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@@ -104,7 +104,10 @@
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<div class="form-group">
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<label>Where do you perform your regular procedures?</label>
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<div class="d-flex flex-column">
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- <!-- <label><input type="checkbox"></label> -->
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+ <label><input type="checkbox" name="where_do_you_perform_regular_procedures[]" value="Office"> <span>Office</span></label>
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+ <label><input type="checkbox" name="where_do_you_perform_regular_procedures[]" value="Endoscopy Center"> <span>Endoscopy Center</span></label>
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+ <label><input type="checkbox" name="where_do_you_perform_regular_procedures[]" value="ASC"> <span>ASC</span></label>
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+ <label><input type="checkbox" name="where_do_you_perform_regular_procedures[]" value="Hospital"> <span>Hospital</span></label>
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</div>
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</div>
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