Feedback Form

Presented by Ohio Health

<script src="https://cdn.jotfor.ms/static/prototype.forms.js" type="text/javascript"></script><script src="https://cdn.jotfor.ms/static/jotform.forms.js?3.3.10813" type="text/javascript"></script><script type="text/javascript"> JotForm.setConditions([{"action":[{"id":"action_1453313951680","visibility":"Require","field":"78","isError":false}],"id":"1453313966652","index":"0","link":"Any","priority":"0","terms":[{"id":"term_1453313951680","field":"75","operator":"equals","value":"No","isError":false}],"type":"require"},{"action":[{"id":"action_1453313878625","visibility":"Require","field":"77","isError":false}],"id":"1453313897220","index":"1","link":"Any","priority":"1","terms":[{"id":"term_1453313878625","field":"76","operator":"equals","value":"No","isError":false}],"type":"require"},{"action":[{"id":"action_1453313131565","visibility":"Require","field":"73","isError":false}],"id":"1453313153656","index":"2","link":"Any","priority":"2","terms":[{"id":"term_1453313131565","field":"71","operator":"equals","value":"No","isError":false}],"type":"require"},{"action":[{"id":"action_1453308390915","visibility":"Require","field":"71","isError":false}],"id":"1453308439921","index":"3","link":"Any","priority":"3","terms":[{"id":"term_1453308390915","field":"70","operator":"equals","value":"Yes","isError":false}],"type":"require"}]); JotForm.init(function(){ setTimeout(function() { $(input_56).hint(ex: myname@example.com); }, 20); JotForm.setCustomHint( input_73, Why was it not useful/informative? What can we do to improve? ); JotForm.setCustomHint( input_78, What were you unsatisfied with? ); JotForm.clearFieldOnHide="disable"; JotForm.onSubmissionError="jumpToSubmit"; }); </script> <link href="https://cdn.jotfor.ms/static/formCss.css?3.3.10813" rel="stylesheet" type="text/css" /> <link href="https://cdn.jotfor.ms/css/printForm.css?3.3.10813" media="print" rel="stylesheet" type="text/css" /> <style type="text/css">.form-label-left{ width:150px !important; } .form-line{ padding-top:10px; padding-bottom:10px; } .form-label-right{ width:150px !important; } .form-all{ width:600px; color:Black !important; font-family:Verdana; font-size:12px; } .form-radio-item label, .form-checkbox-item label, .form-grading-label, .form-header{ color: Black; } </style> <link href="https://cdn.jotfor.ms/css/responsive.css?3.3.10813" rel="stylesheet" type="text/css" /> <form accept-charset="utf-8" action="https://submit.jotform.us/submit/60186243904151/" class="jotform-form" id="60186243904151" method="post" name="form_60186243904151"><input name="formID" type="hidden" value="60186243904151" /> <div class="form-all"> <ul class="form-section page-section"> <li class="form-line" data-type="control_image" id="id_57"> <div class="form-input-wide" id="cid_57">&nbsp;</div> </li> <li class="form-input-wide" data-type="control_head" id="cid_10"> <div class="form-header-group"> <div class="header-text httal htvam"> <h2 class="form-header" id="header_10">Camps/Training Programs Feedback Form</h2> <div class="form-subHeader" id="subHeader_10">We would love to hear from you! Please let us know what you thought about our Columbus Crew SC Camps. We appreciate every response!</div> </div> </div> </li> <li class="form-line jf-required" data-type="control_fullname" id="id_62"><label class="form-label form-label-left form-label-auto" for="input_62" id="label_62">Name <span class="form-required"> * </span> </label> <div class="form-input jf-required" id="cid_62"><span class="form-sub-label-container" style="vertical-align: top"><input class="form-textbox validate[required]" id="first_62" name="q62_name62[first]" size="10" type="text" /> <label class="form-sub-label" for="first_62" id="sublabel_first" style="min-height: 13px;"> First Name </label> </span> <span class="form-sub-label-container" style="vertical-align: top"> <input class="form-textbox validate[required]" id="last_62" name="q62_name62[last]" size="15" type="text" /> <label class="form-sub-label" for="last_62" id="sublabel_last" style="min-height: 13px;"> Last Name </label> </span></div> </li> <li class="form-line jf-required" data-type="control_textbox" id="id_1"><label class="form-label form-label-left form-label-auto" for="input_1" id="label_1">Child&#39;s Name <span class="form-required"> * </span> </label> <div class="form-input jf-required" id="cid_1"><input class="form-textbox validate[required]" data-type="input-textbox" id="input_1" name="q1_childsName" size="20" type="text" value="" /></div> </li> <li class="form-line jf-required" data-type="control_email" id="id_56"><label class="form-label form-label-left form-label-auto" for="input_56" id="label_56">E-mail <span class="form-required"> * </span> </label> <div class="form-input jf-required" id="cid_56"><input class="form-textbox validate[required, Email]" id="input_56" name="q56_email" size="30" type="email" value="" /></div> </li> <li class="form-line jf-required" data-type="control_textbox" id="id_63"><label class="form-label form-label-left form-label-auto" for="input_63" id="label_63">Camp/Training Program Attended <span class="form-required"> * </span> </label> <div class="form-input jf-required" id="cid_63"><input class="form-textbox validate[required]" data-type="input-textbox" id="input_63" name="q63_camptrainingProgram63" size="20" type="text" value="" /></div> </li> <li class="form-line jf-required" data-type="control_radio" id="id_70"><label class="form-label form-label-left form-label-auto" for="input_70" id="label_70">Are you on our camps mailing list? <span class="form-required"> * </span> </label> <div class="form-input jf-required" id="cid_70"> <div class="form-single-column"><span class="form-radio-item" style="clear:left;"><input class="form-radio validate[required]" id="input_70_0" name="q70_areYou" type="radio" value="Yes" /> <label for="input_70_0" id="label_input_70_0"> Yes </label> </span> <span class="form-radio-item" style="clear:left;"> <span class="dragger-item"> </span> <input class="form-radio validate[required]" id="input_70_1" name="q70_areYou" type="radio" value="No" /> <label for="input_70_1" id="label_input_70_1"> No </label> </span></div> </div> </li> <li class="form-line" data-type="control_radio" id="id_71"><label class="form-label form-label-left form-label-auto" for="input_71" id="label_71">Are the emails useful/informative? </label> <div class="form-input jf-required" id="cid_71"> <div class="form-single-column"><span class="form-radio-item" style="clear:left;"><input class="form-radio" id="input_71_0" name="q71_areThe" type="radio" value="Yes" /> <label for="input_71_0" id="label_input_71_0"> Yes </label> </span> <span class="form-radio-item" style="clear:left;"> <span class="dragger-item"> </span> <input class="form-radio" id="input_71_1" name="q71_areThe" type="radio" value="No" /> <label for="input_71_1" id="label_input_71_1"> No </label> </span></div> </div> </li> <li class="form-line" data-type="control_textarea" id="id_73"><label class="form-label form-label-left form-label-auto" for="input_73" id="label_73">If no, why? </label> <div class="form-input jf-required" id="cid_73"><textarea class="form-textarea" cols="40" id="input_73" name="q73_ifNo" rows="6"></textarea></div> </li> <li class="form-line jf-required" data-type="control_radio" id="id_72"><label class="form-label form-label-left form-label-auto" for="input_72" id="label_72">Is our camps website easy to navigate? <span class="form-required"> * </span> </label> <div class="form-input jf-required" id="cid_72"> <div class="form-single-column"><span class="form-radio-item" style="clear:left;"><input class="form-radio validate[required]" id="input_72_0" name="q72_isOur" type="radio" value="Yes" /> <label for="input_72_0" id="label_input_72_0"> Yes </label> </span> <span class="form-radio-item" style="clear:left;"> <span class="dragger-item"> </span> <input class="form-radio validate[required]" id="input_72_1" name="q72_isOur" type="radio" value="No" /> <label for="input_72_1" id="label_input_72_1"> No </label> </span></div> </div> </li> <li class="form-line jf-required" data-type="control_radio" id="id_79"><label class="form-label form-label-left form-label-auto" for="input_79" id="label_79">Were you satisfied with the customer service provided? <span class="form-required"> * </span> </label> <div class="form-input jf-required" id="cid_79"> <div class="form-single-column"><span class="form-radio-item" style="clear:left;"><input class="form-radio validate[required]" id="input_79_0" name="q79_wereYou79" type="radio" value="Yes" /> <label for="input_79_0" id="label_input_79_0"> Yes </label> </span> <span class="form-radio-item" style="clear:left;"> <span class="dragger-item"> </span> <input class="form-radio validate[required]" id="input_79_1" name="q79_wereYou79" type="radio" value="No" /> <label for="input_79_1" id="label_input_79_1"> No </label> </span></div> </div> </li> <li class="form-line jf-required" data-type="control_radio" id="id_75"><label class="form-label form-label-left form-label-auto" for="input_75" id="label_75">Were you satisfied with the coaching/curriculum provided? <span class="form-required"> * </span> </label> <div class="form-input jf-required" id="cid_75"> <div class="form-single-column"><span class="form-radio-item" style="clear:left;"><input class="form-radio validate[required]" id="input_75_0" name="q75_wereYou75" type="radio" value="Yes" /> <label for="input_75_0" id="label_input_75_0"> Yes </label> </span> <span class="form-radio-item" style="clear:left;"> <span class="dragger-item"> </span> <input class="form-radio validate[required]" id="input_75_1" name="q75_wereYou75" type="radio" value="No" /> <label for="input_75_1" id="label_input_75_1"> No </label> </span></div> </div> </li> <li class="form-line" data-type="control_textarea" id="id_78"><label class="form-label form-label-left form-label-auto" for="input_78" id="label_78">If no, why? </label> <div class="form-input jf-required" id="cid_78"><textarea class="form-textarea" cols="40" id="input_78" name="q78_ifNo78" rows="6"></textarea></div> </li> <li class="form-line" data-type="control_textarea" id="id_74"><label class="form-label form-label-left form-label-auto" for="input_74" id="label_74">What kinds of camps/programs would you like to see? </label> <div class="form-input jf-required" id="cid_74"><textarea class="form-textarea" cols="40" id="input_74" name="q74_whatKinds74" rows="6"></textarea></div> </li> <li class="form-line jf-required" data-type="control_textarea" id="id_64"><label class="form-label form-label-left form-label-auto" for="input_64" id="label_64">What did you like about the camp/program? <span class="form-required"> * </span> </label> <div class="form-input jf-required" id="cid_64"><textarea class="form-textarea validate[required]" cols="40" id="input_64" name="q64_whatDid64" rows="6"></textarea></div> </li> <li class="form-line jf-required" data-type="control_textarea" id="id_66"><label class="form-label form-label-left form-label-auto" for="input_66" id="label_66">How can we improve? <span class="form-required"> * </span> </label> <div class="form-input jf-required" id="cid_66"><textarea class="form-textarea validate[required]" cols="40" id="input_66" name="q66_howCan" rows="6"></textarea></div> </li> <li class="form-line jf-required" data-type="control_scale" id="id_68"><label class="form-label form-label-left form-label-auto" for="input_68" id="label_68">Overall Satisfaction of Experience <span class="form-required"> * </span> </label> <div class="form-input jf-required" id="cid_68"> <table cellpadding="4" cellspacing="0" class="form-scale-table" summary=""> <tbody> <tr> <th>&nbsp;</th> <th align="center"><label for="input_68_1">1 </label></th> <th align="center"><label for="input_68_2">2 </label></th> <th align="center"><label for="input_68_3">3 </label></th> <th align="center"><label for="input_68_4">4 </label></th> <th align="center"><label for="input_68_5">5 </label></th> <th>&nbsp;</th> </tr> <tr> <td><label for="input_68_1">Unsatisfied </label></td> <td align="center"><input class="form-radio validate[required]" id="input_68_1" name="q68_overallSatisfaction" title="1" type="radio" value="1" /></td> <td align="center"><input class="form-radio validate[required]" id="input_68_2" name="q68_overallSatisfaction" title="2" type="radio" value="2" /></td> <td align="center"><input class="form-radio validate[required]" id="input_68_3" name="q68_overallSatisfaction" title="3" type="radio" value="3" /></td> <td align="center"><input class="form-radio validate[required]" id="input_68_4" name="q68_overallSatisfaction" title="4" type="radio" value="4" /></td> <td align="center"><input class="form-radio validate[required]" id="input_68_5" name="q68_overallSatisfaction" title="5" type="radio" value="5" /></td> <td><label for="input_68_5">Extremely Satisfied </label></td> </tr> </tbody> </table> </div> </li> <li class="form-line" data-type="control_button" id="id_61"> <div class="form-input-wide" id="cid_61"> <div class="form-buttons-wrapper" style="margin-left:156px"><button class="form-submit-button" id="input_61" type="submit">Submit</button></div> </div> </li> <li style="display:none">Should be Empty: <input name="website" type="text" value="" /></li> </ul> </div> <input id="simple_spc" name="simple_spc" type="hidden" value="60186243904151" /> <script type="text/javascript"> document.getElementById("si" + "mple" + "_spc").value = "60186243904151-60186243904151"; </script></form> <script type="text/javascript">JotForm.ownerView=true;</script>

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