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</div></div><h2>Terms and Conditions</h2><p>Users are advised that the information submitted through this form may be transmitted over unsecured email and releases EvergreenHealth and its employees, agents, and subcontractors from all responsibility or liability for any claims or damages arising from the content of the Email Form or the transmission thereof. &nbsp;By selecting the &quot;I agree to Terms and Conditions&quot; checkbox user acknowledges these terms and conditions and consents to transmission of the form.</p><div class=\'form-group\'><label  class=\'control-label  hidden-label\'>I agree</label><div><div><div class=\'flow Chkbx\'><input type=\'checkbox\' value=\'I agree to the the Terms and Conditions listed above.\'  name=\'eb89c783-74dc-489f-908b-9df57ff33d5f_FormField10_5cedd30e-b9e9-4115-888f-756599450d21_checkbox_10\' id=\'FormField10_5cedd30e-b9e9-4115-888f-756599450d21_1\' class=\'fo-right-margin-5\' data-export-label=\'I_agree\' ><label for=\'FormField10_5cedd30e-b9e9-4115-888f-756599450d21_1\'>I agree to the the Terms and Conditions listed above.</label></div></div></div></div><div class=\'validationSummary\'><p><i class=\'fa fa-exclamation-triangle\'></i> The following fields are required or invalid.</p><ul></ul></div>\
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