if (window.location.protocol != "https:" && window.location.href.indexOf("formulate") == -1 && "False" === "True") { window.location.href = "https:" + window.location.href.substring(window.location.protocol.length); } var fbScriptTag = document.getElementsByClassName("256eeec2-6c25-4efe-9430-9cfd17abcaf8"), fbBodyTag = document.body, fbHeadTag = document.head, fbIsTestResponse = 'False', fbEnableInstaMedScript = 'False', fbRenderContainer = document.createElement("div"), fbRenderedCssContainer = document.createElement("div"), fbConfigScript = document.createElement("script"), fbRequireJSScript = document.createElement("script"), fbInstaMedJSScript = document.createElement("script"), fbGeoCaptchaCallback = document.createElement("script"), fbGeoReCaptchaCallback = document.createElement("script"), fbFormulateRenderer = document.createElement("script"), fbRenderedIntegrations = document.createElement("script"), fbRenderedScripts = document.createElement("script"), fbAutoPopulateFromQueryString = document.createElement("script"), fbEmbeddedCss = "", renderedScripts = 'var conditionalSectionJs = function () {\ requirejs([window.formHost + \'/Scripts/require/fbRequire.config.js\'], function (fbRequireConfig) {\ var fbRequire = fbRequireConfig.fbRequire;\ \ fbRequire([\'jquery\', \'he\'], function ($, he) {\ he.encode.options.decimal = true;\ he.encode.options.allowUnsafeSymbols = true;\ \ var sectionConditions = JSON.parse(\'[{"ElementName":"FormField1_5d21d365-e7a5-4315-91c9-338464412aa8","Value":"I Agree"}]\');\ var conditionOperator = \'and\';\ \ sectionConditions.forEach(function (sectionCondition) {\ $("select[id=" + sectionCondition.ElementName + "]").addClass(\'conditionalSectionListSelection\');\ $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']").addClass(\'conditionalSectionListSelection\');\ $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']").addClass(\'conditionalSectionListSelection\');\ \ $("select[id=" + sectionCondition.ElementName + "]").on(\'change\', function () {\ checkShowHide();\ });\ \ $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']").on(\'change\', function () {\ checkShowHide();\ });\ \ $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']").on(\'change\', function () {\ checkShowHide();\ });\ });\ \ function checkShowHide() {\ var shouldShowSection = conditionOperator === \'and\'; /* set default to true for AND operation and false for OR operation */\ \ sectionConditions.forEach(function (sectionCondition) {\ checkSelect(sectionCondition); \ checkCheckbox(sectionCondition); \ checkRadio(sectionCondition); \ });\ \ showHideSection(shouldShowSection);\ \ function checkSelect(sectionCondition) {\ var matchingSelect = $("select[id=" + sectionCondition.ElementName + "]")[0];\ \ if (!matchingSelect) {\ return;\ }\ \ if (matchingSelect.type === \'select-multiple\') {\ var hasOneMatchingValue = false;\ \ for (var i = 0; i < matchingSelect.selectedOptions.length; i++) {\ if (encode(matchingSelect.selectedOptions[i].value) === sectionCondition.Value) {\ hasOneMatchingValue = true;\ }\ }\ \ shouldShowSection = mergeCondition(shouldShowSection, hasOneMatchingValue, matchingSelect);\ } else {\ shouldShowSection = mergeCondition(shouldShowSection, encode(matchingSelect.value) === sectionCondition.Value, matchingSelect);\ }\ }\ \ function checkCheckbox(sectionCondition) {\ var matchingCheckboxes = $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']");\ \ for (var i = 0; i < matchingCheckboxes.length; i++) {\ if (encode(matchingCheckboxes[i].value) === sectionCondition.Value) {\ shouldShowSection = mergeCondition(shouldShowSection, matchingCheckboxes[i].checked, matchingCheckboxes[i]);\ }\ }\ }\ \ function checkRadio(sectionCondition) {\ var matchingRadios = $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']");\ \ for (var i = 0; i < matchingRadios.length; i++) {\ if (encode(matchingRadios[i].value) === sectionCondition.Value) {\ shouldShowSection = mergeCondition(shouldShowSection, matchingRadios[i].checked, matchingRadios[i]);\ }\ }\ }\ }\ \ function mergeCondition(overallResult, newResult, element) {\ newResult = newResult && isParentVisible(element);\ \ if (conditionOperator === \'and\') {\ return overallResult && newResult;\ } else {\ return overallResult || newResult;\ }\ }\ \ function isParentVisible(element) {\ var parentSectionDiv = $(\'#\' + element.id).closest(".fb-section");\ return parentSectionDiv && !parentSectionDiv.is(":hidden");\ }\ \ function encode(myString) {\ myString = he.encode(he.escape(myString));\ \ /* Fixes issues with single quote and backtick encoding */\ var i,\ entities = [\ [\''\', \''\'],\ [\'`\', \'`\']\ ];\ \ for (i = 0; i < entities.length; i++) {\ myString = String(myString).replace(new RegExp(entities[i][0], \'g\'), entities[i][1]);\ }\ \ return myString;\ }\ \ function showHideSection(showSection) {\ if (showSection) {\ $(\'#FormField14_5d21d365-e7a5-4315-91c9-338464412aa8\').show();\ } else {\ $(\'#FormField14_5d21d365-e7a5-4315-91c9-338464412aa8\').hide();\ }\ \ $("#FormField14_5d21d365-e7a5-4315-91c9-338464412aa8 .conditionalSectionListSelection").each(function (i, obj) {\ if (obj.type === \'radio\' || obj.type === \'checkbox\') {\ if (obj.checked) {\ $(\'#\' + obj.id).change();\ }\ } else {\ $(\'#\' + obj.id).change();\ }\ });\ }\ });\ });\ };\ \ fbRequireJSScript.addEventListener("load", conditionalSectionJs);var conditionalSectionJs = function () {\ requirejs([window.formHost + \'/Scripts/require/fbRequire.config.js\'], function (fbRequireConfig) {\ var fbRequire = fbRequireConfig.fbRequire;\ \ fbRequire([\'jquery\', \'he\'], function ($, he) {\ he.encode.options.decimal = true;\ he.encode.options.allowUnsafeSymbols = true;\ \ var sectionConditions = JSON.parse(\'[{"ElementName":"FormField4_5d21d365-e7a5-4315-91c9-338464412aa8","Value":"No"}]\');\ var conditionOperator = \'and\';\ \ sectionConditions.forEach(function (sectionCondition) {\ $("select[id=" + sectionCondition.ElementName + "]").addClass(\'conditionalSectionListSelection\');\ $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']").addClass(\'conditionalSectionListSelection\');\ $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']").addClass(\'conditionalSectionListSelection\');\ \ $("select[id=" + sectionCondition.ElementName + "]").on(\'change\', function () {\ checkShowHide();\ });\ \ $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']").on(\'change\', function () {\ checkShowHide();\ });\ \ $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']").on(\'change\', function () {\ checkShowHide();\ });\ });\ \ function checkShowHide() {\ var shouldShowSection = conditionOperator === \'and\'; /* set default to true for AND operation and false for OR operation */\ \ sectionConditions.forEach(function (sectionCondition) {\ checkSelect(sectionCondition); \ checkCheckbox(sectionCondition); \ checkRadio(sectionCondition); \ });\ \ showHideSection(shouldShowSection);\ \ function checkSelect(sectionCondition) {\ var matchingSelect = $("select[id=" + sectionCondition.ElementName + "]")[0];\ \ if (!matchingSelect) {\ return;\ }\ \ if (matchingSelect.type === \'select-multiple\') {\ var hasOneMatchingValue = false;\ \ for (var i = 0; i < matchingSelect.selectedOptions.length; i++) {\ if (encode(matchingSelect.selectedOptions[i].value) === sectionCondition.Value) {\ hasOneMatchingValue = true;\ }\ }\ \ shouldShowSection = mergeCondition(shouldShowSection, hasOneMatchingValue, matchingSelect);\ } else {\ shouldShowSection = mergeCondition(shouldShowSection, encode(matchingSelect.value) === sectionCondition.Value, matchingSelect);\ }\ }\ \ function checkCheckbox(sectionCondition) {\ var matchingCheckboxes = $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']");\ \ for (var i = 0; i < matchingCheckboxes.length; i++) {\ if (encode(matchingCheckboxes[i].value) === sectionCondition.Value) {\ shouldShowSection = mergeCondition(shouldShowSection, matchingCheckboxes[i].checked, matchingCheckboxes[i]);\ }\ }\ }\ \ function checkRadio(sectionCondition) {\ var matchingRadios = $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']");\ \ for (var i = 0; i < matchingRadios.length; i++) {\ if (encode(matchingRadios[i].value) === sectionCondition.Value) {\ shouldShowSection = mergeCondition(shouldShowSection, matchingRadios[i].checked, matchingRadios[i]);\ }\ }\ }\ }\ \ function mergeCondition(overallResult, newResult, element) {\ newResult = newResult && isParentVisible(element);\ \ if (conditionOperator === \'and\') {\ return overallResult && newResult;\ } else {\ return overallResult || newResult;\ }\ }\ \ function isParentVisible(element) {\ var parentSectionDiv = $(\'#\' + element.id).closest(".fb-section");\ return parentSectionDiv && !parentSectionDiv.is(":hidden");\ }\ \ function encode(myString) {\ myString = he.encode(he.escape(myString));\ \ /* Fixes issues with single quote and backtick encoding */\ var i,\ entities = [\ [\''\', \''\'],\ [\'`\', \'`\']\ ];\ \ for (i = 0; i < entities.length; i++) {\ myString = String(myString).replace(new RegExp(entities[i][0], \'g\'), entities[i][1]);\ }\ \ return myString;\ }\ \ function showHideSection(showSection) {\ if (showSection) {\ $(\'#FormField23_5d21d365-e7a5-4315-91c9-338464412aa8\').show();\ } else {\ $(\'#FormField23_5d21d365-e7a5-4315-91c9-338464412aa8\').hide();\ }\ \ $("#FormField23_5d21d365-e7a5-4315-91c9-338464412aa8 .conditionalSectionListSelection").each(function (i, obj) {\ if (obj.type === \'radio\' || obj.type === \'checkbox\') {\ if (obj.checked) {\ $(\'#\' + obj.id).change();\ }\ } else {\ $(\'#\' + obj.id).change();\ }\ });\ }\ });\ });\ };\ \ fbRequireJSScript.addEventListener("load", conditionalSectionJs);var conditionalSectionJs = function () {\ requirejs([window.formHost + \'/Scripts/require/fbRequire.config.js\'], function (fbRequireConfig) {\ var fbRequire = fbRequireConfig.fbRequire;\ \ fbRequire([\'jquery\', \'he\'], function ($, he) {\ he.encode.options.decimal = true;\ he.encode.options.allowUnsafeSymbols = true;\ \ var sectionConditions = JSON.parse(\'[{"ElementName":"FormField5_5d21d365-e7a5-4315-91c9-338464412aa8","Value":"I don't know"},{"ElementName":"FormField5_5d21d365-e7a5-4315-91c9-338464412aa8","Value":"Not to my knowledge"}]\');\ var conditionOperator = \'or\';\ \ sectionConditions.forEach(function (sectionCondition) {\ $("select[id=" + sectionCondition.ElementName + "]").addClass(\'conditionalSectionListSelection\');\ $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']").addClass(\'conditionalSectionListSelection\');\ $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']").addClass(\'conditionalSectionListSelection\');\ \ $("select[id=" + sectionCondition.ElementName + "]").on(\'change\', function () {\ checkShowHide();\ });\ \ $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']").on(\'change\', function () {\ checkShowHide();\ });\ \ $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']").on(\'change\', function () {\ checkShowHide();\ });\ });\ \ function checkShowHide() {\ var shouldShowSection = conditionOperator === \'and\'; /* set default to true for AND operation and false for OR operation */\ \ sectionConditions.forEach(function (sectionCondition) {\ checkSelect(sectionCondition); \ checkCheckbox(sectionCondition); \ checkRadio(sectionCondition); \ });\ \ showHideSection(shouldShowSection);\ \ function checkSelect(sectionCondition) {\ var matchingSelect = $("select[id=" + sectionCondition.ElementName + "]")[0];\ \ if (!matchingSelect) {\ return;\ }\ \ if (matchingSelect.type === \'select-multiple\') {\ var hasOneMatchingValue = false;\ \ for (var i = 0; i < matchingSelect.selectedOptions.length; i++) {\ if (encode(matchingSelect.selectedOptions[i].value) === sectionCondition.Value) {\ hasOneMatchingValue = true;\ }\ }\ \ shouldShowSection = mergeCondition(shouldShowSection, hasOneMatchingValue, matchingSelect);\ } else {\ shouldShowSection = mergeCondition(shouldShowSection, encode(matchingSelect.value) === sectionCondition.Value, matchingSelect);\ }\ }\ \ function checkCheckbox(sectionCondition) {\ var matchingCheckboxes = $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']");\ \ for (var i = 0; i < matchingCheckboxes.length; i++) {\ if (encode(matchingCheckboxes[i].value) === sectionCondition.Value) {\ shouldShowSection = mergeCondition(shouldShowSection, matchingCheckboxes[i].checked, matchingCheckboxes[i]);\ }\ }\ }\ \ function checkRadio(sectionCondition) {\ var matchingRadios = $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']");\ \ for (var i = 0; i < matchingRadios.length; i++) {\ if (encode(matchingRadios[i].value) === sectionCondition.Value) {\ shouldShowSection = mergeCondition(shouldShowSection, matchingRadios[i].checked, matchingRadios[i]);\ }\ }\ }\ }\ \ function mergeCondition(overallResult, newResult, element) {\ newResult = newResult && isParentVisible(element);\ \ if (conditionOperator === \'and\') {\ return overallResult && newResult;\ } else {\ return overallResult || newResult;\ }\ }\ \ function isParentVisible(element) {\ var parentSectionDiv = $(\'#\' + element.id).closest(".fb-section");\ return parentSectionDiv && !parentSectionDiv.is(":hidden");\ }\ \ function encode(myString) {\ myString = he.encode(he.escape(myString));\ \ /* Fixes issues with single quote and backtick encoding */\ var i,\ entities = [\ [\''\', \''\'],\ [\'`\', \'`\']\ ];\ \ for (i = 0; i < entities.length; i++) {\ myString = String(myString).replace(new RegExp(entities[i][0], \'g\'), entities[i][1]);\ }\ \ return myString;\ }\ \ function showHideSection(showSection) {\ if (showSection) {\ $(\'#FormField24_5d21d365-e7a5-4315-91c9-338464412aa8\').show();\ } else {\ $(\'#FormField24_5d21d365-e7a5-4315-91c9-338464412aa8\').hide();\ }\ \ $("#FormField24_5d21d365-e7a5-4315-91c9-338464412aa8 .conditionalSectionListSelection").each(function (i, obj) {\ if (obj.type === \'radio\' || obj.type === \'checkbox\') {\ if (obj.checked) {\ $(\'#\' + obj.id).change();\ }\ } else {\ $(\'#\' + obj.id).change();\ }\ });\ }\ });\ });\ };\ \ fbRequireJSScript.addEventListener("load", conditionalSectionJs);var conditionalSectionJs = function () {\ requirejs([window.formHost + \'/Scripts/require/fbRequire.config.js\'], function (fbRequireConfig) {\ var fbRequire = fbRequireConfig.fbRequire;\ \ fbRequire([\'jquery\', \'he\'], function ($, he) {\ he.encode.options.decimal = true;\ he.encode.options.allowUnsafeSymbols = true;\ \ var sectionConditions = JSON.parse(\'[{"ElementName":"FormField6_5d21d365-e7a5-4315-91c9-338464412aa8","Value":"Not to my Knowledge"}]\');\ var conditionOperator = \'and\';\ \ sectionConditions.forEach(function (sectionCondition) {\ $("select[id=" + sectionCondition.ElementName + "]").addClass(\'conditionalSectionListSelection\');\ $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']").addClass(\'conditionalSectionListSelection\');\ $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']").addClass(\'conditionalSectionListSelection\');\ \ $("select[id=" + sectionCondition.ElementName + "]").on(\'change\', function () {\ checkShowHide();\ });\ \ $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']").on(\'change\', function () {\ checkShowHide();\ });\ \ $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']").on(\'change\', function () {\ checkShowHide();\ });\ });\ \ function checkShowHide() {\ var shouldShowSection = conditionOperator === \'and\'; /* set default to true for AND operation and false for OR operation */\ \ sectionConditions.forEach(function (sectionCondition) {\ checkSelect(sectionCondition); \ checkCheckbox(sectionCondition); \ checkRadio(sectionCondition); \ });\ \ showHideSection(shouldShowSection);\ \ function checkSelect(sectionCondition) {\ var matchingSelect = $("select[id=" + sectionCondition.ElementName + "]")[0];\ \ if (!matchingSelect) {\ return;\ }\ \ if (matchingSelect.type === \'select-multiple\') {\ var hasOneMatchingValue = false;\ \ for (var i = 0; i < matchingSelect.selectedOptions.length; i++) {\ if (encode(matchingSelect.selectedOptions[i].value) === sectionCondition.Value) {\ hasOneMatchingValue = true;\ }\ }\ \ shouldShowSection = mergeCondition(shouldShowSection, hasOneMatchingValue, matchingSelect);\ } else {\ shouldShowSection = mergeCondition(shouldShowSection, encode(matchingSelect.value) === sectionCondition.Value, matchingSelect);\ }\ }\ \ function checkCheckbox(sectionCondition) {\ var matchingCheckboxes = $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']");\ \ for (var i = 0; i < matchingCheckboxes.length; i++) {\ if (encode(matchingCheckboxes[i].value) === sectionCondition.Value) {\ shouldShowSection = mergeCondition(shouldShowSection, matchingCheckboxes[i].checked, matchingCheckboxes[i]);\ }\ }\ }\ \ function checkRadio(sectionCondition) {\ var matchingRadios = $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']");\ \ for (var i = 0; i < matchingRadios.length; i++) {\ if (encode(matchingRadios[i].value) === sectionCondition.Value) {\ shouldShowSection = mergeCondition(shouldShowSection, matchingRadios[i].checked, matchingRadios[i]);\ }\ }\ }\ }\ \ function mergeCondition(overallResult, newResult, element) {\ newResult = newResult && isParentVisible(element);\ \ if (conditionOperator === \'and\') {\ return overallResult && newResult;\ } else {\ return overallResult || newResult;\ }\ }\ \ function isParentVisible(element) {\ var parentSectionDiv = $(\'#\' + element.id).closest(".fb-section");\ return parentSectionDiv && !parentSectionDiv.is(":hidden");\ }\ \ function encode(myString) {\ myString = he.encode(he.escape(myString));\ \ /* Fixes issues with single quote and backtick encoding */\ var i,\ entities = [\ [\''\', \''\'],\ [\'`\', \'`\']\ ];\ \ for (i = 0; i < entities.length; i++) {\ myString = String(myString).replace(new RegExp(entities[i][0], \'g\'), entities[i][1]);\ }\ \ return myString;\ }\ \ function showHideSection(showSection) {\ if (showSection) {\ $(\'#FormField25_5d21d365-e7a5-4315-91c9-338464412aa8\').show();\ } else {\ $(\'#FormField25_5d21d365-e7a5-4315-91c9-338464412aa8\').hide();\ }\ \ $("#FormField25_5d21d365-e7a5-4315-91c9-338464412aa8 .conditionalSectionListSelection").each(function (i, obj) {\ if (obj.type === \'radio\' || obj.type === \'checkbox\') {\ if (obj.checked) {\ $(\'#\' + obj.id).change();\ }\ } else {\ $(\'#\' + obj.id).change();\ }\ });\ }\ });\ });\ };\ \ fbRequireJSScript.addEventListener("load", conditionalSectionJs);var conditionalSectionJs = function () {\ requirejs([window.formHost + \'/Scripts/require/fbRequire.config.js\'], function (fbRequireConfig) {\ var fbRequire = fbRequireConfig.fbRequire;\ \ fbRequire([\'jquery\', \'he\'], function ($, he) {\ he.encode.options.decimal = true;\ he.encode.options.allowUnsafeSymbols = true;\ \ var sectionConditions = JSON.parse(\'[{"ElementName":"FormField7_5d21d365-e7a5-4315-91c9-338464412aa8","Value":"No"}]\');\ var conditionOperator = \'and\';\ \ sectionConditions.forEach(function (sectionCondition) {\ $("select[id=" + sectionCondition.ElementName + "]").addClass(\'conditionalSectionListSelection\');\ $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']").addClass(\'conditionalSectionListSelection\');\ $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']").addClass(\'conditionalSectionListSelection\');\ \ $("select[id=" + sectionCondition.ElementName + "]").on(\'change\', function () {\ checkShowHide();\ });\ \ $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']").on(\'change\', function () {\ checkShowHide();\ });\ \ $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']").on(\'change\', function () {\ checkShowHide();\ });\ });\ \ function checkShowHide() {\ var shouldShowSection = conditionOperator === \'and\'; /* set default to true for AND operation and false for OR operation */\ \ sectionConditions.forEach(function (sectionCondition) {\ checkSelect(sectionCondition); \ checkCheckbox(sectionCondition); \ checkRadio(sectionCondition); \ });\ \ showHideSection(shouldShowSection);\ \ function checkSelect(sectionCondition) {\ var matchingSelect = $("select[id=" + sectionCondition.ElementName + "]")[0];\ \ if (!matchingSelect) {\ return;\ }\ \ if (matchingSelect.type === \'select-multiple\') {\ var hasOneMatchingValue = false;\ \ for (var i = 0; i < matchingSelect.selectedOptions.length; i++) {\ if (encode(matchingSelect.selectedOptions[i].value) === sectionCondition.Value) {\ hasOneMatchingValue = true;\ }\ }\ \ shouldShowSection = mergeCondition(shouldShowSection, hasOneMatchingValue, matchingSelect);\ } else {\ shouldShowSection = mergeCondition(shouldShowSection, encode(matchingSelect.value) === sectionCondition.Value, matchingSelect);\ }\ }\ \ function checkCheckbox(sectionCondition) {\ var matchingCheckboxes = $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']");\ \ for (var i = 0; i < matchingCheckboxes.length; i++) {\ if (encode(matchingCheckboxes[i].value) === sectionCondition.Value) {\ shouldShowSection = mergeCondition(shouldShowSection, matchingCheckboxes[i].checked, matchingCheckboxes[i]);\ }\ }\ }\ \ function checkRadio(sectionCondition) {\ var matchingRadios = $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']");\ \ for (var i = 0; i < matchingRadios.length; i++) {\ if (encode(matchingRadios[i].value) === sectionCondition.Value) {\ shouldShowSection = mergeCondition(shouldShowSection, matchingRadios[i].checked, matchingRadios[i]);\ }\ }\ }\ }\ \ function mergeCondition(overallResult, newResult, element) {\ newResult = newResult && isParentVisible(element);\ \ if (conditionOperator === \'and\') {\ return overallResult && newResult;\ } else {\ return overallResult || newResult;\ }\ }\ \ function isParentVisible(element) {\ var parentSectionDiv = $(\'#\' + element.id).closest(".fb-section");\ return parentSectionDiv && !parentSectionDiv.is(":hidden");\ }\ \ function encode(myString) {\ myString = he.encode(he.escape(myString));\ \ /* Fixes issues with single quote and backtick encoding */\ var i,\ entities = [\ [\''\', \''\'],\ [\'`\', \'`\']\ ];\ \ for (i = 0; i < entities.length; i++) {\ myString = String(myString).replace(new RegExp(entities[i][0], \'g\'), entities[i][1]);\ }\ \ return myString;\ }\ \ function showHideSection(showSection) {\ if (showSection) {\ $(\'#FormField26_5d21d365-e7a5-4315-91c9-338464412aa8\').show();\ } else {\ $(\'#FormField26_5d21d365-e7a5-4315-91c9-338464412aa8\').hide();\ }\ \ $("#FormField26_5d21d365-e7a5-4315-91c9-338464412aa8 .conditionalSectionListSelection").each(function (i, obj) {\ if (obj.type === \'radio\' || obj.type === \'checkbox\') {\ if (obj.checked) {\ $(\'#\' + obj.id).change();\ }\ } else {\ $(\'#\' + obj.id).change();\ }\ });\ }\ });\ });\ };\ \ fbRequireJSScript.addEventListener("load", conditionalSectionJs);var conditionalSectionJs = function () {\ requirejs([window.formHost + \'/Scripts/require/fbRequire.config.js\'], function (fbRequireConfig) {\ var fbRequire = fbRequireConfig.fbRequire;\ \ fbRequire([\'jquery\', \'he\'], function ($, he) {\ he.encode.options.decimal = true;\ he.encode.options.allowUnsafeSymbols = true;\ \ var sectionConditions = JSON.parse(\'[{"ElementName":"FormField8_5d21d365-e7a5-4315-91c9-338464412aa8","Value":"No"}]\');\ var conditionOperator = \'and\';\ \ sectionConditions.forEach(function (sectionCondition) {\ $("select[id=" + sectionCondition.ElementName + "]").addClass(\'conditionalSectionListSelection\');\ $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']").addClass(\'conditionalSectionListSelection\');\ $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']").addClass(\'conditionalSectionListSelection\');\ \ $("select[id=" + sectionCondition.ElementName + "]").on(\'change\', function () {\ checkShowHide();\ });\ \ $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']").on(\'change\', function () {\ checkShowHide();\ });\ \ $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']").on(\'change\', function () {\ checkShowHide();\ });\ });\ \ function checkShowHide() {\ var shouldShowSection = conditionOperator === \'and\'; /* set default to true for AND operation and false for OR operation */\ \ sectionConditions.forEach(function (sectionCondition) {\ checkSelect(sectionCondition); \ checkCheckbox(sectionCondition); \ checkRadio(sectionCondition); \ });\ \ showHideSection(shouldShowSection);\ \ function checkSelect(sectionCondition) {\ var matchingSelect = $("select[id=" + sectionCondition.ElementName + "]")[0];\ \ if (!matchingSelect) {\ return;\ }\ \ if (matchingSelect.type === \'select-multiple\') {\ var hasOneMatchingValue = false;\ \ for (var i = 0; i < matchingSelect.selectedOptions.length; i++) {\ if (encode(matchingSelect.selectedOptions[i].value) === sectionCondition.Value) {\ hasOneMatchingValue = true;\ }\ }\ \ shouldShowSection = mergeCondition(shouldShowSection, hasOneMatchingValue, matchingSelect);\ } else {\ shouldShowSection = mergeCondition(shouldShowSection, encode(matchingSelect.value) === sectionCondition.Value, matchingSelect);\ }\ }\ \ function checkCheckbox(sectionCondition) {\ var matchingCheckboxes = $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']");\ \ for (var i = 0; i < matchingCheckboxes.length; i++) {\ if (encode(matchingCheckboxes[i].value) === sectionCondition.Value) {\ shouldShowSection = mergeCondition(shouldShowSection, matchingCheckboxes[i].checked, matchingCheckboxes[i]);\ }\ }\ }\ \ function checkRadio(sectionCondition) {\ var matchingRadios = $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']");\ \ for (var i = 0; i < matchingRadios.length; i++) {\ if (encode(matchingRadios[i].value) === sectionCondition.Value) {\ shouldShowSection = mergeCondition(shouldShowSection, matchingRadios[i].checked, matchingRadios[i]);\ }\ }\ }\ }\ \ function mergeCondition(overallResult, newResult, element) {\ newResult = newResult && isParentVisible(element);\ \ if (conditionOperator === \'and\') {\ return overallResult && newResult;\ } else {\ return overallResult || newResult;\ }\ }\ \ function isParentVisible(element) {\ var parentSectionDiv = $(\'#\' + element.id).closest(".fb-section");\ return parentSectionDiv && !parentSectionDiv.is(":hidden");\ }\ \ function encode(myString) {\ myString = he.encode(he.escape(myString));\ \ /* Fixes issues with single quote and backtick encoding */\ var i,\ entities = [\ [\''\', \''\'],\ [\'`\', \'`\']\ ];\ \ for (i = 0; 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\ \ \ \ \ \ \ \ \ \

This COVID-19 (also known as coronavirus) assessment tool will help you decide if you should see your doctor. Please note, this assessment is not professional medical advice, diagnosis, or treatment. Always consult with a medical professional for serious symptoms.

If you're experiencing any life-threatening symptoms or emergencies, call 911.

When you're ready to proceed, select "I agree" to get started.

Your answers indicate you haven't traveled to an area where there is known COVID-19 cases, nor have you been in contact with someone who may be sick. You don't report any symptoms of an infection, so your risk is low. You can use this assessment again, or call your doctor if anything changes, but in the meantime, here are some ways to stay healthy:

For more information and updates on COVID-19, please visit the Centers for Disease Control and Prevention (CDC).

Please see your doctor or health system to get tested.

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