{"id":7135,"date":"2025-04-08T22:46:16","date_gmt":"2025-04-08T22:46:16","guid":{"rendered":"https:\/\/dreugenelipov.com\/?page_id=7135"},"modified":"2026-02-10T19:05:51","modified_gmt":"2026-02-10T19:05:51","slug":"do-i-have-ptsd","status":"publish","type":"page","link":"https:\/\/dreugenelipov.com\/es\/do-i-have-ptsd\/","title":{"rendered":"Do I Have PTSD?"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"7135\" class=\"elementor elementor-7135\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-892d645 e-flex e-con-boxed e-con e-parent\" data-id=\"892d645\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-5078d78 e-con-full animated-slow e-flex elementor-invisible e-con e-child\" data-id=\"5078d78\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;animation&quot;:&quot;fadeIn&quot;,&quot;animation_delay&quot;:200}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-b876069 elementor-widget elementor-widget-heading\" data-id=\"b876069\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Do I have PTSD?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4d48862 elementor-widget elementor-widget-text-editor\" data-id=\"4d48862\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\">PCL-5 Self-Assessment<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-df0b9e0 elementor-widget elementor-widget-shortcode\" data-id=\"df0b9e0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_1' style='display:none'><div id='gf_1' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Do I Have PTSD? | PCL-5<\/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; se\u00f1ala los campos obligatorios<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_1' id='gform_1'  action='\/es\/wp-json\/wp\/v2\/pages\/7135#gf_1' data-formid='1' novalidate>\n        <div id='gf_progressbar_wrapper_1' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<p class=\"gf_progressbar_title\">Paso <span class='gf_step_current_page'>1<\/span> de <span class='gf_step_page_count'>5<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_20' style='width:20%;'><span>20%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_1_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_1' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_1_40\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full pcl5-intro-body gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p>The following 20-question self-assessment is based on the <em>PTSD Checklist for DSM-5 (PCL-5)<\/em>, a tool developed by the <strong>American Psychiatric Association<\/strong> and published by the <strong>National Center for PTSD<\/strong>. It is part of a broader framework used by clinicians to assess symptoms of post-traumatic stress.<\/p>\n\n<p>This version is designed for personal reflection \u2014 to help you better understand how certain symptoms may be affecting you. It does not provide a diagnosis, but may offer helpful insight into whether a conversation with a licensed mental health professional might be appropriate.<\/p>\n\n<p>Please respond to each item based on how much it has bothered you in the past month. <strong>Your responses are 100% anonymous and no data is saved or shared.<\/strong><\/p><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_1_41' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_1_2' class='gform_page' data-js='page-field-id-41' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_1_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_1_1\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio pcl5-question 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' >1. Repeated, disturbing, and unwanted memories of the stressful experience?<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_1_1'>\n\t\t\t<div class='gchoice gchoice_1_1_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_1' type='radio' value='0'  id='choice_1_1_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_1_0' id='label_1_1_0' class='gform-field-label gform-field-label--type-inline'>Not at all<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_1_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_1' type='radio' value='1'  id='choice_1_1_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_1_1' id='label_1_1_1' class='gform-field-label gform-field-label--type-inline'>A little bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_1_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_1' type='radio' value='2'  id='choice_1_1_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_1_2' id='label_1_1_2' class='gform-field-label gform-field-label--type-inline'>Moderately<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_1_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_1' type='radio' value='3'  id='choice_1_1_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_1_3' id='label_1_1_3' class='gform-field-label gform-field-label--type-inline'>Quite a bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_1_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_1' type='radio' value='4'  id='choice_1_1_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_1_4' id='label_1_1_4' class='gform-field-label gform-field-label--type-inline'>Extremely<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_1_36\" class=\"gfield gfield--type-section gfield--input-type-section gsection pcl5-rule field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">rule<\/h3><\/div><fieldset id=\"field_1_6\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full pcl5-question 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' >2. Repeated, disturbing dreams of the stressful experience?<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_1_6'>\n\t\t\t<div class='gchoice gchoice_1_6_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='0'  id='choice_1_6_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_6_0' id='label_1_6_0' class='gform-field-label gform-field-label--type-inline'>Not at all<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_6_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='1'  id='choice_1_6_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_6_1' id='label_1_6_1' class='gform-field-label gform-field-label--type-inline'>A little bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_6_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='2'  id='choice_1_6_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_6_2' id='label_1_6_2' class='gform-field-label gform-field-label--type-inline'>Moderately<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_6_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='3'  id='choice_1_6_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_6_3' id='label_1_6_3' class='gform-field-label gform-field-label--type-inline'>Quite a bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_6_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='4'  id='choice_1_6_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_6_4' id='label_1_6_4' class='gform-field-label gform-field-label--type-inline'>Extremely<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_1_37\" class=\"gfield gfield--type-section gfield--input-type-section gsection pcl5-rule field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">rule<\/h3><\/div><fieldset id=\"field_1_8\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full pcl5-question 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' >3. Suddenly feeling or acting as if the stressful experience were happening again?<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_1_8'>\n\t\t\t<div class='gchoice gchoice_1_8_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='0'  id='choice_1_8_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_8_0' id='label_1_8_0' class='gform-field-label gform-field-label--type-inline'>Not at all<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_8_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='1'  id='choice_1_8_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_8_1' id='label_1_8_1' class='gform-field-label gform-field-label--type-inline'>A little bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_8_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='2'  id='choice_1_8_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_8_2' id='label_1_8_2' class='gform-field-label gform-field-label--type-inline'>Moderately<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_8_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='3'  id='choice_1_8_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_8_3' id='label_1_8_3' class='gform-field-label gform-field-label--type-inline'>Quite a bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_8_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='4'  id='choice_1_8_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_8_4' id='label_1_8_4' class='gform-field-label gform-field-label--type-inline'>Extremely<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_1_44\" class=\"gfield gfield--type-section gfield--input-type-section gsection pcl5-rule field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">rule<\/h3><\/div><fieldset id=\"field_1_7\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full pcl5-question 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' >4. Feeling very upset when something reminded you of the stressful experience?<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_1_7'>\n\t\t\t<div class='gchoice gchoice_1_7_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='0'  id='choice_1_7_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_7_0' id='label_1_7_0' class='gform-field-label gform-field-label--type-inline'>Not at all<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_7_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='1'  id='choice_1_7_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_7_1' id='label_1_7_1' class='gform-field-label gform-field-label--type-inline'>A little bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_7_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='2'  id='choice_1_7_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_7_2' id='label_1_7_2' class='gform-field-label gform-field-label--type-inline'>Moderately<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_7_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='3'  id='choice_1_7_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_7_3' id='label_1_7_3' class='gform-field-label gform-field-label--type-inline'>Quite a bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_7_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='4'  id='choice_1_7_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_7_4' id='label_1_7_4' class='gform-field-label gform-field-label--type-inline'>Extremely<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_1_46\" class=\"gfield gfield--type-section gfield--input-type-section gsection pcl5-rule field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">rule<\/h3><\/div><fieldset id=\"field_1_9\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full pcl5-question 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' >5. Having strong physical reactions when something reminded you of the stressful experience?<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_1_9'>\n\t\t\t<div class='gchoice gchoice_1_9_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='0'  id='choice_1_9_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_9_0' id='label_1_9_0' class='gform-field-label gform-field-label--type-inline'>Not at all<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_9_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='1'  id='choice_1_9_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_9_1' id='label_1_9_1' class='gform-field-label gform-field-label--type-inline'>A little bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_9_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='2'  id='choice_1_9_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_9_2' id='label_1_9_2' class='gform-field-label gform-field-label--type-inline'>Moderately<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_9_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='3'  id='choice_1_9_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_9_3' id='label_1_9_3' class='gform-field-label gform-field-label--type-inline'>Quite a bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_9_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='4'  id='choice_1_9_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_9_4' id='label_1_9_4' class='gform-field-label gform-field-label--type-inline'>Extremely<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_1_33' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_1_33' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_1_3' class='gform_page' data-js='page-field-id-33' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_1_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_1_10\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full pcl5-question 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' >6. Avoiding memories, thoughts, or feelings related to the stressful experience?<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_1_10'>\n\t\t\t<div class='gchoice gchoice_1_10_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='0'  id='choice_1_10_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_10_0' id='label_1_10_0' class='gform-field-label gform-field-label--type-inline'>Not at all<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_10_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='1'  id='choice_1_10_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_10_1' id='label_1_10_1' class='gform-field-label gform-field-label--type-inline'>A little bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_10_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='2'  id='choice_1_10_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_10_2' id='label_1_10_2' class='gform-field-label gform-field-label--type-inline'>Moderately<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_10_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='3'  id='choice_1_10_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_10_3' id='label_1_10_3' class='gform-field-label gform-field-label--type-inline'>Quite a bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_10_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='4'  id='choice_1_10_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_10_4' id='label_1_10_4' class='gform-field-label gform-field-label--type-inline'>Extremely<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_1_11\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full pcl5-question 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' >7. Avoiding external reminders of the stressful experience (people, places, etc.)?<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_1_11'>\n\t\t\t<div class='gchoice gchoice_1_11_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='0'  id='choice_1_11_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_11_0' id='label_1_11_0' class='gform-field-label gform-field-label--type-inline'>Not at all<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_11_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='1'  id='choice_1_11_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_11_1' id='label_1_11_1' class='gform-field-label gform-field-label--type-inline'>A little bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_11_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='2'  id='choice_1_11_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_11_2' id='label_1_11_2' class='gform-field-label gform-field-label--type-inline'>Moderately<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_11_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='3'  id='choice_1_11_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_11_3' id='label_1_11_3' class='gform-field-label gform-field-label--type-inline'>Quite a bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_11_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='4'  id='choice_1_11_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_11_4' id='label_1_11_4' class='gform-field-label gform-field-label--type-inline'>Extremely<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_1_12\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full pcl5-question 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' >8. Trouble remembering important parts of the stressful experience?<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_1_12'>\n\t\t\t<div class='gchoice gchoice_1_12_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='0'  id='choice_1_12_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_12_0' id='label_1_12_0' class='gform-field-label gform-field-label--type-inline'>Not at all<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_12_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='1'  id='choice_1_12_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_12_1' id='label_1_12_1' class='gform-field-label gform-field-label--type-inline'>A little bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_12_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='2'  id='choice_1_12_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_12_2' id='label_1_12_2' class='gform-field-label gform-field-label--type-inline'>Moderately<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_12_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='3'  id='choice_1_12_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_12_3' id='label_1_12_3' class='gform-field-label gform-field-label--type-inline'>Quite a bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_12_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='4'  id='choice_1_12_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_12_4' id='label_1_12_4' class='gform-field-label gform-field-label--type-inline'>Extremely<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_1_55\" class=\"gfield gfield--type-section gfield--input-type-section gsection pcl5-rule field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">rule<\/h3><\/div><fieldset id=\"field_1_13\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full pcl5-question 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' >9. Having strong negative beliefs about yourself, other people, or the world?<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_1_13'>\n\t\t\t<div class='gchoice gchoice_1_13_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_13' type='radio' value='0'  id='choice_1_13_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_13_0' id='label_1_13_0' class='gform-field-label gform-field-label--type-inline'>Not at all<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_13_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_13' type='radio' value='1'  id='choice_1_13_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_13_1' id='label_1_13_1' class='gform-field-label gform-field-label--type-inline'>A little bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_13_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_13' type='radio' value='2'  id='choice_1_13_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_13_2' id='label_1_13_2' class='gform-field-label gform-field-label--type-inline'>Moderately<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_13_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_13' type='radio' value='3'  id='choice_1_13_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_13_3' id='label_1_13_3' class='gform-field-label gform-field-label--type-inline'>Quite a bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_13_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_13' type='radio' value='4'  id='choice_1_13_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_13_4' id='label_1_13_4' class='gform-field-label gform-field-label--type-inline'>Extremely<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_1_48\" class=\"gfield gfield--type-section gfield--input-type-section gsection pcl5-rule field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">rule<\/h3><\/div><fieldset id=\"field_1_17\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full pcl5-question 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' >10. Blaming yourself or someone else for the stressful experience or what happened after it?<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_1_17'>\n\t\t\t<div class='gchoice gchoice_1_17_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='0'  id='choice_1_17_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_17_0' id='label_1_17_0' class='gform-field-label gform-field-label--type-inline'>Not at all<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_17_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='1'  id='choice_1_17_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_17_1' id='label_1_17_1' class='gform-field-label gform-field-label--type-inline'>A little bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_17_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='2'  id='choice_1_17_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_17_2' id='label_1_17_2' class='gform-field-label gform-field-label--type-inline'>Moderately<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_17_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='3'  id='choice_1_17_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_17_3' id='label_1_17_3' class='gform-field-label gform-field-label--type-inline'>Quite a bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_17_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='4'  id='choice_1_17_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_17_4' id='label_1_17_4' class='gform-field-label gform-field-label--type-inline'>Extremely<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_1_34' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_1_34' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_1_4' class='gform_page' data-js='page-field-id-34' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_1_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_1_14\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full pcl5-question 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' >11. Having strong negative feelings such as fear, horror, anger, guilt, or shame?<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_1_14'>\n\t\t\t<div class='gchoice gchoice_1_14_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='0'  id='choice_1_14_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_14_0' id='label_1_14_0' class='gform-field-label gform-field-label--type-inline'>Not at all<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_14_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='1'  id='choice_1_14_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_14_1' id='label_1_14_1' class='gform-field-label gform-field-label--type-inline'>A little bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_14_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='2'  id='choice_1_14_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_14_2' id='label_1_14_2' class='gform-field-label gform-field-label--type-inline'>Moderately<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_14_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='3'  id='choice_1_14_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_14_3' id='label_1_14_3' class='gform-field-label gform-field-label--type-inline'>Quite a bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_14_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='4'  id='choice_1_14_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_14_4' id='label_1_14_4' class='gform-field-label gform-field-label--type-inline'>Extremely<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_1_54\" class=\"gfield gfield--type-section gfield--input-type-section gsection pcl5-rule field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">rule<\/h3><\/div><fieldset id=\"field_1_18\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full pcl5-question 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' >12. Loss of interest in activities you used to enjoy?<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_1_18'>\n\t\t\t<div class='gchoice gchoice_1_18_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='0'  id='choice_1_18_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_18_0' id='label_1_18_0' class='gform-field-label gform-field-label--type-inline'>Not at all<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_18_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='1'  id='choice_1_18_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_18_1' id='label_1_18_1' class='gform-field-label gform-field-label--type-inline'>A little bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_18_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='2'  id='choice_1_18_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_18_2' id='label_1_18_2' class='gform-field-label gform-field-label--type-inline'>Moderately<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_18_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='3'  id='choice_1_18_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_18_3' id='label_1_18_3' class='gform-field-label gform-field-label--type-inline'>Quite a bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_18_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='4'  id='choice_1_18_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_18_4' id='label_1_18_4' class='gform-field-label gform-field-label--type-inline'>Extremely<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_1_53\" class=\"gfield gfield--type-section gfield--input-type-section gsection pcl5-rule field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">rule<\/h3><\/div><fieldset id=\"field_1_19\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full pcl5-question 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' >13. Feeling distant or cut off from other people?<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_1_19'>\n\t\t\t<div class='gchoice gchoice_1_19_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='0'  id='choice_1_19_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_19_0' id='label_1_19_0' class='gform-field-label gform-field-label--type-inline'>Not at all<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_19_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='1'  id='choice_1_19_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_19_1' id='label_1_19_1' class='gform-field-label gform-field-label--type-inline'>A little bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_19_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='2'  id='choice_1_19_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_19_2' id='label_1_19_2' class='gform-field-label gform-field-label--type-inline'>Moderately<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_19_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='3'  id='choice_1_19_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_19_3' id='label_1_19_3' class='gform-field-label gform-field-label--type-inline'>Quite a bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_19_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='4'  id='choice_1_19_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_19_4' id='label_1_19_4' class='gform-field-label gform-field-label--type-inline'>Extremely<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_1_52\" class=\"gfield gfield--type-section gfield--input-type-section gsection pcl5-rule field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">rule<\/h3><\/div><fieldset id=\"field_1_20\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full pcl5-question 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' >14. Trouble experiencing positive feelings (e.g., happiness, love)?<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_1_20'>\n\t\t\t<div class='gchoice gchoice_1_20_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='0'  id='choice_1_20_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_20_0' id='label_1_20_0' class='gform-field-label gform-field-label--type-inline'>Not at all<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_20_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='1'  id='choice_1_20_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_20_1' id='label_1_20_1' class='gform-field-label gform-field-label--type-inline'>A little bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_20_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='2'  id='choice_1_20_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_20_2' id='label_1_20_2' class='gform-field-label gform-field-label--type-inline'>Moderately<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_20_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='3'  id='choice_1_20_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_20_3' id='label_1_20_3' class='gform-field-label gform-field-label--type-inline'>Quite a bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_20_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='4'  id='choice_1_20_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_20_4' id='label_1_20_4' class='gform-field-label gform-field-label--type-inline'>Extremely<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_1_51\" class=\"gfield gfield--type-section gfield--input-type-section gsection pcl5-rule field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">rule<\/h3><\/div><fieldset id=\"field_1_22\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full pcl5-question 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' >15. Irritable behavior, angry outbursts, or acting aggressively?<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_1_22'>\n\t\t\t<div class='gchoice gchoice_1_22_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='0'  id='choice_1_22_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_22_0' id='label_1_22_0' class='gform-field-label gform-field-label--type-inline'>Not at all<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_22_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='1'  id='choice_1_22_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_22_1' id='label_1_22_1' class='gform-field-label gform-field-label--type-inline'>A little bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_22_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='2'  id='choice_1_22_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_22_2' id='label_1_22_2' class='gform-field-label gform-field-label--type-inline'>Moderately<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_22_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='3'  id='choice_1_22_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_22_3' id='label_1_22_3' class='gform-field-label gform-field-label--type-inline'>Quite a bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_22_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='4'  id='choice_1_22_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_22_4' id='label_1_22_4' class='gform-field-label gform-field-label--type-inline'>Extremely<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_1_35' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_1_35' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_1_5' class='gform_page' data-js='page-field-id-35' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_1_5' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_1_21\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full pcl5-question 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' >16. Taking too many risks or doing things that could cause you harm?<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_1_21'>\n\t\t\t<div class='gchoice gchoice_1_21_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='0'  id='choice_1_21_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_21_0' id='label_1_21_0' class='gform-field-label gform-field-label--type-inline'>Not at all<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_21_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='1'  id='choice_1_21_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_21_1' id='label_1_21_1' class='gform-field-label gform-field-label--type-inline'>A little bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_21_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='2'  id='choice_1_21_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_21_2' id='label_1_21_2' class='gform-field-label gform-field-label--type-inline'>Moderately<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_21_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='3'  id='choice_1_21_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_21_3' id='label_1_21_3' class='gform-field-label gform-field-label--type-inline'>Quite a bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_21_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='4'  id='choice_1_21_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_21_4' id='label_1_21_4' class='gform-field-label gform-field-label--type-inline'>Extremely<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_1_50\" class=\"gfield gfield--type-section gfield--input-type-section gsection pcl5-rule field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">rule<\/h3><\/div><fieldset id=\"field_1_23\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full pcl5-question 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' >17. Being \u201csuperalert\u201d or watchful or on guard?<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_1_23'>\n\t\t\t<div class='gchoice gchoice_1_23_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='0'  id='choice_1_23_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_23_0' id='label_1_23_0' class='gform-field-label gform-field-label--type-inline'>Not at all<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_23_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='1'  id='choice_1_23_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_23_1' id='label_1_23_1' class='gform-field-label gform-field-label--type-inline'>A little bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_23_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='2'  id='choice_1_23_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_23_2' id='label_1_23_2' class='gform-field-label gform-field-label--type-inline'>Moderately<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_23_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='3'  id='choice_1_23_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_23_3' id='label_1_23_3' class='gform-field-label gform-field-label--type-inline'>Quite a bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_23_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='4'  id='choice_1_23_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_23_4' id='label_1_23_4' class='gform-field-label gform-field-label--type-inline'>Extremely<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_1_4\" class=\"gfield gfield--type-section gfield--input-type-section gsection pcl5-rule field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">rule<\/h3><\/div><fieldset id=\"field_1_24\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full pcl5-question 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' >18. Feeling jumpy or easily startled?<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_1_24'>\n\t\t\t<div class='gchoice gchoice_1_24_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='0'  id='choice_1_24_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_24_0' id='label_1_24_0' class='gform-field-label gform-field-label--type-inline'>Not at all<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_24_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='1'  id='choice_1_24_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_24_1' id='label_1_24_1' class='gform-field-label gform-field-label--type-inline'>A little bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_24_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='2'  id='choice_1_24_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_24_2' id='label_1_24_2' class='gform-field-label gform-field-label--type-inline'>Moderately<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_24_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='3'  id='choice_1_24_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_24_3' id='label_1_24_3' class='gform-field-label gform-field-label--type-inline'>Quite a bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_24_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='4'  id='choice_1_24_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_24_4' id='label_1_24_4' class='gform-field-label gform-field-label--type-inline'>Extremely<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_1_49\" class=\"gfield gfield--type-section gfield--input-type-section gsection pcl5-rule field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">rule<\/h3><\/div><fieldset id=\"field_1_25\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full pcl5-question 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' >19. Having difficulty concentrating?<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_1_25'>\n\t\t\t<div class='gchoice gchoice_1_25_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='0'  id='choice_1_25_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_25_0' id='label_1_25_0' class='gform-field-label gform-field-label--type-inline'>Not at all<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_25_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='1'  id='choice_1_25_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_25_1' id='label_1_25_1' class='gform-field-label gform-field-label--type-inline'>A little bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_25_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='2'  id='choice_1_25_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_25_2' id='label_1_25_2' class='gform-field-label gform-field-label--type-inline'>Moderately<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_25_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='3'  id='choice_1_25_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_25_3' id='label_1_25_3' class='gform-field-label gform-field-label--type-inline'>Quite a bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_25_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='4'  id='choice_1_25_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_25_4' id='label_1_25_4' class='gform-field-label gform-field-label--type-inline'>Extremely<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_1_27\" class=\"gfield gfield--type-section gfield--input-type-section gsection pcl5-rule field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">rule<\/h3><\/div><fieldset id=\"field_1_26\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full pcl5-question 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' >20. Trouble falling or staying asleep?<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_1_26'>\n\t\t\t<div class='gchoice gchoice_1_26_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='0'  id='choice_1_26_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_26_0' id='label_1_26_0' class='gform-field-label gform-field-label--type-inline'>Not at all<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_26_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='1'  id='choice_1_26_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_26_1' id='label_1_26_1' class='gform-field-label gform-field-label--type-inline'>A little bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_26_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='2'  id='choice_1_26_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_26_2' id='label_1_26_2' class='gform-field-label gform-field-label--type-inline'>Moderately<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_26_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='3'  id='choice_1_26_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_26_3' id='label_1_26_3' class='gform-field-label gform-field-label--type-inline'>Quite a bit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_1_26_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='4'  id='choice_1_26_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_1_26_4' id='label_1_26_4' class='gform-field-label gform-field-label--type-inline'>Extremely<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_1_57\" class=\"gfield gfield--type-section gfield--input-type-section gsection pcl5-rule field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">rule<\/h3><\/div><div id=\"field_1_29\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_calculation field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_29'>Total Score<\/label><div class='ginput_container ginput_container_number'><input name='input_29' id='input_1_29' type='text' step='any'   value='' class='medium gform-text-input-reset'  readonly=\"readonly\"    aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_1_58\" class=\"gfield gfield--type-section gfield--input-type-section gsection pcl5-rule field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">rule<\/h3><\/div><div id=\"field_1_28\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full pcl5-message gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><span style=\"color:#111;\">Your score is in the 0\u201310 range, which suggests few or no symptoms typically associated with post-traumatic stress. <\/span>While this is a positive result, continue to monitor your well-being and seek support if things change.<\/div><div id=\"field_1_30\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full pcl5-message gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><span style=\"color:#111;\">Your score is in the 11\u201330 range, which suggests the presence of some symptoms associated with post-traumatic stress. <\/span>While this may not indicate significant concern on its own, it could be worth exploring further \u2014 especially if symptoms persist or begin to impact your daily life.<\/div><div id=\"field_1_31\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full pcl5-message gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><span style=\"color:#111;\">Your score is in the 31\u201350 range, which reflects a moderate level of post-traumatic stress symptoms.<\/span> This may be affecting your emotional well-being or everyday functioning. Consider reaching out to a qualified mental health professional to discuss your experience and next steps.<\/div><div id=\"field_1_32\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full pcl5-message gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><span style=\"color:#111;\">Your score is in the 51\u201380 range, which is often associated with more severe post-traumatic stress symptoms.<\/span> This may be significantly impacting your quality of life. We strongly encourage you to speak with a licensed mental health provider who can support you in navigating your next steps with care and confidentiality.<\/div><div id=\"field_1_59\" class=\"gfield gfield--type-section gfield--input-type-section gsection pcl5-rule field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">rule<\/h3><\/div><div id=\"field_1_56\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full ptsd-footer gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p>If any of these questions brought up difficult thoughts or memories, or if you\u2019re unsure how to interpret your responses, consider speaking with a licensed mental health professional. You're not alone \u2014 support is available.<\/p>\n<p>For more information, visit <a href=\"https:\/\/www.ptsd.va.gov\/\" target=\"_blank\" rel=\"noopener\">The National Center for PTSD<\/a>.<\/p><\/div><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><input type='submit' id='gform_previous_button_1' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='submit' id='gform_submit_button_1' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Restart the Assessment'  \/> <input type='hidden' name='gform_ajax' value='form_id=1&amp;title=1&amp;description=1&amp;tabindex=0&amp;theme=gravity-theme&amp;styles=[]&amp;hash=866cf753e183574d37e7522a6857b3bd' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' 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