{"id":7759,"date":"2023-04-19T15:03:26","date_gmt":"2023-04-19T19:03:26","guid":{"rendered":"https:\/\/proanima.stagingsept24.com\/giving-up-your-pet\/abandonment-form\/"},"modified":"2023-05-16T10:51:59","modified_gmt":"2023-05-16T14:51:59","slug":"abandonment-form","status":"publish","type":"page","link":"https:\/\/proanima.stagingsept24.com\/en\/giving-up-your-pet\/abandonment-form\/","title":{"rendered":"Abandonment form"},"content":{"rendered":"<style>.kb-row-layout-id_49ffb3-c3 > .kt-row-column-wrap{align-content:start;}:where(.kb-row-layout-id_49ffb3-c3 > .kt-row-column-wrap) > .wp-block-kadence-column{justify-content:start;}.kb-row-layout-id_49ffb3-c3 > .kt-row-column-wrap{column-gap:var(--global-kb-gap-md, 2rem);row-gap:var(--global-kb-gap-md, 2rem);max-width:var( --global-content-width, 1640px );padding-left:var(--global-content-edge-padding);padding-right:var(--global-content-edge-padding);padding-bottom:120px;grid-template-columns:minmax(0, 1fr);}.kb-row-layout-id_49ffb3-c3 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var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Surrender Form<\/h2>\n                            <p class='gform_description'><\/p>\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_17'  action='\/en\/wp-json\/wp\/v2\/pages\/7759' data-formid='17' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_17' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_17_1\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Would you like a staff member to give you advice on how to keep your pet?<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_17_1'>\n\t\t\t<div class='gchoice gchoice_17_1_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_1' type='radio' value='Yes'  id='choice_17_1_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_1_0' id='label_17_1_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_17_1_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_1' type='radio' value='No'  id='choice_17_1_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_1_1' id='label_17_1_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_91\" 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_below field_validation_below gfield_visibility_visible\"  >Merci de nous contacter pour prendre un rendez-vous : 450 655-2525 ou info@proanima.com<\/div><div id=\"field_17_90\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_90'>Date de votre rendez-vous :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_90' id='input_17_90' type='text' value='' class='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon'   placeholder='dd\/mm\/yyyy' aria-describedby=\"input_17_90_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_17_90_date_format' class='screen-reader-text'>DD slash MM slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_17_90' class='gform_hidden' value='https:\/\/proanima.stagingsept24.com\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><fieldset id=\"field_17_89\" 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_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >D\u00e9sirez-vous qu\u2019un employ\u00e9 vous donne des conseils pour garder votre animal ?<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_17_89'>\n\t\t\t<div class='gchoice gchoice_17_89_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_89' type='radio' value='Oui'  id='choice_17_89_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_89_0' id='label_17_89_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_89_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_89' type='radio' value='Non'  id='choice_17_89_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_89_1' id='label_17_89_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_3\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_3'>Please provide your phone number:<\/label><div class='ginput_container ginput_container_phone'><input name='input_3' id='input_17_3' type='tel' value='' class='small'    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_81\" 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_below field_validation_below gfield_visibility_visible\"  ><br><\/div><div id=\"field_17_62\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">General informations<\/h3><\/div><fieldset id=\"field_17_63\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_17_63'>\n                            \n                            <span id='input_17_63_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_63.3' id='input_17_63_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_17_63_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_17_63_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_63.6' id='input_17_63_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_17_63_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_17_64\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_64'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_64' id='input_17_64' type='tel' value='' class='small'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_65\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_65'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_65' id='input_17_65' type='email' value='' class='small'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><fieldset id=\"field_17_66\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_zip ginput_container_address gform-grid-row' id='input_17_66' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_17_66_1_container' >\n                                        <input type='text' name='input_66.1' id='input_17_66_1' value=''    aria-required='true'    \/>\n                                        <label for='input_17_66_1' id='input_17_66_1_label' class='gform-field-label gform-field-label--type-sub '>Number and street<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_17_66_2_container' >\n                                        <input type='text' name='input_66.2' id='input_17_66_2' value=''     aria-required='false'   \/>\n                                        <label for='input_17_66_2' id='input_17_66_2_label' class='gform-field-label gform-field-label--type-sub '>Apartment<\/label>\n                                    <\/span><input type='hidden' class='gform_hidden' name='input_66.4' id='input_17_66_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_17_66_5_container' >\n                                    <input type='text' name='input_66.5' id='input_17_66_5' value=''    aria-required='true'    \/>\n                                    <label for='input_17_66_5' id='input_17_66_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_66.6' id='input_17_66_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_17_67\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_67'>City<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_67' id='input_17_67' class='large gfield_select'  aria-describedby=\"gfield_description_17_67\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='Select' >Select<\/option><option value='Boucherville' >Boucherville<\/option><option value='Longueuil (including Saint-Hubert, Greenfield Park, LeMoyne)' >Longueuil (including Saint-Hubert, Greenfield Park, LeMoyne)<\/option><option value='Saint-Bruno-de-Montarville' >Saint-Bruno-de-Montarville<\/option><option value='Saint-Jean-sur-Richelieu' >Saint-Jean-sur-Richelieu<\/option><option value='Saint-Alexandre' >Saint-Alexandre<\/option><option value='Saint-Valentin' >Saint-Valentin<\/option><option value='Venise-en-Qu\u00e9bec' >Venise-en-Qu\u00e9bec<\/option><option value='Saint-Mathias-sur-Richelieu' >Saint-Mathias-sur-Richelieu<\/option><option value='Saint-Blaise-sur-Richelieu' >Saint-Blaise-sur-Richelieu<\/option><option value='Noyan' >Noyan<\/option><option value='Clarenceville' >Clarenceville<\/option><option value='Mont-Saint-Gr\u00e9goire' >Mont-Saint-Gr\u00e9goire<\/option><option value='Lacolle' >Lacolle<\/option><option value='Sainte-Julie' >Sainte-Julie<\/option><\/select><\/div><div class='gfield_description' id='gfield_description_17_67'>We offer abandonment service only in the cities that are listed here. If your city does not appear there, you are not entitled to the service.\n<\/div><\/div><div id=\"field_17_80\" 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_below field_validation_below gfield_visibility_visible\"  ><br><\/div><div id=\"field_17_72\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Pet&#039;s infos<\/h3><\/div><div id=\"field_17_5\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_5'>Pet\u2019s name:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_17_5' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_7\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Species:<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_17_7'>\n\t\t\t<div class='gchoice gchoice_17_7_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='Dog'  id='choice_17_7_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_7_0' id='label_17_7_0' class='gform-field-label gform-field-label--type-inline'>Dog<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_7_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='Cat'  id='choice_17_7_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_7_1' id='label_17_7_1' class='gform-field-label gform-field-label--type-inline'>Cat<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_7_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='Rabbit'  id='choice_17_7_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_7_2' id='label_17_7_2' class='gform-field-label gform-field-label--type-inline'>Rabbit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_7_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='Other (please specify) :'  id='choice_17_7_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_7_3' id='label_17_7_3' class='gform-field-label gform-field-label--type-inline'>Other (please specify) :<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_37\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_37'>Other (please specify) :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_37' id='input_17_37' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_8\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_8'>Age:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_17_8' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_9\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_9'>Colour:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_17_9' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_10\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Sex:<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_17_10'>\n\t\t\t<div class='gchoice gchoice_17_10_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='Male'  id='choice_17_10_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_10_0' id='label_17_10_0' class='gform-field-label gform-field-label--type-inline'>Male<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_10_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='Female'  id='choice_17_10_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_10_1' id='label_17_10_1' class='gform-field-label gform-field-label--type-inline'>Female<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_11\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Sterilized<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_17_11'>\n\t\t\t<div class='gchoice gchoice_17_11_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='Yes'  id='choice_17_11_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_11_0' id='label_17_11_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_17_11_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='No'  id='choice_17_11_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_11_1' id='label_17_11_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_70\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Declawed<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_70'>\n\t\t\t<div class='gchoice gchoice_17_70_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_70' type='radio' value='Yes'  id='choice_17_70_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_70_0' id='label_17_70_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_17_70_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_70' type='radio' value='No'  id='choice_17_70_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_70_1' id='label_17_70_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_71\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >How many paws are declawed:<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_17_71'>\n\t\t\t<div class='gchoice gchoice_17_71_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_71' type='radio' value='2 paws'  id='choice_17_71_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_71_0' id='label_17_71_0' class='gform-field-label gform-field-label--type-inline'>2 paws<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_71_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_71' type='radio' value='4 paws'  id='choice_17_71_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_71_1' id='label_17_71_1' class='gform-field-label gform-field-label--type-inline'>4 paws<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_12\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_12'>How long have you had the animal?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_17_12' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_68\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_68'>Why do you have to abandon your pet?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_68' id='input_17_68' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Select' >Select<\/option><option value='Too many animals' >Too many animals<\/option><option value='Moving' >Moving<\/option><option value='Sick animal' >Sick animal<\/option><option value='Behavior issue' >Behavior issue<\/option><option value='Uncleaness of the animal' >Uncleaness of the animal<\/option><option value='Biting\/aggression' >Biting\/aggression<\/option><option value='Neighbor\/owner complaints' >Neighbor\/owner complaints<\/option><option value='Litter of babies without a home' >Litter of babies without a home<\/option><option value='Lack of time' >Lack of time<\/option><option value='Personal issue' >Personal issue<\/option><option value='Allergies' >Allergies<\/option><option value='Other' >Other<\/option><\/select><\/div><\/div><div id=\"field_17_69\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_69'>Specify:<\/label><div class='ginput_container ginput_container_text'><input name='input_69' id='input_17_69' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_14\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_14'>Who lives with the animal<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_17_14'>Child(ren) under 6 years old<\/div><div class='ginput_container ginput_container_number'><input name='input_14' id='input_17_14' type='number' step='any'   value='' class='small'    placeholder='0' aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_17_14\" \/><\/div><\/div><div id=\"field_17_17\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text' for='input_17_17'>0<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_17_17'>Child(ren) over 6 years old<\/div><div class='ginput_container ginput_container_number'><input name='input_17' id='input_17_17' type='number' step='any'   value='' class='small'    placeholder='0' aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_17_17\" \/><\/div><\/div><div id=\"field_17_18\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text' for='input_17_18'>0<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_17_18'>Adult(s)<\/div><div class='ginput_container ginput_container_number'><input name='input_18' id='input_17_18' type='number' step='any'   value='' class='small'    placeholder='0' aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_17_18\" \/><\/div><\/div><div id=\"field_17_19\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text' for='input_17_19'>0<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_17_19'>Elderly person(s)<\/div><div class='ginput_container ginput_container_number'><input name='input_19' id='input_17_19' type='number' step='any'   value='' class='small'    placeholder='0' aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_17_19\" \/><\/div><\/div><div id=\"field_17_20\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text' for='input_17_20'>0<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_17_20'>Dog(s)<\/div><div class='ginput_container ginput_container_number'><input name='input_20' id='input_17_20' type='number' step='any'   value='' class='small'    placeholder='0' aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_17_20\" \/><\/div><\/div><div id=\"field_17_21\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text' for='input_17_21'>0<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_17_21'>Cat(s)<\/div><div class='ginput_container ginput_container_number'><input name='input_21' id='input_17_21' type='number' step='any'   value='' class='small'    placeholder='0' aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_17_21\" \/><\/div><\/div><div id=\"field_17_22\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text' for='input_17_22'>0<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_17_22'>Other animal(s)<\/div><div class='ginput_container ginput_container_number'><input name='input_22' id='input_17_22' type='number' step='any'   value='' class='small'    placeholder='0' aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_17_22\" \/><\/div><\/div><fieldset id=\"field_17_23\" 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_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Your environment is:<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_17_23'>\n\t\t\t<div class='gchoice gchoice_17_23_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='Rather quiet'  id='choice_17_23_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_23_0' id='label_17_23_0' class='gform-field-label gform-field-label--type-inline'>Rather quiet<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_23_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='Rather noisy\/active'  id='choice_17_23_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_23_1' id='label_17_23_1' class='gform-field-label gform-field-label--type-inline'>Rather noisy\/active<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_24\" 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_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Does he get along with everyone in the house?<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_17_24'>\n\t\t\t<div class='gchoice gchoice_17_24_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='Yes'  id='choice_17_24_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_24_0' id='label_17_24_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_24_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='No'  id='choice_17_24_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_24_1' id='label_17_24_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_25\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_25'>Specify :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_25' id='input_17_25' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_17_26\" 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_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Has he ever bitten an animal or a human?<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_17_26'>\n\t\t\t<div class='gchoice gchoice_17_26_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='Yes'  id='choice_17_26_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_26_0' id='label_17_26_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_26_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='No'  id='choice_17_26_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_26_1' id='label_17_26_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_27\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_27'>Please explain the circumstances:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_27' id='input_17_27' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_17_28\" 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_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Has he ever seen a vet?<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_17_28'>\n\t\t\t<div class='gchoice gchoice_17_28_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='Yes'  id='choice_17_28_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_28_0' id='label_17_28_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_17_28_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='No'  id='choice_17_28_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_28_1' id='label_17_28_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_29\" 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_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Does he have any known health problems?<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_17_29'>\n\t\t\t<div class='gchoice gchoice_17_29_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='Yes'  id='choice_17_29_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_29_0' id='label_17_29_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_17_29_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='No'  id='choice_17_29_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_29_1' id='label_17_29_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_30\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_30'>Please specify known health conditions:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_30' id='input_17_30' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_17_77\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_77'>How does he behave at the vet:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_77' id='input_17_77' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_17_78\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_17_78'>If you have your animal&#039;s medical file, please attach it to this form:<\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_17_78' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_17_78&quot;,&quot;container&quot;:&quot;gform_multifile_upload_17_78&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_17_78&quot;,&quot;filelist&quot;:&quot;gform_preview_17_78&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/proanima.stagingsept24.com\\\/en\\\/?gf_page=297c5a7a5c065d6&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/proanima.stagingsept24.com\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/proanima.stagingsept24.com\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;jpg,pdf,png&quot;}],&quot;max_file_size&quot;:&quot;100663296b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:17,&quot;field_id&quot;:78,&quot;_gform_file_upload_nonce_17_78&quot;:&quot;67125fef7f&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_17_78&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_17_78' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_17_78' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_17_78\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_17_78'>Accepted file types: jpg, pdf, png, Max. file size: 96 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_17_78'><\/ul> <div id='gform_preview_17_78' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_17_79\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_79'>You don&#039;t have your pet&#039;s medical records? Please tell us the name and city of your veterinary clinic so that we can contact them directly.<\/label><div class='ginput_container ginput_container_text'><input name='input_79' id='input_17_79' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_31\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_31'>What food does he eat:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_31' id='input_17_31' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_32\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_32'>Daily quantity and frequency:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_32' id='input_17_32' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_33\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Cleanliness of the animal (several choices possible):<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_33'><div class='gchoice gchoice_17_33_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_33.1' type='checkbox'  value='Has always been potty trained (goes outside or uses a litter box)'  id='choice_17_33_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_33_1' id='label_17_33_1' class='gform-field-label gform-field-label--type-inline'>Has always been potty trained (goes outside or uses a litter box)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_33_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_33.2' type='checkbox'  value='Use a pee pad'  id='choice_17_33_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_33_2' id='label_17_33_2' class='gform-field-label gform-field-label--type-inline'>Use a pee pad<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_33_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_33.3' type='checkbox'  value='Is occasionally clean (sometimes escapes)'  id='choice_17_33_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_33_3' id='label_17_33_3' class='gform-field-label gform-field-label--type-inline'>Is occasionally clean (sometimes escapes)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_33_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_33.4' type='checkbox'  value='Urine on furniture\/carpets'  id='choice_17_33_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_33_4' id='label_17_33_4' class='gform-field-label gform-field-label--type-inline'>Urine on furniture\/carpets<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_33_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_33.5' type='checkbox'  value='Defecates on furniture\/carpets'  id='choice_17_33_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_33_5' id='label_17_33_5' class='gform-field-label gform-field-label--type-inline'>Defecates on furniture\/carpets<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_33_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_33.6' type='checkbox'  value='Not clean for a while'  id='choice_17_33_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_33_6' id='label_17_33_6' class='gform-field-label gform-field-label--type-inline'>Not clean for a while<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_33_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_33.7' type='checkbox'  value='Was never clean'  id='choice_17_33_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_33_7' id='label_17_33_7' class='gform-field-label gform-field-label--type-inline'>Was never clean<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_34\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Personality of the animal (several choices possible):<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_34'><div class='gchoice gchoice_17_34_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.1' type='checkbox'  value='Playful'  id='choice_17_34_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_34_1' id='label_17_34_1' class='gform-field-label gform-field-label--type-inline'>Playful<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_34_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.2' type='checkbox'  value='Friendly'  id='choice_17_34_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_34_2' id='label_17_34_2' class='gform-field-label gform-field-label--type-inline'>Friendly<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_34_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.3' type='checkbox'  value='Affectionate'  id='choice_17_34_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_34_3' id='label_17_34_3' class='gform-field-label gform-field-label--type-inline'>Affectionate<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_34_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.4' type='checkbox'  value='Curious'  id='choice_17_34_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_34_4' id='label_17_34_4' class='gform-field-label gform-field-label--type-inline'>Curious<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_34_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.5' type='checkbox'  value='adventurer'  id='choice_17_34_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_34_5' id='label_17_34_5' class='gform-field-label gform-field-label--type-inline'>adventurer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_34_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.6' type='checkbox'  value='Hyperactive'  id='choice_17_34_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_34_6' id='label_17_34_6' class='gform-field-label gform-field-label--type-inline'>Hyperactive<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_34_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.7' type='checkbox'  value='Active'  id='choice_17_34_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_34_7' id='label_17_34_7' class='gform-field-label gform-field-label--type-inline'>Active<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_34_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.8' type='checkbox'  value='Calm'  id='choice_17_34_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_34_8' id='label_17_34_8' class='gform-field-label gform-field-label--type-inline'>Calm<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_34_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.9' type='checkbox'  value='Reserved'  id='choice_17_34_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_34_9' id='label_17_34_9' class='gform-field-label gform-field-label--type-inline'>Reserved<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_34_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.11' type='checkbox'  value='Shy'  id='choice_17_34_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_34_11' id='label_17_34_11' class='gform-field-label gform-field-label--type-inline'>Shy<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_34_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.12' type='checkbox'  value='Anxious'  id='choice_17_34_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_34_12' id='label_17_34_12' class='gform-field-label gform-field-label--type-inline'>Anxious<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_34_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.13' type='checkbox'  value='fearful'  id='choice_17_34_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_34_13' id='label_17_34_13' class='gform-field-label gform-field-label--type-inline'>fearful<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_34_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.14' type='checkbox'  value='Agressive'  id='choice_17_34_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_34_14' id='label_17_34_14' class='gform-field-label gform-field-label--type-inline'>Agressive<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_34_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.15' type='checkbox'  value='Vocal\/Loud'  id='choice_17_34_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_34_15' id='label_17_34_15' class='gform-field-label gform-field-label--type-inline'>Vocal\/Loud<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_34_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.16' type='checkbox'  value='Dependent'  id='choice_17_34_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_34_16' id='label_17_34_16' class='gform-field-label gform-field-label--type-inline'>Dependent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_34_17'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.17' type='checkbox'  value='Independent'  id='choice_17_34_17'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_34_17' id='label_17_34_17' class='gform-field-label gform-field-label--type-inline'>Independent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_34_18'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.18' type='checkbox'  value='Selective'  id='choice_17_34_18'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_34_18' id='label_17_34_18' class='gform-field-label gform-field-label--type-inline'>Selective<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_34_19'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.19' type='checkbox'  value='Other (please specify) :'  id='choice_17_34_19'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_34_19' id='label_17_34_19' class='gform-field-label gform-field-label--type-inline'>Other (please specify) :<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_35\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_35'>Other (please specify) :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_35' id='input_17_35' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_36\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Reaction to the visit:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_36'><div class='gchoice gchoice_17_36_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.1' type='checkbox'  value='fearful'  id='choice_17_36_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_36_1' id='label_17_36_1' class='gform-field-label gform-field-label--type-inline'>fearful<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_36_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.2' type='checkbox'  value='Vocal'  id='choice_17_36_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_36_2' id='label_17_36_2' class='gform-field-label gform-field-label--type-inline'>Vocal<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_36_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.3' type='checkbox'  value='Excited\/jumps'  id='choice_17_36_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_36_3' id='label_17_36_3' class='gform-field-label gform-field-label--type-inline'>Excited\/jumps<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_36_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.4' type='checkbox'  value='Agressive'  id='choice_17_36_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_36_4' id='label_17_36_4' class='gform-field-label gform-field-label--type-inline'>Agressive<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_36_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.5' type='checkbox'  value='Fear of men'  id='choice_17_36_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_36_5' id='label_17_36_5' class='gform-field-label gform-field-label--type-inline'>Fear of men<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_36_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.6' type='checkbox'  value='Other (please specify) :'  id='choice_17_36_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_36_6' id='label_17_36_6' class='gform-field-label gform-field-label--type-inline'>Other (please specify) :<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_38\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_38'>Other (please specify) :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_38' id='input_17_38' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_39\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Reaction to unknown or visiting children:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_39'><div class='gchoice gchoice_17_39_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_39.1' type='checkbox'  value='Friendly'  id='choice_17_39_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_39_1' id='label_17_39_1' class='gform-field-label gform-field-label--type-inline'>Friendly<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_39_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_39.2' type='checkbox'  value='fearful'  id='choice_17_39_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_39_2' id='label_17_39_2' class='gform-field-label gform-field-label--type-inline'>fearful<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_39_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_39.3' type='checkbox'  value='Vocal'  id='choice_17_39_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_39_3' id='label_17_39_3' class='gform-field-label gform-field-label--type-inline'>Vocal<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_39_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_39.4' type='checkbox'  value='Excited\/jumps'  id='choice_17_39_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_39_4' id='label_17_39_4' class='gform-field-label gform-field-label--type-inline'>Excited\/jumps<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_39_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_39.5' type='checkbox'  value='Agressive'  id='choice_17_39_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_39_5' id='label_17_39_5' class='gform-field-label gform-field-label--type-inline'>Agressive<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_39_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_39.6' type='checkbox'  value='Don&#039;t know'  id='choice_17_39_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_39_6' id='label_17_39_6' class='gform-field-label gform-field-label--type-inline'>Don&#8217;t know<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_39_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_39.7' type='checkbox'  value='Never been in contact with children'  id='choice_17_39_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_39_7' id='label_17_39_7' class='gform-field-label gform-field-label--type-inline'>Never been in contact with children<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_39_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_39.8' type='checkbox'  value='Other (please specify) :'  id='choice_17_39_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_39_8' id='label_17_39_8' class='gform-field-label gform-field-label--type-inline'>Other (please specify) :<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_40\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_40'>Other (please specify) :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_40' id='input_17_40' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_41\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Reactions towards other dogs:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_41'><div class='gchoice gchoice_17_41_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.1' type='checkbox'  value='Is NEVER in contact'  id='choice_17_41_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_41_1' id='label_17_41_1' class='gform-field-label gform-field-label--type-inline'>Is NEVER in contact<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_41_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.2' type='checkbox'  value='Curious, interested'  id='choice_17_41_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_41_2' id='label_17_41_2' class='gform-field-label gform-field-label--type-inline'>Curious, interested<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_41_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.3' type='checkbox'  value='Friendly'  id='choice_17_41_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_41_3' id='label_17_41_3' class='gform-field-label gform-field-label--type-inline'>Friendly<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_41_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.4' type='checkbox'  value='Wants to play'  id='choice_17_41_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_41_4' id='label_17_41_4' class='gform-field-label gform-field-label--type-inline'>Wants to play<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_41_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.5' type='checkbox'  value='Ok with small dogs'  id='choice_17_41_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_41_5' id='label_17_41_5' class='gform-field-label gform-field-label--type-inline'>Ok with small dogs<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_41_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.6' type='checkbox'  value='Ok with big dogs'  id='choice_17_41_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_41_6' id='label_17_41_6' class='gform-field-label gform-field-label--type-inline'>Ok with big dogs<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_41_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.7' type='checkbox'  value='Ok with dogs he only knows'  id='choice_17_41_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_41_7' id='label_17_41_7' class='gform-field-label gform-field-label--type-inline'>Ok with dogs he only knows<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_41_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.8' type='checkbox'  value='Selective (doesn&#039;t like all dogs)'  id='choice_17_41_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_41_8' id='label_17_41_8' class='gform-field-label gform-field-label--type-inline'>Selective (doesn&#8217;t like all dogs)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_41_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.9' type='checkbox'  value='Always reacts when on leash'  id='choice_17_41_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_41_9' id='label_17_41_9' class='gform-field-label gform-field-label--type-inline'>Always reacts when on leash<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_41_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.11' type='checkbox'  value='Doesn&#039;t like small dogs'  id='choice_17_41_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_41_11' id='label_17_41_11' class='gform-field-label gform-field-label--type-inline'>Doesn&#8217;t like small dogs<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_41_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.12' type='checkbox'  value='Doesn&#039;t like big dogs'  id='choice_17_41_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_41_12' id='label_17_41_12' class='gform-field-label gform-field-label--type-inline'>Doesn&#8217;t like big dogs<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_42\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >What type of toys does he like?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_42'><div class='gchoice gchoice_17_42_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.1' type='checkbox'  value='Plastic toys'  id='choice_17_42_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_42_1' id='label_17_42_1' class='gform-field-label gform-field-label--type-inline'>Plastic toys<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_42_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.2' type='checkbox'  value='Bones'  id='choice_17_42_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_42_2' id='label_17_42_2' class='gform-field-label gform-field-label--type-inline'>Bones<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_42_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.3' type='checkbox'  value='Noisy\/squeak'  id='choice_17_42_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_42_3' id='label_17_42_3' class='gform-field-label gform-field-label--type-inline'>Noisy\/squeak<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_42_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.4' type='checkbox'  value='Fabric'  id='choice_17_42_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_42_4' id='label_17_42_4' class='gform-field-label gform-field-label--type-inline'>Fabric<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_42_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.5' type='checkbox'  value='None'  id='choice_17_42_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_42_5' id='label_17_42_5' class='gform-field-label gform-field-label--type-inline'>None<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_42_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.6' type='checkbox'  value='Other (please specify) :'  id='choice_17_42_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_42_6' id='label_17_42_6' class='gform-field-label gform-field-label--type-inline'>Other (please specify) :<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_43\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_43'>Other (please specify) :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_43' id='input_17_43' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_44\" 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_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is he used to the cage?<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_17_44'>\n\t\t\t<div class='gchoice gchoice_17_44_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='Yes'  id='choice_17_44_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_44_0' id='label_17_44_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_17_44_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='No'  id='choice_17_44_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_17_44_1' id='label_17_44_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_45\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_45'>Comment on the cage:<\/label><div class='ginput_container ginput_container_text'><input name='input_45' id='input_17_45' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_46\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >What does he do when left alone?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_46'><div class='gchoice gchoice_17_46_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.1' type='checkbox'  value='Cries\/barks'  id='choice_17_46_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_46_1' id='label_17_46_1' class='gform-field-label gform-field-label--type-inline'>Cries\/barks<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_46_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.2' type='checkbox'  value='Destroy'  id='choice_17_46_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_46_2' id='label_17_46_2' class='gform-field-label gform-field-label--type-inline'>Destroy<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_46_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.3' type='checkbox'  value='Urine\/defecation'  id='choice_17_46_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_46_3' id='label_17_46_3' class='gform-field-label gform-field-label--type-inline'>Urine\/defecation<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_46_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.4' type='checkbox'  value='Stay calm'  id='choice_17_46_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_46_4' id='label_17_46_4' class='gform-field-label gform-field-label--type-inline'>Stay calm<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_46_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.5' type='checkbox'  value='Other (please specify) :'  id='choice_17_46_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_46_5' id='label_17_46_5' class='gform-field-label gform-field-label--type-inline'>Other (please specify) :<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_47\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_47'>Other (please specify) :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_47' id='input_17_47' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_48\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_48'>How long does he stay alone in a day?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_48' id='input_17_48' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_49\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_49'>Describe your daily activity (type of exercise, frequency and duration):<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_49' id='input_17_49' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_17_50\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Further information :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_50'><div class='gchoice gchoice_17_50_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.1' type='checkbox'  value='Usually doesn&#039;t listen or obey'  id='choice_17_50_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_50_1' id='label_17_50_1' class='gform-field-label gform-field-label--type-inline'>Usually doesn&#8217;t listen or obey<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_50_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.2' type='checkbox'  value='Eats his stool'  id='choice_17_50_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_50_2' id='label_17_50_2' class='gform-field-label gform-field-label--type-inline'>Eats his stool<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_50_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.3' type='checkbox'  value='Steals food or items'  id='choice_17_50_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_50_3' id='label_17_50_3' class='gform-field-label gform-field-label--type-inline'>Steals food or items<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_50_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.4' type='checkbox'  value='Dig outside'  id='choice_17_50_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_50_4' id='label_17_50_4' class='gform-field-label gform-field-label--type-inline'>Dig outside<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_50_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.5' type='checkbox'  value='Jumps on people'  id='choice_17_50_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_50_5' id='label_17_50_5' class='gform-field-label gform-field-label--type-inline'>Jumps on people<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_50_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.6' type='checkbox'  value='Destroys his toys'  id='choice_17_50_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_50_6' id='label_17_50_6' class='gform-field-label gform-field-label--type-inline'>Destroys his toys<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_50_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.7' type='checkbox'  value='Runs after small animals outside'  id='choice_17_50_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_50_7' id='label_17_50_7' class='gform-field-label gform-field-label--type-inline'>Runs after small animals outside<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_50_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.8' type='checkbox'  value='Yelps\/barks a lot'  id='choice_17_50_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_50_8' id='label_17_50_8' class='gform-field-label gform-field-label--type-inline'>Yelps\/barks a lot<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_50_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.9' type='checkbox'  value='Used to the dog park'  id='choice_17_50_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_50_9' id='label_17_50_9' class='gform-field-label gform-field-label--type-inline'>Used to the dog park<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_50_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.11' type='checkbox'  value='Grows or tries to bite if you approach his food'  id='choice_17_50_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_50_11' id='label_17_50_11' class='gform-field-label gform-field-label--type-inline'>Grows or tries to bite if you approach his food<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_50_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.12' type='checkbox'  value='Urine by emotions'  id='choice_17_50_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_50_12' id='label_17_50_12' class='gform-field-label gform-field-label--type-inline'>Urine by emotions<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_50_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.13' type='checkbox'  value='Tends to run away'  id='choice_17_50_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_50_13' id='label_17_50_13' class='gform-field-label gform-field-label--type-inline'>Tends to run away<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_50_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.14' type='checkbox'  value='Nibble'  id='choice_17_50_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_50_14' id='label_17_50_14' class='gform-field-label gform-field-label--type-inline'>Nibble<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_50_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.15' type='checkbox'  value='Afraid of storms'  id='choice_17_50_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_50_15' id='label_17_50_15' class='gform-field-label gform-field-label--type-inline'>Afraid of storms<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_50_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.16' type='checkbox'  value='Afraid of strangers'  id='choice_17_50_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_50_16' id='label_17_50_16' class='gform-field-label gform-field-label--type-inline'>Afraid of strangers<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_50_17'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.17' type='checkbox'  value='Pull on leash'  id='choice_17_50_17'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_50_17' id='label_17_50_17' class='gform-field-label gform-field-label--type-inline'>Pull on leash<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_50_18'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.18' type='checkbox'  value='Is sick in the car'  id='choice_17_50_18'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_50_18' id='label_17_50_18' class='gform-field-label gform-field-label--type-inline'>Is sick in the car<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_50_19'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.19' type='checkbox'  value='Reactive on leash'  id='choice_17_50_19'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_50_19' id='label_17_50_19' class='gform-field-label gform-field-label--type-inline'>Reactive on leash<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_50_21'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.21' type='checkbox'  value='Protect his toys'  id='choice_17_50_21'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_50_21' id='label_17_50_21' class='gform-field-label gform-field-label--type-inline'>Protect his toys<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_50_22'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.22' type='checkbox'  value='Other (please specify) :'  id='choice_17_50_22'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_50_22' id='label_17_50_22' class='gform-field-label gform-field-label--type-inline'>Other (please specify) :<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_51\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_51'>Other (please specify) :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_51' id='input_17_51' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_52\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_52'>Further information :<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_52' id='input_17_52' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_17_53\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Does the cat like to be with children:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_53'><div class='gchoice gchoice_17_53_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.1' type='checkbox'  value='Aime'  id='choice_17_53_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_53_1' id='label_17_53_1' class='gform-field-label gform-field-label--type-inline'>Aime<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_53_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.2' type='checkbox'  value='N&#039;aime pas'  id='choice_17_53_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_53_2' id='label_17_53_2' class='gform-field-label gform-field-label--type-inline'>N&#8217;aime pas<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_53_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.3' type='checkbox'  value='Est indiff\u00e9rent'  id='choice_17_53_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_53_3' id='label_17_53_3' class='gform-field-label gform-field-label--type-inline'>Est indiff\u00e9rent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_53_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.4' type='checkbox'  value='Va mordre\/griffer'  id='choice_17_53_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_53_4' id='label_17_53_4' class='gform-field-label gform-field-label--type-inline'>Va mordre\/griffer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_53_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.5' type='checkbox'  value='N\/A'  id='choice_17_53_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_53_5' id='label_17_53_5' class='gform-field-label gform-field-label--type-inline'>N\/A<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_74\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Does the cat like to be around other cats:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_74'><div class='gchoice gchoice_17_74_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_74.1' type='checkbox'  value='Aime'  id='choice_17_74_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_74_1' id='label_17_74_1' class='gform-field-label gform-field-label--type-inline'>Aime<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_74_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_74.2' type='checkbox'  value='N&#039;aime pas'  id='choice_17_74_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_74_2' id='label_17_74_2' class='gform-field-label gform-field-label--type-inline'>N&#8217;aime pas<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_74_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_74.3' type='checkbox'  value='Est indiff\u00e9rent'  id='choice_17_74_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_74_3' id='label_17_74_3' class='gform-field-label gform-field-label--type-inline'>Est indiff\u00e9rent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_74_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_74.4' type='checkbox'  value='Va mordre\/griffer'  id='choice_17_74_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_74_4' id='label_17_74_4' class='gform-field-label gform-field-label--type-inline'>Va mordre\/griffer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_74_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_74.5' type='checkbox'  value='N\/A'  id='choice_17_74_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_74_5' id='label_17_74_5' class='gform-field-label gform-field-label--type-inline'>N\/A<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_76\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Does the cat like to be in the presence of other animals (dogs, rabbits, etc.):<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_76'><div class='gchoice gchoice_17_76_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_76.1' type='checkbox'  value='Aime'  id='choice_17_76_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_76_1' id='label_17_76_1' class='gform-field-label gform-field-label--type-inline'>Aime<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_76_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_76.2' type='checkbox'  value='N&#039;aime pas'  id='choice_17_76_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_76_2' id='label_17_76_2' class='gform-field-label gform-field-label--type-inline'>N&#8217;aime pas<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_76_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_76.3' type='checkbox'  value='Est indiff\u00e9rent'  id='choice_17_76_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_76_3' id='label_17_76_3' class='gform-field-label gform-field-label--type-inline'>Est indiff\u00e9rent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_76_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_76.4' type='checkbox'  value='Va mordre\/griffer'  id='choice_17_76_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_76_4' id='label_17_76_4' class='gform-field-label gform-field-label--type-inline'>Va mordre\/griffer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_76_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_76.5' type='checkbox'  value='N\/A'  id='choice_17_76_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_76_5' id='label_17_76_5' class='gform-field-label gform-field-label--type-inline'>N\/A<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_73\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Does the cat like to go outside:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_73'><div class='gchoice gchoice_17_73_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.1' type='checkbox'  value='Aime'  id='choice_17_73_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_73_1' id='label_17_73_1' class='gform-field-label gform-field-label--type-inline'>Aime<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_73_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.2' type='checkbox'  value='N&#039;aime pas'  id='choice_17_73_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_73_2' id='label_17_73_2' class='gform-field-label gform-field-label--type-inline'>N&#8217;aime pas<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_73_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.3' type='checkbox'  value='Est indiff\u00e9rent'  id='choice_17_73_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_73_3' id='label_17_73_3' class='gform-field-label gform-field-label--type-inline'>Est indiff\u00e9rent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_73_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.4' type='checkbox'  value='Va mordre\/griffer'  id='choice_17_73_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_73_4' id='label_17_73_4' class='gform-field-label gform-field-label--type-inline'>Va mordre\/griffer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_73_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.5' type='checkbox'  value='N\/A'  id='choice_17_73_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_73_5' id='label_17_73_5' class='gform-field-label gform-field-label--type-inline'>N\/A<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_82\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Comment r\u00e9agit votre chat face \u00e0 la chose suivante : jouer<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_82'><div class='gchoice gchoice_17_82_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_82.1' type='checkbox'  value='Aime'  id='choice_17_82_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_82_1' id='label_17_82_1' class='gform-field-label gform-field-label--type-inline'>Aime<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_82_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_82.2' type='checkbox'  value='N&#039;aime pas'  id='choice_17_82_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_82_2' id='label_17_82_2' class='gform-field-label gform-field-label--type-inline'>N&#8217;aime pas<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_82_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_82.3' type='checkbox'  value='Est indiff\u00e9rent'  id='choice_17_82_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_82_3' id='label_17_82_3' class='gform-field-label gform-field-label--type-inline'>Est indiff\u00e9rent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_82_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_82.4' type='checkbox'  value='Va mordre\/griffer'  id='choice_17_82_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_82_4' id='label_17_82_4' class='gform-field-label gform-field-label--type-inline'>Va mordre\/griffer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_82_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_82.5' type='checkbox'  value='N\/A'  id='choice_17_82_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_82_5' id='label_17_82_5' class='gform-field-label gform-field-label--type-inline'>N\/A<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_83\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Comment r\u00e9agit votre chat face \u00e0 la chose suivante : se faire prendre<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_83'><div class='gchoice gchoice_17_83_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_83.1' type='checkbox'  value='Aime'  id='choice_17_83_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_83_1' id='label_17_83_1' class='gform-field-label gform-field-label--type-inline'>Aime<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_83_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_83.2' type='checkbox'  value='N&#039;aime pas'  id='choice_17_83_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_83_2' id='label_17_83_2' class='gform-field-label gform-field-label--type-inline'>N&#8217;aime pas<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_83_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_83.3' type='checkbox'  value='Est indiff\u00e9rent'  id='choice_17_83_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_83_3' id='label_17_83_3' class='gform-field-label gform-field-label--type-inline'>Est indiff\u00e9rent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_83_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_83.4' type='checkbox'  value='Va mordre\/griffer'  id='choice_17_83_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_83_4' id='label_17_83_4' class='gform-field-label gform-field-label--type-inline'>Va mordre\/griffer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_83_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_83.5' type='checkbox'  value='N\/A'  id='choice_17_83_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_83_5' id='label_17_83_5' class='gform-field-label gform-field-label--type-inline'>N\/A<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_88\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Comment r\u00e9agit votre chat face \u00e0 la chose suivante : se faire flatter<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_88'><div class='gchoice gchoice_17_88_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_88.1' type='checkbox'  value='Aime'  id='choice_17_88_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_88_1' id='label_17_88_1' class='gform-field-label gform-field-label--type-inline'>Aime<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_88_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_88.2' type='checkbox'  value='N&#039;aime pas'  id='choice_17_88_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_88_2' id='label_17_88_2' class='gform-field-label gform-field-label--type-inline'>N&#8217;aime pas<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_88_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_88.3' type='checkbox'  value='Est indiff\u00e9rent'  id='choice_17_88_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_88_3' id='label_17_88_3' class='gform-field-label gform-field-label--type-inline'>Est indiff\u00e9rent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_88_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_88.4' type='checkbox'  value='Va mordre\/griffer'  id='choice_17_88_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_88_4' id='label_17_88_4' class='gform-field-label gform-field-label--type-inline'>Va mordre\/griffer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_88_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_88.5' type='checkbox'  value='N\/A'  id='choice_17_88_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_88_5' id='label_17_88_5' class='gform-field-label gform-field-label--type-inline'>N\/A<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_84\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Comment r\u00e9agit votre chat face \u00e0 la chose suivante : se faire brosser<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_84'><div class='gchoice gchoice_17_84_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_84.1' type='checkbox'  value='Aime'  id='choice_17_84_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_84_1' id='label_17_84_1' class='gform-field-label gform-field-label--type-inline'>Aime<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_84_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_84.2' type='checkbox'  value='N&#039;aime pas'  id='choice_17_84_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_84_2' id='label_17_84_2' class='gform-field-label gform-field-label--type-inline'>N&#8217;aime pas<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_84_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_84.3' type='checkbox'  value='Est indiff\u00e9rent'  id='choice_17_84_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_84_3' id='label_17_84_3' class='gform-field-label gform-field-label--type-inline'>Est indiff\u00e9rent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_84_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_84.4' type='checkbox'  value='Va mordre\/griffer'  id='choice_17_84_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_84_4' id='label_17_84_4' class='gform-field-label gform-field-label--type-inline'>Va mordre\/griffer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_84_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_84.5' type='checkbox'  value='N\/A'  id='choice_17_84_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_84_5' id='label_17_84_5' class='gform-field-label gform-field-label--type-inline'>N\/A<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_85\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Comment r\u00e9agit votre chat face \u00e0 la chose suivante : se cacher<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_85'><div class='gchoice gchoice_17_85_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.1' type='checkbox'  value='Aime'  id='choice_17_85_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_85_1' id='label_17_85_1' class='gform-field-label gform-field-label--type-inline'>Aime<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_85_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.2' type='checkbox'  value='N&#039;aime pas'  id='choice_17_85_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_85_2' id='label_17_85_2' class='gform-field-label gform-field-label--type-inline'>N&#8217;aime pas<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_85_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.3' type='checkbox'  value='Est indiff\u00e9rent'  id='choice_17_85_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_85_3' id='label_17_85_3' class='gform-field-label gform-field-label--type-inline'>Est indiff\u00e9rent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_85_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.4' type='checkbox'  value='Va mordre\/griffer'  id='choice_17_85_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_85_4' id='label_17_85_4' class='gform-field-label gform-field-label--type-inline'>Va mordre\/griffer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_85_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.5' type='checkbox'  value='N\/A'  id='choice_17_85_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_85_5' id='label_17_85_5' class='gform-field-label gform-field-label--type-inline'>N\/A<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_86\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Comment r\u00e9agit votre chat face \u00e0 la chose suivante : grimper\/\u00eatre en hauteur<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_86'><div class='gchoice gchoice_17_86_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_86.1' type='checkbox'  value='Aime'  id='choice_17_86_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_86_1' id='label_17_86_1' class='gform-field-label gform-field-label--type-inline'>Aime<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_86_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_86.2' type='checkbox'  value='N&#039;aime pas'  id='choice_17_86_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_86_2' id='label_17_86_2' class='gform-field-label gform-field-label--type-inline'>N&#8217;aime pas<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_86_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_86.3' type='checkbox'  value='Est indiff\u00e9rent'  id='choice_17_86_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_86_3' id='label_17_86_3' class='gform-field-label gform-field-label--type-inline'>Est indiff\u00e9rent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_86_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_86.4' type='checkbox'  value='Va mordre\/griffer'  id='choice_17_86_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_86_4' id='label_17_86_4' class='gform-field-label gform-field-label--type-inline'>Va mordre\/griffer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_86_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_86.5' type='checkbox'  value='N\/A'  id='choice_17_86_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_86_5' id='label_17_86_5' class='gform-field-label gform-field-label--type-inline'>N\/A<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_17_87\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Comment r\u00e9agit votre chat face \u00e0 la chose suivante : aller voir la visite<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_87'><div class='gchoice gchoice_17_87_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_87.1' type='checkbox'  value='Aime'  id='choice_17_87_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_87_1' id='label_17_87_1' class='gform-field-label gform-field-label--type-inline'>Aime<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_87_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_87.2' type='checkbox'  value='N&#039;aime pas'  id='choice_17_87_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_87_2' id='label_17_87_2' class='gform-field-label gform-field-label--type-inline'>N&#8217;aime pas<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_87_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_87.3' type='checkbox'  value='Est indiff\u00e9rent'  id='choice_17_87_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_87_3' id='label_17_87_3' class='gform-field-label gform-field-label--type-inline'>Est indiff\u00e9rent<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_87_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_87.4' type='checkbox'  value='Va mordre\/griffer'  id='choice_17_87_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_87_4' id='label_17_87_4' class='gform-field-label gform-field-label--type-inline'>Va mordre\/griffer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_87_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_87.5' type='checkbox'  value='N\/A'  id='choice_17_87_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_87_5' id='label_17_87_5' class='gform-field-label gform-field-label--type-inline'>N\/A<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_54\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_54'>What does the cat dislike (describe its reaction):<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_54' id='input_17_54' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_17_55\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_55'>Further information :<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_55' id='input_17_55' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_17_56\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_56'>How big was his cage?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_56' id='input_17_56' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_17_57\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_57'>How many times did he go out per day:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_57' id='input_17_57' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_17_58\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Does the animal like:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_17_58'><div class='gchoice gchoice_17_58_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.1' type='checkbox'  value='To play'  id='choice_17_58_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_58_1' id='label_17_58_1' class='gform-field-label gform-field-label--type-inline'>To play<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_58_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.2' type='checkbox'  value='To be held'  id='choice_17_58_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_58_2' id='label_17_58_2' class='gform-field-label gform-field-label--type-inline'>To be held<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_58_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.3' type='checkbox'  value='Getting brushed'  id='choice_17_58_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_58_3' id='label_17_58_3' class='gform-field-label gform-field-label--type-inline'>Getting brushed<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_58_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.4' type='checkbox'  value='Hiding'  id='choice_17_58_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_58_4' id='label_17_58_4' class='gform-field-label gform-field-label--type-inline'>Hiding<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_58_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.5' type='checkbox'  value='to be caressed'  id='choice_17_58_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_58_5' id='label_17_58_5' class='gform-field-label gform-field-label--type-inline'>to be caressed<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_58_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.6' type='checkbox'  value='Being with children'  id='choice_17_58_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_58_6' id='label_17_58_6' class='gform-field-label gform-field-label--type-inline'>Being with children<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_17_58_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.7' type='checkbox'  value='Being with other pets'  id='choice_17_58_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_58_7' id='label_17_58_7' class='gform-field-label gform-field-label--type-inline'>Being with other pets<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_17_59\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label 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