio' value='0'  id='choice_93_130_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_130_2' id='label_93_130_2' class='gform-field-label gform-field-label--type-inline'>Neither agree nor disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_130_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_130' type='radio' value='1'  id='choice_93_130_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_130_3' id='label_93_130_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_130_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_130' type='radio' value='2'  id='choice_93_130_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_130_4' id='label_93_130_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_93_131\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question-optional show-only-value hide-score question field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_unchanged gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>A digital tool for depression should be cleared or authorized by the FDA for me to feel comfortable using it.<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_93_131'>\n\t\t\t<div class='gchoice gchoice_93_131_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_131' type='radio' value='-2'  id='choice_93_131_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_131_0' id='label_93_131_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_131_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_131' type='radio' value='-1'  id='choice_93_131_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_131_1' id='label_93_131_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_131_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_131' type='radio' value='0'  id='choice_93_131_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_131_2' id='label_93_131_2' class='gform-field-label gform-field-label--type-inline'>Neither agree nor disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_131_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_131' type='radio' value='1'  id='choice_93_131_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_131_3' id='label_93_131_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_131_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_131' type='radio' value='2'  id='choice_93_131_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_131_4' id='label_93_131_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_93_132\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question-optional show-only-value hide-score question field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_unchanged gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>High ratings in the app store are the most important factor for me when choosing a digital tool for depression.<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_93_132'>\n\t\t\t<div class='gchoice gchoice_93_132_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_132' type='radio' value='-2'  id='choice_93_132_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_132_0' id='label_93_132_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_132_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_132' type='radio' value='-1'  id='choice_93_132_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_132_1' id='label_93_132_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_132_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_132' type='radio' value='0'  id='choice_93_132_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_132_2' id='label_93_132_2' class='gform-field-label gform-field-label--type-inline'>Neither agree nor disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_132_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_132' type='radio' value='1'  id='choice_93_132_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_132_3' id='label_93_132_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_132_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_132' type='radio' value='2'  id='choice_93_132_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_132_4' id='label_93_132_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_93_133\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question-optional show-only-value hide-score question field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_unchanged gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>When choosing a digital tool for depression, the opinions of my friends or family are more important than my doctor\u2019s recommendation.<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_93_133'>\n\t\t\t<div class='gchoice gchoice_93_133_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_133' type='radio' value='-2'  id='choice_93_133_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_133_0' id='label_93_133_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_133_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_133' type='radio' value='-1'  id='choice_93_133_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_133_1' id='label_93_133_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_133_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_133' type='radio' value='0'  id='choice_93_133_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_133_2' id='label_93_133_2' class='gform-field-label gform-field-label--type-inline'>Neither agree nor disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_133_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_133' type='radio' value='1'  id='choice_93_133_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_133_3' id='label_93_133_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_133_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_133' type='radio' value='2'  id='choice_93_133_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_133_4' id='label_93_133_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_93_134\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question-optional show-only-value hide-score question field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_unchanged gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>I am comfortable sharing sensitive information about my depression (such as symptoms or diagnosis) with a digital health company.<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_93_134'>\n\t\t\t<div class='gchoice gchoice_93_134_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_134' type='radio' value='-2'  id='choice_93_134_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_134_0' id='label_93_134_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_134_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_134' type='radio' value='-1'  id='choice_93_134_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_134_1' id='label_93_134_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_134_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_134' type='radio' value='0'  id='choice_93_134_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_134_2' id='label_93_134_2' class='gform-field-label gform-field-label--type-inline'>Neither agree nor disagree<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_134_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_134' type='radio' value='1'  id='choice_93_134_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_134_3' id='label_93_134_3' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_134_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_134' type='radio' value='2'  id='choice_93_134_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_134_4' id='label_93_134_4' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_93_138\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full question-optional show-only-value hide-score question field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_unchanged\"  ><label class='gfield_label gform-field-label' for='input_93_138'><span class='gform-field-label__text'>Optional: What would make a prescription digital therapeutic for depression feel worth trying for you?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_138' id='input_93_138' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_93_140\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><hr \/>\n\nThe following questions ask about your knowledge of <strong>prescription digital therapeutics<\/strong>. If you haven't heard this term before, that's okay! You can still answer these questions.<\/div><fieldset id=\"field_93_109\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question-optional show-only-value hide-score question field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_unchanged gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Before today, had you ever heard the term \u201cprescription digital therapeutic\u201d?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_93_109'>\n\t\t\t<div class='gchoice gchoice_93_109_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_109' type='radio' value='Yes'  id='choice_93_109_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_109_0' id='label_93_109_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_109_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_109' type='radio' value='No'  id='choice_93_109_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_109_1' id='label_93_109_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_109_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_109' type='radio' value='Not sure'  id='choice_93_109_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_109_2' id='label_93_109_2' class='gform-field-label gform-field-label--type-inline'>Not sure<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_93_110\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full traditional question-optional show-only-value hide-score question field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_unchanged gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Which best describes a prescription digital therapeutic?<\/span><\/legend><div class='gfield_description' id='gfield_description_93_110'><em>(If you're not sure, you can give your best guess.)<\/em><\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_93_110'>\n\t\t\t<div class='gchoice gchoice_93_110_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_110' type='radio' value='A digital treatment approved by the FDA and prescribed by a clinician'  id='choice_93_110_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_93_110\"   \/>\n\t\t\t\t\t<label for='choice_93_110_0' id='label_93_110_0' class='gform-field-label gform-field-label--type-inline'>A digital treatment approved by the FDA and prescribed by a clinician<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_110_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_110' type='radio' value='A wellness app'  id='choice_93_110_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_110_1' id='label_93_110_1' class='gform-field-label gform-field-label--type-inline'>A wellness app<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_110_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_110' type='radio' value='A telehealth app'  id='choice_93_110_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_110_2' id='label_93_110_2' class='gform-field-label gform-field-label--type-inline'>A telehealth app<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_110_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_110' type='radio' value='An online support group'  id='choice_93_110_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_110_3' id='label_93_110_3' class='gform-field-label gform-field-label--type-inline'>An online support group<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_110_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_110' type='radio' value='Not sure'  id='choice_93_110_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_110_4' id='label_93_110_4' class='gform-field-label gform-field-label--type-inline'>Not sure<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_93_111\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question-optional show-only-value hide-score question field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_unchanged gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Before today, had you ever heard of using a prescription digital therapeutic to treat depression?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_93_111'>\n\t\t\t<div class='gchoice gchoice_93_111_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_111' type='radio' value='Yes'  id='choice_93_111_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_111_0' id='label_93_111_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_111_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_111' type='radio' value='No'  id='choice_93_111_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_111_1' id='label_93_111_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_111_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_111' type='radio' value='Not sure'  id='choice_93_111_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_111_2' id='label_93_111_2' class='gform-field-label gform-field-label--type-inline'>Not sure<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_93_112\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional question-optional show-only-value hide-score question field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_unchanged gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Where have you heard about prescription digital therapeutics for depression?<\/span><\/legend><div class='gfield_description' id='gfield_description_93_112'>Selecciona todas las opciones que apliquen.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_93_112'><div class='gchoice gchoice_93_112_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_112.1' type='checkbox'  value='Doctor or clinician'  id='choice_93_112_1'   aria-describedby=\"gfield_description_93_112\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_93_112_1' id='label_93_112_1' class='gform-field-label gform-field-label--type-inline'>Doctor or clinician<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_112_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_112.2' type='checkbox'  value='Therapist'  id='choice_93_112_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_112_2' id='label_93_112_2' class='gform-field-label gform-field-label--type-inline'>Therapist<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_112_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_112.3' type='checkbox'  value='Pharmacist'  id='choice_93_112_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_112_3' id='label_93_112_3' class='gform-field-label gform-field-label--type-inline'>Pharmacist<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_112_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_112.4' type='checkbox'  value='Insurance plan'  id='choice_93_112_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_112_4' id='label_93_112_4' class='gform-field-label gform-field-label--type-inline'>Insurance plan<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_112_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_112.5' type='checkbox'  value='Online search'  id='choice_93_112_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_112_5' id='label_93_112_5' class='gform-field-label gform-field-label--type-inline'>Online search<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_112_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_112.6' type='checkbox'  value='Social media'  id='choice_93_112_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_112_6' id='label_93_112_6' class='gform-field-label gform-field-label--type-inline'>Social media<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_112_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_112.7' type='checkbox'  value='Friends\/family'  id='choice_93_112_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_112_7' id='label_93_112_7' class='gform-field-label gform-field-label--type-inline'>Friends\/family<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_112_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_112.8' type='checkbox'  value='Community organization'  id='choice_93_112_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_112_8' id='label_93_112_8' class='gform-field-label gform-field-label--type-inline'>Community organization<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_112_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_112.9' type='checkbox'  value='Have never heard of them'  id='choice_93_112_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_112_9' id='label_93_112_9' class='gform-field-label gform-field-label--type-inline'>Have never heard of them<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_93_113\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-3 question-optional show-only-value hide-score question field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_unchanged gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Where would you look first to find a new treatment or tool for depression?<\/span><\/legend><div class='gfield_description' id='gfield_description_93_113'>Selecciona hasta 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_93_113'><div class='gchoice gchoice_93_113_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_113.1' type='checkbox'  value='Doctor or clinician'  id='choice_93_113_1'   aria-describedby=\"gfield_description_93_113\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_93_113_1' id='label_93_113_1' class='gform-field-label gform-field-label--type-inline'>Doctor or clinician<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_113_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_113.2' type='checkbox'  value='Mental health specialist'  id='choice_93_113_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_113_2' id='label_93_113_2' class='gform-field-label gform-field-label--type-inline'>Mental health specialist<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_113_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_113.3' type='checkbox'  value='Online search'  id='choice_93_113_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_113_3' id='label_93_113_3' class='gform-field-label gform-field-label--type-inline'>Online search<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_113_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_113.4' type='checkbox'  value='Insurance plan'  id='choice_93_113_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_113_4' id='label_93_113_4' class='gform-field-label gform-field-label--type-inline'>Insurance plan<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_113_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_113.5' type='checkbox'  value='Friends\/family'  id='choice_93_113_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_113_5' id='label_93_113_5' class='gform-field-label gform-field-label--type-inline'>Friends\/family<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_113_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_113.6' type='checkbox'  value='Community organization'  id='choice_93_113_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_113_6' id='label_93_113_6' class='gform-field-label gform-field-label--type-inline'>Community organization<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_113_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_113.7' type='checkbox'  value='App store'  id='choice_93_113_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_113_7' id='label_93_113_7' class='gform-field-label gform-field-label--type-inline'>App store<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_93_115\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-3 question-optional show-only-value hide-score question field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_unchanged gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Who would you trust most to recommend a prescription digital therapeutic for depression?<\/span><\/legend><div class='gfield_description' id='gfield_description_93_115'>Selecciona hasta 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_93_115'><div class='gchoice gchoice_93_115_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_115.1' type='checkbox'  value='Doctor or nurse'  id='choice_93_115_1'   aria-describedby=\"gfield_description_93_115\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_93_115_1' id='label_93_115_1' class='gform-field-label gform-field-label--type-inline'>Doctor or nurse<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_115_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_115.2' type='checkbox'  value='Therapist'  id='choice_93_115_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_115_2' id='label_93_115_2' class='gform-field-label gform-field-label--type-inline'>Therapist<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_115_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_115.3' type='checkbox'  value='Community health worker'  id='choice_93_115_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_115_3' id='label_93_115_3' class='gform-field-label gform-field-label--type-inline'>Community health worker<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_115_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_115.4' type='checkbox'  value='Insurance plan'  id='choice_93_115_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_115_4' id='label_93_115_4' class='gform-field-label gform-field-label--type-inline'>Insurance plan<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_115_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_115.5' type='checkbox'  value='Family or friend'  id='choice_93_115_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_115_5' id='label_93_115_5' class='gform-field-label gform-field-label--type-inline'>Family or friend<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_115_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_115.6' type='checkbox'  value='Social media'  id='choice_93_115_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_115_6' id='label_93_115_6' class='gform-field-label gform-field-label--type-inline'>Social media<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_93_115_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_115.7' type='checkbox'  value='No one'  id='choice_93_115_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_93_115_7' id='label_93_115_7' class='gform-field-label gform-field-label--type-inline'>No one<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_93_128\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question-optional show-only-value hide-score question field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_unchanged gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>If a prescription digital therapeutic for depression were offered to you at low or no cost, how likely would you be to try it?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_93_128'>\n\t\t\t<div class='gchoice gchoice_93_128_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_128' type='radio' value='-2'  id='choice_93_128_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_128_0' id='label_93_128_0' class='gform-field-label gform-field-label--type-inline'>Very unlikely<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_128_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_128' type='radio' value='-1'  id='choice_93_128_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_128_1' id='label_93_128_1' class='gform-field-label gform-field-label--type-inline'>Unlikely<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_128_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_128' type='radio' value='0'  id='choice_93_128_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_128_2' id='label_93_128_2' class='gform-field-label gform-field-label--type-inline'>No estoy seguro\/a<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_128_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_128' type='radio' value='1'  id='choice_93_128_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_128_3' id='label_93_128_3' class='gform-field-label gform-field-label--type-inline'>Somewhat likely<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_128_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_128' type='radio' value='2'  id='choice_93_128_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_128_4' id='label_93_128_4' class='gform-field-label gform-field-label--type-inline'>Very likely<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <button type='button' id='gform_next_button_93_17' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Siguiente<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_93_2' class='gform_page demographics' data-js='page-field-id-17' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_93_2' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_93_94\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p class=\"translation-block\">Por favor, toma un momento para responder a las siguientes preguntas <strong>opcionales<\/strong>. Tus respuestas son totalmente an\u00f3nimas: no podremos identificarte a partir de esta informaci\u00f3n. Tus respuestas nos ayudan a proporcionar mejor informaci\u00f3n y apoyo a personas como t\u00fa.<\/p>\n\n<p>Puedes responder a tantas preguntas como desees. Cuando hayas terminado, despl\u00e1zate hasta la parte inferior de la encuesta y haz clic en \"ver resultados\" para recibir los resultados de la evaluaci\u00f3n.<\/p><\/div><div id=\"field_93_95\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full layout-action show-actions_b gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><hr \/><\/div><div id=\"field_93_96\" class=\"gfield gfield--type-html gfield--input-type-html section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>Acerca de ti<\/h2><\/div><div id=\"field_93_97\" class=\"gfield gfield--type-select gfield--input-type-select optional taxonomy field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_93_97'><span class='gform-field-label__text'>Rango de edades<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_97' id='input_93_97' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='under 18' >under 18<\/option><option value='18-24' >18-24<\/option><option value='25-34' >25-34<\/option><option value='35-44' >35-44<\/option><option value='45-54' >45-54<\/option><option value='55-64' >55-64<\/option><option value='65+' >65+<\/option><\/select><\/div><\/div><fieldset id=\"field_93_98\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Gender identity<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_93_98'>\n\t\t\t<div class='gchoice gchoice_93_98_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_98' type='radio' value='Woman'  id='choice_93_98_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_98_0' id='label_93_98_0' class='gform-field-label gform-field-label--type-inline'>Woman<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_98_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_98' type='radio' value='Man'  id='choice_93_98_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_98_1' id='label_93_98_1' class='gform-field-label gform-field-label--type-inline'>Man<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_98_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_98' type='radio' value='Non-Binary'  id='choice_93_98_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_98_2' id='label_93_98_2' class='gform-field-label gform-field-label--type-inline'>No binario<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_98_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_98' type='radio' value='Another identity'  id='choice_93_98_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_98_3' id='label_93_98_3' class='gform-field-label gform-field-label--type-inline'>Another identity<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_98_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_98' type='radio' value='Prefer not to say'  id='choice_93_98_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_98_4' id='label_93_98_4' class='gform-field-label gform-field-label--type-inline'>Prefer not to say<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_93_100\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_93_100'><span class='gform-field-label__text'>\u00bfC\u00f3mo describir\u00edas tu g\u00e9nero?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_100' id='input_93_100' type='text' value='' class='small'    placeholder='Ingresa el g\u00e9nero...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_93_105\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Sex assigned at birth<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_93_105'>\n\t\t\t<div class='gchoice gchoice_93_105_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_105' type='radio' value='Female'  id='choice_93_105_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_105_0' id='label_93_105_0' class='gform-field-label gform-field-label--type-inline'>Femenino<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_105_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_105' type='radio' value='Male'  id='choice_93_105_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_105_1' id='label_93_105_1' class='gform-field-label gform-field-label--type-inline'>Masculino<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_105_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_105' type='radio' value='Intersex'  id='choice_93_105_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_105_2' id='label_93_105_2' class='gform-field-label gform-field-label--type-inline'>Intersex<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_105_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_105' type='radio' value='Prefer not to say'  id='choice_93_105_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_105_3' id='label_93_105_3' class='gform-field-label gform-field-label--type-inline'>Prefer not to say<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_93_101\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfVives en los Estados Unidos de Am\u00e9rica o en otro pa\u00eds?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_93_101'>\n\t\t\t<div class='gchoice gchoice_93_101_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_101' type='radio' value='I live in the United States'  id='choice_93_101_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_101_0' id='label_93_101_0' class='gform-field-label gform-field-label--type-inline'>Vivo en los Estados Unidos de Am\u00e9rica.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_101_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_101' type='radio' value='I live in another country'  id='choice_93_101_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_101_1' id='label_93_101_1' class='gform-field-label gform-field-label--type-inline'>Vivo en otro pa\u00eds.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_93_103\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_93_103'><span class='gform-field-label__text'>C\u00f3digo postal<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_103' id='input_93_103' type='text' value='' class='small'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_93_136\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full traditional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>What type of health insurance do you currently have?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_93_136'>\n\t\t\t<div class='gchoice gchoice_93_136_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_136' type='radio' value='Medicaid'  id='choice_93_136_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_136_0' id='label_93_136_0' class='gform-field-label gform-field-label--type-inline'>Medicaid<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_136_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_136' type='radio' value='Medicare'  id='choice_93_136_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_136_1' id='label_93_136_1' class='gform-field-label gform-field-label--type-inline'>Medicare<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_136_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_136' type='radio' value='Employer-sponsored'  id='choice_93_136_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_136_2' id='label_93_136_2' class='gform-field-label gform-field-label--type-inline'>Employer-sponsored<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_136_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_136' type='radio' value='Marketplace\/ACA'  id='choice_93_136_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_136_3' id='label_93_136_3' class='gform-field-label gform-field-label--type-inline'>Marketplace\/ACA<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_136_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_136' type='radio' value='Uninsured'  id='choice_93_136_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_136_4' id='label_93_136_4' class='gform-field-label gform-field-label--type-inline'>Uninsured<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_136_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_136' type='radio' value='Other'  id='choice_93_136_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_136_5' id='label_93_136_5' class='gform-field-label gform-field-label--type-inline'>Otros<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_93_137\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full traditional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>What is your current employment status?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_93_137'>\n\t\t\t<div class='gchoice gchoice_93_137_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_137' type='radio' value='Employed full-time'  id='choice_93_137_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_137_0' id='label_93_137_0' class='gform-field-label gform-field-label--type-inline'>Employed full-time<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_137_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_137' type='radio' value='Employed part-time'  id='choice_93_137_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_137_1' id='label_93_137_1' class='gform-field-label gform-field-label--type-inline'>Employed part-time<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_137_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_137' type='radio' value='Unemployed'  id='choice_93_137_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_137_2' id='label_93_137_2' class='gform-field-label gform-field-label--type-inline'>Unemployed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_137_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_137' type='radio' value='Student'  id='choice_93_137_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_137_3' id='label_93_137_3' class='gform-field-label gform-field-label--type-inline'>Estudiante<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_137_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_137' type='radio' value='Retired'  id='choice_93_137_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_137_4' id='label_93_137_4' class='gform-field-label gform-field-label--type-inline'>Retired<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_93_137_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_137' type='radio' value='Unable to work'  id='choice_93_137_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_93_137_5' id='label_93_137_5' class='gform-field-label gform-field-label--type-inline'>Unable to work<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><button type='submit' id='gform_previous_button_93' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Anterior<\/button> <button type='submit' id='gform_submit_button_93' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Enviar encuesta<\/button> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_93' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_93' id='gform_theme_93' value='gravity-theme' \/>\n            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This means that psychedelics can be prescribed and possibly covered by health insurance.<\/p>\n<p>This survey was developed to help us explore your opinions about psychedelics and mental health. Sharing these thoughts will help us understand who is interested or not interested in this treatment and which resources and policies we can develop. <strong>No personally identifiable information will be shared outside of MHA.<\/strong><\/p>\n<p>Thank you for participating!<\/p>\n<hr \/><\/div><div id=\"field_92_38\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_38' id='input_92_38' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_92_39\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><input name=\"input_39\" id=\"input_92_39\" type=\"hidden\" class=\"gform_hidden\" aria-invalid=\"false\" value=\"255654\"><\/div><div id=\"field_92_40\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><input name=\"input_40\" id=\"input_92_40\" type=\"hidden\" class=\"gform_hidden\" aria-invalid=\"false\" value=\"e875158b42d4e2ab407c8e264f11f752\"><\/div><div id=\"field_92_41\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_41' id='input_92_41' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_92_51\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_51' id='input_92_51' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='http:\/\/screening.mhanational.org' \/><\/div><\/div><div id=\"field_92_81\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_81' id='input_92_81' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_92_82\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_82' id='input_92_82' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_92_83\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_83' id='input_92_83' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_92_93\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_93' id='input_92_93' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_92_172\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_172' id='input_92_172' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='lang--es' \/><\/div><\/div><fieldset id=\"field_92_157\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full traditional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Have you used any psychedelics now or in the past? Pick one that most represents you.<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_92_157'>\n\t\t\t<div class='gchoice gchoice_92_157_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_157' type='radio' value='No, and I don&#039;t want to'  id='choice_92_157_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_157_0' id='label_92_157_0' class='gform-field-label gform-field-label--type-inline'>No, and I don't want to<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_92_157_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_157' type='radio' value='No, but I would like to'  id='choice_92_157_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_157_1' id='label_92_157_1' class='gform-field-label gform-field-label--type-inline'>No, but I would like to<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_92_157_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_157' type='radio' value='Yes, and I would like to try them again'  id='choice_92_157_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_157_2' id='label_92_157_2' class='gform-field-label gform-field-label--type-inline'>Yes, and I would like to try them again<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_92_157_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_157' type='radio' value='Yes, but I don&#039;t want to use them again'  id='choice_92_157_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_157_3' id='label_92_157_3' class='gform-field-label gform-field-label--type-inline'>Yes, but I don't want to use them again<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_92_157_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_157' type='radio' value='Yes, I use psychedelics regularly'  id='choice_92_157_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_157_4' id='label_92_157_4' class='gform-field-label gform-field-label--type-inline'>Yes, I use psychedelics regularly<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_92_158\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-2 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Which psychedelics did you try or use most often?<\/span><\/legend><div class='gfield_description' id='gfield_description_92_158'>Select up to 2. (For this question, we are intentionally leaving out cannabis.)<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_92_158'><div class='gchoice gchoice_92_158_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_158.1' type='checkbox'  value='Ayahuasca'  id='choice_92_158_1'   aria-describedby=\"gfield_description_92_158\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_92_158_1' id='label_92_158_1' class='gform-field-label gform-field-label--type-inline'>Ayahuasca<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_158_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_158.2' type='checkbox'  value='DMT'  id='choice_92_158_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_158_2' id='label_92_158_2' class='gform-field-label gform-field-label--type-inline'>DMT<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_158_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_158.3' type='checkbox'  value='Ibogaine'  id='choice_92_158_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_158_3' id='label_92_158_3' class='gform-field-label gform-field-label--type-inline'>Ibogaine<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_158_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_158.4' type='checkbox'  value='Ketamine'  id='choice_92_158_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_158_4' id='label_92_158_4' class='gform-field-label gform-field-label--type-inline'>Ketamina<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_158_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_158.5' type='checkbox'  value='LSD (acid)'  id='choice_92_158_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_158_5' id='label_92_158_5' class='gform-field-label gform-field-label--type-inline'>LSD (acid)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_158_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_158.6' type='checkbox'  value='MDMA (ecstasy, molly)'  id='choice_92_158_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_158_6' id='label_92_158_6' class='gform-field-label gform-field-label--type-inline'>MDMA (ecstasy, molly)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_158_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_158.7' type='checkbox'  value='Mescaline (peyote)'  id='choice_92_158_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_158_7' id='label_92_158_7' class='gform-field-label gform-field-label--type-inline'>Mescaline (peyote)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_158_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_158.8' type='checkbox'  value='Psilocybin (mushrooms)'  id='choice_92_158_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_158_8' id='label_92_158_8' class='gform-field-label gform-field-label--type-inline'>Psilocybin (mushrooms)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_158_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_158.9' type='checkbox'  value='Other...'  id='choice_92_158_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_158_9' id='label_92_158_9' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_92_141\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_92_141'><span class='gform-field-label__text'>What other psychedelic did you try or use most often?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_141' id='input_92_141' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_92_159\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-2 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Which psychedelics are you most interested in trying?<\/span><\/legend><div class='gfield_description' id='gfield_description_92_159'>Select up to 2. (For this question, we are intentionally leaving out cannabis.)<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_92_159'><div class='gchoice gchoice_92_159_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_159.1' type='checkbox'  value='Ayahuasca'  id='choice_92_159_1'   aria-describedby=\"gfield_description_92_159\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_92_159_1' id='label_92_159_1' class='gform-field-label gform-field-label--type-inline'>Ayahuasca<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_159_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_159.2' type='checkbox'  value='DMT'  id='choice_92_159_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_159_2' id='label_92_159_2' class='gform-field-label gform-field-label--type-inline'>DMT<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_159_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_159.3' type='checkbox'  value='Ibogaine'  id='choice_92_159_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_159_3' id='label_92_159_3' class='gform-field-label gform-field-label--type-inline'>Ibogaine<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_159_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_159.4' type='checkbox'  value='Ketamine'  id='choice_92_159_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_159_4' id='label_92_159_4' class='gform-field-label gform-field-label--type-inline'>Ketamina<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_159_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_159.5' type='checkbox'  value='LSD (acid)'  id='choice_92_159_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_159_5' id='label_92_159_5' class='gform-field-label gform-field-label--type-inline'>LSD (acid)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_159_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_159.6' type='checkbox'  value='MDMA (ecstasy, molly)'  id='choice_92_159_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_159_6' id='label_92_159_6' class='gform-field-label gform-field-label--type-inline'>MDMA (ecstasy, molly)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_159_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_159.7' type='checkbox'  value='Mescaline (peyote)'  id='choice_92_159_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_159_7' id='label_92_159_7' class='gform-field-label gform-field-label--type-inline'>Mescaline (peyote)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_159_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_159.8' type='checkbox'  value='Psilocybin (mushrooms)'  id='choice_92_159_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_159_8' id='label_92_159_8' class='gform-field-label gform-field-label--type-inline'>Psilocybin (mushrooms)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_159_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_159.9' type='checkbox'  value='Other...'  id='choice_92_159_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_159_9' id='label_92_159_9' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_92_160\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_92_160'><span class='gform-field-label__text'>What other psychedelic are you most interested in trying?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_160' id='input_92_160' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_92_161\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-3 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>What prevents you from using psychedelics?<\/span><\/legend><div class='gfield_description' id='gfield_description_92_161'>Seleccione sus tres favoritos.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_92_161'><div class='gchoice gchoice_92_161_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_161.1' type='checkbox'  value='I don\u2019t know enough about psychedelics'  id='choice_92_161_1'   aria-describedby=\"gfield_description_92_161\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_92_161_1' id='label_92_161_1' class='gform-field-label gform-field-label--type-inline'>I don\u2019t know enough about psychedelics<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_161_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_161.2' type='checkbox'  value='I don\u2019t think people should use drugs'  id='choice_92_161_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_161_2' id='label_92_161_2' class='gform-field-label gform-field-label--type-inline'>I don\u2019t think people should use drugs<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_161_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_161.3' type='checkbox'  value='I think it could make my mental health worse'  id='choice_92_161_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_161_3' id='label_92_161_3' class='gform-field-label gform-field-label--type-inline'>I think it could make my mental health worse<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_161_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_161.4' type='checkbox'  value='I\u2019m afraid of becoming addicted'  id='choice_92_161_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_161_4' id='label_92_161_4' class='gform-field-label gform-field-label--type-inline'>I\u2019m afraid of becoming addicted<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_161_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_161.5' type='checkbox'  value='I\u2019m afraid of a bad experience (bad trip)'  id='choice_92_161_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_161_5' id='label_92_161_5' class='gform-field-label gform-field-label--type-inline'>I\u2019m afraid of a bad experience (bad trip)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_161_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_161.6' type='checkbox'  value='They are illegal'  id='choice_92_161_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_161_6' id='label_92_161_6' class='gform-field-label gform-field-label--type-inline'>They are illegal<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_161_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_161.7' type='checkbox'  value='I don\u2019t know if it\u2019s safe (because it\u2019s unregulated)'  id='choice_92_161_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_161_7' id='label_92_161_7' class='gform-field-label gform-field-label--type-inline'>I don\u2019t know if it\u2019s safe (because it\u2019s unregulated)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_161_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_161.8' type='checkbox'  value='I can\u2019t because of my job (e.g. clearance, drug testing)'  id='choice_92_161_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_161_8' id='label_92_161_8' class='gform-field-label gform-field-label--type-inline'>I can\u2019t because of my job (e.g. clearance, drug testing)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_161_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_161.9' type='checkbox'  value='It\u2019s hard to get even though I want to try them'  id='choice_92_161_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_161_9' id='label_92_161_9' class='gform-field-label gform-field-label--type-inline'>It\u2019s hard to get even though I want to try them<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_161_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_161.11' type='checkbox'  value='They\u2019re too expensive'  id='choice_92_161_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_161_11' id='label_92_161_11' class='gform-field-label gform-field-label--type-inline'>They\u2019re too expensive<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_161_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_161.12' type='checkbox'  value='Other...'  id='choice_92_161_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_161_12' id='label_92_161_12' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_92_162\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_92_162'><span class='gform-field-label__text'>What else prevents you from using psychedelics?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_162' id='input_92_162' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_92_164\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-3 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>What prevents you from using psychedelics as much as you&#039;d like?<\/span><\/legend><div class='gfield_description' id='gfield_description_92_164'>Seleccione sus tres favoritos.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_92_164'><div class='gchoice gchoice_92_164_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.1' type='checkbox'  value='Nothing, I use psychedelics as much as I&#039;d like to'  id='choice_92_164_1'   aria-describedby=\"gfield_description_92_164\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_92_164_1' id='label_92_164_1' class='gform-field-label gform-field-label--type-inline'>Nothing, I use psychedelics as much as I'd like to<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_164_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.2' type='checkbox'  value='I don\u2019t know enough about psychedelics'  id='choice_92_164_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_164_2' id='label_92_164_2' class='gform-field-label gform-field-label--type-inline'>I don\u2019t know enough about psychedelics<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_164_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.3' type='checkbox'  value='I think it could make my mental health worse'  id='choice_92_164_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_164_3' id='label_92_164_3' class='gform-field-label gform-field-label--type-inline'>I think it could make my mental health worse<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_164_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.4' type='checkbox'  value='I\u2019m afraid of becoming addicted'  id='choice_92_164_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_164_4' id='label_92_164_4' class='gform-field-label gform-field-label--type-inline'>I\u2019m afraid of becoming addicted<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_164_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.5' type='checkbox'  value='I\u2019m afraid of a bad experience (bad trip)'  id='choice_92_164_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_164_5' id='label_92_164_5' class='gform-field-label gform-field-label--type-inline'>I\u2019m afraid of a bad experience (bad trip)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_164_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.6' type='checkbox'  value='They are illegal'  id='choice_92_164_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_164_6' id='label_92_164_6' class='gform-field-label gform-field-label--type-inline'>They are illegal<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_164_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.7' type='checkbox'  value='I don\u2019t know if it\u2019s safe (because it\u2019s unregulated)'  id='choice_92_164_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_164_7' id='label_92_164_7' class='gform-field-label gform-field-label--type-inline'>I don\u2019t know if it\u2019s safe (because it\u2019s unregulated)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_164_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.8' type='checkbox'  value='I can\u2019t because of my job (e.g. clearance, drug testing)'  id='choice_92_164_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_164_8' id='label_92_164_8' class='gform-field-label gform-field-label--type-inline'>I can\u2019t because of my job (e.g. clearance, drug testing)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_164_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.9' type='checkbox'  value='It\u2019s hard to get even though I want to try them'  id='choice_92_164_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_164_9' id='label_92_164_9' class='gform-field-label gform-field-label--type-inline'>It\u2019s hard to get even though I want to try them<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_164_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.11' type='checkbox'  value='They\u2019re too expensive'  id='choice_92_164_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_164_11' id='label_92_164_11' class='gform-field-label gform-field-label--type-inline'>They\u2019re too expensive<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_164_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.12' type='checkbox'  value='Other...'  id='choice_92_164_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_164_12' id='label_92_164_12' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_92_163\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_92_163'><span class='gform-field-label__text'>What else prevents you from using psychedelics as much as you&#039;d like to?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_163' id='input_92_163' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_92_165\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-3 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>What did or would you use psychedelics for?<\/span><\/legend><div class='gfield_description' id='gfield_description_92_165'>Seleccione sus tres favoritos.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_92_165'><div class='gchoice gchoice_92_165_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_165.1' type='checkbox'  value='I was\/am curious'  id='choice_92_165_1'   aria-describedby=\"gfield_description_92_165\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_92_165_1' id='label_92_165_1' class='gform-field-label gform-field-label--type-inline'>I was\/am curious<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_165_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_165.2' type='checkbox'  value='I felt or feel pressured to use them'  id='choice_92_165_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_165_2' id='label_92_165_2' class='gform-field-label gform-field-label--type-inline'>I felt or feel pressured to use them<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_165_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_165.3' type='checkbox'  value='To feel more social - for fun'  id='choice_92_165_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_165_3' id='label_92_165_3' class='gform-field-label gform-field-label--type-inline'>To feel more social - for fun<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_165_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_165.4' type='checkbox'  value='To reduce my sadness or anxiety'  id='choice_92_165_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_165_4' id='label_92_165_4' class='gform-field-label gform-field-label--type-inline'>To reduce my sadness or anxiety<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_165_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_165.5' type='checkbox'  value='To recover from trauma'  id='choice_92_165_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_165_5' id='label_92_165_5' class='gform-field-label gform-field-label--type-inline'>To recover from trauma<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_165_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_165.6' type='checkbox'  value='To have a spiritual or beyond conscious experience'  id='choice_92_165_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_165_6' id='label_92_165_6' class='gform-field-label gform-field-label--type-inline'>To have a spiritual or beyond conscious experience<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_165_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_165.7' type='checkbox'  value='To boost energy or motivation'  id='choice_92_165_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_165_7' id='label_92_165_7' class='gform-field-label gform-field-label--type-inline'>To boost energy or motivation<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_165_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_165.8' type='checkbox'  value='To boost creativity (art, music, creative writing)'  id='choice_92_165_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_165_8' id='label_92_165_8' class='gform-field-label gform-field-label--type-inline'>To boost creativity (art, music, creative writing)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_165_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_165.9' type='checkbox'  value='Other...'  id='choice_92_165_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_165_9' id='label_92_165_9' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_92_166\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_92_166'><span class='gform-field-label__text'>What else would or did you use psychedelics for?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_166' id='input_92_166' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_92_167\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-2 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>When thinking about psychedelics and your mental health, which of the following apply most to you?<\/span><\/legend><div class='gfield_description' id='gfield_description_92_167'>Select up to 2.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_92_167'><div class='gchoice gchoice_92_167_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_167.1' type='checkbox'  value='Psychedelics are\/seem more enjoyable than other types of mental health treatment'  id='choice_92_167_1'   aria-describedby=\"gfield_description_92_167\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_92_167_1' id='label_92_167_1' class='gform-field-label gform-field-label--type-inline'>Psychedelics are\/seem more enjoyable than other types of mental health treatment<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_167_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_167.2' type='checkbox'  value='I feel safer using psychedelics than using antidepressants or other medications'  id='choice_92_167_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_167_2' id='label_92_167_2' class='gform-field-label gform-field-label--type-inline'>I feel safer using psychedelics than using antidepressants or other medications<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_167_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_167.3' type='checkbox'  value='I use psychedelics for other reasons, but the emotional benefits are an added bonus'  id='choice_92_167_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_167_3' id='label_92_167_3' class='gform-field-label gform-field-label--type-inline'>I use psychedelics for other reasons, but the emotional benefits are an added bonus<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_167_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_167.4' type='checkbox'  value='Traditional therapy alone hasn\u2019t worked for me'  id='choice_92_167_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_167_4' id='label_92_167_4' class='gform-field-label gform-field-label--type-inline'>Traditional therapy alone hasn\u2019t worked for me<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_167_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_167.5' type='checkbox'  value='Traditional therapy isn&#039;t as available for me'  id='choice_92_167_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_167_5' id='label_92_167_5' class='gform-field-label gform-field-label--type-inline'>Traditional therapy isn't as available for me<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_167_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_167.6' type='checkbox'  value='I\u2019m using traditional treatments and psychedelics'  id='choice_92_167_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_167_6' id='label_92_167_6' class='gform-field-label gform-field-label--type-inline'>I\u2019m using traditional treatments and psychedelics<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_167_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_167.7' type='checkbox'  value='None of the above'  id='choice_92_167_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_167_7' id='label_92_167_7' class='gform-field-label gform-field-label--type-inline'>Ninguna de las anteriores<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_92_168\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full traditional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>If psychedelics became medically available (prescribed and covered by insurance), would you be interested in trying them?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_92_168'>\n\t\t\t<div class='gchoice gchoice_92_168_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_168' type='radio' value='Yes, and having them monitored by a doctor is most important'  id='choice_92_168_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_168_0' id='label_92_168_0' class='gform-field-label gform-field-label--type-inline'>Yes, and having them monitored by a doctor is most important<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_92_168_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_168' type='radio' value='Yes, and having it with a guided therapy session is most important'  id='choice_92_168_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_168_1' id='label_92_168_1' class='gform-field-label gform-field-label--type-inline'>Yes, and having it with a guided therapy session is most important<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_92_168_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_168' type='radio' value='Yes, but only if they\u2019re affordable'  id='choice_92_168_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_168_2' id='label_92_168_2' class='gform-field-label gform-field-label--type-inline'>Yes, but only if they\u2019re affordable<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_92_168_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_168' type='radio' value='I would still use them but not through medical care'  id='choice_92_168_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_168_3' id='label_92_168_3' class='gform-field-label gform-field-label--type-inline'>I would still use them but not through medical care<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_92_168_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_168' type='radio' value='No, I still wouldn\u2019t want to try them'  id='choice_92_168_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_168_4' id='label_92_168_4' class='gform-field-label gform-field-label--type-inline'>No, I still wouldn\u2019t want to try them<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_92_169\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-2 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>What do you think is the most important priority for the government regarding psychedelics today?<\/span><\/legend><div class='gfield_description' id='gfield_description_92_169'>Select up to 2.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_92_169'><div class='gchoice gchoice_92_169_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_169.1' type='checkbox'  value='Ban psychedelics entirely'  id='choice_92_169_1'   aria-describedby=\"gfield_description_92_169\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_92_169_1' id='label_92_169_1' class='gform-field-label gform-field-label--type-inline'>Ban psychedelics entirely<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_169_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_169.2' type='checkbox'  value='Make psychedelics legal'  id='choice_92_169_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_169_2' id='label_92_169_2' class='gform-field-label gform-field-label--type-inline'>Make psychedelics legal<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_169_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_169.3' type='checkbox'  value='Create a regulated recreational market for psychedelics'  id='choice_92_169_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_169_3' id='label_92_169_3' class='gform-field-label gform-field-label--type-inline'>Create a regulated recreational market for psychedelics<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_169_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_169.4' type='checkbox'  value='Make medically available psychedelics accessible (FDA approval)'  id='choice_92_169_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_169_4' id='label_92_169_4' class='gform-field-label gform-field-label--type-inline'>Make medically available psychedelics accessible (FDA approval)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_169_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_169.5' type='checkbox'  value='Make medical psychedelics more affordable'  id='choice_92_169_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_169_5' id='label_92_169_5' class='gform-field-label gform-field-label--type-inline'>Make medical psychedelics more affordable<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_169_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_169.6' type='checkbox'  value='Invest in more research on psychedelics'  id='choice_92_169_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_169_6' id='label_92_169_6' class='gform-field-label gform-field-label--type-inline'>Invest in more research on psychedelics<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_169_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_169.7' type='checkbox'  value='Invest in public education on using psychedelics'  id='choice_92_169_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_169_7' id='label_92_169_7' class='gform-field-label gform-field-label--type-inline'>Invest in public education on using psychedelics<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_169_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_169.8' type='checkbox'  value='Other...'  id='choice_92_169_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_169_8' id='label_92_169_8' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_92_170\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_92_170'><span class='gform-field-label__text'>What else do you think is the most important priority for the government regarding psychedelics today?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_170' id='input_92_170' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <button type='button' id='gform_next_button_92_17' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Siguiente<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_92_2' class='gform_page demographics' data-js='page-field-id-17' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_92_2' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_92_171\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p class=\"translation-block\">Por favor, toma un momento para responder a las siguientes preguntas <strong>opcionales<\/strong>. Tus respuestas son totalmente an\u00f3nimas: no podremos identificarte a partir de esta informaci\u00f3n. Tus respuestas nos ayudan a proporcionar mejor informaci\u00f3n y apoyo a personas como t\u00fa.<\/p>\n\n<p>You can answer as many or as few questions as you would like. When you are done, scroll to the bottom of the survey and click \"submit\".<\/p><\/div><div id=\"field_92_53\" class=\"gfield gfield--type-html gfield--input-type-html section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>Acerca de ti<\/h2><\/div><div id=\"field_92_54\" class=\"gfield gfield--type-select gfield--input-type-select optional taxonomy field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_92_54'><span class='gform-field-label__text'>Rango de edades<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_54' id='input_92_54' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Under 18' >Menores de 18 a\u00f1os<\/option><option value='18-24' >18-24<\/option><option value='25-34' >25-34<\/option><option value='35-44' >35-44<\/option><option value='45-54' >45-54<\/option><option value='55-64' >55-64<\/option><option value='65+' >65+<\/option><option value='Prefer not to answer' >Prefiero no responder<\/option><\/select><\/div><\/div><fieldset id=\"field_92_55\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional mb-2 short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>G\u00e9nero<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_92_55'>\n\t\t\t<div class='gchoice gchoice_92_55_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='Female'  id='choice_92_55_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_55_0' id='label_92_55_0' class='gform-field-label gform-field-label--type-inline'>Femenino<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_92_55_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='Male'  id='choice_92_55_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_55_1' id='label_92_55_1' class='gform-field-label gform-field-label--type-inline'>Masculino<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_92_55_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='Non-Binary'  id='choice_92_55_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_55_2' id='label_92_55_2' class='gform-field-label gform-field-label--type-inline'>No binario<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_92_55_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='Prefer not to answer'  id='choice_92_55_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_55_3' id='label_92_55_3' class='gform-field-label gform-field-label--type-inline'>Prefiero no responder<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_92_156\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTe identificas como transg\u00e9nero?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_92_156'>\n\t\t\t<div class='gchoice gchoice_92_156_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_156' type='radio' value='Yes'  id='choice_92_156_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_156_0' id='label_92_156_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_92_156_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_156' type='radio' value='No'  id='choice_92_156_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_156_1' id='label_92_156_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_92_135\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_92_135'><span class='gform-field-label__text'>\u00bfC\u00f3mo describir\u00edas tu g\u00e9nero?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_135' id='input_92_135' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_92_58\" class=\"gfield gfield--type-select gfield--input-type-select optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_92_58'><span class='gform-field-label__text'>Raza\/etnia<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_58' id='input_92_58' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='American Indian or Alaska Native' >Amerindio o nativo de Alaska<\/option><option value='Asian' >Asi\u00e1tico<\/option><option value='Black or African American (non-Hispanic)' >Negro o afroamericano (no hispano)<\/option><option value='Hispanic or Latino' >Hispano o latino<\/option><option value='Middle Eastern or North African' >Del medio oriente o norteafricano<\/option><option value='Native Hawaiian or other Pacific Islander' >Isle\u00f1o nativo hawaiano o pac\u00edfico<\/option><option value='White (non-Hispanic)' >Blanco (no hispano)<\/option><option value='More than one of the above' >M\u00e1s de uno de los anteriores<\/option><option value='Other...' >Otros...<\/option><\/select><\/div><\/div><div id=\"field_92_134\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_92_134'><span class='gform-field-label__text'>\u00bfC\u00f3mo describir\u00edas tu raza\/etnia?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_134' id='input_92_134' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_92_59\" class=\"gfield gfield--type-select gfield--input-type-select optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_92_59'><span class='gform-field-label__text'>Ingresos familiares (USD)<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_59' id='input_92_59' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Less than $20,000' >Menos de $20,000<\/option><option value='$20,000 - $39,999' >$20,000 - $39,999<\/option><option value='$40,000 - $59,999' >$40,000 - $59,999<\/option><option value='$60,000 - $79,999' >$60,000 - $79,999<\/option><option value='$80,000 - $99,999' >$80,000 - $99,999<\/option><option value='$100,000 - $149,999' >$100,000 - $149,999<\/option><option value='$150,000+' >$150,000+<\/option><\/select><\/div><\/div><fieldset id=\"field_92_87\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfVives en los Estados Unidos de Am\u00e9rica o en otro pa\u00eds?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_92_87'>\n\t\t\t<div class='gchoice gchoice_92_87_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_87' type='radio' value='I live in the United States'  id='choice_92_87_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_87_0' id='label_92_87_0' class='gform-field-label gform-field-label--type-inline'>Vivo en los Estados Unidos de Am\u00e9rica.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_92_87_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_87' type='radio' value='I live in another country'  id='choice_92_87_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_87_1' id='label_92_87_1' class='gform-field-label gform-field-label--type-inline'>Vivo en otro pa\u00eds.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_92_78\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_92_78'><span class='gform-field-label__text'>Estado<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_78' id='input_92_78' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >Distrito de Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Hawaii' >Haw\u00e1i<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Luisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >M\u00edchigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Misisipi<\/option><option value='Missouri' >Misuri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >Nuevo Hampshire<\/option><option value='New Jersey' >Nueva Jersey<\/option><option value='New Mexico' >Nuevo M\u00e9xico<\/option><option value='New York' >Nueva York<\/option><option value='North Carolina' >Carolina del Norte<\/option><option value='North Dakota' >Dakota del Norte<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oreg\u00f3n<\/option><option value='Pennsylvania' >Pensilvania<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >Carolina del Sur<\/option><option value='South Dakota' >Dakota del Sur<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >Virginia Occidental<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='I live in a U.S. Territory' >Vivo en un territorio de los Estados Unidos.<\/option><\/select><\/div><\/div><fieldset id=\"field_92_109\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfVive con alguna de las siguientes discapacidades o afecciones?<\/span><\/legend><div class='gfield_description' id='gfield_description_92_109'>Selecciona todas las opciones que apliquen.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_92_109'><div class='gchoice gchoice_92_109_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.1' type='checkbox'  value='Physical disability (blind\/low vision, hearing, mobility)'  id='choice_92_109_1'   aria-describedby=\"gfield_description_92_109\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_92_109_1' id='label_92_109_1' class='gform-field-label gform-field-label--type-inline'>Physical disability (blind\/low vision, hearing, mobility)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_109_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.2' type='checkbox'  value='Arthritis or other chronic pain'  id='choice_92_109_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_109_2' id='label_92_109_2' class='gform-field-label gform-field-label--type-inline'>Artritis u otros dolores cr\u00f3nicos<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_109_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.3' type='checkbox'  value='Anxiety'  id='choice_92_109_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_109_3' id='label_92_109_3' class='gform-field-label gform-field-label--type-inline'>Ansiedad<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_109_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.4' type='checkbox'  value='Autism spectrum and\/or ADHD'  id='choice_92_109_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_109_4' id='label_92_109_4' class='gform-field-label gform-field-label--type-inline'>Espectro autista y\/o TDAH<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_109_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.5' type='checkbox'  value='Mood conditions: depression or mania'  id='choice_92_109_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_109_5' id='label_92_109_5' class='gform-field-label gform-field-label--type-inline'>Mood conditions: depression or mania<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_109_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.6' type='checkbox'  value='Intellectual or learning disability'  id='choice_92_109_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_109_6' id='label_92_109_6' class='gform-field-label gform-field-label--type-inline'>Discapacidad intelectual o del aprendizaje<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_109_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.7' type='checkbox'  value='Neurological condition (epilepsy, etc.) or traumatic brain injury (TBI)'  id='choice_92_109_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_109_7' id='label_92_109_7' class='gform-field-label gform-field-label--type-inline'>Afecci\u00f3n neurol\u00f3gica (epilepsia, etc.) o lesi\u00f3n cerebral traum\u00e1tica (LCT)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_109_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.8' type='checkbox'  value='Trauma'  id='choice_92_109_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_109_8' id='label_92_109_8' class='gform-field-label gform-field-label--type-inline'>Trauma<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_109_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.9' type='checkbox'  value='None of the above'  id='choice_92_109_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_109_9' id='label_92_109_9' class='gform-field-label gform-field-label--type-inline'>Ninguna de las anteriores<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_109_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.11' type='checkbox'  value='Other mental health condition...'  id='choice_92_109_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_109_11' id='label_92_109_11' class='gform-field-label gform-field-label--type-inline'>Otros trastornos de salud mental...<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_109_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.12' type='checkbox'  value='Other...'  id='choice_92_109_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_109_12' id='label_92_109_12' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_92_111\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_92_111'><span class='gform-field-label__text'>\u00bfQu\u00e9 otras afecciones de salud mental tiene?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_111' id='input_92_111' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_92_112\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_92_112'><span class='gform-field-label__text'>What other disabilities or condition(s) do you have?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_112' id='input_92_112' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><button type='submit' id='gform_previous_button_92' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' 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\u00bfQu\u00e9 hace que un d\u00eda sea bueno?"},"content":{"rendered":"<div class='gf_browser_chrome gform_wrapper gravity-theme gform-theme--no-framework full-pager_wrapper' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_90' style='display:none'><form method='post' enctype='multipart\/form-data'  id='gform_90' class='full-pager' action='\/es\/wp-json\/wp\/v2\/screen' data-formid='90' novalidate data-trp-original-action=\"\/es\/wp-json\/wp\/v2\/screen\"><ol class=\"full-progress-bar clearfix step-1-of-3\"><li class=\"step-1 active\"><span>Preguntas de la encuesta<\/span><\/li><li class=\"step-2 empty\"><span>Preguntas opcionales<\/span><\/li><\/ol>\n                        <div class='gform-body gform_body'><div id='gform_page_90_1' class='gform_page' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_90' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_90_139\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_90_139'><span class='gform-field-label__text'>LinkedIn<\/span><\/label><div class='gfield_description' id='gfield_description_90_139'>Este campo es para fines de validaci\u00f3n y no debe modificarse.<\/div><div class='ginput_container'><input name='input_139' id='input_90_139' type='text' value='' autocomplete='new-password'\/><\/div><\/div><div id=\"field_90_38\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_38' id='input_90_38' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_90_39\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><input name=\"input_39\" id=\"input_90_39\" type=\"hidden\" class=\"gform_hidden\" aria-invalid=\"false\" value=\"254207\"><\/div><div id=\"field_90_40\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><input name=\"input_40\" id=\"input_90_40\" type=\"hidden\" class=\"gform_hidden\" aria-invalid=\"false\" value=\"e875158b42d4e2ab407c8e264f11f752\"><\/div><div id=\"field_90_41\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_41' id='input_90_41' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_90_51\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_51' id='input_90_51' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='http:\/\/screening.mhanational.org' \/><\/div><\/div><div id=\"field_90_81\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_81' id='input_90_81' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_90_82\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_82' id='input_90_82' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_90_83\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_83' id='input_90_83' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_90_93\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_93' id='input_90_93' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_90_138\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_138' id='input_90_138' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='lang--es' \/><\/div><\/div><div id=\"field_90_99\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p>Queremos saber qu\u00e9 significa para ti personalmente tener un buen d\u00eda. Tus respuestas nos ayudar\u00e1n a promover estrategias que nos permitan a todos tener m\u00e1s d\u00edas buenos.<\/p><\/div><div id=\"field_90_95\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_90_95'><span class='gform-field-label__text'>Para ti, <strong>\u00bfQu\u00e9 hace que un d\u00eda sea bueno?<\/strong>?<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_95' id='input_90_95' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_90_96\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfCu\u00e1ntos \"buenos d\u00edas\" tienes a la semana?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_90_96'>\n\t\t\t<div class='gchoice gchoice_90_96_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_96' type='radio' value='Zero'  id='choice_90_96_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_96_0' id='label_90_96_0' class='gform-field-label gform-field-label--type-inline'>Cero<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_90_96_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_96' type='radio' value='1 or 2'  id='choice_90_96_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_96_1' id='label_90_96_1' class='gform-field-label gform-field-label--type-inline'>1 o 2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_90_96_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_96' type='radio' value='3 or 4'  id='choice_90_96_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_96_2' id='label_90_96_2' class='gform-field-label gform-field-label--type-inline'>3 o 4<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_90_96_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_96' type='radio' value='5 or 6'  id='choice_90_96_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_96_3' id='label_90_96_3' class='gform-field-label gform-field-label--type-inline'>5 o 6<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_90_96_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_96' type='radio' value='7'  id='choice_90_96_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_96_4' id='label_90_96_4' class='gform-field-label gform-field-label--type-inline'>7<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_90_97\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_90_97'><span class='gform-field-label__text'>\u00bfQu\u00e9 cosas haces para mejorar tu estado de \u00e1nimo cuando has tenido un mal d\u00eda?<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_97' id='input_90_97' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_90_136\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  >A veces suceden cosas buenas y malas en el mismo d\u00eda, pero nuestro cerebro solo se fija en las malas.<\/div><div id=\"field_90_98\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_90_98'><span class='gform-field-label__text'>Piensa en un \"mal d\u00eda\" que hayas tenido recientemente. <strong>\u00bfQu\u00e9 fue lo mejor que pas\u00f3 ese d\u00eda?<\/strong>\u2014\u00bfIncluso si es algo muy peque\u00f1o?<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_98' id='input_90_98' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <button type='button' id='gform_next_button_90_100' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Siguiente<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_90_2' class='gform_page demographics' data-js='page-field-id-100' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_90_2' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_90_103\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p class=\"translation-block\">Por favor, toma un momento para responder a las siguientes preguntas <strong>opcionales<\/strong>. Tus respuestas son totalmente an\u00f3nimas: no podremos identificarte a partir de esta informaci\u00f3n. Tus respuestas nos ayudan a proporcionar mejor informaci\u00f3n y apoyo a personas como t\u00fa.<\/p>\n\n<p>Puedes responder a tantas preguntas como desees. Cuando hayas terminado, despl\u00e1zate hasta la parte inferior de la encuesta y haz clic en \"ver resultados\" para recibir los resultados de la evaluaci\u00f3n.<\/p><\/div><fieldset id=\"field_90_101\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfYa ha respondido hoy a estas preguntas opcionales en nuestro sitio web?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_90_101'>\n\t\t\t<div class='gchoice gchoice_90_101_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_101' type='radio' value='Yes'  id='choice_90_101_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_101_0' id='label_90_101_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_90_101_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_101' type='radio' value='No'  id='choice_90_101_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_101_1' id='label_90_101_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_90_137\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  >\u00a1De acuerdo! Esta vez las omitiremos.<\/div><div id=\"field_90_104\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><hr \/><\/div><div id=\"field_90_105\" class=\"gfield gfield--type-html gfield--input-type-html section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>Acerca de ti<\/h2><\/div><div id=\"field_90_106\" class=\"gfield gfield--type-select gfield--input-type-select optional taxonomy field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_90_106'><span class='gform-field-label__text'>Rango de edades<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_106' id='input_90_106' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='8-10' >8-10<\/option><option value='11-13' >11-13<\/option><option value='14-15' >14-15<\/option><option value='16-17' >16-17<\/option><option value='18-24' >18-24<\/option><option value='25-34' >25-34<\/option><option value='35-44' >35-44<\/option><option value='45-54' >45-54<\/option><option value='55-64' >55-64<\/option><option value='65+' >65+<\/option><\/select><\/div><\/div><fieldset id=\"field_90_107\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>G\u00e9nero<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_90_107'>\n\t\t\t<div class='gchoice gchoice_90_107_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_107' type='radio' value='Female'  id='choice_90_107_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_107_0' id='label_90_107_0' class='gform-field-label gform-field-label--type-inline'>Femenino<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_90_107_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_107' type='radio' value='Male'  id='choice_90_107_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_107_1' id='label_90_107_1' class='gform-field-label gform-field-label--type-inline'>Masculino<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_90_107_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_107' type='radio' value='Non-Binary'  id='choice_90_107_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_107_2' id='label_90_107_2' class='gform-field-label gform-field-label--type-inline'>No binario<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_90_108\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTe identificas como transg\u00e9nero?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_90_108'>\n\t\t\t<div class='gchoice gchoice_90_108_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_108' type='radio' value='Yes'  id='choice_90_108_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_108_0' id='label_90_108_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_90_108_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_108' type='radio' value='No'  id='choice_90_108_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_108_1' id='label_90_108_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_90_109\" class=\"gfield gfield--type-text gfield--input-type-text optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_90_109'><span class='gform-field-label__text'>\u00bfC\u00f3mo describir\u00edas tu g\u00e9nero?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_109' id='input_90_109' type='text' value='' class='small'    placeholder='Ingresa el g\u00e9nero...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_90_110\" class=\"gfield gfield--type-select gfield--input-type-select optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_90_110'><span class='gform-field-label__text'>Raza\/etnia<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_110' id='input_90_110' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='American Indian or Alaska Native' >Amerindio o nativo de Alaska<\/option><option value='Asian' >Asi\u00e1tico<\/option><option value='Black or African American (non-Hispanic)' >Negro o afroamericano (no hispano)<\/option><option value='Hispanic or Latino' >Hispano o latino<\/option><option value='Middle Eastern or North African' >Del medio oriente o norteafricano<\/option><option value='Native Hawaiian or other Pacific Islander' >Isle\u00f1o nativo hawaiano o pac\u00edfico<\/option><option value='White (non-Hispanic)' >Blanco (no hispano)<\/option><option value='More than one of the above' >M\u00e1s de uno de los anteriores<\/option><option value='Other' >Otros<\/option><\/select><\/div><\/div><div id=\"field_90_111\" class=\"gfield gfield--type-select gfield--input-type-select optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_90_111'><span class='gform-field-label__text'>Ingresos familiares (USD)<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_111' id='input_90_111' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Less than $20,000' >Menos de $20,000<\/option><option value='$20,000 - $39,999' >$20,000 - $39,999<\/option><option value='$40,000 - $59,999' >$40,000 - $59,999<\/option><option value='$60,000 - $79,999' >$60,000 - $79,999<\/option><option value='$80,000 - $99,999' >$80,000 - $99,999<\/option><option value='$100,000 - $149,999' >$100,000 - $149,999<\/option><option value='$150,000+' >$150,000+<\/option><\/select><\/div><\/div><fieldset id=\"field_90_112\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfVives en los Estados Unidos de Am\u00e9rica o en otro pa\u00eds?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_90_112'>\n\t\t\t<div class='gchoice gchoice_90_112_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_112' type='radio' value='I live in the United States'  id='choice_90_112_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_112_0' id='label_90_112_0' class='gform-field-label gform-field-label--type-inline'>Vivo en los Estados Unidos de Am\u00e9rica.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_90_112_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_112' type='radio' value='I live in another country'  id='choice_90_112_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_112_1' id='label_90_112_1' class='gform-field-label gform-field-label--type-inline'>Vivo en otro pa\u00eds.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_90_113\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_90_113'><span class='gform-field-label__text'>Estado<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_113' id='input_90_113' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >Distrito de Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Hawaii' >Haw\u00e1i<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Luisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >M\u00edchigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Misisipi<\/option><option value='Missouri' >Misuri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >Nuevo Hampshire<\/option><option value='New Jersey' >Nueva Jersey<\/option><option value='New Mexico' >Nuevo M\u00e9xico<\/option><option value='New York' >Nueva York<\/option><option value='North Carolina' >Carolina del Norte<\/option><option value='North Dakota' >Dakota del Norte<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oreg\u00f3n<\/option><option value='Pennsylvania' >Pensilvania<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >Carolina del Sur<\/option><option value='South Dakota' >Dakota del Sur<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >Virginia Occidental<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='I live in a U.S. Territory' >Vivo en un territorio de los Estados Unidos.<\/option><\/select><\/div><\/div><div id=\"field_90_114\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_90_114'><span class='gform-field-label__text'>\u00bfEn qu\u00e9 pa\u00eds vives?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_114' id='input_90_114' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Afghanistan' >Afganist\u00e1n<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Argelia<\/option><option value='American Samoa' >Samoa Americana<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguila<\/option><option value='Antarctica' >Ant\u00e1rtida<\/option><option value='Antigua and Barbuda' >Antigua y Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaiy\u00e1n<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrein<\/option><option value='Bangladesh' >Banglad\u00e9s<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Bielorrusia<\/option><option value='Belgium' >B\u00e9lgica<\/option><option value='Belize' >Belice<\/option><option value='Benin' >Ben\u00edn<\/option><option value='Bermuda' >Bermudas<\/option><option value='Bhutan' >But\u00e1n<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, San Eustaquio y Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia y Herzegovina<\/option><option value='Botswana' >Botsuana<\/option><option value='Bouvet Island' >Isla Bouvet<\/option><option value='Brazil' >Brasil<\/option><option value='British Indian Ocean Territory' >Territorio Brit\u00e1nico del Oc\u00e9ano \u00cdndico<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cambodia' >Camboya<\/option><option value='Cameroon' >Camer\u00fan<\/option><option value='Canada' >Canad\u00e1<\/option><option value='Cape Verde' >Cabo Verde<\/option><option value='Cayman Islands' >Islas Caim\u00e1n<\/option><option value='Central African Republic' >Rep\u00fablica Centroafricana<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Isla de Navidad<\/option><option value='Cocos Islands' >Islas Cocos<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoras<\/option><option value='Congo, Democratic Republic of the' >Rep\u00fablica Democr\u00e1tica del Congo<\/option><option value='Congo, Republic of the' >Rep\u00fablica del Congo<\/option><option value='Cook Islands' >Islas Cook<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croacia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Curazao<\/option><option value='Cyprus' >Chipre<\/option><option value='Czech Republic' >Rep\u00fablica Checa<\/option><option value='C\u00f4te d&#039;Ivoire' >Costa de Marfil<\/option><option value='Denmark' >Dinamarca<\/option><option value='Djibouti' >Yibuti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Rep\u00fablica Dominicana<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egipto<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Guinea Ecuatorial<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini (Swaziland)' >Esuatini (Suazilandia)<\/option><option value='Ethiopia' >Etiop\u00eda<\/option><option value='Falkland Islands' >Islas Malvinas<\/option><option value='Faroe Islands' >Islas Feroe<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finlandia<\/option><option value='France' >Francia<\/option><option value='French Guiana' >Guayana Francesa<\/option><option value='French Polynesia' >Polinesia Francesa<\/option><option value='French Southern Territories' >Territorios Australes Franceses<\/option><option value='Gabon' >Gab\u00f3n<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Alemania<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Grecia<\/option><option value='Greenland' >Groenlandia<\/option><option value='Grenada' >Granada<\/option><option value='Guadeloupe' >Guadalupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Hait\u00ed<\/option><option value='Heard and McDonald Islands' >Islas Heard y McDonald<\/option><option value='Holy See' >Santa Sede<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungr\u00eda<\/option><option value='Iceland' >Islandia<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Ir\u00e1n<\/option><option value='Iraq' >Irak<\/option><option value='Ireland' >Irlanda<\/option><option value='Isle of Man' >Isla de Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italia<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Jap\u00f3n<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordania<\/option><option value='Kazakhstan' >Kazajist\u00e1n<\/option><option value='Kenya' >Kenia<\/option><option value='Kiribati' >Kiribati<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kirguist\u00e1n<\/option><option value='Lao People&#039;s Democratic Republic' >Rep\u00fablica Democr\u00e1tica Popular Lao<\/option><option value='Latvia' >Letonia<\/option><option value='Lebanon' >L\u00edbano<\/option><option value='Lesotho' >Lesoto<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libia<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lituania<\/option><option value='Luxembourg' >Luxemburgo<\/option><option value='Macau' >Macao<\/option><option value='Macedonia' >Macedonia<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malaui<\/option><option value='Malaysia' >Malasia<\/option><option value='Maldives' >Maldivas<\/option><option value='Mali' >Mal\u00ed<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Islas Marshall<\/option><option value='Martinique' >Martinica<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauricio<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >M\u00e9xico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldavia<\/option><option value='Monaco' >M\u00f3naco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Marruecos<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Pa\u00edses Bajos<\/option><option value='New Caledonia' >Nueva Caledonia<\/option><option value='New Zealand' >Nueva Zelanda<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >N\u00edger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Isla Norfolk<\/option><option value='North Korea' >Corea del Norte<\/option><option value='Northern Mariana Islands' >Islas Marianas del Norte<\/option><option value='Norway' >Noruega<\/option><option value='Oman' >Om\u00e1n<\/option><option value='Pakistan' >Pakist\u00e1n<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestina, Estado de<\/option><option value='Panama' >Panam\u00e1<\/option><option value='Papua New Guinea' >Pap\u00faa Nueva Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Per\u00fa<\/option><option value='Philippines' >Filipinas<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Polonia<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Rumania<\/option><option value='Russia' >Rusia<\/option><option value='Rwanda' >Ruanda<\/option><option value='R\u00e9union' >Reuni\u00f3n<\/option><option value='Saint Barth\u00e9lemy' >San Bartolom\u00e9<\/option><option value='Saint Helena' >Santa Elena<\/option><option value='Saint Kitts and Nevis' >San Crist\u00f3bal y Nieves<\/option><option value='Saint Lucia' >Santa Luc\u00eda<\/option><option value='Saint Martin' >San Mart\u00edn<\/option><option value='Saint Pierre and Miquelon' >San Pedro y Miquel\u00f3n<\/option><option value='Saint Vincent and the Grenadines' >San Vicente y las Granadinas<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Santo Tom\u00e9 y Pr\u00edncipe<\/option><option value='Saudi Arabia' >Arabia Saudita<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leona<\/option><option value='Singapore' >Singapur<\/option><option value='Sint Maarten' >San Mart\u00edn<\/option><option value='Slovakia' >Eslovaquia<\/option><option value='Slovenia' >Eslovenia<\/option><option value='Solomon Islands' >Islas Salom\u00f3n<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >Sud\u00e1frica<\/option><option value='South Georgia' >Georgia del Sur<\/option><option value='South Korea' >Corea del Sur<\/option><option value='South Sudan' >Sud\u00e1n del Sur<\/option><option value='Spain' >Espa\u00f1a<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sud\u00e1n<\/option><option value='Suriname' >Surinam<\/option><option value='Svalbard and Jan Mayen Islands' >Islas Svalbard y Jan Mayen<\/option><option value='Sweden' >Suecia<\/option><option value='Switzerland' >Suiza<\/option><option value='Syria' >Siria<\/option><option value='Taiwan' >Taiw\u00e1n<\/option><option value='Tajikistan' >Tayikist\u00e1n<\/option><option value='Tanzania' >Tanzania<\/option><option value='Thailand' >Tailandia<\/option><option value='Timor-Leste' >Timor Oriental<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad y Tobago<\/option><option value='Tunisia' >T\u00fanez<\/option><option value='Turkey' >Turqu\u00eda<\/option><option value='Turkmenistan' >Turkmenist\u00e1n<\/option><option value='Turks and Caicos Islands' >Islas Turcas y Caicos<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='US Minor Outlying Islands' >Islas menores alejadas de los Estados Unidos<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ucrania<\/option><option value='United Arab Emirates' >Emiratos \u00c1rabes Unidos<\/option><option value='United Kingdom' >Reino Unido<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekist\u00e1n<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Vietnam' >Vietnam<\/option><option value='Virgin Islands, British' >Islas V\u00edrgenes Brit\u00e1nicas<\/option><option value='Virgin Islands, U.S.' >Islas V\u00edrgenes de los Estados Unidos.<\/option><option value='Wallis and Futuna' >Wallis y Futuna<\/option><option value='Western Sahara' >S\u00e1hara Occidental<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabue<\/option><option value='\u00c5land Islands' >Islas \u00c5land<\/option><\/select><\/div><\/div><div id=\"field_90_115\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_90_115'><span class='gform-field-label__text'>C\u00f3digo postal<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_115' id='input_90_115' type='text' value='' class='small'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_90_116\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox optional traditional field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfCu\u00e1l de las siguientes poblaciones te describe?<\/span><\/legend><div class='gfield_description' id='gfield_description_90_116'>Selecciona todas las opciones que apliquen.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_90_116'><div class='gchoice gchoice_90_116_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_116.1' type='checkbox'  value='Veteran or active-duty military'  id='choice_90_116_1'   aria-describedby=\"gfield_description_90_116\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_90_116_1' id='label_90_116_1' class='gform-field-label gform-field-label--type-inline'>Militar veterano(a) o en servicio activo<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_116_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_116.2' type='checkbox'  value='Caregiver of someone living with emotional or physical illness'  id='choice_90_116_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_116_2' id='label_90_116_2' class='gform-field-label gform-field-label--type-inline'>Cuidador(a) de una persona que padece una enfermedad emocional o f\u00edsica.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_116_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_116.3' type='checkbox'  value='LGBTQ+'  id='choice_90_116_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_116_3' id='label_90_116_3' class='gform-field-label gform-field-label--type-inline'>LGBTQ+<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_116_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_116.4' type='checkbox'  value='Student'  id='choice_90_116_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_116_4' id='label_90_116_4' class='gform-field-label gform-field-label--type-inline'>Estudiante<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_116_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_116.5' type='checkbox'  value='Trauma survivor'  id='choice_90_116_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_116_5' id='label_90_116_5' class='gform-field-label gform-field-label--type-inline'>Sobrevivente de un trauma<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_116_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_116.6' type='checkbox'  value='New or expecting parent'  id='choice_90_116_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_116_6' id='label_90_116_6' class='gform-field-label gform-field-label--type-inline'>Madre primeriza, padre primerizo, futura madre, o futuro padre<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_116_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_116.7' type='checkbox'  value='Healthcare worker'  id='choice_90_116_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_116_7' id='label_90_116_7' class='gform-field-label gform-field-label--type-inline'>Trabajador(a) de la salud<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_90_117\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full traditional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfCuidas a alguien con una enfermedad mental o f\u00edsica?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_90_117'>\n\t\t\t<div class='gchoice gchoice_90_117_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_117' type='radio' value='Mental health condition'  id='choice_90_117_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_117_0' id='label_90_117_0' class='gform-field-label gform-field-label--type-inline'>Condici\u00f3n de salud mental<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_90_117_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_117' type='radio' value='Physical health condition'  id='choice_90_117_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_117_1' id='label_90_117_1' class='gform-field-label gform-field-label--type-inline'>Condici\u00f3n f\u00edsica<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_90_117_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_117' type='radio' value='Both mental and physical health conditions'  id='choice_90_117_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_117_2' id='label_90_117_2' class='gform-field-label gform-field-label--type-inline'>Tanto las condiciones de salud mental como las f\u00edsicas.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_90_118\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_90_118'><span class='gform-field-label__text'>\u00bfCu\u00e1l de las siguientes opciones describe mejor tu orientaci\u00f3n sexual?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_118' id='input_90_118' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Lesbian or Gay' >Lesbiana o gay<\/option><option value='Bisexual' >Bisexual<\/option><option value='Queer' >Queer<\/option><option value='Pansexual' >Pansexual<\/option><option value='Asexual' >Asexual<\/option><option value='Straight' >Heterosexual<\/option><option value='Other...' >Otros...<\/option><\/select><\/div><\/div><div id=\"field_90_119\" class=\"gfield gfield--type-text gfield--input-type-text optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_90_119'><span class='gform-field-label__text'>\u00bfCu\u00e1l es tu orientaci\u00f3n sexual?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_119' id='input_90_119' type='text' value='' class='small'    placeholder='Ingresa la orientaci\u00f3n sexual...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_90_120\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfCu\u00e1l de las siguientes opciones describe tu experiencia con el trauma?<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_90_120'><div class='gchoice gchoice_90_120_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.1' type='checkbox'  value='Child abuse\/violence'  id='choice_90_120_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_120_1' id='label_90_120_1' class='gform-field-label gform-field-label--type-inline'>Maltrato infantil\/violencia<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_120_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.2' type='checkbox'  value='Intimate partner violence'  id='choice_90_120_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_120_2' id='label_90_120_2' class='gform-field-label gform-field-label--type-inline'>Violencia de pareja<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_120_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.3' type='checkbox'  value='Sexual assault\/violence'  id='choice_90_120_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_120_3' id='label_90_120_3' class='gform-field-label gform-field-label--type-inline'>Agresi\u00f3n\/violencia sexual<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_120_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.4' type='checkbox'  value='Serious illness\/injury\/assault'  id='choice_90_120_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_120_4' id='label_90_120_4' class='gform-field-label gform-field-label--type-inline'>Enfermedad\/lesi\u00f3n\/agresi\u00f3n grave<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_120_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.5' type='checkbox'  value='Family conflict (identity acceptance\/separation\/divorce)'  id='choice_90_120_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_120_5' id='label_90_120_5' class='gform-field-label gform-field-label--type-inline'>Conflicto familiar (aceptaci\u00f3n de la identidad\/separaci\u00f3n\/divorcio)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_120_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.6' type='checkbox'  value='Traumatic event (natural disaster, accident, witnessing violence, etc.)'  id='choice_90_120_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_120_6' id='label_90_120_6' class='gform-field-label gform-field-label--type-inline'>Evento traum\u00e1tico (desastre natural, accidente, presenciar violencia, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_120_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.7' type='checkbox'  value='Death of a loved one'  id='choice_90_120_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_120_7' id='label_90_120_7' class='gform-field-label gform-field-label--type-inline'>Muerte de un ser querido<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_120_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.8' type='checkbox'  value='Other and\/or tell us more about your trauma'  id='choice_90_120_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_120_8' id='label_90_120_8' class='gform-field-label gform-field-label--type-inline'>Otros y\/o cu\u00e9ntenos m\u00e1s sobre tu trauma.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_90_121\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_90_121'><span class='gform-field-label__text'>Cu\u00e9ntanos m\u00e1s sobre tu experiencia con el trauma:<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_121' id='input_90_121' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_90_122\" class=\"gfield gfield--type-html gfield--input-type-html section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>Acerca de tu salud mental<\/h2><\/div><fieldset id=\"field_90_123\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfAlguna vez has recibido tratamiento o apoyo por un problema de salud mental?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_90_123'>\n\t\t\t<div class='gchoice gchoice_90_123_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_123' type='radio' value='Yes'  id='choice_90_123_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_123_0' id='label_90_123_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_90_123_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_123' type='radio' value='No'  id='choice_90_123_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_123_1' id='label_90_123_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_90_124\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfEst\u00e1s recibiendo tratamiento o apoyo actualmente?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_90_124'>\n\t\t\t<div class='gchoice gchoice_90_124_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_124' type='radio' value='Yes'  id='choice_90_124_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_124_0' id='label_90_124_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_90_124_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_124' type='radio' value='No'  id='choice_90_124_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_124_1' id='label_90_124_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_90_125\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full optional traditional limit-3 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfQu\u00e9 te ha impedido buscar tratamiento en el pasado?<\/span><\/legend><div class='gfield_description' id='gfield_description_90_125'>Selecciona hasta 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_90_125'><div class='gchoice gchoice_90_125_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_125.1' type='checkbox'  value='I wanted to handle my mental health on my own'  id='choice_90_125_1'   aria-describedby=\"gfield_description_90_125\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_90_125_1' id='label_90_125_1' class='gform-field-label gform-field-label--type-inline'>Quer\u00eda manejar mi salud mental por mi cuenta.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_125_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_125.2' type='checkbox'  value='I didn\u2019t know how or where to start'  id='choice_90_125_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_125_2' id='label_90_125_2' class='gform-field-label gform-field-label--type-inline'>No sab\u00eda c\u00f3mo ni por d\u00f3nde empezar.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_125_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_125.3' type='checkbox'  value='I thought it would cost too much'  id='choice_90_125_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_125_3' id='label_90_125_3' class='gform-field-label gform-field-label--type-inline'>Pensaba que costar\u00eda demasiado.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_125_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_125.4' type='checkbox'  value='I didn\u2019t have time'  id='choice_90_125_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_125_4' id='label_90_125_4' class='gform-field-label gform-field-label--type-inline'>No ten\u00eda tiempo.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_125_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_125.5' type='checkbox'  value='I didn\u2019t think it would help me'  id='choice_90_125_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_125_5' id='label_90_125_5' class='gform-field-label gform-field-label--type-inline'>No cre\u00eda que me fuera a ayudar.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_125_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_125.6' type='checkbox'  value='I didn&#039;t feel ready to start treatment'  id='choice_90_125_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_125_6' id='label_90_125_6' class='gform-field-label gform-field-label--type-inline'>No me sent\u00eda preparado para comenzar el tratamiento.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_125_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_125.7' type='checkbox'  value='I was worried about what people would think or say if I got treatment'  id='choice_90_125_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_125_7' id='label_90_125_7' class='gform-field-label gform-field-label--type-inline'>Me preocupaba lo que la gente fuera a pensar o decir si me sometiera al tratamiento.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_125_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_125.8' type='checkbox'  value='I was afraid of being forced into a hospital or forced to take medication'  id='choice_90_125_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_125_8' id='label_90_125_8' class='gform-field-label gform-field-label--type-inline'>Ten\u00eda miedo de que me internaran en un hospital o me obligaran a tomar medicamentos.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_125_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_125.9' type='checkbox'  value='I tried, but couldn\u2019t find available treatment (no openings, wouldn\u2019t take insurance, etc.)'  id='choice_90_125_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_125_9' id='label_90_125_9' class='gform-field-label gform-field-label--type-inline'>Lo intent\u00e9, pero no pude encontrar un tratamiento disponible (no hab\u00eda plazas, no aceptaban el seguro, etc.).<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_125_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_125.11' type='checkbox'  value='My parent(s) or guardian wouldn&#039;t let me, or I didn&#039;t want to ask'  id='choice_90_125_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_125_11' id='label_90_125_11' class='gform-field-label gform-field-label--type-inline'>Mis pap\u00e1s o mi tutor no me dejaron, o no quer\u00eda pedir permiso.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_125_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_125.12' type='checkbox'  value='Other...'  id='choice_90_125_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_125_12' id='label_90_125_12' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_90_126\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_90_126'><span class='gform-field-label__text'>\u00bfQu\u00e9 otras cosas te han impedido buscar tratamiento en el pasado?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_126' id='input_90_126' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_90_127\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox optional traditional limit-3 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Piensa en tu prueba de salud mental. \u00bfCu\u00e1les son los principales factores que contribuyen a tus problemas de salud mental en este momento?<\/span><\/legend><div class='gfield_description' id='gfield_description_90_127'>Selecciona hasta 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_90_127'><div class='gchoice gchoice_90_127_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.1' type='checkbox'  value='Abuse or violence'  id='choice_90_127_1'   aria-describedby=\"gfield_description_90_127\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_90_127_1' id='label_90_127_1' class='gform-field-label gform-field-label--type-inline'>Abuso o violencia<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_127_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.2' type='checkbox'  value='Relationship problems (friends, family, or significant other)'  id='choice_90_127_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_127_2' id='label_90_127_2' class='gform-field-label gform-field-label--type-inline'>Problemas de relaci\u00f3n (amigos, familia o pareja)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_127_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.3' type='checkbox'  value='Body image'  id='choice_90_127_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_127_3' id='label_90_127_3' class='gform-field-label gform-field-label--type-inline'>Imagen corporal<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_127_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.4' type='checkbox'  value='Low self-esteem or self-image'  id='choice_90_127_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_127_4' id='label_90_127_4' class='gform-field-label gform-field-label--type-inline'>Baja autoestima o imagen de uno mismo<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_127_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.5' type='checkbox'  value='School or work problems'  id='choice_90_127_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_127_5' id='label_90_127_5' class='gform-field-label gform-field-label--type-inline'>Problemas en la escuela o en el trabajo<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_127_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.6' type='checkbox'  value='Financial problems'  id='choice_90_127_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_127_6' id='label_90_127_6' class='gform-field-label gform-field-label--type-inline'>Problemas financieros<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_127_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.7' type='checkbox'  value='Loneliness or isolation'  id='choice_90_127_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_127_7' id='label_90_127_7' class='gform-field-label gform-field-label--type-inline'>Soledad o aislamiento<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_127_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.8' type='checkbox'  value='Grief or loss of someone or something'  id='choice_90_127_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_127_8' id='label_90_127_8' class='gform-field-label gform-field-label--type-inline'>Dolor o p\u00e9rdida de alguien o algo.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_127_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.9' type='checkbox'  value='Experiencing hate\/bullying (including racism, homophobia, transphobia, or discrimination)'  id='choice_90_127_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_127_9' id='label_90_127_9' class='gform-field-label gform-field-label--type-inline'>Sufrir odio o acoso (incluido el racismo, la homofobia, la transfobia o la discriminaci\u00f3n)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_127_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.11' type='checkbox'  value='State of the world (war, climate, politics, immigration)'  id='choice_90_127_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_127_11' id='label_90_127_11' class='gform-field-label gform-field-label--type-inline'>Situaci\u00f3n mundial (guerra, clima, pol\u00edtica, inmigraci\u00f3n)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_127_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.12' type='checkbox'  value='I don\u2019t know (something just feels wrong)'  id='choice_90_127_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_127_12' id='label_90_127_12' class='gform-field-label gform-field-label--type-inline'>No lo s\u00e9 (s\u00f3lo que algo no va bien)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_127_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.13' type='checkbox'  value='Other...'  id='choice_90_127_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_127_13' id='label_90_127_13' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_90_128\" class=\"gfield gfield--type-text gfield--input-type-text optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_90_128'><span class='gform-field-label__text'>\u00bfQu\u00e9 m\u00e1s est\u00e1 contribuyendo a tus problemas de salud mental en este momento?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_128' id='input_90_128' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_90_129\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_90_129'><span class='gform-field-label__text'>\u00bfQu\u00e9 aspecto de la situaci\u00f3n mundial te afecta m\u00e1s?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_129' id='input_90_129' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_90_130\" class=\"gfield gfield--type-html gfield--input-type-html section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>Acerca de tu salud<\/h2><\/div><fieldset id=\"field_90_131\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTienes actualmente un seguro m\u00e9dico?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_90_131'>\n\t\t\t<div class='gchoice gchoice_90_131_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_131' type='radio' value='Yes'  id='choice_90_131_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_131_0' id='label_90_131_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_90_131_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_131' type='radio' value='No'  id='choice_90_131_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_131_1' id='label_90_131_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_90_131_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_131' type='radio' value='I don&#039;t know'  id='choice_90_131_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_131_2' id='label_90_131_2' class='gform-field-label gform-field-label--type-inline'>No lo s\u00e9<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_90_132\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox optional traditional field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfTienes alguna de las siguientes condiciones f\u00edsicas?<\/span><\/legend><div class='gfield_description' id='gfield_description_90_132'>Selecciona todas las opciones que apliquen.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_90_132'><div class='gchoice gchoice_90_132_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_132.1' type='checkbox'  value='Heart disease'  id='choice_90_132_1'   aria-describedby=\"gfield_description_90_132\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_90_132_1' id='label_90_132_1' class='gform-field-label gform-field-label--type-inline'>Enfermedad card\u00edaca<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_132_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_132.2' type='checkbox'  value='Reproductive health concerns (PCOS, endometriosis, infertility, etc.)'  id='choice_90_132_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_132_2' id='label_90_132_2' class='gform-field-label gform-field-label--type-inline'>Problemas de salud reproductiva (s\u00edndrome de ovario poliqu\u00edstico, endometriosis, infertilidad, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_132_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_132.3' type='checkbox'  value='Diabetes'  id='choice_90_132_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_132_3' id='label_90_132_3' class='gform-field-label gform-field-label--type-inline'>Diabetes<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_132_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_132.4' type='checkbox'  value='Cancer'  id='choice_90_132_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_132_4' id='label_90_132_4' class='gform-field-label gform-field-label--type-inline'>C\u00e1ncer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_132_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_132.5' type='checkbox'  value='Arthritis or other chronic pain'  id='choice_90_132_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_132_5' id='label_90_132_5' class='gform-field-label gform-field-label--type-inline'>Artritis u otros dolores cr\u00f3nicos<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_132_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_132.6' type='checkbox'  value='Asthma, COPD or other lung conditions'  id='choice_90_132_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_132_6' id='label_90_132_6' class='gform-field-label gform-field-label--type-inline'>Asma, EPOC u otras afecciones pulmonares<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_132_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_132.7' type='checkbox'  value='Movement Disorders (involuntary tics, tardive dyskinesia, etc.)'  id='choice_90_132_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_132_7' id='label_90_132_7' class='gform-field-label gform-field-label--type-inline'>Trastornos del movimiento (tics involuntarios, discinesia tard\u00eda, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_132_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_132.8' type='checkbox'  value='Digestive problems (Crohn\u2019s, colitis, IBS, etc.)'  id='choice_90_132_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_132_8' id='label_90_132_8' class='gform-field-label gform-field-label--type-inline'>Problemas digestivos (enfermedad de Crohn, colitis, s\u00edndrome del intestino irritable, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_132_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_132.9' type='checkbox'  value='Neurological conditions (epilepsy, etc.) or traumatic brain injury (TBI)'  id='choice_90_132_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_132_9' id='label_90_132_9' class='gform-field-label gform-field-label--type-inline'>Afecciones neurol\u00f3gicas (epilepsia, etc.) o traumatismo craneoencef\u00e1lico (TCE)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_90_132_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_132.11' type='checkbox'  value='Other...'  id='choice_90_132_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_90_132_11' id='label_90_132_11' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_90_133\" class=\"gfield gfield--type-text gfield--input-type-text optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_90_133'><span class='gform-field-label__text'>\u00bfQu\u00e9 otras condiciones f\u00edsicas tienes?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_133' id='input_90_133' type='text' value='' class='large'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_90_134\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTienes una mascota que te ayuda a cuidar tu salud mental?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_90_134'>\n\t\t\t<div class='gchoice gchoice_90_134_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_134' type='radio' value='Yes'  id='choice_90_134_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_134_0' id='label_90_134_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_90_134_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_134' type='radio' value='No'  id='choice_90_134_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_134_1' id='label_90_134_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_90_135\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTe interesa tener una mascota que te ayude a cuidar tu salud mental?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_90_135'>\n\t\t\t<div class='gchoice gchoice_90_135_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_135' type='radio' value='Yes'  id='choice_90_135_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_135_0' id='label_90_135_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_90_135_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_135' type='radio' value='No'  id='choice_90_135_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_90_135_1' id='label_90_135_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><button type='submit' id='gform_previous_button_90' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Anterior<\/button> <button type='submit' id='gform_submit_button_90' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Enviar encuesta<\/button> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_90' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_90' id='gform_theme_90' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_90' id='gform_style_settings_90' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_90' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='90' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='F+ZuptKvGxdBEoKRulClmOhvjMEyRcq9cztfXCL8BKBoYv3j47jSqAz5Y1x5KuJN\/sSMCauc4NFO4g1D+qNQyiR\/4PXOqFDoNNzgsxo5R3s4Fuk=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_90' 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Esto es una encuesta, no una prueba de salud mental.<\/p>","protected":false},"template":"","tags":[],"age_group":[],"condition":[],"class_list":["post-254207","screen","type-screen","status-publish","hentry"],"acf":[],"yoast_head":"<title>Survey: What Makes a Good Day? &#8211; Mental Health America<\/title>\n<meta name=\"description\" content=\"We want to learn more about how to help us all have more good days.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/screening.mhanational.org\/es\/screening-tools\/survey-what-makes-a-good-day\/\" \/>\n<meta property=\"og:locale\" content=\"es_MX\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Survey: What Makes a Good Day? &#8211; Mental Health America\" \/>\n<meta property=\"og:description\" content=\"We want to learn more about how to help us all have more good days.\" \/>\n<meta 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demogr\u00e1ficas (prueba)"},"content":{"rendered":"<div class='gf_browser_chrome gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_89' style='display:none'>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Preguntas demogr\u00e1ficas (prueba)<\/h2>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_89'  class='clearfix' action='\/es\/wp-json\/wp\/v2\/screen' data-formid='89' novalidate data-trp-original-action=\"\/es\/wp-json\/wp\/v2\/screen\">\n                        <div class='gform-body gform_body'><div id='gform_fields_89' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_89_84\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_89_84'><span class='gform-field-label__text'>Facebook<\/span><\/label><div class='gfield_description' id='gfield_description_89_84'>Este campo es para fines de validaci\u00f3n y no debe modificarse.<\/div><div class='ginput_container'><input name='input_84' id='input_89_84' type='text' value='' autocomplete='new-password'\/><\/div><\/div><div id=\"field_89_38\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_38' id='input_89_38' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_89_39\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below 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\/><\/div><\/div><div id=\"field_89_47\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_47' id='input_89_47' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='http:\/\/screening.mhanational.org' \/><\/div><\/div><div id=\"field_89_58\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_58' id='input_89_58' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_89_59\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_59' id='input_89_59' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_89_60\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_60' id='input_89_60' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_89_77\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_77' id='input_89_77' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='https:\/\/screening.mhanational.org\/es\/wp-json\/wp\/v2\/screen' \/><\/div><\/div><div id=\"field_89_83\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_83' id='input_89_83' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='lang--es' \/><\/div><\/div><div id=\"field_89_18\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p class=\"translation-block\">Por favor, toma un momento para responder a las siguientes preguntas <strong>opcionales<\/strong>. Tus respuestas son totalmente an\u00f3nimas: no podremos identificarte a partir de esta informaci\u00f3n. Tus respuestas nos ayudan a proporcionar mejor informaci\u00f3n y apoyo a personas como t\u00fa.<\/p>\n\n<p>Puedes responder a tantas preguntas como desees. Cuando hayas terminado, despl\u00e1zate hasta la parte inferior de la encuesta y haz clic en \"ver resultados\" para recibir los resultados de la evaluaci\u00f3n.<\/p><\/div><div id=\"field_89_61\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><hr \/><\/div><fieldset id=\"field_89_69\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full traditional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfQu\u00e9 es lo principal que quieres hacer despu\u00e9s de realizar este test de salud mental? (Selecciona una opci\u00f3n)<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_89_69'>\n\t\t\t<div class='gchoice gchoice_89_69_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='Take another mental health test'  id='choice_89_69_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_69_0' id='label_89_69_0' class='gform-field-label gform-field-label--type-inline'>Hacer otro test de salud mental.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_89_69_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='Understand what depression is like (reading articles)'  id='choice_89_69_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_69_1' id='label_89_69_1' class='gform-field-label gform-field-label--type-inline'>Comprender c\u00f3mo es la depresi\u00f3n (leyendo art\u00edculos)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_89_69_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='Understand and manage self-harm or suicidal thoughts'  id='choice_89_69_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_69_2' id='label_89_69_2' class='gform-field-label gform-field-label--type-inline'>Comprender y manejar las autolesiones o los pensamientos suicidas<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_89_69_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='Tips for managing depression (reading articles)'  id='choice_89_69_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_69_3' id='label_89_69_3' class='gform-field-label gform-field-label--type-inline'>Consejos para manejar la depresi\u00f3n (lectura de art\u00edculos)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_89_69_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='Learn and practice skills for how to manage depression (try a free self-help tool)'  id='choice_89_69_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_69_4' id='label_89_69_4' class='gform-field-label gform-field-label--type-inline'>Aprender y practicar habilidades para manejar la depresi\u00f3n (probar una herramienta de autoayuda gratuita).<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_89_69_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='Learn about what therapy\/treatment is like (reading articles)'  id='choice_89_69_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_69_5' id='label_89_69_5' class='gform-field-label gform-field-label--type-inline'>Informarte sobre c\u00f3mo es la terapia o el tratamiento (leyendo art\u00edculos).<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_89_69_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='Find a treatment provider near you'  id='choice_89_69_6' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_69_6' id='label_89_69_6' class='gform-field-label gform-field-label--type-inline'>Buscar un proveedor de tratamiento cerca de ti.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_89_69_7'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='Find a forum or support group for people with depression'  id='choice_89_69_7' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_69_7' id='label_89_69_7' class='gform-field-label gform-field-label--type-inline'>Buscar un foro o grupo de apoyo para personas con depresi\u00f3n.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_89_69_8'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='Other...'  id='choice_89_69_8' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_69_8' id='label_89_69_8' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_89_69_9'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='I don\u2019t want to do anything'  id='choice_89_69_9' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_69_9' id='label_89_69_9' class='gform-field-label gform-field-label--type-inline'>No quiero hacer nada.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_89_70\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_89_70'><span class='gform-field-label__text'>Pr\u00f3ximos pasos - Otros<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_70' id='input_89_70' type='text' value='' class='medium'    placeholder='Anotar otro...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_89_71\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full layout-action show-actions_b traditional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfSientes que necesitas hacer algo para mejorar tu salud mental?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_89_71'>\n\t\t\t<div class='gchoice gchoice_89_71_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_71' type='radio' value='Yes'  id='choice_89_71_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_71_0' id='label_89_71_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_89_71_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_71' type='radio' value='No'  id='choice_89_71_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_71_1' id='label_89_71_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_89_71_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_71' type='radio' value='I don&#039;t know'  id='choice_89_71_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_71_2' id='label_89_71_2' class='gform-field-label gform-field-label--type-inline'>No lo s\u00e9<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_89_72\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full layout-action show-actions_b gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><hr \/><\/div><fieldset id=\"field_89_62\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfEst\u00e1s haciendo este test por ti o en lugar de otra persona?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_89_62'>\n\t\t\t<div class='gchoice gchoice_89_62_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_62' type='radio' value='For myself'  id='choice_89_62_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_62_0' id='label_89_62_0' class='gform-field-label gform-field-label--type-inline'>Por m\u00ed mismo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_89_62_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_62' type='radio' value='For someone else'  id='choice_89_62_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_62_1' id='label_89_62_1' class='gform-field-label gform-field-label--type-inline'>En lugar de otra persona<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_89_63\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  >Si est\u00e1s haciendo este test en lugar de otra persona, <strong>Por favor, utilice la informaci\u00f3n de esa persona.<\/strong> para las preguntas siguientes, o d\u00e9jalas en blanco si no sabes la respuesta. Recuerda que, <em>estas preguntas son opcionales<\/em>.<\/div><div id=\"field_89_42\" class=\"gfield gfield--type-html gfield--input-type-html section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>Acerca de ti<\/h2><\/div><div id=\"field_89_19\" class=\"gfield gfield--type-select gfield--input-type-select optional taxonomy field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_89_19'><span class='gform-field-label__text'>Rango de edades<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_19' id='input_89_19' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='8-10' >8-10<\/option><option value='11-13' >11-13<\/option><option value='14-15' >14-15<\/option><option value='16-17' >16-17<\/option><option value='18-24' >18-24<\/option><option value='25-34' >25-34<\/option><option value='35-44' >35-44<\/option><option value='45-54' >45-54<\/option><option value='55-64' >55-64<\/option><option value='65+' >65+<\/option><\/select><\/div><\/div><fieldset id=\"field_89_46\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>G\u00e9nero<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_89_46'>\n\t\t\t<div class='gchoice gchoice_89_46_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='Female'  id='choice_89_46_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_46_0' id='label_89_46_0' class='gform-field-label gform-field-label--type-inline'>Femenino<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_89_46_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='Male'  id='choice_89_46_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_46_1' id='label_89_46_1' class='gform-field-label gform-field-label--type-inline'>Masculino<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_89_46_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='Non-Binary'  id='choice_89_46_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_46_2' id='label_89_46_2' class='gform-field-label gform-field-label--type-inline'>No binario<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_89_80\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTe identificas como transg\u00e9nero?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_89_80'>\n\t\t\t<div class='gchoice gchoice_89_80_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_80' type='radio' value='Yes'  id='choice_89_80_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_80_0' id='label_89_80_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_89_80_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_80' type='radio' value='No'  id='choice_89_80_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_80_1' id='label_89_80_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_89_48\" class=\"gfield gfield--type-text gfield--input-type-text optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_89_48'><span class='gform-field-label__text'>\u00bfC\u00f3mo describir\u00edas tu g\u00e9nero?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_48' id='input_89_48' type='text' value='' class='small'    placeholder='Ingresa el g\u00e9nero...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_89_22\" class=\"gfield gfield--type-select gfield--input-type-select optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_89_22'><span class='gform-field-label__text'>Raza\/etnia<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_22' id='input_89_22' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='American Indian or Alaska Native' >Amerindio o nativo de Alaska<\/option><option value='Asian' >Asi\u00e1tico<\/option><option value='Black or African American (non-Hispanic)' >Negro o afroamericano (no hispano)<\/option><option value='Hispanic or Latino' >Hispano o latino<\/option><option value='Middle Eastern or North African' >Del medio oriente o norteafricano<\/option><option value='Native Hawaiian or other Pacific Islander' >Isle\u00f1o nativo hawaiano o pac\u00edfico<\/option><option value='White (non-Hispanic)' >Blanco (no hispano)<\/option><option value='More than one of the above' >M\u00e1s de uno de los anteriores<\/option><option value='Other' >Otros<\/option><\/select><\/div><\/div><div id=\"field_89_23\" class=\"gfield gfield--type-select gfield--input-type-select optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_89_23'><span class='gform-field-label__text'>Ingresos familiares (USD)<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_23' id='input_89_23' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Less than $20,000' >Menos de $20,000<\/option><option value='$20,000 - $39,999' >$20,000 - $39,999<\/option><option value='$40,000 - $59,999' >$40,000 - $59,999<\/option><option value='$60,000 - $79,999' >$60,000 - $79,999<\/option><option value='$80,000 - $99,999' >$80,000 - $99,999<\/option><option value='$100,000 - $149,999' >$100,000 - $149,999<\/option><option value='$150,000+' >$150,000+<\/option><\/select><\/div><\/div><fieldset id=\"field_89_64\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfVives en los Estados Unidos de Am\u00e9rica o en otro pa\u00eds?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_89_64'>\n\t\t\t<div class='gchoice gchoice_89_64_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_64' type='radio' value='I live in the United States'  id='choice_89_64_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_64_0' id='label_89_64_0' class='gform-field-label gform-field-label--type-inline'>Vivo en los Estados Unidos de Am\u00e9rica.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_89_64_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_64' type='radio' value='I live in another country'  id='choice_89_64_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_64_1' id='label_89_64_1' class='gform-field-label gform-field-label--type-inline'>Vivo en otro pa\u00eds.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_89_32\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_89_32'><span class='gform-field-label__text'>Estado<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_32' id='input_89_32' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >Distrito de Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Hawaii' >Haw\u00e1i<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Luisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >M\u00edchigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Misisipi<\/option><option value='Missouri' >Misuri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >Nuevo Hampshire<\/option><option value='New Jersey' >Nueva Jersey<\/option><option value='New Mexico' >Nuevo M\u00e9xico<\/option><option value='New York' >Nueva York<\/option><option value='North Carolina' >Carolina del Norte<\/option><option value='North Dakota' >Dakota del Norte<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oreg\u00f3n<\/option><option value='Pennsylvania' >Pensilvania<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >Carolina del Sur<\/option><option value='South Dakota' >Dakota del Sur<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >Virginia Occidental<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='I live in a U.S. Territory' >Vivo en un territorio de los Estados Unidos.<\/option><\/select><\/div><\/div><div id=\"field_89_36\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_89_36'><span class='gform-field-label__text'>\u00bfEn qu\u00e9 pa\u00eds vives?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_36' id='input_89_36' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Afghanistan' >Afganist\u00e1n<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Argelia<\/option><option value='American Samoa' >Samoa Americana<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguila<\/option><option value='Antarctica' >Ant\u00e1rtida<\/option><option value='Antigua and Barbuda' >Antigua y Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaiy\u00e1n<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrein<\/option><option value='Bangladesh' >Banglad\u00e9s<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Bielorrusia<\/option><option value='Belgium' >B\u00e9lgica<\/option><option value='Belize' >Belice<\/option><option value='Benin' >Ben\u00edn<\/option><option value='Bermuda' >Bermudas<\/option><option value='Bhutan' >But\u00e1n<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, San Eustaquio y Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia y Herzegovina<\/option><option value='Botswana' >Botsuana<\/option><option value='Bouvet Island' >Isla Bouvet<\/option><option value='Brazil' >Brasil<\/option><option value='British Indian Ocean Territory' >Territorio Brit\u00e1nico del Oc\u00e9ano \u00cdndico<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cambodia' >Camboya<\/option><option value='Cameroon' >Camer\u00fan<\/option><option value='Canada' >Canad\u00e1<\/option><option value='Cape Verde' >Cabo Verde<\/option><option value='Cayman Islands' >Islas Caim\u00e1n<\/option><option value='Central African Republic' >Rep\u00fablica Centroafricana<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Isla de Navidad<\/option><option value='Cocos Islands' >Islas Cocos<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoras<\/option><option value='Congo, Democratic Republic of the' >Rep\u00fablica Democr\u00e1tica del Congo<\/option><option value='Congo, Republic of the' >Rep\u00fablica del Congo<\/option><option value='Cook Islands' >Islas Cook<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croacia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Curazao<\/option><option value='Cyprus' >Chipre<\/option><option value='Czech Republic' >Rep\u00fablica Checa<\/option><option value='C\u00f4te d&#039;Ivoire' >Costa de Marfil<\/option><option value='Denmark' >Dinamarca<\/option><option value='Djibouti' >Yibuti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Rep\u00fablica Dominicana<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egipto<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Guinea Ecuatorial<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini (Swaziland)' >Esuatini (Suazilandia)<\/option><option value='Ethiopia' >Etiop\u00eda<\/option><option value='Falkland Islands' >Islas Malvinas<\/option><option value='Faroe Islands' >Islas Feroe<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finlandia<\/option><option value='France' >Francia<\/option><option value='French Guiana' >Guayana Francesa<\/option><option value='French Polynesia' >Polinesia Francesa<\/option><option value='French Southern Territories' >Territorios Australes Franceses<\/option><option value='Gabon' >Gab\u00f3n<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Alemania<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Grecia<\/option><option value='Greenland' >Groenlandia<\/option><option value='Grenada' >Granada<\/option><option value='Guadeloupe' >Guadalupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Hait\u00ed<\/option><option value='Heard and McDonald Islands' >Islas Heard y McDonald<\/option><option value='Holy See' >Santa Sede<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungr\u00eda<\/option><option value='Iceland' >Islandia<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Ir\u00e1n<\/option><option value='Iraq' >Irak<\/option><option value='Ireland' >Irlanda<\/option><option value='Isle of Man' >Isla de Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italia<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Jap\u00f3n<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordania<\/option><option value='Kazakhstan' >Kazajist\u00e1n<\/option><option value='Kenya' >Kenia<\/option><option value='Kiribati' >Kiribati<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kirguist\u00e1n<\/option><option value='Lao People&#039;s Democratic Republic' >Rep\u00fablica Democr\u00e1tica Popular Lao<\/option><option value='Latvia' >Letonia<\/option><option value='Lebanon' >L\u00edbano<\/option><option value='Lesotho' >Lesoto<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libia<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lituania<\/option><option value='Luxembourg' >Luxemburgo<\/option><option value='Macau' >Macao<\/option><option value='Macedonia' >Macedonia<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malaui<\/option><option value='Malaysia' >Malasia<\/option><option value='Maldives' >Maldivas<\/option><option value='Mali' >Mal\u00ed<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Islas Marshall<\/option><option value='Martinique' >Martinica<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauricio<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >M\u00e9xico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldavia<\/option><option value='Monaco' >M\u00f3naco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Marruecos<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Pa\u00edses Bajos<\/option><option value='New Caledonia' >Nueva Caledonia<\/option><option value='New Zealand' >Nueva Zelanda<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >N\u00edger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Isla Norfolk<\/option><option value='North Korea' >Corea del Norte<\/option><option value='Northern Mariana Islands' >Islas Marianas del Norte<\/option><option value='Norway' >Noruega<\/option><option value='Oman' >Om\u00e1n<\/option><option value='Pakistan' >Pakist\u00e1n<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestina, Estado de<\/option><option value='Panama' >Panam\u00e1<\/option><option value='Papua New Guinea' >Pap\u00faa Nueva Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Per\u00fa<\/option><option value='Philippines' >Filipinas<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Polonia<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Rumania<\/option><option value='Russia' >Rusia<\/option><option value='Rwanda' >Ruanda<\/option><option value='R\u00e9union' >Reuni\u00f3n<\/option><option value='Saint Barth\u00e9lemy' >San Bartolom\u00e9<\/option><option value='Saint Helena' >Santa Elena<\/option><option value='Saint Kitts and Nevis' >San Crist\u00f3bal y Nieves<\/option><option value='Saint Lucia' >Santa Luc\u00eda<\/option><option value='Saint Martin' >San Mart\u00edn<\/option><option value='Saint Pierre and Miquelon' >San Pedro y Miquel\u00f3n<\/option><option value='Saint Vincent and the Grenadines' >San Vicente y las Granadinas<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Santo Tom\u00e9 y Pr\u00edncipe<\/option><option value='Saudi Arabia' >Arabia Saudita<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leona<\/option><option value='Singapore' >Singapur<\/option><option value='Sint Maarten' >San Mart\u00edn<\/option><option value='Slovakia' >Eslovaquia<\/option><option value='Slovenia' >Eslovenia<\/option><option value='Solomon Islands' >Islas Salom\u00f3n<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >Sud\u00e1frica<\/option><option value='South Georgia' >Georgia del Sur<\/option><option value='South Korea' >Corea del Sur<\/option><option value='South Sudan' >Sud\u00e1n del Sur<\/option><option value='Spain' >Espa\u00f1a<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sud\u00e1n<\/option><option value='Suriname' >Surinam<\/option><option value='Svalbard and Jan Mayen Islands' >Islas Svalbard y Jan Mayen<\/option><option value='Sweden' >Suecia<\/option><option value='Switzerland' >Suiza<\/option><option value='Syria' >Siria<\/option><option value='Taiwan' >Taiw\u00e1n<\/option><option value='Tajikistan' >Tayikist\u00e1n<\/option><option value='Tanzania' >Tanzania<\/option><option value='Thailand' >Tailandia<\/option><option value='Timor-Leste' >Timor Oriental<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad y Tobago<\/option><option value='Tunisia' >T\u00fanez<\/option><option value='Turkey' >Turqu\u00eda<\/option><option value='Turkmenistan' >Turkmenist\u00e1n<\/option><option value='Turks and Caicos Islands' >Islas Turcas y Caicos<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='US Minor Outlying Islands' >Islas menores alejadas de los Estados Unidos<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ucrania<\/option><option value='United Arab Emirates' >Emiratos \u00c1rabes Unidos<\/option><option value='United Kingdom' >Reino Unido<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekist\u00e1n<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Vietnam' >Vietnam<\/option><option value='Virgin Islands, British' >Islas V\u00edrgenes Brit\u00e1nicas<\/option><option value='Virgin Islands, U.S.' >Islas V\u00edrgenes de los Estados Unidos.<\/option><option value='Wallis and Futuna' >Wallis y Futuna<\/option><option value='Western Sahara' >S\u00e1hara Occidental<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabue<\/option><option value='\u00c5land Islands' >Islas \u00c5land<\/option><\/select><\/div><\/div><div id=\"field_89_34\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_89_34'><span class='gform-field-label__text'>C\u00f3digo postal<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_34' id='input_89_34' type='text' value='' class='small'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_89_28\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox optional traditional field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfCu\u00e1l de las siguientes poblaciones te describe?<\/span><\/legend><div class='gfield_description' id='gfield_description_89_28'>Selecciona todas las opciones que apliquen.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_89_28'><div class='gchoice gchoice_89_28_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.1' type='checkbox'  value='Veteran or active-duty military'  id='choice_89_28_1'   aria-describedby=\"gfield_description_89_28\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_89_28_1' id='label_89_28_1' class='gform-field-label gform-field-label--type-inline'>Militar veterano(a) o en servicio activo<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_28_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.2' type='checkbox'  value='Caregiver of someone living with emotional or physical illness'  id='choice_89_28_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_28_2' id='label_89_28_2' class='gform-field-label gform-field-label--type-inline'>Cuidador(a) de una persona que padece una enfermedad emocional o f\u00edsica.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_28_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.3' type='checkbox'  value='LGBTQ+'  id='choice_89_28_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_28_3' id='label_89_28_3' class='gform-field-label gform-field-label--type-inline'>LGBTQ+<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_28_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.4' type='checkbox'  value='Student'  id='choice_89_28_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_28_4' id='label_89_28_4' class='gform-field-label gform-field-label--type-inline'>Estudiante<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_28_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.5' type='checkbox'  value='Trauma survivor'  id='choice_89_28_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_28_5' id='label_89_28_5' class='gform-field-label gform-field-label--type-inline'>Sobrevivente de un trauma<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_28_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.6' type='checkbox'  value='New or expecting parent'  id='choice_89_28_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_28_6' id='label_89_28_6' class='gform-field-label gform-field-label--type-inline'>Madre primeriza, padre primerizo, futura madre, o futuro padre<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_28_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.7' type='checkbox'  value='Healthcare worker'  id='choice_89_28_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_28_7' id='label_89_28_7' class='gform-field-label gform-field-label--type-inline'>Trabajador(a) de la salud<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_89_65\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full traditional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfCuidas a alguien con una enfermedad mental o f\u00edsica?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_89_65'>\n\t\t\t<div class='gchoice gchoice_89_65_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_65' type='radio' value='Mental health condition'  id='choice_89_65_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_65_0' id='label_89_65_0' class='gform-field-label gform-field-label--type-inline'>Condici\u00f3n de salud mental<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_89_65_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_65' type='radio' value='Physical health condition'  id='choice_89_65_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_65_1' id='label_89_65_1' class='gform-field-label gform-field-label--type-inline'>Condici\u00f3n f\u00edsica<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_89_65_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_65' type='radio' value='Both mental and physical health conditions'  id='choice_89_65_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_65_2' id='label_89_65_2' class='gform-field-label gform-field-label--type-inline'>Tanto las condiciones de salud mental como las f\u00edsicas.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_89_66\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_89_66'><span class='gform-field-label__text'>\u00bfCu\u00e1l de las siguientes opciones describe mejor tu orientaci\u00f3n sexual?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_66' id='input_89_66' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Lesbian or Gay' >Lesbiana o gay<\/option><option value='Bisexual' >Bisexual<\/option><option value='Queer' >Queer<\/option><option value='Pansexual' >Pansexual<\/option><option value='Asexual' >Asexual<\/option><option value='Straight' >Heterosexual<\/option><option value='Other...' >Otros...<\/option><\/select><\/div><\/div><div id=\"field_89_50\" class=\"gfield gfield--type-text gfield--input-type-text optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_89_50'><span class='gform-field-label__text'>\u00bfCu\u00e1l es tu orientaci\u00f3n sexual?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_50' id='input_89_50' type='text' value='' class='small'    placeholder='Ingresa la orientaci\u00f3n sexual...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_89_67\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfCu\u00e1l de las siguientes opciones describe tu experiencia con el trauma?<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_89_67'><div class='gchoice gchoice_89_67_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_67.1' type='checkbox'  value='Child abuse\/violence'  id='choice_89_67_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_67_1' id='label_89_67_1' class='gform-field-label gform-field-label--type-inline'>Maltrato infantil\/violencia<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_67_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_67.2' type='checkbox'  value='Intimate partner violence'  id='choice_89_67_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_67_2' id='label_89_67_2' class='gform-field-label gform-field-label--type-inline'>Violencia de pareja<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_67_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_67.3' type='checkbox'  value='Sexual assault\/violence'  id='choice_89_67_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_67_3' id='label_89_67_3' class='gform-field-label gform-field-label--type-inline'>Agresi\u00f3n\/violencia sexual<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_67_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_67.4' type='checkbox'  value='Serious illness\/injury\/assault'  id='choice_89_67_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_67_4' id='label_89_67_4' class='gform-field-label gform-field-label--type-inline'>Enfermedad\/lesi\u00f3n\/agresi\u00f3n grave<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_67_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_67.5' type='checkbox'  value='Family conflict (identity acceptance\/separation\/divorce)'  id='choice_89_67_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_67_5' id='label_89_67_5' class='gform-field-label gform-field-label--type-inline'>Conflicto familiar (aceptaci\u00f3n de la identidad\/separaci\u00f3n\/divorcio)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_67_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_67.6' type='checkbox'  value='Traumatic event (natural disaster, accident, witnessing violence, etc.)'  id='choice_89_67_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_67_6' id='label_89_67_6' class='gform-field-label gform-field-label--type-inline'>Evento traum\u00e1tico (desastre natural, accidente, presenciar violencia, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_67_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_67.7' type='checkbox'  value='Death of a loved one'  id='choice_89_67_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_67_7' id='label_89_67_7' class='gform-field-label gform-field-label--type-inline'>Muerte de un ser querido<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_67_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_67.8' type='checkbox'  value='Other and\/or tell us more about your trauma'  id='choice_89_67_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_67_8' id='label_89_67_8' class='gform-field-label gform-field-label--type-inline'>Otros y\/o cu\u00e9ntenos m\u00e1s sobre tu trauma.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_89_68\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_89_68'><span class='gform-field-label__text'>Cu\u00e9ntanos m\u00e1s sobre tu experiencia con el trauma:<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_68' id='input_89_68' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_89_43\" class=\"gfield gfield--type-html gfield--input-type-html section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>Acerca de tu salud mental<\/h2><\/div><fieldset id=\"field_89_25\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfAlguna vez has recibido tratamiento o apoyo por un problema de salud mental?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_89_25'>\n\t\t\t<div class='gchoice gchoice_89_25_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='Yes'  id='choice_89_25_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_25_0' id='label_89_25_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_89_25_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='No'  id='choice_89_25_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_25_1' id='label_89_25_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_89_57\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfEst\u00e1s recibiendo tratamiento o apoyo actualmente?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_89_57'>\n\t\t\t<div class='gchoice gchoice_89_57_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_57' type='radio' value='Yes'  id='choice_89_57_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_57_0' id='label_89_57_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_89_57_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_57' type='radio' value='No'  id='choice_89_57_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_57_1' id='label_89_57_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_89_81\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full optional traditional limit-3 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfQu\u00e9 te ha impedido buscar tratamiento en el pasado?<\/span><\/legend><div class='gfield_description' id='gfield_description_89_81'>Selecciona hasta 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_89_81'><div class='gchoice gchoice_89_81_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_81.1' type='checkbox'  value='I wanted to handle my mental health on my own'  id='choice_89_81_1'   aria-describedby=\"gfield_description_89_81\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_89_81_1' id='label_89_81_1' class='gform-field-label gform-field-label--type-inline'>Quer\u00eda manejar mi salud mental por mi cuenta.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_81_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_81.2' type='checkbox'  value='I didn\u2019t know how or where to start'  id='choice_89_81_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_81_2' id='label_89_81_2' class='gform-field-label gform-field-label--type-inline'>No sab\u00eda c\u00f3mo ni por d\u00f3nde empezar.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_81_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_81.3' type='checkbox'  value='I thought it would cost too much'  id='choice_89_81_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_81_3' id='label_89_81_3' class='gform-field-label gform-field-label--type-inline'>Pensaba que costar\u00eda demasiado.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_81_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_81.4' type='checkbox'  value='I didn\u2019t have time'  id='choice_89_81_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_81_4' id='label_89_81_4' class='gform-field-label gform-field-label--type-inline'>No ten\u00eda tiempo.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_81_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_81.5' type='checkbox'  value='I didn\u2019t think it would help me'  id='choice_89_81_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_81_5' id='label_89_81_5' class='gform-field-label gform-field-label--type-inline'>No cre\u00eda que me fuera a ayudar.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_81_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_81.6' type='checkbox'  value='I didn&#039;t feel ready to start treatment'  id='choice_89_81_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_81_6' id='label_89_81_6' class='gform-field-label gform-field-label--type-inline'>No me sent\u00eda preparado para comenzar el tratamiento.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_81_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_81.7' type='checkbox'  value='I was worried about what people would think or say if I got treatment'  id='choice_89_81_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_81_7' id='label_89_81_7' class='gform-field-label gform-field-label--type-inline'>Me preocupaba lo que la gente fuera a pensar o decir si me sometiera al tratamiento.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_81_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_81.8' type='checkbox'  value='I was afraid of being forced into a hospital or forced to take medication'  id='choice_89_81_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_81_8' id='label_89_81_8' class='gform-field-label gform-field-label--type-inline'>Ten\u00eda miedo de que me internaran en un hospital o me obligaran a tomar medicamentos.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_81_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_81.9' type='checkbox'  value='I tried, but couldn\u2019t find available treatment (no openings, wouldn\u2019t take insurance, etc.)'  id='choice_89_81_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_81_9' id='label_89_81_9' class='gform-field-label gform-field-label--type-inline'>Lo intent\u00e9, pero no pude encontrar un tratamiento disponible (no hab\u00eda plazas, no aceptaban el seguro, etc.).<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_81_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_81.11' type='checkbox'  value='My parent(s) or guardian wouldn&#039;t let me, or I didn&#039;t want to ask'  id='choice_89_81_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_81_11' id='label_89_81_11' class='gform-field-label gform-field-label--type-inline'>Mis pap\u00e1s o mi tutor no me dejaron, o no quer\u00eda pedir permiso.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_81_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_81.12' type='checkbox'  value='Other...'  id='choice_89_81_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_81_12' id='label_89_81_12' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_89_82\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_89_82'><span class='gform-field-label__text'>\u00bfQu\u00e9 otras cosas te han impedido buscar tratamiento en el pasado?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_82' id='input_89_82' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_89_26\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox optional traditional limit-3 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Piensa en tu prueba de salud mental. \u00bfCu\u00e1les son los principales factores que contribuyen a tus problemas de salud mental en este momento?<\/span><\/legend><div class='gfield_description' id='gfield_description_89_26'>Selecciona hasta 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_89_26'><div class='gchoice gchoice_89_26_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.1' type='checkbox'  value='Abuse or violence'  id='choice_89_26_1'   aria-describedby=\"gfield_description_89_26\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_89_26_1' id='label_89_26_1' class='gform-field-label gform-field-label--type-inline'>Abuso o violencia<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_26_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.2' type='checkbox'  value='Relationship problems (friends, family, or significant other)'  id='choice_89_26_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_26_2' id='label_89_26_2' class='gform-field-label gform-field-label--type-inline'>Problemas de relaci\u00f3n (amigos, familia o pareja)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_26_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.3' type='checkbox'  value='Body image'  id='choice_89_26_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_26_3' id='label_89_26_3' class='gform-field-label gform-field-label--type-inline'>Imagen corporal<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_26_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.4' type='checkbox'  value='Low self-esteem or self-image'  id='choice_89_26_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_26_4' id='label_89_26_4' class='gform-field-label gform-field-label--type-inline'>Baja autoestima o imagen de uno mismo<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_26_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.5' type='checkbox'  value='School or work problems'  id='choice_89_26_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_26_5' id='label_89_26_5' class='gform-field-label gform-field-label--type-inline'>Problemas en la escuela o en el trabajo<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_26_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.6' type='checkbox'  value='Financial problems'  id='choice_89_26_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_26_6' id='label_89_26_6' class='gform-field-label gform-field-label--type-inline'>Problemas financieros<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_26_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.7' type='checkbox'  value='Loneliness or isolation'  id='choice_89_26_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_26_7' id='label_89_26_7' class='gform-field-label gform-field-label--type-inline'>Soledad o aislamiento<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_26_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.8' type='checkbox'  value='Grief or loss of someone or something'  id='choice_89_26_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_26_8' id='label_89_26_8' class='gform-field-label gform-field-label--type-inline'>Dolor o p\u00e9rdida de alguien o algo.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_26_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.9' type='checkbox'  value='Experiencing hate\/bullying (including racism, homophobia, transphobia, or discrimination)'  id='choice_89_26_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_26_9' id='label_89_26_9' class='gform-field-label gform-field-label--type-inline'>Sufrir odio o acoso (incluido el racismo, la homofobia, la transfobia o la discriminaci\u00f3n)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_26_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.11' type='checkbox'  value='State of the world (war, climate, politics, immigration)'  id='choice_89_26_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_26_11' id='label_89_26_11' class='gform-field-label gform-field-label--type-inline'>Situaci\u00f3n mundial (guerra, clima, pol\u00edtica, inmigraci\u00f3n)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_26_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.12' type='checkbox'  value='I don\u2019t know (something just feels wrong)'  id='choice_89_26_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_26_12' id='label_89_26_12' class='gform-field-label gform-field-label--type-inline'>No lo s\u00e9 (s\u00f3lo que algo no va bien)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_26_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.13' type='checkbox'  value='Other...'  id='choice_89_26_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_26_13' id='label_89_26_13' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_89_27\" class=\"gfield gfield--type-text gfield--input-type-text optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_89_27'><span class='gform-field-label__text'>\u00bfQu\u00e9 m\u00e1s est\u00e1 contribuyendo a tus problemas de salud mental en este momento?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_27' id='input_89_27' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_89_74\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_89_74'><span class='gform-field-label__text'>\u00bfQu\u00e9 aspecto de la situaci\u00f3n mundial te afecta m\u00e1s?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_74' id='input_89_74' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_89_44\" class=\"gfield gfield--type-html gfield--input-type-html section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>Acerca de tu salud<\/h2><\/div><fieldset id=\"field_89_29\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTienes actualmente un seguro m\u00e9dico?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_89_29'>\n\t\t\t<div class='gchoice gchoice_89_29_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='Yes'  id='choice_89_29_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_29_0' id='label_89_29_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_89_29_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='No'  id='choice_89_29_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_29_1' id='label_89_29_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_89_29_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='I don&#039;t know'  id='choice_89_29_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_29_2' id='label_89_29_2' class='gform-field-label gform-field-label--type-inline'>No lo s\u00e9<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_89_30\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox optional traditional field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfTienes alguna de las siguientes condiciones f\u00edsicas?<\/span><\/legend><div class='gfield_description' id='gfield_description_89_30'>Selecciona todas las opciones que apliquen.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_89_30'><div class='gchoice gchoice_89_30_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.1' type='checkbox'  value='Heart disease'  id='choice_89_30_1'   aria-describedby=\"gfield_description_89_30\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_89_30_1' id='label_89_30_1' class='gform-field-label gform-field-label--type-inline'>Enfermedad card\u00edaca<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_30_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.2' type='checkbox'  value='Reproductive health concerns (PCOS, endometriosis, infertility, etc.)'  id='choice_89_30_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_30_2' id='label_89_30_2' class='gform-field-label gform-field-label--type-inline'>Problemas de salud reproductiva (s\u00edndrome de ovario poliqu\u00edstico, endometriosis, infertilidad, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_30_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.3' type='checkbox'  value='Diabetes'  id='choice_89_30_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_30_3' id='label_89_30_3' class='gform-field-label gform-field-label--type-inline'>Diabetes<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_30_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.4' type='checkbox'  value='Cancer'  id='choice_89_30_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_30_4' id='label_89_30_4' class='gform-field-label gform-field-label--type-inline'>C\u00e1ncer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_30_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.5' type='checkbox'  value='Arthritis or other chronic pain'  id='choice_89_30_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_30_5' id='label_89_30_5' class='gform-field-label gform-field-label--type-inline'>Artritis u otros dolores cr\u00f3nicos<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_30_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.6' type='checkbox'  value='Asthma, COPD or other lung conditions'  id='choice_89_30_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_30_6' id='label_89_30_6' class='gform-field-label gform-field-label--type-inline'>Asma, EPOC u otras afecciones pulmonares<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_30_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.7' type='checkbox'  value='Movement Disorders (involuntary tics, tardive dyskinesia, etc.)'  id='choice_89_30_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_30_7' id='label_89_30_7' class='gform-field-label gform-field-label--type-inline'>Trastornos del movimiento (tics involuntarios, discinesia tard\u00eda, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_30_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.8' type='checkbox'  value='Digestive problems (Crohn\u2019s, colitis, IBS, etc.)'  id='choice_89_30_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_30_8' id='label_89_30_8' class='gform-field-label gform-field-label--type-inline'>Problemas digestivos (enfermedad de Crohn, colitis, s\u00edndrome del intestino irritable, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_30_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.9' type='checkbox'  value='Neurological conditions (epilepsy, etc.) or traumatic brain injury (TBI)'  id='choice_89_30_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_30_9' id='label_89_30_9' class='gform-field-label gform-field-label--type-inline'>Afecciones neurol\u00f3gicas (epilepsia, etc.) o traumatismo craneoencef\u00e1lico (TCE)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_89_30_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.11' type='checkbox'  value='Other...'  id='choice_89_30_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_89_30_11' id='label_89_30_11' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_89_31\" class=\"gfield gfield--type-text gfield--input-type-text optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_89_31'><span class='gform-field-label__text'>\u00bfQu\u00e9 otras condiciones f\u00edsicas tienes?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_31' id='input_89_31' type='text' value='' class='large'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_89_75\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTienes una mascota que te ayuda a cuidar tu salud mental?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_89_75'>\n\t\t\t<div class='gchoice gchoice_89_75_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_75' type='radio' value='Yes'  id='choice_89_75_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_75_0' id='label_89_75_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_89_75_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_75' type='radio' value='No'  id='choice_89_75_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_75_1' id='label_89_75_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_89_76\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTe interesa tener una mascota que te ayude a cuidar tu salud mental?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_89_76'>\n\t\t\t<div class='gchoice gchoice_89_76_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_76' type='radio' value='Yes'  id='choice_89_76_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_76_0' id='label_89_76_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_89_76_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_76' type='radio' value='No'  id='choice_89_76_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_89_76_1' id='label_89_76_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <button type='submit' id='gform_submit_button_89' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Ver resultados<\/button> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_89' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_89' id='gform_theme_89' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_89' id='gform_style_settings_89' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_89' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='89' \/>\n            \n            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\/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_89' id='gform_target_page_number_89' value='0' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_89' id='gform_source_page_number_89' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <input type=\"hidden\" name=\"trp-form-language\" value=\"es\"\/><\/form>\n                        <\/div>\n<p>&nbsp;<\/p>\n<hr \/>\n<h2 class=\"smaller\">Fuente:<\/h2>\n<div class=\"references\">\n<p>Moyer et al. (2023). Desarrollo de la Escala de Depresi\u00f3n Posparto de Edimburgo-Estados Unidos: una herramienta actualizada de detecci\u00f3n de la salud mental perinatal que utiliza un enfoque respetuoso y basado en el trauma. <em>Revista de Salud de la Mujer, 32(<\/em>10), pp. 1080-1085.<\/p>\n<p>Cox et al. (1987). Detecci\u00f3n de la depresi\u00f3n posparto: desarrollo de la Escala de Depresi\u00f3n Posparto de Edimburgo de 10 \u00edtems. <em>Revista Brit\u00e1nica de Psiquiatr\u00eda 150<\/em>(6), pp. 782-786.<\/p>\n<p><a href=\"https:\/\/screening.mhanational.org\/es\/about-our-mental-health-tests\/\" target=\"_blank\" rel=\"noopener\">Para aprender m\u00e1s sobre nuestras herramientas de detecci\u00f3n, haz clic aqu\u00ed.<\/a><\/p>\n<p><em><strong>Ten en cuenta:<\/strong> Las herramientas de evaluaci\u00f3n en l\u00ednea no son instrumentos de diagn\u00f3stico. Te recomendamos que compartas tus resultados con un m\u00e9dico o profesional de la salud. Mental Health America Inc., sus patrocinadores, socios y anunciantes no se hacen responsables de ninguna responsabilidad, p\u00e9rdida o riesgo que se derive, directa o indirectamente, del uso y la aplicaci\u00f3n de estas evaluaciones.<\/em><\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>&nbsp; Fuente: Moyer et al. (2023). Desarrollo de la Escala de Depresi\u00f3n Posparto de Edimburgo-Estados Unidos: una herramienta actualizada de detecci\u00f3n de la salud mental perinatal que utiliza un enfoque respetuoso y basado en el trauma. Revista de Salud de la Mujer, 32(10), pp. 1080-1085. Cox et al. (1987). Detecci\u00f3n de la depresi\u00f3n posparto: desarrollo de la Escala de Depresi\u00f3n Posparto de Edimburgo de 10 \u00edtems. Revista brit\u00e1nica de... <\/p>\n<p class=\"link-more\"><a href=\"https:\/\/screening.mhanational.org\/es\/screening-tools\/demographics\/\" class=\"more-link\">Seguir leyendo<span class=\"screen-reader-text\"> \u201cPreguntas demogr\u00e1ficas (prueba)\u201d<\/span><\/a><\/p>","protected":false},"template":"","tags":[],"age_group":[],"condition":[83,86,99],"class_list":["post-252437","screen","type-screen","status-publish","hentry","condition-anxiety","condition-depression","condition-postpartum-depression"],"acf":[],"yoast_head":"<title>Demographics Questions (test) &#8211; Free, quick, &amp; confidential<\/title>\n<meta name=\"robots\" content=\"noindex, nofollow\" \/>\n<meta property=\"og:locale\" content=\"es_MX\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Postpartum Depression Test\" \/>\n<meta property=\"og:description\" content=\"The Postpartum Depression Test is for new and expecting mothers who began feeling overwhelming sadness after becoming pregnant or giving birth.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/screening.mhanational.org\/es\/screening-tools\/demographics\/\" \/>\n<meta property=\"og:site_name\" content=\"Mental Health America\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/mentalhealthamerica\" \/>\n<meta property=\"article:modified_time\" content=\"2026-02-10T18:27:01+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/screening.mhanational.org\/wp-content\/uploads\/2022\/04\/Social-media-share-preview.png\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"631\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:title\" content=\"Postpartum Depression Test\" \/>\n<meta name=\"twitter:description\" content=\"The Postpartum Depression Test is for new and expecting mothers 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de ansiedad social"},"content":{"rendered":"<div class='gf_browser_chrome gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_88' style='display:none'>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Test de ansiedad social<\/h2>\n                            <p class='gform_description'><\/p>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>\"<span class=\"gfield_required gfield_required_asterisk\">*<\/span>\"indica campos obligatorios<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_88'  class='clearfix' action='\/es\/wp-json\/wp\/v2\/screen' data-formid='88' novalidate data-trp-original-action=\"\/es\/wp-json\/wp\/v2\/screen\"><ol class=\"screen-progress-bar clearfix step-1-of-3\">\n\t\t\t\t\t<li class=\"step-1 translation-block\"><span>Preguntas<br>del Test<\/span><\/li>\n\t\t\t\t\t<li class=\"step-2 translation-block\"><span>Preguntas<br>Opcionales<\/span><\/li>\n\t\t\t\t\t<li class=\"step-3 translation-block\"><span>Tus<br>Resultados<\/span><\/li>\n\t\t\t\t<\/ol>\n                        <div class='gform-body gform_body'><div id='gform_page_88_1' class='gform_page' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_88' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_88_145\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_88_145'><span class='gform-field-label__text'>LinkedIn<\/span><\/label><div class='gfield_description' id='gfield_description_88_145'>Este campo es para fines de validaci\u00f3n y no debe modificarse.<\/div><div class='ginput_container'><input name='input_145' id='input_88_145' type='text' value='' autocomplete='new-password'\/><\/div><\/div><div id=\"field_88_38\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_38' id='input_88_38' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_88_39\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><input name=\"input_39\" id=\"input_88_39\" type=\"hidden\" class=\"gform_hidden\" aria-invalid=\"false\" value=\"251896\"><\/div><div id=\"field_88_40\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><input name=\"input_40\" id=\"input_88_40\" type=\"hidden\" class=\"gform_hidden\" aria-invalid=\"false\" value=\"e875158b42d4e2ab407c8e264f11f752\"><\/div><div id=\"field_88_41\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_41' id='input_88_41' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_88_54\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_54' id='input_88_54' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='http:\/\/screening.mhanational.org' \/><\/div><\/div><div id=\"field_88_84\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_84' id='input_88_84' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_88_85\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_85' id='input_88_85' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_88_86\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_86' id='input_88_86' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_88_96\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_96' id='input_88_96' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_88_97\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_97' id='input_88_97' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='https:\/\/screening.mhanational.org\/es\/wp-json\/wp\/v2\/screen' \/><\/div><\/div><div id=\"field_88_144\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_144' id='input_88_144' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='lang--es' \/><\/div><\/div><div id=\"field_88_120\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p>\nLas siguientes preguntas se refieren a los pensamientos, sentimientos y comportamientos que puedes haber tenido con respecto a <strong>situaciones sociales<\/strong>. Algunas situaciones comunes incluyen:\n<\/p>\n<ul>\n<li>\nhablar en p\u00fablico\n<\/li><li>\nhablar en reuniones\n<\/li><li>\nasistir a eventos sociales o fiestas\n<\/li><li>\npresentarte a los dem\u00e1s\n<\/li><li>\ntener conversaciones\n<\/li><li>\ndar y recibir cumplidos\n<\/li><li>\nhacerles peticiones a los dem\u00e1s\n<\/li><li>\ncomer y escribir en p\u00fablico\n<\/li><\/ul>\n\n<p>Ten en cuenta que todas las preguntas son obligatorias.<\/p><\/div><div id=\"field_88_113\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><hr \/>\nEstamos probando diferentes formas de preguntar a las personas sobre sus s\u00edntomas de ansiedad social.<\/div><fieldset id=\"field_88_114\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfPodr\u00eda ayudarnos a responder dos preguntas adicionales sobre sus experiencias en diferentes periodos de tiempo (7 d\u00edas frente a 3 meses)?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_88_114'>\n\t\t\t<div class='gchoice gchoice_88_114_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_114' type='radio' value='Yes'  id='choice_88_114_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_114_0' id='label_88_114_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_114_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_114' type='radio' value='No'  id='choice_88_114_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_114_1' id='label_88_114_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_88_115\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  >\u00a1Gracias por tu ayuda!<\/div><div id=\"field_88_116\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  >\u00a1De acuerdo! Solo ver\u00e1s las preguntas normales que siempre hacemos.<\/div><div id=\"field_88_117\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><hr \/><\/div><fieldset id=\"field_88_98\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'><strong>En los \u00faltimos tres meses<\/strong>, \u00bfTe has sentido a menudo muy nervioso o inc\u00f3modo cuando has estado con un grupo de personas (por ejemplo, en una comida o en una fiesta)?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_88_98'>\n\t\t\t<div class='gchoice gchoice_88_98_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_98' type='radio' value='Yes'  id='choice_88_98_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_98_0' id='label_88_98_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_98_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_98' type='radio' value='No'  id='choice_88_98_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_98_1' id='label_88_98_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_88_134\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'><strong>En los \u00faltimos tres meses<\/strong>, \u00bfTe has sentido a menudo muy nervioso cuando has tenido que hacer cosas delante de otras personas?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_88_134'>\n\t\t\t<div class='gchoice gchoice_88_134_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_134' type='radio' value='Yes'  id='choice_88_134_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_134_0' id='label_88_134_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_134_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_134' type='radio' value='No'  id='choice_88_134_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_134_1' id='label_88_134_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_88_122\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><hr \/><\/div><div id=\"field_88_123\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>Durante los \u00faltimos 7 d\u00edas...<\/h2><\/div><fieldset id=\"field_88_47\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>1. He sentido momentos de terror, miedo o p\u00e1nico repentinos en situaciones sociales.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_88_47'>\n\t\t\t<div class='gchoice gchoice_88_47_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_47' type='radio' value='0'  id='choice_88_47_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_47_0' id='label_88_47_0' class='gform-field-label gform-field-label--type-inline'>Nunca<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_47_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_47' type='radio' value='1'  id='choice_88_47_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_47_1' id='label_88_47_1' class='gform-field-label gform-field-label--type-inline'>De vez en cuando<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_47_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_47' type='radio' value='2'  id='choice_88_47_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_47_2' id='label_88_47_2' class='gform-field-label gform-field-label--type-inline'>La mitad del tiempo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_47_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_47' type='radio' value='3'  id='choice_88_47_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_47_3' id='label_88_47_3' class='gform-field-label gform-field-label--type-inline'>La mayor parte del tiempo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_47_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_47' type='radio' value='4'  id='choice_88_47_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_47_4' id='label_88_47_4' class='gform-field-label gform-field-label--type-inline'>Todo el tiempo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_88_131\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>2. Me he sentido ansioso\/a, preocupado\/a o nervioso\/a ante situaciones sociales.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_88_131'>\n\t\t\t<div class='gchoice gchoice_88_131_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_131' type='radio' value='0'  id='choice_88_131_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_131_0' id='label_88_131_0' class='gform-field-label gform-field-label--type-inline'>Nunca<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_131_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_131' type='radio' value='1'  id='choice_88_131_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_131_1' id='label_88_131_1' class='gform-field-label gform-field-label--type-inline'>De vez en cuando<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_131_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_131' type='radio' value='2'  id='choice_88_131_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_131_2' id='label_88_131_2' class='gform-field-label gform-field-label--type-inline'>La mitad del tiempo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_131_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_131' type='radio' value='3'  id='choice_88_131_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_131_3' id='label_88_131_3' class='gform-field-label gform-field-label--type-inline'>La mayor parte del tiempo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_131_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_131' type='radio' value='4'  id='choice_88_131_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_131_4' id='label_88_131_4' class='gform-field-label gform-field-label--type-inline'>Todo el tiempo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_88_130\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>3. He tenido pensamientos de ser rechazado, humillado, avergonzado, ridiculizado, o de ofender a otros.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_88_130'>\n\t\t\t<div class='gchoice gchoice_88_130_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_130' type='radio' value='0'  id='choice_88_130_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_130_0' id='label_88_130_0' class='gform-field-label gform-field-label--type-inline'>Nunca<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_130_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_130' type='radio' value='1'  id='choice_88_130_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_130_1' id='label_88_130_1' class='gform-field-label gform-field-label--type-inline'>De vez en cuando<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_130_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_130' type='radio' value='2'  id='choice_88_130_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_130_2' id='label_88_130_2' class='gform-field-label gform-field-label--type-inline'>La mitad del tiempo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_130_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_130' type='radio' value='3'  id='choice_88_130_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_130_3' id='label_88_130_3' class='gform-field-label gform-field-label--type-inline'>La mayor parte del tiempo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_130_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_130' type='radio' value='4'  id='choice_88_130_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_130_4' id='label_88_130_4' class='gform-field-label gform-field-label--type-inline'>Todo el tiempo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_88_129\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>4. He sentido taquicardia, sudoraci\u00f3n, dificultad para respirar, mareos o temblores en situaciones sociales.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_88_129'>\n\t\t\t<div class='gchoice gchoice_88_129_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_129' type='radio' value='0'  id='choice_88_129_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_129_0' id='label_88_129_0' class='gform-field-label gform-field-label--type-inline'>Nunca<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_129_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_129' type='radio' value='1'  id='choice_88_129_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_129_1' id='label_88_129_1' class='gform-field-label gform-field-label--type-inline'>De vez en cuando<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_129_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_129' type='radio' value='2'  id='choice_88_129_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_129_2' id='label_88_129_2' class='gform-field-label gform-field-label--type-inline'>La mitad del tiempo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_129_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_129' type='radio' value='3'  id='choice_88_129_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_129_3' id='label_88_129_3' class='gform-field-label gform-field-label--type-inline'>La mayor parte del tiempo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_129_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_129' type='radio' value='4'  id='choice_88_129_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_129_4' id='label_88_129_4' class='gform-field-label gform-field-label--type-inline'>Todo el tiempo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_88_128\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>5. He sentido los m\u00fasculos tensos, me he sentido nervioso\/a o inquieto\/a, o me ha costado relajarme en situaciones sociales.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_88_128'>\n\t\t\t<div class='gchoice gchoice_88_128_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_128' type='radio' value='0'  id='choice_88_128_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_128_0' id='label_88_128_0' class='gform-field-label gform-field-label--type-inline'>Nunca<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_128_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_128' type='radio' value='1'  id='choice_88_128_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_128_1' id='label_88_128_1' class='gform-field-label gform-field-label--type-inline'>De vez en cuando<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_128_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_128' type='radio' value='2'  id='choice_88_128_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_128_2' id='label_88_128_2' class='gform-field-label gform-field-label--type-inline'>La mitad del tiempo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_128_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_128' type='radio' value='3'  id='choice_88_128_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_128_3' id='label_88_128_3' class='gform-field-label gform-field-label--type-inline'>La mayor parte del tiempo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_128_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_128' type='radio' value='4'  id='choice_88_128_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_128_4' id='label_88_128_4' class='gform-field-label gform-field-label--type-inline'>Todo el tiempo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_88_127\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>6. He evitado, o no me he acercado ni entrado en situaciones sociales.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_88_127'>\n\t\t\t<div class='gchoice gchoice_88_127_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_127' type='radio' value='0'  id='choice_88_127_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_127_0' id='label_88_127_0' class='gform-field-label gform-field-label--type-inline'>Nunca<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_127_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_127' type='radio' value='1'  id='choice_88_127_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_127_1' id='label_88_127_1' class='gform-field-label gform-field-label--type-inline'>De vez en cuando<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_127_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_127' type='radio' value='2'  id='choice_88_127_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_127_2' id='label_88_127_2' class='gform-field-label gform-field-label--type-inline'>La mitad del tiempo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_127_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_127' type='radio' value='3'  id='choice_88_127_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_127_3' id='label_88_127_3' class='gform-field-label gform-field-label--type-inline'>La mayor parte del tiempo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_127_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_127' type='radio' value='4'  id='choice_88_127_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_127_4' id='label_88_127_4' class='gform-field-label gform-field-label--type-inline'>Todo el tiempo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_88_126\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>7. He dejado pronto algunas situaciones sociales o participado m\u00ednimamente (por ejemplo, hablaba poco, evitaba el contacto visual).<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_88_126'>\n\t\t\t<div class='gchoice gchoice_88_126_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_126' type='radio' value='0'  id='choice_88_126_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_126_0' id='label_88_126_0' class='gform-field-label gform-field-label--type-inline'>Nunca<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_126_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_126' type='radio' value='1'  id='choice_88_126_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_126_1' id='label_88_126_1' class='gform-field-label gform-field-label--type-inline'>De vez en cuando<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_126_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_126' type='radio' value='2'  id='choice_88_126_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_126_2' id='label_88_126_2' class='gform-field-label gform-field-label--type-inline'>La mitad del tiempo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_126_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_126' type='radio' value='3'  id='choice_88_126_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_126_3' id='label_88_126_3' class='gform-field-label gform-field-label--type-inline'>La mayor parte del tiempo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_126_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_126' type='radio' value='4'  id='choice_88_126_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_126_4' id='label_88_126_4' class='gform-field-label gform-field-label--type-inline'>Todo el tiempo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_88_125\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>8. He pasado mucho tiempo preparando qu\u00e9 decir o c\u00f3mo actuar en situaciones sociales.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_88_125'>\n\t\t\t<div class='gchoice gchoice_88_125_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_125' type='radio' value='0'  id='choice_88_125_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_125_0' id='label_88_125_0' class='gform-field-label gform-field-label--type-inline'>Nunca<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_125_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_125' type='radio' value='1'  id='choice_88_125_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_125_1' id='label_88_125_1' class='gform-field-label gform-field-label--type-inline'>De vez en cuando<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_125_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_125' type='radio' value='2'  id='choice_88_125_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_125_2' id='label_88_125_2' class='gform-field-label gform-field-label--type-inline'>La mitad del tiempo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_125_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_125' type='radio' value='3'  id='choice_88_125_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_125_3' id='label_88_125_3' class='gform-field-label gform-field-label--type-inline'>La mayor parte del tiempo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_125_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_125' type='radio' value='4'  id='choice_88_125_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_125_4' id='label_88_125_4' class='gform-field-label gform-field-label--type-inline'>Todo el tiempo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_88_124\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>9. Me he distra\u00eddo para evitar pensar en situaciones sociales.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_88_124'>\n\t\t\t<div class='gchoice gchoice_88_124_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_124' type='radio' value='0'  id='choice_88_124_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_124_0' id='label_88_124_0' class='gform-field-label gform-field-label--type-inline'>Nunca<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_124_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_124' type='radio' value='1'  id='choice_88_124_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_124_1' id='label_88_124_1' class='gform-field-label gform-field-label--type-inline'>De vez en cuando<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_124_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_124' type='radio' value='2'  id='choice_88_124_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_124_2' id='label_88_124_2' class='gform-field-label gform-field-label--type-inline'>La mitad del tiempo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_124_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_124' type='radio' value='3'  id='choice_88_124_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_124_3' id='label_88_124_3' class='gform-field-label gform-field-label--type-inline'>La mayor parte del tiempo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_124_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_124' type='radio' value='4'  id='choice_88_124_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_124_4' id='label_88_124_4' class='gform-field-label gform-field-label--type-inline'>Todo el tiempo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_88_133\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>10. He necesitado ayuda para aguantar situaciones sociales (por ejemplo, alcohol o medicamentos, objetos supersticiosos).<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_88_133'>\n\t\t\t<div class='gchoice gchoice_88_133_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_133' type='radio' value='0'  id='choice_88_133_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_133_0' id='label_88_133_0' class='gform-field-label gform-field-label--type-inline'>Nunca<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_133_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_133' type='radio' value='1'  id='choice_88_133_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_133_1' id='label_88_133_1' class='gform-field-label gform-field-label--type-inline'>De vez en cuando<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_133_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_133' type='radio' value='2'  id='choice_88_133_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_133_2' id='label_88_133_2' class='gform-field-label gform-field-label--type-inline'>La mitad del tiempo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_133_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_133' type='radio' value='3'  id='choice_88_133_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_133_3' id='label_88_133_3' class='gform-field-label gform-field-label--type-inline'>La mayor parte del tiempo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_133_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_133' type='radio' value='4'  id='choice_88_133_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_133_4' id='label_88_133_4' class='gform-field-label gform-field-label--type-inline'>Todo el tiempo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_88_121\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><hr \/><\/div><fieldset id=\"field_88_135\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'><strong>En los \u00faltimos tres meses<\/strong>, \u00bfTe has sentido a menudo muy nervioso o inc\u00f3modo cuando has estado con un grupo de personas (por ejemplo, en una comida o en una fiesta)?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_88_135'>\n\t\t\t<div class='gchoice gchoice_88_135_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_135' type='radio' value='Yes'  id='choice_88_135_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_135_0' id='label_88_135_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_135_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_135' type='radio' value='No'  id='choice_88_135_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_135_1' id='label_88_135_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_88_136\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'><strong>En los \u00faltimos tres meses<\/strong>, \u00bfTe has sentido a menudo muy nervioso cuando has tenido que hacer cosas delante de otras personas?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_88_136'>\n\t\t\t<div class='gchoice gchoice_88_136_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_136' type='radio' value='Yes'  id='choice_88_136_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_136_0' id='label_88_136_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_136_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_136' type='radio' value='No'  id='choice_88_136_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_136_1' id='label_88_136_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_88_139\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><hr \/><\/div><div id=\"field_88_140\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_88_140'><span class='gform-field-label__text'>Opcional: \u00bfQu\u00e9 es lo que m\u00e1s te preocupa de los s\u00edntomas de ansiedad social que has estado experimentando?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_140' id='input_88_140' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <button type='button' id='gform_next_button_88_17' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Siguiente<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_88_2' class='gform_page demographics' data-js='page-field-id-17' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_88_2' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_88_55\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p class=\"translation-block\">Por favor, toma un momento para responder a las siguientes preguntas <strong>opcionales<\/strong>. Tus respuestas son totalmente an\u00f3nimas: no podremos identificarte a partir de esta informaci\u00f3n. Tus respuestas nos ayudan a proporcionar mejor informaci\u00f3n y apoyo a personas como t\u00fa.<\/p>\n\n<p>Puedes responder a tantas preguntas como desees. Cuando hayas terminado, despl\u00e1zate hasta la parte inferior de la encuesta y haz clic en \"ver resultados\" para recibir los resultados de la evaluaci\u00f3n.<\/p><\/div><div id=\"field_88_87\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><hr \/><\/div><fieldset id=\"field_88_88\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfEst\u00e1s haciendo este test por ti o en lugar de otra persona?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_88_88'>\n\t\t\t<div class='gchoice gchoice_88_88_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_88' type='radio' value='For myself'  id='choice_88_88_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_88_0' id='label_88_88_0' class='gform-field-label gform-field-label--type-inline'>Por m\u00ed mismo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_88_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_88' type='radio' value='For someone else'  id='choice_88_88_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_88_1' id='label_88_88_1' class='gform-field-label gform-field-label--type-inline'>En lugar de otra persona<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_88_89\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  >Si est\u00e1s haciendo este test en lugar de otra persona, <strong>Por favor, utilice la informaci\u00f3n de esa persona.<\/strong> para las preguntas siguientes, o d\u00e9jalas en blanco si no sabes la respuesta. Recuerda que, <em>estas preguntas son opcionales<\/em>.<\/div><div id=\"field_88_56\" class=\"gfield gfield--type-html gfield--input-type-html section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>Acerca de ti<\/h2><\/div><div id=\"field_88_57\" class=\"gfield gfield--type-select gfield--input-type-select optional taxonomy field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_88_57'><span class='gform-field-label__text'>Rango de edades<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_57' id='input_88_57' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='8-10' >8-10<\/option><option value='11-13' >11-13<\/option><option value='14-15' >14-15<\/option><option value='16-17' >16-17<\/option><option value='18-24' >18-24<\/option><option value='25-34' >25-34<\/option><option value='35-44' >35-44<\/option><option value='45-54' >45-54<\/option><option value='55-64' >55-64<\/option><option value='65+' >65+<\/option><\/select><\/div><\/div><fieldset id=\"field_88_58\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>G\u00e9nero<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_88_58'>\n\t\t\t<div class='gchoice gchoice_88_58_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_58' type='radio' value='Female'  id='choice_88_58_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_58_0' id='label_88_58_0' class='gform-field-label gform-field-label--type-inline'>Femenino<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_58_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_58' type='radio' value='Male'  id='choice_88_58_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_58_1' id='label_88_58_1' class='gform-field-label gform-field-label--type-inline'>Masculino<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_58_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_58' type='radio' value='Non-Binary'  id='choice_88_58_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_58_2' id='label_88_58_2' class='gform-field-label gform-field-label--type-inline'>No binario<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_88_141\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTe identificas como transg\u00e9nero?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_88_141'>\n\t\t\t<div class='gchoice gchoice_88_141_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_141' type='radio' value='Yes'  id='choice_88_141_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_141_0' id='label_88_141_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_141_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_141' type='radio' value='No'  id='choice_88_141_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_141_1' id='label_88_141_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_88_59\" class=\"gfield gfield--type-text gfield--input-type-text optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_88_59'><span class='gform-field-label__text'>\u00bfC\u00f3mo describir\u00edas tu g\u00e9nero?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_59' id='input_88_59' type='text' value='' class='small'    placeholder='Ingresa el g\u00e9nero...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_88_61\" class=\"gfield gfield--type-select gfield--input-type-select optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_88_61'><span class='gform-field-label__text'>Raza\/etnia<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_61' id='input_88_61' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='American Indian or Alaska Native' >Amerindio o nativo de Alaska<\/option><option value='Asian' >Asi\u00e1tico<\/option><option value='Black or African American (non-Hispanic)' >Negro o afroamericano (no hispano)<\/option><option value='Hispanic or Latino' >Hispano o latino<\/option><option value='Middle Eastern or North African' >Del medio oriente o norteafricano<\/option><option value='Native Hawaiian or other Pacific Islander' >Isle\u00f1o nativo hawaiano o pac\u00edfico<\/option><option value='White (non-Hispanic)' >Blanco (no hispano)<\/option><option value='More than one of the above' >M\u00e1s de uno de los anteriores<\/option><option value='Other' >Otros<\/option><\/select><\/div><\/div><div id=\"field_88_62\" class=\"gfield gfield--type-select gfield--input-type-select optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_88_62'><span class='gform-field-label__text'>Ingresos familiares (USD)<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_62' id='input_88_62' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Less than $20,000' >Menos de $20,000<\/option><option value='$20,000 - $39,999' >$20,000 - $39,999<\/option><option value='$40,000 - $59,999' >$40,000 - $59,999<\/option><option value='$60,000 - $79,999' >$60,000 - $79,999<\/option><option value='$80,000 - $99,999' >$80,000 - $99,999<\/option><option value='$100,000 - $149,999' >$100,000 - $149,999<\/option><option value='$150,000+' >$150,000+<\/option><\/select><\/div><\/div><fieldset id=\"field_88_90\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfVives en los Estados Unidos de Am\u00e9rica o en otro pa\u00eds?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_88_90'>\n\t\t\t<div class='gchoice gchoice_88_90_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_90' type='radio' value='I live in the United States'  id='choice_88_90_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_90_0' id='label_88_90_0' class='gform-field-label gform-field-label--type-inline'>Vivo en los Estados Unidos de Am\u00e9rica.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_90_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_90' type='radio' value='I live in another country'  id='choice_88_90_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_90_1' id='label_88_90_1' class='gform-field-label gform-field-label--type-inline'>Vivo en otro pa\u00eds.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_88_81\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_88_81'><span class='gform-field-label__text'>Estado<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_81' id='input_88_81' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >Distrito de Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Hawaii' >Haw\u00e1i<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Luisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >M\u00edchigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Misisipi<\/option><option value='Missouri' >Misuri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >Nuevo Hampshire<\/option><option value='New Jersey' >Nueva Jersey<\/option><option value='New Mexico' >Nuevo M\u00e9xico<\/option><option value='New York' >Nueva York<\/option><option value='North Carolina' >Carolina del Norte<\/option><option value='North Dakota' >Dakota del Norte<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oreg\u00f3n<\/option><option value='Pennsylvania' >Pensilvania<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >Carolina del Sur<\/option><option value='South Dakota' >Dakota del Sur<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >Virginia Occidental<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='I live in a U.S. Territory' >Vivo en un territorio de los Estados Unidos.<\/option><\/select><\/div><\/div><div id=\"field_88_83\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_88_83'><span class='gform-field-label__text'>\u00bfEn qu\u00e9 pa\u00eds vives?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_83' id='input_88_83' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Afghanistan' >Afganist\u00e1n<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Argelia<\/option><option value='American Samoa' >Samoa Americana<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguila<\/option><option value='Antarctica' >Ant\u00e1rtida<\/option><option value='Antigua and Barbuda' >Antigua y Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaiy\u00e1n<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrein<\/option><option value='Bangladesh' >Banglad\u00e9s<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Bielorrusia<\/option><option value='Belgium' >B\u00e9lgica<\/option><option value='Belize' >Belice<\/option><option value='Benin' >Ben\u00edn<\/option><option value='Bermuda' >Bermudas<\/option><option value='Bhutan' >But\u00e1n<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, San Eustaquio y Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia y Herzegovina<\/option><option value='Botswana' >Botsuana<\/option><option value='Bouvet Island' >Isla Bouvet<\/option><option value='Brazil' >Brasil<\/option><option value='British Indian Ocean Territory' >Territorio Brit\u00e1nico del Oc\u00e9ano \u00cdndico<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cambodia' >Camboya<\/option><option value='Cameroon' >Camer\u00fan<\/option><option value='Canada' >Canad\u00e1<\/option><option value='Cape Verde' >Cabo Verde<\/option><option value='Cayman Islands' >Islas Caim\u00e1n<\/option><option value='Central African Republic' >Rep\u00fablica Centroafricana<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Isla de Navidad<\/option><option value='Cocos Islands' >Islas Cocos<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoras<\/option><option value='Congo, Democratic Republic of the' >Rep\u00fablica Democr\u00e1tica del Congo<\/option><option value='Congo, Republic of the' >Rep\u00fablica del Congo<\/option><option value='Cook Islands' >Islas Cook<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croacia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Curazao<\/option><option value='Cyprus' >Chipre<\/option><option value='Czech Republic' >Rep\u00fablica Checa<\/option><option value='C\u00f4te d&#039;Ivoire' >Costa de Marfil<\/option><option value='Denmark' >Dinamarca<\/option><option value='Djibouti' >Yibuti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Rep\u00fablica Dominicana<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egipto<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Guinea Ecuatorial<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini (Swaziland)' >Esuatini (Suazilandia)<\/option><option value='Ethiopia' >Etiop\u00eda<\/option><option value='Falkland Islands' >Islas Malvinas<\/option><option value='Faroe Islands' >Islas Feroe<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finlandia<\/option><option value='France' >Francia<\/option><option value='French Guiana' >Guayana Francesa<\/option><option value='French Polynesia' >Polinesia Francesa<\/option><option value='French Southern Territories' >Territorios Australes Franceses<\/option><option value='Gabon' >Gab\u00f3n<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Alemania<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Grecia<\/option><option value='Greenland' >Groenlandia<\/option><option value='Grenada' >Granada<\/option><option value='Guadeloupe' >Guadalupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Hait\u00ed<\/option><option value='Heard and McDonald Islands' >Islas Heard y McDonald<\/option><option value='Holy See' >Santa Sede<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungr\u00eda<\/option><option value='Iceland' >Islandia<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Ir\u00e1n<\/option><option value='Iraq' >Irak<\/option><option value='Ireland' >Irlanda<\/option><option value='Isle of Man' >Isla de Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italia<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Jap\u00f3n<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordania<\/option><option value='Kazakhstan' >Kazajist\u00e1n<\/option><option value='Kenya' >Kenia<\/option><option value='Kiribati' >Kiribati<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kirguist\u00e1n<\/option><option value='Lao People&#039;s Democratic Republic' >Rep\u00fablica Democr\u00e1tica Popular Lao<\/option><option value='Latvia' >Letonia<\/option><option value='Lebanon' >L\u00edbano<\/option><option value='Lesotho' >Lesoto<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libia<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lituania<\/option><option value='Luxembourg' >Luxemburgo<\/option><option value='Macau' >Macao<\/option><option value='Macedonia' >Macedonia<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malaui<\/option><option value='Malaysia' >Malasia<\/option><option value='Maldives' >Maldivas<\/option><option value='Mali' >Mal\u00ed<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Islas Marshall<\/option><option value='Martinique' >Martinica<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauricio<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >M\u00e9xico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldavia<\/option><option value='Monaco' >M\u00f3naco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Marruecos<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Pa\u00edses Bajos<\/option><option value='New Caledonia' >Nueva Caledonia<\/option><option value='New Zealand' >Nueva Zelanda<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >N\u00edger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Isla Norfolk<\/option><option value='North Korea' >Corea del Norte<\/option><option value='Northern Mariana Islands' >Islas Marianas del Norte<\/option><option value='Norway' >Noruega<\/option><option value='Oman' >Om\u00e1n<\/option><option value='Pakistan' >Pakist\u00e1n<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestina, Estado de<\/option><option value='Panama' >Panam\u00e1<\/option><option value='Papua New Guinea' >Pap\u00faa Nueva Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Per\u00fa<\/option><option value='Philippines' >Filipinas<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Polonia<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Rumania<\/option><option value='Russia' >Rusia<\/option><option value='Rwanda' >Ruanda<\/option><option value='R\u00e9union' >Reuni\u00f3n<\/option><option value='Saint Barth\u00e9lemy' >San Bartolom\u00e9<\/option><option value='Saint Helena' >Santa Elena<\/option><option value='Saint Kitts and Nevis' >San Crist\u00f3bal y Nieves<\/option><option value='Saint Lucia' >Santa Luc\u00eda<\/option><option value='Saint Martin' >San Mart\u00edn<\/option><option value='Saint Pierre and Miquelon' >San Pedro y Miquel\u00f3n<\/option><option value='Saint Vincent and the Grenadines' >San Vicente y las Granadinas<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Santo Tom\u00e9 y Pr\u00edncipe<\/option><option value='Saudi Arabia' >Arabia Saudita<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leona<\/option><option value='Singapore' >Singapur<\/option><option value='Sint Maarten' >San Mart\u00edn<\/option><option value='Slovakia' >Eslovaquia<\/option><option value='Slovenia' >Eslovenia<\/option><option value='Solomon Islands' >Islas Salom\u00f3n<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >Sud\u00e1frica<\/option><option value='South Georgia' >Georgia del Sur<\/option><option value='South Korea' >Corea del Sur<\/option><option value='South Sudan' >Sud\u00e1n del Sur<\/option><option value='Spain' >Espa\u00f1a<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sud\u00e1n<\/option><option value='Suriname' >Surinam<\/option><option value='Svalbard and Jan Mayen Islands' >Islas Svalbard y Jan Mayen<\/option><option value='Sweden' >Suecia<\/option><option value='Switzerland' >Suiza<\/option><option value='Syria' >Siria<\/option><option value='Taiwan' >Taiw\u00e1n<\/option><option value='Tajikistan' >Tayikist\u00e1n<\/option><option value='Tanzania' >Tanzania<\/option><option value='Thailand' >Tailandia<\/option><option value='Timor-Leste' >Timor Oriental<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad y Tobago<\/option><option value='Tunisia' >T\u00fanez<\/option><option value='Turkey' >Turqu\u00eda<\/option><option value='Turkmenistan' >Turkmenist\u00e1n<\/option><option value='Turks and Caicos Islands' >Islas Turcas y Caicos<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='US Minor Outlying Islands' >Islas menores alejadas de los Estados Unidos<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ucrania<\/option><option value='United Arab Emirates' >Emiratos \u00c1rabes Unidos<\/option><option value='United Kingdom' >Reino Unido<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekist\u00e1n<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Vietnam' >Vietnam<\/option><option value='Virgin Islands, British' >Islas V\u00edrgenes Brit\u00e1nicas<\/option><option value='Virgin Islands, U.S.' >Islas V\u00edrgenes de los Estados Unidos.<\/option><option value='Wallis and Futuna' >Wallis y Futuna<\/option><option value='Western Sahara' >S\u00e1hara Occidental<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabue<\/option><option value='\u00c5land Islands' >Islas \u00c5land<\/option><\/select><\/div><\/div><div id=\"field_88_82\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_88_82'><span class='gform-field-label__text'>C\u00f3digo postal<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_82' id='input_88_82' type='text' value='' class='small'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_88_63\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox optional traditional field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfCu\u00e1l de las siguientes poblaciones te describe?<\/span><\/legend><div class='gfield_description' id='gfield_description_88_63'>Selecciona todas las opciones que apliquen.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_88_63'><div class='gchoice gchoice_88_63_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_63.1' type='checkbox'  value='Veteran or active-duty military'  id='choice_88_63_1'   aria-describedby=\"gfield_description_88_63\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_88_63_1' id='label_88_63_1' class='gform-field-label gform-field-label--type-inline'>Militar veterano(a) o en servicio activo<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_63_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_63.2' type='checkbox'  value='Caregiver of someone living with emotional or physical illness'  id='choice_88_63_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_63_2' id='label_88_63_2' class='gform-field-label gform-field-label--type-inline'>Cuidador(a) de una persona que padece una enfermedad emocional o f\u00edsica.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_63_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_63.3' type='checkbox'  value='LGBTQ+'  id='choice_88_63_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_63_3' id='label_88_63_3' class='gform-field-label gform-field-label--type-inline'>LGBTQ+<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_63_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_63.4' type='checkbox'  value='Student'  id='choice_88_63_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_63_4' id='label_88_63_4' class='gform-field-label gform-field-label--type-inline'>Estudiante<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_63_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_63.5' type='checkbox'  value='Trauma survivor'  id='choice_88_63_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_63_5' id='label_88_63_5' class='gform-field-label gform-field-label--type-inline'>Sobrevivente de un trauma<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_63_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_63.6' type='checkbox'  value='New or expecting parent'  id='choice_88_63_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_63_6' id='label_88_63_6' class='gform-field-label gform-field-label--type-inline'>Madre primeriza, padre primerizo, futura madre, o futuro padre<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_63_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_63.7' type='checkbox'  value='Healthcare worker'  id='choice_88_63_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_63_7' id='label_88_63_7' class='gform-field-label gform-field-label--type-inline'>Trabajador(a) de la salud<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_88_94\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full traditional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfCuidas a alguien con una enfermedad mental o f\u00edsica?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_88_94'>\n\t\t\t<div class='gchoice gchoice_88_94_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_94' type='radio' value='Mental health condition'  id='choice_88_94_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_94_0' id='label_88_94_0' class='gform-field-label gform-field-label--type-inline'>Condici\u00f3n de salud mental<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_94_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_94' type='radio' value='Physical health condition'  id='choice_88_94_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_94_1' id='label_88_94_1' class='gform-field-label gform-field-label--type-inline'>Condici\u00f3n f\u00edsica<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_94_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_94' type='radio' value='Both mental and physical health conditions'  id='choice_88_94_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_94_2' id='label_88_94_2' class='gform-field-label gform-field-label--type-inline'>Tanto las condiciones de salud mental como las f\u00edsicas.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_88_91\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_88_91'><span class='gform-field-label__text'>\u00bfCu\u00e1l de las siguientes opciones describe mejor tu orientaci\u00f3n sexual?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_91' id='input_88_91' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Lesbian or Gay' >Lesbiana o gay<\/option><option value='Bisexual' >Bisexual<\/option><option value='Queer' >Queer<\/option><option value='Pansexual' >Pansexual<\/option><option value='Asexual' >Asexual<\/option><option value='Straight' >Heterosexual<\/option><option value='Other...' >Otros...<\/option><\/select><\/div><\/div><div id=\"field_88_69\" class=\"gfield gfield--type-text gfield--input-type-text optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_88_69'><span class='gform-field-label__text'>\u00bfCu\u00e1l es tu orientaci\u00f3n sexual?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_69' id='input_88_69' type='text' value='' class='small'    placeholder='Ingresa la orientaci\u00f3n sexual...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_88_92\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfCu\u00e1l de las siguientes opciones describe tu experiencia con el trauma?<\/span><\/legend><div class='gfield_description' id='gfield_description_88_92'>Selecciona todas las opciones que apliquen.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_88_92'><div class='gchoice gchoice_88_92_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_92.1' type='checkbox'  value='Child abuse\/violence'  id='choice_88_92_1'   aria-describedby=\"gfield_description_88_92\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_88_92_1' id='label_88_92_1' class='gform-field-label gform-field-label--type-inline'>Maltrato infantil\/violencia<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_92_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_92.2' type='checkbox'  value='Intimate partner violence'  id='choice_88_92_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_92_2' id='label_88_92_2' class='gform-field-label gform-field-label--type-inline'>Violencia de pareja<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_92_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_92.3' type='checkbox'  value='Sexual assault\/violence'  id='choice_88_92_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_92_3' id='label_88_92_3' class='gform-field-label gform-field-label--type-inline'>Agresi\u00f3n\/violencia sexual<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_92_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_92.4' type='checkbox'  value='Serious illness\/injury\/assault'  id='choice_88_92_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_92_4' id='label_88_92_4' class='gform-field-label gform-field-label--type-inline'>Enfermedad\/lesi\u00f3n\/agresi\u00f3n grave<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_92_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_92.5' type='checkbox'  value='Family conflict (identity acceptance\/separation\/divorce)'  id='choice_88_92_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_92_5' id='label_88_92_5' class='gform-field-label gform-field-label--type-inline'>Conflicto familiar (aceptaci\u00f3n de la identidad\/separaci\u00f3n\/divorcio)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_92_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_92.6' type='checkbox'  value='Traumatic event (natural disaster, accident, witnessing violence, etc.)'  id='choice_88_92_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_92_6' id='label_88_92_6' class='gform-field-label gform-field-label--type-inline'>Evento traum\u00e1tico (desastre natural, accidente, presenciar violencia, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_92_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_92.7' type='checkbox'  value='Death of a loved one'  id='choice_88_92_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_92_7' id='label_88_92_7' class='gform-field-label gform-field-label--type-inline'>Muerte de un ser querido<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_92_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_92.8' type='checkbox'  value='Other and\/or tell us more about your trauma'  id='choice_88_92_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_92_8' id='label_88_92_8' class='gform-field-label gform-field-label--type-inline'>Otros y\/o cu\u00e9ntenos m\u00e1s sobre tu trauma.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_88_93\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_88_93'><span class='gform-field-label__text'>Cu\u00e9ntanos m\u00e1s sobre tu experiencia con el trauma:<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_93' id='input_88_93' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_88_70\" class=\"gfield gfield--type-html gfield--input-type-html section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>Acerca de tu salud mental<\/h2><\/div><fieldset id=\"field_88_72\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfAlguna vez has recibido tratamiento o apoyo por un problema de salud mental?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_88_72'>\n\t\t\t<div class='gchoice gchoice_88_72_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='Yes'  id='choice_88_72_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_72_0' id='label_88_72_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_72_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='No'  id='choice_88_72_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_72_1' id='label_88_72_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_88_73\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfEst\u00e1s recibiendo tratamiento o apoyo actualmente?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_88_73'>\n\t\t\t<div class='gchoice gchoice_88_73_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_73' type='radio' value='Yes'  id='choice_88_73_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_73_0' id='label_88_73_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_73_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_73' type='radio' value='No'  id='choice_88_73_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_73_1' id='label_88_73_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_88_142\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full optional traditional limit-3 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfQu\u00e9 te ha impedido buscar tratamiento en el pasado?<\/span><\/legend><div class='gfield_description' id='gfield_description_88_142'>Selecciona hasta 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_88_142'><div class='gchoice gchoice_88_142_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_142.1' type='checkbox'  value='I wanted to handle my mental health on my own'  id='choice_88_142_1'   aria-describedby=\"gfield_description_88_142\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_88_142_1' id='label_88_142_1' class='gform-field-label gform-field-label--type-inline'>Quer\u00eda manejar mi salud mental por mi cuenta.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_142_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_142.2' type='checkbox'  value='I didn\u2019t know how or where to start'  id='choice_88_142_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_142_2' id='label_88_142_2' class='gform-field-label gform-field-label--type-inline'>No sab\u00eda c\u00f3mo ni por d\u00f3nde empezar.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_142_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_142.3' type='checkbox'  value='I thought it would cost too much'  id='choice_88_142_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_142_3' id='label_88_142_3' class='gform-field-label gform-field-label--type-inline'>Pensaba que costar\u00eda demasiado.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_142_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_142.4' type='checkbox'  value='I didn\u2019t have time'  id='choice_88_142_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_142_4' id='label_88_142_4' class='gform-field-label gform-field-label--type-inline'>No ten\u00eda tiempo.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_142_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_142.5' type='checkbox'  value='I didn\u2019t think it would help me'  id='choice_88_142_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_142_5' id='label_88_142_5' class='gform-field-label gform-field-label--type-inline'>No cre\u00eda que me fuera a ayudar.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_142_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_142.6' type='checkbox'  value='I didn&#039;t feel ready to start treatment'  id='choice_88_142_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_142_6' id='label_88_142_6' class='gform-field-label gform-field-label--type-inline'>No me sent\u00eda preparado para comenzar el tratamiento.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_142_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_142.7' type='checkbox'  value='I was worried about what people would think or say if I got treatment'  id='choice_88_142_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_142_7' id='label_88_142_7' class='gform-field-label gform-field-label--type-inline'>Me preocupaba lo que la gente fuera a pensar o decir si me sometiera al tratamiento.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_142_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_142.8' type='checkbox'  value='I was afraid of being forced into a hospital or forced to take medication'  id='choice_88_142_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_142_8' id='label_88_142_8' class='gform-field-label gform-field-label--type-inline'>Ten\u00eda miedo de que me internaran en un hospital o me obligaran a tomar medicamentos.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_142_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_142.9' type='checkbox'  value='I tried, but couldn\u2019t find available treatment (no openings, wouldn\u2019t take insurance, etc.)'  id='choice_88_142_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_142_9' id='label_88_142_9' class='gform-field-label gform-field-label--type-inline'>Lo intent\u00e9, pero no pude encontrar un tratamiento disponible (no hab\u00eda plazas, no aceptaban el seguro, etc.).<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_142_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_142.11' type='checkbox'  value='My parent(s) or guardian wouldn&#039;t let me, or I didn&#039;t want to ask'  id='choice_88_142_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_142_11' id='label_88_142_11' class='gform-field-label gform-field-label--type-inline'>Mis pap\u00e1s o mi tutor no me dejaron, o no quer\u00eda pedir permiso.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_142_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_142.12' type='checkbox'  value='Other...'  id='choice_88_142_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_142_12' id='label_88_142_12' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_88_143\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_88_143'><span class='gform-field-label__text'>\u00bfQu\u00e9 otras cosas te han impedido buscar tratamiento en el pasado?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_143' id='input_88_143' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_88_74\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox optional traditional limit-3 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Piensa en tu prueba de salud mental. \u00bfCu\u00e1les son los principales factores que contribuyen a tus problemas de salud mental en este momento?<\/span><\/legend><div class='gfield_description' id='gfield_description_88_74'>Selecciona hasta 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_88_74'><div class='gchoice gchoice_88_74_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_74.1' type='checkbox'  value='Abuse or violence'  id='choice_88_74_1'   aria-describedby=\"gfield_description_88_74\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_88_74_1' id='label_88_74_1' class='gform-field-label gform-field-label--type-inline'>Abuso o violencia<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_74_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_74.2' type='checkbox'  value='Relationship problems (friends, family, or significant other)'  id='choice_88_74_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_74_2' id='label_88_74_2' class='gform-field-label gform-field-label--type-inline'>Problemas de relaci\u00f3n (amigos, familia o pareja)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_74_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_74.3' type='checkbox'  value='Body image'  id='choice_88_74_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_74_3' id='label_88_74_3' class='gform-field-label gform-field-label--type-inline'>Imagen corporal<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_74_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_74.4' type='checkbox'  value='Low self-esteem or self-image'  id='choice_88_74_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_74_4' id='label_88_74_4' class='gform-field-label gform-field-label--type-inline'>Baja autoestima o imagen de uno mismo<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_74_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_74.5' type='checkbox'  value='School or work problems'  id='choice_88_74_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_74_5' id='label_88_74_5' class='gform-field-label gform-field-label--type-inline'>Problemas en la escuela o en el trabajo<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_74_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_74.6' type='checkbox'  value='Financial problems'  id='choice_88_74_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_74_6' id='label_88_74_6' class='gform-field-label gform-field-label--type-inline'>Problemas financieros<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_74_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_74.7' type='checkbox'  value='Loneliness or isolation'  id='choice_88_74_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_74_7' id='label_88_74_7' class='gform-field-label gform-field-label--type-inline'>Soledad o aislamiento<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_74_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_74.8' type='checkbox'  value='Grief or loss of someone or something'  id='choice_88_74_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_74_8' id='label_88_74_8' class='gform-field-label gform-field-label--type-inline'>Dolor o p\u00e9rdida de alguien o algo.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_74_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_74.9' type='checkbox'  value='Experiencing hate\/bullying (including racism, homophobia, transphobia, or discrimination)'  id='choice_88_74_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_74_9' id='label_88_74_9' class='gform-field-label gform-field-label--type-inline'>Sufrir odio o acoso (incluido el racismo, la homofobia, la transfobia o la discriminaci\u00f3n)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_74_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_74.11' type='checkbox'  value='State of the world (war, climate, politics, immigration)'  id='choice_88_74_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_74_11' id='label_88_74_11' class='gform-field-label gform-field-label--type-inline'>Situaci\u00f3n mundial (guerra, clima, pol\u00edtica, inmigraci\u00f3n)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_74_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_74.12' type='checkbox'  value='I don\u2019t know (something just feels wrong)'  id='choice_88_74_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_74_12' id='label_88_74_12' class='gform-field-label gform-field-label--type-inline'>No lo s\u00e9 (s\u00f3lo que algo no va bien)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_74_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_74.13' type='checkbox'  value='Other...'  id='choice_88_74_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_74_13' id='label_88_74_13' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_88_75\" class=\"gfield gfield--type-text gfield--input-type-text optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_88_75'><span class='gform-field-label__text'>\u00bfQu\u00e9 m\u00e1s est\u00e1 contribuyendo a tus problemas de salud mental en este momento?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_75' id='input_88_75' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_88_95\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_88_95'><span class='gform-field-label__text'>\u00bfQu\u00e9 aspecto de la situaci\u00f3n mundial te afecta m\u00e1s?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_95' id='input_88_95' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_88_76\" class=\"gfield gfield--type-html gfield--input-type-html section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>Acerca de tu salud<\/h2><\/div><fieldset id=\"field_88_77\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTienes actualmente un seguro m\u00e9dico?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_88_77'>\n\t\t\t<div class='gchoice gchoice_88_77_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_77' type='radio' value='Yes'  id='choice_88_77_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_77_0' id='label_88_77_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_77_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_77' type='radio' value='No'  id='choice_88_77_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_77_1' id='label_88_77_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_77_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_77' type='radio' value='I don&#039;t know'  id='choice_88_77_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_77_2' id='label_88_77_2' class='gform-field-label gform-field-label--type-inline'>No lo s\u00e9<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_88_78\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox optional traditional field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfTienes alguna de las siguientes condiciones f\u00edsicas?<\/span><\/legend><div class='gfield_description' id='gfield_description_88_78'>Selecciona todas las opciones que apliquen.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_88_78'><div class='gchoice gchoice_88_78_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_78.1' type='checkbox'  value='Heart disease'  id='choice_88_78_1'   aria-describedby=\"gfield_description_88_78\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_88_78_1' id='label_88_78_1' class='gform-field-label gform-field-label--type-inline'>Enfermedad card\u00edaca<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_78_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_78.2' type='checkbox'  value='Reproductive health concerns (PCOS, endometriosis, infertility, etc.)'  id='choice_88_78_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_78_2' id='label_88_78_2' class='gform-field-label gform-field-label--type-inline'>Problemas de salud reproductiva (s\u00edndrome de ovario poliqu\u00edstico, endometriosis, infertilidad, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_78_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_78.3' type='checkbox'  value='Diabetes'  id='choice_88_78_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_78_3' id='label_88_78_3' class='gform-field-label gform-field-label--type-inline'>Diabetes<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_78_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_78.4' type='checkbox'  value='Cancer'  id='choice_88_78_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_78_4' id='label_88_78_4' class='gform-field-label gform-field-label--type-inline'>C\u00e1ncer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_78_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_78.5' type='checkbox'  value='Arthritis or other chronic pain'  id='choice_88_78_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_78_5' id='label_88_78_5' class='gform-field-label gform-field-label--type-inline'>Artritis u otros dolores cr\u00f3nicos<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_78_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_78.6' type='checkbox'  value='Asthma, COPD or other lung conditions'  id='choice_88_78_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_78_6' id='label_88_78_6' class='gform-field-label gform-field-label--type-inline'>Asma, EPOC u otras afecciones pulmonares<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_78_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_78.7' type='checkbox'  value='Movement Disorders (involuntary tics, tardive dyskinesia, etc.)'  id='choice_88_78_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_78_7' id='label_88_78_7' class='gform-field-label gform-field-label--type-inline'>Trastornos del movimiento (tics involuntarios, discinesia tard\u00eda, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_78_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_78.8' type='checkbox'  value='Digestive problems (Crohn\u2019s, colitis, IBS, etc.)'  id='choice_88_78_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_78_8' id='label_88_78_8' class='gform-field-label gform-field-label--type-inline'>Problemas digestivos (enfermedad de Crohn, colitis, s\u00edndrome del intestino irritable, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_78_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_78.9' type='checkbox'  value='Neurological conditions (epilepsy, etc.) or traumatic brain injury (TBI)'  id='choice_88_78_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_78_9' id='label_88_78_9' class='gform-field-label gform-field-label--type-inline'>Afecciones neurol\u00f3gicas (epilepsia, etc.) o traumatismo craneoencef\u00e1lico (TCE)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_88_78_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_78.11' type='checkbox'  value='Other...'  id='choice_88_78_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_88_78_11' id='label_88_78_11' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_88_79\" class=\"gfield gfield--type-text gfield--input-type-text optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_88_79'><span class='gform-field-label__text'>\u00bfQu\u00e9 otras condiciones f\u00edsicas tienes?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_79' id='input_88_79' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_88_106\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTienes una mascota que te ayuda a cuidar tu salud mental?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_88_106'>\n\t\t\t<div class='gchoice gchoice_88_106_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_106' type='radio' value='Yes'  id='choice_88_106_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_106_0' id='label_88_106_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_106_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_106' type='radio' value='No'  id='choice_88_106_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_106_1' id='label_88_106_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_88_107\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTe interesa tener una mascota que te ayude a cuidar tu salud mental?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_88_107'>\n\t\t\t<div class='gchoice gchoice_88_107_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_107' type='radio' value='Yes'  id='choice_88_107_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_107_0' id='label_88_107_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_88_107_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_107' type='radio' value='No'  id='choice_88_107_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_88_107_1' id='label_88_107_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><button type='submit' id='gform_previous_button_88' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Anterior<\/button> <button type='submit' id='gform_submit_button_88' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Ver resultados<\/button> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_88' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_88' id='gform_theme_88' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_88' id='gform_style_settings_88' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_88' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='88' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='myqD6aRtIO3+JpRcFQHImlemGllM3mSSXcmOOTKZx\/08UGXmnL4ol3jaTF+qbTdBGfgIaKaesF+74HbBJQqRN7GgGC7qq36b9dMc+O47JjFIMaw=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_88' 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\/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_88' id='gform_target_page_number_88' value='2' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_88' id='gform_source_page_number_88' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n             <\/div><\/div>\n                        <input type=\"hidden\" name=\"trp-form-language\" value=\"es\"\/><\/form>\n                        <\/div>\n<p>&nbsp;<\/p>\n<hr \/>\n<h2 class=\"smaller\">Fuente:<\/h2>\n<div class=\"references\">\n<p>Social Anxiety Disorder Dimensional Scale &#8211; SAD-D<\/p>\n<p>Lebeau, R. T., et al. (2012). Un enfoque dimensional para medir la ansiedad para el DSM-5. <i>Revista internacional de m\u00e9todos en investigaci\u00f3n psiqui\u00e1trica<\/i>\u00a0<i>21<\/i>(4), 258-272. Obtenido de <a href=\"https:\/\/doi.org\/10.1002\/mpr.1369\">https:\/\/doi.org\/10.1002\/mpr.1369<\/a><\/p>\n<p><a href=\"https:\/\/screening.mhanational.org\/es\/about-our-mental-health-tests\/\" target=\"_blank\" rel=\"noopener\">Para aprender m\u00e1s sobre nuestras herramientas de detecci\u00f3n, haz clic aqu\u00ed.<\/a><\/p>\n<p><em><strong>Ten en cuenta:<\/strong> Las herramientas de evaluaci\u00f3n en l\u00ednea no son instrumentos de diagn\u00f3stico. Te recomendamos que compartas tus resultados con un m\u00e9dico o profesional de la salud. Mental Health America Inc., sus patrocinadores, socios y anunciantes no se hacen responsables de ninguna responsabilidad, p\u00e9rdida o riesgo que se derive, directa o indirectamente, del uso y la aplicaci\u00f3n de estas evaluaciones.<\/em><\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Para personas que experimentan una preocupaci\u00f3n o un miedo extremos en situaciones sociales.<\/p>","protected":false},"template":"","tags":[],"age_group":[],"condition":[83,35],"class_list":["post-251896","screen","type-screen","status-publish","hentry","condition-anxiety","condition-loneliness"],"acf":[],"yoast_head":"<title>Social Anxiety Test &#8211; Free mental health tests from Mental Health America<\/title>\n<meta name=\"description\" content=\"Do social situations overwhelm you with worry and fear? 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&#038; Mental Health Survey 4.0 (testing)"},"content":{"rendered":"<div class='gf_browser_chrome gform_wrapper gravity-theme gform-theme--no-framework full-pager_wrapper' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_97' style='display:none'>\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>\"<span class=\"gfield_required gfield_required_asterisk\">*<\/span>\"indica campos obligatorios<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_97' class='full-pager' action='\/es\/wp-json\/wp\/v2\/screen' data-formid='97' novalidate data-trp-original-action=\"\/es\/wp-json\/wp\/v2\/screen\"><ol class=\"full-progress-bar clearfix step-1-of-3\"><li class=\"step-1 active\"><span>Preguntas de la encuesta<\/span><\/li><li class=\"step-2 empty\"><span>Preguntas opcionales<\/span><\/li><\/ol>\n                        <div class='gform-body gform_body'><div id='gform_page_97_1' class='gform_page' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_97' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_97_167\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_167'><span class='gform-field-label__text'>URL<\/span><\/label><div class='gfield_description' id='gfield_description_97_167'>Este campo es para fines de validaci\u00f3n y no debe modificarse.<\/div><div class='ginput_container'><input name='input_167' id='input_97_167' type='text' value='' autocomplete='new-password'\/><\/div><\/div><div id=\"field_97_4\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p>Esta encuesta se ha elaborado con el fin de conocer su opini\u00f3n sobre la inteligencia artificial (IA) y la salud mental.<\/p><p>Compartir estas ideas nos ayudar\u00e1 a comprender qu\u00e9 recursos y pol\u00edticas debemos tener en cuenta al pensar en el futuro de la IA en el \u00e1mbito de la salud mental. \u00a1Gracias por participar!<\/p><\/div><div id=\"field_97_38\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_38' id='input_97_38' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_97_39\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above 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gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_51' id='input_97_51' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='http:\/\/screening.mhanational.org' \/><\/div><\/div><div id=\"field_97_81\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_81' id='input_97_81' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_97_82\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_82' id='input_97_82' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_97_83\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_83' id='input_97_83' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_97_93\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_93' id='input_97_93' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_97_157\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_157' id='input_97_157' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='lang--es' \/><\/div><\/div><fieldset id=\"field_97_103\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio traditional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfCu\u00e1l de las siguientes opciones? <strong>mejor<\/strong> \u00bfC\u00f3mo describir\u00edas tu uso de la IA?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_103'>\n\t\t\t<div class='gchoice gchoice_97_103_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_103' type='radio' value='I have never used AI, but I would like to'  id='choice_97_103_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_103_0' id='label_97_103_0' class='gform-field-label gform-field-label--type-inline'>Nunca he usado la IA, pero me gustar\u00eda hacerlo.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_103_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_103' type='radio' value='I will never use AI if I can avoid it'  id='choice_97_103_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_103_1' id='label_97_103_1' class='gform-field-label gform-field-label--type-inline'>Nunca utilizar\u00e9 la IA si puedo evitarlo.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_103_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_103' type='radio' value='I have only used AI when forced to'  id='choice_97_103_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_103_2' id='label_97_103_2' class='gform-field-label gform-field-label--type-inline'>Solo he usado la IA cuando me he visto obligado a hacerlo.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_103_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_103' type='radio' value='I only use AI when it\u2019s included in another product (ex: Zoom, Office, Google)'  id='choice_97_103_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_103_3' id='label_97_103_3' class='gform-field-label gform-field-label--type-inline'>Solo utilizo la IA cuando est\u00e1 incluida en otro producto (por ejemplo: Zoom, Office, Google).<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_103_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_103' type='radio' value='I use AI less than once a month'  id='choice_97_103_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_103_4' id='label_97_103_4' class='gform-field-label gform-field-label--type-inline'>Uso la IA menos de una vez al mes.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_103_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_103' type='radio' value='I use AI once a month'  id='choice_97_103_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_103_5' id='label_97_103_5' class='gform-field-label gform-field-label--type-inline'>Uso la IA una vez al mes.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_103_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_103' type='radio' value='I use AI once or twice a week'  id='choice_97_103_6' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_103_6' id='label_97_103_6' class='gform-field-label gform-field-label--type-inline'>Uso la IA una o dos veces por semana.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_103_7'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_103' type='radio' value='I use AI every day'  id='choice_97_103_7' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_103_7' id='label_97_103_7' class='gform-field-label gform-field-label--type-inline'>Uso la IA todos los d\u00edas.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_97_110\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-3 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfQu\u00e9 te impide utilizar la IA?<\/span><\/legend><div class='gfield_description' id='gfield_description_97_110'>Seleccione sus tres favoritos.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_97_110'><div class='gchoice gchoice_97_110_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_110.1' type='checkbox'  value='AI doesn\u2019t seem interesting or useful to me'  id='choice_97_110_1'   aria-describedby=\"gfield_description_97_110\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_97_110_1' id='label_97_110_1' class='gform-field-label gform-field-label--type-inline'>La IA no me parece interesante ni \u00fatil.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_110_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_110.2' type='checkbox'  value='I don\u2019t know how to use AI'  id='choice_97_110_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_110_2' id='label_97_110_2' class='gform-field-label gform-field-label--type-inline'>No s\u00e9 c\u00f3mo usar la IA.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_110_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_110.3' type='checkbox'  value='I don\u2019t have access to AI'  id='choice_97_110_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_110_3' id='label_97_110_3' class='gform-field-label gform-field-label--type-inline'>No tengo acceso a la IA.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_110_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_110.4' type='checkbox'  value='AI can\u2019t do anything for me that I can\u2019t do for myself'  id='choice_97_110_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_110_4' id='label_97_110_4' class='gform-field-label gform-field-label--type-inline'>La IA no puede hacer nada por m\u00ed que yo no pueda hacer por m\u00ed mismo.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_110_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_110.5' type='checkbox'  value='I don\u2019t trust AI to give me good advice or accurate information'  id='choice_97_110_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_110_5' id='label_97_110_5' class='gform-field-label gform-field-label--type-inline'>No conf\u00edo en que la IA me d\u00e9 buenos consejos o informaci\u00f3n precisa.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_110_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_110.6' type='checkbox'  value='I don\u2019t want my personal information to be tracked'  id='choice_97_110_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_110_6' id='label_97_110_6' class='gform-field-label gform-field-label--type-inline'>No deseo que se rastree mi informaci\u00f3n personal.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_110_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_110.7' type='checkbox'  value='I don\u2019t trust the companies behind AI'  id='choice_97_110_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_110_7' id='label_97_110_7' class='gform-field-label gform-field-label--type-inline'>No conf\u00edo en las empresas que est\u00e1n detr\u00e1s de la IA.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_110_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_110.8' type='checkbox'  value='I am opposed to using AI because of its negative impact on society'  id='choice_97_110_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_110_8' id='label_97_110_8' class='gform-field-label gform-field-label--type-inline'>Me opongo al uso de la IA debido a su impacto negativo en la sociedad.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_110_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_110.9' type='checkbox'  value='The technology isn\u2019t good enough yet'  id='choice_97_110_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_110_9' id='label_97_110_9' class='gform-field-label gform-field-label--type-inline'>La tecnolog\u00eda a\u00fan no es lo suficientemente buena.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_97_140\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full traditional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfQu\u00e9 sistema de IA utiliza? <strong>lo m\u00e1s<\/strong>?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_140'>\n\t\t\t<div class='gchoice gchoice_97_140_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_140' type='radio' value='ChatGPT'  id='choice_97_140_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_140_0' id='label_97_140_0' class='gform-field-label gform-field-label--type-inline'>ChatGPT<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_140_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_140' type='radio' value='Claude (Anthropic)'  id='choice_97_140_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_140_1' id='label_97_140_1' class='gform-field-label gform-field-label--type-inline'>Claude (Antr\u00f3pico)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_140_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_140' type='radio' value='Gemini (Google)'  id='choice_97_140_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_140_2' id='label_97_140_2' class='gform-field-label gform-field-label--type-inline'>G\u00e9minis (Google)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_140_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_140' type='radio' value='Character AI'  id='choice_97_140_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_140_3' id='label_97_140_3' class='gform-field-label gform-field-label--type-inline'>Character AI<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_140_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_140' type='radio' value='Grok'  id='choice_97_140_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_140_4' id='label_97_140_4' class='gform-field-label gform-field-label--type-inline'>Grok<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_140_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_140' type='radio' value='Microsoft Copilot'  id='choice_97_140_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_140_5' id='label_97_140_5' class='gform-field-label gform-field-label--type-inline'>Microsoft Copilot<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_140_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_140' type='radio' value='Meta AI'  id='choice_97_140_6' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_140_6' id='label_97_140_6' class='gform-field-label gform-field-label--type-inline'>Meta IA<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_140_7'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_140' type='radio' value='Other (examples: Perplexity, Snapchat AI)'  id='choice_97_140_7' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_140_7' id='label_97_140_7' class='gform-field-label gform-field-label--type-inline'>Other (examples: Perplexity, Snapchat AI)<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_97_141\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_141'><span class='gform-field-label__text'>\u00bfQu\u00e9 otro sistema de IA usas m\u00e1s?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_141' id='input_97_141' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_97_132\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_97_105\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio traditional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHas utilizado la IA para obtener apoyo emocional?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_105'>\n\t\t\t<div class='gchoice gchoice_97_105_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_105' type='radio' value='No, never'  id='choice_97_105_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_105_0' id='label_97_105_0' class='gform-field-label gform-field-label--type-inline'>No, nunca<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_105_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_105' type='radio' value='Yes, a few times'  id='choice_97_105_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_105_1' id='label_97_105_1' class='gform-field-label gform-field-label--type-inline'>S\u00ed, unas cuantas veces.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_105_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_105' type='radio' value='Yes, regularly \/ often'  id='choice_97_105_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_105_2' id='label_97_105_2' class='gform-field-label gform-field-label--type-inline'>S\u00ed, con regularidad \/ a menudo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_97_120\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-3 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfQu\u00e9 te impide utilizar la IA para obtener apoyo emocional con m\u00e1s frecuencia?<\/span><\/legend><div class='gfield_description' id='gfield_description_97_120'>Seleccione sus tres favoritos.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_97_120'><div class='gchoice gchoice_97_120_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.1' type='checkbox'  value='I don\u2019t trust AI to give me good advice or accurate information'  id='choice_97_120_1'   aria-describedby=\"gfield_description_97_120\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_97_120_1' id='label_97_120_1' class='gform-field-label gform-field-label--type-inline'>No conf\u00edo en que la IA me d\u00e9 buenos consejos o informaci\u00f3n precisa.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_120_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.2' type='checkbox'  value='I\u2019m worried that my personal information could be tracked'  id='choice_97_120_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_120_2' id='label_97_120_2' class='gform-field-label gform-field-label--type-inline'>Me preocupa que mi informaci\u00f3n personal pueda ser rastreada.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_120_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.3' type='checkbox'  value='I don\u2019t trust the companies behind AI'  id='choice_97_120_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_120_3' id='label_97_120_3' class='gform-field-label gform-field-label--type-inline'>No conf\u00edo en las empresas que est\u00e1n detr\u00e1s de la IA.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_120_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.4' type='checkbox'  value='I don\u2019t know how to use it for this purpose'  id='choice_97_120_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_120_4' id='label_97_120_4' class='gform-field-label gform-field-label--type-inline'>No s\u00e9 c\u00f3mo utilizarlo para este fin.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_120_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.5' type='checkbox'  value='I prefer to talk to a human'  id='choice_97_120_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_120_5' id='label_97_120_5' class='gform-field-label gform-field-label--type-inline'>Prefiero hablar con una persona.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_120_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.6' type='checkbox'  value='The technology isn\u2019t good enough yet'  id='choice_97_120_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_120_6' id='label_97_120_6' class='gform-field-label gform-field-label--type-inline'>La tecnolog\u00eda a\u00fan no es lo suficientemente buena.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_120_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.7' type='checkbox'  value='I am opposed to using AI because of its negative impact on society'  id='choice_97_120_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_120_7' id='label_97_120_7' class='gform-field-label gform-field-label--type-inline'>Me opongo al uso de la IA debido a su impacto negativo en la sociedad.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_120_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.8' type='checkbox'  value='I don\u2019t need it because I am already receiving treatment or support another way'  id='choice_97_120_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_120_8' id='label_97_120_8' class='gform-field-label gform-field-label--type-inline'>No lo necesito porque ya estoy recibiendo tratamiento o apoyo de otra manera.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_120_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_120.9' type='checkbox'  value='I already got what I needed from it'  id='choice_97_120_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_120_9' id='label_97_120_9' class='gform-field-label gform-field-label--type-inline'>Ya obtuve lo que necesitaba de \u00e9l.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_97_125\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfConsiderar\u00edas alguna vez utilizar la IA para obtener apoyo emocional?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_125'>\n\t\t\t<div class='gchoice gchoice_97_125_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_125' type='radio' value='Yes'  id='choice_97_125_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_125_0' id='label_97_125_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_125_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_125' type='radio' value='No'  id='choice_97_125_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_125_1' id='label_97_125_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_97_127\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-3 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfQu\u00e9 te impedir\u00eda utilizar la IA para obtener apoyo emocional?<\/span><\/legend><div class='gfield_description' id='gfield_description_97_127'>Seleccione sus tres favoritos.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_97_127'><div class='gchoice gchoice_97_127_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.1' type='checkbox'  value='I don\u2019t trust AI to give me good advice or accurate information'  id='choice_97_127_1'   aria-describedby=\"gfield_description_97_127\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_97_127_1' id='label_97_127_1' class='gform-field-label gform-field-label--type-inline'>No conf\u00edo en que la IA me d\u00e9 buenos consejos o informaci\u00f3n precisa.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_127_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.2' type='checkbox'  value='I\u2019m worried that my personal information could be tracked'  id='choice_97_127_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_127_2' id='label_97_127_2' class='gform-field-label gform-field-label--type-inline'>Me preocupa que mi informaci\u00f3n personal pueda ser rastreada.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_127_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.3' type='checkbox'  value='I don\u2019t trust the companies behind AI'  id='choice_97_127_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_127_3' id='label_97_127_3' class='gform-field-label gform-field-label--type-inline'>No conf\u00edo en las empresas que est\u00e1n detr\u00e1s de la IA.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_127_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.4' type='checkbox'  value='I don\u2019t know how to use it for this purpose'  id='choice_97_127_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_127_4' id='label_97_127_4' class='gform-field-label gform-field-label--type-inline'>No s\u00e9 c\u00f3mo utilizarlo para este fin.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_127_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.5' type='checkbox'  value='I prefer to talk to a human'  id='choice_97_127_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_127_5' id='label_97_127_5' class='gform-field-label gform-field-label--type-inline'>Prefiero hablar con una persona.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_127_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.6' type='checkbox'  value='The technology isn\u2019t good enough yet'  id='choice_97_127_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_127_6' id='label_97_127_6' class='gform-field-label gform-field-label--type-inline'>La tecnolog\u00eda a\u00fan no es lo suficientemente buena.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_127_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.7' type='checkbox'  value='I am opposed to using AI because of its negative impact on society'  id='choice_97_127_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_127_7' id='label_97_127_7' class='gform-field-label gform-field-label--type-inline'>Me opongo al uso de la IA debido a su impacto negativo en la sociedad.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_127_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.8' type='checkbox'  value='I don\u2019t need it because I am already receiving treatment or support another way'  id='choice_97_127_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_127_8' id='label_97_127_8' class='gform-field-label gform-field-label--type-inline'>No lo necesito porque ya estoy recibiendo tratamiento o apoyo de otra manera.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_127_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.9' type='checkbox'  value='I already got what I needed from it'  id='choice_97_127_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_127_9' id='label_97_127_9' class='gform-field-label gform-field-label--type-inline'>Ya obtuve lo que necesitaba de \u00e9l.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_97_139\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-3 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfPor qu\u00e9 considerar\u00edas utilizar la IA para obtener apoyo mental o emocional?<\/span><\/legend><div class='gfield_description' id='gfield_description_97_139'>Seleccione sus tres favoritos.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_97_139'><div class='gchoice gchoice_97_139_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_139.1' type='checkbox'  value='I feel more comfortable talking to a bot than to a human'  id='choice_97_139_1'   aria-describedby=\"gfield_description_97_139\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_97_139_1' id='label_97_139_1' class='gform-field-label gform-field-label--type-inline'>Me siento m\u00e1s c\u00f3modo hablando con un bot que con un humano.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_139_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_139.2' type='checkbox'  value='It\u2019s convenient\/available 24\/7'  id='choice_97_139_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_139_2' id='label_97_139_2' class='gform-field-label gform-field-label--type-inline'>Es conveniente\/est\u00e1 disponible las 24 horas del d\u00eda, los 7 d\u00edas de la semana.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_139_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_139.3' type='checkbox'  value='It\u2019s free'  id='choice_97_139_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_139_3' id='label_97_139_3' class='gform-field-label gform-field-label--type-inline'>Es gratis.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_139_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_139.4' type='checkbox'  value='Traditional therapy isn\u2019t available to me'  id='choice_97_139_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_139_4' id='label_97_139_4' class='gform-field-label gform-field-label--type-inline'>No tengo acceso a la terapia tradicional.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_139_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_139.5' type='checkbox'  value='It\u2019s safer. It lets me stay anonymous'  id='choice_97_139_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_139_5' id='label_97_139_5' class='gform-field-label gform-field-label--type-inline'>Es m\u00e1s seguro. Me permite mantener el anonimato.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_139_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_139.6' type='checkbox'  value='It lets me get help without telling my family'  id='choice_97_139_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_139_6' id='label_97_139_6' class='gform-field-label gform-field-label--type-inline'>Me permite obtener ayuda sin dec\u00edrselo a mi familia.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_139_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_139.7' type='checkbox'  value='Therapy or help I\u2019ve received from people has not helped'  id='choice_97_139_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_139_7' id='label_97_139_7' class='gform-field-label gform-field-label--type-inline'>La terapia o la ayuda que he recibido de otras personas no me ha servido de nada.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_139_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_139.8' type='checkbox'  value='It\u2019s entertaining\/engaging'  id='choice_97_139_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_139_8' id='label_97_139_8' class='gform-field-label gform-field-label--type-inline'>Es entretenido\/atractivo.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_97_138\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_138'><span class='gform-field-label__text'><strong>Opcional:<\/strong> Piensa en alguna ocasi\u00f3n en la que hayas utilizado la IA para obtener apoyo emocional. \u00bfPuedes compartir algo sobre c\u00f3mo fue esa conversaci\u00f3n? \u00bfDe qu\u00e9 hablaron? \u00bfC\u00f3mo te sentiste?<\/span><\/label><div class='gfield_description' id='gfield_description_97_138'><em><strong>Comparte tanto o tan poco como quieras.<\/strong> Por ejemplo, puedes describir tu experiencia en una sola frase, compartir las indicaciones que has utilizado y que te han resultado especialmente eficaces, o cualquier otra cosa.<\/em><\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_138' id='input_97_138' class='textarea medium'  aria-describedby=\"gfield_description_97_138\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_97_142\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full limit-3 traditional question field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfQui\u00e9nes crees que son los tres principales grupos que deber\u00edan ser los m\u00e1s responsables de implementar medidas de protecci\u00f3n de la salud mental para las personas que utilizan la IA?<\/span><\/legend><div class='gfield_description' id='gfield_description_97_142'>Seleccione hasta 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_97_142'><div class='gchoice gchoice_97_142_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_142.1' type='checkbox'  value='Myself \/ individual users'  id='choice_97_142_1'   aria-describedby=\"gfield_description_97_142\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_97_142_1' id='label_97_142_1' class='gform-field-label gform-field-label--type-inline'>Yo mismo \/ usuarios individuales<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_142_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_142.2' type='checkbox'  value='Parents \/ guardians'  id='choice_97_142_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_142_2' id='label_97_142_2' class='gform-field-label gform-field-label--type-inline'>Padres\/tutores<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_142_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_142.3' type='checkbox'  value='Technology companies'  id='choice_97_142_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_142_3' id='label_97_142_3' class='gform-field-label gform-field-label--type-inline'>Empresas tecnol\u00f3gicas<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_142_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_142.4' type='checkbox'  value='Companies using AI software (employers, healthcare, schools)'  id='choice_97_142_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_142_4' id='label_97_142_4' class='gform-field-label gform-field-label--type-inline'>Companies using AI software (employers, healthcare, schools)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_142_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_142.5' type='checkbox'  value='Government'  id='choice_97_142_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_142_5' id='label_97_142_5' class='gform-field-label gform-field-label--type-inline'>Gobierno<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_142_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_142.6' type='checkbox'  value='Other...'  id='choice_97_142_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_142_6' id='label_97_142_6' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_97_143\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_143'><span class='gform-field-label__text'>\u00bfQui\u00e9n m\u00e1s crees que es el principal responsable de implementar medidas de protecci\u00f3n de la salud mental?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_143' id='input_97_143' type='text' value='' class='large'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_97_144\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full limit-3 traditional question field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfCu\u00e1les son las tres cosas m\u00e1s importantes que pueden hacer las empresas tecnol\u00f3gicas para proteger a las personas de posibles da\u00f1os cuando reciben apoyo en materia de salud mental mediante IA?<\/span><\/legend><div class='gfield_description' id='gfield_description_97_144'>Seleccione hasta 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_97_144'><div class='gchoice gchoice_97_144_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_144.1' type='checkbox'  value='Refer me to a mental health professional instead of providing direct advice'  id='choice_97_144_1'   aria-describedby=\"gfield_description_97_144\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_97_144_1' id='label_97_144_1' class='gform-field-label gform-field-label--type-inline'>Rem\u00edtame a un profesional de la salud mental en lugar de darme consejos directos.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_144_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_144.2' type='checkbox'  value='Remind me that I\u2019m talking to a machine and not a human'  id='choice_97_144_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_144_2' id='label_97_144_2' class='gform-field-label gform-field-label--type-inline'>Recu\u00e9rdame que estoy hablando con una m\u00e1quina y no con un humano.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_144_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_144.3' type='checkbox'  value='Make the AI less like a human'  id='choice_97_144_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_144_3' id='label_97_144_3' class='gform-field-label gform-field-label--type-inline'>Haz que la IA se parezca menos a un humano.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_144_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_144.4' type='checkbox'  value='Make the AI more like a human'  id='choice_97_144_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_144_4' id='label_97_144_4' class='gform-field-label gform-field-label--type-inline'>Haz que la IA se parezca m\u00e1s a un humano.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_144_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_144.5' type='checkbox'  value='Tell me about my emotional risks when I\u2019m using AI'  id='choice_97_144_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_144_5' id='label_97_144_5' class='gform-field-label gform-field-label--type-inline'>Cu\u00e9ntame cu\u00e1les son los riesgos emocionales que corro cuando utilizo la IA.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_144_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_144.6' type='checkbox'  value='Guarantee that my conversations won\u2019t be used to train the AI'  id='choice_97_144_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_144_6' id='label_97_144_6' class='gform-field-label gform-field-label--type-inline'>Garantizar que mis conversaciones no se utilizar\u00e1n para entrenar a la IA.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_144_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_144.7' type='checkbox'  value='Make sure no one else can ever see the conversations I have with AI'  id='choice_97_144_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_144_7' id='label_97_144_7' class='gform-field-label gform-field-label--type-inline'>Aseg\u00farate de que nadie m\u00e1s pueda ver las conversaciones que mantengo con la IA.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_144_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_144.8' type='checkbox'  value='Develop industry standards for measuring impact on communities of users'  id='choice_97_144_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_144_8' id='label_97_144_8' class='gform-field-label gform-field-label--type-inline'>Desarrollar est\u00e1ndares de la industria para medir el impacto en las comunidades de usuarios.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_144_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_144.9' type='checkbox'  value='Other...'  id='choice_97_144_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_144_9' id='label_97_144_9' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_97_145\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_145'><span class='gform-field-label__text'>\u00bfQu\u00e9 m\u00e1s pueden hacer las empresas tecnol\u00f3gicas para proteger la salud mental de las personas que utilizan su IA?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_145' id='input_97_145' type='text' value='' class='large'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_97_146\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full limit-3 traditional question field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfCu\u00e1les son las tres medidas principales que puede tomar el gobierno para proteger la salud mental de las personas que utilizan la IA?<\/span><\/legend><div class='gfield_description' id='gfield_description_97_146'>Seleccione hasta 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_97_146'><div class='gchoice gchoice_97_146_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_146.1' type='checkbox'  value='Set policies\/laws that tech companies have to follow'  id='choice_97_146_1'   aria-describedby=\"gfield_description_97_146\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_97_146_1' id='label_97_146_1' class='gform-field-label gform-field-label--type-inline'>Establecer pol\u00edticas\/leyes que las empresas tecnol\u00f3gicas deben cumplir.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_146_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_146.2' type='checkbox'  value='Create a group of people responsible for reviewing and giving limitations on safety'  id='choice_97_146_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_146_2' id='label_97_146_2' class='gform-field-label gform-field-label--type-inline'>Crear un grupo de personas responsables de revisar y establecer limitaciones en materia de seguridad.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_146_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_146.3' type='checkbox'  value='Create guidelines and incentives for safety'  id='choice_97_146_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_146_3' id='label_97_146_3' class='gform-field-label gform-field-label--type-inline'>Crear directrices e incentivos para la seguridad.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_146_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_146.4' type='checkbox'  value='Incentivize research on potential harms or positive impacts of AI'  id='choice_97_146_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_146_4' id='label_97_146_4' class='gform-field-label gform-field-label--type-inline'>Incentivar la investigaci\u00f3n sobre los posibles da\u00f1os o impactos positivos de la IA.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_146_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_146.5' type='checkbox'  value='Fine technology companies for harm towards people'  id='choice_97_146_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_146_5' id='label_97_146_5' class='gform-field-label gform-field-label--type-inline'>Multas a empresas tecnol\u00f3gicas por da\u00f1os a las personas<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_146_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_146.6' type='checkbox'  value='Invest in public education on using AIsafely'  id='choice_97_146_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_146_6' id='label_97_146_6' class='gform-field-label gform-field-label--type-inline'>Invertir en educaci\u00f3n p\u00fablica sobre el uso seguro de la IA.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_146_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_146.7' type='checkbox'  value='Other...'  id='choice_97_146_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_146_7' id='label_97_146_7' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_97_147\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_147'><span class='gform-field-label__text'>\u00bfQu\u00e9 m\u00e1s puede hacer el gobierno para proteger la salud mental de las personas que utilizan la IA?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_147' id='input_97_147' type='text' value='' class='large'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_97_152\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full traditional field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Cuando usas herramientas de IA, \u00bfqu\u00e9 modo utilizas con m\u00e1s frecuencia?<\/span><\/legend><div class='gfield_description' id='gfield_description_97_152'>Seleccionar 1.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_152'>\n\t\t\t<div class='gchoice gchoice_97_152_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_152' type='radio' value='Text-based chat (typing)'  id='choice_97_152_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_97_152\"   \/>\n\t\t\t\t\t<label for='choice_97_152_0' id='label_97_152_0' class='gform-field-label gform-field-label--type-inline'>Chat basado en texto (escribiendo)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_152_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_152' type='radio' value='Voice-based conversation (speaking\/listening)'  id='choice_97_152_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_152_1' id='label_97_152_1' class='gform-field-label gform-field-label--type-inline'>Conversaci\u00f3n basada en la voz (hablar\/escuchar)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_152_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_152' type='radio' value='Both equally'  id='choice_97_152_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_152_2' id='label_97_152_2' class='gform-field-label gform-field-label--type-inline'>Ambos por igual<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_152_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_152' type='radio' value='Other...'  id='choice_97_152_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_152_3' id='label_97_152_3' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_152_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_152' type='radio' value='I don&#039;t know \/ not sure'  id='choice_97_152_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_152_4' id='label_97_152_4' class='gform-field-label gform-field-label--type-inline'>No s\u00e9 \/ No estoy seguro<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_97_153\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_153'><span class='gform-field-label__text'>\u00bfDe qu\u00e9 otra manera interact\u00faa con las herramientas de IA con mayor frecuencia?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_153' id='input_97_153' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_97_154\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Cuando interact\u00faas con herramientas de IA mediante chat de texto, \u00bfqu\u00e9 tan natural o humana te parece la interacci\u00f3n?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_154'>\n\t\t\t<div class='gchoice gchoice_97_154_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_154' type='radio' value='Not natural at all'  id='choice_97_154_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_154_0' id='label_97_154_0' class='gform-field-label gform-field-label--type-inline'>No es nada natural.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_154_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_154' type='radio' value='Somewhat natural'  id='choice_97_154_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_154_1' id='label_97_154_1' class='gform-field-label gform-field-label--type-inline'>Algo natural<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_154_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_154' type='radio' value='Very natural'  id='choice_97_154_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_154_2' id='label_97_154_2' class='gform-field-label gform-field-label--type-inline'>Muy natural<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_97_155\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Cuando interact\u00faas con herramientas de IA mediante conversaciones de voz, \u00bfqu\u00e9 tan natural o humana te parece la interacci\u00f3n?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_155'>\n\t\t\t<div class='gchoice gchoice_97_155_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_155' type='radio' value='Not natural at all'  id='choice_97_155_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_155_0' id='label_97_155_0' class='gform-field-label gform-field-label--type-inline'>No es nada natural.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_155_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_155' type='radio' value='Somewhat natural'  id='choice_97_155_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_155_1' id='label_97_155_1' class='gform-field-label gform-field-label--type-inline'>Algo natural<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_155_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_155' type='radio' value='Very natural'  id='choice_97_155_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_155_2' id='label_97_155_2' class='gform-field-label gform-field-label--type-inline'>Muy natural<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_97_159\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Trust &amp; privacy<\/h3><\/div><fieldset id=\"field_97_158\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>How much do you trust the results or advice provided by AI?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_158'>\n\t\t\t<div class='gchoice gchoice_97_158_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_158' type='radio' value='Do not trust at all'  id='choice_97_158_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_158_0' id='label_97_158_0' class='gform-field-label gform-field-label--type-inline'>Do not trust at all<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_158_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_158' type='radio' value='Slightly trust'  id='choice_97_158_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_158_1' id='label_97_158_1' class='gform-field-label gform-field-label--type-inline'>Slightly trust<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_158_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_158' type='radio' value='Moderately trust'  id='choice_97_158_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_158_2' id='label_97_158_2' class='gform-field-label gform-field-label--type-inline'>Moderately trust<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_158_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_158' type='radio' value='Highly trust'  id='choice_97_158_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_158_3' id='label_97_158_3' class='gform-field-label gform-field-label--type-inline'>Highly trust<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_158_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_158' type='radio' value='Completely trust'  id='choice_97_158_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_158_4' id='label_97_158_4' class='gform-field-label gform-field-label--type-inline'>Completely trust<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_97_160\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>When AI provides advice or recommendations, how often do you follow them?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_160'>\n\t\t\t<div class='gchoice gchoice_97_160_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_160' type='radio' value='Never'  id='choice_97_160_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_160_0' id='label_97_160_0' class='gform-field-label gform-field-label--type-inline'>Nunca<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_160_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_160' type='radio' value='Rarely'  id='choice_97_160_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_160_1' id='label_97_160_1' class='gform-field-label gform-field-label--type-inline'>Casi nunca<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_160_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_160' type='radio' value='Sometimes'  id='choice_97_160_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_160_2' id='label_97_160_2' class='gform-field-label gform-field-label--type-inline'>A veces<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_160_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_160' type='radio' value='Often'  id='choice_97_160_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_160_3' id='label_97_160_3' class='gform-field-label gform-field-label--type-inline'>A menudo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_160_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_160' type='radio' value='Almost always'  id='choice_97_160_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_160_4' id='label_97_160_4' class='gform-field-label gform-field-label--type-inline'>Almost always<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_97_162\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-3 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>In which of the following areas are you <strong><em>least<\/em> likely to trust<\/strong> AI\u2019s advice?<\/span><\/legend><div class='gfield_description' id='gfield_description_97_162'>Selecciona hasta 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_97_162'><div class='gchoice gchoice_97_162_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_162.1' type='checkbox'  value='Emotional support'  id='choice_97_162_1'   aria-describedby=\"gfield_description_97_162\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_97_162_1' id='label_97_162_1' class='gform-field-label gform-field-label--type-inline'>Emotional support<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_162_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_162.2' type='checkbox'  value='Medical or physical health'  id='choice_97_162_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_162_2' id='label_97_162_2' class='gform-field-label gform-field-label--type-inline'>Medical or physical health<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_162_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_162.3' type='checkbox'  value='Legal or financial decisions'  id='choice_97_162_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_162_3' id='label_97_162_3' class='gform-field-label gform-field-label--type-inline'>Legal or financial decisions<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_162_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_162.4' type='checkbox'  value='Managing personal relationships'  id='choice_97_162_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_162_4' id='label_97_162_4' class='gform-field-label gform-field-label--type-inline'>Managing personal relationships<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_162_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_162.5' type='checkbox'  value='Academic or work-related decisions'  id='choice_97_162_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_162_5' id='label_97_162_5' class='gform-field-label gform-field-label--type-inline'>Academic or work-related decisions<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_162_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_162.6' type='checkbox'  value='I generally trust AI across almost all areas'  id='choice_97_162_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_162_6' id='label_97_162_6' class='gform-field-label gform-field-label--type-inline'>I generally trust AI across almost all areas<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_162_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_162.7' type='checkbox'  value='Other...'  id='choice_97_162_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_162_7' id='label_97_162_7' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_97_163\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_163'><span class='gform-field-label__text'>In what other areas are you <strong><em>least<\/em> likely to trust<\/strong> AI\u2019s advice?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_163' id='input_97_163' type='text' value='' class='large'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_97_161\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>When using AI, how often do you share your personal information about yourself?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_161'>\n\t\t\t<div class='gchoice gchoice_97_161_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_161' type='radio' value='Never'  id='choice_97_161_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_161_0' id='label_97_161_0' class='gform-field-label gform-field-label--type-inline'>Nunca<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_161_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_161' type='radio' value='Rarely'  id='choice_97_161_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_161_1' id='label_97_161_1' class='gform-field-label gform-field-label--type-inline'>Casi nunca<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_161_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_161' type='radio' value='Sometimes'  id='choice_97_161_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_161_2' id='label_97_161_2' class='gform-field-label gform-field-label--type-inline'>A veces<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_161_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_161' type='radio' value='Often'  id='choice_97_161_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_161_3' id='label_97_161_3' class='gform-field-label gform-field-label--type-inline'>A menudo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_161_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_161' type='radio' value='Almost always'  id='choice_97_161_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_161_4' id='label_97_161_4' class='gform-field-label gform-field-label--type-inline'>Almost always<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_97_164\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Do you take any actions to protect your privacy when using AI?<\/span><\/legend><div class='gfield_description' id='gfield_description_97_164'>Selecciona todas las opciones que apliquen.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_97_164'><div class='gchoice gchoice_97_164_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.1' type='checkbox'  value='I avoid certain personal topics'  id='choice_97_164_1'   aria-describedby=\"gfield_description_97_164\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_97_164_1' id='label_97_164_1' class='gform-field-label gform-field-label--type-inline'>I avoid certain personal topics<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_164_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.2' type='checkbox'  value='I use vague or incomplete information'  id='choice_97_164_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_164_2' id='label_97_164_2' class='gform-field-label gform-field-label--type-inline'>I use vague or incomplete information<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_164_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.3' type='checkbox'  value='I use made-up or altered details'  id='choice_97_164_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_164_3' id='label_97_164_3' class='gform-field-label gform-field-label--type-inline'>I use made-up or altered details<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_164_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.4' type='checkbox'  value='I avoid long conversations'  id='choice_97_164_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_164_4' id='label_97_164_4' class='gform-field-label gform-field-label--type-inline'>I avoid long conversations<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_164_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.5' type='checkbox'  value='I use a specific AI system and\/or pay for a subscription because of its privacy policies'  id='choice_97_164_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_164_5' id='label_97_164_5' class='gform-field-label gform-field-label--type-inline'>I use a specific AI system and\/or pay for a subscription because of its privacy policies<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_164_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.6' type='checkbox'  value='I do not take any special privacy precations'  id='choice_97_164_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_164_6' id='label_97_164_6' class='gform-field-label gform-field-label--type-inline'>I do not take any special privacy precations<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_164_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.7' type='checkbox'  value='Other...'  id='choice_97_164_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_164_7' id='label_97_164_7' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_97_165\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_165'><span class='gform-field-label__text'>What other actions do you take to protect your privacy when using AI?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_165' id='input_97_165' type='text' value='' class='large'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_97_166\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>How important is it for you to be able to control what information AI remembers or stores about you?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_166'>\n\t\t\t<div class='gchoice gchoice_97_166_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_166' type='radio' value='Not important at all'  id='choice_97_166_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_166_0' id='label_97_166_0' class='gform-field-label gform-field-label--type-inline'>Not important at all<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_166_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_166' type='radio' value='Somewhat important'  id='choice_97_166_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_166_1' id='label_97_166_1' class='gform-field-label gform-field-label--type-inline'>Somewhat important<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_166_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_166' type='radio' value='Moderately important'  id='choice_97_166_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_166_2' id='label_97_166_2' class='gform-field-label gform-field-label--type-inline'>Moderately important<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_166_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_166' type='radio' value='Very important'  id='choice_97_166_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_166_3' id='label_97_166_3' class='gform-field-label gform-field-label--type-inline'>Very important<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_166_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_166' type='radio' value='Extremely important'  id='choice_97_166_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_166_4' id='label_97_166_4' class='gform-field-label gform-field-label--type-inline'>Extremely important<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <button type='button' id='gform_next_button_97_17' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Siguiente<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_97_2' class='gform_page demographics' data-js='page-field-id-17' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_97_2' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_97_53\" class=\"gfield gfield--type-html gfield--input-type-html section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>Acerca de ti<\/h2><\/div><div id=\"field_97_54\" class=\"gfield gfield--type-select gfield--input-type-select optional taxonomy field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_54'><span class='gform-field-label__text'>Rango de edades<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_54' id='input_97_54' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='8-10' >8-10<\/option><option value='11-13' >11-13<\/option><option value='14-15' >14-15<\/option><option value='16-17' >16-17<\/option><option value='18-24' >18-24<\/option><option value='25-34' >25-34<\/option><option value='35-44' >35-44<\/option><option value='45-54' >45-54<\/option><option value='55-64' >55-64<\/option><option value='65+' >65+<\/option><option value='Prefer not to answer' >Prefiero no responder<\/option><\/select><\/div><\/div><fieldset id=\"field_97_55\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional mb-2 short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>G\u00e9nero<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_55'>\n\t\t\t<div class='gchoice gchoice_97_55_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='Female'  id='choice_97_55_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_55_0' id='label_97_55_0' class='gform-field-label gform-field-label--type-inline'>Femenino<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_55_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='Male'  id='choice_97_55_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_55_1' id='label_97_55_1' class='gform-field-label gform-field-label--type-inline'>Masculino<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_55_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='Non-Binary'  id='choice_97_55_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_55_2' id='label_97_55_2' class='gform-field-label gform-field-label--type-inline'>No binario<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_55_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='Prefer not to answer'  id='choice_97_55_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_55_3' id='label_97_55_3' class='gform-field-label gform-field-label--type-inline'>Prefiero no responder<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_97_156\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTe identificas como transg\u00e9nero?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_156'>\n\t\t\t<div class='gchoice gchoice_97_156_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_156' type='radio' value='Yes'  id='choice_97_156_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_156_0' id='label_97_156_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_156_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_156' type='radio' value='No'  id='choice_97_156_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_156_1' id='label_97_156_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_97_135\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_135'><span class='gform-field-label__text'>\u00bfC\u00f3mo describir\u00edas tu g\u00e9nero?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_135' id='input_97_135' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_97_58\" class=\"gfield gfield--type-select gfield--input-type-select optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_58'><span class='gform-field-label__text'>Raza\/etnia<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_58' id='input_97_58' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='American Indian or Alaska Native' >Amerindio o nativo de Alaska<\/option><option value='Asian' >Asi\u00e1tico<\/option><option value='Black or African American (non-Hispanic)' >Negro o afroamericano (no hispano)<\/option><option value='Hispanic or Latino' >Hispano o latino<\/option><option value='Middle Eastern or North African' >Del medio oriente o norteafricano<\/option><option value='Native Hawaiian or other Pacific Islander' >Isle\u00f1o nativo hawaiano o pac\u00edfico<\/option><option value='White (non-Hispanic)' >Blanco (no hispano)<\/option><option value='More than one of the above' >M\u00e1s de uno de los anteriores<\/option><option value='Other...' >Otros...<\/option><\/select><\/div><\/div><div id=\"field_97_134\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_134'><span class='gform-field-label__text'>\u00bfC\u00f3mo describir\u00edas tu raza\/etnia?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_134' id='input_97_134' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_97_59\" class=\"gfield gfield--type-select gfield--input-type-select optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_59'><span class='gform-field-label__text'>Ingresos familiares (USD)<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_59' id='input_97_59' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Less than $20,000' >Menos de $20,000<\/option><option value='$20,000 - $39,999' >$20,000 - $39,999<\/option><option value='$40,000 - $59,999' >$40,000 - $59,999<\/option><option value='$60,000 - $79,999' >$60,000 - $79,999<\/option><option value='$80,000 - $99,999' >$80,000 - $99,999<\/option><option value='$100,000 - $149,999' >$100,000 - $149,999<\/option><option value='$150,000+' >$150,000+<\/option><\/select><\/div><\/div><fieldset id=\"field_97_87\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfVives en los Estados Unidos de Am\u00e9rica o en otro pa\u00eds?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_87'>\n\t\t\t<div class='gchoice gchoice_97_87_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_87' type='radio' value='I live in the United States'  id='choice_97_87_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_87_0' id='label_97_87_0' class='gform-field-label gform-field-label--type-inline'>Vivo en los Estados Unidos de Am\u00e9rica.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_87_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_87' type='radio' value='I live in another country'  id='choice_97_87_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_87_1' id='label_97_87_1' class='gform-field-label gform-field-label--type-inline'>Vivo en otro pa\u00eds.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_97_78\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_78'><span class='gform-field-label__text'>Estado<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_78' id='input_97_78' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >Distrito de Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Hawaii' >Haw\u00e1i<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Luisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >M\u00edchigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Misisipi<\/option><option value='Missouri' >Misuri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >Nuevo Hampshire<\/option><option value='New Jersey' >Nueva Jersey<\/option><option value='New Mexico' >Nuevo M\u00e9xico<\/option><option value='New York' >Nueva York<\/option><option value='North Carolina' >Carolina del Norte<\/option><option value='North Dakota' >Dakota del Norte<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oreg\u00f3n<\/option><option value='Pennsylvania' >Pensilvania<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >Carolina del Sur<\/option><option value='South Dakota' >Dakota del Sur<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >Virginia Occidental<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='I live in a U.S. Territory' >Vivo en un territorio de los Estados Unidos.<\/option><\/select><\/div><\/div><div id=\"field_97_80\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_80'><span class='gform-field-label__text'>\u00bfEn qu\u00e9 pa\u00eds vives?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_80' id='input_97_80' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Afghanistan' >Afganist\u00e1n<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Argelia<\/option><option value='American Samoa' >Samoa Americana<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguila<\/option><option value='Antarctica' >Ant\u00e1rtida<\/option><option value='Antigua and Barbuda' >Antigua y Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaiy\u00e1n<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrein<\/option><option value='Bangladesh' >Banglad\u00e9s<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Bielorrusia<\/option><option value='Belgium' >B\u00e9lgica<\/option><option value='Belize' >Belice<\/option><option value='Benin' >Ben\u00edn<\/option><option value='Bermuda' >Bermudas<\/option><option value='Bhutan' >But\u00e1n<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, San Eustaquio y Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia y Herzegovina<\/option><option value='Botswana' >Botsuana<\/option><option value='Bouvet Island' >Isla Bouvet<\/option><option value='Brazil' >Brasil<\/option><option value='British Indian Ocean Territory' >Territorio Brit\u00e1nico del Oc\u00e9ano \u00cdndico<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cambodia' >Camboya<\/option><option value='Cameroon' >Camer\u00fan<\/option><option value='Canada' >Canad\u00e1<\/option><option value='Cape Verde' >Cabo Verde<\/option><option value='Cayman Islands' >Islas Caim\u00e1n<\/option><option value='Central African Republic' >Rep\u00fablica Centroafricana<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Isla de Navidad<\/option><option value='Cocos Islands' >Islas Cocos<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoras<\/option><option value='Congo, Democratic Republic of the' >Rep\u00fablica Democr\u00e1tica del Congo<\/option><option value='Congo, Republic of the' >Rep\u00fablica del Congo<\/option><option value='Cook Islands' >Islas Cook<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croacia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Curazao<\/option><option value='Cyprus' >Chipre<\/option><option value='Czech Republic' >Rep\u00fablica Checa<\/option><option value='C\u00f4te d&#039;Ivoire' >Costa de Marfil<\/option><option value='Denmark' >Dinamarca<\/option><option value='Djibouti' >Yibuti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Rep\u00fablica Dominicana<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egipto<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Guinea Ecuatorial<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini (Swaziland)' >Esuatini (Suazilandia)<\/option><option value='Ethiopia' >Etiop\u00eda<\/option><option value='Falkland Islands' >Islas Malvinas<\/option><option value='Faroe Islands' >Islas Feroe<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finlandia<\/option><option value='France' >Francia<\/option><option value='French Guiana' >Guayana Francesa<\/option><option value='French Polynesia' >Polinesia Francesa<\/option><option value='French Southern Territories' >Territorios Australes Franceses<\/option><option value='Gabon' >Gab\u00f3n<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Alemania<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Grecia<\/option><option value='Greenland' >Groenlandia<\/option><option value='Grenada' >Granada<\/option><option value='Guadeloupe' >Guadalupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Hait\u00ed<\/option><option value='Heard and McDonald Islands' >Islas Heard y McDonald<\/option><option value='Holy See' >Santa Sede<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungr\u00eda<\/option><option value='Iceland' >Islandia<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Ir\u00e1n<\/option><option value='Iraq' >Irak<\/option><option value='Ireland' >Irlanda<\/option><option value='Isle of Man' >Isla de Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italia<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Jap\u00f3n<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordania<\/option><option value='Kazakhstan' >Kazajist\u00e1n<\/option><option value='Kenya' >Kenia<\/option><option value='Kiribati' >Kiribati<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kirguist\u00e1n<\/option><option value='Lao People&#039;s Democratic Republic' >Rep\u00fablica Democr\u00e1tica Popular Lao<\/option><option value='Latvia' >Letonia<\/option><option value='Lebanon' >L\u00edbano<\/option><option value='Lesotho' >Lesoto<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libia<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lituania<\/option><option value='Luxembourg' >Luxemburgo<\/option><option value='Macau' >Macao<\/option><option value='Macedonia' >Macedonia<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malaui<\/option><option value='Malaysia' >Malasia<\/option><option value='Maldives' >Maldivas<\/option><option value='Mali' >Mal\u00ed<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Islas Marshall<\/option><option value='Martinique' >Martinica<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauricio<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >M\u00e9xico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldavia<\/option><option value='Monaco' >M\u00f3naco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Marruecos<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Pa\u00edses Bajos<\/option><option value='New Caledonia' >Nueva Caledonia<\/option><option value='New Zealand' >Nueva Zelanda<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >N\u00edger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Isla Norfolk<\/option><option value='North Korea' >Corea del Norte<\/option><option value='Northern Mariana Islands' >Islas Marianas del Norte<\/option><option value='Norway' >Noruega<\/option><option value='Oman' >Om\u00e1n<\/option><option value='Pakistan' >Pakist\u00e1n<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestina, Estado de<\/option><option value='Panama' >Panam\u00e1<\/option><option value='Papua New Guinea' >Pap\u00faa Nueva Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Per\u00fa<\/option><option value='Philippines' >Filipinas<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Polonia<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Rumania<\/option><option value='Russia' >Rusia<\/option><option value='Rwanda' >Ruanda<\/option><option value='R\u00e9union' >Reuni\u00f3n<\/option><option value='Saint Barth\u00e9lemy' >San Bartolom\u00e9<\/option><option value='Saint Helena' >Santa Elena<\/option><option value='Saint Kitts and Nevis' >San Crist\u00f3bal y Nieves<\/option><option value='Saint Lucia' >Santa Luc\u00eda<\/option><option value='Saint Martin' >San Mart\u00edn<\/option><option value='Saint Pierre and Miquelon' >San Pedro y Miquel\u00f3n<\/option><option value='Saint Vincent and the Grenadines' >San Vicente y las Granadinas<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Santo Tom\u00e9 y Pr\u00edncipe<\/option><option value='Saudi Arabia' >Arabia Saudita<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leona<\/option><option value='Singapore' >Singapur<\/option><option value='Sint Maarten' >San Mart\u00edn<\/option><option value='Slovakia' >Eslovaquia<\/option><option value='Slovenia' >Eslovenia<\/option><option value='Solomon Islands' >Islas Salom\u00f3n<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >Sud\u00e1frica<\/option><option value='South Georgia' >Georgia del Sur<\/option><option value='South Korea' >Corea del Sur<\/option><option value='South Sudan' >Sud\u00e1n del Sur<\/option><option value='Spain' >Espa\u00f1a<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sud\u00e1n<\/option><option value='Suriname' >Surinam<\/option><option value='Svalbard and Jan Mayen Islands' >Islas Svalbard y Jan Mayen<\/option><option value='Sweden' >Suecia<\/option><option value='Switzerland' >Suiza<\/option><option value='Syria' >Siria<\/option><option value='Taiwan' >Taiw\u00e1n<\/option><option value='Tajikistan' >Tayikist\u00e1n<\/option><option value='Tanzania' >Tanzania<\/option><option value='Thailand' >Tailandia<\/option><option value='Timor-Leste' >Timor Oriental<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad y Tobago<\/option><option value='Tunisia' >T\u00fanez<\/option><option value='Turkey' >Turqu\u00eda<\/option><option value='Turkmenistan' >Turkmenist\u00e1n<\/option><option value='Turks and Caicos Islands' >Islas Turcas y Caicos<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='US Minor Outlying Islands' >Islas menores alejadas de los Estados Unidos<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ucrania<\/option><option value='United Arab Emirates' >Emiratos \u00c1rabes Unidos<\/option><option value='United Kingdom' >Reino Unido<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekist\u00e1n<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Vietnam' >Vietnam<\/option><option value='Virgin Islands, British' >Islas V\u00edrgenes Brit\u00e1nicas<\/option><option value='Virgin Islands, U.S.' >Islas V\u00edrgenes de los Estados Unidos.<\/option><option value='Wallis and Futuna' >Wallis y Futuna<\/option><option value='Western Sahara' >S\u00e1hara Occidental<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabue<\/option><option value='\u00c5land Islands' >Islas \u00c5land<\/option><\/select><\/div><\/div><fieldset id=\"field_97_109\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfVive con alguna de las siguientes discapacidades o afecciones?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_97_109'>Selecciona todas las opciones que apliquen.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_97_109'><div class='gchoice gchoice_97_109_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.1' type='checkbox'  value='Blind\/Low vision'  id='choice_97_109_1'   aria-describedby=\"gfield_description_97_109\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_97_109_1' id='label_97_109_1' class='gform-field-label gform-field-label--type-inline'>Ceguera\/Baja visi\u00f3n<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_109_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.2' type='checkbox'  value='Hearing impairment'  id='choice_97_109_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_109_2' id='label_97_109_2' class='gform-field-label gform-field-label--type-inline'>Discapacidad auditiva<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_109_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.3' type='checkbox'  value='Limited Mobility'  id='choice_97_109_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_109_3' id='label_97_109_3' class='gform-field-label gform-field-label--type-inline'>Movilidad limitada<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_109_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.4' type='checkbox'  value='Arthritis or other chronic pain'  id='choice_97_109_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_109_4' id='label_97_109_4' class='gform-field-label gform-field-label--type-inline'>Artritis u otros dolores cr\u00f3nicos<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_109_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.5' type='checkbox'  value='Anxiety'  id='choice_97_109_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_109_5' id='label_97_109_5' class='gform-field-label gform-field-label--type-inline'>Ansiedad<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_109_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.6' type='checkbox'  value='Mood conditions: depression or bipolar'  id='choice_97_109_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_109_6' id='label_97_109_6' class='gform-field-label gform-field-label--type-inline'>Trastornos del estado de \u00e1nimo: depresi\u00f3n o trastorno bipolar<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_109_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.7' type='checkbox'  value='Autism spectrum and\/or ADHD'  id='choice_97_109_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_109_7' id='label_97_109_7' class='gform-field-label gform-field-label--type-inline'>Espectro autista y\/o TDAH<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_109_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.8' type='checkbox'  value='Intellectual or learning disability'  id='choice_97_109_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_109_8' id='label_97_109_8' class='gform-field-label gform-field-label--type-inline'>Discapacidad intelectual o del aprendizaje<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_109_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.9' type='checkbox'  value='Neurological condition (epilepsy, etc.) or traumatic brain injury (TBI)'  id='choice_97_109_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_109_9' id='label_97_109_9' class='gform-field-label gform-field-label--type-inline'>Afecci\u00f3n neurol\u00f3gica (epilepsia, etc.) o lesi\u00f3n cerebral traum\u00e1tica (LCT)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_109_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.11' type='checkbox'  value='None of the above'  id='choice_97_109_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_109_11' id='label_97_109_11' class='gform-field-label gform-field-label--type-inline'>Ninguna de las anteriores<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_109_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.12' type='checkbox'  value='Other mental health condition...'  id='choice_97_109_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_109_12' id='label_97_109_12' class='gform-field-label gform-field-label--type-inline'>Otros trastornos de salud mental...<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_109_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.13' type='checkbox'  value='Other...'  id='choice_97_109_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_109_13' id='label_97_109_13' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_97_111\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_111'><span class='gform-field-label__text'>\u00bfQu\u00e9 otras afecciones de salud mental tiene?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_111' id='input_97_111' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_97_112\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_112'><span class='gform-field-label__text'>\u00bfQu\u00e9 otras discapacidades o afecciones tiene?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_112' id='input_97_112' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_97_150\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>En las \u00faltimas dos semanas, \u00bfc\u00f3mo calificar\u00eda su salud mental y bienestar?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_150'>\n\t\t\t<div class='gchoice gchoice_97_150_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_150' type='radio' value='Very Poor'  id='choice_97_150_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_150_0' id='label_97_150_0' class='gform-field-label gform-field-label--type-inline'>Muy deficiente<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice 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No es un test de salud mental.<\/p>","protected":false},"template":"","tags":[],"age_group":[],"condition":[],"class_list":["post-251583","screen","type-screen","status-publish","hentry"],"acf":[],"yoast_head":"<title>AI &amp; Mental Health Survey 4.0 (testing) &#8211; Mental Health America<\/title>\n<meta name=\"robots\" content=\"noindex, nofollow\" \/>\n<meta property=\"og:locale\" content=\"es_MX\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"AI &amp; Mental Health Survey 4.0 (testing)\" \/>\n<meta property=\"og:description\" content=\"This survey was developed to help us explore your opinions about artificial intelligence (AI) and mental health. 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de TOC (OCD)"},"content":{"rendered":"<div class='gf_browser_chrome gform_wrapper gravity-theme gform-theme--no-framework trp-contextual-choices_wrapper trp-ctx-ocd_wrapper' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_84' style='display:none'>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Test de TOC (OCD)<\/h2>\n                            <p class='gform_description'><\/p>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>\"<span class=\"gfield_required gfield_required_asterisk\">*<\/span>\"indica campos obligatorios<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_84' class='trp-contextual-choices trp-ctx-ocd' action='\/es\/wp-json\/wp\/v2\/screen' data-formid='84' novalidate data-trp-original-action=\"\/es\/wp-json\/wp\/v2\/screen\"><ol class=\"screen-progress-bar clearfix step-1-of-3\">\n\t\t\t\t\t<li class=\"step-1 translation-block\"><span>Preguntas<br>del Test<\/span><\/li>\n\t\t\t\t\t<li class=\"step-2 translation-block\"><span>Preguntas<br>Opcionales<\/span><\/li>\n\t\t\t\t\t<li class=\"step-3 translation-block\"><span>Tus<br>Resultados<\/span><\/li>\n\t\t\t\t<\/ol>\n                        <div class='gform-body gform_body'><div id='gform_page_84_1' class='gform_page' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_84' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_84_139\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_84_139'><span class='gform-field-label__text'>Comentarios<\/span><\/label><div class='gfield_description' id='gfield_description_84_139'>Este campo es para fines de validaci\u00f3n y no debe modificarse.<\/div><div class='ginput_container'><input name='input_139' id='input_84_139' type='text' value='' autocomplete='new-password'\/><\/div><\/div><div id=\"field_84_38\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_38' id='input_84_38' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_84_39\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><input name=\"input_39\" id=\"input_84_39\" type=\"hidden\" class=\"gform_hidden\" aria-invalid=\"false\" value=\"245905\"><\/div><div id=\"field_84_40\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><input name=\"input_40\" id=\"input_84_40\" type=\"hidden\" class=\"gform_hidden\" aria-invalid=\"false\" value=\"e875158b42d4e2ab407c8e264f11f752\"><\/div><div id=\"field_84_41\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_41' id='input_84_41' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_84_47\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_47' id='input_84_47' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='http:\/\/screening.mhanational.org' \/><\/div><\/div><div id=\"field_84_58\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_58' id='input_84_58' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_84_59\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_59' id='input_84_59' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_84_60\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_60' id='input_84_60' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_84_73\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_73' id='input_84_73' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_84_99\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_99' id='input_84_99' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='https:\/\/screening.mhanational.org\/es\/wp-json\/wp\/v2\/screen' \/><\/div><\/div><div id=\"field_84_136\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_136' id='input_84_136' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='lang--es' \/><\/div><\/div><div id=\"field_84_104\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p>Algunas personas tienen momentos en los que un pensamiento o una idea les viene a la mente una y otra vez. Cuando las personas tienen estos pensamientos, suelen sentirse molestas porque son extra\u00f1os. Por mucho que lo intenten, los pensamientos siguen volviendo.<\/p>\n<p>Ahora le preguntaremos si ha tenido pensamientos como estos en los \u00faltimos tres meses.<\/p>\n<\/div><div id=\"field_84_105\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>En los \u00faltimos 3 meses...<\/h2>\n<\/div><fieldset id=\"field_84_101\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHa tenido que contar cosas una y otra vez o obligarse a hacer cosas un n\u00famero determinado de veces?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_101'>\n\t\t\t<div class='gchoice gchoice_84_101_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_101' type='radio' value='1'  id='choice_84_101_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_101_0' id='label_84_101_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-yes\">Yes<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_101_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_101' type='radio' value='0'  id='choice_84_101_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_101_1' id='label_84_101_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-no\">No<\/span><\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_106\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHubo alg\u00fan momento en el que te lavaste las manos o el cuerpo una y otra vez, o te cambiaste de ropa muchas veces al d\u00eda porque pensabas que estaban sucias?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_106'>\n\t\t\t<div class='gchoice gchoice_84_106_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_106' type='radio' value='1'  id='choice_84_106_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_106_0' id='label_84_106_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-yes\">Yes<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_106_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_106' type='radio' value='0'  id='choice_84_106_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_106_1' id='label_84_106_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-no\">No<\/span><\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_107\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHa sentido a menudo la necesidad de revisar las cosas una y otra vez? Por ejemplo, comprobar que la puerta principal est\u00e1 cerrada con llave, que la estufa est\u00e1 apagada o que se ha hecho algo, aunque sepa que ya lo ha hecho?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_107'>\n\t\t\t<div class='gchoice gchoice_84_107_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_107' type='radio' value='1'  id='choice_84_107_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_107_0' id='label_84_107_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-yes\">Yes<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_107_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_107' type='radio' value='0'  id='choice_84_107_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_107_1' id='label_84_107_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-no\">No<\/span><\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_108\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTe has preocupado a menudo y repetidamente por si las cosas que tocas est\u00e1n sucias o tienen g\u00e9rmenes?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_108'>\n\t\t\t<div class='gchoice gchoice_84_108_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_108' type='radio' value='1'  id='choice_84_108_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_108_0' id='label_84_108_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-yes\">Yes<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_108_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_108' type='radio' value='0'  id='choice_84_108_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_108_1' id='label_84_108_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-no\">No<\/span><\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_109\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHa tenido alg\u00fan otro pensamiento que se le repitiera una y otra vez y del que no pudiera deshacerse?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_109'>\n\t\t\t<div class='gchoice gchoice_84_109_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_109' type='radio' value='1'  id='choice_84_109_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_109_0' id='label_84_109_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-yes\">Yes<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_109_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_109' type='radio' value='0'  id='choice_84_109_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_109_1' id='label_84_109_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-no\">No<\/span><\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_138\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Have you done things like counting, checking, washing, over and over again because you like to do these things?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_138'>\n\t\t\t<div class='gchoice gchoice_84_138_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_138' type='radio' value='1'  id='choice_84_138_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_138_0' id='label_84_138_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-yes\">Yes<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_138_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_138' type='radio' value='0'  id='choice_84_138_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_138_1' id='label_84_138_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-no\">No<\/span><\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_113\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfAlguna vez has hecho cosas como contar, revisar o lavar una y otra vez solo porque alguien te ha dicho que lo hagas para asegurarte de que lo has hecho bien?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_113'>\n\t\t\t<div class='gchoice gchoice_84_113_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_113' type='radio' value='1'  id='choice_84_113_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_113_0' id='label_84_113_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-yes\">Yes<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_113_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_113' type='radio' value='0'  id='choice_84_113_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_113_1' id='label_84_113_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-no\">No<\/span><\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_115\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfAlguna vez has deseado poder dejar de hacer cosas como contar, revisar o lavar una y otra vez?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_115'>\n\t\t\t<div class='gchoice gchoice_84_115_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_115' type='radio' value='1'  id='choice_84_115_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_115_0' id='label_84_115_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-yes\">Yes<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_115_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_115' type='radio' value='0'  id='choice_84_115_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_115_1' id='label_84_115_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-no\">No<\/span><\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_116\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHa pasado mucho tiempo cada d\u00eda haciendo cosas como contar, revisar o lavar una y otra vez... digamos, durante una hora?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_116'>\n\t\t\t<div class='gchoice gchoice_84_116_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_116' type='radio' value='1'  id='choice_84_116_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_116_0' id='label_84_116_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-yes\">Yes<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_116_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_116' type='radio' value='0'  id='choice_84_116_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_116_1' id='label_84_116_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-no\">No<\/span><\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_84_94\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><hr class=\"layout-action show-actions_b\" \/>\n\n<p>Las siguientes afirmaciones se refieren a experiencias que muchas personas tienen en su vida cotidiana. Seleccione la opci\u00f3n que mejor describa <strong>cu\u00e1nto te ha molestado o preocupado esa experiencia<\/strong> durante el \u00faltimo mes.<\/p>\n\n<h2>Durante el \u00faltimo mes...<\/h2><\/div><fieldset id=\"field_84_5\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio question exclude gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>1. He acumulado tantas cosas que me estorban.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_5'>\n\t\t\t<div class='gchoice gchoice_84_5_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_5' type='radio' value='0'  id='choice_84_5_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_5_0' id='label_84_5_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Nada<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_5_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_5' type='radio' value='1'  id='choice_84_5_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_5_1' id='label_84_5_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Un poco<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_5_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_5' type='radio' value='2'  id='choice_84_5_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_5_2' id='label_84_5_2' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Moderadamente<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_5_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_5' type='radio' value='3'  id='choice_84_5_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_5_3' id='label_84_5_3' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Mucho<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_5_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_5' type='radio' value='4'  id='choice_84_5_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_5_4' id='label_84_5_4' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Much\u00edsimo<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_75\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>2. Compruebo las cosas m\u00e1s a menudo de lo necesario.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_75'>\n\t\t\t<div class='gchoice gchoice_84_75_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_75' type='radio' value='0'  id='choice_84_75_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_75_0' id='label_84_75_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Nada<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_75_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_75' type='radio' value='1'  id='choice_84_75_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_75_1' id='label_84_75_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Un poco<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_75_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_75' type='radio' value='2'  id='choice_84_75_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_75_2' id='label_84_75_2' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Moderadamente<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_75_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_75' type='radio' value='3'  id='choice_84_75_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_75_3' id='label_84_75_3' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Mucho<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_75_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_75' type='radio' value='4'  id='choice_84_75_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_75_4' id='label_84_75_4' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Much\u00edsimo<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_76\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>3. Me enfada que los objetos no est\u00e9n bien ordenados.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_76'>\n\t\t\t<div class='gchoice gchoice_84_76_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_76' type='radio' value='0'  id='choice_84_76_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_76_0' id='label_84_76_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Nada<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_76_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_76' type='radio' value='1'  id='choice_84_76_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_76_1' id='label_84_76_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Un poco<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_76_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_76' type='radio' value='2'  id='choice_84_76_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_76_2' id='label_84_76_2' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Moderadamente<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_76_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_76' type='radio' value='3'  id='choice_84_76_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_76_3' id='label_84_76_3' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Mucho<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_76_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_76' type='radio' value='4'  id='choice_84_76_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_76_4' id='label_84_76_4' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Much\u00edsimo<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_77\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>4. Me siento obligado(a) a contar n\u00fameros mientras hago cosas.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_77'>\n\t\t\t<div class='gchoice gchoice_84_77_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_77' type='radio' value='0'  id='choice_84_77_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_77_0' id='label_84_77_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Nada<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_77_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_77' type='radio' value='1'  id='choice_84_77_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_77_1' id='label_84_77_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Un poco<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_77_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_77' type='radio' value='2'  id='choice_84_77_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_77_2' id='label_84_77_2' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Moderadamente<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_77_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_77' type='radio' value='3'  id='choice_84_77_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_77_3' id='label_84_77_3' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Mucho<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_77_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_77' type='radio' value='4'  id='choice_84_77_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_77_4' id='label_84_77_4' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Much\u00edsimo<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_78\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>5. Me resulta dif\u00edcil tocar un objeto cuando s\u00e9 que lo han tocado desconocidos o ciertas personas.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_78'>\n\t\t\t<div class='gchoice gchoice_84_78_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_78' type='radio' value='0'  id='choice_84_78_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_78_0' id='label_84_78_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Nada<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_78_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_78' type='radio' value='1'  id='choice_84_78_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_78_1' id='label_84_78_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Un poco<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_78_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_78' type='radio' value='2'  id='choice_84_78_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_78_2' id='label_84_78_2' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Moderadamente<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_78_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_78' type='radio' value='3'  id='choice_84_78_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_78_3' id='label_84_78_3' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Mucho<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_78_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_78' type='radio' value='4'  id='choice_84_78_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_78_4' id='label_84_78_4' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Much\u00edsimo<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_79\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>6. Me resulta dif\u00edcil controlar mis propios pensamientos.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_79'>\n\t\t\t<div class='gchoice gchoice_84_79_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_79' type='radio' value='0'  id='choice_84_79_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_79_0' id='label_84_79_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Nada<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_79_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_79' type='radio' value='1'  id='choice_84_79_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_79_1' id='label_84_79_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Un poco<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_79_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_79' type='radio' value='2'  id='choice_84_79_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_79_2' id='label_84_79_2' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Moderadamente<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_79_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_79' type='radio' value='3'  id='choice_84_79_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_79_3' id='label_84_79_3' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Mucho<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_79_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_79' type='radio' value='4'  id='choice_84_79_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_79_4' id='label_84_79_4' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Much\u00edsimo<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_80\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question exclude gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>7. Acumulo cosas que no necesito.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_80'>\n\t\t\t<div class='gchoice gchoice_84_80_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_80' type='radio' value='0'  id='choice_84_80_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_80_0' id='label_84_80_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Nada<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_80_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_80' type='radio' value='1'  id='choice_84_80_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_80_1' id='label_84_80_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Un poco<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_80_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_80' type='radio' value='2'  id='choice_84_80_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_80_2' id='label_84_80_2' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Moderadamente<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_80_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_80' type='radio' value='3'  id='choice_84_80_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_80_3' id='label_84_80_3' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Mucho<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_80_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_80' type='radio' value='4'  id='choice_84_80_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_80_4' id='label_84_80_4' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Much\u00edsimo<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_81\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>8. Compruebo repetidamente puertas, ventanas, cajones, etc.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_81'>\n\t\t\t<div class='gchoice gchoice_84_81_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_81' type='radio' value='0'  id='choice_84_81_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_81_0' id='label_84_81_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Nada<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_81_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_81' type='radio' value='1'  id='choice_84_81_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_81_1' id='label_84_81_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Un poco<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_81_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_81' type='radio' value='2'  id='choice_84_81_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_81_2' id='label_84_81_2' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Moderadamente<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_81_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_81' type='radio' value='3'  id='choice_84_81_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_81_3' id='label_84_81_3' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Mucho<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_81_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_81' type='radio' value='4'  id='choice_84_81_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_81_4' id='label_84_81_4' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Much\u00edsimo<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_82\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>9. Me enfada que los dem\u00e1s cambien la forma en que he ordenado las cosas.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_82'>\n\t\t\t<div class='gchoice gchoice_84_82_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_82' type='radio' value='0'  id='choice_84_82_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_82_0' id='label_84_82_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Nada<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_82_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_82' type='radio' value='1'  id='choice_84_82_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_82_1' id='label_84_82_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Un poco<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_82_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_82' type='radio' value='2'  id='choice_84_82_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_82_2' id='label_84_82_2' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Moderadamente<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_82_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_82' type='radio' value='3'  id='choice_84_82_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_82_3' id='label_84_82_3' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Mucho<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_82_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_82' type='radio' value='4'  id='choice_84_82_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_82_4' id='label_84_82_4' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Much\u00edsimo<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_83\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>10. Siento que tengo que repetir ciertos n\u00fameros.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_83'>\n\t\t\t<div class='gchoice gchoice_84_83_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_83' type='radio' value='0'  id='choice_84_83_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_83_0' id='label_84_83_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Nada<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_83_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_83' type='radio' value='1'  id='choice_84_83_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_83_1' id='label_84_83_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Un poco<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_83_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_83' type='radio' value='2'  id='choice_84_83_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_83_2' id='label_84_83_2' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Moderadamente<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_83_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_83' type='radio' value='3'  id='choice_84_83_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_83_3' id='label_84_83_3' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Mucho<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_83_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_83' type='radio' value='4'  id='choice_84_83_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_83_4' id='label_84_83_4' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Much\u00edsimo<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_84\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>11. A veces tengo que asearme o limpiarme simplemente porque me siento contaminado.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_84'>\n\t\t\t<div class='gchoice gchoice_84_84_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_84' type='radio' value='0'  id='choice_84_84_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_84_0' id='label_84_84_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Nada<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_84_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_84' type='radio' value='1'  id='choice_84_84_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_84_1' id='label_84_84_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Un poco<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_84_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_84' type='radio' value='2'  id='choice_84_84_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_84_2' id='label_84_84_2' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Moderadamente<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_84_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_84' type='radio' value='3'  id='choice_84_84_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_84_3' id='label_84_84_3' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Mucho<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_84_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_84' type='radio' value='4'  id='choice_84_84_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_84_4' id='label_84_84_4' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Much\u00edsimo<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_85\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>12. Me molestan los pensamientos desagradables que me vienen a la mente contra mi voluntad.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_85'>\n\t\t\t<div class='gchoice gchoice_84_85_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_85' type='radio' value='0'  id='choice_84_85_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_85_0' id='label_84_85_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Nada<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_85_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_85' type='radio' value='1'  id='choice_84_85_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_85_1' id='label_84_85_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Un poco<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_85_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_85' type='radio' value='2'  id='choice_84_85_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_85_2' id='label_84_85_2' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Moderadamente<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_85_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_85' type='radio' value='3'  id='choice_84_85_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_85_3' id='label_84_85_3' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Mucho<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_85_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_85' type='radio' value='4'  id='choice_84_85_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_85_4' id='label_84_85_4' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Much\u00edsimo<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_86\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question exclude gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>13. Evito tirar cosas por temor a necesitarlas despu\u00e9s.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_86'>\n\t\t\t<div class='gchoice gchoice_84_86_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_86' type='radio' value='0'  id='choice_84_86_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_86_0' id='label_84_86_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Nada<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_86_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_86' type='radio' value='1'  id='choice_84_86_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_86_1' id='label_84_86_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Un poco<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_86_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_86' type='radio' value='2'  id='choice_84_86_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_86_2' id='label_84_86_2' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Moderadamente<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_86_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_86' type='radio' value='3'  id='choice_84_86_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_86_3' id='label_84_86_3' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Mucho<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_86_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_86' type='radio' value='4'  id='choice_84_86_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_86_4' id='label_84_86_4' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Much\u00edsimo<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_87\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>14. Compruebo repetidamente los grifos del gas y del agua y los interruptores de la luz despu\u00e9s de apagarlos.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_87'>\n\t\t\t<div class='gchoice gchoice_84_87_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_87' type='radio' value='0'  id='choice_84_87_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_87_0' id='label_84_87_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Nada<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_87_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_87' type='radio' value='1'  id='choice_84_87_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_87_1' id='label_84_87_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Un poco<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_87_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_87' type='radio' value='2'  id='choice_84_87_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_87_2' id='label_84_87_2' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Moderadamente<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_87_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_87' type='radio' value='3'  id='choice_84_87_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_87_3' id='label_84_87_3' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Mucho<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_87_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_87' type='radio' value='4'  id='choice_84_87_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_87_4' id='label_84_87_4' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Much\u00edsimo<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_88\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>15. Necesito que las cosas est\u00e9n ordenadas de una manera determinada.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_88'>\n\t\t\t<div class='gchoice gchoice_84_88_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_88' type='radio' value='0'  id='choice_84_88_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_88_0' id='label_84_88_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Nada<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_88_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_88' type='radio' value='1'  id='choice_84_88_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_88_1' id='label_84_88_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Un poco<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_88_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_88' type='radio' value='2'  id='choice_84_88_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_88_2' id='label_84_88_2' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Moderadamente<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_88_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_88' type='radio' value='3'  id='choice_84_88_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_88_3' id='label_84_88_3' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Mucho<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_88_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_88' type='radio' value='4'  id='choice_84_88_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_88_4' id='label_84_88_4' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Much\u00edsimo<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_89\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>16. Siento que hay n\u00fameros buenos y malos.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_89'>\n\t\t\t<div class='gchoice gchoice_84_89_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_89' type='radio' value='0'  id='choice_84_89_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_89_0' id='label_84_89_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Nada<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_89_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_89' type='radio' value='1'  id='choice_84_89_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_89_1' id='label_84_89_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Un poco<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_89_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_89' type='radio' value='2'  id='choice_84_89_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_89_2' id='label_84_89_2' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Moderadamente<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_89_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_89' type='radio' value='3'  id='choice_84_89_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_89_3' id='label_84_89_3' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Mucho<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_89_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_89' type='radio' value='4'  id='choice_84_89_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_89_4' id='label_84_89_4' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Much\u00edsimo<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_90\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>17. Me lavo las manos m\u00e1s a menudo y durante m\u00e1s tiempo de lo necesario.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_90'>\n\t\t\t<div class='gchoice gchoice_84_90_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_90' type='radio' value='0'  id='choice_84_90_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_90_0' id='label_84_90_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Nada<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_90_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_90' type='radio' value='1'  id='choice_84_90_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_90_1' id='label_84_90_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Un poco<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_90_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_90' type='radio' value='2'  id='choice_84_90_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_90_2' id='label_84_90_2' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Moderadamente<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_90_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_90' type='radio' value='3'  id='choice_84_90_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_90_3' id='label_84_90_3' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Mucho<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_90_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_90' type='radio' value='4'  id='choice_84_90_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_90_4' id='label_84_90_4' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Much\u00edsimo<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_91\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>18. Con frecuencia tengo pensamientos repugnantes y me cuesta deshacerme de ellos.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_91'>\n\t\t\t<div class='gchoice gchoice_84_91_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_91' type='radio' value='0'  id='choice_84_91_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_91_0' id='label_84_91_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Nada<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_91_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_91' type='radio' value='1'  id='choice_84_91_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_91_1' id='label_84_91_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Un poco<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_91_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_91' type='radio' value='2'  id='choice_84_91_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_91_2' id='label_84_91_2' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Moderadamente<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_91_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_91' type='radio' value='3'  id='choice_84_91_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_91_3' id='label_84_91_3' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Mucho<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_91_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_91' type='radio' value='4'  id='choice_84_91_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_91_4' id='label_84_91_4' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\">Much\u00edsimo<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_84_117\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><hr \/>\n<p>Algunas personas tienen momentos en los que un pensamiento o una idea les viene a la mente una y otra vez. Cuando las personas tienen estos pensamientos, suelen sentirse molestas porque son extra\u00f1os. Por mucho que lo intenten, los pensamientos siguen volviendo.<\/p>\n<p>Ahora le preguntaremos si ha tenido pensamientos como estos en los \u00faltimos tres meses.<\/p>\n<\/div><div id=\"field_84_119\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>En los \u00faltimos 3 meses...<\/h2>\n<\/div><fieldset id=\"field_84_120\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHa tenido que contar cosas una y otra vez o obligarse a hacer cosas un n\u00famero determinado de veces?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_120'>\n\t\t\t<div class='gchoice gchoice_84_120_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_120' type='radio' value='1'  id='choice_84_120_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_120_0' id='label_84_120_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-yes\">Yes<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_120_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_120' type='radio' value='0'  id='choice_84_120_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_120_1' id='label_84_120_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-no\">No<\/span><\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_121\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHubo alg\u00fan momento en el que te lavaste las manos o el cuerpo una y otra vez, o te cambiaste de ropa muchas veces al d\u00eda porque pensabas que estaban sucias?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_121'>\n\t\t\t<div class='gchoice gchoice_84_121_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_121' type='radio' value='1'  id='choice_84_121_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_121_0' id='label_84_121_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-yes\">Yes<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_121_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_121' type='radio' value='0'  id='choice_84_121_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_121_1' id='label_84_121_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-no\">No<\/span><\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_122\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHa sentido a menudo la necesidad de revisar las cosas una y otra vez? Por ejemplo, comprobar que la puerta principal est\u00e1 cerrada con llave, que la estufa est\u00e1 apagada o que se ha hecho algo, aunque sepa que ya lo ha hecho?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_122'>\n\t\t\t<div class='gchoice gchoice_84_122_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_122' type='radio' value='1'  id='choice_84_122_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_122_0' id='label_84_122_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-yes\">Yes<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_122_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_122' type='radio' value='0'  id='choice_84_122_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_122_1' id='label_84_122_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-no\">No<\/span><\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_123\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTe has preocupado a menudo y repetidamente por si las cosas que tocas est\u00e1n sucias o tienen g\u00e9rmenes?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_123'>\n\t\t\t<div class='gchoice gchoice_84_123_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_123' type='radio' value='1'  id='choice_84_123_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_123_0' id='label_84_123_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-yes\">Yes<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_123_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_123' type='radio' value='0'  id='choice_84_123_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_123_1' id='label_84_123_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-no\">No<\/span><\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_124\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHa tenido alg\u00fan otro pensamiento que se le repitiera una y otra vez y del que no pudiera deshacerse?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_124'>\n\t\t\t<div class='gchoice gchoice_84_124_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_124' type='radio' value='1'  id='choice_84_124_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_124_0' id='label_84_124_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-yes\">Yes<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_124_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_124' type='radio' value='0'  id='choice_84_124_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_124_1' id='label_84_124_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-no\">No<\/span><\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_137\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Have you done things like counting, checking, washing, over and over again because you like to do these things?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_137'>\n\t\t\t<div class='gchoice gchoice_84_137_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_137' type='radio' value='1'  id='choice_84_137_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_137_0' id='label_84_137_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-yes\">Yes<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_137_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_137' type='radio' value='0'  id='choice_84_137_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_137_1' id='label_84_137_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-no\">No<\/span><\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_127\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfAlguna vez has hecho cosas como contar, revisar o lavar una y otra vez solo porque alguien te ha dicho que lo hagas para asegurarte de que lo has hecho bien?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_127'>\n\t\t\t<div class='gchoice gchoice_84_127_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_127' type='radio' value='1'  id='choice_84_127_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_127_0' id='label_84_127_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-yes\">Yes<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_127_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_127' type='radio' value='0'  id='choice_84_127_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_127_1' id='label_84_127_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-no\">No<\/span><\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_128\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfAlguna vez has deseado poder dejar de hacer cosas como contar, revisar o lavar una y otra vez?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_128'>\n\t\t\t<div class='gchoice gchoice_84_128_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_128' type='radio' value='1'  id='choice_84_128_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_128_0' id='label_84_128_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-yes\">Yes<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_128_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_128' type='radio' value='0'  id='choice_84_128_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_128_1' id='label_84_128_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-no\">No<\/span><\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_129\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHa pasado mucho tiempo cada d\u00eda haciendo cosas como contar, revisar o lavar una y otra vez... digamos, durante una hora?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_129'>\n\t\t\t<div class='gchoice gchoice_84_129_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_129' type='radio' value='1'  id='choice_84_129_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_129_0' id='label_84_129_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-yes\">Yes<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_129_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_129' type='radio' value='0'  id='choice_84_129_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_129_1' id='label_84_129_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-no\">No<\/span><\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_84_130\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><hr \/><\/div><div id=\"field_84_92\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_84_92'><span class='gform-field-label__text'>Opcional: \u00bfQu\u00e9 es lo que m\u00e1s te preocupa de los s\u00edntomas de TOC que has estado experimentando?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_92' id='input_84_92' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <button type='button' id='gform_next_button_84_17' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Siguiente<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_84_2' class='gform_page demographics' data-js='page-field-id-17' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_84_2' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_84_18\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p class=\"translation-block\">Por favor, toma un momento para responder a las siguientes preguntas <strong>opcionales<\/strong>. Tus respuestas son totalmente an\u00f3nimas: no podremos identificarte a partir de esta informaci\u00f3n. Tus respuestas nos ayudan a proporcionar mejor informaci\u00f3n y apoyo a personas como t\u00fa.<\/p>\n\n<p>Puedes responder a tantas preguntas como desees. Cuando hayas terminado, despl\u00e1zate hasta la parte inferior de la encuesta y haz clic en \"ver resultados\" para recibir los resultados de la evaluaci\u00f3n.<\/p><\/div><div id=\"field_84_61\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><hr \/><\/div><fieldset id=\"field_84_69\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full traditional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfQu\u00e9 es lo principal que quieres hacer despu\u00e9s de realizar este test de salud mental? (Selecciona una opci\u00f3n)<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_69'>\n\t\t\t<div class='gchoice gchoice_84_69_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='Take another mental health test'  id='choice_84_69_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_69_0' id='label_84_69_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-take-another-mental-health-test\">Take another mental health test<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_69_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='Understand what OCD is like (reading articles)'  id='choice_84_69_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_69_1' id='label_84_69_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-understand-what-ocd-is-like-reading-articles\">Understand what OCD is like (reading articles)<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_69_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='Understand and manage self-harm or suicidal thoughts'  id='choice_84_69_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_69_2' id='label_84_69_2' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-understand-and-manage-self-harm-or-suicidal-thoughts\">Understand and manage self-harm or suicidal thoughts<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_69_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='Tips for managing OCD (reading articles)'  id='choice_84_69_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_69_3' id='label_84_69_3' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-tips-for-managing-ocd-reading-articles\">Tips for managing OCD (reading articles)<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_69_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='Learn and practice skills for how to manage depression (try a free self-help tool)'  id='choice_84_69_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_69_4' id='label_84_69_4' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-learn-and-practice-skills-for-how-to-manage-depression-try-a-free-self-help-tool\">Learn and practice skills for how to manage depression (try a free self-help tool)<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_69_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='Learn about what therapy\/treatment is like (reading articles)'  id='choice_84_69_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_69_5' id='label_84_69_5' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-learn-about-what-therapy-treatment-is-like-reading-articles\">Learn about what therapy\/treatment is like (reading articles)<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_69_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='Find a treatment provider near you'  id='choice_84_69_6' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_69_6' id='label_84_69_6' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-find-a-treatment-provider-near-you\">Find a treatment provider near you<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_69_7'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='Find a forum or support group for people with OCD'  id='choice_84_69_7' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_69_7' id='label_84_69_7' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-find-a-forum-or-support-group-for-people-with-ocd\">Find a forum or support group for people with OCD<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_69_8'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='Other...'  id='choice_84_69_8' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_69_8' id='label_84_69_8' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-other\">Other...<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_69_9'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='I don\u2019t want to do anything'  id='choice_84_69_9' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_69_9' id='label_84_69_9' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-i-dont-want-to-do-anything\">I don\u2019t want to do anything<\/span><\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_84_70\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_84_70'><span class='gform-field-label__text'>Pr\u00f3ximos pasos - Otros<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_70' id='input_84_70' type='text' value='' class='medium'    placeholder='Anotar otro...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_84_72\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full layout-action show-actions_b gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><hr \/><\/div><fieldset id=\"field_84_62\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfEst\u00e1s haciendo este test por ti o en lugar de otra persona?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_62'>\n\t\t\t<div class='gchoice gchoice_84_62_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_62' type='radio' value='For myself'  id='choice_84_62_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_62_0' id='label_84_62_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-for-myself\">For myself<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_62_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_62' type='radio' value='For someone else'  id='choice_84_62_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_62_1' id='label_84_62_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-for-someone-else\">For someone else<\/span><\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_84_63\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  >Si est\u00e1s haciendo este test en lugar de otra persona, <strong>Por favor, utilice la informaci\u00f3n de esa persona.<\/strong> para las preguntas siguientes, o d\u00e9jalas en blanco si no sabes la respuesta. Recuerda que, <em>estas preguntas son opcionales<\/em>.<\/div><div id=\"field_84_42\" class=\"gfield gfield--type-html gfield--input-type-html section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>Acerca de ti<\/h2><\/div><div id=\"field_84_19\" class=\"gfield gfield--type-select gfield--input-type-select optional taxonomy field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_84_19'><span class='gform-field-label__text'>Rango de edades<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_19' id='input_84_19' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='8-10'  class=\"translation-block trp-ctx-ocd-8-10\">8-10<\/option><option value='11-13'  class=\"translation-block trp-ctx-ocd-11-13\">11-13<\/option><option value='14-15'  class=\"translation-block trp-ctx-ocd-14-15\">14-15<\/option><option value='16-17'  class=\"translation-block trp-ctx-ocd-16-17\">16-17<\/option><option value='18-24'  class=\"translation-block trp-ctx-ocd-18-24\">18-24<\/option><option value='25-34'  class=\"translation-block trp-ctx-ocd-25-34\">25-34<\/option><option value='35-44'  class=\"translation-block trp-ctx-ocd-35-44\">35-44<\/option><option value='45-54'  class=\"translation-block trp-ctx-ocd-45-54\">45-54<\/option><option value='55-64'  class=\"translation-block trp-ctx-ocd-55-64\">55-64<\/option><option value='65+'  class=\"translation-block trp-ctx-ocd-65\">65+<\/option><\/select><\/div><\/div><fieldset id=\"field_84_46\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>G\u00e9nero<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_46'>\n\t\t\t<div class='gchoice gchoice_84_46_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='Female'  id='choice_84_46_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_46_0' id='label_84_46_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-female\">Female<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_46_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='Male'  id='choice_84_46_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_46_1' id='label_84_46_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-male\">Male<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_46_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='Non-Binary'  id='choice_84_46_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_46_2' id='label_84_46_2' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-non-binary\">Non-Binary<\/span><\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_133\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTe identificas como transg\u00e9nero?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_133'>\n\t\t\t<div class='gchoice gchoice_84_133_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_133' type='radio' value='Yes'  id='choice_84_133_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_133_0' id='label_84_133_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-yes\">Yes<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_133_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_133' type='radio' value='No'  id='choice_84_133_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_133_1' id='label_84_133_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-no\">No<\/span><\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_84_48\" class=\"gfield gfield--type-text gfield--input-type-text optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_84_48'><span class='gform-field-label__text'>\u00bfC\u00f3mo describir\u00edas tu g\u00e9nero?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_48' id='input_84_48' type='text' value='' class='small'    placeholder='Ingresa el g\u00e9nero...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_84_22\" class=\"gfield gfield--type-select gfield--input-type-select optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_84_22'><span class='gform-field-label__text'>Raza\/etnia<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_22' id='input_84_22' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='American Indian or Alaska Native'  class=\"translation-block trp-ctx-ocd-american-indian-or-alaska-native\">Amerindio o nativo de Alaska<\/option><option value='Asian'  class=\"translation-block trp-ctx-ocd-asian\">Asi\u00e1tico<\/option><option value='Black or African American (non-Hispanic)'  class=\"translation-block trp-ctx-ocd-black-or-african-american-non-hispanic\">Negro o afroamericano (no hispano)<\/option><option value='Hispanic or Latino'  class=\"translation-block trp-ctx-ocd-hispanic-or-latino\">Hispano o latino<\/option><option value='Middle Eastern or North African'  class=\"translation-block trp-ctx-ocd-middle-eastern-or-north-african\">Del medio oriente o norteafricano<\/option><option value='Native Hawaiian or other Pacific Islander'  class=\"translation-block trp-ctx-ocd-native-hawaiian-or-other-pacific-islander\">Isle\u00f1o nativo hawaiano o pac\u00edfico<\/option><option value='White (non-Hispanic)'  class=\"translation-block trp-ctx-ocd-white-non-hispanic\">Blanco (no hispano)<\/option><option value='More than one of the above'  class=\"translation-block trp-ctx-ocd-more-than-one-of-the-above\">M\u00e1s de uno de los anteriores<\/option><option value='Other'  class=\"translation-block trp-ctx-ocd-other\">Otros<\/option><\/select><\/div><\/div><div id=\"field_84_23\" class=\"gfield gfield--type-select gfield--input-type-select optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_84_23'><span class='gform-field-label__text'>Ingresos familiares (USD)<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_23' id='input_84_23' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Less than $20,000'  class=\"translation-block trp-ctx-ocd-less-than-20000\">Menos de $20,000<\/option><option value='$20,000 - $39,999'  class=\"translation-block trp-ctx-ocd-20000-39999\">$20,000 - $39,999<\/option><option value='$40,000 - $59,999'  class=\"translation-block trp-ctx-ocd-40000-59999\">$40,000 - $59,999<\/option><option value='$60,000 - $79,999'  class=\"translation-block trp-ctx-ocd-60000-79999\">$60,000 - $79,999<\/option><option value='$80,000 - $99,999'  class=\"translation-block trp-ctx-ocd-80000-99999\">$80,000 - $99,999<\/option><option value='$100,000 - $149,999'  class=\"translation-block trp-ctx-ocd-100000-149999\">$100,000 - $149,999<\/option><option value='$150,000+'  class=\"translation-block trp-ctx-ocd-150000\">$150,000+<\/option><\/select><\/div><\/div><fieldset id=\"field_84_64\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfVives en los Estados Unidos de Am\u00e9rica o en otro pa\u00eds?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_64'>\n\t\t\t<div class='gchoice gchoice_84_64_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_64' type='radio' value='I live in the United States'  id='choice_84_64_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_64_0' id='label_84_64_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-i-live-in-the-united-states\">I live in the United States<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_64_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_64' type='radio' value='I live in another country'  id='choice_84_64_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_64_1' id='label_84_64_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-i-live-in-another-country\">I live in another country<\/span><\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_84_32\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_84_32'><span class='gform-field-label__text'>Estado<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_32' id='input_84_32' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Alabama'  class=\"translation-block trp-ctx-ocd-alabama\">Alabama<\/option><option value='Alaska'  class=\"translation-block trp-ctx-ocd-alaska\">Alaska<\/option><option value='Arizona'  class=\"translation-block trp-ctx-ocd-arizona\">Arizona<\/option><option value='Arkansas'  class=\"translation-block trp-ctx-ocd-arkansas\">Arkansas<\/option><option value='California'  class=\"translation-block trp-ctx-ocd-california\">California<\/option><option value='Colorado'  class=\"translation-block trp-ctx-ocd-colorado\">Colorado<\/option><option value='Connecticut'  class=\"translation-block trp-ctx-ocd-connecticut\">Connecticut<\/option><option value='Delaware'  class=\"translation-block trp-ctx-ocd-delaware\">Delaware<\/option><option value='District of Columbia'  class=\"translation-block trp-ctx-ocd-district-of-columbia\">Distrito de Columbia<\/option><option value='Florida'  class=\"translation-block trp-ctx-ocd-florida\">Florida<\/option><option value='Georgia'  class=\"translation-block trp-ctx-ocd-georgia\">Georgia<\/option><option value='Hawaii'  class=\"translation-block trp-ctx-ocd-hawaii\">Haw\u00e1i<\/option><option value='Idaho'  class=\"translation-block trp-ctx-ocd-idaho\">Idaho<\/option><option value='Illinois'  class=\"translation-block trp-ctx-ocd-illinois\">Illinois<\/option><option value='Indiana'  class=\"translation-block trp-ctx-ocd-indiana\">Indiana<\/option><option value='Iowa'  class=\"translation-block trp-ctx-ocd-iowa\">Iowa<\/option><option value='Kansas'  class=\"translation-block trp-ctx-ocd-kansas\">Kansas<\/option><option value='Kentucky'  class=\"translation-block trp-ctx-ocd-kentucky\">Kentucky<\/option><option value='Louisiana'  class=\"translation-block trp-ctx-ocd-louisiana\">Luisiana<\/option><option value='Maine'  class=\"translation-block trp-ctx-ocd-maine\">Maine<\/option><option value='Maryland'  class=\"translation-block trp-ctx-ocd-maryland\">Maryland<\/option><option value='Massachusetts'  class=\"translation-block trp-ctx-ocd-massachusetts\">Massachusetts<\/option><option value='Michigan'  class=\"translation-block trp-ctx-ocd-michigan\">M\u00edchigan<\/option><option value='Minnesota'  class=\"translation-block trp-ctx-ocd-minnesota\">Minnesota<\/option><option value='Mississippi'  class=\"translation-block trp-ctx-ocd-mississippi\">Misisipi<\/option><option value='Missouri'  class=\"translation-block trp-ctx-ocd-missouri\">Misuri<\/option><option value='Montana'  class=\"translation-block trp-ctx-ocd-montana\">Montana<\/option><option value='Nebraska'  class=\"translation-block trp-ctx-ocd-nebraska\">Nebraska<\/option><option value='Nevada'  class=\"translation-block trp-ctx-ocd-nevada\">Nevada<\/option><option value='New Hampshire'  class=\"translation-block trp-ctx-ocd-new-hampshire\">Nuevo Hampshire<\/option><option value='New Jersey'  class=\"translation-block trp-ctx-ocd-new-jersey\">Nueva Jersey<\/option><option value='New Mexico'  class=\"translation-block trp-ctx-ocd-new-mexico\">Nuevo M\u00e9xico<\/option><option value='New York'  class=\"translation-block trp-ctx-ocd-new-york\">Nueva York<\/option><option value='North Carolina'  class=\"translation-block trp-ctx-ocd-north-carolina\">Carolina del Norte<\/option><option value='North Dakota'  class=\"translation-block trp-ctx-ocd-north-dakota\">Dakota del Norte<\/option><option value='Ohio'  class=\"translation-block trp-ctx-ocd-ohio\">Ohio<\/option><option value='Oklahoma'  class=\"translation-block trp-ctx-ocd-oklahoma\">Oklahoma<\/option><option value='Oregon'  class=\"translation-block trp-ctx-ocd-oregon\">Oreg\u00f3n<\/option><option value='Pennsylvania'  class=\"translation-block trp-ctx-ocd-pennsylvania\">Pensilvania<\/option><option value='Rhode Island'  class=\"translation-block trp-ctx-ocd-rhode-island\">Rhode Island<\/option><option value='South Carolina'  class=\"translation-block trp-ctx-ocd-south-carolina\">Carolina del Sur<\/option><option value='South Dakota'  class=\"translation-block trp-ctx-ocd-south-dakota\">Dakota del Sur<\/option><option value='Tennessee'  class=\"translation-block trp-ctx-ocd-tennessee\">Tennessee<\/option><option value='Texas'  class=\"translation-block trp-ctx-ocd-texas\">Texas<\/option><option value='Utah'  class=\"translation-block trp-ctx-ocd-utah\">Utah<\/option><option value='Vermont'  class=\"translation-block trp-ctx-ocd-vermont\">Vermont<\/option><option value='Virginia'  class=\"translation-block trp-ctx-ocd-virginia\">Virginia<\/option><option value='Washington'  class=\"translation-block trp-ctx-ocd-washington\">Washington<\/option><option value='West Virginia'  class=\"translation-block trp-ctx-ocd-west-virginia\">Virginia Occidental<\/option><option value='Wisconsin'  class=\"translation-block trp-ctx-ocd-wisconsin\">Wisconsin<\/option><option value='Wyoming'  class=\"translation-block trp-ctx-ocd-wyoming\">Wyoming<\/option><option value='I live in a U.S. Territory'  class=\"translation-block trp-ctx-ocd-i-live-in-a-u-s-territory\">Vivo en un territorio de los Estados Unidos.<\/option><\/select><\/div><\/div><div id=\"field_84_36\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_84_36'><span class='gform-field-label__text'>\u00bfEn qu\u00e9 pa\u00eds vives?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_36' id='input_84_36' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Afghanistan'  class=\"translation-block trp-ctx-ocd-afghanistan\">Afganist\u00e1n<\/option><option value='Albania'  class=\"translation-block trp-ctx-ocd-albania\">Albania<\/option><option value='Algeria'  class=\"translation-block trp-ctx-ocd-algeria\">Argelia<\/option><option value='American Samoa'  class=\"translation-block trp-ctx-ocd-american-samoa\">Samoa Americana<\/option><option value='Andorra'  class=\"translation-block trp-ctx-ocd-andorra\">Andorra<\/option><option value='Angola'  class=\"translation-block trp-ctx-ocd-angola\">Angola<\/option><option value='Anguilla'  class=\"translation-block trp-ctx-ocd-anguilla\">Anguila<\/option><option value='Antarctica'  class=\"translation-block trp-ctx-ocd-antarctica\">Ant\u00e1rtida<\/option><option value='Antigua and Barbuda'  class=\"translation-block trp-ctx-ocd-antigua-and-barbuda\">Antigua y Barbuda<\/option><option value='Argentina'  class=\"translation-block trp-ctx-ocd-argentina\">Argentina<\/option><option value='Armenia'  class=\"translation-block trp-ctx-ocd-armenia\">Armenia<\/option><option value='Aruba'  class=\"translation-block trp-ctx-ocd-aruba\">Aruba<\/option><option value='Australia'  class=\"translation-block trp-ctx-ocd-australia\">Australia<\/option><option value='Austria'  class=\"translation-block trp-ctx-ocd-austria\">Austria<\/option><option value='Azerbaijan'  class=\"translation-block trp-ctx-ocd-azerbaijan\">Azerbaiy\u00e1n<\/option><option value='Bahamas'  class=\"translation-block trp-ctx-ocd-bahamas\">Bahamas<\/option><option value='Bahrain'  class=\"translation-block trp-ctx-ocd-bahrain\">Bahrein<\/option><option value='Bangladesh'  class=\"translation-block trp-ctx-ocd-bangladesh\">Banglad\u00e9s<\/option><option value='Barbados'  class=\"translation-block trp-ctx-ocd-barbados\">Barbados<\/option><option value='Belarus'  class=\"translation-block trp-ctx-ocd-belarus\">Bielorrusia<\/option><option value='Belgium'  class=\"translation-block trp-ctx-ocd-belgium\">B\u00e9lgica<\/option><option value='Belize'  class=\"translation-block trp-ctx-ocd-belize\">Belice<\/option><option value='Benin'  class=\"translation-block trp-ctx-ocd-benin\">Ben\u00edn<\/option><option value='Bermuda'  class=\"translation-block trp-ctx-ocd-bermuda\">Bermudas<\/option><option value='Bhutan'  class=\"translation-block trp-ctx-ocd-bhutan\">But\u00e1n<\/option><option value='Bolivia'  class=\"translation-block trp-ctx-ocd-bolivia\">Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba'  class=\"translation-block trp-ctx-ocd-bonaire-sint-eustatius-and-saba\">Bonaire, San Eustaquio y Saba<\/option><option value='Bosnia and Herzegovina'  class=\"translation-block trp-ctx-ocd-bosnia-and-herzegovina\">Bosnia y Herzegovina<\/option><option value='Botswana'  class=\"translation-block trp-ctx-ocd-botswana\">Botsuana<\/option><option value='Bouvet Island'  class=\"translation-block trp-ctx-ocd-bouvet-island\">Isla Bouvet<\/option><option value='Brazil'  class=\"translation-block trp-ctx-ocd-brazil\">Brasil<\/option><option value='British Indian Ocean Territory'  class=\"translation-block trp-ctx-ocd-british-indian-ocean-territory\">Territorio Brit\u00e1nico del Oc\u00e9ano \u00cdndico<\/option><option value='Brunei Darussalam'  class=\"translation-block trp-ctx-ocd-brunei-darussalam\">Brunei Darussalam<\/option><option value='Bulgaria'  class=\"translation-block trp-ctx-ocd-bulgaria\">Bulgaria<\/option><option value='Burkina Faso'  class=\"translation-block trp-ctx-ocd-burkina-faso\">Burkina Faso<\/option><option value='Burundi'  class=\"translation-block trp-ctx-ocd-burundi\">Burundi<\/option><option value='Cambodia'  class=\"translation-block trp-ctx-ocd-cambodia\">Camboya<\/option><option value='Cameroon'  class=\"translation-block trp-ctx-ocd-cameroon\">Camer\u00fan<\/option><option value='Canada'  class=\"translation-block trp-ctx-ocd-canada\">Canad\u00e1<\/option><option value='Cape Verde'  class=\"translation-block trp-ctx-ocd-cape-verde\">Cabo Verde<\/option><option value='Cayman Islands'  class=\"translation-block trp-ctx-ocd-cayman-islands\">Islas Caim\u00e1n<\/option><option value='Central African Republic'  class=\"translation-block trp-ctx-ocd-central-african-republic\">Rep\u00fablica Centroafricana<\/option><option value='Chad'  class=\"translation-block trp-ctx-ocd-chad\">Chad<\/option><option value='Chile'  class=\"translation-block trp-ctx-ocd-chile\">Chile<\/option><option value='China'  class=\"translation-block trp-ctx-ocd-china\">China<\/option><option value='Christmas Island'  class=\"translation-block trp-ctx-ocd-christmas-island\">Isla de Navidad<\/option><option value='Cocos Islands'  class=\"translation-block trp-ctx-ocd-cocos-islands\">Islas Cocos<\/option><option value='Colombia'  class=\"translation-block trp-ctx-ocd-colombia\">Colombia<\/option><option value='Comoros'  class=\"translation-block trp-ctx-ocd-comoros\">Comoras<\/option><option value='Congo, Democratic Republic of the'  class=\"translation-block trp-ctx-ocd-congo-democratic-republic-of-the\">Rep\u00fablica Democr\u00e1tica del Congo<\/option><option value='Congo, Republic of the'  class=\"translation-block trp-ctx-ocd-congo-republic-of-the\">Rep\u00fablica del Congo<\/option><option value='Cook Islands'  class=\"translation-block trp-ctx-ocd-cook-islands\">Islas Cook<\/option><option value='Costa Rica'  class=\"translation-block trp-ctx-ocd-costa-rica\">Costa Rica<\/option><option value='Croatia'  class=\"translation-block trp-ctx-ocd-croatia\">Croacia<\/option><option value='Cuba'  class=\"translation-block trp-ctx-ocd-cuba\">Cuba<\/option><option value='Cura\u00e7ao'  class=\"translation-block trp-ctx-ocd-curacao\">Curazao<\/option><option value='Cyprus'  class=\"translation-block trp-ctx-ocd-cyprus\">Chipre<\/option><option value='Czech Republic'  class=\"translation-block trp-ctx-ocd-czech-republic\">Rep\u00fablica Checa<\/option><option value='C\u00f4te d&#039;Ivoire'  class=\"translation-block trp-ctx-ocd-cote-divoire\">Costa de Marfil<\/option><option value='Denmark'  class=\"translation-block trp-ctx-ocd-denmark\">Dinamarca<\/option><option value='Djibouti'  class=\"translation-block trp-ctx-ocd-djibouti\">Yibuti<\/option><option value='Dominica'  class=\"translation-block trp-ctx-ocd-dominica\">Dominica<\/option><option value='Dominican Republic'  class=\"translation-block trp-ctx-ocd-dominican-republic\">Rep\u00fablica Dominicana<\/option><option value='Ecuador'  class=\"translation-block trp-ctx-ocd-ecuador\">Ecuador<\/option><option value='Egypt'  class=\"translation-block trp-ctx-ocd-egypt\">Egipto<\/option><option value='El Salvador'  class=\"translation-block trp-ctx-ocd-el-salvador\">El Salvador<\/option><option value='Equatorial Guinea'  class=\"translation-block trp-ctx-ocd-equatorial-guinea\">Guinea Ecuatorial<\/option><option value='Eritrea'  class=\"translation-block trp-ctx-ocd-eritrea\">Eritrea<\/option><option value='Estonia'  class=\"translation-block trp-ctx-ocd-estonia\">Estonia<\/option><option value='Eswatini (Swaziland)'  class=\"translation-block trp-ctx-ocd-eswatini-swaziland\">Esuatini (Suazilandia)<\/option><option value='Ethiopia'  class=\"translation-block trp-ctx-ocd-ethiopia\">Etiop\u00eda<\/option><option value='Falkland Islands'  class=\"translation-block trp-ctx-ocd-falkland-islands\">Islas Malvinas<\/option><option value='Faroe Islands'  class=\"translation-block trp-ctx-ocd-faroe-islands\">Islas Feroe<\/option><option value='Fiji'  class=\"translation-block trp-ctx-ocd-fiji\">Fiji<\/option><option value='Finland'  class=\"translation-block trp-ctx-ocd-finland\">Finlandia<\/option><option value='France'  class=\"translation-block trp-ctx-ocd-france\">Francia<\/option><option value='French Guiana'  class=\"translation-block trp-ctx-ocd-french-guiana\">Guayana Francesa<\/option><option value='French Polynesia'  class=\"translation-block trp-ctx-ocd-french-polynesia\">Polinesia Francesa<\/option><option value='French Southern Territories'  class=\"translation-block trp-ctx-ocd-french-southern-territories\">Territorios Australes Franceses<\/option><option value='Gabon'  class=\"translation-block trp-ctx-ocd-gabon\">Gab\u00f3n<\/option><option value='Gambia'  class=\"translation-block trp-ctx-ocd-gambia\">Gambia<\/option><option value='Georgia'  class=\"translation-block trp-ctx-ocd-georgia\">Georgia<\/option><option value='Germany'  class=\"translation-block trp-ctx-ocd-germany\">Alemania<\/option><option value='Ghana'  class=\"translation-block trp-ctx-ocd-ghana\">Ghana<\/option><option value='Gibraltar'  class=\"translation-block trp-ctx-ocd-gibraltar\">Gibraltar<\/option><option value='Greece'  class=\"translation-block trp-ctx-ocd-greece\">Grecia<\/option><option value='Greenland'  class=\"translation-block trp-ctx-ocd-greenland\">Groenlandia<\/option><option value='Grenada'  class=\"translation-block trp-ctx-ocd-grenada\">Granada<\/option><option value='Guadeloupe'  class=\"translation-block trp-ctx-ocd-guadeloupe\">Guadalupe<\/option><option value='Guam'  class=\"translation-block trp-ctx-ocd-guam\">Guam<\/option><option value='Guatemala'  class=\"translation-block trp-ctx-ocd-guatemala\">Guatemala<\/option><option value='Guernsey'  class=\"translation-block trp-ctx-ocd-guernsey\">Guernsey<\/option><option value='Guinea'  class=\"translation-block trp-ctx-ocd-guinea\">Guinea<\/option><option value='Guinea-Bissau'  class=\"translation-block trp-ctx-ocd-guinea-bissau\">Guinea-Bissau<\/option><option value='Guyana'  class=\"translation-block trp-ctx-ocd-guyana\">Guyana<\/option><option value='Haiti'  class=\"translation-block trp-ctx-ocd-haiti\">Hait\u00ed<\/option><option value='Heard and McDonald Islands'  class=\"translation-block trp-ctx-ocd-heard-and-mcdonald-islands\">Islas Heard y McDonald<\/option><option value='Holy See'  class=\"translation-block trp-ctx-ocd-holy-see\">Santa Sede<\/option><option value='Honduras'  class=\"translation-block trp-ctx-ocd-honduras\">Honduras<\/option><option value='Hong Kong'  class=\"translation-block trp-ctx-ocd-hong-kong\">Hong Kong<\/option><option value='Hungary'  class=\"translation-block trp-ctx-ocd-hungary\">Hungr\u00eda<\/option><option value='Iceland'  class=\"translation-block trp-ctx-ocd-iceland\">Islandia<\/option><option value='India'  class=\"translation-block trp-ctx-ocd-india\">India<\/option><option value='Indonesia'  class=\"translation-block trp-ctx-ocd-indonesia\">Indonesia<\/option><option value='Iran'  class=\"translation-block trp-ctx-ocd-iran\">Ir\u00e1n<\/option><option value='Iraq'  class=\"translation-block trp-ctx-ocd-iraq\">Irak<\/option><option value='Ireland'  class=\"translation-block trp-ctx-ocd-ireland\">Irlanda<\/option><option value='Isle of Man'  class=\"translation-block trp-ctx-ocd-isle-of-man\">Isla de Man<\/option><option value='Israel'  class=\"translation-block trp-ctx-ocd-israel\">Israel<\/option><option value='Italy'  class=\"translation-block trp-ctx-ocd-italy\">Italia<\/option><option value='Jamaica'  class=\"translation-block trp-ctx-ocd-jamaica\">Jamaica<\/option><option value='Japan'  class=\"translation-block trp-ctx-ocd-japan\">Jap\u00f3n<\/option><option value='Jersey'  class=\"translation-block trp-ctx-ocd-jersey\">Jersey<\/option><option value='Jordan'  class=\"translation-block trp-ctx-ocd-jordan\">Jordania<\/option><option value='Kazakhstan'  class=\"translation-block trp-ctx-ocd-kazakhstan\">Kazajist\u00e1n<\/option><option value='Kenya'  class=\"translation-block trp-ctx-ocd-kenya\">Kenia<\/option><option value='Kiribati'  class=\"translation-block trp-ctx-ocd-kiribati\">Kiribati<\/option><option value='Kuwait'  class=\"translation-block trp-ctx-ocd-kuwait\">Kuwait<\/option><option value='Kyrgyzstan'  class=\"translation-block trp-ctx-ocd-kyrgyzstan\">Kirguist\u00e1n<\/option><option value='Lao People&#039;s Democratic Republic'  class=\"translation-block trp-ctx-ocd-lao-peoples-democratic-republic\">Rep\u00fablica Democr\u00e1tica Popular Lao<\/option><option value='Latvia'  class=\"translation-block trp-ctx-ocd-latvia\">Letonia<\/option><option value='Lebanon'  class=\"translation-block trp-ctx-ocd-lebanon\">L\u00edbano<\/option><option value='Lesotho'  class=\"translation-block trp-ctx-ocd-lesotho\">Lesoto<\/option><option value='Liberia'  class=\"translation-block trp-ctx-ocd-liberia\">Liberia<\/option><option value='Libya'  class=\"translation-block trp-ctx-ocd-libya\">Libia<\/option><option value='Liechtenstein'  class=\"translation-block trp-ctx-ocd-liechtenstein\">Liechtenstein<\/option><option value='Lithuania'  class=\"translation-block trp-ctx-ocd-lithuania\">Lituania<\/option><option value='Luxembourg'  class=\"translation-block trp-ctx-ocd-luxembourg\">Luxemburgo<\/option><option value='Macau'  class=\"translation-block trp-ctx-ocd-macau\">Macao<\/option><option value='Macedonia'  class=\"translation-block trp-ctx-ocd-macedonia\">Macedonia<\/option><option value='Madagascar'  class=\"translation-block trp-ctx-ocd-madagascar\">Madagascar<\/option><option value='Malawi'  class=\"translation-block trp-ctx-ocd-malawi\">Malaui<\/option><option value='Malaysia'  class=\"translation-block trp-ctx-ocd-malaysia\">Malasia<\/option><option value='Maldives'  class=\"translation-block trp-ctx-ocd-maldives\">Maldivas<\/option><option value='Mali'  class=\"translation-block trp-ctx-ocd-mali\">Mal\u00ed<\/option><option value='Malta'  class=\"translation-block trp-ctx-ocd-malta\">Malta<\/option><option value='Marshall Islands'  class=\"translation-block trp-ctx-ocd-marshall-islands\">Islas Marshall<\/option><option value='Martinique'  class=\"translation-block trp-ctx-ocd-martinique\">Martinica<\/option><option value='Mauritania'  class=\"translation-block trp-ctx-ocd-mauritania\">Mauritania<\/option><option value='Mauritius'  class=\"translation-block trp-ctx-ocd-mauritius\">Mauricio<\/option><option value='Mayotte'  class=\"translation-block trp-ctx-ocd-mayotte\">Mayotte<\/option><option value='Mexico'  class=\"translation-block trp-ctx-ocd-mexico\">M\u00e9xico<\/option><option value='Micronesia'  class=\"translation-block trp-ctx-ocd-micronesia\">Micronesia<\/option><option value='Moldova'  class=\"translation-block trp-ctx-ocd-moldova\">Moldavia<\/option><option value='Monaco'  class=\"translation-block trp-ctx-ocd-monaco\">M\u00f3naco<\/option><option value='Mongolia'  class=\"translation-block trp-ctx-ocd-mongolia\">Mongolia<\/option><option value='Montenegro'  class=\"translation-block trp-ctx-ocd-montenegro\">Montenegro<\/option><option value='Montserrat'  class=\"translation-block trp-ctx-ocd-montserrat\">Montserrat<\/option><option value='Morocco'  class=\"translation-block trp-ctx-ocd-morocco\">Marruecos<\/option><option value='Mozambique'  class=\"translation-block trp-ctx-ocd-mozambique\">Mozambique<\/option><option value='Myanmar'  class=\"translation-block trp-ctx-ocd-myanmar\">Myanmar<\/option><option value='Namibia'  class=\"translation-block trp-ctx-ocd-namibia\">Namibia<\/option><option value='Nauru'  class=\"translation-block trp-ctx-ocd-nauru\">Nauru<\/option><option value='Nepal'  class=\"translation-block trp-ctx-ocd-nepal\">Nepal<\/option><option value='Netherlands'  class=\"translation-block trp-ctx-ocd-netherlands\">Pa\u00edses Bajos<\/option><option value='New Caledonia'  class=\"translation-block trp-ctx-ocd-new-caledonia\">Nueva Caledonia<\/option><option value='New Zealand'  class=\"translation-block trp-ctx-ocd-new-zealand\">Nueva Zelanda<\/option><option value='Nicaragua'  class=\"translation-block trp-ctx-ocd-nicaragua\">Nicaragua<\/option><option value='Niger'  class=\"translation-block trp-ctx-ocd-niger\">N\u00edger<\/option><option value='Nigeria'  class=\"translation-block trp-ctx-ocd-nigeria\">Nigeria<\/option><option value='Niue'  class=\"translation-block trp-ctx-ocd-niue\">Niue<\/option><option value='Norfolk Island'  class=\"translation-block trp-ctx-ocd-norfolk-island\">Isla Norfolk<\/option><option value='North Korea'  class=\"translation-block trp-ctx-ocd-north-korea\">Corea del Norte<\/option><option value='Northern Mariana Islands'  class=\"translation-block trp-ctx-ocd-northern-mariana-islands\">Islas Marianas del Norte<\/option><option value='Norway'  class=\"translation-block trp-ctx-ocd-norway\">Noruega<\/option><option value='Oman'  class=\"translation-block trp-ctx-ocd-oman\">Om\u00e1n<\/option><option value='Pakistan'  class=\"translation-block trp-ctx-ocd-pakistan\">Pakist\u00e1n<\/option><option value='Palau'  class=\"translation-block trp-ctx-ocd-palau\">Palau<\/option><option value='Palestine, State of'  class=\"translation-block trp-ctx-ocd-palestine-state-of\">Palestina, Estado de<\/option><option value='Panama'  class=\"translation-block trp-ctx-ocd-panama\">Panam\u00e1<\/option><option value='Papua New Guinea'  class=\"translation-block trp-ctx-ocd-papua-new-guinea\">Pap\u00faa Nueva Guinea<\/option><option value='Paraguay'  class=\"translation-block trp-ctx-ocd-paraguay\">Paraguay<\/option><option value='Peru'  class=\"translation-block trp-ctx-ocd-peru\">Per\u00fa<\/option><option value='Philippines'  class=\"translation-block trp-ctx-ocd-philippines\">Filipinas<\/option><option value='Pitcairn'  class=\"translation-block trp-ctx-ocd-pitcairn\">Pitcairn<\/option><option value='Poland'  class=\"translation-block trp-ctx-ocd-poland\">Polonia<\/option><option value='Portugal'  class=\"translation-block trp-ctx-ocd-portugal\">Portugal<\/option><option value='Puerto Rico'  class=\"translation-block trp-ctx-ocd-puerto-rico\">Puerto Rico<\/option><option value='Qatar'  class=\"translation-block trp-ctx-ocd-qatar\">Qatar<\/option><option value='Romania'  class=\"translation-block trp-ctx-ocd-romania\">Rumania<\/option><option value='Russia'  class=\"translation-block trp-ctx-ocd-russia\">Rusia<\/option><option value='Rwanda'  class=\"translation-block trp-ctx-ocd-rwanda\">Ruanda<\/option><option value='R\u00e9union'  class=\"translation-block trp-ctx-ocd-reunion\">Reuni\u00f3n<\/option><option value='Saint Barth\u00e9lemy'  class=\"translation-block trp-ctx-ocd-saint-barthelemy\">San Bartolom\u00e9<\/option><option value='Saint Helena'  class=\"translation-block trp-ctx-ocd-saint-helena\">Santa Elena<\/option><option value='Saint Kitts and Nevis'  class=\"translation-block trp-ctx-ocd-saint-kitts-and-nevis\">San Crist\u00f3bal y Nieves<\/option><option value='Saint Lucia'  class=\"translation-block trp-ctx-ocd-saint-lucia\">Santa Luc\u00eda<\/option><option value='Saint Martin'  class=\"translation-block trp-ctx-ocd-saint-martin\">San Mart\u00edn<\/option><option value='Saint Pierre and Miquelon'  class=\"translation-block trp-ctx-ocd-saint-pierre-and-miquelon\">San Pedro y Miquel\u00f3n<\/option><option value='Saint Vincent and the Grenadines'  class=\"translation-block trp-ctx-ocd-saint-vincent-and-the-grenadines\">San Vicente y las Granadinas<\/option><option value='Samoa'  class=\"translation-block trp-ctx-ocd-samoa\">Samoa<\/option><option value='San Marino'  class=\"translation-block trp-ctx-ocd-san-marino\">San Marino<\/option><option value='Sao Tome and Principe'  class=\"translation-block trp-ctx-ocd-sao-tome-and-principe\">Santo Tom\u00e9 y Pr\u00edncipe<\/option><option value='Saudi Arabia'  class=\"translation-block trp-ctx-ocd-saudi-arabia\">Arabia Saudita<\/option><option value='Senegal'  class=\"translation-block trp-ctx-ocd-senegal\">Senegal<\/option><option value='Serbia'  class=\"translation-block trp-ctx-ocd-serbia\">Serbia<\/option><option value='Seychelles'  class=\"translation-block trp-ctx-ocd-seychelles\">Seychelles<\/option><option value='Sierra Leone'  class=\"translation-block trp-ctx-ocd-sierra-leone\">Sierra Leona<\/option><option value='Singapore'  class=\"translation-block trp-ctx-ocd-singapore\">Singapur<\/option><option value='Sint Maarten'  class=\"translation-block trp-ctx-ocd-sint-maarten\">San Mart\u00edn<\/option><option value='Slovakia'  class=\"translation-block trp-ctx-ocd-slovakia\">Eslovaquia<\/option><option value='Slovenia'  class=\"translation-block trp-ctx-ocd-slovenia\">Eslovenia<\/option><option value='Solomon Islands'  class=\"translation-block trp-ctx-ocd-solomon-islands\">Islas Salom\u00f3n<\/option><option value='Somalia'  class=\"translation-block trp-ctx-ocd-somalia\">Somalia<\/option><option value='South Africa'  class=\"translation-block trp-ctx-ocd-south-africa\">Sud\u00e1frica<\/option><option value='South Georgia'  class=\"translation-block trp-ctx-ocd-south-georgia\">Georgia del Sur<\/option><option value='South Korea'  class=\"translation-block trp-ctx-ocd-south-korea\">Corea del Sur<\/option><option value='South Sudan'  class=\"translation-block trp-ctx-ocd-south-sudan\">Sud\u00e1n del Sur<\/option><option value='Spain'  class=\"translation-block trp-ctx-ocd-spain\">Espa\u00f1a<\/option><option value='Sri Lanka'  class=\"translation-block trp-ctx-ocd-sri-lanka\">Sri Lanka<\/option><option value='Sudan'  class=\"translation-block trp-ctx-ocd-sudan\">Sud\u00e1n<\/option><option value='Suriname'  class=\"translation-block trp-ctx-ocd-suriname\">Surinam<\/option><option value='Svalbard and Jan Mayen Islands'  class=\"translation-block trp-ctx-ocd-svalbard-and-jan-mayen-islands\">Islas Svalbard y Jan Mayen<\/option><option value='Sweden'  class=\"translation-block trp-ctx-ocd-sweden\">Suecia<\/option><option value='Switzerland'  class=\"translation-block trp-ctx-ocd-switzerland\">Suiza<\/option><option value='Syria'  class=\"translation-block trp-ctx-ocd-syria\">Siria<\/option><option value='Taiwan'  class=\"translation-block trp-ctx-ocd-taiwan\">Taiw\u00e1n<\/option><option value='Tajikistan'  class=\"translation-block trp-ctx-ocd-tajikistan\">Tayikist\u00e1n<\/option><option value='Tanzania'  class=\"translation-block trp-ctx-ocd-tanzania\">Tanzania<\/option><option value='Thailand'  class=\"translation-block trp-ctx-ocd-thailand\">Tailandia<\/option><option value='Timor-Leste'  class=\"translation-block trp-ctx-ocd-timor-leste\">Timor Oriental<\/option><option value='Togo'  class=\"translation-block trp-ctx-ocd-togo\">Togo<\/option><option value='Tokelau'  class=\"translation-block trp-ctx-ocd-tokelau\">Tokelau<\/option><option value='Tonga'  class=\"translation-block trp-ctx-ocd-tonga\">Tonga<\/option><option value='Trinidad and Tobago'  class=\"translation-block trp-ctx-ocd-trinidad-and-tobago\">Trinidad y Tobago<\/option><option value='Tunisia'  class=\"translation-block trp-ctx-ocd-tunisia\">T\u00fanez<\/option><option value='Turkey'  class=\"translation-block trp-ctx-ocd-turkey\">Turqu\u00eda<\/option><option value='Turkmenistan'  class=\"translation-block trp-ctx-ocd-turkmenistan\">Turkmenist\u00e1n<\/option><option value='Turks and Caicos Islands'  class=\"translation-block trp-ctx-ocd-turks-and-caicos-islands\">Islas Turcas y Caicos<\/option><option value='Tuvalu'  class=\"translation-block trp-ctx-ocd-tuvalu\">Tuvalu<\/option><option value='US Minor Outlying Islands'  class=\"translation-block trp-ctx-ocd-us-minor-outlying-islands\">Islas menores alejadas de los Estados Unidos<\/option><option value='Uganda'  class=\"translation-block trp-ctx-ocd-uganda\">Uganda<\/option><option value='Ukraine'  class=\"translation-block trp-ctx-ocd-ukraine\">Ucrania<\/option><option value='United Arab Emirates'  class=\"translation-block trp-ctx-ocd-united-arab-emirates\">Emiratos \u00c1rabes Unidos<\/option><option value='United Kingdom'  class=\"translation-block trp-ctx-ocd-united-kingdom\">Reino Unido<\/option><option value='Uruguay'  class=\"translation-block trp-ctx-ocd-uruguay\">Uruguay<\/option><option value='Uzbekistan'  class=\"translation-block trp-ctx-ocd-uzbekistan\">Uzbekist\u00e1n<\/option><option value='Vanuatu'  class=\"translation-block trp-ctx-ocd-vanuatu\">Vanuatu<\/option><option value='Venezuela'  class=\"translation-block trp-ctx-ocd-venezuela\">Venezuela<\/option><option value='Vietnam'  class=\"translation-block trp-ctx-ocd-vietnam\">Vietnam<\/option><option value='Virgin Islands, British'  class=\"translation-block trp-ctx-ocd-virgin-islands-british\">Islas V\u00edrgenes Brit\u00e1nicas<\/option><option value='Virgin Islands, U.S.'  class=\"translation-block trp-ctx-ocd-virgin-islands-u-s\">Islas V\u00edrgenes de los Estados Unidos.<\/option><option value='Wallis and Futuna'  class=\"translation-block trp-ctx-ocd-wallis-and-futuna\">Wallis y Futuna<\/option><option value='Western Sahara'  class=\"translation-block trp-ctx-ocd-western-sahara\">S\u00e1hara Occidental<\/option><option value='Yemen'  class=\"translation-block trp-ctx-ocd-yemen\">Yemen<\/option><option value='Zambia'  class=\"translation-block trp-ctx-ocd-zambia\">Zambia<\/option><option value='Zimbabwe'  class=\"translation-block trp-ctx-ocd-zimbabwe\">Zimbabue<\/option><option value='\u00c5land Islands'  class=\"translation-block trp-ctx-ocd-aland-islands\">Islas \u00c5land<\/option><\/select><\/div><\/div><div id=\"field_84_34\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_84_34'><span class='gform-field-label__text'>C\u00f3digo postal<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_34' id='input_84_34' type='text' value='' class='small'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_84_28\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox optional traditional field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfCu\u00e1l de las siguientes poblaciones te describe?<\/span><\/legend><div class='gfield_description' id='gfield_description_84_28'>Selecciona todas las opciones que apliquen.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_84_28'><div class='gchoice gchoice_84_28_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.1' type='checkbox'  value='Veteran or active-duty military'  id='choice_84_28_1'   aria-describedby=\"gfield_description_84_28\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_84_28_1' id='label_84_28_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-veteran-or-active-duty-military\">Veteran or active-duty military<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_28_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.2' type='checkbox'  value='Caregiver of someone living with emotional or physical illness'  id='choice_84_28_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_28_2' id='label_84_28_2' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-caregiver-of-someone-living-with-emotional-or-physical-illness\">Caregiver of someone living with emotional or physical illness<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_28_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.3' type='checkbox'  value='LGBTQ+'  id='choice_84_28_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_28_3' id='label_84_28_3' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-lgbtq\">LGBTQ+<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_28_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.4' type='checkbox'  value='Student'  id='choice_84_28_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_28_4' id='label_84_28_4' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-student\">Student<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_28_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.5' type='checkbox'  value='Trauma survivor'  id='choice_84_28_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_28_5' id='label_84_28_5' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-trauma-survivor\">Trauma survivor<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_28_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.6' type='checkbox'  value='New or expecting parent'  id='choice_84_28_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_28_6' id='label_84_28_6' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-new-or-expecting-parent\">New or expecting parent<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_28_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.7' type='checkbox'  value='Healthcare worker'  id='choice_84_28_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_28_7' id='label_84_28_7' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-healthcare-worker\">Healthcare worker<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_65\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full traditional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfCuidas a alguien con una enfermedad mental o f\u00edsica?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_65'>\n\t\t\t<div class='gchoice gchoice_84_65_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_65' type='radio' value='Mental health condition'  id='choice_84_65_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_65_0' id='label_84_65_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-mental-health-condition\">Mental health condition<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_65_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_65' type='radio' value='Physical health condition'  id='choice_84_65_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_65_1' id='label_84_65_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-physical-health-condition\">Physical health condition<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_65_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_65' type='radio' value='Both mental and physical health conditions'  id='choice_84_65_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_65_2' id='label_84_65_2' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-both-mental-and-physical-health-conditions\">Both mental and physical health conditions<\/span><\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_84_66\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_84_66'><span class='gform-field-label__text'>\u00bfCu\u00e1l de las siguientes opciones describe mejor tu orientaci\u00f3n sexual?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_66' id='input_84_66' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Lesbian or Gay'  class=\"translation-block trp-ctx-ocd-lesbian-or-gay\">Lesbiana o gay<\/option><option value='Bisexual'  class=\"translation-block trp-ctx-ocd-bisexual\">Bisexual<\/option><option value='Queer'  class=\"translation-block trp-ctx-ocd-queer\">Queer<\/option><option value='Pansexual'  class=\"translation-block trp-ctx-ocd-pansexual\">Pansexual<\/option><option value='Asexual'  class=\"translation-block trp-ctx-ocd-asexual\">Asexual<\/option><option value='Straight'  class=\"translation-block trp-ctx-ocd-straight\">Heterosexual<\/option><option value='Other...'  class=\"translation-block trp-ctx-ocd-other\">Otros...<\/option><\/select><\/div><\/div><div id=\"field_84_50\" class=\"gfield gfield--type-text gfield--input-type-text optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_84_50'><span class='gform-field-label__text'>\u00bfCu\u00e1l es tu orientaci\u00f3n sexual?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_50' id='input_84_50' type='text' value='' class='small'    placeholder='Ingresa la orientaci\u00f3n sexual...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_84_67\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfCu\u00e1l de las siguientes opciones describe tu experiencia con el trauma?<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_84_67'><div class='gchoice gchoice_84_67_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_67.1' type='checkbox'  value='Child abuse\/violence'  id='choice_84_67_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_67_1' id='label_84_67_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-child-abuse-violence\">Child abuse\/violence<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_67_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_67.2' type='checkbox'  value='Intimate partner violence'  id='choice_84_67_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_67_2' id='label_84_67_2' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-intimate-partner-violence\">Intimate partner violence<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_67_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_67.3' type='checkbox'  value='Sexual assault\/violence'  id='choice_84_67_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_67_3' id='label_84_67_3' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-sexual-assault-violence\">Sexual assault\/violence<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_67_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_67.4' type='checkbox'  value='Serious illness\/injury\/assault'  id='choice_84_67_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_67_4' id='label_84_67_4' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-serious-illness-injury-assault\">Serious illness\/injury\/assault<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_67_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_67.5' type='checkbox'  value='Family conflict (identity acceptance\/separation\/divorce)'  id='choice_84_67_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_67_5' id='label_84_67_5' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-family-conflict-identity-acceptance-separation-divorce\">Family conflict (identity acceptance\/separation\/divorce)<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_67_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_67.6' type='checkbox'  value='Traumatic event (natural disaster, accident, witnessing violence, etc.)'  id='choice_84_67_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_67_6' id='label_84_67_6' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-traumatic-event-natural-disaster-accident-witnessing-violence-etc\">Traumatic event (natural disaster, accident, witnessing violence, etc.)<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_67_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_67.7' type='checkbox'  value='Death of a loved one'  id='choice_84_67_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_67_7' id='label_84_67_7' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-death-of-a-loved-one\">Death of a loved one<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_67_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_67.8' type='checkbox'  value='Other and\/or tell us more about your trauma'  id='choice_84_67_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_67_8' id='label_84_67_8' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-other-and-or-tell-us-more-about-your-trauma\">Other and\/or tell us more about your trauma<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_84_68\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_84_68'><span class='gform-field-label__text'>Cu\u00e9ntanos m\u00e1s sobre tu experiencia con el trauma:<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_68' id='input_84_68' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_84_43\" class=\"gfield gfield--type-html gfield--input-type-html section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>Acerca de tu salud mental<\/h2><\/div><fieldset id=\"field_84_25\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfAlguna vez has recibido tratamiento o apoyo por un problema de salud mental?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_25'>\n\t\t\t<div class='gchoice gchoice_84_25_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='Yes'  id='choice_84_25_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_25_0' id='label_84_25_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-yes\">Yes<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_25_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='No'  id='choice_84_25_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_25_1' id='label_84_25_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-no\">No<\/span><\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_57\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full optional short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfEst\u00e1s recibiendo tratamiento o apoyo actualmente?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_57'>\n\t\t\t<div class='gchoice gchoice_84_57_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_57' type='radio' value='Yes'  id='choice_84_57_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_57_0' id='label_84_57_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-yes\">Yes<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_57_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_57' type='radio' value='No'  id='choice_84_57_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_57_1' id='label_84_57_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-no\">No<\/span><\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_134\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full optional traditional limit-3 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfQu\u00e9 te ha impedido buscar tratamiento en el pasado?<\/span><\/legend><div class='gfield_description' id='gfield_description_84_134'>Selecciona hasta 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_84_134'><div class='gchoice gchoice_84_134_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_134.1' type='checkbox'  value='I wanted to handle my mental health on my own'  id='choice_84_134_1'   aria-describedby=\"gfield_description_84_134\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_84_134_1' id='label_84_134_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-i-wanted-to-handle-my-mental-health-on-my-own\">I wanted to handle my mental health on my own<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_134_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_134.2' type='checkbox'  value='I didn\u2019t know how or where to start'  id='choice_84_134_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_134_2' id='label_84_134_2' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-i-didnt-know-how-or-where-to-start\">I didn\u2019t know how or where to start<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_134_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_134.3' type='checkbox'  value='I thought it would cost too much'  id='choice_84_134_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_134_3' id='label_84_134_3' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-i-thought-it-would-cost-too-much\">I thought it would cost too much<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_134_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_134.4' type='checkbox'  value='I didn\u2019t have time'  id='choice_84_134_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_134_4' id='label_84_134_4' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-i-didnt-have-time\">I didn\u2019t have time<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_134_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_134.5' type='checkbox'  value='I didn\u2019t think it would help me'  id='choice_84_134_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_134_5' id='label_84_134_5' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-i-didnt-think-it-would-help-me\">I didn\u2019t think it would help me<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_134_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_134.6' type='checkbox'  value='I didn&#039;t feel ready to start treatment'  id='choice_84_134_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_134_6' id='label_84_134_6' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-i-didnt-feel-ready-to-start-treatment\">I didn't feel ready to start treatment<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_134_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_134.7' type='checkbox'  value='I was worried about what people would think or say if I got treatment'  id='choice_84_134_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_134_7' id='label_84_134_7' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-i-was-worried-about-what-people-would-think-or-say-if-i-got-treatment\">I was worried about what people would think or say if I got treatment<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_134_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_134.8' type='checkbox'  value='I was afraid of being forced into a hospital or forced to take medication'  id='choice_84_134_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_134_8' id='label_84_134_8' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-i-was-afraid-of-being-forced-into-a-hospital-or-forced-to-take-medication\">I was afraid of being forced into a hospital or forced to take medication<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_134_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_134.9' type='checkbox'  value='I tried, but couldn\u2019t find available treatment (no openings, wouldn\u2019t take insurance, etc.)'  id='choice_84_134_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_134_9' id='label_84_134_9' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-i-tried-but-couldnt-find-available-treatment-no-openings-wouldnt-take-insurance-etc\">I tried, but couldn\u2019t find available treatment (no openings, wouldn\u2019t take insurance, etc.)<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_134_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_134.11' type='checkbox'  value='My parent(s) or guardian wouldn&#039;t let me, or I didn&#039;t want to ask'  id='choice_84_134_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_134_11' id='label_84_134_11' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-my-parents-or-guardian-wouldnt-let-me-or-i-didnt-want-to-ask\">My parent(s) or guardian wouldn't let me, or I didn't want to ask<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_134_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_134.12' type='checkbox'  value='Other...'  id='choice_84_134_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_134_12' id='label_84_134_12' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-other\">Other...<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_84_135\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_84_135'><span class='gform-field-label__text'>\u00bfQu\u00e9 otras cosas te han impedido buscar tratamiento en el pasado?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_135' id='input_84_135' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_84_26\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox optional traditional limit-3 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Piensa en tu prueba de salud mental. \u00bfCu\u00e1les son los principales factores que contribuyen a tus problemas de salud mental en este momento?<\/span><\/legend><div class='gfield_description' id='gfield_description_84_26'>Selecciona hasta 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_84_26'><div class='gchoice gchoice_84_26_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.1' type='checkbox'  value='Abuse or violence'  id='choice_84_26_1'   aria-describedby=\"gfield_description_84_26\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_84_26_1' id='label_84_26_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-abuse-or-violence\">Abuse or violence<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_26_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.2' type='checkbox'  value='Relationship problems (friends, family, or significant other)'  id='choice_84_26_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_26_2' id='label_84_26_2' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-relationship-problems-friends-family-or-significant-other\">Relationship problems (friends, family, or significant other)<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_26_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.3' type='checkbox'  value='Body image'  id='choice_84_26_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_26_3' id='label_84_26_3' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-body-image\">Body image<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_26_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.4' type='checkbox'  value='Low self-esteem or self-image'  id='choice_84_26_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_26_4' id='label_84_26_4' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-low-self-esteem-or-self-image\">Low self-esteem or self-image<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_26_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.5' type='checkbox'  value='School or work problems'  id='choice_84_26_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_26_5' id='label_84_26_5' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-school-or-work-problems\">School or work problems<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_26_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.6' type='checkbox'  value='Financial problems'  id='choice_84_26_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_26_6' id='label_84_26_6' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-financial-problems\">Financial problems<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_26_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.7' type='checkbox'  value='Loneliness or isolation'  id='choice_84_26_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_26_7' id='label_84_26_7' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-loneliness-or-isolation\">Loneliness or isolation<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_26_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.8' type='checkbox'  value='Grief or loss of someone or something'  id='choice_84_26_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_26_8' id='label_84_26_8' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-grief-or-loss-of-someone-or-something\">Grief or loss of someone or something<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_26_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.9' type='checkbox'  value='Experiencing hate\/bullying (including racism, homophobia, transphobia, or discrimination)'  id='choice_84_26_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_26_9' id='label_84_26_9' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-experiencing-hate-bullying-including-racism-homophobia-transphobia-or-discrimination\">Experiencing hate\/bullying (including racism, homophobia, transphobia, or discrimination)<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_26_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.11' type='checkbox'  value='State of the world (war, climate, politics, immigration)'  id='choice_84_26_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_26_11' id='label_84_26_11' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-state-of-the-world-war-climate-politics-immigration\">State of the world (war, climate, politics, immigration)<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_26_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.12' type='checkbox'  value='I don\u2019t know (something just feels wrong)'  id='choice_84_26_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_26_12' id='label_84_26_12' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-i-dont-know-something-just-feels-wrong\">I don\u2019t know (something just feels wrong)<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_26_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.13' type='checkbox'  value='Other...'  id='choice_84_26_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_26_13' id='label_84_26_13' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-other\">Other...<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_84_27\" class=\"gfield gfield--type-text gfield--input-type-text optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_84_27'><span class='gform-field-label__text'>\u00bfQu\u00e9 m\u00e1s est\u00e1 contribuyendo a tus problemas de salud mental en este momento?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_27' id='input_84_27' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_84_74\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_84_74'><span class='gform-field-label__text'>\u00bfQu\u00e9 aspecto de la situaci\u00f3n mundial te afecta m\u00e1s?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_74' id='input_84_74' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_84_44\" class=\"gfield gfield--type-html gfield--input-type-html section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>Acerca de tu salud<\/h2><\/div><fieldset id=\"field_84_29\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTienes actualmente un seguro m\u00e9dico?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_84_29'>\n\t\t\t<div class='gchoice gchoice_84_29_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='Yes'  id='choice_84_29_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_29_0' id='label_84_29_0' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-yes\">Yes<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_29_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='No'  id='choice_84_29_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_29_1' id='label_84_29_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-no\">No<\/span><\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_84_29_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='I don&#039;t know'  id='choice_84_29_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_84_29_2' id='label_84_29_2' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-i-dont-know\">I don't know<\/span><\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_84_30\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox optional traditional field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfTienes alguna de las siguientes condiciones f\u00edsicas?<\/span><\/legend><div class='gfield_description' id='gfield_description_84_30'>Selecciona todas las opciones que apliquen.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_84_30'><div class='gchoice gchoice_84_30_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.1' type='checkbox'  value='Heart disease'  id='choice_84_30_1'   aria-describedby=\"gfield_description_84_30\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_84_30_1' id='label_84_30_1' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-heart-disease\">Heart disease<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_30_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.2' type='checkbox'  value='Reproductive health concerns (PCOS, endometriosis, infertility, etc.)'  id='choice_84_30_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_30_2' id='label_84_30_2' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-reproductive-health-concerns-pcos-endometriosis-infertility-etc\">Reproductive health concerns (PCOS, endometriosis, infertility, etc.)<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_30_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.3' type='checkbox'  value='Diabetes'  id='choice_84_30_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_30_3' id='label_84_30_3' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-diabetes\">Diabetes<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_30_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.4' type='checkbox'  value='Cancer'  id='choice_84_30_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_30_4' id='label_84_30_4' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-cancer\">Cancer<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_30_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.5' type='checkbox'  value='Arthritis or other chronic pain'  id='choice_84_30_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_30_5' id='label_84_30_5' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-arthritis-or-other-chronic-pain\">Arthritis or other chronic pain<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_30_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.6' type='checkbox'  value='Asthma, COPD or other lung conditions'  id='choice_84_30_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_84_30_6' id='label_84_30_6' class='gform-field-label gform-field-label--type-inline'><span class=\"translation-block\"><span class=\"trp-ctx-ocd-asthma-copd-or-other-lung-conditions\">Asthma, COPD or other lung conditions<\/span><\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_84_30_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.7' type='checkbox'  value='Movement Disorders (involuntary tics, tardive dyskinesia, etc.)'  id='choice_84_30_7'   \/>\n\t\t\t\t\t\t\t\t<label 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gfield--input-type-text optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_84_31'><span class='gform-field-label__text'>\u00bfQu\u00e9 otras condiciones f\u00edsicas tienes?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_31' id='input_84_31' type='text' value='' class='large'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_84_131\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTienes una mascota que te ayuda a cuidar tu salud mental?<\/span><\/legend><div 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\/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_84' id='gform_target_page_number_84' value='2' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_84' id='gform_source_page_number_84' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n             <\/div><\/div>\n                        <input type=\"hidden\" name=\"trp-form-language\" value=\"es\"\/><\/form>\n                        <\/div>\n<p>&nbsp;<\/p>\n<hr \/>\n<h2 class=\"smaller\">Fuente:<\/h2>\n<div class=\"references\">\n<p>Cuestionario obsesivo-compulsivo \u2013 revisado (OCI-R)<\/p>\n<p>Foa et al. (2002). El Inventario Obsesivo-Compulsivo: desarrollo y validaci\u00f3n de una versi\u00f3n breve. <em>Evaluaci\u00f3n psicol\u00f3gica 14<\/em>(4), pp. 485-495. Obtenido de <a href=\"https:\/\/doi.org\/10.1037\/\/1040-3590.14.4.485\">https:\/\/doi.org\/10.1037\/\/1040-3590.14.4.485<\/a><\/p>\n<p><a href=\"https:\/\/screening.mhanational.org\/es\/about-our-mental-health-tests\/\" target=\"_blank\" rel=\"noopener\">Para aprender m\u00e1s sobre nuestras herramientas de detecci\u00f3n, haz clic aqu\u00ed.<\/a><\/p>\n<p><strong><em>Ten en cuenta:<\/em><\/strong><em> Las herramientas de evaluaci\u00f3n en l\u00ednea no son instrumentos de diagn\u00f3stico. Te recomendamos que compartas tus resultados con un m\u00e9dico o profesional de la salud. Mental Health America Inc., sus patrocinadores, socios y anunciantes no se hacen responsables de ninguna responsabilidad, p\u00e9rdida o riesgo que se derive, directa o indirectamente, del uso y la aplicaci\u00f3n de estas evaluaciones.<\/em><\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Para personas cuyos pensamientos y comportamientos repetitivos interfieren en su vida cotidiana. Tambi\u00e9n eval\u00faa el trastorno de acumulaci\u00f3n compulsiva.<\/p>","protected":false},"template":"","tags":[],"age_group":[],"condition":[109],"class_list":["post-245905","screen","type-screen","status-publish","hentry","condition-ocd"],"acf":[],"yoast_head":"<title>OCD Test &#8211; Obsessive-Compulsive Disorder &#8211; Mental Health America<\/title>\n<meta name=\"description\" content=\"Getting stuck in obsessive thoughts and behaviors? Our online OCD test is free, quick, confidential, and scientifically validated.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/screening.mhanational.org\/es\/screening-tools\/ocd\/\" \/>\n<meta property=\"og:locale\" content=\"es_MX\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"OCD Test &#8211; Mental Health America\" \/>\n<meta property=\"og:description\" content=\"Getting stuck in obsessive thoughts and behaviors? Our online OCD test is free, quick, confidential, and scientifically validated.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/screening.mhanational.org\/es\/screening-tools\/ocd\/\" \/>\n<meta property=\"og:site_name\" content=\"Mental Health America\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/mentalhealthamerica\" \/>\n<meta property=\"article:modified_time\" content=\"2026-05-15T19:37:49+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/screening.mhanational.org\/wp-content\/uploads\/2022\/04\/Social-media-share-preview.png\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"631\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:title\" content=\"OCD Test &#8211; Mental Health America\" \/>\n<meta name=\"twitter:description\" content=\"Getting stuck in obsessive thoughts and behaviors? Our online OCD test is free, quick, confidential, and scientifically validated.\" \/>\n<meta name=\"twitter:site\" content=\"@mentalhealtham\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"3 minutos\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/screening.mhanational.org\\\/screening-tools\\\/ocd\\\/\",\"url\":\"https:\\\/\\\/screening.mhanational.org\\\/screening-tools\\\/ocd\\\/\",\"name\":\"OCD Test &#8211; Obsessive-Compulsive Disorder &#8211; Mental Health America\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/screening.mhanational.org\\\/#website\"},\"datePublished\":\"2025-08-14T18:18:22+00:00\",\"dateModified\":\"2026-05-15T19:37:49+00:00\",\"description\":\"Getting stuck in obsessive thoughts and behaviors? 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Nuestra prueba de TOC en l\u00ednea es gratuita, r\u00e1pida, confidencial y est\u00e1 validada cient\u00edficamente.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/screening.mhanational.org\/es\/screening-tools\/ocd\/","og_locale":"es_MX","og_type":"article","og_title":"OCD Test &#8211; Mental Health America","og_description":"Getting stuck in obsessive thoughts and behaviors? 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de adicci\u00f3n al juego \/ las apuestas"},"content":{"rendered":"<div class='gf_browser_chrome gform_wrapper gravity-theme gform-theme--no-framework full-pager_wrapper' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_82' style='display:none'>\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>\"<span class=\"gfield_required gfield_required_asterisk\">*<\/span>\"indica campos obligatorios<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_82' class='full-pager' action='\/es\/wp-json\/wp\/v2\/screen' data-formid='82' novalidate data-trp-original-action=\"\/es\/wp-json\/wp\/v2\/screen\"><ol class=\"full-progress-bar clearfix step-1-of-3\"><li class=\"step-1 active\"><span>Preguntas del test<\/span><\/li><li class=\"step-2 empty\"><span>Preguntas opcionales<\/span><\/li><\/ol>\n                        <div class='gform-body gform_body'><div id='gform_page_82_1' class='gform_page' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_82' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_82_307\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_82_307'><span class='gform-field-label__text'>X\/Twitter<\/span><\/label><div class='gfield_description' id='gfield_description_82_307'>Este campo es para fines de validaci\u00f3n y no debe modificarse.<\/div><div class='ginput_container'><input name='input_307' id='input_82_307' type='text' value='' autocomplete='new-password'\/><\/div><\/div><div id=\"field_82_4\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  >Al responder a las siguientes preguntas, piensa en tu actividad con el juego o las apuestas durante los <strong>\u00faltimos 12 meses<\/strong>.<\/div><div id=\"field_82_306\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  >Cuando leas \"jugar\" o \"el juego\", piensa en actividades como apuestas, juegos de casino, tragamonedas, etc.<\/div><div id=\"field_82_38\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_38' id='input_82_38' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_82_39\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><input name=\"input_39\" id=\"input_82_39\" type=\"hidden\" class=\"gform_hidden\" aria-invalid=\"false\" value=\"245618\"><\/div><div id=\"field_82_40\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><input name=\"input_40\" id=\"input_82_40\" type=\"hidden\" class=\"gform_hidden\" aria-invalid=\"false\" value=\"e875158b42d4e2ab407c8e264f11f752\"><\/div><div id=\"field_82_41\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_41' id='input_82_41' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_82_53\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_53' id='input_82_53' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='http:\/\/screening.mhanational.org' \/><\/div><\/div><div id=\"field_82_83\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_83' id='input_82_83' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_82_84\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_84' id='input_82_84' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_82_85\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_85' id='input_82_85' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_82_97\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_97' id='input_82_97' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_82_169\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_169' id='input_82_169' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='https:\/\/screening.mhanational.org\/es\/wp-json\/wp\/v2\/screen' \/><\/div><\/div><div id=\"field_82_302\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_302' id='input_82_302' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='lang--es' \/><\/div><\/div><div id=\"field_82_293\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>En los \u00faltimos 12 meses...<\/h2><\/div><fieldset id=\"field_82_149\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHas tenido un fuerte deseo o ansia de jugar o apostar?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_149'>\n\t\t\t<div class='gchoice gchoice_82_149_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_149' type='radio' value='1'  id='choice_82_149_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_149_0' id='label_82_149_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_149_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_149' type='radio' value='0'  id='choice_82_149_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_149_1' id='label_82_149_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_137\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHas querido reducir o dejar de jugar o apostar, pero no lo as logrado?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_137'>\n\t\t\t<div class='gchoice gchoice_82_137_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_137' type='radio' value='1'  id='choice_82_137_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_137_0' id='label_82_137_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_137_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_137' type='radio' value='0'  id='choice_82_137_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_137_1' id='label_82_137_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_139\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHas pasado mucho tiempo prepar\u00e1ndote para jugar, jugando o recuper\u00e1ndote del juego?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_139'>\n\t\t\t<div class='gchoice gchoice_82_139_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_139' type='radio' value='1'  id='choice_82_139_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_139_0' id='label_82_139_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_139_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_139' type='radio' value='0'  id='choice_82_139_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_139_1' id='label_82_139_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_135\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHa habido momentos en los que has jugado m\u00e1s o durante m\u00e1s tiempo de lo que quer\u00edas?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_135'>\n\t\t\t<div class='gchoice gchoice_82_135_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_135' type='radio' value='1'  id='choice_82_135_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_135_0' id='label_82_135_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_135_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_135' type='radio' value='0'  id='choice_82_135_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_135_1' id='label_82_135_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_131\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfEl juego ha tenido menos efecto que antes? \u00bfO has tenido que jugar m\u00e1s para sentir el efecto que deseabas?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_82_131'>Responda \u201cs\u00ed\u201d si cualquiera de las preguntas es cierta en tu caso.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_131'>\n\t\t\t<div class='gchoice gchoice_82_131_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_131' type='radio' value='1'  id='choice_82_131_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_82_131\"   \/>\n\t\t\t\t\t<label for='choice_82_131_0' id='label_82_131_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_131_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_131' type='radio' value='0'  id='choice_82_131_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_131_1' id='label_82_131_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_133\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTe has sentido inquieto\/a o irritable cuando no jugabas? \u00bfO has jugado para evitar sentirte inquieto o irritable?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_82_133'>Responda \u201cs\u00ed\u201d si cualquiera de las preguntas es cierta en tu caso.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_133'>\n\t\t\t<div class='gchoice gchoice_82_133_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_133' type='radio' value='1'  id='choice_82_133_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_82_133\"   \/>\n\t\t\t\t\t<label for='choice_82_133_0' id='label_82_133_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_133_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_133' type='radio' value='0'  id='choice_82_133_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_133_1' id='label_82_133_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_141\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHas seguido jugando aunque pensabas que podr\u00eda estar caus\u00e1ndote problemas mentales o f\u00edsicos, o empeor\u00e1ndolos?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_141'>\n\t\t\t<div class='gchoice gchoice_82_141_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_141' type='radio' value='1'  id='choice_82_141_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_141_0' id='label_82_141_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_141_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_141' type='radio' value='0'  id='choice_82_141_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_141_1' id='label_82_141_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_147\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHas jugado a pesar de que pensabas que podr\u00eda causar problemas con tu familia u otras personas?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_147'>\n\t\t\t<div class='gchoice gchoice_82_147_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_147' type='radio' value='1'  id='choice_82_147_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_147_0' id='label_82_147_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_147_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_147' type='radio' value='0'  id='choice_82_147_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_147_1' id='label_82_147_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_143\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfEl juego te ha hecho m\u00e1s duro mantener tus responsabilidades del trabajo, de la escuela o del hogar?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_143'>\n\t\t\t<div class='gchoice gchoice_82_143_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_143' type='radio' value='1'  id='choice_82_143_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_143_0' id='label_82_143_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_143_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_143' type='radio' value='0'  id='choice_82_143_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_143_1' id='label_82_143_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_151\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHas pasado menos tiempo trabajando, disfrutando de tus pasatiempos o estando con otras personas debido al juego?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_151'>\n\t\t\t<div class='gchoice gchoice_82_151_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_151' type='radio' value='1'  id='choice_82_151_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_151_0' id='label_82_151_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_151_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_151' type='radio' value='0'  id='choice_82_151_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_151_1' id='label_82_151_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_145\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHas terminado en una situaci\u00f3n arriesgada m\u00e1s de una vez debido del juego \u2014 por ejemplo, en la que t\u00fa u otra persona podr\u00edan haber sufrido lesiones o da\u00f1os?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_145'>\n\t\t\t<div class='gchoice gchoice_82_145_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_145' type='radio' value='1'  id='choice_82_145_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_145_0' id='label_82_145_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_145_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_145' type='radio' value='0'  id='choice_82_145_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_145_1' id='label_82_145_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_238\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHa habido alg\u00fan periodo de dos semanas o m\u00e1s en el que has pasado mucho tiempo pensando en tus experiencias con el juego o planeando futuras apuestas o actividades con el juego?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_238'>\n\t\t\t<div class='gchoice gchoice_82_238_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_238' type='radio' value='1'  id='choice_82_238_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_238_0' id='label_82_238_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_238_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_238' type='radio' value='0'  id='choice_82_238_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_238_1' id='label_82_238_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_240\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHa habido periodos de dos semanas o m\u00e1s en los que has pasado mucho tiempo pensando en formas de conseguir dinero para jugar?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_240'>\n\t\t\t<div class='gchoice gchoice_82_240_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_240' type='radio' value='1'  id='choice_82_240_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_240_0' id='label_82_240_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_240_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_240' type='radio' value='0'  id='choice_82_240_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_240_1' id='label_82_240_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_241\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHa habido periodos en los que has necesitado apostar m\u00e1s y m\u00e1s dinero o hacer apuestas m\u00e1s elevadas que antes para sentir la misma emoci\u00f3n?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_241'>\n\t\t\t<div class='gchoice gchoice_82_241_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_241' type='radio' value='1'  id='choice_82_241_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_241_0' id='label_82_241_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_241_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_241' type='radio' value='0'  id='choice_82_241_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_241_1' id='label_82_241_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_242\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHas intentado dejar, reducir o controlar tu actividad con el juego?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_242'>\n\t\t\t<div class='gchoice gchoice_82_242_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_242' type='radio' value='Yes'  id='choice_82_242_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_242_0' id='label_82_242_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_242_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_242' type='radio' value='No'  id='choice_82_242_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_242_1' id='label_82_242_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_244\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question indent short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>En una o m\u00e1s veces en las que intentaste dejar, reducir o controlar tu actividad con el juego, \u00bfte has sentido inquieto\/a o irritable?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_244'>\n\t\t\t<div class='gchoice gchoice_82_244_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_244' type='radio' value='1'  id='choice_82_244_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_244_0' id='label_82_244_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_244_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_244' type='radio' value='0'  id='choice_82_244_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_244_1' id='label_82_244_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_243\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHas intentado dejar, reducir o controlar tus apuestas, pero sin \u00e9xito?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_243'>\n\t\t\t<div class='gchoice gchoice_82_243_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_243' type='radio' value='Yes'  id='choice_82_243_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_243_0' id='label_82_243_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_243_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_243' type='radio' value='No'  id='choice_82_243_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_243_1' id='label_82_243_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_246\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question indent short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfEsto ha pasado tres veces o m\u00e1s?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_246'>\n\t\t\t<div class='gchoice gchoice_82_246_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_246' type='radio' value='1'  id='choice_82_246_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_246_0' id='label_82_246_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_246_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_246' type='radio' value='0'  id='choice_82_246_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_246_1' id='label_82_246_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_245\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHas jugado como una forma de escapar de tus problemas personales?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_245'>\n\t\t\t<div class='gchoice gchoice_82_245_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_245' type='radio' value='1'  id='choice_82_245_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_245_0' id='label_82_245_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_245_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_245' type='radio' value='0'  id='choice_82_245_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_245_1' id='label_82_245_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_247\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHas jugado para aliviar sentimientos inc\u00f3modos como la culpa, la ansiedad, la impotencia o la depresi\u00f3n?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_247'>\n\t\t\t<div class='gchoice gchoice_82_247_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_247' type='radio' value='1'  id='choice_82_247_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_247_0' id='label_82_247_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_247_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_247' type='radio' value='0'  id='choice_82_247_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_247_1' id='label_82_247_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_248\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHa habido alg\u00fan periodo en el que, si perd\u00edas dinero jugando un d\u00eda, volv\u00edas otro d\u00eda para recuperar lo perdido?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_248'>\n\t\t\t<div class='gchoice gchoice_82_248_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_248' type='radio' value='1'  id='choice_82_248_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_248_0' id='label_82_248_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_248_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_248' type='radio' value='0'  id='choice_82_248_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_248_1' id='label_82_248_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_249\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfLes has mentido m\u00e1s de una vez a tus familiares, amigos u otras personas sobre cu\u00e1nto juegas o cu\u00e1nto dinero has perdido en el juego?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_249'>\n\t\t\t<div class='gchoice gchoice_82_249_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_249' type='radio' value='Yes'  id='choice_82_249_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_249_0' id='label_82_249_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_249_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_249' type='radio' value='No'  id='choice_82_249_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_249_1' id='label_82_249_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_250\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question indent short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfEsto ha pasado tres veces o m\u00e1s?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_250'>\n\t\t\t<div class='gchoice gchoice_82_250_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_250' type='radio' value='1'  id='choice_82_250_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_250_0' id='label_82_250_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_250_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_250' type='radio' value='0'  id='choice_82_250_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_250_1' id='label_82_250_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_251\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTu actividad con el juego ha causado problemas graves o repetidos en tus relaciones con alg\u00fan miembro de tu familia o alguno de tus amigos?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_251'>\n\t\t\t<div class='gchoice gchoice_82_251_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_251' type='radio' value='1'  id='choice_82_251_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_251_0' id='label_82_251_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_251_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_251' type='radio' value='0'  id='choice_82_251_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_251_1' id='label_82_251_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_254\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfEl juego te ha causado problemas en la escuela, como faltar a clases o d\u00edas de escuela, o empeorar tus notas?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_254'>\n\t\t\t<div class='gchoice gchoice_82_254_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_254' type='radio' value='1'  id='choice_82_254_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_254_0' id='label_82_254_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_254_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_254' type='radio' value='0'  id='choice_82_254_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_254_1' id='label_82_254_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_252\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfEl juego te ha hecho perder un trabajo, tener problemas en el trabajo o perder una importante oportunidad de carrera?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_252'>\n\t\t\t<div class='gchoice gchoice_82_252_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_252' type='radio' value='1'  id='choice_82_252_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_252_0' id='label_82_252_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_252_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_252' type='radio' value='0'  id='choice_82_252_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_252_1' id='label_82_252_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_253\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHas tenido que pedirles a familiares o a otras personas dinero prestado, o que te sacaran de una desesperada situaci\u00f3n monetaria causada en gran medida por el juego?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_253'>\n\t\t\t<div class='gchoice gchoice_82_253_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_253' type='radio' value='1'  id='choice_82_253_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_253_0' id='label_82_253_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_253_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_253' type='radio' value='0'  id='choice_82_253_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_253_1' id='label_82_253_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_278\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHas tenido un fuerte deseo o ansia de jugar o apostar?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_278'>\n\t\t\t<div class='gchoice gchoice_82_278_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_278' type='radio' value='1'  id='choice_82_278_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_278_0' id='label_82_278_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_278_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_278' type='radio' value='0'  id='choice_82_278_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_278_1' id='label_82_278_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_279\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHas querido reducir o dejar de jugar o apostar, pero no lo as logrado?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_279'>\n\t\t\t<div class='gchoice gchoice_82_279_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_279' type='radio' value='1'  id='choice_82_279_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_279_0' id='label_82_279_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_279_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_279' type='radio' value='0'  id='choice_82_279_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_279_1' id='label_82_279_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_280\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHas pasado mucho tiempo prepar\u00e1ndote para jugar, jugando o recuper\u00e1ndote del juego?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_280'>\n\t\t\t<div class='gchoice gchoice_82_280_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_280' type='radio' value='1'  id='choice_82_280_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_280_0' id='label_82_280_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_280_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_280' type='radio' value='0'  id='choice_82_280_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_280_1' id='label_82_280_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_281\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHa habido momentos en los que has jugado m\u00e1s o durante m\u00e1s tiempo de lo que quer\u00edas?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_281'>\n\t\t\t<div class='gchoice gchoice_82_281_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_281' type='radio' value='1'  id='choice_82_281_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_281_0' id='label_82_281_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_281_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_281' type='radio' value='0'  id='choice_82_281_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_281_1' id='label_82_281_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_282\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfEl juego ha tenido menos efecto que antes? \u00bfO has tenido que jugar m\u00e1s para sentir el efecto que deseabas?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_82_282'>Responda \u201cs\u00ed\u201d si cualquiera de las preguntas es cierta en tu caso.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_282'>\n\t\t\t<div class='gchoice gchoice_82_282_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_282' type='radio' value='1'  id='choice_82_282_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_82_282\"   \/>\n\t\t\t\t\t<label for='choice_82_282_0' id='label_82_282_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_282_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_282' type='radio' value='0'  id='choice_82_282_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_282_1' id='label_82_282_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_283\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTe has sentido inquieto\/a o irritable cuando no jugabas? \u00bfO has jugado para evitar sentirte inquieto o irritable?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_82_283'>Responda \u201cs\u00ed\u201d si cualquiera de las preguntas es cierta en tu caso.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_283'>\n\t\t\t<div class='gchoice gchoice_82_283_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_283' type='radio' value='1'  id='choice_82_283_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_82_283\"   \/>\n\t\t\t\t\t<label for='choice_82_283_0' id='label_82_283_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_283_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_283' type='radio' value='0'  id='choice_82_283_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_283_1' id='label_82_283_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_284\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHas seguido jugando aunque pensabas que podr\u00eda estar caus\u00e1ndote problemas mentales o f\u00edsicos, o empeor\u00e1ndolos?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_284'>\n\t\t\t<div class='gchoice gchoice_82_284_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_284' type='radio' value='1'  id='choice_82_284_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_284_0' id='label_82_284_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_284_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_284' type='radio' value='0'  id='choice_82_284_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_284_1' id='label_82_284_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_285\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHas jugado a pesar de que pensabas que podr\u00eda causar problemas con tu familia u otras personas?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_285'>\n\t\t\t<div class='gchoice gchoice_82_285_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_285' type='radio' value='1'  id='choice_82_285_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_285_0' id='label_82_285_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_285_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_285' type='radio' value='0'  id='choice_82_285_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_285_1' id='label_82_285_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_286\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfEl juego te ha hecho m\u00e1s duro mantener tus responsabilidades del trabajo, de la escuela o del hogar?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_286'>\n\t\t\t<div class='gchoice gchoice_82_286_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_286' type='radio' value='1'  id='choice_82_286_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_286_0' id='label_82_286_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_286_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_286' type='radio' value='0'  id='choice_82_286_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_286_1' id='label_82_286_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_287\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHas pasado menos tiempo trabajando, disfrutando de tus pasatiempos o estando con otras personas debido al juego?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_287'>\n\t\t\t<div class='gchoice gchoice_82_287_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_287' type='radio' value='1'  id='choice_82_287_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_287_0' id='label_82_287_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_287_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_287' type='radio' value='0'  id='choice_82_287_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_287_1' id='label_82_287_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_288\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfHas terminado en una situaci\u00f3n arriesgada m\u00e1s de una vez debido del juego \u2014 por ejemplo, en la que t\u00fa u otra persona podr\u00edan haber sufrido lesiones o da\u00f1os?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_288'>\n\t\t\t<div class='gchoice gchoice_82_288_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_288' type='radio' value='1'  id='choice_82_288_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_288_0' id='label_82_288_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_288_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_288' type='radio' value='0'  id='choice_82_288_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_288_1' id='label_82_288_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_82_274\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_82_166\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible translation-block\"  ><hr>\n\nLas siguientes preguntas <strong>opcionales<\/strong> nos ayudar\u00e1n a comprender las experiencias de las personas que luchan con el juego o las apuestas.<\/div><div id=\"field_82_296\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_82_296'><span class='gform-field-label__text'>\u00bfQu\u00e9 es lo que m\u00e1s te angustia de tu actividad con el juego?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_296' id='input_82_296' type='text' value='' class='large'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_82_163\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question-optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfCon qu\u00e9 frecuencia has jugado en los \u00faltimos 12 meses?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_163'>\n\t\t\t<div class='gchoice gchoice_82_163_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_163' type='radio' value='More than once a day'  id='choice_82_163_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_163_0' id='label_82_163_0' class='gform-field-label gform-field-label--type-inline'>M\u00e1s de una vez al d\u00eda<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_163_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_163' type='radio' value='More than once a week'  id='choice_82_163_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_163_1' id='label_82_163_1' class='gform-field-label gform-field-label--type-inline'>M\u00e1s de una vez a la semana<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_163_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_163' type='radio' value='More than once a month'  id='choice_82_163_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_163_2' id='label_82_163_2' class='gform-field-label gform-field-label--type-inline'>M\u00e1s de una vez al mes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_163_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_163' type='radio' value='Once a month or less'  id='choice_82_163_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_163_3' id='label_82_163_3' class='gform-field-label gform-field-label--type-inline'>Una vez al mes o menos<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_207\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question-optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfQu\u00e9 tan de acuerdo est\u00e1s con la siguiente afirmaci\u00f3n: \"Creo que el juego es moralmente incorrecto o pecaminoso\"?\"<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_207'>\n\t\t\t<div class='gchoice gchoice_82_207_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_207' type='radio' value='Strongly Disagree'  id='choice_82_207_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_207_0' id='label_82_207_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_207_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_207' type='radio' value='Disagree'  id='choice_82_207_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_207_1' id='label_82_207_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_207_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_207' type='radio' value='Agree'  id='choice_82_207_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_207_2' id='label_82_207_2' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_207_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_207' type='radio' value='Strongly Agree'  id='choice_82_207_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_207_3' id='label_82_207_3' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_165\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full question-optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfQu\u00e9 tan de acuerdo est\u00e1s con la siguiente afirmaci\u00f3n: \"Creo que soy adicto al juego\"?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_165'>\n\t\t\t<div class='gchoice gchoice_82_165_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_165' type='radio' value='Strongly Disagree'  id='choice_82_165_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_165_0' id='label_82_165_0' class='gform-field-label gform-field-label--type-inline'>Totalmente en desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_165_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_165' type='radio' value='Disagree'  id='choice_82_165_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_165_1' id='label_82_165_1' class='gform-field-label gform-field-label--type-inline'>En desacuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_165_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_165' type='radio' value='Agree'  id='choice_82_165_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_165_2' id='label_82_165_2' class='gform-field-label gform-field-label--type-inline'>De acuerdo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_165_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_165' type='radio' value='Strongly Agree'  id='choice_82_165_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_165_3' id='label_82_165_3' class='gform-field-label gform-field-label--type-inline'>Totalmente de acuerdo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_304\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full traditional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfQu\u00e9 tipo de juego o apuesta <strong>m\u00e1s<\/strong> te preocupa?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_304'>\n\t\t\t<div class='gchoice gchoice_82_304_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_304' type='radio' value='Casino games \/ table games (poker, roulette, etc.)'  id='choice_82_304_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_304_0' id='label_82_304_0' class='gform-field-label gform-field-label--type-inline'>Juegos de casino (p\u00f3ker, ruleta, etc.)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_304_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_304' type='radio' value='Slot machines'  id='choice_82_304_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_304_1' id='label_82_304_1' class='gform-field-label gform-field-label--type-inline'>Tragamonedas \/ tragaperras<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_304_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_304' type='radio' value='Lotteries'  id='choice_82_304_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_304_2' id='label_82_304_2' class='gform-field-label gform-field-label--type-inline'>Loter\u00edas<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_304_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_304' type='radio' value='Sports betting'  id='choice_82_304_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_304_3' id='label_82_304_3' class='gform-field-label gform-field-label--type-inline'>Apuestas deportivas<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_304_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_304' type='radio' value='Prediction markets'  id='choice_82_304_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_304_4' id='label_82_304_4' class='gform-field-label gform-field-label--type-inline'>Mercados de predicci\u00f3n<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_304_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_304' type='radio' value='Other...'  id='choice_82_304_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_304_5' id='label_82_304_5' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_82_305\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_82_305'><span class='gform-field-label__text'>\u00bfQu\u00e9 otro tipo de juego o apuesta te preocupa?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_305' id='input_82_305' type='text' value='' class='medium'    placeholder='Anotar otro...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_82_295\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Adem\u00e1s del juego, \u00bfte preocupa que puedas ser adicto a alg\u00fan otro comportamiento?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_295'>\n\t\t\t<div class='gchoice gchoice_82_295_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_295' type='radio' value='Yes'  id='choice_82_295_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_295_0' id='label_82_295_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_295_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_295' type='radio' value='No'  id='choice_82_295_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_295_1' id='label_82_295_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_218\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfCu\u00e1les de los siguientes comportamientos te preocupan?<\/span><\/legend><div class='gfield_description' id='gfield_description_82_218'>Selecciona todas las opciones que apliquen.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_82_218'><div class='gchoice gchoice_82_218_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_218.1' type='checkbox'  value='Self-injury (cutting, burning, hitting, etc.)'  id='choice_82_218_1'   aria-describedby=\"gfield_description_82_218\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_82_218_1' id='label_82_218_1' class='gform-field-label gform-field-label--type-inline'>Autolesiones (cortarse, quemarse, golpearse, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_218_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_218.2' type='checkbox'  value='Pornography'  id='choice_82_218_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_218_2' id='label_82_218_2' class='gform-field-label gform-field-label--type-inline'>Pornograf\u00eda<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_218_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_218.3' type='checkbox'  value='Sex'  id='choice_82_218_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_218_3' id='label_82_218_3' class='gform-field-label gform-field-label--type-inline'>Sexo<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_218_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_218.4' type='checkbox'  value='Internet (social media, videos, doomscrolling, etc.)'  id='choice_82_218_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_218_4' id='label_82_218_4' class='gform-field-label gform-field-label--type-inline'>Internet (redes sociales, videos, \"doomscrolling\", etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_218_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_218.5' type='checkbox'  value='Food (junk food, binge eating, etc.)'  id='choice_82_218_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_218_5' id='label_82_218_5' class='gform-field-label gform-field-label--type-inline'>Alimentaci\u00f3n (comida chatarra, atracones, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_218_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_218.6' type='checkbox'  value='Masturbation'  id='choice_82_218_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_218_6' id='label_82_218_6' class='gform-field-label gform-field-label--type-inline'>Masturbaci\u00f3n<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_218_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_218.7' type='checkbox'  value='Shopping'  id='choice_82_218_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_218_7' id='label_82_218_7' class='gform-field-label gform-field-label--type-inline'>Compras<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_218_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_218.8' type='checkbox'  value='Video games'  id='choice_82_218_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_218_8' id='label_82_218_8' class='gform-field-label gform-field-label--type-inline'>Videojuegos<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_218_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_218.9' type='checkbox'  value='Substances (nicotine\/vaping, alcohol, drugs, etc.)'  id='choice_82_218_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_218_9' id='label_82_218_9' class='gform-field-label gform-field-label--type-inline'>Sustancias (nicotina\/vapeo, alcohol, drogas, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_218_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_218.11' type='checkbox'  value='Other...'  id='choice_82_218_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_218_11' id='label_82_218_11' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_82_227\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_82_227'><span class='gform-field-label__text'>\u00bfQu\u00e9 sustancia m\u00e1s te preocupa?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_227' id='input_82_227' type='text' value='' class='medium'    placeholder='Anotar otro...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_82_220\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_82_220'><span class='gform-field-label__text'>\u00bfQu\u00e9 otro comportamiento te preocupa?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_220' id='input_82_220' type='text' value='' class='medium'    placeholder='Anotar otro...'  aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <button type='button' id='gform_next_button_82_17' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Siguiente<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_82_2' class='gform_page demographics' data-js='page-field-id-17' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_82_2' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_82_54\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p class=\"translation-block\">Por favor, toma un momento para responder a las siguientes preguntas <strong>opcionales<\/strong>. Tus respuestas son totalmente an\u00f3nimas: no podremos identificarte a partir de esta informaci\u00f3n. Tus respuestas nos ayudan a proporcionar mejor informaci\u00f3n y apoyo a personas como t\u00fa.<\/p>\n\n<p>Puedes responder a tantas preguntas como desees. Cuando hayas terminado, despl\u00e1zate hasta la parte inferior de la encuesta y haz clic en \"ver resultados\" para recibir los resultados de la evaluaci\u00f3n.<\/p><\/div><div id=\"field_82_90\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><hr \/><\/div><fieldset id=\"field_82_167\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full traditional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfQu\u00e9 es lo principal que quieres hacer despu\u00e9s de realizar este test de salud mental? (Selecciona una opci\u00f3n)<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_167'>\n\t\t\t<div class='gchoice gchoice_82_167_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_167' type='radio' value='Take another mental health test'  id='choice_82_167_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_167_0' id='label_82_167_0' class='gform-field-label gform-field-label--type-inline'>Hacer otro test de salud mental.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_167_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_167' type='radio' value='Understand what addiction is like (reading articles)'  id='choice_82_167_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_167_1' id='label_82_167_1' class='gform-field-label gform-field-label--type-inline'>Comprender c\u00f3mo es la adicci\u00f3n (leyendo art\u00edculos)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_167_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_167' type='radio' value='Understand and manage self-harm or suicidal thoughts'  id='choice_82_167_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_167_2' id='label_82_167_2' class='gform-field-label gform-field-label--type-inline'>Comprender y manejar las autolesiones o los pensamientos suicidas<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_167_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_167' type='radio' value='Tips for managing addiction (reading articles)'  id='choice_82_167_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_167_3' id='label_82_167_3' class='gform-field-label gform-field-label--type-inline'>Consejos para manejar la adicci\u00f3n (lectura de art\u00edculos)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_167_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_167' type='radio' value='Learn and practice skills for how to manage addiction (try a free self-help tool)'  id='choice_82_167_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_167_4' id='label_82_167_4' class='gform-field-label gform-field-label--type-inline'>Aprenda y practique habilidades para manejar la adicci\u00f3n (pruebe una herramienta de autoayuda gratuita).<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_167_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_167' type='radio' value='Learn about what therapy\/treatment is like (reading articles)'  id='choice_82_167_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_167_5' id='label_82_167_5' class='gform-field-label gform-field-label--type-inline'>Informarte sobre c\u00f3mo es la terapia o el tratamiento (leyendo art\u00edculos).<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_167_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_167' type='radio' value='Find a treatment provider near you'  id='choice_82_167_6' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_167_6' id='label_82_167_6' class='gform-field-label gform-field-label--type-inline'>Buscar un proveedor de tratamiento cerca de ti.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_167_7'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_167' type='radio' value='Find a forum or support group for people with addiction'  id='choice_82_167_7' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_167_7' id='label_82_167_7' class='gform-field-label gform-field-label--type-inline'>Busca un foro o grupo de apoyo para personas con adicciones.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_167_8'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_167' type='radio' value='Other...'  id='choice_82_167_8' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_167_8' id='label_82_167_8' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_167_9'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_167' type='radio' value='I don\u2019t want to do anything'  id='choice_82_167_9' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_167_9' id='label_82_167_9' class='gform-field-label gform-field-label--type-inline'>No quiero hacer nada.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_82_168\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_82_168'><span class='gform-field-label__text'>Pr\u00f3ximos pasos - Otros<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_168' id='input_82_168' type='text' value='' class='medium'    placeholder='Anotar otro...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_82_87\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfEst\u00e1s haciendo este test por ti o en lugar de otra persona?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_87'>\n\t\t\t<div class='gchoice gchoice_82_87_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_87' type='radio' value='For myself'  id='choice_82_87_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_87_0' id='label_82_87_0' class='gform-field-label gform-field-label--type-inline'>Por m\u00ed mismo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_87_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_87' type='radio' value='For someone else'  id='choice_82_87_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_87_1' id='label_82_87_1' class='gform-field-label gform-field-label--type-inline'>En lugar de otra persona<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_82_88\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  >Si est\u00e1s haciendo este test en lugar de otra persona, <strong>Por favor, utilice la informaci\u00f3n de esa persona.<\/strong> para las preguntas siguientes, o d\u00e9jalas en blanco si no sabes la respuesta. Recuerda que, <em>estas preguntas son opcionales<\/em>.<\/div><div id=\"field_82_55\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>Acerca de ti<\/h2><\/div><div id=\"field_82_56\" class=\"gfield gfield--type-select gfield--input-type-select optional taxonomy field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_82_56'><span class='gform-field-label__text'>Rango de edades<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_56' id='input_82_56' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='8-10' >8-10<\/option><option value='11-13' >11-13<\/option><option value='14-15' >14-15<\/option><option value='16-17' >16-17<\/option><option value='18-24' >18-24<\/option><option value='25-34' >25-34<\/option><option value='35-44' >35-44<\/option><option value='45-54' >45-54<\/option><option value='55-64' >55-64<\/option><option value='65+' >65+<\/option><\/select><\/div><\/div><fieldset id=\"field_82_57\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>G\u00e9nero<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_57'>\n\t\t\t<div class='gchoice gchoice_82_57_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_57' type='radio' value='Female'  id='choice_82_57_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_57_0' id='label_82_57_0' class='gform-field-label gform-field-label--type-inline'>Femenino<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_57_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_57' type='radio' value='Male'  id='choice_82_57_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_57_1' id='label_82_57_1' class='gform-field-label gform-field-label--type-inline'>Masculino<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_57_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_57' type='radio' value='Non-Binary'  id='choice_82_57_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_57_2' id='label_82_57_2' class='gform-field-label gform-field-label--type-inline'>No binario<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_299\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTe identificas como transg\u00e9nero?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_299'>\n\t\t\t<div class='gchoice gchoice_82_299_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_299' type='radio' value='Yes'  id='choice_82_299_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_299_0' id='label_82_299_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_299_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_299' type='radio' value='No'  id='choice_82_299_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_299_1' id='label_82_299_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_82_58\" class=\"gfield gfield--type-text gfield--input-type-text optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_82_58'><span class='gform-field-label__text'>\u00bfC\u00f3mo describir\u00edas tu g\u00e9nero?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_58' id='input_82_58' type='text' value='' class='small'    placeholder='Ingresa el g\u00e9nero...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_82_60\" class=\"gfield gfield--type-select gfield--input-type-select optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_82_60'><span class='gform-field-label__text'>Raza\/etnia<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_60' id='input_82_60' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='American Indian or Alaska Native' >Amerindio o nativo de Alaska<\/option><option value='Asian' >Asi\u00e1tico<\/option><option value='Black or African American (non-Hispanic)' >Negro o afroamericano (no hispano)<\/option><option value='Hispanic or Latino' >Hispano o latino<\/option><option value='Middle Eastern or North African' >Del medio oriente o norteafricano<\/option><option value='Native Hawaiian or other Pacific Islander' >Isle\u00f1o nativo hawaiano o pac\u00edfico<\/option><option value='White (non-Hispanic)' >Blanco (no hispano)<\/option><option value='More than one of the above' >M\u00e1s de uno de los anteriores<\/option><option value='Other' >Otros<\/option><\/select><\/div><\/div><div id=\"field_82_61\" class=\"gfield gfield--type-select gfield--input-type-select optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_82_61'><span class='gform-field-label__text'>Ingresos familiares (USD)<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_61' id='input_82_61' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Less than $20,000' >Menos de $20,000<\/option><option value='$20,000 - $39,999' >$20,000 - $39,999<\/option><option value='$40,000 - $59,999' >$40,000 - $59,999<\/option><option value='$60,000 - $79,999' >$60,000 - $79,999<\/option><option value='$80,000 - $99,999' >$80,000 - $99,999<\/option><option value='$100,000 - $149,999' >$100,000 - $149,999<\/option><option value='$150,000+' >$150,000+<\/option><\/select><\/div><\/div><fieldset id=\"field_82_91\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfVives en los Estados Unidos de Am\u00e9rica o en otro pa\u00eds?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_91'>\n\t\t\t<div class='gchoice gchoice_82_91_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_91' type='radio' value='I live in the United States'  id='choice_82_91_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_91_0' id='label_82_91_0' class='gform-field-label gform-field-label--type-inline'>Vivo en los Estados Unidos de Am\u00e9rica.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_91_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_91' type='radio' value='I live in another country'  id='choice_82_91_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_91_1' id='label_82_91_1' class='gform-field-label gform-field-label--type-inline'>Vivo en otro pa\u00eds.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_82_80\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_82_80'><span class='gform-field-label__text'>Estado<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_80' id='input_82_80' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >Distrito de Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Hawaii' >Haw\u00e1i<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Luisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >M\u00edchigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Misisipi<\/option><option value='Missouri' >Misuri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >Nuevo Hampshire<\/option><option value='New Jersey' >Nueva Jersey<\/option><option value='New Mexico' >Nuevo M\u00e9xico<\/option><option value='New York' >Nueva York<\/option><option value='North Carolina' >Carolina del Norte<\/option><option value='North Dakota' >Dakota del Norte<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oreg\u00f3n<\/option><option value='Pennsylvania' >Pensilvania<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >Carolina del Sur<\/option><option value='South Dakota' >Dakota del Sur<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >Virginia Occidental<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='I live in a U.S. Territory' >Vivo en un territorio de los Estados Unidos.<\/option><\/select><\/div><\/div><div id=\"field_82_82\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_82_82'><span class='gform-field-label__text'>\u00bfEn qu\u00e9 pa\u00eds vives?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_82' id='input_82_82' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Afghanistan' >Afganist\u00e1n<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Argelia<\/option><option value='American Samoa' >Samoa Americana<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguila<\/option><option value='Antarctica' >Ant\u00e1rtida<\/option><option value='Antigua and Barbuda' >Antigua y Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaiy\u00e1n<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrein<\/option><option value='Bangladesh' >Banglad\u00e9s<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Bielorrusia<\/option><option value='Belgium' >B\u00e9lgica<\/option><option value='Belize' >Belice<\/option><option value='Benin' >Ben\u00edn<\/option><option value='Bermuda' >Bermudas<\/option><option value='Bhutan' >But\u00e1n<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, San Eustaquio y Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia y Herzegovina<\/option><option value='Botswana' >Botsuana<\/option><option value='Bouvet Island' >Isla Bouvet<\/option><option value='Brazil' >Brasil<\/option><option value='British Indian Ocean Territory' >Territorio Brit\u00e1nico del Oc\u00e9ano \u00cdndico<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cambodia' >Camboya<\/option><option value='Cameroon' >Camer\u00fan<\/option><option value='Canada' >Canad\u00e1<\/option><option value='Cape Verde' >Cabo Verde<\/option><option value='Cayman Islands' >Islas Caim\u00e1n<\/option><option value='Central African Republic' >Rep\u00fablica Centroafricana<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Isla de Navidad<\/option><option value='Cocos Islands' >Islas Cocos<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoras<\/option><option value='Congo, Democratic Republic of the' >Rep\u00fablica Democr\u00e1tica del Congo<\/option><option value='Congo, Republic of the' >Rep\u00fablica del Congo<\/option><option value='Cook Islands' >Islas Cook<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croacia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Curazao<\/option><option value='Cyprus' >Chipre<\/option><option value='Czech Republic' >Rep\u00fablica Checa<\/option><option value='C\u00f4te d&#039;Ivoire' >Costa de Marfil<\/option><option value='Denmark' >Dinamarca<\/option><option value='Djibouti' >Yibuti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Rep\u00fablica Dominicana<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egipto<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Guinea Ecuatorial<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini (Swaziland)' >Esuatini (Suazilandia)<\/option><option value='Ethiopia' >Etiop\u00eda<\/option><option value='Falkland Islands' >Islas Malvinas<\/option><option value='Faroe Islands' >Islas Feroe<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finlandia<\/option><option value='France' >Francia<\/option><option value='French Guiana' >Guayana Francesa<\/option><option value='French Polynesia' >Polinesia Francesa<\/option><option value='French Southern Territories' >Territorios Australes Franceses<\/option><option value='Gabon' >Gab\u00f3n<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Alemania<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Grecia<\/option><option value='Greenland' >Groenlandia<\/option><option value='Grenada' >Granada<\/option><option value='Guadeloupe' >Guadalupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Hait\u00ed<\/option><option value='Heard and McDonald Islands' >Islas Heard y McDonald<\/option><option value='Holy See' >Santa Sede<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungr\u00eda<\/option><option value='Iceland' >Islandia<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Ir\u00e1n<\/option><option value='Iraq' >Irak<\/option><option value='Ireland' >Irlanda<\/option><option value='Isle of Man' >Isla de Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italia<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Jap\u00f3n<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordania<\/option><option value='Kazakhstan' >Kazajist\u00e1n<\/option><option value='Kenya' >Kenia<\/option><option value='Kiribati' >Kiribati<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kirguist\u00e1n<\/option><option value='Lao People&#039;s Democratic Republic' >Rep\u00fablica Democr\u00e1tica Popular Lao<\/option><option value='Latvia' >Letonia<\/option><option value='Lebanon' >L\u00edbano<\/option><option value='Lesotho' >Lesoto<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libia<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lituania<\/option><option value='Luxembourg' >Luxemburgo<\/option><option value='Macau' >Macao<\/option><option value='Macedonia' >Macedonia<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malaui<\/option><option value='Malaysia' >Malasia<\/option><option value='Maldives' >Maldivas<\/option><option value='Mali' >Mal\u00ed<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Islas Marshall<\/option><option value='Martinique' >Martinica<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauricio<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >M\u00e9xico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldavia<\/option><option value='Monaco' >M\u00f3naco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Marruecos<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Pa\u00edses Bajos<\/option><option value='New Caledonia' >Nueva Caledonia<\/option><option value='New Zealand' >Nueva Zelanda<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >N\u00edger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Isla Norfolk<\/option><option value='North Korea' >Corea del Norte<\/option><option value='Northern Mariana Islands' >Islas Marianas del Norte<\/option><option value='Norway' >Noruega<\/option><option value='Oman' >Om\u00e1n<\/option><option value='Pakistan' >Pakist\u00e1n<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestina, Estado de<\/option><option value='Panama' >Panam\u00e1<\/option><option value='Papua New Guinea' >Pap\u00faa Nueva Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Per\u00fa<\/option><option value='Philippines' >Filipinas<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Polonia<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Rumania<\/option><option value='Russia' >Rusia<\/option><option value='Rwanda' >Ruanda<\/option><option value='R\u00e9union' >Reuni\u00f3n<\/option><option value='Saint Barth\u00e9lemy' >San Bartolom\u00e9<\/option><option value='Saint Helena' >Santa Elena<\/option><option value='Saint Kitts and Nevis' >San Crist\u00f3bal y Nieves<\/option><option value='Saint Lucia' >Santa Luc\u00eda<\/option><option value='Saint Martin' >San Mart\u00edn<\/option><option value='Saint Pierre and Miquelon' >San Pedro y Miquel\u00f3n<\/option><option value='Saint Vincent and the Grenadines' >San Vicente y las Granadinas<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Santo Tom\u00e9 y Pr\u00edncipe<\/option><option value='Saudi Arabia' >Arabia Saudita<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leona<\/option><option value='Singapore' >Singapur<\/option><option value='Sint Maarten' >San Mart\u00edn<\/option><option value='Slovakia' >Eslovaquia<\/option><option value='Slovenia' >Eslovenia<\/option><option value='Solomon Islands' >Islas Salom\u00f3n<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >Sud\u00e1frica<\/option><option value='South Georgia' >Georgia del Sur<\/option><option value='South Korea' >Corea del Sur<\/option><option value='South Sudan' >Sud\u00e1n del Sur<\/option><option value='Spain' >Espa\u00f1a<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sud\u00e1n<\/option><option value='Suriname' >Surinam<\/option><option value='Svalbard and Jan Mayen Islands' >Islas Svalbard y Jan Mayen<\/option><option value='Sweden' >Suecia<\/option><option value='Switzerland' >Suiza<\/option><option value='Syria' >Siria<\/option><option value='Taiwan' >Taiw\u00e1n<\/option><option value='Tajikistan' >Tayikist\u00e1n<\/option><option value='Tanzania' >Tanzania<\/option><option value='Thailand' >Tailandia<\/option><option value='Timor-Leste' >Timor Oriental<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad y Tobago<\/option><option value='Tunisia' >T\u00fanez<\/option><option value='Turkey' >Turqu\u00eda<\/option><option value='Turkmenistan' >Turkmenist\u00e1n<\/option><option value='Turks and Caicos Islands' >Islas Turcas y Caicos<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='US Minor Outlying Islands' >Islas menores alejadas de los Estados Unidos<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ucrania<\/option><option value='United Arab Emirates' >Emiratos \u00c1rabes Unidos<\/option><option value='United Kingdom' >Reino Unido<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekist\u00e1n<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Vietnam' >Vietnam<\/option><option value='Virgin Islands, British' >Islas V\u00edrgenes Brit\u00e1nicas<\/option><option value='Virgin Islands, U.S.' >Islas V\u00edrgenes de los Estados Unidos.<\/option><option value='Wallis and Futuna' >Wallis y Futuna<\/option><option value='Western Sahara' >S\u00e1hara Occidental<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabue<\/option><option value='\u00c5land Islands' >Islas \u00c5land<\/option><\/select><\/div><\/div><div id=\"field_82_81\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_82_81'><span class='gform-field-label__text'>C\u00f3digo postal<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_81' id='input_82_81' type='text' value='' class='small'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_82_62\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox optional traditional field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfCu\u00e1l de las siguientes poblaciones te describe?<\/span><\/legend><div class='gfield_description' id='gfield_description_82_62'>Selecciona todas las opciones que apliquen.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_82_62'><div class='gchoice gchoice_82_62_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.1' type='checkbox'  value='Veteran or active-duty military'  id='choice_82_62_1'   aria-describedby=\"gfield_description_82_62\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_82_62_1' id='label_82_62_1' class='gform-field-label gform-field-label--type-inline'>Militar veterano(a) o en servicio activo<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_62_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.2' type='checkbox'  value='Caregiver of someone living with emotional or physical illness'  id='choice_82_62_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_62_2' id='label_82_62_2' class='gform-field-label gform-field-label--type-inline'>Cuidador(a) de una persona que padece una enfermedad emocional o f\u00edsica.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_62_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.3' type='checkbox'  value='LGBTQ+'  id='choice_82_62_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_62_3' id='label_82_62_3' class='gform-field-label gform-field-label--type-inline'>LGBTQ+<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_62_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.4' type='checkbox'  value='Student'  id='choice_82_62_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_62_4' id='label_82_62_4' class='gform-field-label gform-field-label--type-inline'>Estudiante<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_62_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.5' type='checkbox'  value='Trauma survivor'  id='choice_82_62_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_62_5' id='label_82_62_5' class='gform-field-label gform-field-label--type-inline'>Sobrevivente de un trauma<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_62_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.6' type='checkbox'  value='New or expecting parent'  id='choice_82_62_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_62_6' id='label_82_62_6' class='gform-field-label gform-field-label--type-inline'>Madre primeriza, padre primerizo, futura madre, o futuro padre<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_62_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.7' type='checkbox'  value='Healthcare worker'  id='choice_82_62_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_62_7' id='label_82_62_7' class='gform-field-label gform-field-label--type-inline'>Trabajador(a) de la salud<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_92\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full traditional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfCuidas a alguien con una enfermedad mental o f\u00edsica?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_92'>\n\t\t\t<div class='gchoice gchoice_82_92_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_92' type='radio' value='Mental health condition'  id='choice_82_92_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_92_0' id='label_82_92_0' class='gform-field-label gform-field-label--type-inline'>Condici\u00f3n de salud mental<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_92_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_92' type='radio' value='Physical health condition'  id='choice_82_92_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_92_1' id='label_82_92_1' class='gform-field-label gform-field-label--type-inline'>Condici\u00f3n f\u00edsica<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_92_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_92' type='radio' value='Both mental and physical health conditions'  id='choice_82_92_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_92_2' id='label_82_92_2' class='gform-field-label gform-field-label--type-inline'>Tanto las condiciones de salud mental como las f\u00edsicas.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_82_93\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_82_93'><span class='gform-field-label__text'>\u00bfCu\u00e1l de las siguientes opciones describe mejor tu orientaci\u00f3n sexual?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_93' id='input_82_93' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Lesbian or Gay' >Lesbiana o gay<\/option><option value='Bisexual' >Bisexual<\/option><option value='Queer' >Queer<\/option><option value='Pansexual' >Pansexual<\/option><option value='Asexual' >Asexual<\/option><option value='Straight' >Heterosexual<\/option><option value='Other...' >Otros...<\/option><\/select><\/div><\/div><div id=\"field_82_68\" class=\"gfield gfield--type-text gfield--input-type-text optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_82_68'><span class='gform-field-label__text'>\u00bfCu\u00e1l es tu orientaci\u00f3n sexual?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_68' id='input_82_68' type='text' value='' class='small'    placeholder='Ingresa la orientaci\u00f3n sexual...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_82_94\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full optional traditional field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfCu\u00e1l de las siguientes opciones describe tu experiencia con el trauma?<\/span><\/legend><div class='gfield_description' id='gfield_description_82_94'>Selecciona todas las opciones que apliquen.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_82_94'><div class='gchoice gchoice_82_94_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_94.1' type='checkbox'  value='Child abuse\/violence'  id='choice_82_94_1'   aria-describedby=\"gfield_description_82_94\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_82_94_1' id='label_82_94_1' class='gform-field-label gform-field-label--type-inline'>Maltrato infantil\/violencia<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_94_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_94.2' type='checkbox'  value='Intimate partner violence'  id='choice_82_94_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_94_2' id='label_82_94_2' class='gform-field-label gform-field-label--type-inline'>Violencia de pareja<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_94_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_94.3' type='checkbox'  value='Sexual assault\/violence'  id='choice_82_94_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_94_3' id='label_82_94_3' class='gform-field-label gform-field-label--type-inline'>Agresi\u00f3n\/violencia sexual<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_94_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_94.4' type='checkbox'  value='Serious illness\/injury\/assault'  id='choice_82_94_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_94_4' id='label_82_94_4' class='gform-field-label gform-field-label--type-inline'>Enfermedad\/lesi\u00f3n\/agresi\u00f3n grave<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_94_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_94.5' type='checkbox'  value='Family conflict (identity acceptance\/separation\/divorce)'  id='choice_82_94_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_94_5' id='label_82_94_5' class='gform-field-label gform-field-label--type-inline'>Conflicto familiar (aceptaci\u00f3n de la identidad\/separaci\u00f3n\/divorcio)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_94_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_94.6' type='checkbox'  value='Traumatic event (natural disaster, accident, witnessing violence, etc.)'  id='choice_82_94_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_94_6' id='label_82_94_6' class='gform-field-label gform-field-label--type-inline'>Evento traum\u00e1tico (desastre natural, accidente, presenciar violencia, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_94_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_94.7' type='checkbox'  value='Death of a loved one'  id='choice_82_94_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_94_7' id='label_82_94_7' class='gform-field-label gform-field-label--type-inline'>Muerte de un ser querido<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_94_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_94.8' type='checkbox'  value='Other and\/or tell us more about your trauma'  id='choice_82_94_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_94_8' id='label_82_94_8' class='gform-field-label gform-field-label--type-inline'>Otros y\/o cu\u00e9ntenos m\u00e1s sobre tu trauma.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_82_95\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_82_95'><span class='gform-field-label__text'>Cu\u00e9ntanos m\u00e1s sobre tu experiencia con el trauma:<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_95' id='input_82_95' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_82_69\" class=\"gfield gfield--type-html gfield--input-type-html section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>Acerca de tu salud mental<\/h2><\/div><fieldset id=\"field_82_71\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfAlguna vez has recibido tratamiento o apoyo por un problema de salud mental?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_71'>\n\t\t\t<div class='gchoice gchoice_82_71_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_71' type='radio' value='Yes'  id='choice_82_71_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_71_0' id='label_82_71_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_71_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_71' type='radio' value='No'  id='choice_82_71_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_71_1' id='label_82_71_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_72\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfEst\u00e1s recibiendo tratamiento o apoyo actualmente?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_72'>\n\t\t\t<div class='gchoice gchoice_82_72_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='Yes'  id='choice_82_72_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_72_0' id='label_82_72_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_72_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='No'  id='choice_82_72_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_72_1' id='label_82_72_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_300\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full optional traditional limit-3 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfQu\u00e9 te ha impedido buscar tratamiento en el pasado?<\/span><\/legend><div class='gfield_description' id='gfield_description_82_300'>Selecciona hasta 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_82_300'><div class='gchoice gchoice_82_300_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_300.1' type='checkbox'  value='I wanted to handle my mental health on my own'  id='choice_82_300_1'   aria-describedby=\"gfield_description_82_300\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_82_300_1' id='label_82_300_1' class='gform-field-label gform-field-label--type-inline'>Quer\u00eda manejar mi salud mental por mi cuenta.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_300_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_300.2' type='checkbox'  value='I didn\u2019t know how or where to start'  id='choice_82_300_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_300_2' id='label_82_300_2' class='gform-field-label gform-field-label--type-inline'>No sab\u00eda c\u00f3mo ni por d\u00f3nde empezar.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_300_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_300.3' type='checkbox'  value='I thought it would cost too much'  id='choice_82_300_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_300_3' id='label_82_300_3' class='gform-field-label gform-field-label--type-inline'>Pensaba que costar\u00eda demasiado.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_300_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_300.4' type='checkbox'  value='I didn\u2019t have time'  id='choice_82_300_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_300_4' id='label_82_300_4' class='gform-field-label gform-field-label--type-inline'>No ten\u00eda tiempo.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_300_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_300.5' type='checkbox'  value='I didn\u2019t think it would help me'  id='choice_82_300_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_300_5' id='label_82_300_5' class='gform-field-label gform-field-label--type-inline'>No cre\u00eda que me fuera a ayudar.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_300_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_300.6' type='checkbox'  value='I didn&#039;t feel ready to start treatment'  id='choice_82_300_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_300_6' id='label_82_300_6' class='gform-field-label gform-field-label--type-inline'>No me sent\u00eda preparado para comenzar el tratamiento.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_300_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_300.7' type='checkbox'  value='I was worried about what people would think or say if I got treatment'  id='choice_82_300_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_300_7' id='label_82_300_7' class='gform-field-label gform-field-label--type-inline'>Me preocupaba lo que la gente fuera a pensar o decir si me sometiera al tratamiento.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_300_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_300.8' type='checkbox'  value='I was afraid of being forced into a hospital or forced to take medication'  id='choice_82_300_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_300_8' id='label_82_300_8' class='gform-field-label gform-field-label--type-inline'>Ten\u00eda miedo de que me internaran en un hospital o me obligaran a tomar medicamentos.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_300_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_300.9' type='checkbox'  value='I tried, but couldn\u2019t find available treatment (no openings, wouldn\u2019t take insurance, etc.)'  id='choice_82_300_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_300_9' id='label_82_300_9' class='gform-field-label gform-field-label--type-inline'>Lo intent\u00e9, pero no pude encontrar un tratamiento disponible (no hab\u00eda plazas, no aceptaban el seguro, etc.).<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_300_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_300.11' type='checkbox'  value='My parent(s) or guardian wouldn&#039;t let me, or I didn&#039;t want to ask'  id='choice_82_300_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_300_11' id='label_82_300_11' class='gform-field-label gform-field-label--type-inline'>Mis pap\u00e1s o mi tutor no me dejaron, o no quer\u00eda pedir permiso.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_300_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_300.12' type='checkbox'  value='Other...'  id='choice_82_300_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_300_12' id='label_82_300_12' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_82_301\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_82_301'><span class='gform-field-label__text'>\u00bfQu\u00e9 otras cosas te han impedido buscar tratamiento en el pasado?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_301' id='input_82_301' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_82_73\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox optional traditional limit-3 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Piensa en tu prueba de salud mental. \u00bfCu\u00e1les son los principales factores que contribuyen a tus problemas de salud mental en este momento?<\/span><\/legend><div class='gfield_description' id='gfield_description_82_73'>Selecciona hasta 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_82_73'><div class='gchoice gchoice_82_73_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.1' type='checkbox'  value='Abuse or violence'  id='choice_82_73_1'   aria-describedby=\"gfield_description_82_73\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_82_73_1' id='label_82_73_1' class='gform-field-label gform-field-label--type-inline'>Abuso o violencia<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_73_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.2' type='checkbox'  value='Relationship problems (friends, family, or significant other)'  id='choice_82_73_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_73_2' id='label_82_73_2' class='gform-field-label gform-field-label--type-inline'>Problemas de relaci\u00f3n (amigos, familia o pareja)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_73_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.3' type='checkbox'  value='Body image'  id='choice_82_73_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_73_3' id='label_82_73_3' class='gform-field-label gform-field-label--type-inline'>Imagen corporal<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_73_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.4' type='checkbox'  value='Low self-esteem or self-image'  id='choice_82_73_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_73_4' id='label_82_73_4' class='gform-field-label gform-field-label--type-inline'>Baja autoestima o imagen de uno mismo<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_73_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.5' type='checkbox'  value='School or work problems'  id='choice_82_73_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_73_5' id='label_82_73_5' class='gform-field-label gform-field-label--type-inline'>Problemas en la escuela o en el trabajo<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_73_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.6' type='checkbox'  value='Financial problems'  id='choice_82_73_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_73_6' id='label_82_73_6' class='gform-field-label gform-field-label--type-inline'>Problemas financieros<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_73_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.7' type='checkbox'  value='Loneliness or isolation'  id='choice_82_73_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_73_7' id='label_82_73_7' class='gform-field-label gform-field-label--type-inline'>Soledad o aislamiento<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_73_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.8' type='checkbox'  value='Grief or loss of someone or something'  id='choice_82_73_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_73_8' id='label_82_73_8' class='gform-field-label gform-field-label--type-inline'>Dolor o p\u00e9rdida de alguien o algo.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_73_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.9' type='checkbox'  value='Experiencing hate\/bullying (including racism, homophobia, transphobia, or discrimination)'  id='choice_82_73_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_73_9' id='label_82_73_9' class='gform-field-label gform-field-label--type-inline'>Sufrir odio o acoso (incluido el racismo, la homofobia, la transfobia o la discriminaci\u00f3n)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_73_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.11' type='checkbox'  value='State of the world (war, climate, politics, immigration)'  id='choice_82_73_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_73_11' id='label_82_73_11' class='gform-field-label gform-field-label--type-inline'>Situaci\u00f3n mundial (guerra, clima, pol\u00edtica, inmigraci\u00f3n)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_73_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.12' type='checkbox'  value='I don\u2019t know (something just feels wrong)'  id='choice_82_73_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_73_12' id='label_82_73_12' class='gform-field-label gform-field-label--type-inline'>No lo s\u00e9 (s\u00f3lo que algo no va bien)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_73_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.13' type='checkbox'  value='Other...'  id='choice_82_73_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_73_13' id='label_82_73_13' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_82_74\" class=\"gfield gfield--type-text gfield--input-type-text optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_82_74'><span class='gform-field-label__text'>\u00bfQu\u00e9 m\u00e1s est\u00e1 contribuyendo a tus problemas de salud mental en este momento?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_74' id='input_82_74' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_82_96\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_82_96'><span class='gform-field-label__text'>\u00bfQu\u00e9 aspecto de la situaci\u00f3n mundial te afecta m\u00e1s?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_96' id='input_82_96' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_82_75\" class=\"gfield gfield--type-html gfield--input-type-html section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>Acerca de tu salud<\/h2><\/div><fieldset id=\"field_82_76\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTienes actualmente un seguro m\u00e9dico?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_76'>\n\t\t\t<div class='gchoice gchoice_82_76_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_76' type='radio' value='Yes'  id='choice_82_76_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_76_0' id='label_82_76_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_76_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_76' type='radio' value='No'  id='choice_82_76_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_76_1' id='label_82_76_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_76_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_76' type='radio' value='I don&#039;t know'  id='choice_82_76_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_76_2' id='label_82_76_2' class='gform-field-label gform-field-label--type-inline'>No lo s\u00e9<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_77\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox optional traditional field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>\u00bfTienes alguna de las siguientes condiciones f\u00edsicas?<\/span><\/legend><div class='gfield_description' id='gfield_description_82_77'>Selecciona todas las opciones que apliquen.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_82_77'><div class='gchoice gchoice_82_77_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_77.1' type='checkbox'  value='Heart disease'  id='choice_82_77_1'   aria-describedby=\"gfield_description_82_77\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_82_77_1' id='label_82_77_1' class='gform-field-label gform-field-label--type-inline'>Enfermedad card\u00edaca<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_77_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_77.2' type='checkbox'  value='Reproductive health concerns (PCOS, endometriosis, infertility, etc.)'  id='choice_82_77_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_77_2' id='label_82_77_2' class='gform-field-label gform-field-label--type-inline'>Problemas de salud reproductiva (s\u00edndrome de ovario poliqu\u00edstico, endometriosis, infertilidad, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_77_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_77.3' type='checkbox'  value='Diabetes'  id='choice_82_77_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_77_3' id='label_82_77_3' class='gform-field-label gform-field-label--type-inline'>Diabetes<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_77_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_77.4' type='checkbox'  value='Cancer'  id='choice_82_77_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_77_4' id='label_82_77_4' class='gform-field-label gform-field-label--type-inline'>C\u00e1ncer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_77_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_77.5' type='checkbox'  value='Arthritis or other chronic pain'  id='choice_82_77_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_77_5' id='label_82_77_5' class='gform-field-label gform-field-label--type-inline'>Artritis u otros dolores cr\u00f3nicos<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_77_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_77.6' type='checkbox'  value='Asthma, COPD or other lung conditions'  id='choice_82_77_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_77_6' id='label_82_77_6' class='gform-field-label gform-field-label--type-inline'>Asma, EPOC u otras afecciones pulmonares<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_77_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_77.7' type='checkbox'  value='Movement Disorders (involuntary tics, tardive dyskinesia, etc.)'  id='choice_82_77_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_77_7' id='label_82_77_7' class='gform-field-label gform-field-label--type-inline'>Trastornos del movimiento (tics involuntarios, discinesia tard\u00eda, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_77_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_77.8' type='checkbox'  value='Digestive problems (Crohn\u2019s, colitis, IBS, etc.)'  id='choice_82_77_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_77_8' id='label_82_77_8' class='gform-field-label gform-field-label--type-inline'>Problemas digestivos (enfermedad de Crohn, colitis, s\u00edndrome del intestino irritable, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_77_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_77.9' type='checkbox'  value='Neurological conditions (epilepsy, etc.) or traumatic brain injury (TBI)'  id='choice_82_77_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_77_9' id='label_82_77_9' class='gform-field-label gform-field-label--type-inline'>Afecciones neurol\u00f3gicas (epilepsia, etc.) o traumatismo craneoencef\u00e1lico (TCE)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_82_77_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_77.11' type='checkbox'  value='Other...'  id='choice_82_77_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_82_77_11' id='label_82_77_11' class='gform-field-label gform-field-label--type-inline'>Otros...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_82_78\" class=\"gfield gfield--type-text gfield--input-type-text optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_82_78'><span class='gform-field-label__text'>\u00bfQu\u00e9 otras condiciones f\u00edsicas tienes?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_78' id='input_82_78' type='text' value='' class='medium'    placeholder='Cu\u00e9ntanos m\u00e1s...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_82_297\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTienes una mascota que te ayuda a cuidar tu salud mental?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_297'>\n\t\t\t<div class='gchoice gchoice_82_297_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_297' type='radio' value='Yes'  id='choice_82_297_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_297_0' id='label_82_297_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_297_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_297' type='radio' value='No'  id='choice_82_297_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_297_1' id='label_82_297_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_82_298\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full short indent field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfTe interesa tener una mascota que te ayude a cuidar tu salud mental?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_82_298'>\n\t\t\t<div class='gchoice gchoice_82_298_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_298' type='radio' value='Yes'  id='choice_82_298_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_298_0' id='label_82_298_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_82_298_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_298' type='radio' value='No'  id='choice_82_298_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_82_298_1' id='label_82_298_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><button type='submit' id='gform_previous_button_82' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Anterior<\/button> <button type='submit' id='gform_submit_button_82' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Ver resultados<\/button> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_82' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_82' id='gform_theme_82' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_82' id='gform_style_settings_82' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_82' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='82' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='2S\/fvlYIQSo6qwUqTNEz2vu1hMD6CfI2ebJqOu\/mucFMu6LpwcnNd9Hrwd9HXxNIMw4lAhIX+0118geCALMO86O+RR11Fng1oZKNFdqk2iX\/0pg=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_82' value='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' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_82' id='gform_target_page_number_82' value='2' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_82' id='gform_source_page_number_82' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n             <\/div><\/div>\n                        <input type=\"hidden\" name=\"trp-form-language\" value=\"es\"\/><\/form>\n                        <\/div>\n<p>&nbsp;<\/p>\n<hr \/>\n<h2 class=\"smaller\">Fuente:<\/h2>\n<div class=\"references\">\n<p>Pantalla de diagn\u00f3stico NORC para problemas de juego: Trastorno por juego del DSM-5<br \/>\n(NODS-GD)<\/p>\n<p>Brazeau y Hodgins. (2022). Evaluaci\u00f3n psicom\u00e9trica de la prueba de diagn\u00f3stico NORC para problemas de juego (NODS) para la evaluaci\u00f3n del trastorno por juego del DSM-5. <em>Conductas adictivas 130<\/em>, p. 107310. Obtenido de <a href=\"https:\/\/doi.org\/10.1016\/j.addbeh.2022.107310\">https:\/\/doi.org\/10.1016\/j.addbeh.2022.107310<\/a><\/p>\n<p>NODS original:<\/p>\n<p>Wickwire Jr, E. M., Burke, R. S., Brown, S. A., Parker, J. D. y May, R. K. (2008). Evaluaci\u00f3n psicom\u00e9trica del cuestionario DSM-IV del Centro Nacional de Investigaci\u00f3n de Opini\u00f3n P\u00fablica para detectar problemas de juego (NODS). <i>Revista estadounidense sobre adicciones<\/i>, <i>17<\/i>(5), 392-395.<\/p>\n<p><a href=\"https:\/\/screening.mhanational.org\/es\/about-our-mental-health-tests\/\" target=\"_blank\" rel=\"noopener\">Para aprender m\u00e1s sobre nuestras herramientas de detecci\u00f3n, haz clic aqu\u00ed.<\/a><\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Para personas preocupadas por su comportamiento con respecto al juego \/ las apuestas.<\/p>","protected":false},"template":"","tags":[123],"age_group":[],"condition":[],"class_list":["post-245618","screen","type-screen","status-publish","hentry","tag-addictive-compulsive-behaviors"],"acf":[],"yoast_head":"<title>Gambling Addiction Test &#8211; Mental Health America<\/title>\n<meta name=\"description\" content=\"Worried that you gamble too much? 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