{"id":5,"date":"2018-04-30T12:51:15","date_gmt":"2018-04-30T12:51:15","guid":{"rendered":"http:\/\/csipreview.com\/clients\/bounceback\/?page_id=5"},"modified":"2019-03-28T13:31:41","modified_gmt":"2019-03-28T13:31:41","slug":"bounceback-quiz","status":"publish","type":"page","link":"https:\/\/bouncebackbc.ca\/bounceback-quiz\/","title":{"rendered":"Bounceback Quiz"},"content":{"rendered":"<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_chrome gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_1' ><div id='gf_1' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_1' id='gform_1'  action='\/wp-json\/wp\/v2\/pages\/5#gf_1' data-formid='1' novalidate>\n        <div id='gf_progressbar_wrapper_1' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<h3 class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>6<\/span>\n        \t<\/h3>\n            <div class='gf_progressbar gf_progressbar_orange' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_orange percentbar_16' style='width:16%;'><span>16%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_1_1' class='gform_page ' data-js='page-field-id-1' >\n                                    <div class='gform_page_fields'><ul id='gform_fields_1' class='gform_fields top_label form_sublabel_below description_below'><li id=\"field_1_25\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_25\" ><div class=\"welcome-page\"><h1 class=\"start-quiz__title\">BounceBack<sup>\u00ae<\/sup><\/h1><h2 class=\"start-quiz__subtitle\">Adults Quiz<\/h2><img decoding=\"async\" class=\"smiley-face\" src=\"https:\/\/bouncebackbc.ca\/wp-content\/themes\/bounceback\/dist\/images\/face-animated.gif\"><img decoding=\"async\" class=\"five-minutes five-minutes-desktop\" src=\"https:\/\/bouncebackbc.ca\/wp-content\/themes\/bounceback\/dist\/images\/5-minutes.png\"><img decoding=\"async\" class=\"five-minutes five-minutes-mobile\" src=\"https:\/\/bouncebackbc.ca\/wp-content\/themes\/bounceback\/dist\/images\/five-minutes-mobile.svg\"> <p>It\u2019s not always easy to know when our mental health is at risk. We have ups and downs and get used to having a few bad days here and there. Sometimes we're the last ones to notice there are more bad days than good.<\/p><p><b>Taking this quiz can help you start living life more fully<\/b> and point you towards steps you can take to start feeling better.<\/p><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                         <div class=\"bounceback-next\"><input type='button' id='gform_next_button_1_24' class='gform_next_button gform-theme-button button' value='GET STARTED'  onclick='jQuery(\"#gform_target_page_number_1\").val(\"2\");  jQuery(\"#gform_1\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_1\").val(\"2\");  jQuery(\"#gform_1\").trigger(\"submit\",[true]); } ' \/><\/div> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_1_2' class='gform_page get-started' data-js='page-field-id-24' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_1_2' class='gform_fields top_label form_sublabel_below description_below'><li id=\"field_1_2\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_2\" ><label class='gfield_label gform-field-label' >How did you sleep last night?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_1_2'>\n\t\t\t<li class='gchoice gchoice_1_2_0'>\n\t\t\t\t<input name='input_2' type='radio' value='3'  id='choice_1_2_0'    \/>\n\t\t\t\t<label for='choice_1_2_0' id='label_1_2_0' class='gform-field-label gform-field-label--type-inline'>I\u2019m trying but I really haven\u2019t slept much in weeks<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_2_1'>\n\t\t\t\t<input name='input_2' type='radio' value='2'  id='choice_1_2_1'    \/>\n\t\t\t\t<label for='choice_1_2_1' id='label_1_2_1' class='gform-field-label gform-field-label--type-inline'>Not great, I still felt tired when I woke up<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_2_2'>\n\t\t\t\t<input name='input_2' type='radio' value='1'  id='choice_1_2_2'    \/>\n\t\t\t\t<label for='choice_1_2_2' id='label_1_2_2' class='gform-field-label gform-field-label--type-inline'>Pretty good<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_1_3\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_3\" ><label class='gfield_label gform-field-label' >How long did it take you to fall asleep last night<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_1_3'>\n\t\t\t<li class='gchoice gchoice_1_3_0'>\n\t\t\t\t<input name='input_3' type='radio' value='1'  id='choice_1_3_0'    \/>\n\t\t\t\t<label for='choice_1_3_0' id='label_1_3_0' class='gform-field-label gform-field-label--type-inline'>As soon as my head hit the pillow<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_3_1'>\n\t\t\t\t<input name='input_3' type='radio' value='3'  id='choice_1_3_1'    \/>\n\t\t\t\t<label for='choice_1_3_1' id='label_1_3_1' class='gform-field-label gform-field-label--type-inline'>Quite a while, with a lot of tossing and turning<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_3_2'>\n\t\t\t\t<input name='input_3' type='radio' value='2'  id='choice_1_3_2'    \/>\n\t\t\t\t<label for='choice_1_3_2' id='label_1_3_2' class='gform-field-label gform-field-label--type-inline'>Not right away but not too long either<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_1_6\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_6\" ><label class='gfield_label gform-field-label' >Is something weighing on your mind?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_1_6'>\n\t\t\t<li class='gchoice gchoice_1_6_0'>\n\t\t\t\t<input name='input_6' type='radio' value='2'  id='choice_1_6_0'    \/>\n\t\t\t\t<label for='choice_1_6_0' id='label_1_6_0' class='gform-field-label gform-field-label--type-inline'>Lots of little things, but nothing too serious<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_6_1'>\n\t\t\t\t<input name='input_6' type='radio' value='1'  id='choice_1_6_1'    \/>\n\t\t\t\t<label for='choice_1_6_1' id='label_1_6_1' class='gform-field-label gform-field-label--type-inline'>Not really<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_6_2'>\n\t\t\t\t<input name='input_6' type='radio' value='3'  id='choice_1_6_2'    \/>\n\t\t\t\t<label for='choice_1_6_2' id='label_1_6_2' class='gform-field-label gform-field-label--type-inline'>Yes, 1 or 2 worries are bothering me; this happens a lot<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_1_21\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_21\" ><div class='ginput_container ginput_container_text'><input name='input_21' id='input_1_21' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <div class=\"bounceback-prev\"><input type='button' id='gform_previous_button_1_10' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_1\").val(\"1\");  jQuery(\"#gform_1\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_1\").val(\"1\");  jQuery(\"#gform_1\").trigger(\"submit\",[true]); } ' \/><\/div> <div class=\"bounceback-next\"><input type='button' id='gform_next_button_1_10' class='gform_next_button gform-theme-button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_1\").val(\"3\");  jQuery(\"#gform_1\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_1\").val(\"3\");  jQuery(\"#gform_1\").trigger(\"submit\",[true]); } ' \/><\/div> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_1_3' class='gform_page' data-js='page-field-id-10' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_1_3' class='gform_fields top_label form_sublabel_below description_below'><li id=\"field_1_5\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_5\" ><label class='gfield_label gform-field-label' >How\u2019s your mood generally?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_1_5'>\n\t\t\t<li class='gchoice gchoice_1_5_0'>\n\t\t\t\t<input name='input_5' type='radio' value='1'  id='choice_1_5_0'    \/>\n\t\t\t\t<label for='choice_1_5_0' id='label_1_5_0' class='gform-field-label gform-field-label--type-inline'>I have my moments but generally OK<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_5_1'>\n\t\t\t\t<input name='input_5' type='radio' value='2'  id='choice_1_5_1'    \/>\n\t\t\t\t<label for='choice_1_5_1' id='label_1_5_1' class='gform-field-label gform-field-label--type-inline'>I\u2019m noticing more often that I\u2019m feeling sad, irritable or numb<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_5_2'>\n\t\t\t\t<input name='input_5' type='radio' value='3'  id='choice_1_5_2'    \/>\n\t\t\t\t<label for='choice_1_5_2' id='label_1_5_2' class='gform-field-label gform-field-label--type-inline'>Most days I feel sad, irritable or numb<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_1_7\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_7\" ><label class='gfield_label gform-field-label' >How\u2019s your appetite?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_1_7'>\n\t\t\t<li class='gchoice gchoice_1_7_0'>\n\t\t\t\t<input name='input_7' type='radio' value='3'  id='choice_1_7_0'    \/>\n\t\t\t\t<label for='choice_1_7_0' id='label_1_7_0' class='gform-field-label gform-field-label--type-inline'>Changed, I\u2019ve noticed that I\u2019m eating more or less than usual<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_7_1'>\n\t\t\t\t<input name='input_7' type='radio' value='1'  id='choice_1_7_1'    \/>\n\t\t\t\t<label for='choice_1_7_1' id='label_1_7_1' class='gform-field-label gform-field-label--type-inline'>Good, I eat regular meals most of the time<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_7_2'>\n\t\t\t\t<input name='input_7' type='radio' value='2'  id='choice_1_7_2'    \/>\n\t\t\t\t<label for='choice_1_7_2' id='label_1_7_2' class='gform-field-label gform-field-label--type-inline'>Sometimes I skip meals or eat too much<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_1_8\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_8\" ><label class='gfield_label gform-field-label' >What would you say about your drinking habits?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_1_8'>\n\t\t\t<li class='gchoice gchoice_1_8_0'>\n\t\t\t\t<input name='input_8' type='radio' value='1'  id='choice_1_8_0'    \/>\n\t\t\t\t<label for='choice_1_8_0' id='label_1_8_0' class='gform-field-label gform-field-label--type-inline'>I don\u2019t drink alcohol or very rarely do<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_8_1'>\n\t\t\t\t<input name='input_8' type='radio' value='3'  id='choice_1_8_1'    \/>\n\t\t\t\t<label for='choice_1_8_1' id='label_1_8_1' class='gform-field-label gform-field-label--type-inline'>I have been drinking more alcohol than usual lately<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_8_2'>\n\t\t\t\t<input name='input_8' type='radio' value='2'  id='choice_1_8_2'    \/>\n\t\t\t\t<label for='choice_1_8_2' id='label_1_8_2' class='gform-field-label gform-field-label--type-inline'>I drink a few times a week but I don\u2019t overdo it<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_1_33\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_33\" ><label class='gfield_label gform-field-label' >How\u2019s your social life?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_1_33'>\n\t\t\t<li class='gchoice gchoice_1_33_0'>\n\t\t\t\t<input name='input_33' type='radio' value='3'  id='choice_1_33_0'    \/>\n\t\t\t\t<label for='choice_1_33_0' id='label_1_33_0' class='gform-field-label gform-field-label--type-inline'>Not great, I have a hard time developing friendships<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_33_1'>\n\t\t\t\t<input name='input_33' type='radio' value='1'  id='choice_1_33_1'    \/>\n\t\t\t\t<label for='choice_1_33_1' id='label_1_33_1' class='gform-field-label gform-field-label--type-inline'>Good, I have good friends and enjoy spending time with them<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_33_2'>\n\t\t\t\t<input name='input_33' type='radio' value='2'  id='choice_1_33_2'    \/>\n\t\t\t\t<label for='choice_1_33_2' id='label_1_33_2' class='gform-field-label gform-field-label--type-inline'>So-so, I get out or connect with others but don't have as many close friends as I'd like<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <div class=\"bounceback-prev\"><input type='button' id='gform_previous_button_1_12' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_1\").val(\"2\");  jQuery(\"#gform_1\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_1\").val(\"2\");  jQuery(\"#gform_1\").trigger(\"submit\",[true]); } ' \/><\/div> <div class=\"bounceback-next\"><input type='button' id='gform_next_button_1_12' class='gform_next_button gform-theme-button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_1\").val(\"4\");  jQuery(\"#gform_1\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_1\").val(\"4\");  jQuery(\"#gform_1\").trigger(\"submit\",[true]); } ' \/><\/div> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_1_4' class='gform_page' data-js='page-field-id-12' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_1_4' class='gform_fields top_label form_sublabel_below description_below'><li id=\"field_1_11\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_11\" ><label class='gfield_label gform-field-label' >Are you still doing things you used to do?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_1_11'>\n\t\t\t<li class='gchoice gchoice_1_11_0'>\n\t\t\t\t<input name='input_11' type='radio' value='1'  id='choice_1_11_0'    \/>\n\t\t\t\t<label for='choice_1_11_0' id='label_1_11_0' class='gform-field-label gform-field-label--type-inline'>Sure, I\u2019m sticking to my usual routines and activities even if I don\u2019t always feel like it<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_11_1'>\n\t\t\t\t<input name='input_11' type='radio' value='3'  id='choice_1_11_1'    \/>\n\t\t\t\t<label for='choice_1_11_1' id='label_1_11_1' class='gform-field-label gform-field-label--type-inline'>Not really, I'm doing less and avoiding more<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_11_2'>\n\t\t\t\t<input name='input_11' type='radio' value='2'  id='choice_1_11_2'    \/>\n\t\t\t\t<label for='choice_1_11_2' id='label_1_11_2' class='gform-field-label gform-field-label--type-inline'>Sometimes, but I don\u2019t enjoy my activities as much as I used to<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_1_13\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_13\" ><label class='gfield_label gform-field-label' >Are you able to share your feelings?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_1_13'>\n\t\t\t<li class='gchoice gchoice_1_13_0'>\n\t\t\t\t<input name='input_13' type='radio' value='1'  id='choice_1_13_0'    \/>\n\t\t\t\t<label for='choice_1_13_0' id='label_1_13_0' class='gform-field-label gform-field-label--type-inline'>Yes, I have a strong support network of friends and family that I can talk to if I need to<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_13_1'>\n\t\t\t\t<input name='input_13' type='radio' value='2'  id='choice_1_13_1'    \/>\n\t\t\t\t<label for='choice_1_13_1' id='label_1_13_1' class='gform-field-label gform-field-label--type-inline'>I try sometimes, but not as much as I'd like to<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_13_2'>\n\t\t\t\t<input name='input_13' type='radio' value='3'  id='choice_1_13_2'    \/>\n\t\t\t\t<label for='choice_1_13_2' id='label_1_13_2' class='gform-field-label gform-field-label--type-inline'>No, I tend to keep my feelings to myself<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_1_14\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_14\" ><label class='gfield_label gform-field-label' >A big deadline or important date is coming up. How do you handle it?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_1_14'>\n\t\t\t<li class='gchoice gchoice_1_14_0'>\n\t\t\t\t<input name='input_14' type='radio' value='1'  id='choice_1_14_0'    \/>\n\t\t\t\t<label for='choice_1_14_0' id='label_1_14_0' class='gform-field-label gform-field-label--type-inline'>It\u2019s fine, I can prioritize or put it in perspective and work through it<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_14_1'>\n\t\t\t\t<input name='input_14' type='radio' value='3'  id='choice_1_14_1'    \/>\n\t\t\t\t<label for='choice_1_14_1' id='label_1_14_1' class='gform-field-label gform-field-label--type-inline'>I tend to panic or have a meltdown<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_14_2'>\n\t\t\t\t<input name='input_14' type='radio' value='2'  id='choice_1_14_2'    \/>\n\t\t\t\t<label for='choice_1_14_2' id='label_1_14_2' class='gform-field-label gform-field-label--type-inline'>Some nail-biting, but I get through it ok<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_1_34\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_34\" ><label class='gfield_label gform-field-label' >How do you feel about yourself overall?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_1_34'>\n\t\t\t<li class='gchoice gchoice_1_34_0'>\n\t\t\t\t<input name='input_34' type='radio' value='1'  id='choice_1_34_0'    \/>\n\t\t\t\t<label for='choice_1_34_0' id='label_1_34_0' class='gform-field-label gform-field-label--type-inline'>I feel pretty strong and generally well<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_34_1'>\n\t\t\t\t<input name='input_34' type='radio' value='3'  id='choice_1_34_1'    \/>\n\t\t\t\t<label for='choice_1_34_1' id='label_1_34_1' class='gform-field-label gform-field-label--type-inline'>I honestly feel awful and really not myself at all<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_34_2'>\n\t\t\t\t<input name='input_34' type='radio' value='2'  id='choice_1_34_2'    \/>\n\t\t\t\t<label for='choice_1_34_2' id='label_1_34_2' class='gform-field-label gform-field-label--type-inline'>Mostly ok, some days are better than others<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <div class=\"bounceback-prev\"><input type='button' id='gform_previous_button_1_22' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_1\").val(\"3\");  jQuery(\"#gform_1\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_1\").val(\"3\");  jQuery(\"#gform_1\").trigger(\"submit\",[true]); } ' \/><\/div> <div class=\"bounceback-next\"><input type='button' id='gform_next_button_1_22' class='gform_next_button gform-theme-button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_1\").val(\"5\");  jQuery(\"#gform_1\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_1\").val(\"5\");  jQuery(\"#gform_1\").trigger(\"submit\",[true]); } ' \/><\/div> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_1_5' class='gform_page' data-js='page-field-id-22' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_1_5' class='gform_fields top_label form_sublabel_below description_below'><li id=\"field_1_23\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_23\" ><label class='gfield_label gform-field-label' >How do you feel about yourself overall?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_1_23'>\n\t\t\t<li class='gchoice gchoice_1_23_0'>\n\t\t\t\t<input name='input_23' type='radio' value='1'  id='choice_1_23_0'    \/>\n\t\t\t\t<label for='choice_1_23_0' id='label_1_23_0' class='gform-field-label gform-field-label--type-inline'>I feel pretty strong and generally well<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_23_1'>\n\t\t\t\t<input name='input_23' type='radio' value='3'  id='choice_1_23_1'    \/>\n\t\t\t\t<label for='choice_1_23_1' id='label_1_23_1' class='gform-field-label gform-field-label--type-inline'>I don't feel great and I'm really not myself at all<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_23_2'>\n\t\t\t\t<input name='input_23' type='radio' value='3'  id='choice_1_23_2'    \/>\n\t\t\t\t<label for='choice_1_23_2' id='label_1_23_2' class='gform-field-label gform-field-label--type-inline'>Mostly ok, some days are better than others<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <div class=\"bounceback-prev\"><input type='button' id='gform_previous_button_1_32' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_1\").val(\"4\");  jQuery(\"#gform_1\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_1\").val(\"4\");  jQuery(\"#gform_1\").trigger(\"submit\",[true]); } ' \/><\/div> <div class=\"bounceback-next\"><input type='button' id='gform_next_button_1_32' class='gform_next_button gform-theme-button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_1\").val(\"6\");  jQuery(\"#gform_1\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_1\").val(\"6\");  jQuery(\"#gform_1\").trigger(\"submit\",[true]); } ' \/><\/div> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_1_6' class='gform_page' data-js='page-field-id-32' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_1_6' class='gform_fields top_label form_sublabel_below description_below'><li id=\"field_1_27\" class=\"gfield gfield--type-html gfield_html gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_27\" ><h3 class=\"about yourself\">If you like, tell us a bit more about yourself<\/h3><\/li><li id=\"field_1_29\" class=\"gfield gfield--type-select field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_29\" ><label class='gfield_label gform-field-label' for='input_1_29'>What gender do you identify as?<\/label><div class='ginput_container ginput_container_select'><select name='input_29' id='input_1_29' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Click drop-down to select<\/option><option value='Male' >Male<\/option><option value='Female' >Female<\/option><option value='Non-binary' >Non-binary<\/option><option value='Other' >Other<\/option><\/select><\/div><\/li><li id=\"field_1_17\" class=\"gfield gfield--type-select bounceback-age optional field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_17\" ><label class='gfield_label gform-field-label' for='input_1_17'>What age are you?<\/label><div class='ginput_container ginput_container_select'><select name='input_17' id='input_1_17' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Click drop-down to select<\/option><option value='Under 15' >Under 15<\/option><option value='15-18' >15-18<\/option><option value='19-24' >19-24<\/option><option value='25-30' >25-30<\/option><option value='31-40' >31-40<\/option><option value='41-50' >41-50<\/option><option value='51-60' >51-60<\/option><option value='61-70' >61-70<\/option><option value='71-79' >71-79<\/option><option value='80 and above' >80 and above<\/option><\/select><\/div><\/li><li id=\"field_1_26\" class=\"gfield gfield--type-select field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_26\" ><label class='gfield_label gform-field-label' for='input_1_26'>Where do you currently live?<\/label><div class='ginput_container ginput_container_select'><select name='input_26' id='input_1_26' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Click drop-down to select<\/option><option value='British Columbia' >British Columbia<\/option><option value='Another province of Canada' >Another province of Canada<\/option><option value='Outside of Canada' >Outside of Canada<\/option><\/select><\/div><\/li><li id=\"field_1_19\" class=\"gfield gfield--type-select bounceback-etnicity-select optional gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_19\" ><label class='gfield_label gform-field-label' for='input_1_19'>Please select your ethnic background:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_19' id='input_1_19' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Arab' >Arab<\/option><option value='Black' >Black<\/option><option value='Chinese' >Chinese<\/option><option value='Filipino' >Filipino<\/option><option value='First Nations\/Aboriginal\/Metis\/Inuit' >First Nations\/Aboriginal\/Metis\/Inuit<\/option><option value='Japanese' >Japanese<\/option><option value='Korean' >Korean<\/option><option value='Latin American' >Latin American<\/option><option value='South Asian [e.g. East Indian, Pakistani, Sri Lankan]' >South Asian [e.g. East Indian, Pakistani, Sri Lankan]<\/option><option value='Southeast Asian [e.g. Vietnamese, Cambodian, Laotian, Thai]' >Southeast Asian [e.g. Vietnamese, Cambodian, Laotian, Thai]<\/option><option value='West Asian [e.g. Iranian, Afghani]' >West Asian [e.g. Iranian, Afghani]<\/option><option value='White' >White<\/option><option value='Other' >Other<\/option><\/select><\/div><\/li><li id=\"field_1_31\" class=\"gfield gfield--type-checkbox gfield--type-choice did-you-learn field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_31\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >How did you learn about this quiz?<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_1_31'><li class='gchoice gchoice_1_31_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.1' type='checkbox'  value='Facebook'  id='choice_1_31_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_31_1' id='label_1_31_1' class='gform-field-label gform-field-label--type-inline'>Facebook<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_31_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.2' type='checkbox'  value='Friend'  id='choice_1_31_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_31_2' id='label_1_31_2' class='gform-field-label gform-field-label--type-inline'>Friend<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_31_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.3' type='checkbox'  value='Instagram'  id='choice_1_31_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_31_3' id='label_1_31_3' class='gform-field-label gform-field-label--type-inline'>Instagram<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_31_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.4' type='checkbox'  value='News article or segment'  id='choice_1_31_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_31_4' id='label_1_31_4' class='gform-field-label gform-field-label--type-inline'>News article or segment<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_31_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.5' type='checkbox'  value='Radio'  id='choice_1_31_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_31_5' id='label_1_31_5' class='gform-field-label gform-field-label--type-inline'>Radio<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_31_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.6' type='checkbox'  value='Television'  id='choice_1_31_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_31_6' id='label_1_31_6' class='gform-field-label gform-field-label--type-inline'>Television<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_31_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.7' type='checkbox'  value='Twitter'  id='choice_1_31_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_31_7' id='label_1_31_7' class='gform-field-label gform-field-label--type-inline'>Twitter<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_31_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.8' type='checkbox'  value='YouTube'  id='choice_1_31_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_31_8' id='label_1_31_8' class='gform-field-label gform-field-label--type-inline'>YouTube<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><\/ul><\/div>\n        <div class='gform_page_footer top_label'><div class=\"bounceback-prev\"><input type='submit' id='gform_previous_button_1' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Previous'  onclick='if(window[\"gf_submitting_1\"]){return false;}  if( !jQuery(\"#gform_1\")[0].checkValidity || jQuery(\"#gform_1\")[0].checkValidity()){window[\"gf_submitting_1\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_1\"]){return false;} if( !jQuery(\"#gform_1\")[0].checkValidity || jQuery(\"#gform_1\")[0].checkValidity()){window[\"gf_submitting_1\"]=true;}  jQuery(\"#gform_1\").trigger(\"submit\",[true]); }' \/><\/div> <div class=\"bounceback-next\"><input type='submit' id='gform_submit_button_1' class='gform_button button' value='See Results'  onclick='if(window[\"gf_submitting_1\"]){return false;}  if( !jQuery(\"#gform_1\")[0].checkValidity || jQuery(\"#gform_1\")[0].checkValidity()){window[\"gf_submitting_1\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_1\"]){return false;} if( !jQuery(\"#gform_1\")[0].checkValidity || jQuery(\"#gform_1\")[0].checkValidity()){window[\"gf_submitting_1\"]=true;}  jQuery(\"#gform_1\").trigger(\"submit\",[true]); }' \/><\/div> <input type='hidden' name='gform_ajax' value='form_id=1&amp;title=&amp;description=&amp;tabindex=0&amp;theme=legacy' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_1' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='1' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_1' value='WyJbXSIsIjBlNjQ2ZjQzMWU4Y2ViYzk3N2YzMDU0YTAxNmY5YTA0Il0=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_target_page_number_1' id='gform_target_page_number_1' value='2' \/>\n            <input type='hidden' class='gform_hidden' name='gform_source_page_number_1' id='gform_source_page_number_1' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/div><\/div>\n                        <\/form>\n                        <\/div>\n\t\t                <iframe style='display:none;width:0px;height:0px;' src='about:blank' name='gform_ajax_frame_1' id='gform_ajax_frame_1' title='This iframe contains the logic required to handle Ajax powered Gravity Forms.'><\/iframe>\n\t\t                <script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\n 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