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+<div class="gem-nodes"> <div class="my-3 node node-level-0" data-key="blood_ox">
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+ <label>Blood Oxygen</label>
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+<div class="subs pl-4"> <div class="my-3 node node-level-1" data-key="blood_ox__ever_used_fingertip_meter">
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+ <label>Have you ever used a fingertip blood oxygen saturation meter before?</label>
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+ <div class="d-flex align-items-center">
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="blood_ox__ever_used_fingertip_meter" type="radio" value="YES" class="mr-1">
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+ <span>Yes</span>
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+ </label>
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="blood_ox__ever_used_fingertip_meter" type="radio" value="NO" class="mr-1">
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+ <span>No</span>
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+ </label>
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="blood_ox__ever_used_fingertip_meter" type="radio" value="UNKNOWN" class="mr-1">
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+ <span>Unknown</span>
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+ </label>
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+ <input name="blood_ox__ever_used_fingertip_meter_memo" type="text" class="form-control form-control-sm">
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+ </div>
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+<div class="subs pl-4"> <div class="my-3 node node-level-2" data-key="blood_ox__ever_used_fingertip_meter__has_one">
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+ <label>Do you currently have one at home?</label>
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+ <div class="d-flex align-items-center">
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="blood_ox__ever_used_fingertip_meter__has_one" type="radio" value="YES" class="mr-1">
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+ <span>Yes</span>
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+ </label>
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="blood_ox__ever_used_fingertip_meter__has_one" type="radio" value="NO" class="mr-1">
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+ <span>No</span>
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+ </label>
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="blood_ox__ever_used_fingertip_meter__has_one" type="radio" value="UNKNOWN" class="mr-1">
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+ <span>Unknown</span>
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+ </label>
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+ <input name="blood_ox__ever_used_fingertip_meter__has_one_memo" type="text" class="form-control form-control-sm">
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+ </div>
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+ </div>
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+
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+ <div class="my-3 node node-level-2" data-key="blood_ox__ever_used_fingertip_meter__confirmed_will_discontinue_current">
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+ <label>If yes, please discontinue use of that when you receive the one we send you.</label>
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+ <div class="d-flex align-items-center">
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="blood_ox__ever_used_fingertip_meter__confirmed_will_discontinue_current" type="radio" value="YES" class="mr-1">
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+ <span>Yes</span>
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+ </label>
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="blood_ox__ever_used_fingertip_meter__confirmed_will_discontinue_current" type="radio" value="NO" class="mr-1">
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+ <span>No</span>
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+ </label>
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="blood_ox__ever_used_fingertip_meter__confirmed_will_discontinue_current" type="radio" value="UNKNOWN" class="mr-1">
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+ <span>Unknown</span>
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+ </label>
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+ <input name="blood_ox__ever_used_fingertip_meter__confirmed_will_discontinue_current_memo" type="text" class="form-control form-control-sm">
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+ </div>
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+ </div>
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+
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+</div> </div>
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+
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+ <div class="my-3 node node-level-1" data-key="blood_ox__does_pcp_regularly_check">
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+ <label>Does your PCP regularly check your resting oxygen saturation?</label>
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+ <div class="d-flex align-items-center">
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="blood_ox__does_pcp_regularly_check" type="radio" value="YES" class="mr-1">
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+ <span>Yes</span>
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+ </label>
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="blood_ox__does_pcp_regularly_check" type="radio" value="NO" class="mr-1">
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+ <span>No</span>
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+ </label>
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="blood_ox__does_pcp_regularly_check" type="radio" value="UNKNOWN" class="mr-1">
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+ <span>Unknown</span>
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+ </label>
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+ <input name="blood_ox__does_pcp_regularly_check_memo" type="text" class="form-control form-control-sm">
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+ </div>
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+ </div>
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+
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+ <div class="my-3 node node-level-1" data-key="blood_ox__baseline_resting_spo2_level">
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+ <label>Do you know what your baseline resting oxygen saturation usually measures at?</label>
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+ </div>
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+
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+ <div class="my-3 node node-level-1" data-key="blood_ox__lung_condition_that_may_affect">
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+ <label>Do you have any lung condition, such as asthma or COPD, that might affect the reading when you measure your blood oxygen level?</label>
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+ <div class="d-flex align-items-center">
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="blood_ox__lung_condition_that_may_affect" type="radio" value="YES" class="mr-1">
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+ <span>Yes</span>
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+ </label>
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="blood_ox__lung_condition_that_may_affect" type="radio" value="NO" class="mr-1">
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+ <span>No</span>
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+ </label>
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="blood_ox__lung_condition_that_may_affect" type="radio" value="UNKNOWN" class="mr-1">
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+ <span>Unknown</span>
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+ </label>
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+ <input name="blood_ox__lung_condition_that_may_affect_memo" type="text" class="form-control form-control-sm">
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+ </div>
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+ </div>
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+
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+ <div class="my-3 node node-level-1" data-key="blood_ox__o2_and_activity">
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+ <label>Blood oxygen values depend a lot on your level of physical activity.</label>
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+<div class="subs pl-4"> <div class="my-3 node node-level-2" data-key="blood_ox__o2_and_activity__days_per_week_aerobic_exercise_with_exertion">
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+ <label>How many days per week do you currently perform aerobic exercise to the point that you can feel your lungs working harder and your heart beating faster?</label>
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+ </div>
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+
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+ <div class="my-3 node node-level-2" data-key="blood_ox__o2_and_activity__minutes_per_week_aerobic_exercise_with_exertion">
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+ <label>How many total minutes per week on average would you say you are in a state of aerobic exercise, where you feel your lungs working harder and your heart beating faster?</label>
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+ </div>
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+
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+ <div class="my-3 node node-level-2" data-key="blood_ox__o2_and_activity__ever_had_o2_checked_before_after_exercise">
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+ <label>Have you ever had your oxygen checked before and after exercise?</label>
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+ <div class="d-flex align-items-center">
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="blood_ox__o2_and_activity__ever_had_o2_checked_before_after_exercise" type="radio" value="YES" class="mr-1">
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+ <span>Yes</span>
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+ </label>
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="blood_ox__o2_and_activity__ever_had_o2_checked_before_after_exercise" type="radio" value="NO" class="mr-1">
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+ <span>No</span>
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+ </label>
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="blood_ox__o2_and_activity__ever_had_o2_checked_before_after_exercise" type="radio" value="UNKNOWN" class="mr-1">
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+ <span>Unknown</span>
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+ </label>
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+ <input name="blood_ox__o2_and_activity__ever_had_o2_checked_before_after_exercise_memo" type="text" class="form-control form-control-sm">
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+ </div>
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+ </div>
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+
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+ <div class="my-3 node node-level-2" data-key="blood_ox__o2_and_activity__baseline_o2_assessment">
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+ <label>Once you receive the oxygen meter, we will need to call you to make sure you take a proper baseline resting measurement, and then another measurement after you have you walk for 1 minute. When is the best time and number to call usually?</label>
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+<div class="subs pl-4"> <div class="my-3 node node-level-3" data-key="blood_ox__o2_and_activity__baseline_o2_assessment__best_time_to_call">
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+ <label>Best time to call:</label>
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+ </div>
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+
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+ <div class="my-3 node node-level-3" data-key="blood_ox__o2_and_activity__baseline_o2_assessment__best_number_to_call">
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+ <label>Best number to call:</label>
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+ </div>
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+
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+</div> </div>
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+
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+ <div class="my-3 node node-level-2" data-key="blood_ox__o2_and_activity__has_covid_made_you_less_physically_active">
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+ <label>Has the COVID-19 pandemic made you less physically active than you were before?</label>
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+ <div class="d-flex align-items-center">
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="blood_ox__o2_and_activity__has_covid_made_you_less_physically_active" type="radio" value="YES" class="mr-1">
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+ <span>Yes</span>
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+ </label>
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="blood_ox__o2_and_activity__has_covid_made_you_less_physically_active" type="radio" value="NO" class="mr-1">
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+ <span>No</span>
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+ </label>
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="blood_ox__o2_and_activity__has_covid_made_you_less_physically_active" type="radio" value="UNKNOWN" class="mr-1">
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+ <span>Unknown</span>
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+ </label>
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+ <input name="blood_ox__o2_and_activity__has_covid_made_you_less_physically_active_memo" type="text" class="form-control form-control-sm">
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+ </div>
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+ </div>
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+
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+ <div class="my-3 node node-level-2" data-key="blood_ox__o2_and_activity__has_covid_made_you_less_physically_active">
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+ <label>Has the COVID-19 pandemic made you less physically active than you were before?</label>
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+ <div class="d-flex align-items-center">
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="blood_ox__o2_and_activity__has_covid_made_you_less_physically_active" type="radio" value="YES" class="mr-1">
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+ <span>Yes</span>
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+ </label>
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="blood_ox__o2_and_activity__has_covid_made_you_less_physically_active" type="radio" value="NO" class="mr-1">
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+ <span>No</span>
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+ </label>
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="blood_ox__o2_and_activity__has_covid_made_you_less_physically_active" type="radio" value="UNKNOWN" class="mr-1">
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+ <span>Unknown</span>
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+ </label>
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+ <input name="blood_ox__o2_and_activity__has_covid_made_you_less_physically_active_memo" type="text" class="form-control form-control-sm">
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+ </div>
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+ </div>
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+
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+</div> </div>
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+
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+</div> </div>
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+
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+ <div class="my-3 node node-level-0" data-key="pulse_and_bp">
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+ <label>Pulse & BP</label>
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+<div class="subs pl-4"> <div class="my-3 node node-level-1" data-key="pulse_and_bp__ever_used_auto_pulse_bp_meter">
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+ <label>Have you ever used an automatic pulse and blood pressure meter before?</label>
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+ <div class="d-flex align-items-center">
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="pulse_and_bp__ever_used_auto_pulse_bp_meter" type="radio" value="YES" class="mr-1">
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+ <span>Yes</span>
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+ </label>
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="pulse_and_bp__ever_used_auto_pulse_bp_meter" type="radio" value="NO" class="mr-1">
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+ <span>No</span>
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+ </label>
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="pulse_and_bp__ever_used_auto_pulse_bp_meter" type="radio" value="UNKNOWN" class="mr-1">
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+ <span>Unknown</span>
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+ </label>
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+ <input name="pulse_and_bp__ever_used_auto_pulse_bp_meter_memo" type="text" class="form-control form-control-sm">
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+ </div>
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+<div class="subs pl-4"> <div class="my-3 node node-level-2" data-key="pulse_and_bp__ever_used_auto_pulse_bp_meter__has_one">
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+ <label>Do you currently have one at home?</label>
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+ <div class="d-flex align-items-center">
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="pulse_and_bp__ever_used_auto_pulse_bp_meter__has_one" type="radio" value="YES" class="mr-1">
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+ <span>Yes</span>
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+ </label>
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="pulse_and_bp__ever_used_auto_pulse_bp_meter__has_one" type="radio" value="NO" class="mr-1">
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+ <span>No</span>
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+ </label>
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="pulse_and_bp__ever_used_auto_pulse_bp_meter__has_one" type="radio" value="UNKNOWN" class="mr-1">
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+ <span>Unknown</span>
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+ </label>
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+ <input name="pulse_and_bp__ever_used_auto_pulse_bp_meter__has_one_memo" type="text" class="form-control form-control-sm">
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+ </div>
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+ </div>
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+
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+ <div class="my-3 node node-level-2" data-key="pulse_and_bp__ever_used_auto_pulse_bp_meter__confirmed_will_discontinue_current">
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+ <label>If yes, please discontinue use of that when you receive the one we send you.</label>
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+ <div class="d-flex align-items-center">
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="pulse_and_bp__ever_used_auto_pulse_bp_meter__confirmed_will_discontinue_current" type="radio" value="YES" class="mr-1">
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+ <span>Yes</span>
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+ </label>
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="pulse_and_bp__ever_used_auto_pulse_bp_meter__confirmed_will_discontinue_current" type="radio" value="NO" class="mr-1">
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+ <span>No</span>
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+ </label>
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="pulse_and_bp__ever_used_auto_pulse_bp_meter__confirmed_will_discontinue_current" type="radio" value="UNKNOWN" class="mr-1">
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+ <span>Unknown</span>
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+ </label>
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+ <input name="pulse_and_bp__ever_used_auto_pulse_bp_meter__confirmed_will_discontinue_current_memo" type="text" class="form-control form-control-sm">
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+ </div>
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+ </div>
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+
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+</div> </div>
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+
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+ <div class="my-3 node node-level-1" data-key="pulse_and_bp__usual_resting_pulse">
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+ <label>What is your usual resting pulse?</label>
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+ </div>
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+
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+ <div class="my-3 node node-level-1" data-key="pulse_and_bp__usual_resting_bp">
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+ <label>What is your usual resting blood pressure?</label>
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+<div class="subs pl-4"> <div class="my-3 node node-level-2" data-key="pulse_and_bp__usual_resting_bp__systolic">
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+ <label>Systolic</label>
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+ </div>
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+
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+ <div class="my-3 node node-level-2" data-key="pulse_and_bp__usual_resting_bp__diastolic">
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+ <label>Diastolic</label>
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+ </div>
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+
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+</div> </div>
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+
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+ <div class="my-3 node node-level-1" data-key="pulse_and_bp__ever_dx_with_htn">
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+ <label>Have you ever been diagnosed with high blood pressure?</label>
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+ <div class="d-flex align-items-center">
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="pulse_and_bp__ever_dx_with_htn" type="radio" value="YES" class="mr-1">
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+ <span>Yes</span>
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+ </label>
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="pulse_and_bp__ever_dx_with_htn" type="radio" value="NO" class="mr-1">
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+ <span>No</span>
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+ </label>
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+ <label class="d-inline-flex align-items-center my-0 mr-3">
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+ <input name="pulse_and_bp__ever_dx_with_htn" type="radio" value="UNKNOWN" class="mr-1">
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+ <span>Unknown</span>
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+ </label>
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+ <input name="pulse_and_bp__ever_dx_with_htn_memo" type="text" class="form-control form-control-sm">
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+ </div>
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+<div class="subs pl-4"> <div class="my-3 node node-level-2" data-key="pulse_and_bp__ever_dx_with_htn__on_bp_medications">
|
|
|
+ <label>Are you on any BP medication?</label>
|
|
|
+ <div class="d-flex align-items-center">
|
|
|
+ <label class="d-inline-flex align-items-center my-0 mr-3">
|
|
|
+ <input name="pulse_and_bp__ever_dx_with_htn__on_bp_medications" type="radio" value="YES" class="mr-1">
|
|
|
+ <span>Yes</span>
|
|
|
+ </label>
|
|
|
+ <label class="d-inline-flex align-items-center my-0 mr-3">
|
|
|
+ <input name="pulse_and_bp__ever_dx_with_htn__on_bp_medications" type="radio" value="NO" class="mr-1">
|
|
|
+ <span>No</span>
|
|
|
+ </label>
|
|
|
+ <label class="d-inline-flex align-items-center my-0 mr-3">
|
|
|
+ <input name="pulse_and_bp__ever_dx_with_htn__on_bp_medications" type="radio" value="UNKNOWN" class="mr-1">
|
|
|
+ <span>Unknown</span>
|
|
|
+ </label>
|
|
|
+ <input name="pulse_and_bp__ever_dx_with_htn__on_bp_medications_memo" type="text" class="form-control form-control-sm">
|
|
|
+ </div>
|
|
|
+ </div>
|
|
|
+
|
|
|
+ <div class="my-3 node node-level-2" data-key="pulse_and_bp__ever_dx_with_htn__who_treats">
|
|
|
+ <label>Who primarily treats your HTN?</label>
|
|
|
+ </div>
|
|
|
+
|
|
|
+</div> </div>
|
|
|
+
|
|
|
+ <div class="my-3 node node-level-1" data-key="pulse_and_bp__pcp_or_other_doc_bp_target">
|
|
|
+ <label>Has your primary care physician, or another doctor, ever told you what your target BP should be?</label>
|
|
|
+<div class="subs pl-4"> <div class="my-3 node node-level-2" data-key="pulse_and_bp__pcp_or_other_doc_bp_target__systolic">
|
|
|
+ <label>Systolic</label>
|
|
|
+ </div>
|
|
|
+
|
|
|
+ <div class="my-3 node node-level-2" data-key="pulse_and_bp__pcp_or_other_doc_bp_target__diastolic">
|
|
|
+ <label>Diastolic</label>
|
|
|
+ </div>
|
|
|
+
|
|
|
+</div> </div>
|
|
|
+
|
|
|
+ <div class="my-3 node node-level-1" data-key="pulse_and_bp__pulse_during_exercise">
|
|
|
+ <label>When you exercise, what does your pulse reach?</label>
|
|
|
+ </div>
|
|
|
+
|
|
|
+</div> </div>
|
|
|
+
|
|
|
+ <div class="my-3 node node-level-0" data-key="temp_thermometer">
|
|
|
+ <label>Thermometer / Temp.</label>
|
|
|
+<div class="subs pl-4"> <div class="my-3 node node-level-1" data-key="temp_thermometer__ever_used_itg_before">
|
|
|
+ <label>Have you ever used an infrared temperature gun before?</label>
|
|
|
+ <div class="d-flex align-items-center">
|
|
|
+ <label class="d-inline-flex align-items-center my-0 mr-3">
|
|
|
+ <input name="temp_thermometer__ever_used_itg_before" type="radio" value="YES" class="mr-1">
|
|
|
+ <span>Yes</span>
|
|
|
+ </label>
|
|
|
+ <label class="d-inline-flex align-items-center my-0 mr-3">
|
|
|
+ <input name="temp_thermometer__ever_used_itg_before" type="radio" value="NO" class="mr-1">
|
|
|
+ <span>No</span>
|
|
|
+ </label>
|
|
|
+ <label class="d-inline-flex align-items-center my-0 mr-3">
|
|
|
+ <input name="temp_thermometer__ever_used_itg_before" type="radio" value="UNKNOWN" class="mr-1">
|
|
|
+ <span>Unknown</span>
|
|
|
+ </label>
|
|
|
+ <input name="temp_thermometer__ever_used_itg_before_memo" type="text" class="form-control form-control-sm">
|
|
|
+ </div>
|
|
|
+ </div>
|
|
|
+
|
|
|
+ <div class="my-3 node node-level-1" data-key="temp_thermometer__usual_resting_temp">
|
|
|
+ <label>What does your resting temperature usually run at?</label>
|
|
|
+ <div class="d-flex align-items-center">
|
|
|
+ <label class="d-inline-flex align-items-center my-0 mr-3">
|
|
|
+ <input name="temp_thermometer__usual_resting_temp" type="radio" value="YES" class="mr-1">
|
|
|
+ <span>Yes</span>
|
|
|
+ </label>
|
|
|
+ <label class="d-inline-flex align-items-center my-0 mr-3">
|
|
|
+ <input name="temp_thermometer__usual_resting_temp" type="radio" value="NO" class="mr-1">
|
|
|
+ <span>No</span>
|
|
|
+ </label>
|
|
|
+ <label class="d-inline-flex align-items-center my-0 mr-3">
|
|
|
+ <input name="temp_thermometer__usual_resting_temp" type="radio" value="UNKNOWN" class="mr-1">
|
|
|
+ <span>Unknown</span>
|
|
|
+ </label>
|
|
|
+ <input name="temp_thermometer__usual_resting_temp_memo" type="text" class="form-control form-control-sm">
|
|
|
+ </div>
|
|
|
+ </div>
|
|
|
+
|
|
|
+ <div class="my-3 node node-level-1" data-key="temp_thermometer__do_you_or_someone_at_home_go_outdoors">
|
|
|
+ <label>Do you or anyone you live with currently go outdoors in public places?</label>
|
|
|
+ <div class="d-flex align-items-center">
|
|
|
+ <label class="d-inline-flex align-items-center my-0 mr-3">
|
|
|
+ <input name="temp_thermometer__do_you_or_someone_at_home_go_outdoors" type="radio" value="YES" class="mr-1">
|
|
|
+ <span>Yes</span>
|
|
|
+ </label>
|
|
|
+ <label class="d-inline-flex align-items-center my-0 mr-3">
|
|
|
+ <input name="temp_thermometer__do_you_or_someone_at_home_go_outdoors" type="radio" value="NO" class="mr-1">
|
|
|
+ <span>No</span>
|
|
|
+ </label>
|
|
|
+ <label class="d-inline-flex align-items-center my-0 mr-3">
|
|
|
+ <input name="temp_thermometer__do_you_or_someone_at_home_go_outdoors" type="radio" value="UNKNOWN" class="mr-1">
|
|
|
+ <span>Unknown</span>
|
|
|
+ </label>
|
|
|
+ <input name="temp_thermometer__do_you_or_someone_at_home_go_outdoors_memo" type="text" class="form-control form-control-sm">
|
|
|
+ </div>
|
|
|
+ </div>
|
|
|
+
|
|
|
+ <div class="my-3 node node-level-1" data-key="temp_thermometer__will_you_check_people_temp_before_they_come_near">
|
|
|
+ <label>Can you start to check people's temperature before they come near you?</label>
|
|
|
+ <div class="d-flex align-items-center">
|
|
|
+ <label class="d-inline-flex align-items-center my-0 mr-3">
|
|
|
+ <input name="temp_thermometer__will_you_check_people_temp_before_they_come_near" type="radio" value="YES" class="mr-1">
|
|
|
+ <span>Yes</span>
|
|
|
+ </label>
|
|
|
+ <label class="d-inline-flex align-items-center my-0 mr-3">
|
|
|
+ <input name="temp_thermometer__will_you_check_people_temp_before_they_come_near" type="radio" value="NO" class="mr-1">
|
|
|
+ <span>No</span>
|
|
|
+ </label>
|
|
|
+ <label class="d-inline-flex align-items-center my-0 mr-3">
|
|
|
+ <input name="temp_thermometer__will_you_check_people_temp_before_they_come_near" type="radio" value="UNKNOWN" class="mr-1">
|
|
|
+ <span>Unknown</span>
|
|
|
+ </label>
|
|
|
+ <input name="temp_thermometer__will_you_check_people_temp_before_they_come_near_memo" type="text" class="form-control form-control-sm">
|
|
|
+ </div>
|
|
|
+ </div>
|
|
|
+
|
|
|
+</div> </div>
|
|
|
+
|
|
|
+ <div class="my-3 node node-level-0" data-key="bmi">
|
|
|
+ <label>BMI</label>
|
|
|
+<div class="subs pl-4"> <div class="my-3 node node-level-1" data-key="bmi__current">
|
|
|
+ <label>What is your current:</label>
|
|
|
+<div class="subs pl-4"> <div class="my-3 node node-level-2" data-key="bmi__current__height_in_inches">
|
|
|
+ <label>Height in inches?</label>
|
|
|
+ </div>
|
|
|
+
|
|
|
+ <div class="my-3 node node-level-2" data-key="bmi__current__weight_in_pounds">
|
|
|
+ <label>Weight in pounds?</label>
|
|
|
+ </div>
|
|
|
+
|
|
|
+ <div class="my-3 node node-level-2" data-key="bmi__current__waistline_in_inches">
|
|
|
+ <label>Waistline in inches?</label>
|
|
|
+ </div>
|
|
|
+
|
|
|
+ <div class="my-3 node node-level-2" data-key="bmi__current__body_fat_percent">
|
|
|
+ <label>Body fat %?</label>
|
|
|
+ </div>
|
|
|
+
|
|
|
+</div> </div>
|
|
|
+
|
|
|
+ <div class="my-3 node node-level-1" data-key="bmi__at_20_years_old">
|
|
|
+ <label>When you were 20 years old, what was your:</label>
|
|
|
+<div class="subs pl-4"> <div class="my-3 node node-level-2" data-key="bmi__at_20_years_old__weight_in_pounds">
|
|
|
+ <label>Weight in pounds?</label>
|
|
|
+ </div>
|
|
|
+
|
|
|
+ <div class="my-3 node node-level-2" data-key="bmi__at_20_years_old__waistline_in_inches">
|
|
|
+ <label>Waistline in inches?</label>
|
|
|
+ </div>
|
|
|
+
|
|
|
+ <div class="my-3 node node-level-2" data-key="bmi__at_20_years_old__height_in_inches">
|
|
|
+ <label>Height in inches?</label>
|
|
|
+ </div>
|
|
|
+
|
|
|
+</div> </div>
|
|
|
+
|
|
|
+ <div class="my-3 node node-level-1" data-key="bmi__weight_goal_today">
|
|
|
+ <label>Personal weight goal today</label>
|
|
|
+ </div>
|
|
|
+
|
|
|
+ <div class="my-3 node node-level-1" data-key="bmi__barriers_to_exercise">
|
|
|
+ <label>Do you currently have any conditions, such as arthritis or joint pain, that limit your ability to exercise?</label>
|
|
|
+ </div>
|
|
|
+
|
|
|
+</div> </div>
|
|
|
+
|
|
|
+</div>
|