@@ -162,6 +162,13 @@ $medicaidStates = Config::get('constants.medicaid_states');
<input class='form-control' type='text' required="" name='initiative' />
</div>
+ <div class='form-group mb-3 checkbox'>
+ <label>
+ <input type='checkbox' name='isTestRecord' />
+ This is a test record
+ </label>
+ </div>
+
<div class="col-md-7">
<div class="border-lighter">