What's your major health concern?
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How did you hear about me?
{"type":"checkbox","name":"__generic","width":100,"value":"","size":"Normal","validation":"C1","validationMessage":"Please check at least one item.","options":"Google\nInstagram\nFacebook\nYouTube\nReferral"}
If referred by who
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How excited are you about addressing your health?
{"type":"radio","name":"__generic","width":20,"value":"","size":"Normal","validation":"C1","validationMessage":"Please choose one of the above options.","options":"1- Not\n2\n3- So, So\n4\n5- Very"}
