{"id":2469,"date":"2026-10-09T22:51:32","date_gmt":"2026-10-09T14:51:32","guid":{"rendered":"https:\/\/healingthee.com\/?page_id=2469"},"modified":"2026-10-09T22:53:32","modified_gmt":"2026-10-09T14:53:32","slug":"scale-relationship-self-check","status":"publish","type":"page","link":"https:\/\/healingthee.com\/en\/scale-relationship-self-check\/","title":{"rendered":"\u89aa\u5bc6\u95dc\u4fc2\u81ea\u6211\u8a55\u4f30\u91cf\u8868"},"content":{"rendered":"<style id=\"wpforms-css-vars-2446-block-2002d569-ec1a-4732-b5d1-91722d2ef0e8\">\n\t\t\t\t#wpforms-2446.wpforms-block-2002d569-ec1a-4732-b5d1-91722d2ef0e8 {\n\t\t\t\t--wpforms-field-size-input-height: 43px;\n--wpforms-field-size-input-spacing: 15px;\n--wpforms-field-size-font-size: 16px;\n--wpforms-field-size-line-height: 19px;\n--wpforms-field-size-padding-h: 14px;\n--wpforms-field-size-checkbox-size: 16px;\n--wpforms-field-size-sublabel-spacing: 5px;\n--wpforms-field-size-icon-size: 1;\n--wpforms-label-size-font-size: 16px;\n--wpforms-label-size-line-height: 19px;\n--wpforms-label-size-sublabel-font-size: 14px;\n--wpforms-label-size-sublabel-line-height: 17px;\n--wpforms-button-size-font-size: 17px;\n--wpforms-button-size-height: 41px;\n--wpforms-button-size-padding-h: 15px;\n--wpforms-button-size-margin-top: 10px;\n--wpforms-container-shadow-size-box-shadow: none;\n\t\t\t}\n\t\t\t<\/style><div class=\"wpforms-container wpforms-container-full wpforms-block wpforms-block-2002d569-ec1a-4732-b5d1-91722d2ef0e8 wpforms-render-modern\" id=\"wpforms-2446\"><form id=\"wpforms-form-2446\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"2446\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/en\/wp-json\/wp\/v2\/pages\/2469\" data-token=\"d75a2720f555360a0c9037d5bd7dc155\" data-token-time=\"1791836096\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div id=\"wpforms-error-noscript\" style=\"display: none;\">Please enable JavaScript in your browser to complete this form.<\/div><div class=\"wpforms-field-container\"><div id=\"wpforms-2446-field_37-container\" class=\"wpforms-field wpforms-field-layout\" data-field-type=\"layout\" data-field-id=\"37\"><div class=\"wpforms-field-layout-rows wpforms-field-large\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-33\"><div id=\"wpforms-2446-field_30-container\" class=\"wpforms-field wpforms-field-name\" data-field-type=\"name\" data-field-id=\"30\"><label class=\"wpforms-field-label\" for=\"wpforms-2446-field_30\">\u59d3\u540d <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-2446-field_30\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][30]\" aria-errormessage=\"wpforms-2446-field_30-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-33\"><div id=\"wpforms-2446-field_32-container\" class=\"wpforms-field wpforms-field-email\" data-field-type=\"email\" data-field-id=\"32\"><label class=\"wpforms-field-label\" for=\"wpforms-2446-field_32\">\u96fb\u5b50\u90f5\u4ef6 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"email\" id=\"wpforms-2446-field_32\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][32]\" spellcheck=\"false\" aria-errormessage=\"wpforms-2446-field_32-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-33\"><div id=\"wpforms-2446-field_33-container\" class=\"wpforms-field wpforms-field-phone\" data-field-type=\"phone\" data-field-id=\"33\"><label class=\"wpforms-field-label\" for=\"wpforms-2446-field_33\">\u806f\u7d61\u96fb\u8a71<\/label><input type=\"tel\" id=\"wpforms-2446-field_33\" class=\"wpforms-field-medium wpforms-smart-phone-field\" data-rule-smart-phone-field=\"true\" name=\"wpforms[fields][33]\" aria-label=\"\u806f\u7d61\u96fb\u8a71\" aria-errormessage=\"wpforms-2446-field_33-error\" ><\/div><\/div><\/div><\/div><\/div><div id=\"wpforms-2446-field_36-container\" class=\"wpforms-field wpforms-field-content\" data-field-type=\"content\" data-field-id=\"36\"><div id=\"wpforms-2446-field_36\" class=\"wpforms-field-large wpforms-field-row\" aria-errormessage=\"wpforms-2446-field_36-error\"><h4><strong>\u7b2c\u4e00\u90e8\u5206\uff1a\u95dc\u4fc2\u6eff\u610f\u5ea6\uff08\u53c3\u8003 Couples Satisfaction Index \u6982\u5ff5\uff09<\/strong><\/h4>\n<div class=\"wpforms-field-content-display-frontend-clear\"><\/div><\/div><\/div><div id=\"wpforms-2446-field_2-container\" class=\"wpforms-field wpforms-field-payment-multiple wpforms-list-inline\" data-field-type=\"payment-multiple\" data-field-id=\"2\"><fieldset><legend class=\"wpforms-field-label\">1) \u6574\u9ad4\u800c\u8a00\uff0c\u6211\u5c0d\u9019\u6bb5\u95dc\u4fc2\u611f\u5230\u6eff\u610f\u3002 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-2446-field_2\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"radio\" id=\"wpforms-2446-field_2_1\" class=\"wpforms-payment-price\" data-amount=\"1.00\" name=\"wpforms[fields][2]\" value=\"1\" aria-errormessage=\"wpforms-2446-field_2_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_2_1\">\u975e\u5e38\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-2\"><input type=\"radio\" id=\"wpforms-2446-field_2_2\" class=\"wpforms-payment-price\" data-amount=\"2.00\" name=\"wpforms[fields][2]\" value=\"2\" aria-errormessage=\"wpforms-2446-field_2_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_2_2\">\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-3\"><input type=\"radio\" id=\"wpforms-2446-field_2_3\" class=\"wpforms-payment-price\" data-amount=\"3.00\" name=\"wpforms[fields][2]\" value=\"3\" aria-errormessage=\"wpforms-2446-field_2_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_2_3\">\u666e\u901a<\/label><\/li><li class=\"choice-4\"><input type=\"radio\" id=\"wpforms-2446-field_2_4\" class=\"wpforms-payment-price\" data-amount=\"4.00\" name=\"wpforms[fields][2]\" value=\"4\" aria-errormessage=\"wpforms-2446-field_2_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_2_4\">\u540c\u610f<\/label><\/li><li class=\"choice-5\"><input type=\"radio\" id=\"wpforms-2446-field_2_5\" class=\"wpforms-payment-price\" data-amount=\"5.00\" name=\"wpforms[fields][2]\" value=\"5\" aria-errormessage=\"wpforms-2446-field_2_5-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_2_5\">\u975e\u5e38\u540c\u610f<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-2446-field_38-container\" class=\"wpforms-field wpforms-field-payment-multiple wpforms-list-inline\" data-field-type=\"payment-multiple\" data-field-id=\"38\"><fieldset><legend class=\"wpforms-field-label\">2) \u6211\u7684\u4f34\u4fb6\u80fd\u6eff\u8db3\u6211\u5927\u90e8\u5206\u7684\u60c5\u611f\u9700\u6c42\u3002 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-2446-field_38\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"radio\" id=\"wpforms-2446-field_38_1\" class=\"wpforms-payment-price\" data-amount=\"1.00\" name=\"wpforms[fields][38]\" value=\"1\" aria-errormessage=\"wpforms-2446-field_38_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_38_1\">\u975e\u5e38\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-2\"><input type=\"radio\" id=\"wpforms-2446-field_38_2\" class=\"wpforms-payment-price\" data-amount=\"2.00\" name=\"wpforms[fields][38]\" value=\"2\" aria-errormessage=\"wpforms-2446-field_38_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_38_2\">\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-3\"><input type=\"radio\" id=\"wpforms-2446-field_38_3\" class=\"wpforms-payment-price\" data-amount=\"3.00\" name=\"wpforms[fields][38]\" value=\"3\" aria-errormessage=\"wpforms-2446-field_38_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_38_3\">\u666e\u901a<\/label><\/li><li class=\"choice-4\"><input type=\"radio\" id=\"wpforms-2446-field_38_4\" class=\"wpforms-payment-price\" data-amount=\"4.00\" name=\"wpforms[fields][38]\" value=\"4\" aria-errormessage=\"wpforms-2446-field_38_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_38_4\">\u540c\u610f<\/label><\/li><li class=\"choice-5\"><input type=\"radio\" id=\"wpforms-2446-field_38_5\" class=\"wpforms-payment-price\" data-amount=\"5.00\" name=\"wpforms[fields][38]\" value=\"5\" aria-errormessage=\"wpforms-2446-field_38_5-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_38_5\">\u975e\u5e38\u540c\u610f<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-2446-field_39-container\" class=\"wpforms-field wpforms-field-payment-multiple wpforms-list-inline\" data-field-type=\"payment-multiple\" data-field-id=\"39\"><fieldset><legend class=\"wpforms-field-label\">3) \u9019\u6bb5\u95dc\u4fc2\u7b26\u5408\u6211\u539f\u672c\u5c0d\u89aa\u5bc6\u95dc\u4fc2\u7684\u671f\u5f85\u3002 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-2446-field_39\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"radio\" id=\"wpforms-2446-field_39_1\" class=\"wpforms-payment-price\" data-amount=\"1.00\" name=\"wpforms[fields][39]\" value=\"1\" aria-errormessage=\"wpforms-2446-field_39_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_39_1\">\u975e\u5e38\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-2\"><input type=\"radio\" id=\"wpforms-2446-field_39_2\" class=\"wpforms-payment-price\" data-amount=\"2.00\" name=\"wpforms[fields][39]\" value=\"2\" aria-errormessage=\"wpforms-2446-field_39_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_39_2\">\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-3\"><input type=\"radio\" id=\"wpforms-2446-field_39_3\" class=\"wpforms-payment-price\" data-amount=\"3.00\" name=\"wpforms[fields][39]\" value=\"3\" aria-errormessage=\"wpforms-2446-field_39_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_39_3\">\u666e\u901a<\/label><\/li><li class=\"choice-4\"><input type=\"radio\" id=\"wpforms-2446-field_39_4\" class=\"wpforms-payment-price\" data-amount=\"4.00\" name=\"wpforms[fields][39]\" value=\"4\" aria-errormessage=\"wpforms-2446-field_39_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_39_4\">\u540c\u610f<\/label><\/li><li class=\"choice-5\"><input type=\"radio\" id=\"wpforms-2446-field_39_5\" class=\"wpforms-payment-price\" data-amount=\"5.00\" name=\"wpforms[fields][39]\" value=\"5\" aria-errormessage=\"wpforms-2446-field_39_5-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_39_5\">\u975e\u5e38\u540c\u610f<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-2446-field_40-container\" class=\"wpforms-field wpforms-field-payment-multiple wpforms-list-inline\" data-field-type=\"payment-multiple\" data-field-id=\"40\"><fieldset><legend class=\"wpforms-field-label\">4) \u5982\u679c\u53ef\u4ee5\u91cd\u65b0\u9078\u64c7\uff0c\u6211\u9084\u662f\u6703\u9078\u64c7\u548c\u73fe\u5728\u7684\u4f34\u4fb6\u5728\u4e00\u8d77\u3002 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-2446-field_40\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"radio\" id=\"wpforms-2446-field_40_1\" class=\"wpforms-payment-price\" data-amount=\"1.00\" name=\"wpforms[fields][40]\" value=\"1\" aria-errormessage=\"wpforms-2446-field_40_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_40_1\">\u975e\u5e38\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-2\"><input type=\"radio\" id=\"wpforms-2446-field_40_2\" class=\"wpforms-payment-price\" data-amount=\"2.00\" name=\"wpforms[fields][40]\" value=\"2\" aria-errormessage=\"wpforms-2446-field_40_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_40_2\">\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-3\"><input type=\"radio\" id=\"wpforms-2446-field_40_3\" class=\"wpforms-payment-price\" data-amount=\"3.00\" name=\"wpforms[fields][40]\" value=\"3\" aria-errormessage=\"wpforms-2446-field_40_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_40_3\">\u666e\u901a<\/label><\/li><li class=\"choice-4\"><input type=\"radio\" id=\"wpforms-2446-field_40_4\" class=\"wpforms-payment-price\" data-amount=\"4.00\" name=\"wpforms[fields][40]\" value=\"4\" aria-errormessage=\"wpforms-2446-field_40_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_40_4\">\u540c\u610f<\/label><\/li><li class=\"choice-5\"><input type=\"radio\" id=\"wpforms-2446-field_40_5\" class=\"wpforms-payment-price\" data-amount=\"5.00\" name=\"wpforms[fields][40]\" value=\"5\" aria-errormessage=\"wpforms-2446-field_40_5-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_40_5\">\u975e\u5e38\u540c\u610f<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-2446-field_41-container\" class=\"wpforms-field wpforms-field-payment-multiple wpforms-list-inline\" data-field-type=\"payment-multiple\" data-field-id=\"41\"><fieldset><legend class=\"wpforms-field-label\">5) \u6211\u89ba\u5f97\u9019\u6bb5\u95dc\u4fc2\u5e36\u7d66\u6211\u7684\u5feb\u6a02\u591a\u65bc\u75db\u82e6\u3002 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-2446-field_41\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"radio\" id=\"wpforms-2446-field_41_1\" class=\"wpforms-payment-price\" data-amount=\"1.00\" name=\"wpforms[fields][41]\" value=\"1\" aria-errormessage=\"wpforms-2446-field_41_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_41_1\">\u975e\u5e38\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-2\"><input type=\"radio\" id=\"wpforms-2446-field_41_2\" class=\"wpforms-payment-price\" data-amount=\"2.00\" name=\"wpforms[fields][41]\" value=\"2\" aria-errormessage=\"wpforms-2446-field_41_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_41_2\">\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-3\"><input type=\"radio\" id=\"wpforms-2446-field_41_3\" class=\"wpforms-payment-price\" data-amount=\"3.00\" name=\"wpforms[fields][41]\" value=\"3\" aria-errormessage=\"wpforms-2446-field_41_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_41_3\">\u666e\u901a<\/label><\/li><li class=\"choice-4\"><input type=\"radio\" id=\"wpforms-2446-field_41_4\" class=\"wpforms-payment-price\" data-amount=\"4.00\" name=\"wpforms[fields][41]\" value=\"4\" aria-errormessage=\"wpforms-2446-field_41_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_41_4\">\u540c\u610f<\/label><\/li><li class=\"choice-5\"><input type=\"radio\" id=\"wpforms-2446-field_41_5\" class=\"wpforms-payment-price\" data-amount=\"5.00\" name=\"wpforms[fields][41]\" value=\"5\" aria-errormessage=\"wpforms-2446-field_41_5-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_41_5\">\u975e\u5e38\u540c\u610f<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-2446-field_65-container\" class=\"wpforms-field wpforms-field-content\" data-field-type=\"content\" data-field-id=\"65\"><div id=\"wpforms-2446-field_65\" class=\"wpforms-field-large wpforms-field-row\" aria-errormessage=\"wpforms-2446-field_65-error\"><h4><strong>\u7b2c\u4e8c\u90e8\u5206\uff1a\u4f9d\u9644\u98a8\u683c\u50be\u5411\uff08\u53c3\u8003 ECR \u7c21\u5f0f\u6982\u5ff5\uff09<\/strong><\/h4>\n<div class=\"wpforms-field-content-display-frontend-clear\"><\/div><\/div><\/div><div id=\"wpforms-2446-field_67-container\" class=\"wpforms-field wpforms-field-content\" data-field-type=\"content\" data-field-id=\"67\"><div id=\"wpforms-2446-field_67\" class=\"wpforms-field-large wpforms-field-row\" aria-errormessage=\"wpforms-2446-field_67-error\"><h5><em>A. \u7126\u616e\u50be\u5411<\/em><\/h5>\n<div class=\"wpforms-field-content-display-frontend-clear\"><\/div><\/div><\/div><div id=\"wpforms-2446-field_42-container\" class=\"wpforms-field wpforms-field-payment-multiple wpforms-list-inline\" data-field-type=\"payment-multiple\" data-field-id=\"42\"><fieldset><legend class=\"wpforms-field-label\">6) \u6211\u5e38\u5e38\u64d4\u5fc3\u4f34\u4fb6\u4e0d\u5920\u611b\u6211\u3002 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-2446-field_42\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"radio\" id=\"wpforms-2446-field_42_1\" class=\"wpforms-payment-price\" data-amount=\"1.00\" name=\"wpforms[fields][42]\" value=\"1\" aria-errormessage=\"wpforms-2446-field_42_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_42_1\">\u975e\u5e38\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-2\"><input type=\"radio\" id=\"wpforms-2446-field_42_2\" class=\"wpforms-payment-price\" data-amount=\"2.00\" name=\"wpforms[fields][42]\" value=\"2\" aria-errormessage=\"wpforms-2446-field_42_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_42_2\">\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-3\"><input type=\"radio\" id=\"wpforms-2446-field_42_3\" class=\"wpforms-payment-price\" data-amount=\"3.00\" name=\"wpforms[fields][42]\" value=\"3\" aria-errormessage=\"wpforms-2446-field_42_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_42_3\">\u666e\u901a<\/label><\/li><li class=\"choice-4\"><input type=\"radio\" id=\"wpforms-2446-field_42_4\" class=\"wpforms-payment-price\" data-amount=\"4.00\" name=\"wpforms[fields][42]\" value=\"4\" aria-errormessage=\"wpforms-2446-field_42_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_42_4\">\u540c\u610f<\/label><\/li><li class=\"choice-5\"><input type=\"radio\" id=\"wpforms-2446-field_42_5\" class=\"wpforms-payment-price\" data-amount=\"5.00\" name=\"wpforms[fields][42]\" value=\"5\" aria-errormessage=\"wpforms-2446-field_42_5-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_42_5\">\u975e\u5e38\u540c\u610f<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-2446-field_43-container\" class=\"wpforms-field wpforms-field-payment-multiple wpforms-list-inline\" data-field-type=\"payment-multiple\" data-field-id=\"43\"><fieldset><legend class=\"wpforms-field-label\">7) \u7576\u4f34\u4fb6\u6c92\u6709\u53ca\u6642\u56de\u61c9\u6211\uff0c\u6211\u6703\u611f\u5230\u4e0d\u5b89\u6216\u6050\u614c\u3002 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-2446-field_43\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"radio\" id=\"wpforms-2446-field_43_1\" class=\"wpforms-payment-price\" data-amount=\"1.00\" name=\"wpforms[fields][43]\" value=\"1\" aria-errormessage=\"wpforms-2446-field_43_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_43_1\">\u975e\u5e38\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-2\"><input type=\"radio\" id=\"wpforms-2446-field_43_2\" class=\"wpforms-payment-price\" data-amount=\"2.00\" name=\"wpforms[fields][43]\" value=\"2\" aria-errormessage=\"wpforms-2446-field_43_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_43_2\">\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-3\"><input type=\"radio\" id=\"wpforms-2446-field_43_3\" class=\"wpforms-payment-price\" data-amount=\"3.00\" name=\"wpforms[fields][43]\" value=\"3\" aria-errormessage=\"wpforms-2446-field_43_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_43_3\">\u666e\u901a<\/label><\/li><li class=\"choice-4\"><input type=\"radio\" id=\"wpforms-2446-field_43_4\" class=\"wpforms-payment-price\" data-amount=\"4.00\" name=\"wpforms[fields][43]\" value=\"4\" aria-errormessage=\"wpforms-2446-field_43_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_43_4\">\u540c\u610f<\/label><\/li><li class=\"choice-5\"><input type=\"radio\" id=\"wpforms-2446-field_43_5\" class=\"wpforms-payment-price\" data-amount=\"5.00\" name=\"wpforms[fields][43]\" value=\"5\" aria-errormessage=\"wpforms-2446-field_43_5-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_43_5\">\u975e\u5e38\u540c\u610f<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-2446-field_44-container\" class=\"wpforms-field wpforms-field-payment-multiple wpforms-list-inline\" data-field-type=\"payment-multiple\" data-field-id=\"44\"><fieldset><legend class=\"wpforms-field-label\">8) \u6211\u5f88\u9700\u8981\u4f34\u4fb6\u4e0d\u65b7\u5730\u4fdd\u8b49\u4ed6\uff0f\u5979\u611b\u6211\u3002 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-2446-field_44\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"radio\" id=\"wpforms-2446-field_44_1\" class=\"wpforms-payment-price\" data-amount=\"1.00\" name=\"wpforms[fields][44]\" value=\"1\" aria-errormessage=\"wpforms-2446-field_44_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_44_1\">\u975e\u5e38\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-2\"><input type=\"radio\" id=\"wpforms-2446-field_44_2\" class=\"wpforms-payment-price\" data-amount=\"2.00\" name=\"wpforms[fields][44]\" value=\"2\" aria-errormessage=\"wpforms-2446-field_44_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_44_2\">\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-3\"><input type=\"radio\" id=\"wpforms-2446-field_44_3\" class=\"wpforms-payment-price\" data-amount=\"3.00\" name=\"wpforms[fields][44]\" value=\"3\" aria-errormessage=\"wpforms-2446-field_44_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_44_3\">\u666e\u901a<\/label><\/li><li class=\"choice-4\"><input type=\"radio\" id=\"wpforms-2446-field_44_4\" class=\"wpforms-payment-price\" data-amount=\"4.00\" name=\"wpforms[fields][44]\" value=\"4\" aria-errormessage=\"wpforms-2446-field_44_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_44_4\">\u540c\u610f<\/label><\/li><li class=\"choice-5\"><input type=\"radio\" id=\"wpforms-2446-field_44_5\" class=\"wpforms-payment-price\" data-amount=\"5.00\" name=\"wpforms[fields][44]\" value=\"5\" aria-errormessage=\"wpforms-2446-field_44_5-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_44_5\">\u975e\u5e38\u540c\u610f<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-2446-field_45-container\" class=\"wpforms-field wpforms-field-payment-multiple wpforms-list-inline\" data-field-type=\"payment-multiple\" data-field-id=\"45\"><fieldset><legend class=\"wpforms-field-label\">9) \u6211\u5f88\u5bb3\u6015\u88ab\u4f34\u4fb6\u62cb\u68c4\u6216\u5ffd\u7565\u3002 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-2446-field_45\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"radio\" id=\"wpforms-2446-field_45_1\" class=\"wpforms-payment-price\" data-amount=\"1.00\" name=\"wpforms[fields][45]\" value=\"1\" aria-errormessage=\"wpforms-2446-field_45_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_45_1\">\u975e\u5e38\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-2\"><input type=\"radio\" id=\"wpforms-2446-field_45_2\" class=\"wpforms-payment-price\" data-amount=\"2.00\" name=\"wpforms[fields][45]\" value=\"2\" aria-errormessage=\"wpforms-2446-field_45_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_45_2\">\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-3\"><input type=\"radio\" id=\"wpforms-2446-field_45_3\" class=\"wpforms-payment-price\" data-amount=\"3.00\" name=\"wpforms[fields][45]\" value=\"3\" aria-errormessage=\"wpforms-2446-field_45_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_45_3\">\u666e\u901a<\/label><\/li><li class=\"choice-4\"><input type=\"radio\" id=\"wpforms-2446-field_45_4\" class=\"wpforms-payment-price\" data-amount=\"4.00\" name=\"wpforms[fields][45]\" value=\"4\" aria-errormessage=\"wpforms-2446-field_45_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_45_4\">\u540c\u610f<\/label><\/li><li class=\"choice-5\"><input type=\"radio\" id=\"wpforms-2446-field_45_5\" class=\"wpforms-payment-price\" data-amount=\"5.00\" name=\"wpforms[fields][45]\" value=\"5\" aria-errormessage=\"wpforms-2446-field_45_5-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_45_5\">\u975e\u5e38\u540c\u610f<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-2446-field_68-container\" class=\"wpforms-field wpforms-field-content\" data-field-type=\"content\" data-field-id=\"68\"><div id=\"wpforms-2446-field_68\" class=\"wpforms-field-large wpforms-field-row\" aria-errormessage=\"wpforms-2446-field_68-error\"><h5><em>B. \u8ff4\u907f\u50be\u5411<\/em><\/h5>\n<div class=\"wpforms-field-content-display-frontend-clear\"><\/div><\/div><\/div><div id=\"wpforms-2446-field_46-container\" class=\"wpforms-field wpforms-field-payment-multiple wpforms-list-inline\" data-field-type=\"payment-multiple\" data-field-id=\"46\"><fieldset><legend class=\"wpforms-field-label\">10) \u6211\u4e0d\u592a\u7fd2\u6163\u8ddf\u4f34\u4fb6\u5206\u4eab\u81ea\u5df1\u5167\u5fc3\u771f\u5be6\u7684\u611f\u53d7\u3002 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-2446-field_46\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"radio\" id=\"wpforms-2446-field_46_1\" class=\"wpforms-payment-price\" data-amount=\"1.00\" name=\"wpforms[fields][46]\" value=\"1\" aria-errormessage=\"wpforms-2446-field_46_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_46_1\">\u975e\u5e38\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-2\"><input type=\"radio\" id=\"wpforms-2446-field_46_2\" class=\"wpforms-payment-price\" data-amount=\"2.00\" name=\"wpforms[fields][46]\" value=\"2\" aria-errormessage=\"wpforms-2446-field_46_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_46_2\">\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-3\"><input type=\"radio\" id=\"wpforms-2446-field_46_3\" class=\"wpforms-payment-price\" data-amount=\"3.00\" name=\"wpforms[fields][46]\" value=\"3\" aria-errormessage=\"wpforms-2446-field_46_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_46_3\">\u666e\u901a<\/label><\/li><li class=\"choice-4\"><input type=\"radio\" id=\"wpforms-2446-field_46_4\" class=\"wpforms-payment-price\" data-amount=\"4.00\" name=\"wpforms[fields][46]\" value=\"4\" aria-errormessage=\"wpforms-2446-field_46_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_46_4\">\u540c\u610f<\/label><\/li><li class=\"choice-5\"><input type=\"radio\" id=\"wpforms-2446-field_46_5\" class=\"wpforms-payment-price\" data-amount=\"5.00\" name=\"wpforms[fields][46]\" value=\"5\" aria-errormessage=\"wpforms-2446-field_46_5-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_46_5\">\u975e\u5e38\u540c\u610f<\/label><\/li><\/ul><\/fieldset><\/div>\t\t<div id=\"wpforms-2446-field_1-container\"\n\t\t\tclass=\"wpforms-field wpforms-field-text\"\n\t\t\tdata-field-type=\"text\"\n\t\t\tdata-field-id=\"1\"\n\t\t\t>\n\t\t\t<label class=\"wpforms-field-label\" for=\"wpforms-2446-field_1\" >Part \u9047\u5230\u554f\u984c\u6642\uff0c\u6211\u5011\u6703\u4e00\u8d77\u60f3\u8fa6\u6cd5\u89e3\u6c7a\uff0c\u800c\u4e0d\u662f\u4e92\u76f8\u6307\u8cac\u3002 \u9019\u6bb5\u95dc\u4fc2\u7b26\u5408\u6211\u539f\u672c\u5c0d\u89aa\u5bc6\u95dc\u4fc2\u7684\u671f\u5f85\u3002<\/label>\n\t\t\t<input type=\"text\" id=\"wpforms-2446-field_1\" class=\"wpforms-field-medium\" name=\"wpforms[fields][1]\" >\n\t\t<\/div>\n\t\t<div id=\"wpforms-2446-field_47-container\" class=\"wpforms-field wpforms-field-payment-multiple wpforms-list-inline\" data-field-type=\"payment-multiple\" data-field-id=\"47\"><fieldset><legend class=\"wpforms-field-label\">11) \u7576\u4f34\u4fb6\u60f3\u8981\u66f4\u89aa\u8fd1\u6211\u6642\uff0c\u6211\u6703\u611f\u5230\u4e0d\u81ea\u5728\uff0c\u60f3\u4fdd\u6301\u8ddd\u96e2\u3002 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-2446-field_47\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"radio\" id=\"wpforms-2446-field_47_1\" class=\"wpforms-payment-price\" data-amount=\"1.00\" name=\"wpforms[fields][47]\" value=\"1\" aria-errormessage=\"wpforms-2446-field_47_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_47_1\">\u975e\u5e38\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-2\"><input type=\"radio\" id=\"wpforms-2446-field_47_2\" class=\"wpforms-payment-price\" data-amount=\"2.00\" name=\"wpforms[fields][47]\" value=\"2\" aria-errormessage=\"wpforms-2446-field_47_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_47_2\">\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-3\"><input type=\"radio\" id=\"wpforms-2446-field_47_3\" class=\"wpforms-payment-price\" data-amount=\"3.00\" name=\"wpforms[fields][47]\" value=\"3\" aria-errormessage=\"wpforms-2446-field_47_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_47_3\">\u666e\u901a<\/label><\/li><li class=\"choice-4\"><input type=\"radio\" id=\"wpforms-2446-field_47_4\" class=\"wpforms-payment-price\" data-amount=\"4.00\" name=\"wpforms[fields][47]\" value=\"4\" aria-errormessage=\"wpforms-2446-field_47_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_47_4\">\u540c\u610f<\/label><\/li><li class=\"choice-5\"><input type=\"radio\" id=\"wpforms-2446-field_47_5\" class=\"wpforms-payment-price\" data-amount=\"5.00\" name=\"wpforms[fields][47]\" value=\"5\" aria-errormessage=\"wpforms-2446-field_47_5-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_47_5\">\u975e\u5e38\u540c\u610f<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-2446-field_48-container\" class=\"wpforms-field wpforms-field-payment-multiple wpforms-list-inline\" data-field-type=\"payment-multiple\" data-field-id=\"48\"><fieldset><legend class=\"wpforms-field-label\">12) \u6211\u50be\u5411\u7368\u81ea\u8655\u7406\u81ea\u5df1\u7684\u60c5\u7dd2\uff0c\u8f03\u5c11\u4f9d\u8cf4\u4f34\u4fb6\u3002 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-2446-field_48\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"radio\" id=\"wpforms-2446-field_48_1\" class=\"wpforms-payment-price\" data-amount=\"1.00\" name=\"wpforms[fields][48]\" value=\"1\" aria-errormessage=\"wpforms-2446-field_48_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_48_1\">\u975e\u5e38\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-2\"><input type=\"radio\" id=\"wpforms-2446-field_48_2\" class=\"wpforms-payment-price\" data-amount=\"2.00\" name=\"wpforms[fields][48]\" value=\"2\" aria-errormessage=\"wpforms-2446-field_48_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_48_2\">\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-3\"><input type=\"radio\" id=\"wpforms-2446-field_48_3\" class=\"wpforms-payment-price\" data-amount=\"3.00\" name=\"wpforms[fields][48]\" value=\"3\" aria-errormessage=\"wpforms-2446-field_48_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_48_3\">\u666e\u901a<\/label><\/li><li class=\"choice-4\"><input type=\"radio\" id=\"wpforms-2446-field_48_4\" class=\"wpforms-payment-price\" data-amount=\"4.00\" name=\"wpforms[fields][48]\" value=\"4\" aria-errormessage=\"wpforms-2446-field_48_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_48_4\">\u540c\u610f<\/label><\/li><li class=\"choice-5\"><input type=\"radio\" id=\"wpforms-2446-field_48_5\" class=\"wpforms-payment-price\" data-amount=\"5.00\" name=\"wpforms[fields][48]\" value=\"5\" aria-errormessage=\"wpforms-2446-field_48_5-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_48_5\">\u975e\u5e38\u540c\u610f<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-2446-field_52-container\" class=\"wpforms-field wpforms-field-payment-multiple wpforms-list-inline\" data-field-type=\"payment-multiple\" data-field-id=\"52\"><fieldset><legend class=\"wpforms-field-label\">13) \u6211\u89ba\u5f97\u592a\u89aa\u5bc6\u7684\u95dc\u4fc2\u6703\u8b93\u6211\u611f\u5230\u88ab\u675f\u7e1b\u3002 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-2446-field_52\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"radio\" id=\"wpforms-2446-field_52_1\" class=\"wpforms-payment-price\" data-amount=\"1.00\" name=\"wpforms[fields][52]\" value=\"1\" aria-errormessage=\"wpforms-2446-field_52_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_52_1\">\u975e\u5e38\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-2\"><input type=\"radio\" id=\"wpforms-2446-field_52_2\" class=\"wpforms-payment-price\" data-amount=\"2.00\" name=\"wpforms[fields][52]\" value=\"2\" aria-errormessage=\"wpforms-2446-field_52_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_52_2\">\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-3\"><input type=\"radio\" id=\"wpforms-2446-field_52_3\" class=\"wpforms-payment-price\" data-amount=\"3.00\" name=\"wpforms[fields][52]\" value=\"3\" aria-errormessage=\"wpforms-2446-field_52_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_52_3\">\u666e\u901a<\/label><\/li><li class=\"choice-4\"><input type=\"radio\" id=\"wpforms-2446-field_52_4\" class=\"wpforms-payment-price\" data-amount=\"4.00\" name=\"wpforms[fields][52]\" value=\"4\" aria-errormessage=\"wpforms-2446-field_52_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_52_4\">\u540c\u610f<\/label><\/li><li class=\"choice-5\"><input type=\"radio\" id=\"wpforms-2446-field_52_5\" class=\"wpforms-payment-price\" data-amount=\"5.00\" name=\"wpforms[fields][52]\" value=\"5\" aria-errormessage=\"wpforms-2446-field_52_5-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_52_5\">\u975e\u5e38\u540c\u610f<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-2446-field_66-container\" class=\"wpforms-field wpforms-field-content\" data-field-type=\"content\" data-field-id=\"66\"><div id=\"wpforms-2446-field_66\" class=\"wpforms-field-large wpforms-field-row\" aria-errormessage=\"wpforms-2446-field_66-error\"><h4><strong>\u7b2c\u4e09\u90e8\u5206\uff1a\u6e9d\u901a\u6a21\u5f0f\uff08\u53c3\u8003 Communication Patterns Questionnaire \u7c21\u5f0f\u6982\u5ff5\uff09<\/strong><\/h4>\n<div class=\"wpforms-field-content-display-frontend-clear\"><\/div><\/div><\/div><div id=\"wpforms-2446-field_53-container\" class=\"wpforms-field wpforms-field-payment-multiple wpforms-list-inline\" data-field-type=\"payment-multiple\" data-field-id=\"53\"><fieldset><legend class=\"wpforms-field-label\">14) \u7576\u6211\u5011\u6709\u5206\u6b67\u6642\uff0c\u6211\u5011\u80fd\u7406\u6027\u8a0e\u8ad6\u800c\u975e\u722d\u5435\u3002 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-2446-field_53\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"radio\" id=\"wpforms-2446-field_53_1\" class=\"wpforms-payment-price\" data-amount=\"1.00\" name=\"wpforms[fields][53]\" value=\"1\" aria-errormessage=\"wpforms-2446-field_53_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_53_1\">\u975e\u5e38\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-2\"><input type=\"radio\" id=\"wpforms-2446-field_53_2\" class=\"wpforms-payment-price\" data-amount=\"2.00\" name=\"wpforms[fields][53]\" value=\"2\" aria-errormessage=\"wpforms-2446-field_53_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_53_2\">\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-3\"><input type=\"radio\" id=\"wpforms-2446-field_53_3\" class=\"wpforms-payment-price\" data-amount=\"3.00\" name=\"wpforms[fields][53]\" value=\"3\" aria-errormessage=\"wpforms-2446-field_53_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_53_3\">\u666e\u901a<\/label><\/li><li class=\"choice-4\"><input type=\"radio\" id=\"wpforms-2446-field_53_4\" class=\"wpforms-payment-price\" data-amount=\"4.00\" name=\"wpforms[fields][53]\" value=\"4\" aria-errormessage=\"wpforms-2446-field_53_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_53_4\">\u540c\u610f<\/label><\/li><li class=\"choice-5\"><input type=\"radio\" id=\"wpforms-2446-field_53_5\" class=\"wpforms-payment-price\" data-amount=\"5.00\" name=\"wpforms[fields][53]\" value=\"5\" aria-errormessage=\"wpforms-2446-field_53_5-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_53_5\">\u975e\u5e38\u540c\u610f<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-2446-field_54-container\" class=\"wpforms-field wpforms-field-payment-multiple wpforms-list-inline\" data-field-type=\"payment-multiple\" data-field-id=\"54\"><fieldset><legend class=\"wpforms-field-label\">15) \u6211\u89ba\u5f97\u4f34\u4fb6\u9858\u610f\u8046\u807d\u6211\u7684\u60f3\u6cd5\u8207\u611f\u53d7\u3002 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-2446-field_54\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"radio\" id=\"wpforms-2446-field_54_1\" class=\"wpforms-payment-price\" data-amount=\"1.00\" name=\"wpforms[fields][54]\" value=\"1\" aria-errormessage=\"wpforms-2446-field_54_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_54_1\">\u975e\u5e38\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-2\"><input type=\"radio\" id=\"wpforms-2446-field_54_2\" class=\"wpforms-payment-price\" data-amount=\"2.00\" name=\"wpforms[fields][54]\" value=\"2\" aria-errormessage=\"wpforms-2446-field_54_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_54_2\">\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-3\"><input type=\"radio\" id=\"wpforms-2446-field_54_3\" class=\"wpforms-payment-price\" data-amount=\"3.00\" name=\"wpforms[fields][54]\" value=\"3\" aria-errormessage=\"wpforms-2446-field_54_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_54_3\">\u666e\u901a<\/label><\/li><li class=\"choice-4\"><input type=\"radio\" id=\"wpforms-2446-field_54_4\" class=\"wpforms-payment-price\" data-amount=\"4.00\" name=\"wpforms[fields][54]\" value=\"4\" aria-errormessage=\"wpforms-2446-field_54_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_54_4\">\u540c\u610f<\/label><\/li><li class=\"choice-5\"><input type=\"radio\" id=\"wpforms-2446-field_54_5\" class=\"wpforms-payment-price\" data-amount=\"5.00\" name=\"wpforms[fields][54]\" value=\"5\" aria-errormessage=\"wpforms-2446-field_54_5-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_54_5\">\u975e\u5e38\u540c\u610f<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-2446-field_55-container\" class=\"wpforms-field wpforms-field-payment-multiple wpforms-list-inline\" data-field-type=\"payment-multiple\" data-field-id=\"55\"><fieldset><legend class=\"wpforms-field-label\">16) \u9047\u5230\u554f\u984c\u6642\uff0c\u6211\u5011\u6703\u4e00\u8d77\u60f3\u8fa6\u6cd5\u89e3\u6c7a\uff0c\u800c\u4e0d\u662f\u4e92\u76f8\u6307\u8cac\u3002 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-2446-field_55\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"radio\" id=\"wpforms-2446-field_55_1\" class=\"wpforms-payment-price\" data-amount=\"1.00\" name=\"wpforms[fields][55]\" value=\"1\" aria-errormessage=\"wpforms-2446-field_55_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_55_1\">\u975e\u5e38\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-2\"><input type=\"radio\" id=\"wpforms-2446-field_55_2\" class=\"wpforms-payment-price\" data-amount=\"2.00\" name=\"wpforms[fields][55]\" value=\"2\" aria-errormessage=\"wpforms-2446-field_55_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_55_2\">\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-3\"><input type=\"radio\" id=\"wpforms-2446-field_55_3\" class=\"wpforms-payment-price\" data-amount=\"3.00\" name=\"wpforms[fields][55]\" value=\"3\" aria-errormessage=\"wpforms-2446-field_55_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_55_3\">\u666e\u901a<\/label><\/li><li class=\"choice-4\"><input type=\"radio\" id=\"wpforms-2446-field_55_4\" class=\"wpforms-payment-price\" data-amount=\"4.00\" name=\"wpforms[fields][55]\" value=\"4\" aria-errormessage=\"wpforms-2446-field_55_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_55_4\">\u540c\u610f<\/label><\/li><li class=\"choice-5\"><input type=\"radio\" id=\"wpforms-2446-field_55_5\" class=\"wpforms-payment-price\" data-amount=\"5.00\" name=\"wpforms[fields][55]\" value=\"5\" aria-errormessage=\"wpforms-2446-field_55_5-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_55_5\">\u975e\u5e38\u540c\u610f<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-2446-field_56-container\" class=\"wpforms-field wpforms-field-payment-multiple wpforms-list-inline\" data-field-type=\"payment-multiple\" data-field-id=\"56\"><fieldset><legend class=\"wpforms-field-label\">17) \u6211\u53ef\u4ee5\u81ea\u5728\u5730\u5411\u4f34\u4fb6\u8868\u9054\u4e0d\u6eff\uff0c\u800c\u4e0d\u6015\u95dc\u4fc2\u56e0\u6b64\u53d7\u640d\u3002 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-2446-field_56\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"radio\" id=\"wpforms-2446-field_56_1\" class=\"wpforms-payment-price\" data-amount=\"1.00\" name=\"wpforms[fields][56]\" value=\"1\" aria-errormessage=\"wpforms-2446-field_56_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_56_1\">\u975e\u5e38\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-2\"><input type=\"radio\" id=\"wpforms-2446-field_56_2\" class=\"wpforms-payment-price\" data-amount=\"2.00\" name=\"wpforms[fields][56]\" value=\"2\" aria-errormessage=\"wpforms-2446-field_56_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_56_2\">\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-3\"><input type=\"radio\" id=\"wpforms-2446-field_56_3\" class=\"wpforms-payment-price\" data-amount=\"3.00\" name=\"wpforms[fields][56]\" value=\"3\" aria-errormessage=\"wpforms-2446-field_56_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_56_3\">\u666e\u901a<\/label><\/li><li class=\"choice-4\"><input type=\"radio\" id=\"wpforms-2446-field_56_4\" class=\"wpforms-payment-price\" data-amount=\"4.00\" name=\"wpforms[fields][56]\" value=\"4\" aria-errormessage=\"wpforms-2446-field_56_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_56_4\">\u540c\u610f<\/label><\/li><li class=\"choice-5\"><input type=\"radio\" id=\"wpforms-2446-field_56_5\" class=\"wpforms-payment-price\" data-amount=\"5.00\" name=\"wpforms[fields][56]\" value=\"5\" aria-errormessage=\"wpforms-2446-field_56_5-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_56_5\">\u975e\u5e38\u540c\u610f<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-2446-field_57-container\" class=\"wpforms-field wpforms-field-payment-multiple wpforms-list-inline\" data-field-type=\"payment-multiple\" data-field-id=\"57\"><fieldset><legend class=\"wpforms-field-label\">18) \u6211\u5011\u5435\u67b6\u5f8c\uff0c\u901a\u5e38\u80fd\u5920\u548c\u597d\u4e26\u6062\u5fa9\u6b63\u5e38\u6e9d\u901a\u3002 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-2446-field_57\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"radio\" id=\"wpforms-2446-field_57_1\" class=\"wpforms-payment-price\" data-amount=\"1.00\" name=\"wpforms[fields][57]\" value=\"1\" aria-errormessage=\"wpforms-2446-field_57_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_57_1\">\u975e\u5e38\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-2\"><input type=\"radio\" id=\"wpforms-2446-field_57_2\" class=\"wpforms-payment-price\" data-amount=\"2.00\" name=\"wpforms[fields][57]\" value=\"2\" aria-errormessage=\"wpforms-2446-field_57_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_57_2\">\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-3\"><input type=\"radio\" id=\"wpforms-2446-field_57_3\" class=\"wpforms-payment-price\" data-amount=\"3.00\" name=\"wpforms[fields][57]\" value=\"3\" aria-errormessage=\"wpforms-2446-field_57_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_57_3\">\u666e\u901a<\/label><\/li><li class=\"choice-4\"><input type=\"radio\" id=\"wpforms-2446-field_57_4\" class=\"wpforms-payment-price\" data-amount=\"4.00\" name=\"wpforms[fields][57]\" value=\"4\" aria-errormessage=\"wpforms-2446-field_57_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_57_4\">\u540c\u610f<\/label><\/li><li class=\"choice-5\"><input type=\"radio\" id=\"wpforms-2446-field_57_5\" class=\"wpforms-payment-price\" data-amount=\"5.00\" name=\"wpforms[fields][57]\" value=\"5\" aria-errormessage=\"wpforms-2446-field_57_5-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_57_5\">\u975e\u5e38\u540c\u610f<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-2446-field_61-container\" class=\"wpforms-field wpforms-field-payment-multiple wpforms-list-inline\" data-field-type=\"payment-multiple\" data-field-id=\"61\"><fieldset><legend class=\"wpforms-field-label\">19) \u5728\u722d\u57f7\u4e2d\uff0c\u6211\u5011\u5f88\u5c11\u51fa\u73fe\u51b7\u6230\u6216\u8ff4\u907f\u6e9d\u901a\u7684\u60c5\u6cc1\u3002 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-2446-field_61\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"radio\" id=\"wpforms-2446-field_61_1\" class=\"wpforms-payment-price\" data-amount=\"1.00\" name=\"wpforms[fields][61]\" value=\"1\" aria-errormessage=\"wpforms-2446-field_61_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_61_1\">\u975e\u5e38\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-2\"><input type=\"radio\" id=\"wpforms-2446-field_61_2\" class=\"wpforms-payment-price\" data-amount=\"2.00\" name=\"wpforms[fields][61]\" value=\"2\" aria-errormessage=\"wpforms-2446-field_61_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_61_2\">\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-3\"><input type=\"radio\" id=\"wpforms-2446-field_61_3\" class=\"wpforms-payment-price\" data-amount=\"3.00\" name=\"wpforms[fields][61]\" value=\"3\" aria-errormessage=\"wpforms-2446-field_61_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_61_3\">\u666e\u901a<\/label><\/li><li class=\"choice-4\"><input type=\"radio\" id=\"wpforms-2446-field_61_4\" class=\"wpforms-payment-price\" data-amount=\"4.00\" name=\"wpforms[fields][61]\" value=\"4\" aria-errormessage=\"wpforms-2446-field_61_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_61_4\">\u540c\u610f<\/label><\/li><li class=\"choice-5\"><input type=\"radio\" id=\"wpforms-2446-field_61_5\" class=\"wpforms-payment-price\" data-amount=\"5.00\" name=\"wpforms[fields][61]\" value=\"5\" aria-errormessage=\"wpforms-2446-field_61_5-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_61_5\">\u975e\u5e38\u540c\u610f<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-2446-field_62-container\" class=\"wpforms-field wpforms-field-payment-multiple wpforms-list-inline\" data-field-type=\"payment-multiple\" data-field-id=\"62\"><fieldset><legend class=\"wpforms-field-label\">20) \u4f34\u4fb6\u5f88\u5c11\u7528\u6279\u8a55\u6216\u8f15\u8996\u7684\u8a9e\u6c23\u8ddf\u6211\u8aaa\u8a71\u3002 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-2446-field_62\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"radio\" id=\"wpforms-2446-field_62_1\" class=\"wpforms-payment-price\" data-amount=\"1.00\" name=\"wpforms[fields][62]\" value=\"1\" aria-errormessage=\"wpforms-2446-field_62_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_62_1\">\u975e\u5e38\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-2\"><input type=\"radio\" id=\"wpforms-2446-field_62_2\" class=\"wpforms-payment-price\" data-amount=\"2.00\" name=\"wpforms[fields][62]\" value=\"2\" aria-errormessage=\"wpforms-2446-field_62_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_62_2\">\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-3\"><input type=\"radio\" id=\"wpforms-2446-field_62_3\" class=\"wpforms-payment-price\" data-amount=\"3.00\" name=\"wpforms[fields][62]\" value=\"3\" aria-errormessage=\"wpforms-2446-field_62_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_62_3\">\u666e\u901a<\/label><\/li><li class=\"choice-4\"><input type=\"radio\" id=\"wpforms-2446-field_62_4\" class=\"wpforms-payment-price\" data-amount=\"4.00\" name=\"wpforms[fields][62]\" value=\"4\" aria-errormessage=\"wpforms-2446-field_62_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_62_4\">\u540c\u610f<\/label><\/li><li class=\"choice-5\"><input type=\"radio\" id=\"wpforms-2446-field_62_5\" class=\"wpforms-payment-price\" data-amount=\"5.00\" name=\"wpforms[fields][62]\" value=\"5\" aria-errormessage=\"wpforms-2446-field_62_5-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_62_5\">\u975e\u5e38\u540c\u610f<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-2446-field_63-container\" class=\"wpforms-field wpforms-field-payment-multiple wpforms-list-inline\" data-field-type=\"payment-multiple\" data-field-id=\"63\"><fieldset><legend class=\"wpforms-field-label\">21) \u6211\u89ba\u5f97\u8ddf\u4f34\u4fb6\u6e9d\u901a\u5f8c\uff0c\u554f\u984c\u901a\u5e38\u6709\u88ab\u89e3\u6c7a\u6216\u6539\u5584\u3002 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-2446-field_63\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"radio\" id=\"wpforms-2446-field_63_1\" class=\"wpforms-payment-price\" data-amount=\"1.00\" name=\"wpforms[fields][63]\" value=\"1\" aria-errormessage=\"wpforms-2446-field_63_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_63_1\">\u975e\u5e38\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-2\"><input type=\"radio\" id=\"wpforms-2446-field_63_2\" class=\"wpforms-payment-price\" data-amount=\"2.00\" name=\"wpforms[fields][63]\" value=\"2\" aria-errormessage=\"wpforms-2446-field_63_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_63_2\">\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-3\"><input type=\"radio\" id=\"wpforms-2446-field_63_3\" class=\"wpforms-payment-price\" data-amount=\"3.00\" name=\"wpforms[fields][63]\" value=\"3\" aria-errormessage=\"wpforms-2446-field_63_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_63_3\">\u666e\u901a<\/label><\/li><li class=\"choice-4\"><input type=\"radio\" id=\"wpforms-2446-field_63_4\" class=\"wpforms-payment-price\" data-amount=\"4.00\" name=\"wpforms[fields][63]\" value=\"4\" aria-errormessage=\"wpforms-2446-field_63_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_63_4\">\u540c\u610f<\/label><\/li><li class=\"choice-5\"><input type=\"radio\" id=\"wpforms-2446-field_63_5\" class=\"wpforms-payment-price\" data-amount=\"5.00\" name=\"wpforms[fields][63]\" value=\"5\" aria-errormessage=\"wpforms-2446-field_63_5-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_63_5\">\u975e\u5e38\u540c\u610f<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-2446-field_64-container\" class=\"wpforms-field wpforms-field-payment-multiple wpforms-list-inline\" data-field-type=\"payment-multiple\" data-field-id=\"64\"><fieldset><legend class=\"wpforms-field-label\">22) \u6574\u9ad4\u4f86\u8aaa\uff0c\u6211\u5c0d\u6211\u5011\u4e4b\u9593\u7684\u6e9d\u901a\u65b9\u5f0f\u611f\u5230\u6eff\u610f\u3002 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-2446-field_64\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"radio\" id=\"wpforms-2446-field_64_1\" class=\"wpforms-payment-price\" data-amount=\"1.00\" name=\"wpforms[fields][64]\" value=\"1\" aria-errormessage=\"wpforms-2446-field_64_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_64_1\">\u975e\u5e38\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-2\"><input type=\"radio\" id=\"wpforms-2446-field_64_2\" class=\"wpforms-payment-price\" data-amount=\"2.00\" name=\"wpforms[fields][64]\" value=\"2\" aria-errormessage=\"wpforms-2446-field_64_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_64_2\">\u4e0d\u540c\u610f<\/label><\/li><li class=\"choice-3\"><input type=\"radio\" id=\"wpforms-2446-field_64_3\" class=\"wpforms-payment-price\" data-amount=\"3.00\" name=\"wpforms[fields][64]\" value=\"3\" aria-errormessage=\"wpforms-2446-field_64_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_64_3\">\u666e\u901a<\/label><\/li><li class=\"choice-4\"><input type=\"radio\" id=\"wpforms-2446-field_64_4\" class=\"wpforms-payment-price\" data-amount=\"4.00\" name=\"wpforms[fields][64]\" value=\"4\" aria-errormessage=\"wpforms-2446-field_64_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_64_4\">\u540c\u610f<\/label><\/li><li class=\"choice-5\"><input type=\"radio\" id=\"wpforms-2446-field_64_5\" class=\"wpforms-payment-price\" data-amount=\"5.00\" name=\"wpforms[fields][64]\" value=\"5\" aria-errormessage=\"wpforms-2446-field_64_5-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2446-field_64_5\">\u975e\u5e38\u540c\u610f<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-2446-field_23-container\" class=\"wpforms-field wpforms-field-layout\" data-field-type=\"layout\" data-field-id=\"23\"><div class=\"wpforms-field-layout-rows wpforms-field-large\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-2446-field_24-container\" class=\"wpforms-field wpforms-field-hidden wpforms-calculations-field\" data-field-type=\"hidden\" data-field-id=\"24\"><input type=\"hidden\" id=\"wpforms-2446-field_24\" name=\"wpforms[fields][24]\"><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-2446-field_25-container\" class=\"wpforms-field wpforms-field-hidden wpforms-calculations-field\" data-field-type=\"hidden\" data-field-id=\"25\"><input type=\"hidden\" id=\"wpforms-2446-field_25\" name=\"wpforms[fields][25]\"><\/div><\/div><\/div><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-2446-field_69-container\" class=\"wpforms-field wpforms-field-hidden wpforms-calculations-field\" data-field-type=\"hidden\" data-field-id=\"69\"><input type=\"hidden\" id=\"wpforms-2446-field_69\" name=\"wpforms[fields][69]\"><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-50\"><\/div><\/div><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-2446-field_70-container\" class=\"wpforms-field wpforms-field-hidden wpforms-calculations-field\" data-field-type=\"hidden\" data-field-id=\"70\"><input type=\"hidden\" id=\"wpforms-2446-field_70\" name=\"wpforms[fields][70]\"><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-50\"><\/div><\/div><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column 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