{"id":122,"date":"2025-05-05T19:45:28","date_gmt":"2025-05-05T19:45:28","guid":{"rendered":"https:\/\/greenapple.cgehmlich.madisonwebclass.com\/?page_id=122"},"modified":"2025-05-15T22:32:05","modified_gmt":"2025-05-15T22:32:05","slug":"forms","status":"publish","type":"page","link":"https:\/\/greenapple.cgehmlich.madisonwebclass.com\/index.php\/forms\/","title":{"rendered":"Forms"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"122\" class=\"elementor elementor-122\">\n\t\t\t\t<div class=\"aux-parallax-section elementor-element elementor-element-34bf3a4 animated-slow e-flex e-con-boxed elementor-invisible e-con e-parent\" data-id=\"34bf3a4\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;animation&quot;:&quot;fadeIn&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c59d25f elementor-invisible elementor-widget elementor-widget-heading\" data-id=\"c59d25f\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;slideInLeft&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Forms<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"aux-parallax-section elementor-element elementor-element-ac418c3 e-flex e-con-boxed e-con e-parent\" data-id=\"ac418c3\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-846753a e-con-full e-flex elementor-invisible e-con e-child\" data-id=\"846753a\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;animation&quot;:&quot;slideInLeft&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-251c282 elementor-widget elementor-widget-text-editor\" data-id=\"251c282\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h2><a href=\"https:\/\/greenapple.cgehmlich.madisonwebclass.com\/wp-content\/uploads\/2025\/05\/FORMS-Mental-Health-Packet.pdf\" target=\"_blank\" rel=\"noopener\">Mental Health Packet<\/a><\/h2>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-c97bf5c e-con-full e-flex elementor-invisible e-con e-child\" data-id=\"c97bf5c\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;animation&quot;:&quot;slideInLeft&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-92f7b49 elementor-widget elementor-widget-text-editor\" data-id=\"92f7b49\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h2><a href=\"https:\/\/greenapple.cgehmlich.madisonwebclass.com\/wp-content\/uploads\/2025\/05\/FORMS-Mental-Health-SUD-Packet.pdf\" target=\"_blank\" rel=\"noopener\">Mental Health SUD Packet<\/a><\/h2>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-a26c57d e-con-full e-flex elementor-invisible e-con e-child\" data-id=\"a26c57d\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;animation&quot;:&quot;slideInLeft&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-478617c elementor-widget elementor-widget-text-editor\" data-id=\"478617c\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h2><a href=\"https:\/\/greenapple.cgehmlich.madisonwebclass.com\/wp-content\/uploads\/2025\/05\/FORMS-Prime-4-Life-Packet.pdf\" target=\"_blank\" rel=\"noopener\">Prime for Life Packet<\/a><\/h2>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-9e805be e-con-full e-flex elementor-invisible e-con e-child\" data-id=\"9e805be\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;animation&quot;:&quot;slideInLeft&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-53944f8 elementor-widget elementor-widget-text-editor\" data-id=\"53944f8\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h2><a href=\"https:\/\/greenapple.cgehmlich.madisonwebclass.com\/wp-content\/uploads\/2025\/05\/FORMS-Release-of-Information.pdf\" target=\"_blank\" rel=\"noopener\">Release of Information Form<\/a><\/h2>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"aux-parallax-section elementor-element elementor-element-99207e2 e-flex e-con-boxed e-con e-parent\" data-id=\"99207e2\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-13b723a e-con-full e-flex e-con e-child\" data-id=\"13b723a\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-ff33c3d elementor-widget elementor-widget-text-editor\" data-id=\"ff33c3d\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h2>Form Process Steps<\/h2><ul><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Fill out form<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Bring in to one of the locations<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Green Apple will screen for services and schedule an appointment<\/span><\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f8dbfab elementor-widget elementor-widget-formidable\" data-id=\"f8dbfab\" data-element_type=\"widget\" data-widget_type=\"formidable.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"frm_forms  with_frm_style frm_style_formidable-style\" id=\"frm_form_2_container\" data-token=\"d65e1879dbf1f4ea812bbd8db0762005\">\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form \" id=\"form_grievance-report\" data-token=\"d65e1879dbf1f4ea812bbd8db0762005\">\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_screen_reader\">Grievance Report<\/legend>\n<h3 class=\"frm_form_title\">Grievance Report<\/h3>\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"2\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_2\" id=\"frm_hide_fields_2\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"grievance-report\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_2\" name=\"frm_submit_entry_2\" value=\"264e163c06\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index.php\/wp-json\/wp\/v2\/pages\/122\" \/><div id=\"frm_field_7_container\" class=\"frm_form_field form-field  frm_top_container frm6 frm_first\">\n\t<div  id=\"field_frq54_label\" class=\"frm_primary_label\">Name of Grievant\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n\t<\/div>\n\t<fieldset aria-labelledby=\"field_frq54_label\">\n\t<legend class=\"frm_screen_reader frm_hidden\">\n\t\tName of Grievant\t<\/legend>\n\n\t<div  class=\"frm_combo_inputs_container\" id=\"frm_combo_inputs_container_7\" data-name-layout=\"first_last\">\n\t\t\t\t\t<div\n\t\t\t\tid=\"frm_field_7-first_container\"\n\t\t\t\tclass=\"frm_form_field form-field frm_form_subfield-first  frm6\"\n\t\t\t\tdata-sub-field-name=\"first\"\n\t\t\t>\n\t\t\t\t<label for=\"field_frq54_first\" class=\"frm_screen_reader frm_hidden\">\n\t\t\t\t\tFirst Name\t\t\t\t<\/label>\n\n\t\t\t\t\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"text\"\n\t\t\t\t\t\t\tid=\"field_frq54_first\"\n\t\t\t\t\t\t\tvalue=\"\"\n\t\t\t\t\t\t\tname=\"item_meta[7][first]\"  data-invmsg=\"Name of Grievant is invalid\" aria-invalid=\"false\"  \t\t\t\t\t\t\/>\n\t\t\t\t\t\t<div class=\"frm_description\" id=\"frm_field_7_first_desc\">First Name<\/div>\t\t\t<\/div>\n\t\t\t\t\t\t<div\n\t\t\t\tid=\"frm_field_7-last_container\"\n\t\t\t\tclass=\"frm_form_field form-field frm_form_subfield-last  frm6\"\n\t\t\t\tdata-sub-field-name=\"last\"\n\t\t\t>\n\t\t\t\t<label for=\"field_frq54_last\" class=\"frm_screen_reader frm_hidden\">\n\t\t\t\t\tLast Name\t\t\t\t<\/label>\n\n\t\t\t\t\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"text\"\n\t\t\t\t\t\t\tid=\"field_frq54_last\"\n\t\t\t\t\t\t\tvalue=\"\"\n\t\t\t\t\t\t\tname=\"item_meta[7][last]\"  data-invmsg=\"Name of Grievant is invalid\" aria-invalid=\"false\"  \t\t\t\t\t\t\/>\n\t\t\t\t\t\t<div class=\"frm_description\" id=\"frm_field_7_last_desc\">Last Name<\/div>\t\t\t<\/div>\n\t\t\t\t<\/div>\n<\/fieldset>\n\n\t\n\t\n<\/div>\n<div id=\"frm_field_8_container\" class=\"frm_form_field form-field  frm_top_container frm6\">\n\t<label for=\"field_13fpz\" id=\"field_13fpz_label\" class=\"frm_primary_label\">Date of Grievence (MM\/DD\/YYYY)\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n\t<\/label>\n\t<input type=\"text\" id=\"field_13fpz\" name=\"item_meta[8]\" value=\"\"  data-invmsg=\"Date of Grievence (MM\/DD\/YYYY) is invalid\" aria-invalid=\"false\"  \/>\n\t\n\t\n<\/div>\n<div id=\"frm_field_9_container\" class=\"frm_form_field form-field  frm_top_container frm6 frm_first\">\n\t<div  id=\"field_vvj37_label\" class=\"frm_primary_label\">Client of Green Apple\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n\t<\/div>\n\t<fieldset aria-labelledby=\"field_vvj37_label\">\n\t<legend class=\"frm_screen_reader frm_hidden\">\n\t\tClient of Green Apple\t<\/legend>\n\n\t<div  class=\"frm_combo_inputs_container\" id=\"frm_combo_inputs_container_9\" data-name-layout=\"first_last\">\n\t\t\t\t\t<div\n\t\t\t\tid=\"frm_field_9-first_container\"\n\t\t\t\tclass=\"frm_form_field form-field frm_form_subfield-first  frm6\"\n\t\t\t\tdata-sub-field-name=\"first\"\n\t\t\t>\n\t\t\t\t<label for=\"field_vvj37_first\" class=\"frm_screen_reader frm_hidden\">\n\t\t\t\t\tFirst Name\t\t\t\t<\/label>\n\n\t\t\t\t\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"text\"\n\t\t\t\t\t\t\tid=\"field_vvj37_first\"\n\t\t\t\t\t\t\tvalue=\"\"\n\t\t\t\t\t\t\tname=\"item_meta[9][first]\"  data-invmsg=\"Client of Green Apple is invalid\" aria-invalid=\"false\"  \t\t\t\t\t\t\/>\n\t\t\t\t\t\t<div class=\"frm_description\" id=\"frm_field_9_first_desc\">First Name<\/div>\t\t\t<\/div>\n\t\t\t\t\t\t<div\n\t\t\t\tid=\"frm_field_9-last_container\"\n\t\t\t\tclass=\"frm_form_field form-field frm_form_subfield-last  frm6\"\n\t\t\t\tdata-sub-field-name=\"last\"\n\t\t\t>\n\t\t\t\t<label for=\"field_vvj37_last\" class=\"frm_screen_reader frm_hidden\">\n\t\t\t\t\tLast Name\t\t\t\t<\/label>\n\n\t\t\t\t\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"text\"\n\t\t\t\t\t\t\tid=\"field_vvj37_last\"\n\t\t\t\t\t\t\tvalue=\"\"\n\t\t\t\t\t\t\tname=\"item_meta[9][last]\"  data-invmsg=\"Client of Green Apple is invalid\" aria-invalid=\"false\"  \t\t\t\t\t\t\/>\n\t\t\t\t\t\t<div class=\"frm_description\" id=\"frm_field_9_last_desc\">Last Name<\/div>\t\t\t<\/div>\n\t\t\t\t<\/div>\n<\/fieldset>\n\n\t\n\t\n<\/div>\n<div id=\"frm_field_10_container\" class=\"frm_form_field form-field  frm_top_container frm6\">\n\t<label for=\"field_x1v5y\" id=\"field_x1v5y_label\" class=\"frm_primary_label\">Phone Number\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n\t<\/label>\n\t<input type=\"tel\" id=\"field_x1v5y\" name=\"item_meta[10]\" value=\"\"  data-invmsg=\"Phone Number is invalid\" aria-invalid=\"false\" pattern=\"((\\+\\d{1,3}(-|.| )?\\(?\\d\\)?(-| |.)?\\d{1,5})|(\\(?\\d{2,6}\\)?))(-|.| )?(\\d{3,4})(-|.| )?(\\d{4})(( x| ext)\\d{1,5}){0,1}$\"  \/>\n\t\n\t\n<\/div>\n<div id=\"frm_field_11_container\" class=\"frm_form_field form-field  frm_top_container\">\n\t<label for=\"field_xshhc\" id=\"field_xshhc_label\" class=\"frm_primary_label\">Statement of Grievence\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n\t<\/label>\n\t<input type=\"text\" id=\"field_xshhc\" name=\"item_meta[11]\" value=\"\"  data-invmsg=\"Statement of Grievence is invalid\" aria-invalid=\"false\"  \/>\n\t\n\t\n<\/div>\n<div id=\"frm_field_12_container\" class=\"frm_form_field form-field  frm_top_container\">\n\t<label for=\"field_sfh13\" id=\"field_sfh13_label\" class=\"frm_primary_label\">Relief Sought\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n\t<\/label>\n\t<input type=\"text\" id=\"field_sfh13\" name=\"item_meta[12]\" value=\"\"  data-invmsg=\"Relief Sought is invalid\" aria-invalid=\"false\"  \/>\n\t\n\t\n<\/div>\n<div id=\"frm_field_13_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_fourth vertical_radio\">\n\t<div  id=\"field_77k86_label\" class=\"frm_primary_label\">Request Meeting\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n\t<\/div>\n\t<div class=\"frm_opt_container\" aria-labelledby=\"field_77k86_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_13-0\">\t\t\t<label  for=\"field_77k86-0\">\n\t\t\t<input type=\"checkbox\" name=\"item_meta[13][]\" id=\"field_77k86-0\" value=\"Yes\"  data-invmsg=\"Request Meeting is invalid\" aria-invalid=\"false\"   \/> Yes<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_13-1\">\t\t\t<label  for=\"field_77k86-1\">\n\t\t\t<input type=\"checkbox\" name=\"item_meta[13][]\" id=\"field_77k86-1\" value=\"No\"  data-invmsg=\"Request Meeting is invalid\" aria-invalid=\"false\"   \/> No<\/label><\/div>\n<\/div>\n\t\n\t\n<\/div>\n<div id=\"frm_field_14_container\" class=\"frm_form_field form-field  frm_top_container frm6\">\n\t<label for=\"field_fckrz\" id=\"field_fckrz_label\" class=\"frm_primary_label\">Meeting Date (MM\/DD\/YYYY)\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n\t<\/label>\n\t<input type=\"text\" id=\"field_fckrz\" name=\"item_meta[14]\" value=\"\"  data-invmsg=\"Meeting Date (MM\/DD\/YYYY) is invalid\" aria-invalid=\"false\"  \/>\n\t\n\t\n<\/div>\n<div id=\"frm_field_15_container\" class=\"frm_form_field form-field  frm_top_container frm6 frm_first\">\n\t<div  id=\"field_uazfd_label\" class=\"frm_primary_label\">Grievance Signatures\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n\t<\/div>\n\t<fieldset aria-labelledby=\"field_uazfd_label\">\n\t<legend class=\"frm_screen_reader frm_hidden\">\n\t\tGrievance Signatures\t<\/legend>\n\n\t<div  class=\"frm_combo_inputs_container\" id=\"frm_combo_inputs_container_15\" data-name-layout=\"first_last\">\n\t\t\t\t\t<div\n\t\t\t\tid=\"frm_field_15-first_container\"\n\t\t\t\tclass=\"frm_form_field form-field frm_form_subfield-first  frm6\"\n\t\t\t\tdata-sub-field-name=\"first\"\n\t\t\t>\n\t\t\t\t<label for=\"field_uazfd_first\" class=\"frm_screen_reader frm_hidden\">\n\t\t\t\t\tFirst Name\t\t\t\t<\/label>\n\n\t\t\t\t\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"text\"\n\t\t\t\t\t\t\tid=\"field_uazfd_first\"\n\t\t\t\t\t\t\tvalue=\"\"\n\t\t\t\t\t\t\tname=\"item_meta[15][first]\"  data-invmsg=\"Grievance Signatures is invalid\" aria-invalid=\"false\"  \t\t\t\t\t\t\/>\n\t\t\t\t\t\t<div class=\"frm_description\" id=\"frm_field_15_first_desc\">First Name<\/div>\t\t\t<\/div>\n\t\t\t\t\t\t<div\n\t\t\t\tid=\"frm_field_15-last_container\"\n\t\t\t\tclass=\"frm_form_field form-field frm_form_subfield-last  frm6\"\n\t\t\t\tdata-sub-field-name=\"last\"\n\t\t\t>\n\t\t\t\t<label for=\"field_uazfd_last\" class=\"frm_screen_reader frm_hidden\">\n\t\t\t\t\tLast Name\t\t\t\t<\/label>\n\n\t\t\t\t\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"text\"\n\t\t\t\t\t\t\tid=\"field_uazfd_last\"\n\t\t\t\t\t\t\tvalue=\"\"\n\t\t\t\t\t\t\tname=\"item_meta[15][last]\"  data-invmsg=\"Grievance Signatures is invalid\" aria-invalid=\"false\"  \t\t\t\t\t\t\/>\n\t\t\t\t\t\t<div class=\"frm_description\" id=\"frm_field_15_last_desc\">Last Name<\/div>\t\t\t<\/div>\n\t\t\t\t<\/div>\n<\/fieldset>\n\n\t\n\t\n<\/div>\n<div id=\"frm_field_16_container\" class=\"frm_form_field form-field  frm_top_container frm6\">\n\t<label for=\"field_50klb\" id=\"field_50klb_label\" class=\"frm_primary_label\">Date (MM\/DD\/YYYY)\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n\t<\/label>\n\t<input type=\"text\" id=\"field_50klb\" name=\"item_meta[16]\" value=\"\"  data-invmsg=\"Date (MM\/DD\/YYYY) is invalid\" aria-invalid=\"false\"  \/>\n\t\n\t\n<\/div>\n<div id=\"frm_field_17_container\" class=\"frm_form_field form-field  frm_top_container frm6 frm_first\">\n\t<div  id=\"field_qdvdp_label\" class=\"frm_primary_label\">Recieved by\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n\t<\/div>\n\t<fieldset aria-labelledby=\"field_qdvdp_label\">\n\t<legend class=\"frm_screen_reader frm_hidden\">\n\t\tRecieved by\t<\/legend>\n\n\t<div  class=\"frm_combo_inputs_container\" id=\"frm_combo_inputs_container_17\" data-name-layout=\"first_last\">\n\t\t\t\t\t<div\n\t\t\t\tid=\"frm_field_17-first_container\"\n\t\t\t\tclass=\"frm_form_field form-field frm_form_subfield-first  frm6\"\n\t\t\t\tdata-sub-field-name=\"first\"\n\t\t\t>\n\t\t\t\t<label for=\"field_qdvdp_first\" class=\"frm_screen_reader frm_hidden\">\n\t\t\t\t\tFirst Name\t\t\t\t<\/label>\n\n\t\t\t\t\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"text\"\n\t\t\t\t\t\t\tid=\"field_qdvdp_first\"\n\t\t\t\t\t\t\tvalue=\"\"\n\t\t\t\t\t\t\tname=\"item_meta[17][first]\"  data-invmsg=\"Recieved by is invalid\" aria-invalid=\"false\"  \t\t\t\t\t\t\/>\n\t\t\t\t\t\t<div class=\"frm_description\" id=\"frm_field_17_first_desc\">First Name<\/div>\t\t\t<\/div>\n\t\t\t\t\t\t<div\n\t\t\t\tid=\"frm_field_17-last_container\"\n\t\t\t\tclass=\"frm_form_field form-field frm_form_subfield-last  frm6\"\n\t\t\t\tdata-sub-field-name=\"last\"\n\t\t\t>\n\t\t\t\t<label for=\"field_qdvdp_last\" class=\"frm_screen_reader frm_hidden\">\n\t\t\t\t\tLast Name\t\t\t\t<\/label>\n\n\t\t\t\t\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"text\"\n\t\t\t\t\t\t\tid=\"field_qdvdp_last\"\n\t\t\t\t\t\t\tvalue=\"\"\n\t\t\t\t\t\t\tname=\"item_meta[17][last]\"  data-invmsg=\"Recieved by is invalid\" aria-invalid=\"false\"  \t\t\t\t\t\t\/>\n\t\t\t\t\t\t<div class=\"frm_description\" id=\"frm_field_17_last_desc\">Last Name<\/div>\t\t\t<\/div>\n\t\t\t\t<\/div>\n<\/fieldset>\n\n\t\n\t\n<\/div>\n<div id=\"frm_field_18_container\" class=\"frm_form_field form-field  frm_top_container frm6\">\n\t<label for=\"field_hzaj1\" id=\"field_hzaj1_label\" class=\"frm_primary_label\">Date (MM\/DD\/YYYY)\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n\t<\/label>\n\t<input type=\"text\" id=\"field_hzaj1\" name=\"item_meta[18]\" value=\"\"  data-invmsg=\"Date (MM\/DD\/YYYY) is invalid\" aria-invalid=\"false\"  \/>\n\t\n\t\n<\/div>\n<div id=\"frm_field_20_container\" class=\"frm_form_field form-field  frm_top_container\">\n\t<label for=\"field_ossb3\" id=\"field_ossb3_label\" class=\"frm_primary_label\">Rectified\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n\t<\/label>\n\t<input type=\"text\" id=\"field_ossb3\" name=\"item_meta[20]\" value=\"\"  placeholder=\"Yes: Action Taken:\" data-invmsg=\"Rectified is invalid\" aria-invalid=\"false\"  \/>\n\t\n\t\n<\/div>\n<div id=\"frm_field_21_container\" class=\"frm_form_field form-field  frm_top_container\">\n\t<label for=\"field_nipnp\" id=\"field_nipnp_label\" class=\"frm_primary_label\">\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n\t<\/label>\n\t<input type=\"text\" id=\"field_nipnp\" name=\"item_meta[21]\" value=\"\"  placeholder=\"No: Action Needed\" data-invmsg=\"This field is invalid\" aria-invalid=\"false\"  \/>\n\t\n\t\n<\/div>\n<div id=\"frm_field_22_container\" class=\"frm_form_field form-field  frm_top_container frm6 frm_first\">\n\t<div  id=\"field_w53nr_label\" class=\"frm_primary_label\">Grievant Signature\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n\t<\/div>\n\t<fieldset aria-labelledby=\"field_w53nr_label\">\n\t<legend class=\"frm_screen_reader frm_hidden\">\n\t\tGrievant Signature\t<\/legend>\n\n\t<div  class=\"frm_combo_inputs_container\" id=\"frm_combo_inputs_container_22\" data-name-layout=\"first_last\">\n\t\t\t\t\t<div\n\t\t\t\tid=\"frm_field_22-first_container\"\n\t\t\t\tclass=\"frm_form_field form-field frm_form_subfield-first  frm6\"\n\t\t\t\tdata-sub-field-name=\"first\"\n\t\t\t>\n\t\t\t\t<label for=\"field_w53nr_first\" class=\"frm_screen_reader frm_hidden\">\n\t\t\t\t\tFirst Name\t\t\t\t<\/label>\n\n\t\t\t\t\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"text\"\n\t\t\t\t\t\t\tid=\"field_w53nr_first\"\n\t\t\t\t\t\t\tvalue=\"\"\n\t\t\t\t\t\t\tname=\"item_meta[22][first]\"  data-invmsg=\"Grievant Signature is invalid\" aria-invalid=\"false\"  \t\t\t\t\t\t\/>\n\t\t\t\t\t\t<div class=\"frm_description\" id=\"frm_field_22_first_desc\">First Name<\/div>\t\t\t<\/div>\n\t\t\t\t\t\t<div\n\t\t\t\tid=\"frm_field_22-last_container\"\n\t\t\t\tclass=\"frm_form_field form-field frm_form_subfield-last  frm6\"\n\t\t\t\tdata-sub-field-name=\"last\"\n\t\t\t>\n\t\t\t\t<label for=\"field_w53nr_last\" class=\"frm_screen_reader frm_hidden\">\n\t\t\t\t\tLast Name\t\t\t\t<\/label>\n\n\t\t\t\t\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"text\"\n\t\t\t\t\t\t\tid=\"field_w53nr_last\"\n\t\t\t\t\t\t\tvalue=\"\"\n\t\t\t\t\t\t\tname=\"item_meta[22][last]\"  data-invmsg=\"Grievant Signature is invalid\" aria-invalid=\"false\"  \t\t\t\t\t\t\/>\n\t\t\t\t\t\t<div class=\"frm_description\" id=\"frm_field_22_last_desc\">Last Name<\/div>\t\t\t<\/div>\n\t\t\t\t<\/div>\n<\/fieldset>\n\n\t\n\t\n<\/div>\n<div id=\"frm_field_23_container\" class=\"frm_form_field form-field  frm_top_container frm6\">\n\t<label for=\"field_vcbtl\" id=\"field_vcbtl_label\" class=\"frm_primary_label\">Date (MM\/DD\/YYYY)\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n\t<\/label>\n\t<input type=\"text\" id=\"field_vcbtl\" name=\"item_meta[23]\" value=\"\"  data-invmsg=\"Date (MM\/DD\/YYYY) is invalid\" aria-invalid=\"false\"  \/>\n\t\n\t\n<\/div>\n<div id=\"frm_field_24_container\" class=\"frm_form_field form-field  frm_top_container frm6 frm_first\">\n\t<div  id=\"field_cudmn_label\" class=\"frm_primary_label\">Green Apple Director\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n\t<\/div>\n\t<fieldset aria-labelledby=\"field_cudmn_label\">\n\t<legend class=\"frm_screen_reader frm_hidden\">\n\t\tGreen Apple Director\t<\/legend>\n\n\t<div  class=\"frm_combo_inputs_container\" id=\"frm_combo_inputs_container_24\" data-name-layout=\"first_last\">\n\t\t\t\t\t<div\n\t\t\t\tid=\"frm_field_24-first_container\"\n\t\t\t\tclass=\"frm_form_field form-field frm_form_subfield-first  frm6\"\n\t\t\t\tdata-sub-field-name=\"first\"\n\t\t\t>\n\t\t\t\t<label for=\"field_cudmn_first\" class=\"frm_screen_reader frm_hidden\">\n\t\t\t\t\tFirst Name\t\t\t\t<\/label>\n\n\t\t\t\t\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"text\"\n\t\t\t\t\t\t\tid=\"field_cudmn_first\"\n\t\t\t\t\t\t\tvalue=\"\"\n\t\t\t\t\t\t\tname=\"item_meta[24][first]\"  data-invmsg=\"Green Apple Director is invalid\" aria-invalid=\"false\"  \t\t\t\t\t\t\/>\n\t\t\t\t\t\t<div class=\"frm_description\" id=\"frm_field_24_first_desc\">First Name<\/div>\t\t\t<\/div>\n\t\t\t\t\t\t<div\n\t\t\t\tid=\"frm_field_24-last_container\"\n\t\t\t\tclass=\"frm_form_field form-field frm_form_subfield-last  frm6\"\n\t\t\t\tdata-sub-field-name=\"last\"\n\t\t\t>\n\t\t\t\t<label for=\"field_cudmn_last\" class=\"frm_screen_reader frm_hidden\">\n\t\t\t\t\tLast Name\t\t\t\t<\/label>\n\n\t\t\t\t\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"text\"\n\t\t\t\t\t\t\tid=\"field_cudmn_last\"\n\t\t\t\t\t\t\tvalue=\"\"\n\t\t\t\t\t\t\tname=\"item_meta[24][last]\"  data-invmsg=\"Green Apple Director is invalid\" aria-invalid=\"false\"  \t\t\t\t\t\t\/>\n\t\t\t\t\t\t<div class=\"frm_description\" id=\"frm_field_24_last_desc\">Last Name<\/div>\t\t\t<\/div>\n\t\t\t\t<\/div>\n<\/fieldset>\n\n\t\n\t\n<\/div>\n<div id=\"frm_field_25_container\" class=\"frm_form_field form-field  frm_top_container frm6\">\n\t<label for=\"field_c66q1\" id=\"field_c66q1_label\" class=\"frm_primary_label\">Date (MM\/DD\/YYYY)\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n\t<\/label>\n\t<input type=\"text\" id=\"field_c66q1\" name=\"item_meta[25]\" value=\"\"  data-invmsg=\"Date (MM\/DD\/YYYY) is invalid\" aria-invalid=\"false\"  \/>\n\t\n\t\n<\/div>\n<div id=\"frm_field_6_container\" class=\"frm_form_field form-field \">\n\t<div class=\"frm_submit frm_flex\">\n<button class=\"frm_button_submit\" type=\"submit\"  >Submit<\/button>\n\n\n\n<\/div>\n<\/div>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t\t\t\t<div class=\"frm__6813d4f92e01d\">\n\t\t\t\t<label for=\"frm_email_2\" >\n\t\t\t\t\tIf you are human, leave this field blank.\t\t\t\t<\/label>\n\t\t\t\t<input  id=\"frm_email_2\" type=\"text\" class=\"frm_verify\" name=\"frm__6813d4f92e01d\" value=\"\" autocomplete=\"off\"  \/>\n\t\t\t<\/div>\n\t\t<\/div>\n<\/fieldset>\n<\/div>\n\n<\/form>\n<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"aux-parallax-section elementor-element elementor-element-24dd37d e-flex e-con-boxed e-con e-parent\" data-id=\"24dd37d\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-15f94ed aux-appear-watch-animation aux-fade-in-up-1 e-con-full e-flex e-con e-child\" data-id=\"15f94ed\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-0989127 elementor-widget elementor-widget-text-editor\" data-id=\"0989127\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h5 class=\"font_5 wixui-rich-text__text\">If you have any questions about the forms, please call us at 406 866-0350<\/h5>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Forms Mental Health Packet Mental Health SUD Packet Prime for Life Packet Release of Information Form Form Process Steps Fill out form Bring in to one of the locations Green Apple will screen for services and schedule an appointment Grievance Report Grievance Report Name of Grievant Name of Grievant First Name First Name Last Name [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-122","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/greenapple.cgehmlich.madisonwebclass.com\/index.php\/wp-json\/wp\/v2\/pages\/122","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/greenapple.cgehmlich.madisonwebclass.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/greenapple.cgehmlich.madisonwebclass.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/greenapple.cgehmlich.madisonwebclass.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/greenapple.cgehmlich.madisonwebclass.com\/index.php\/wp-json\/wp\/v2\/comments?post=122"}],"version-history":[{"count":43,"href":"https:\/\/greenapple.cgehmlich.madisonwebclass.com\/index.php\/wp-json\/wp\/v2\/pages\/122\/revisions"}],"predecessor-version":[{"id":446,"href":"https:\/\/greenapple.cgehmlich.madisonwebclass.com\/index.php\/wp-json\/wp\/v2\/pages\/122\/revisions\/446"}],"wp:attachment":[{"href":"https:\/\/greenapple.cgehmlich.madisonwebclass.com\/index.php\/wp-json\/wp\/v2\/media?parent=122"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}