{"id":2925,"date":"2022-10-28T12:16:52","date_gmt":"2022-10-28T01:16:52","guid":{"rendered":"https:\/\/ningyuantang.com.au\/?page_id=2925"},"modified":"2023-01-24T15:51:55","modified_gmt":"2023-01-24T04:51:55","slug":"patient-form","status":"publish","type":"page","link":"https:\/\/ningyuantang.com.au\/zh\/patient-form\/","title":{"rendered":"\u4fe1\u606f\u8868"},"content":{"rendered":"<div data-elementor-type=\"wp-page\" data-elementor-id=\"2925\" class=\"elementor elementor-2925\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-4c45a05 elementor-section-height-min-height elementor-section-content-middle elementor-section-boxed elementor-section-height-default elementor-section-items-middle\" data-id=\"4c45a05\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;gradient&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-4030135\" data-id=\"4030135\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5648c34 elementor-widget elementor-widget-heading\" data-id=\"5648c34\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">\u4fe1\u606f\u8868<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-3217104 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"3217104\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-97f1abd\" data-id=\"97f1abd\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-e6d2501 elementor-widget elementor-widget-shortcode\" data-id=\"e6d2501\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><div class=\"forminator-ui forminator-custom-form forminator-custom-form-1957 forminator-design--default  forminator_ajax\" data-forminator-render=\"0\" data-form=\"forminator-module-1957\" data-uid=\"69ded2e190856\"><br\/><\/div><form\n\t\t\t\tid=\"forminator-module-1957\"\n\t\t\t\tclass=\"forminator-ui forminator-custom-form forminator-custom-form-1957 forminator-design--default  forminator_ajax\"\n\t\t\t\tmethod=\"post\"\n\t\t\t\tdata-forminator-render=\"0\"\n\t\t\t\tdata-form-id=\"1957\"\n\t\t\t\t data-color-option=\"default\" data-design=\"default\" data-grid=\"open\" style=\"display: none;\"\n\t\t\t\tdata-uid=\"69ded2e190856\" action=\"\"\n\t\t\t><div role=\"alert\" aria-live=\"polite\" class=\"forminator-response-message forminator-error\" aria-hidden=\"true\"><\/div><div role=\"tablist\" class=\"forminator-pagination-steps\" aria-label=\"Pagination\"><\/div><div\n\t\t\t\ttabindex=\"-1\"\n\t\t\t\trole=\"tabpanel\"\n\t\t\t\tid=\"forminator-custom-form-1957--page-0\"\n\t\t\t\tclass=\"forminator-pagination forminator-pagination-start\"\n\t\t\t\taria-labelledby=\"forminator-custom-form-1957--page-0-label\"\n\t\t\t\tdata-step=\"0\"\n\t\t\t\tdata-label=\"\u5b8c\u6210\"\n\t\t\t\tdata-actual-label=\"Page 1\"\n\t\t\t\tdata-name=\"page-break-1\"\n\t\t\t><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"section-5\" class=\"forminator-field-section forminator-col forminator-col-12\"><div class=\"forminator-field\"><h2 class=\"forminator-title\">\u57fa\u672c\u4fe1\u606f<\/h2><hr class=\"forminator-border\" style=\"border: 1px solid #aaaaaa;\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"name-1\" class=\"forminator-field-name forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-name-1_69ded2e190856\" id=\"forminator-field-name-1_69ded2e190856-label\" class=\"forminator-label\">\u540d\u5b57 <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"name-1\" value=\"\" placeholder=\"E.g. John Doe\" id=\"forminator-field-name-1_69ded2e190856\" class=\"forminator-input forminator-name--field\" aria-required=\"true\" autocomplete=\"name\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"phone-1\" class=\"forminator-field-phone forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-phone-1_69ded2e190856\" id=\"forminator-field-phone-1_69ded2e190856-label\" class=\"forminator-label\">\u7535\u8bdd <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"phone-1\" value=\"\" placeholder=\"E.g. +1 300 400 5000\" id=\"forminator-field-phone-1_69ded2e190856\" class=\"forminator-input forminator-field--phone\" data-required=\"1\" aria-required=\"true\" autocomplete=\"off\" \/><\/div><\/div><div id=\"email-1\" class=\"forminator-field-email forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-email-1_69ded2e190856\" id=\"forminator-field-email-1_69ded2e190856-label\" class=\"forminator-label\">\u7535\u5b50\u90ae\u7bb1<\/label><input type=\"email\" name=\"email-1\" value=\"\" placeholder=\"E.g. john@doe.com\" id=\"forminator-field-email-1_69ded2e190856\" class=\"forminator-input forminator-email--field\" data-required=\"\" aria-required=\"false\" autocomplete=\"email\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"date-1\" class=\"forminator-field-date forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-date-1-picker_69ded2e190856\" id=\"forminator-field-date-1-picker_69ded2e190856-label\" class=\"forminator-label\">\u751f\u65e5 <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-input-with-icon\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-1\" value=\"\" placeholder=\"Choose Date\" id=\"forminator-field-date-1-picker_69ded2e190856\" class=\"forminator-input forminator-datepicker\" data-required=\"1\" data-format=\"mm\/dd\/yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1926\" data-end-year=\"2126\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" \/><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-1\" class=\"forminator-field-radio forminator-col forminator-col-12\"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-1-69ded2e190856-label\"><span id=\"forminator-radiogroup-radio-1-69ded2e190856-label\" class=\"forminator-label\">\u6027\u522b <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-1-label-1\" for=\"forminator-field-radio-1-1-69ded2e190856\" class=\"forminator-radio\" title=\"\u7537\"><input type=\"radio\" name=\"radio-1\" value=\"one\" id=\"forminator-field-radio-1-1-69ded2e190856\" aria-labelledby=\"forminator-field-radio-1-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">\u7537<\/span><\/label><label id=\"forminator-field-radio-1-label-2\" for=\"forminator-field-radio-1-2-69ded2e190856\" class=\"forminator-radio\" title=\"\u5973\"><input type=\"radio\" name=\"radio-1\" value=\"two\" id=\"forminator-field-radio-1-2-69ded2e190856\" aria-labelledby=\"forminator-field-radio-1-label-2\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">\u5973<\/span><\/label><label id=\"forminator-field-radio-1-label-3\" for=\"forminator-field-radio-1-3-69ded2e190856\" class=\"forminator-radio\" title=\"\u5176\u4ed6\"><input type=\"radio\" name=\"radio-1\" value=\"Other\" id=\"forminator-field-radio-1-3-69ded2e190856\" aria-labelledby=\"forminator-field-radio-1-label-3\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">\u5176\u4ed6<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"section-1\" class=\"forminator-field-section forminator-col forminator-col-12\"><div class=\"forminator-field\"><h3 class=\"forminator-subtitle\">\u51fa\u751f\u5730<\/h3><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"address-2\" class=\"forminator-field-address forminator-col forminator-col-12\"><div class=\"forminator-row\" data-multiple=\"false\"><div id=\"address-2-city\" class=\"forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-address-2-city_69ded2e190856\" id=\"forminator-field-address-2-city_69ded2e190856-label\" class=\"forminator-label\">\u57ce\u5e02 <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"address-2-city\" placeholder=\"E.g. Sydney\" id=\"forminator-field-address-2-city_69ded2e190856\" class=\"forminator-input\" data-required=\"1\" aria-required=\"true\" autocomplete=\"address-level2\" value=\"\" \/><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"section-2\" class=\"forminator-field-section forminator-col forminator-col-12\"><div class=\"forminator-field\"><h3 class=\"forminator-subtitle\">\u5c45\u4f4f\u5730<\/h3><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"address-1\" class=\"forminator-field-address forminator-col forminator-col-12\"><div class=\"forminator-row\"><div id=\"address-1-street_address\" class=\"forminator-col\"><div class=\"forminator-field\"><label for=\"forminator-field-address-1-street_address_69ded2e190856\" id=\"forminator-field-address-1-street_address_69ded2e190856-label\" class=\"forminator-label\">\u8857\u9053\u5730\u5740 <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"address-1-street_address\" placeholder=\"E.g. 42 Wallaby Way\" id=\"forminator-field-address-1-street_address_69ded2e190856\" class=\"forminator-input\" data-required=\"1\" aria-required=\"true\" autocomplete=\"address-line1\" value=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\" data-multiple=\"false\"><div id=\"address-1-state\" class=\"forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-address-1-state_69ded2e190856\" id=\"forminator-field-address-1-state_69ded2e190856-label\" class=\"forminator-label\">\u5dde\/\u7701 <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"address-1-state\" placeholder=\"E.g. New South Wales\" id=\"forminator-field-address-1-state_69ded2e190856\" class=\"forminator-input\" data-required=\"1\" aria-required=\"true\" autocomplete=\"address-level1\" value=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\" data-multiple=\"false\"><div id=\"address-1-zip\" class=\"forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-address-1-zip_69ded2e190856\" id=\"forminator-field-address-1-zip_69ded2e190856-label\" class=\"forminator-label\">\u90ae\u7f16 <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"address-1-zip\" placeholder=\"E.g. 2000\" id=\"forminator-field-address-1-zip_69ded2e190856\" class=\"forminator-input\" autocomplete=\"postal-code\" value=\"\" \/><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div\n\t\t\t\ttabindex=\"-1\"\n\t\t\t\trole=\"tabpanel\"\n\t\t\t\tid=\"forminator-custom-form-1957--page-1\"\n\t\t\t\tclass=\"forminator-pagination\"\n\t\t\t\taria-labelledby=\"forminator-custom-form-1957--page-1-label\"\n\t\t\t\taria-hidden=\"true\"\n\t\t\t\tdata-step=\"1\"\n\t\t\t\tdata-label=\"\u9875\u9762  1\"\n\t\t\t\tdata-actual-label=\"Page 2\"\n\t\t\t\tdata-name=\"\"\n\t\t\t\thidden\n\t\t\t><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"section-4\" class=\"forminator-field-section forminator-col forminator-col-12\"><div class=\"forminator-field\"><h3 class=\"forminator-subtitle\">\u7d27\u6025\u8054\u7cfb\u4eba<\/h3><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"name-2\" class=\"forminator-field-name forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-name-2_69ded2e190856\" id=\"forminator-field-name-2_69ded2e190856-label\" class=\"forminator-label\">\u540d\u5b57<\/label><input type=\"text\" name=\"name-2\" value=\"\" placeholder=\"E.g. John Doe\" id=\"forminator-field-name-2_69ded2e190856\" class=\"forminator-input forminator-name--field\" aria-required=\"false\" autocomplete=\"name\" \/><\/div><\/div><div id=\"phone-2\" class=\"forminator-field-phone forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-phone-2_69ded2e190856\" id=\"forminator-field-phone-2_69ded2e190856-label\" class=\"forminator-label\">\u7535\u8bdd<\/label><input type=\"text\" name=\"phone-2\" value=\"\" placeholder=\"E.g. +1 300 400 5000\" id=\"forminator-field-phone-2_69ded2e190856\" class=\"forminator-input forminator-field--phone\" data-required=\"\" aria-required=\"false\" autocomplete=\"off\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"section-6\" class=\"forminator-field-section forminator-col forminator-col-12\"><div class=\"forminator-field\"><h3 class=\"forminator-subtitle\">\u4fdd\u9669<\/h3><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-1\" class=\"forminator-field-text forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-text-1_69ded2e190856\" id=\"forminator-field-text-1_69ded2e190856-label\" class=\"forminator-label\">\u4fdd\u9669\u540d\u79f0<\/label><input type=\"text\" name=\"text-1\" value=\"\" placeholder=\"E.g. text placeholder\" id=\"forminator-field-text-1_69ded2e190856\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><div id=\"text-2\" class=\"forminator-field-text forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-text-2_69ded2e190856\" id=\"forminator-field-text-2_69ded2e190856-label\" class=\"forminator-label\">\u4fdd\u9669\u53f7\u7801<\/label><input type=\"text\" name=\"text-2\" value=\"\" placeholder=\"E.g. 12345678\" id=\"forminator-field-text-2_69ded2e190856\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"section-3\" class=\"forminator-field-section forminator-col forminator-col-12\"><div class=\"forminator-field\"><h2 class=\"forminator-title\">\u533b\u7597\u4fe1\u606f<\/h2><hr class=\"forminator-border\" style=\"border: 1px solid #aaaaaa;\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-3\" class=\"forminator-field-text forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-text-3_69ded2e190856\" id=\"forminator-field-text-3_69ded2e190856-label\" class=\"forminator-label\">\u770b\u8bca\u539f\u56e0 <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-3\" value=\"\" placeholder=\"E.g. back pain\" id=\"forminator-field-text-3_69ded2e190856\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><div id=\"date-2\" class=\"forminator-field-date forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-date-2-picker_69ded2e190856\" id=\"forminator-field-date-2-picker_69ded2e190856-label\" class=\"forminator-label\">\u7b2c\u4e00\u6b21\u75c7\u72b6\u53d1\u4f5c\u65f6\u95f4<\/label><div class=\"forminator-input-with-icon\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-2\" value=\"\" placeholder=\"Choose Date\" id=\"forminator-field-date-2-picker_69ded2e190856\" class=\"forminator-input forminator-datepicker\" data-required=\"\" data-format=\"mm\/dd\/yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1926\" data-end-year=\"2126\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" \/><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-4\" class=\"forminator-field-text forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-text-4_69ded2e190856\" id=\"forminator-field-text-4_69ded2e190856-label\" class=\"forminator-label\">\u75be\u75c5\u53f2<\/label><input type=\"text\" name=\"text-4\" value=\"\" placeholder=\"E.g. asthma, heart disease\" id=\"forminator-field-text-4_69ded2e190856\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><div id=\"text-5\" class=\"forminator-field-text forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-text-5_69ded2e190856\" id=\"forminator-field-text-5_69ded2e190856-label\" class=\"forminator-label\">\u624b\u672f\u53f2<\/label><input type=\"text\" name=\"text-5\" value=\"\" placeholder=\"E.g. Cholecystectomy\" id=\"forminator-field-text-5_69ded2e190856\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-2\" class=\"forminator-field-radio forminator-col forminator-col-12\"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-2-69ded2e190856-label\"><span id=\"forminator-radiogroup-radio-2-69ded2e190856-label\" class=\"forminator-label\">\u7d20\u98df\u8005<\/span><label id=\"forminator-field-radio-2-label-1\" for=\"forminator-field-radio-2-1-69ded2e190856\" class=\"forminator-radio\" title=\"Vegetarian\"><input type=\"radio\" name=\"radio-2\" value=\"one\" id=\"forminator-field-radio-2-1-69ded2e190856\" aria-labelledby=\"forminator-field-radio-2-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Vegetarian<\/span><\/label><label id=\"forminator-field-radio-2-label-2\" for=\"forminator-field-radio-2-2-69ded2e190856\" class=\"forminator-radio\" title=\"Vegan\"><input type=\"radio\" name=\"radio-2\" value=\"two\" id=\"forminator-field-radio-2-2-69ded2e190856\" aria-labelledby=\"forminator-field-radio-2-label-2\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Vegan<\/span><\/label><label id=\"forminator-field-radio-2-label-3\" for=\"forminator-field-radio-2-3-69ded2e190856\" class=\"forminator-radio\" title=\"Neither\"><input type=\"radio\" name=\"radio-2\" value=\"Neighter\" id=\"forminator-field-radio-2-3-69ded2e190856\" aria-labelledby=\"forminator-field-radio-2-label-3\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Neither<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-3\" class=\"forminator-field-radio forminator-col forminator-col-12\"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-3-69ded2e190856-label\"><span id=\"forminator-radiogroup-radio-3-69ded2e190856-label\" class=\"forminator-label\">\u8fc7\u654f\u6216\u4e0d\u8010\u53d7<\/span><label id=\"forminator-field-radio-3-label-1\" for=\"forminator-field-radio-3-1-69ded2e190856\" class=\"forminator-radio\" title=\"\u6709\"><input type=\"radio\" name=\"radio-3\" value=\"one\" id=\"forminator-field-radio-3-1-69ded2e190856\" aria-labelledby=\"forminator-field-radio-3-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">\u6709<\/span><\/label><label id=\"forminator-field-radio-3-label-2\" for=\"forminator-field-radio-3-2-69ded2e190856\" class=\"forminator-radio\" title=\"\u6ca1\u6709\"><input type=\"radio\" name=\"radio-3\" value=\"two\" id=\"forminator-field-radio-3-2-69ded2e190856\" aria-labelledby=\"forminator-field-radio-3-label-2\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">\u6ca1\u6709<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-6\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><input type=\"text\" name=\"text-6\" value=\"\" placeholder=\"\u5177\u4f53\u5217\u51fa\" id=\"forminator-field-text-6_69ded2e190856\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"consent-1\" class=\"forminator-field-consent forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-consent-1_69ded2e190856\" id=\"forminator-field-consent-1_69ded2e190856-label\" class=\"forminator-label\">\u540c\u610f <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-checkbox__wrapper\"><label id=\"forminator-field-consent-1_69ded2e190856__label\" class=\"forminator-checkbox forminator-consent\" aria-labelledby=\"forminator-field-consent-1_69ded2e190856-label\"><input type=\"checkbox\" name=\"consent-1\" id=\"forminator-field-consent-1_69ded2e190856\" value=\"checked\" aria-labelledby=\"forminator-field-consent-1_69ded2e190856-label\" aria-describedby=\"forminator-field-consent-1_69ded2e190856__description\" data-required=\"true\" aria-required=\"true\" \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><\/label><div id=\"forminator-field-consent-1_69ded2e190856__description\" class=\"forminator-checkbox__label forminator-consent__label\">\u6211\u540c\u610f\u9690\u79c1\u653f\u7b56\u548c\u76f8\u5173\u6761\u6b3e <a href=\"#\" target=\"_blank\">privacy policy<\/a> and <a href=\"#\" target=\"_blank\">terms and 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