{"id":23868,"date":"2021-11-16T11:41:16","date_gmt":"2021-11-16T16:41:16","guid":{"rendered":"https:\/\/www.ncqa.org\/?page_id=23868"},"modified":"2025-11-21T16:35:02","modified_gmt":"2025-11-21T21:35:02","slug":"gen-form-page-with-dropdown","status":"publish","type":"page","link":"https:\/\/www.ncqa.org\/gen-form-page-with-dropdown\/","title":{"rendered":"Gen Form Page with Dropdown"},"content":{"rendered":"<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_unknown gform_wrapper gform-theme gform-theme--foundation gform-theme--framework gform-theme--orbital' data-form-theme='orbital' data-form-index='0' id='gform_wrapper_99' style='display:none'><style>#gform_wrapper_99[data-form-index=\"0\"].gform-theme,[data-parent-form=\"99_0\"]{--gf-color-primary: #204ce5;--gf-color-primary-rgb: 32, 76, 229;--gf-color-primary-contrast: #fff;--gf-color-primary-contrast-rgb: 255, 255, 255;--gf-color-primary-darker: #001AB3;--gf-color-primary-lighter: #527EFF;--gf-color-secondary: #fff;--gf-color-secondary-rgb: 255, 255, 255;--gf-color-secondary-contrast: #112337;--gf-color-secondary-contrast-rgb: 17, 35, 55;--gf-color-secondary-darker: #F5F5F5;--gf-color-secondary-lighter: #FFFFFF;--gf-color-out-ctrl-light: rgba(17, 35, 55, 0.1);--gf-color-out-ctrl-light-rgb: 17, 35, 55;--gf-color-out-ctrl-light-darker: rgba(104, 110, 119, 0.35);--gf-color-out-ctrl-light-lighter: #F5F5F5;--gf-color-out-ctrl-dark: #585e6a;--gf-color-out-ctrl-dark-rgb: 88, 94, 106;--gf-color-out-ctrl-dark-darker: #112337;--gf-color-out-ctrl-dark-lighter: rgba(17, 35, 55, 0.65);--gf-color-in-ctrl: #fff;--gf-color-in-ctrl-rgb: 255, 255, 255;--gf-color-in-ctrl-contrast: #112337;--gf-color-in-ctrl-contrast-rgb: 17, 35, 55;--gf-color-in-ctrl-darker: #F5F5F5;--gf-color-in-ctrl-lighter: #FFFFFF;--gf-color-in-ctrl-primary: #204ce5;--gf-color-in-ctrl-primary-rgb: 32, 76, 229;--gf-color-in-ctrl-primary-contrast: #fff;--gf-color-in-ctrl-primary-contrast-rgb: 255, 255, 255;--gf-color-in-ctrl-primary-darker: #001AB3;--gf-color-in-ctrl-primary-lighter: #527EFF;--gf-color-in-ctrl-light: rgba(17, 35, 55, 0.1);--gf-color-in-ctrl-light-rgb: 17, 35, 55;--gf-color-in-ctrl-light-darker: rgba(104, 110, 119, 0.35);--gf-color-in-ctrl-light-lighter: #F5F5F5;--gf-color-in-ctrl-dark: #585e6a;--gf-color-in-ctrl-dark-rgb: 88, 94, 106;--gf-color-in-ctrl-dark-darker: #112337;--gf-color-in-ctrl-dark-lighter: rgba(17, 35, 55, 0.65);--gf-radius: 3px;--gf-font-size-secondary: 14px;--gf-font-size-tertiary: 13px;--gf-icon-ctrl-number: url(\"data:image\/svg+xml,%3Csvg width='8' height='14' viewBox='0 0 8 14' fill='none' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath fill-rule='evenodd' clip-rule='evenodd' d='M4 0C4.26522 5.96046e-08 4.51957 0.105357 4.70711 0.292893L7.70711 3.29289C8.09763 3.68342 8.09763 4.31658 7.70711 4.70711C7.31658 5.09763 6.68342 5.09763 6.29289 4.70711L4 2.41421L1.70711 4.70711C1.31658 5.09763 0.683417 5.09763 0.292893 4.70711C-0.0976311 4.31658 -0.097631 3.68342 0.292893 3.29289L3.29289 0.292893C3.48043 0.105357 3.73478 0 4 0ZM0.292893 9.29289C0.683417 8.90237 1.31658 8.90237 1.70711 9.29289L4 11.5858L6.29289 9.29289C6.68342 8.90237 7.31658 8.90237 7.70711 9.29289C8.09763 9.68342 8.09763 10.3166 7.70711 10.7071L4.70711 13.7071C4.31658 14.0976 3.68342 14.0976 3.29289 13.7071L0.292893 10.7071C-0.0976311 10.3166 -0.0976311 9.68342 0.292893 9.29289Z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-icon-ctrl-select: url(\"data:image\/svg+xml,%3Csvg width='10' height='6' viewBox='0 0 10 6' fill='none' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath fill-rule='evenodd' clip-rule='evenodd' d='M0.292893 0.292893C0.683417 -0.097631 1.31658 -0.097631 1.70711 0.292893L5 3.58579L8.29289 0.292893C8.68342 -0.0976311 9.31658 -0.0976311 9.70711 0.292893C10.0976 0.683417 10.0976 1.31658 9.70711 1.70711L5.70711 5.70711C5.31658 6.09763 4.68342 6.09763 4.29289 5.70711L0.292893 1.70711C-0.0976311 1.31658 -0.0976311 0.683418 0.292893 0.292893Z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-icon-ctrl-search: url(\"data:image\/svg+xml,%3Csvg width='640' height='640' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath d='M256 128c-70.692 0-128 57.308-128 128 0 70.691 57.308 128 128 128 70.691 0 128-57.309 128-128 0-70.692-57.309-128-128-128zM64 256c0-106.039 85.961-192 192-192s192 85.961 192 192c0 41.466-13.146 79.863-35.498 111.248l154.125 154.125c12.496 12.496 12.496 32.758 0 45.254s-32.758 12.496-45.254 0L367.248 412.502C335.862 434.854 297.467 448 256 448c-106.039 0-192-85.962-192-192z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-label-space-y-secondary: var(--gf-label-space-y-md-secondary);--gf-ctrl-border-color: #686e77;--gf-ctrl-size: var(--gf-ctrl-size-md);--gf-ctrl-label-color-primary: #112337;--gf-ctrl-label-color-secondary: #112337;--gf-ctrl-choice-size: var(--gf-ctrl-choice-size-md);--gf-ctrl-checkbox-check-size: var(--gf-ctrl-checkbox-check-size-md);--gf-ctrl-radio-check-size: var(--gf-ctrl-radio-check-size-md);--gf-ctrl-btn-font-size: var(--gf-ctrl-btn-font-size-md);--gf-ctrl-btn-padding-x: var(--gf-ctrl-btn-padding-x-md);--gf-ctrl-btn-size: var(--gf-ctrl-btn-size-md);--gf-ctrl-btn-border-color-secondary: #686e77;--gf-ctrl-file-btn-bg-color-hover: #EBEBEB;--gf-field-img-choice-size: var(--gf-field-img-choice-size-md);--gf-field-img-choice-card-space: var(--gf-field-img-choice-card-space-md);--gf-field-img-choice-check-ind-size: var(--gf-field-img-choice-check-ind-size-md);--gf-field-img-choice-check-ind-icon-size: var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Sales Lead Submission Form Drop Downs<\/h2>\n                            <p class='gform_description'><\/p>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_99'  action='\/wp-json\/wp\/v2\/pages\/23868' data-formid='99' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_99' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_99_64\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_99_64'>Phone<\/label><div class='ginput_container'><input name='input_64' id='input_99_64' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_99_64'>This field is for validation purposes and should be left unchanged.<\/div><\/div><div id=\"field_99_63\" class=\"gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_99_63'>First Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_63' id='input_99_63' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_99_62\" class=\"gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_99_62'>Last Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_62' id='input_99_62' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_99_22\" class=\"gfield gfield--type-text gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_99_22'>Title<\/label><div class='ginput_container ginput_container_text'><input name='input_22' id='input_99_22' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_99_3\" class=\"gfield gfield--type-email gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_99_3'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_3' id='input_99_3' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_99_4\" class=\"gfield gfield--type-phone gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_99_4'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_4' id='input_99_4' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_99_53\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><strong style=\"color: #000000\">Points of Interest (Click on Titles Below to See Options)<\/strong><\/div><fieldset id=\"field_99_54\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full hidden-title dropdown-title field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Show Accreditation\/Certification<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_99_54'><div class='gchoice gchoice_99_54_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.1' type='checkbox'  value='Accreditation\/Certification'  id='choice_99_54_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_54_1' id='label_99_54_1' class='gform-field-label gform-field-label--type-inline'>Accreditation\/Certification<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_99_45\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gf_list_3col hidden-title field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Accreditation\/Certification<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_99_45'><div class='gchoice gchoice_99_45_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.1' type='checkbox'  value='Case Management:Accreditation\/Certification;'  id='choice_99_45_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_45_1' id='label_99_45_1' class='gform-field-label gform-field-label--type-inline'>Case Management<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_45_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.2' type='checkbox'  value='CM with LTSS Dis:Accreditation\/Certification;'  id='choice_99_45_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_45_2' id='label_99_45_2' class='gform-field-label gform-field-label--type-inline'>CM with LTSS Dis<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_45_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.3' type='checkbox'  value='CM-LTSS:Accreditation\/Certification;'  id='choice_99_45_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_45_3' id='label_99_45_3' class='gform-field-label gform-field-label--type-inline'>CM-LTSS<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_45_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.4' type='checkbox'  value='Credentialing:Accreditation\/Certification;'  id='choice_99_45_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_45_4' id='label_99_45_4' class='gform-field-label gform-field-label--type-inline'>Credentialing<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_45_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.5' type='checkbox'  value='CVO:Accreditation\/Certification;'  id='choice_99_45_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_45_5' id='label_99_45_5' class='gform-field-label gform-field-label--type-inline'>CVO<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_45_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.6' type='checkbox'  value='Health Equity:Accreditation\/Certification;'  id='choice_99_45_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_45_6' id='label_99_45_6' class='gform-field-label gform-field-label--type-inline'>Health Equity<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_45_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.7' type='checkbox'  value='Health Equity Plus:Accreditation\/Certification;'  id='choice_99_45_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_45_7' id='label_99_45_7' class='gform-field-label gform-field-label--type-inline'>Health Equity Plus<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_45_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.8' type='checkbox'  value='Health Information Products:Accreditation\/Certification;'  id='choice_99_45_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_45_8' id='label_99_45_8' class='gform-field-label gform-field-label--type-inline'>Health Information Products<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_45_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.9' type='checkbox'  value='Health Plan Accreditation:Accreditation\/Certification;'  id='choice_99_45_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_45_9' id='label_99_45_9' class='gform-field-label gform-field-label--type-inline'>Health Plan Accreditation<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_45_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.11' type='checkbox'  value='HPA with LTSS Dis:Accreditation\/Certification;'  id='choice_99_45_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_45_11' id='label_99_45_11' class='gform-field-label gform-field-label--type-inline'>HPA with LTSS Dis<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_45_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.12' type='checkbox'  value='LTSS-Distinction:Accreditation\/Certification;'  id='choice_99_45_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_45_12' id='label_99_45_12' class='gform-field-label gform-field-label--type-inline'>LTSS-Distinction<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_45_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.13' type='checkbox'  value='MA Deeming:Accreditation\/Certification;'  id='choice_99_45_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_45_13' id='label_99_45_13' class='gform-field-label gform-field-label--type-inline'>MA Deeming<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_45_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.14' type='checkbox'  value='MBHO:Accreditation\/Certification;'  id='choice_99_45_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_45_14' id='label_99_45_14' class='gform-field-label gform-field-label--type-inline'>MBHO<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_45_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.15' type='checkbox'  value='MBHO with LTSS Dis:Accreditation\/Certification;'  id='choice_99_45_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_45_15' id='label_99_45_15' class='gform-field-label gform-field-label--type-inline'>MBHO with LTSS Dis<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_45_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.16' type='checkbox'  value='Medicaid Module:Accreditation\/Certification;'  id='choice_99_45_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_45_16' id='label_99_45_16' class='gform-field-label gform-field-label--type-inline'>Medicaid Module<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_45_17'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.17' type='checkbox'  value='MHC-Distinction:Accreditation\/Certification;'  id='choice_99_45_17'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_45_17' id='label_99_45_17' class='gform-field-label gform-field-label--type-inline'>MHC-Distinction<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_45_18'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.18' type='checkbox'  value='Physician and Hospital Quality:Accreditation\/Certification;'  id='choice_99_45_18'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_45_18' id='label_99_45_18' class='gform-field-label gform-field-label--type-inline'>Physician and Hospital Quality<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_45_19'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.19' type='checkbox'  value='Physician Health Quality:Accreditation\/Certification;'  id='choice_99_45_19'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_45_19' id='label_99_45_19' class='gform-field-label gform-field-label--type-inline'>Physician Health Quality<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_45_21'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.21' type='checkbox'  value='Population Health Management:Accreditation\/Certification;'  id='choice_99_45_21'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_45_21' id='label_99_45_21' class='gform-field-label gform-field-label--type-inline'>Population Health Management<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_45_22'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.22' type='checkbox'  value='Provider Network:Accreditation\/Certification;'  id='choice_99_45_22'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_45_22' id='label_99_45_22' class='gform-field-label gform-field-label--type-inline'>Provider Network<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_45_23'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.23' type='checkbox'  value='SDOH:Accreditation\/Certification;'  id='choice_99_45_23'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_45_23' id='label_99_45_23' class='gform-field-label gform-field-label--type-inline'>SDOH<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_45_24'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.24' type='checkbox'  value='Specialty Rx:Accreditation\/Certification;'  id='choice_99_45_24'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_45_24' id='label_99_45_24' class='gform-field-label gform-field-label--type-inline'>Specialty Rx<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_45_25'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.25' type='checkbox'  value='Telehealth-Plans:Accreditation\/Certification;'  id='choice_99_45_25'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_45_25' id='label_99_45_25' class='gform-field-label gform-field-label--type-inline'>Telehealth-Plans<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_45_26'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.26' type='checkbox'  value='Utilization Management:Accreditation\/Certification;'  id='choice_99_45_26'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_45_26' id='label_99_45_26' class='gform-field-label gform-field-label--type-inline'>Utilization Management<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_45_27'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.27' type='checkbox'  value='Utilization Mgt &amp; Credentialing:Accreditation\/Certification;'  id='choice_99_45_27'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_45_27' id='label_99_45_27' class='gform-field-label gform-field-label--type-inline'>Utilization Mgt & Credentialing<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_45_28'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.28' type='checkbox'  value='Utilization Mgt &amp; Provider Ntwk:Accreditation\/Certification;'  id='choice_99_45_28'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_45_28' id='label_99_45_28' class='gform-field-label gform-field-label--type-inline'>Utilization Mgt & Provider Ntwk<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_45_29'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.29' type='checkbox'  value='WHP:Accreditation\/Certification;'  id='choice_99_45_29'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_45_29' id='label_99_45_29' class='gform-field-label gform-field-label--type-inline'>WHP<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_99_56\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full hidden-title dropdown-title field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Show Education<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_99_56'><div class='gchoice gchoice_99_56_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.1' type='checkbox'  value='Education'  id='choice_99_56_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_56_1' id='label_99_56_1' class='gform-field-label gform-field-label--type-inline'>Education<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_99_48\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gf_list_3col hidden-title field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Education<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_99_48'><div class='gchoice gchoice_99_48_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_48.1' type='checkbox'  value='CME Services:Education;'  id='choice_99_48_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_48_1' id='label_99_48_1' class='gform-field-label gform-field-label--type-inline'>CME Services<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_48_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_48.2' type='checkbox'  value='Corporate Training:Education;'  id='choice_99_48_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_48_2' id='label_99_48_2' class='gform-field-label gform-field-label--type-inline'>Corporate Training<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_48_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_48.3' type='checkbox'  value='Enterprise-HIS:Education;'  id='choice_99_48_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_48_3' id='label_99_48_3' class='gform-field-label gform-field-label--type-inline'>Enterprise-HIS<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_48_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_48.4' type='checkbox'  value='Enterprise-QIS:Education;'  id='choice_99_48_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_48_4' id='label_99_48_4' class='gform-field-label gform-field-label--type-inline'>Enterprise-QIS<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_48_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_48.5' type='checkbox'  value='Sponsorship-HIS:Education;'  id='choice_99_48_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_48_5' id='label_99_48_5' class='gform-field-label gform-field-label--type-inline'>Sponsorship-HIS<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_48_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_48.6' type='checkbox'  value='Sponsorship-QIS:Education;'  id='choice_99_48_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_48_6' id='label_99_48_6' class='gform-field-label gform-field-label--type-inline'>Sponsorship-QIS<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_99_55\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full hidden-title dropdown-title field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Show HIT\/IP<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_99_55'><div class='gchoice gchoice_99_55_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_55.1' type='checkbox'  value='HIT\/IP'  id='choice_99_55_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_55_1' id='label_99_55_1' class='gform-field-label gform-field-label--type-inline'>HIT\/IP<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_99_47\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gf_list_3col hidden-title field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >HIT\/IP<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_99_47'><div class='gchoice gchoice_99_47_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.1' type='checkbox'  value='CAHPS-5.0H Certification:HIT\/IP;'  id='choice_99_47_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_47_1' id='label_99_47_1' class='gform-field-label gform-field-label--type-inline'>CAHPS-5.0H Certification<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_47_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.2' type='checkbox'  value='CAHPS-PCMH Certification:HIT\/IP;'  id='choice_99_47_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_47_2' id='label_99_47_2' class='gform-field-label gform-field-label--type-inline'>CAHPS-PCMH Certification<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_47_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.3' type='checkbox'  value='Custom Data License\/Extracts:HIT\/IP;'  id='choice_99_47_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_47_3' id='label_99_47_3' class='gform-field-label gform-field-label--type-inline'>Custom Data License\/Extracts<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_47_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.4' type='checkbox'  value='Data Aggregator Validation:HIT\/IP;'  id='choice_99_47_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_47_4' id='label_99_47_4' class='gform-field-label gform-field-label--type-inline'>Data Aggregator Validation<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_47_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.5' type='checkbox'  value='Digital Measurement Community:HIT\/IP;'  id='choice_99_47_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_47_5' id='label_99_47_5' class='gform-field-label gform-field-label--type-inline'>Digital Measurement Community<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_47_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.6' type='checkbox'  value='Digital Quality Measures (DQM):HIT\/IP;'  id='choice_99_47_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_47_6' id='label_99_47_6' class='gform-field-label gform-field-label--type-inline'>Digital Quality Measures (DQM)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_47_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.7' type='checkbox'  value='Digital Solutions:HIT\/IP;'  id='choice_99_47_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_47_7' id='label_99_47_7' class='gform-field-label gform-field-label--type-inline'>Digital Solutions<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_47_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.8' type='checkbox'  value='e-Measure Certification:HIT\/IP;'  id='choice_99_47_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_47_8' id='label_99_47_8' class='gform-field-label gform-field-label--type-inline'>e-Measure Certification<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_47_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.9' type='checkbox'  value='MAAS:HIT\/IP;'  id='choice_99_47_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_47_9' id='label_99_47_9' class='gform-field-label gform-field-label--type-inline'>MAAS<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_47_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.11' type='checkbox'  value='Natural Language Processing:HIT\/IP;'  id='choice_99_47_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_47_11' id='label_99_47_11' class='gform-field-label gform-field-label--type-inline'>Natural Language Processing<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_47_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.12' type='checkbox'  value='Quality Compass:HIT\/IP;'  id='choice_99_47_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_47_12' id='label_99_47_12' class='gform-field-label gform-field-label--type-inline'>Quality Compass<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_47_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.13' type='checkbox'  value='Specification Licensing:HIT\/IP;'  id='choice_99_47_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_47_13' id='label_99_47_13' class='gform-field-label gform-field-label--type-inline'>Specification Licensing<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_99_61\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full hidden-title dropdown-title field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Show Recognition<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_99_61'><div class='gchoice gchoice_99_61_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_61.1' type='checkbox'  value='Recognition'  id='choice_99_61_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_61_1' id='label_99_61_1' class='gform-field-label gform-field-label--type-inline'>Recognition<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_99_50\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gf_list_3col hidden-title field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Recognition<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_99_50'><div class='gchoice gchoice_99_50_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.1' type='checkbox'  value='ACO:Recognition;'  id='choice_99_50_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_50_1' id='label_99_50_1' class='gform-field-label gform-field-label--type-inline'>ACO<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_50_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.2' type='checkbox'  value='Diabetes Recognition Program:Recognition;'  id='choice_99_50_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_50_2' id='label_99_50_2' class='gform-field-label gform-field-label--type-inline'>Diabetes Recognition Program<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_50_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.3' type='checkbox'  value='Heart\/Stroke Recognition Program:Recognition;'  id='choice_99_50_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_50_3' id='label_99_50_3' class='gform-field-label gform-field-label--type-inline'>Heart\/Stroke Recognition Program<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_50_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.4' type='checkbox'  value='Patient-Centered Connected Care:Recognition;'  id='choice_99_50_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_50_4' id='label_99_50_4' class='gform-field-label gform-field-label--type-inline'>Patient-Centered Connected Care<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_50_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.5' type='checkbox'  value='PCMH:Recognition;'  id='choice_99_50_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_50_5' id='label_99_50_5' class='gform-field-label gform-field-label--type-inline'>PCMH<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_50_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.6' type='checkbox'  value='PCMH &amp; PCSP:Recognition;'  id='choice_99_50_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_50_6' id='label_99_50_6' class='gform-field-label gform-field-label--type-inline'>PCMH & PCSP<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_50_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.7' type='checkbox'  value='PCMH-NYS:Recognition;'  id='choice_99_50_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_50_7' id='label_99_50_7' class='gform-field-label gform-field-label--type-inline'>PCMH-NYS<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_50_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.8' type='checkbox'  value='PCSP:Recognition;'  id='choice_99_50_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_50_8' id='label_99_50_8' class='gform-field-label gform-field-label--type-inline'>PCSP<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_50_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.9' type='checkbox'  value='Prevalidation-PCMH &amp; PCSP:Recognition;'  id='choice_99_50_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_50_9' id='label_99_50_9' class='gform-field-label gform-field-label--type-inline'>Prevalidation-PCMH & PCSP<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_50_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.11' type='checkbox'  value='Prevalidation-PHM:Recognition;'  id='choice_99_50_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_50_11' id='label_99_50_11' class='gform-field-label gform-field-label--type-inline'>Prevalidation-PHM<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_50_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.12' type='checkbox'  value='Telehealth-Provider:Recognition;'  id='choice_99_50_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_50_12' id='label_99_50_12' class='gform-field-label gform-field-label--type-inline'>Telehealth-Provider<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_99_60\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full hidden-title dropdown-title field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Show Users Groups<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_99_60'><div class='gchoice gchoice_99_60_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_60.1' type='checkbox'  value='Users Groups'  id='choice_99_60_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_60_1' id='label_99_60_1' class='gform-field-label gform-field-label--type-inline'>Users Groups<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_99_49\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gf_list_3col hidden-title field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Users Groups<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_99_49'><div class='gchoice gchoice_99_49_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.1' type='checkbox'  value='CEC:Users Groups;'  id='choice_99_49_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_49_1' id='label_99_49_1' class='gform-field-label gform-field-label--type-inline'>CEC<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_49_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.2' type='checkbox'  value='HEDIS Users Group:Users Groups;'  id='choice_99_49_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_49_2' id='label_99_49_2' class='gform-field-label gform-field-label--type-inline'>HEDIS Users Group<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_49_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.3' type='checkbox'  value='LTSS Best Practices Academy:Users Groups;'  id='choice_99_49_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_49_3' id='label_99_49_3' class='gform-field-label gform-field-label--type-inline'>LTSS Best Practices Academy<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_99_57\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full hidden-title dropdown-title field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Show Other<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_99_57'><div class='gchoice gchoice_99_57_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_57.1' type='checkbox'  value='Other'  id='choice_99_57_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_57_1' id='label_99_57_1' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_99_51\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gf_list_3col hidden-title field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Other<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_99_51'><div class='gchoice gchoice_99_51_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_51.1' type='checkbox'  value='HEDIS:Other;'  id='choice_99_51_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_51_1' id='label_99_51_1' class='gform-field-label gform-field-label--type-inline'>HEDIS<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_99_51_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_51.2' type='checkbox'  value='Other:Other;'  id='choice_99_51_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_99_51_2' id='label_99_51_2' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_99_2\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_99_2'>Organization<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_2' id='input_99_2' type='text' value='Other' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_99_42\" class=\"gfield gfield--type-select field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_99_42'>Organization Type<\/label><div class='ginput_container ginput_container_select'><select name='input_42' id='input_99_42' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Select One' >Select One<\/option><option value='ACO - Accountable Care Organization' >ACO - Accountable Care Organization<\/option><option value='Case Management Org' >Case Management Org<\/option><option value='CBO - Community Based Organization' >CBO - Community Based Organization<\/option><option value='Certified HEDIS Survey Vendor' >Certified HEDIS Survey Vendor<\/option><option value='Clinically Integrated Network' >Clinically Integrated Network<\/option><option value='Consulting Firm' >Consulting Firm<\/option><option value='Credentialing' >Credentialing<\/option><option value='Employer' >Employer<\/option><option value='Government' >Government<\/option><option value='Health IT' >Health IT<\/option><option value='Health Plan' >Health Plan<\/option><option value='Hospital' >Hospital<\/option><option value='Medical Institution\/Assoc' >Medical Institution\/Assoc<\/option><option value='Non-Profit' >Non-Profit<\/option><option value='Other' >Other<\/option><option value='Population Health Vendor' >Population Health Vendor<\/option><option value='Practice' >Practice<\/option><\/select><\/div><\/div><div id=\"field_99_23\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_23' id='input_99_23' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='not set' \/><\/div><\/div><div id=\"field_99_34\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_34' id='input_99_34' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='not set' \/><\/div><\/div><div id=\"field_99_24\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_24' id='input_99_24' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='not set' \/><\/div><\/div><div id=\"field_99_6\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_6' id='input_99_6' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='policy-leadership' \/><\/div><\/div><div id=\"field_99_7\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_7' id='input_99_7' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='prnewswire' \/><\/div><\/div><div id=\"field_99_8\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_8' id='input_99_8' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='not set' \/><\/div><\/div><div id=\"field_99_9\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_9' id='input_99_9' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='_general_____01-06-2026' \/><\/div><\/div><div id=\"field_99_10\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_10' id='input_99_10' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='press-release' \/><\/div><\/div><div id=\"field_99_11\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_11' id='input_99_11' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='http:\/\/connect.facebook.net\/en_US\/fbevents.js' \/><\/div><\/div><div id=\"field_99_12\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_12' id='input_99_12' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='not set' \/><\/div><\/div><div id=\"field_99_13\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_13' id='input_99_13' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='not set' \/><\/div><\/div><div id=\"field_99_15\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_15' id='input_99_15' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='not set' \/><\/div><\/div><div id=\"field_99_16\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_16' id='input_99_16' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='not set' \/><\/div><\/div><div id=\"field_99_17\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_17' id='input_99_17' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='not set' \/><\/div><\/div><div id=\"field_99_18\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_18' id='input_99_18' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='not set' \/><\/div><\/div><div id=\"field_99_25\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_25' id='input_99_25' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='not set' \/><\/div><\/div><div id=\"field_99_26\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_26' id='input_99_26' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='not set' \/><\/div><\/div><div id=\"field_99_30\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_30' id='input_99_30' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='Other' \/><\/div><\/div><div id=\"field_99_31\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_31' id='input_99_31' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='not set' \/><\/div><\/div><div id=\"field_99_33\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_33' id='input_99_33' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='Marketing' \/><\/div><\/div><div id=\"field_99_35\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_35' id='input_99_35' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='not set' \/><\/div><\/div><div id=\"field_99_36\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_36' id='input_99_36' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='not set' \/><\/div><\/div><div id=\"field_99_38\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_38' id='input_99_38' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='not set' \/><\/div><\/div><div id=\"field_99_39\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_39' id='input_99_39' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='not set' \/><\/div><\/div><div id=\"field_99_40\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_40' id='input_99_40' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='not set' \/><\/div><\/div><div id=\"field_99_46\" class=\"gfield gfield--type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_46' id='input_99_46' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='not set' \/><\/div><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_99' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Submit Lead'  \/> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_99' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_99' id='gform_theme_99' value='orbital' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_99' id='gform_style_settings_99' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_99' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='99' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='FqPYa\/FnAgRMboXeV6GdGYo076xiuybZQRyKLGKErz7bdKnGP\/zJnqbwMu7ZwKHjn8jmivPJ8HQuKdnqL3oE3N58gpbajUohmcsGb0sHyTz8NJQ=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_99' value='WyJbXSIsIjlmZjIyN2FmZmJhMTQzMjMxNzM1ODRlMjVjZGRjYzRlIl0=' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_99' id='gform_target_page_number_99' value='0' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_99' id='gform_source_page_number_99' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/form>\n                        <\/div><script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\n gform.initializeOnLoaded( function() {gformInitSpinner( 99, 'https:\/\/www.ncqa.org\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', false );jQuery('#gform_ajax_frame_99').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_99');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_99').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){form_content.find('form').css('opacity', 0);jQuery('#gform_wrapper_99').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_99').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_99').removeClass('gform_validation_error');}setTimeout( function() { \/* delay the scroll by 50 milliseconds to fix a bug in chrome *\/  }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_99').val();gformInitSpinner( 99, 'https:\/\/www.ncqa.org\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', false );jQuery(document).trigger('gform_page_loaded', [99, current_page]);window['gf_submitting_99'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}jQuery('#gform_wrapper_99').replaceWith(confirmation_content);jQuery(document).trigger('gform_confirmation_loaded', [99]);window['gf_submitting_99'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_99').text());}else{jQuery('#gform_99').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger(\"gform_pre_post_render\", [{ formId: \"99\", currentPage: \"current_page\", abort: function() { this.preventDefault(); } }]);        if (event && event.defaultPrevented) {                return;        }        const gformWrapperDiv = document.getElementById( \"gform_wrapper_99\" );        if ( gformWrapperDiv ) {            const visibilitySpan = document.createElement( \"span\" );            visibilitySpan.id = \"gform_visibility_test_99\";            gformWrapperDiv.insertAdjacentElement( \"afterend\", visibilitySpan );        }        const visibilityTestDiv = document.getElementById( \"gform_visibility_test_99\" );        let postRenderFired = false;        function triggerPostRender() {            if ( postRenderFired ) {                return;            }            postRenderFired = true;            gform.core.triggerPostRenderEvents( 99, current_page );            if ( visibilityTestDiv ) {                visibilityTestDiv.parentNode.removeChild( visibilityTestDiv );            }        }        function debounce( func, wait, immediate ) {            var timeout;            return function() {                var context = this, args = arguments;                var later = function() {                    timeout = null;                    if ( !immediate ) func.apply( context, args );                };                var callNow = immediate && !timeout;                clearTimeout( timeout );                timeout = setTimeout( later, wait );                if ( callNow ) func.apply( context, args );            };        }        const debouncedTriggerPostRender = debounce( function() {            triggerPostRender();        }, 200 );        if ( visibilityTestDiv && visibilityTestDiv.offsetParent === null ) {            const observer = new MutationObserver( ( mutations ) => {                mutations.forEach( ( mutation ) => {                    if ( mutation.type === 'attributes' && visibilityTestDiv.offsetParent !== null ) {                        debouncedTriggerPostRender();                        observer.disconnect();                    }                });            });            observer.observe( document.body, {                attributes: true,                childList: false,                subtree: true,                attributeFilter: [ 'style', 'class' ],            });        } else {            triggerPostRender();        }    } );} ); \n\/* ]]> *\/\n<\/script>\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":4,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page-single-column.php","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-23868","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Gen Form Page with Dropdown - NCQA<\/title>\n<meta name=\"description\" content=\"Gen Form Page with Dropdown\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ncqa.org\/gen-form-page-with-dropdown\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Gen Form Page with Dropdown - NCQA\" \/>\n<meta property=\"og:description\" content=\"Gen Form Page with Dropdown\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.ncqa.org\/gen-form-page-with-dropdown\/\" \/>\n<meta property=\"og:site_name\" content=\"NCQA\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/NCQA.org\" \/>\n<meta property=\"article:modified_time\" content=\"2025-11-21T21:35:02+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.ncqa.org\/wp-content\/uploads\/2021\/04\/NCQA_cmyk_tag.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"627\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:site\" content=\"@NCQA\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.ncqa.org\/gen-form-page-with-dropdown\/\",\"url\":\"https:\/\/www.ncqa.org\/gen-form-page-with-dropdown\/\",\"name\":\"Gen Form Page with Dropdown - NCQA\",\"isPartOf\":{\"@id\":\"https:\/\/www.ncqa.org\/#website\"},\"datePublished\":\"2021-11-16T16:41:16+00:00\",\"dateModified\":\"2025-11-21T21:35:02+00:00\",\"description\":\"Gen Form Page with Dropdown\",\"breadcrumb\":{\"@id\":\"https:\/\/www.ncqa.org\/gen-form-page-with-dropdown\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.ncqa.org\/gen-form-page-with-dropdown\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.ncqa.org\/gen-form-page-with-dropdown\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/www.ncqa.org\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Gen Form Page with Dropdown\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.ncqa.org\/#website\",\"url\":\"https:\/\/www.ncqa.org\/\",\"name\":\"NCQA\",\"description\":\"Measuring quality. Improving health care.\",\"publisher\":{\"@id\":\"https:\/\/www.ncqa.org\/#organization\"},\"alternateName\":\"National Committee for Quality Assurance\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/www.ncqa.org\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/www.ncqa.org\/#organization\",\"name\":\"NCQA\",\"alternateName\":\"National Committee for Quality Assurance\",\"url\":\"https:\/\/www.ncqa.org\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/www.ncqa.org\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/www.ncqa.org\/wp-content\/uploads\/NCQA-Blog-Logo-Thumbnail.jpg\",\"contentUrl\":\"https:\/\/www.ncqa.org\/wp-content\/uploads\/NCQA-Blog-Logo-Thumbnail.jpg\",\"width\":876,\"height\":673,\"caption\":\"NCQA\"},\"image\":{\"@id\":\"https:\/\/www.ncqa.org\/#\/schema\/logo\/image\/\"},\"sameAs\":[\"https:\/\/www.facebook.com\/NCQA.org\",\"https:\/\/x.com\/NCQA\",\"https:\/\/www.instagram.com\/ncqa_dc\/\",\"https:\/\/www.youtube.com\/@NcqaOrg\",\"https:\/\/www.linkedin.com\/company\/ncqa\/\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Gen Form Page with Dropdown - NCQA","description":"Gen Form Page with Dropdown","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.ncqa.org\/gen-form-page-with-dropdown\/","og_locale":"en_US","og_type":"article","og_title":"Gen Form Page with Dropdown - NCQA","og_description":"Gen Form Page with Dropdown","og_url":"https:\/\/www.ncqa.org\/gen-form-page-with-dropdown\/","og_site_name":"NCQA","article_publisher":"https:\/\/www.facebook.com\/NCQA.org","article_modified_time":"2025-11-21T21:35:02+00:00","og_image":[{"width":1200,"height":627,"url":"https:\/\/www.ncqa.org\/wp-content\/uploads\/2021\/04\/NCQA_cmyk_tag.jpg","type":"image\/jpeg"}],"twitter_card":"summary_large_image","twitter_site":"@NCQA","twitter_misc":{"Est. reading time":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.ncqa.org\/gen-form-page-with-dropdown\/","url":"https:\/\/www.ncqa.org\/gen-form-page-with-dropdown\/","name":"Gen Form Page with Dropdown - NCQA","isPartOf":{"@id":"https:\/\/www.ncqa.org\/#website"},"datePublished":"2021-11-16T16:41:16+00:00","dateModified":"2025-11-21T21:35:02+00:00","description":"Gen Form Page with Dropdown","breadcrumb":{"@id":"https:\/\/www.ncqa.org\/gen-form-page-with-dropdown\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.ncqa.org\/gen-form-page-with-dropdown\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/www.ncqa.org\/gen-form-page-with-dropdown\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.ncqa.org\/"},{"@type":"ListItem","position":2,"name":"Gen Form Page with Dropdown"}]},{"@type":"WebSite","@id":"https:\/\/www.ncqa.org\/#website","url":"https:\/\/www.ncqa.org\/","name":"NCQA","description":"Measuring quality. Improving health care.","publisher":{"@id":"https:\/\/www.ncqa.org\/#organization"},"alternateName":"National Committee for Quality Assurance","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.ncqa.org\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/www.ncqa.org\/#organization","name":"NCQA","alternateName":"National Committee for Quality Assurance","url":"https:\/\/www.ncqa.org\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/www.ncqa.org\/#\/schema\/logo\/image\/","url":"https:\/\/www.ncqa.org\/wp-content\/uploads\/NCQA-Blog-Logo-Thumbnail.jpg","contentUrl":"https:\/\/www.ncqa.org\/wp-content\/uploads\/NCQA-Blog-Logo-Thumbnail.jpg","width":876,"height":673,"caption":"NCQA"},"image":{"@id":"https:\/\/www.ncqa.org\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/NCQA.org","https:\/\/x.com\/NCQA","https:\/\/www.instagram.com\/ncqa_dc\/","https:\/\/www.youtube.com\/@NcqaOrg","https:\/\/www.linkedin.com\/company\/ncqa\/"]}]}},"_links":{"self":[{"href":"https:\/\/www.ncqa.org\/wp-json\/wp\/v2\/pages\/23868","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ncqa.org\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.ncqa.org\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.ncqa.org\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ncqa.org\/wp-json\/wp\/v2\/comments?post=23868"}],"version-history":[{"count":1,"href":"https:\/\/www.ncqa.org\/wp-json\/wp\/v2\/pages\/23868\/revisions"}],"predecessor-version":[{"id":47650,"href":"https:\/\/www.ncqa.org\/wp-json\/wp\/v2\/pages\/23868\/revisions\/47650"}],"wp:attachment":[{"href":"https:\/\/www.ncqa.org\/wp-json\/wp\/v2\/media?parent=23868"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}