{"id":1156,"date":"2024-11-05T14:19:09","date_gmt":"2024-11-05T06:19:09","guid":{"rendered":"https:\/\/hctm.ukm.my\/uka\/?page_id=1156"},"modified":"2024-11-07T15:24:12","modified_gmt":"2024-11-07T07:24:12","slug":"patient-screening-and-appointment","status":"publish","type":"page","link":"https:\/\/hctm.ukm.my\/uka\/patient-screening-and-appointment\/","title":{"rendered":"Patient Screening and Appointment"},"content":{"rendered":"<p>[vc_row][vc_column][vc_column_text css=&#8221;.vc_custom_1730964195163{background-color: #219ed3 !important;}&#8221;]<\/p>\n<h3>PATIENT HEALTH QUESTIONNAIRE (PHQ-9)<\/h3>\n<p>[\/vc_column_text][vc_column_text]<div class=\"forminator-ui forminator-custom-form forminator-custom-form-1133 forminator-design--flat forminator-custom forminator_ajax\" data-forminator-render=\"0\" data-form=\"forminator-module-1133\" data-uid=\"69d4678b0cb72\"><br\/><\/div><form\n\t\t\t\tid=\"forminator-module-1133\"\n\t\t\t\tclass=\"forminator-ui forminator-custom-form forminator-custom-form-1133 forminator-design--flat forminator-custom forminator_ajax\"\n\t\t\t\tmethod=\"post\"\n\t\t\t\tdata-forminator-render=\"0\"\n\t\t\t\tdata-form-id=\"1133\"\n\t\t\t\t data-color-option=\"default\" data-design=\"flat\" data-grid=\"custom\" style=\"display: none;\"\n\t\t\t\tdata-uid=\"69d4678b0cb72\"\n\t\t\t><div role=\"alert\" aria-live=\"polite\" class=\"forminator-response-message forminator-error\" aria-hidden=\"true\"><\/div><div\n\t\t\t\ttabindex=\"-1\"\n\t\t\t\trole=\"tabpanel\"\n\t\t\t\tid=\"forminator-custom-form-1133--page-0\"\n\t\t\t\tclass=\"forminator-pagination forminator-pagination-start\"\n\t\t\t\taria-labelledby=\"forminator-custom-form-1133--page-0-label\"\n\t\t\t\tdata-step=\"0\"\n\t\t\t\tdata-label=\"Finish\"\n\t\t\t\tdata-actual-label=\"Consent\"\n\t\t\t\tdata-name=\"page-break-1\"\n\t\t\t><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"name-1\" class=\"forminator-field-name forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-1_69d4678b0cb72\" id=\"forminator-field-name-1_69d4678b0cb72-label\" class=\"forminator-label\">Full Name <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"name-1\" value=\"\" placeholder=\"Ahmad bin Ali\" id=\"forminator-field-name-1_69d4678b0cb72\" class=\"forminator-input forminator-name--field\" aria-required=\"true\" autocomplete=\"name\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"phone-1\" class=\"forminator-field-phone forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-1_69d4678b0cb72\" id=\"forminator-field-phone-1_69d4678b0cb72-label\" class=\"forminator-label\">Phone <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"phone-1\" value=\"\" placeholder=\"01234578923\" id=\"forminator-field-phone-1_69d4678b0cb72\" class=\"forminator-input forminator-field--phone\" data-required=\"1\" aria-required=\"true\" autocomplete=\"off\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"email-1\" class=\"forminator-field-email forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-email-1_69d4678b0cb72\" id=\"forminator-field-email-1_69d4678b0cb72-label\" class=\"forminator-label\">Email Address <span class=\"forminator-required\">*<\/span><\/label><input type=\"email\" name=\"email-1\" value=\"\" placeholder=\"ahmad@gmail.com\" id=\"forminator-field-email-1_69d4678b0cb72\" class=\"forminator-input forminator-email--field\" data-required=\"1\" aria-required=\"true\" autocomplete=\"email\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"consent-1\" class=\"forminator-field-consent forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-consent-1_69d4678b0cb72\" id=\"forminator-field-consent-1_69d4678b0cb72-label\" class=\"forminator-label\">Consent <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-checkbox__wrapper\"><label id=\"forminator-field-consent-1_69d4678b0cb72__label\" class=\"forminator-checkbox forminator-consent\" aria-labelledby=\"forminator-field-consent-1_69d4678b0cb72-label\"><input type=\"checkbox\" name=\"consent-1\" id=\"forminator-field-consent-1_69d4678b0cb72\" value=\"checked\" aria-labelledby=\"forminator-field-consent-1_69d4678b0cb72-label\" aria-describedby=\"forminator-field-consent-1_69d4678b0cb72__description\" data-required=\"true\" aria-required=\"true\" \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><\/label><div id=\"forminator-field-consent-1_69d4678b0cb72__description\" class=\"forminator-checkbox__label forminator-consent__label\"><p>I agree to participate in this survey and understand that my information will be kept private and used only for healthcare purposes.<\/p><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div\n\t\t\t\ttabindex=\"-1\"\n\t\t\t\trole=\"tabpanel\"\n\t\t\t\tid=\"forminator-custom-form-1133--page-1\"\n\t\t\t\tclass=\"forminator-pagination\"\n\t\t\t\taria-labelledby=\"forminator-custom-form-1133--page-1-label\"\n\t\t\t\taria-hidden=\"true\"\n\t\t\t\tdata-step=\"1\"\n\t\t\t\tdata-label=\"Consent\"\n\t\t\t\tdata-actual-label=\"Page 2\"\n\t\t\t\tdata-name=\"page-break-2\"\n\t\t\t\thidden\n\t\t\t><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"html-1\" class=\"forminator-field-html forminator-col forminator-col-12 \"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-1\"><div style=\"text-align: center;font-weight: normal;font-size: 18px;margin-bottom: 15px\"><br>Over the last 2 weeks, how often have you been bothered by any of the following problems?<\/div>\n<div style=\"margin-bottom: 20px;padding: 10px;background-color: #f7f7f7;border-left: 4px solid #0073aa\">\n<p>0 - Not at all<br><br>1 - Several days<br><br>2 - More than half the days<br><br>3 - Nearly every day<\/p>\n<\/div>\n<p>&nbsp;<\/p><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-1\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-1-69d4678b0cb72-label\"><span id=\"forminator-radiogroup-radio-1-69d4678b0cb72-label\" class=\"forminator-label\">Little interest or pleasure in doing things <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-1-label-1\" for=\"forminator-field-radio-1-1-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"0\"><input type=\"radio\" name=\"radio-1\" value=\"one\" id=\"forminator-field-radio-1-1-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-1-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">0<\/span><\/label><label id=\"forminator-field-radio-1-label-2\" for=\"forminator-field-radio-1-2-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"1\"><input type=\"radio\" name=\"radio-1\" value=\"two\" id=\"forminator-field-radio-1-2-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-1-label-2\" data-calculation=\"1\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">1<\/span><\/label><label id=\"forminator-field-radio-1-label-3\" for=\"forminator-field-radio-1-3-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"2\"><input type=\"radio\" name=\"radio-1\" value=\"2\" id=\"forminator-field-radio-1-3-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-1-label-3\" data-calculation=\"2\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">2<\/span><\/label><label id=\"forminator-field-radio-1-label-4\" for=\"forminator-field-radio-1-4-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"3\"><input type=\"radio\" name=\"radio-1\" value=\"3\" id=\"forminator-field-radio-1-4-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-1-label-4\" data-calculation=\"3\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">3<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-2\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-2-69d4678b0cb72-label\"><span id=\"forminator-radiogroup-radio-2-69d4678b0cb72-label\" class=\"forminator-label\">Feeling down, depressed or hopeless <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-2-label-1\" for=\"forminator-field-radio-2-1-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"0\"><input type=\"radio\" name=\"radio-2\" value=\"one\" id=\"forminator-field-radio-2-1-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-2-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">0<\/span><\/label><label id=\"forminator-field-radio-2-label-2\" for=\"forminator-field-radio-2-2-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"1\"><input type=\"radio\" name=\"radio-2\" value=\"two\" id=\"forminator-field-radio-2-2-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-2-label-2\" data-calculation=\"1\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">1<\/span><\/label><label id=\"forminator-field-radio-2-label-3\" for=\"forminator-field-radio-2-3-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"2\"><input type=\"radio\" name=\"radio-2\" value=\"2\" id=\"forminator-field-radio-2-3-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-2-label-3\" data-calculation=\"2\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">2<\/span><\/label><label id=\"forminator-field-radio-2-label-4\" for=\"forminator-field-radio-2-4-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"3\"><input type=\"radio\" name=\"radio-2\" value=\"3\" id=\"forminator-field-radio-2-4-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-2-label-4\" data-calculation=\"3\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">3<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-3\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-3-69d4678b0cb72-label\"><span id=\"forminator-radiogroup-radio-3-69d4678b0cb72-label\" class=\"forminator-label\">Trouble falling or staying asleep, or sleeping too much <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-3-label-1\" for=\"forminator-field-radio-3-1-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"0\"><input type=\"radio\" name=\"radio-3\" value=\"one\" id=\"forminator-field-radio-3-1-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-3-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">0<\/span><\/label><label id=\"forminator-field-radio-3-label-2\" for=\"forminator-field-radio-3-2-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"1\"><input type=\"radio\" name=\"radio-3\" value=\"two\" id=\"forminator-field-radio-3-2-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-3-label-2\" data-calculation=\"1\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">1<\/span><\/label><label id=\"forminator-field-radio-3-label-3\" for=\"forminator-field-radio-3-3-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"2\"><input type=\"radio\" name=\"radio-3\" value=\"2\" id=\"forminator-field-radio-3-3-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-3-label-3\" data-calculation=\"2\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">2<\/span><\/label><label id=\"forminator-field-radio-3-label-4\" for=\"forminator-field-radio-3-4-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"3\"><input type=\"radio\" name=\"radio-3\" value=\"3\" id=\"forminator-field-radio-3-4-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-3-label-4\" data-calculation=\"3\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">3<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-4\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-4-69d4678b0cb72-label\"><span id=\"forminator-radiogroup-radio-4-69d4678b0cb72-label\" class=\"forminator-label\">Feeling tired or having little energy <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-4-label-1\" for=\"forminator-field-radio-4-1-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"0\"><input type=\"radio\" name=\"radio-4\" value=\"one\" id=\"forminator-field-radio-4-1-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-4-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">0<\/span><\/label><label id=\"forminator-field-radio-4-label-2\" for=\"forminator-field-radio-4-2-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"1\"><input type=\"radio\" name=\"radio-4\" value=\"two\" id=\"forminator-field-radio-4-2-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-4-label-2\" data-calculation=\"1\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">1<\/span><\/label><label id=\"forminator-field-radio-4-label-3\" for=\"forminator-field-radio-4-3-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"2\"><input type=\"radio\" name=\"radio-4\" value=\"2\" id=\"forminator-field-radio-4-3-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-4-label-3\" data-calculation=\"2\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">2<\/span><\/label><label id=\"forminator-field-radio-4-label-4\" for=\"forminator-field-radio-4-4-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"3\"><input type=\"radio\" name=\"radio-4\" value=\"3\" id=\"forminator-field-radio-4-4-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-4-label-4\" data-calculation=\"3\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">3<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-5\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-5-69d4678b0cb72-label\"><span id=\"forminator-radiogroup-radio-5-69d4678b0cb72-label\" class=\"forminator-label\">Poor appetite or overeating <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-5-label-1\" for=\"forminator-field-radio-5-1-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"0\"><input type=\"radio\" name=\"radio-5\" value=\"one\" id=\"forminator-field-radio-5-1-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-5-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">0<\/span><\/label><label id=\"forminator-field-radio-5-label-2\" for=\"forminator-field-radio-5-2-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"1\"><input type=\"radio\" name=\"radio-5\" value=\"two\" id=\"forminator-field-radio-5-2-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-5-label-2\" data-calculation=\"1\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">1<\/span><\/label><label id=\"forminator-field-radio-5-label-3\" for=\"forminator-field-radio-5-3-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"2\"><input type=\"radio\" name=\"radio-5\" value=\"2\" id=\"forminator-field-radio-5-3-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-5-label-3\" data-calculation=\"2\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">2<\/span><\/label><label id=\"forminator-field-radio-5-label-4\" for=\"forminator-field-radio-5-4-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"3\"><input type=\"radio\" name=\"radio-5\" value=\"3\" id=\"forminator-field-radio-5-4-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-5-label-4\" data-calculation=\"3\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">3<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-6\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-6-69d4678b0cb72-label\"><span id=\"forminator-radiogroup-radio-6-69d4678b0cb72-label\" class=\"forminator-label\">Feeling bad about yourself- or that you are a failure or have let yourself or your family down <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-6-label-1\" for=\"forminator-field-radio-6-1-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"0\"><input type=\"radio\" name=\"radio-6\" value=\"one\" id=\"forminator-field-radio-6-1-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-6-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">0<\/span><\/label><label id=\"forminator-field-radio-6-label-2\" for=\"forminator-field-radio-6-2-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"1\"><input type=\"radio\" name=\"radio-6\" value=\"two\" id=\"forminator-field-radio-6-2-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-6-label-2\" data-calculation=\"1\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">1<\/span><\/label><label id=\"forminator-field-radio-6-label-3\" for=\"forminator-field-radio-6-3-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"2\"><input type=\"radio\" name=\"radio-6\" value=\"2\" id=\"forminator-field-radio-6-3-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-6-label-3\" data-calculation=\"2\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">2<\/span><\/label><label id=\"forminator-field-radio-6-label-4\" for=\"forminator-field-radio-6-4-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"3\"><input type=\"radio\" name=\"radio-6\" value=\"3\" id=\"forminator-field-radio-6-4-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-6-label-4\" data-calculation=\"3\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">3<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-7\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-7-69d4678b0cb72-label\"><span id=\"forminator-radiogroup-radio-7-69d4678b0cb72-label\" class=\"forminator-label\">Trouble concentrating on things, such as reading the newspaper or watching television <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-7-label-1\" for=\"forminator-field-radio-7-1-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"0\"><input type=\"radio\" name=\"radio-7\" value=\"one\" id=\"forminator-field-radio-7-1-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-7-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">0<\/span><\/label><label id=\"forminator-field-radio-7-label-2\" for=\"forminator-field-radio-7-2-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"1\"><input type=\"radio\" name=\"radio-7\" value=\"two\" id=\"forminator-field-radio-7-2-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-7-label-2\" data-calculation=\"1\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">1<\/span><\/label><label id=\"forminator-field-radio-7-label-3\" for=\"forminator-field-radio-7-3-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"2\"><input type=\"radio\" name=\"radio-7\" value=\"2\" id=\"forminator-field-radio-7-3-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-7-label-3\" data-calculation=\"2\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">2<\/span><\/label><label id=\"forminator-field-radio-7-label-4\" for=\"forminator-field-radio-7-4-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"3\"><input type=\"radio\" name=\"radio-7\" value=\"3\" id=\"forminator-field-radio-7-4-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-7-label-4\" data-calculation=\"3\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">3<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-8\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-8-69d4678b0cb72-label\"><span id=\"forminator-radiogroup-radio-8-69d4678b0cb72-label\" class=\"forminator-label\">Moving or speaking so slowly that people could have noticed? Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-8-label-1\" for=\"forminator-field-radio-8-1-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"0\"><input type=\"radio\" name=\"radio-8\" value=\"one\" id=\"forminator-field-radio-8-1-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-8-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">0<\/span><\/label><label id=\"forminator-field-radio-8-label-2\" for=\"forminator-field-radio-8-2-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"1\"><input type=\"radio\" name=\"radio-8\" value=\"two\" id=\"forminator-field-radio-8-2-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-8-label-2\" data-calculation=\"1\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">1<\/span><\/label><label id=\"forminator-field-radio-8-label-3\" for=\"forminator-field-radio-8-3-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"2\"><input type=\"radio\" name=\"radio-8\" value=\"2\" id=\"forminator-field-radio-8-3-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-8-label-3\" data-calculation=\"2\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">2<\/span><\/label><label id=\"forminator-field-radio-8-label-4\" for=\"forminator-field-radio-8-4-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"3\"><input type=\"radio\" name=\"radio-8\" value=\"3\" id=\"forminator-field-radio-8-4-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-8-label-4\" data-calculation=\"3\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">3<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-9\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-9-69d4678b0cb72-label\"><span id=\"forminator-radiogroup-radio-9-69d4678b0cb72-label\" class=\"forminator-label\">Thoughts that you would be better off dead, or of hurting yourself <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-9-label-1\" for=\"forminator-field-radio-9-1-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"0\"><input type=\"radio\" name=\"radio-9\" value=\"one\" id=\"forminator-field-radio-9-1-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-9-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">0<\/span><\/label><label id=\"forminator-field-radio-9-label-2\" for=\"forminator-field-radio-9-2-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"1\"><input type=\"radio\" name=\"radio-9\" value=\"two\" id=\"forminator-field-radio-9-2-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-9-label-2\" data-calculation=\"1\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">1<\/span><\/label><label id=\"forminator-field-radio-9-label-3\" for=\"forminator-field-radio-9-3-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"2\"><input type=\"radio\" name=\"radio-9\" value=\"2\" id=\"forminator-field-radio-9-3-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-9-label-3\" data-calculation=\"2\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">2<\/span><\/label><label id=\"forminator-field-radio-9-label-4\" for=\"forminator-field-radio-9-4-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"3\"><input type=\"radio\" name=\"radio-9\" value=\"3\" id=\"forminator-field-radio-9-4-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-9-label-4\" data-calculation=\"3\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">3<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"calculation-1\" class=\"forminator-field-calculation forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"calculation-1-field_69d4678b0cb72\" id=\"calculation-1-field_69d4678b0cb72-label\" class=\"forminator-label\">Result PHQ-9<\/label><input type=\"text\" name=\"calculation-1\" value=\"\" id=\"calculation-1-field_69d4678b0cb72\" class=\"forminator-calculation forminator-input\" data-formula=\"{radio-1}+{radio-2}+{radio-3}+{radio-4}+{radio-5}+{radio-6}+{radio-7}+{radio-8}+{radio-9}\" data-required=\"\" data-decimal-point=\"\" data-precision=\"0\" data-is-hidden=\"1\" disabled=\"disabled\" data-decimals=\"0\" data-inputmask=\"&#039;groupSeparator&#039;: &#039;&#039;, &#039;radixPoint&#039;: &#039;&#039;, &#039;digits&#039;: &#039;0&#039;\" readonly=\"readonly\" data-hidden-behavior=\"zero\" \/><\/div><\/div><\/div><\/div><\/div><div\n\t\t\t\ttabindex=\"-1\"\n\t\t\t\trole=\"tabpanel\"\n\t\t\t\tid=\"forminator-custom-form-1133--page-2\"\n\t\t\t\tclass=\"forminator-pagination\"\n\t\t\t\taria-labelledby=\"forminator-custom-form-1133--page-2-label\"\n\t\t\t\taria-hidden=\"true\"\n\t\t\t\tdata-step=\"2\"\n\t\t\t\tdata-label=\"Page  2\"\n\t\t\t\tdata-actual-label=\"Finish\"\n\t\t\t\tdata-name=\"\"\n\t\t\t\thidden\n\t\t\t><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"html-2\" class=\"forminator-field-html forminator-col forminator-col-12 \"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-2\"><label class=\"forminator-label\">HTML<\/label><div style=\"text-align: center;font-weight: normal;font-size: 18px;margin-bottom: 15px\"><br>Over the last 2 weeks, how often have you been bothered by any of the following problems?<\/div>\n<div style=\"margin-bottom: 20px;padding: 10px;background-color: #f7f7f7;border-left: 4px solid #0073aa\">\n<p>0 - Not at all sure<br><br>1 - Several days<br><br>2 - Over half the days<br><br>3 - Nearly every day<\/p>\n<\/div>\n<p>&nbsp;<\/p><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-10\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-10-69d4678b0cb72-label\"><span id=\"forminator-radiogroup-radio-10-69d4678b0cb72-label\" class=\"forminator-label\">Feeling nervous, anxious, or on edge <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-10-label-1\" for=\"forminator-field-radio-10-1-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"0\"><input type=\"radio\" name=\"radio-10\" value=\"one\" id=\"forminator-field-radio-10-1-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-10-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">0<\/span><\/label><label id=\"forminator-field-radio-10-label-2\" for=\"forminator-field-radio-10-2-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"1\"><input type=\"radio\" name=\"radio-10\" value=\"two\" id=\"forminator-field-radio-10-2-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-10-label-2\" data-calculation=\"1\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">1<\/span><\/label><label id=\"forminator-field-radio-10-label-3\" for=\"forminator-field-radio-10-3-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"2\"><input type=\"radio\" name=\"radio-10\" value=\"2\" id=\"forminator-field-radio-10-3-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-10-label-3\" data-calculation=\"2\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">2<\/span><\/label><label id=\"forminator-field-radio-10-label-4\" for=\"forminator-field-radio-10-4-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"3\"><input type=\"radio\" name=\"radio-10\" value=\"3\" id=\"forminator-field-radio-10-4-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-10-label-4\" data-calculation=\"3\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">3<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-11\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-11-69d4678b0cb72-label\"><span id=\"forminator-radiogroup-radio-11-69d4678b0cb72-label\" class=\"forminator-label\">Not being able to stop or control worrying <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-11-label-1\" for=\"forminator-field-radio-11-1-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"0\"><input type=\"radio\" name=\"radio-11\" value=\"one\" id=\"forminator-field-radio-11-1-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-11-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">0<\/span><\/label><label id=\"forminator-field-radio-11-label-2\" for=\"forminator-field-radio-11-2-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"1\"><input type=\"radio\" name=\"radio-11\" value=\"two\" id=\"forminator-field-radio-11-2-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-11-label-2\" data-calculation=\"1\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">1<\/span><\/label><label id=\"forminator-field-radio-11-label-3\" for=\"forminator-field-radio-11-3-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"2\"><input type=\"radio\" name=\"radio-11\" value=\"2\" id=\"forminator-field-radio-11-3-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-11-label-3\" data-calculation=\"2\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">2<\/span><\/label><label id=\"forminator-field-radio-11-label-4\" for=\"forminator-field-radio-11-4-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"3\"><input type=\"radio\" name=\"radio-11\" value=\"3\" id=\"forminator-field-radio-11-4-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-11-label-4\" data-calculation=\"3\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">3<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-12\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-12-69d4678b0cb72-label\"><span id=\"forminator-radiogroup-radio-12-69d4678b0cb72-label\" class=\"forminator-label\">Worrying too much about different things <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-12-label-1\" for=\"forminator-field-radio-12-1-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"0\"><input type=\"radio\" name=\"radio-12\" value=\"one\" id=\"forminator-field-radio-12-1-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-12-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">0<\/span><\/label><label id=\"forminator-field-radio-12-label-2\" for=\"forminator-field-radio-12-2-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"1\"><input type=\"radio\" name=\"radio-12\" value=\"two\" id=\"forminator-field-radio-12-2-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-12-label-2\" data-calculation=\"1\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">1<\/span><\/label><label id=\"forminator-field-radio-12-label-3\" for=\"forminator-field-radio-12-3-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"2\"><input type=\"radio\" name=\"radio-12\" value=\"2\" id=\"forminator-field-radio-12-3-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-12-label-3\" data-calculation=\"2\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">2<\/span><\/label><label id=\"forminator-field-radio-12-label-4\" for=\"forminator-field-radio-12-4-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"3\"><input type=\"radio\" name=\"radio-12\" value=\"3\" id=\"forminator-field-radio-12-4-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-12-label-4\" data-calculation=\"3\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">3<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-13\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-13-69d4678b0cb72-label\"><span id=\"forminator-radiogroup-radio-13-69d4678b0cb72-label\" class=\"forminator-label\">Trouble relaxing <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-13-label-1\" for=\"forminator-field-radio-13-1-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"0\"><input type=\"radio\" name=\"radio-13\" value=\"one\" id=\"forminator-field-radio-13-1-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-13-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">0<\/span><\/label><label id=\"forminator-field-radio-13-label-2\" for=\"forminator-field-radio-13-2-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"1\"><input type=\"radio\" name=\"radio-13\" value=\"two\" id=\"forminator-field-radio-13-2-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-13-label-2\" data-calculation=\"1\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">1<\/span><\/label><label id=\"forminator-field-radio-13-label-3\" for=\"forminator-field-radio-13-3-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"2\"><input type=\"radio\" name=\"radio-13\" value=\"2\" id=\"forminator-field-radio-13-3-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-13-label-3\" data-calculation=\"2\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">2<\/span><\/label><label id=\"forminator-field-radio-13-label-4\" for=\"forminator-field-radio-13-4-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"3\"><input type=\"radio\" name=\"radio-13\" value=\"3\" id=\"forminator-field-radio-13-4-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-13-label-4\" data-calculation=\"3\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">3<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-14\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-14-69d4678b0cb72-label\"><span id=\"forminator-radiogroup-radio-14-69d4678b0cb72-label\" class=\"forminator-label\">Being so restless that it&#039;s hard to sit still <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-14-label-1\" for=\"forminator-field-radio-14-1-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"0\"><input type=\"radio\" name=\"radio-14\" value=\"one\" id=\"forminator-field-radio-14-1-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-14-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">0<\/span><\/label><label id=\"forminator-field-radio-14-label-2\" for=\"forminator-field-radio-14-2-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"1\"><input type=\"radio\" name=\"radio-14\" value=\"two\" id=\"forminator-field-radio-14-2-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-14-label-2\" data-calculation=\"1\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">1<\/span><\/label><label id=\"forminator-field-radio-14-label-3\" for=\"forminator-field-radio-14-3-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"2\"><input type=\"radio\" name=\"radio-14\" value=\"2\" id=\"forminator-field-radio-14-3-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-14-label-3\" data-calculation=\"2\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">2<\/span><\/label><label id=\"forminator-field-radio-14-label-4\" for=\"forminator-field-radio-14-4-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"3\"><input type=\"radio\" name=\"radio-14\" value=\"3\" id=\"forminator-field-radio-14-4-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-14-label-4\" data-calculation=\"3\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">3<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-15\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-15-69d4678b0cb72-label\"><span id=\"forminator-radiogroup-radio-15-69d4678b0cb72-label\" class=\"forminator-label\">Becoming easily annoyed or irritable <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-15-label-1\" for=\"forminator-field-radio-15-1-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"0\"><input type=\"radio\" name=\"radio-15\" value=\"one\" id=\"forminator-field-radio-15-1-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-15-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">0<\/span><\/label><label id=\"forminator-field-radio-15-label-2\" for=\"forminator-field-radio-15-2-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"1\"><input type=\"radio\" name=\"radio-15\" value=\"two\" id=\"forminator-field-radio-15-2-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-15-label-2\" data-calculation=\"1\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">1<\/span><\/label><label id=\"forminator-field-radio-15-label-3\" for=\"forminator-field-radio-15-3-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"2\"><input type=\"radio\" name=\"radio-15\" value=\"2\" id=\"forminator-field-radio-15-3-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-15-label-3\" data-calculation=\"2\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">2<\/span><\/label><label id=\"forminator-field-radio-15-label-4\" for=\"forminator-field-radio-15-4-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"3\"><input type=\"radio\" name=\"radio-15\" value=\"3\" id=\"forminator-field-radio-15-4-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-15-label-4\" data-calculation=\"3\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">3<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-16\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-16-69d4678b0cb72-label\"><span id=\"forminator-radiogroup-radio-16-69d4678b0cb72-label\" class=\"forminator-label\">Feeling afraid as if something awful might happen <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-16-label-1\" for=\"forminator-field-radio-16-1-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"0\"><input type=\"radio\" name=\"radio-16\" value=\"one\" id=\"forminator-field-radio-16-1-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-16-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">0<\/span><\/label><label id=\"forminator-field-radio-16-label-2\" for=\"forminator-field-radio-16-2-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"1\"><input type=\"radio\" name=\"radio-16\" value=\"two\" id=\"forminator-field-radio-16-2-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-16-label-2\" data-calculation=\"1\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">1<\/span><\/label><label id=\"forminator-field-radio-16-label-3\" for=\"forminator-field-radio-16-3-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"2\"><input type=\"radio\" name=\"radio-16\" value=\"2\" id=\"forminator-field-radio-16-3-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-16-label-3\" data-calculation=\"2\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">2<\/span><\/label><label id=\"forminator-field-radio-16-label-4\" for=\"forminator-field-radio-16-4-69d4678b0cb72\" class=\"forminator-radio forminator-radio-inline\" title=\"3\"><input type=\"radio\" name=\"radio-16\" value=\"3\" id=\"forminator-field-radio-16-4-69d4678b0cb72\" aria-labelledby=\"forminator-field-radio-16-label-4\" data-calculation=\"3\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">3<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"calculation-2\" class=\"forminator-field-calculation forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"calculation-2-field_69d4678b0cb72\" id=\"calculation-2-field_69d4678b0cb72-label\" class=\"forminator-label\">Result GAD-7<\/label><input type=\"text\" name=\"calculation-2\" value=\"\" id=\"calculation-2-field_69d4678b0cb72\" class=\"forminator-calculation forminator-input\" data-formula=\"{radio-10}+{radio-11}+{radio-12}+{radio-13}+{radio-14}+{radio-15}+{radio-16}\" data-required=\"\" data-decimal-point=\"\" data-precision=\"0\" data-is-hidden=\"1\" disabled=\"disabled\" data-decimals=\"0\" data-inputmask=\"&#039;groupSeparator&#039;: &#039;&#039;, &#039;radixPoint&#039;: &#039;&#039;, &#039;digits&#039;: &#039;0&#039;\" readonly=\"readonly\" data-hidden-behavior=\"zero\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"consent-2\" class=\"forminator-field-consent forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-consent-2_69d4678b0cb72\" id=\"forminator-field-consent-2_69d4678b0cb72-label\" class=\"forminator-label\">Consent <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-checkbox__wrapper\"><label id=\"forminator-field-consent-2_69d4678b0cb72__label\" class=\"forminator-checkbox forminator-consent\" aria-labelledby=\"forminator-field-consent-2_69d4678b0cb72-label\"><input type=\"checkbox\" name=\"consent-2\" id=\"forminator-field-consent-2_69d4678b0cb72\" value=\"checked\" aria-labelledby=\"forminator-field-consent-2_69d4678b0cb72-label\" aria-describedby=\"forminator-field-consent-2_69d4678b0cb72__description\" data-required=\"true\" aria-required=\"true\" \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><\/label><div id=\"forminator-field-consent-2_69d4678b0cb72__description\" class=\"forminator-checkbox__label forminator-consent__label\"><p>I consent to the use of this data for medical research purposes.<\/p><\/div><\/div><\/div><\/div><\/div><\/div><button class=\"forminator-button forminator-pagination-submit\" style=\"display: none;\" disabled>Submit<\/button><\/div><input type=\"hidden\" name=\"referer_url\" value=\"\" \/><input type=\"hidden\" id=\"forminator_nonce\" name=\"forminator_nonce\" value=\"6d1a9e7ceb\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/uka\/wp-json\/wp\/v2\/pages\/1156\" \/><input type=\"hidden\" name=\"form_id\" value=\"1133\"><input type=\"hidden\" name=\"page_id\" value=\"1156\"><input type=\"hidden\" name=\"form_type\" value=\"default\"><input type=\"hidden\" name=\"current_url\" value=\"https:\/\/hctm.ukm.my\/uka\/patient-screening-and-appointment\/\"><input type=\"hidden\" name=\"render_id\" value=\"0\"><input type=\"hidden\" name=\"action\" value=\"forminator_submit_form_custom-forms\"><label for=\"input_24\" class=\"forminator-hidden\" aria-hidden=\"true\">Please do not fill in this field. <input id=\"input_24\" type=\"text\" name=\"input_24\" value=\"\" autocomplete=\"off\"><\/label><\/form>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][\/vc_column][\/vc_row]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>[vc_row][vc_column][vc_column_text css=&#8221;.vc_custom_1730964195163{background-color: #219ed3 !important;}&#8221;] PATIENT HEALTH QUESTIONNAIRE (PHQ-9) [\/vc_column_text][vc_column_text][\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][\/vc_column][\/vc_row]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1156","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/hctm.ukm.my\/uka\/wp-json\/wp\/v2\/pages\/1156","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/hctm.ukm.my\/uka\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/hctm.ukm.my\/uka\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/hctm.ukm.my\/uka\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/hctm.ukm.my\/uka\/wp-json\/wp\/v2\/comments?post=1156"}],"version-history":[{"count":10,"href":"https:\/\/hctm.ukm.my\/uka\/wp-json\/wp\/v2\/pages\/1156\/revisions"}],"predecessor-version":[{"id":1175,"href":"https:\/\/hctm.ukm.my\/uka\/wp-json\/wp\/v2\/pages\/1156\/revisions\/1175"}],"wp:attachment":[{"href":"https:\/\/hctm.ukm.my\/uka\/wp-json\/wp\/v2\/media?parent=1156"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}