{"id":6,"date":"2010-06-02T21:23:44","date_gmt":"2010-06-02T21:23:44","guid":{"rendered":"https:\/\/www.swinefluclassaction.com\/?page_id=6"},"modified":"2017-06-19T23:05:47","modified_gmt":"2017-06-19T23:05:47","slug":"questionaire","status":"publish","type":"page","link":"https:\/\/www.swinefluclassaction.com\/","title":{"rendered":"Questionaire"},"content":{"rendered":"<div role=\"form\" class=\"wpcf7\" id=\"wpcf7-f16-o1\" dir=\"ltr\">\n<div class=\"screen-reader-response\"><\/div>\n<form action=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F6#wpcf7-f16-o1\" method=\"post\" class=\"wpcf7-form\" novalidate=\"novalidate\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"16\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"5.0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f16-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<\/div>\n<p><b>\n<p>Your Name (required)<br \/><\/b><br \/>\n    <span class=\"wpcf7-form-control-wrap your-name\"><input type=\"text\" name=\"your-name\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span> <\/p>\n<p><b>\n<p>Your Email (required)<br \/><\/b><br \/>\n    <span class=\"wpcf7-form-control-wrap your-email\"><input type=\"email\" name=\"your-email\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-email wpcf7-validates-as-required wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span> <\/p>\n<p><b>\n<p>How were you or loved one affected by Swine Flu (H1N1)?<br \/><\/b><br \/>\n    <span class=\"wpcf7-form-control-wrap affected\"><textarea name=\"affected\" cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\"><\/textarea><\/span> <\/p>\n<p><b>\n<p>Do you understand that the information you provide is intended only for use for the purpose of gathering information about a potential class action lawsuit and that by submitting this form voluntarily and without coercion you are not guaranteed any kind of representation based off the information you provide?<br \/><\/b><br \/>\n<span class=\"wpcf7-form-control-wrap confirm\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"confirm[]\" value=\"yes\" \/><span class=\"wpcf7-list-item-label\">yes<\/span><\/span><\/span><\/span><\/p>\n<p><em>To use CAPTCHA, you need <a href=\"https:\/\/wordpress.org\/plugins\/really-simple-captcha\/\">Really Simple CAPTCHA<\/a> plugin installed.<\/em><br \/>\n<span class=\"wpcf7-form-control-wrap captcha-608\"><input type=\"text\" name=\"captcha-608\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-captchar\" autocomplete=\"off\" aria-invalid=\"false\" \/><\/span><\/p>\n<p><input type=\"submit\" value=\"Send\" class=\"wpcf7-form-control wpcf7-submit\" \/><\/p>\n<div class=\"wpcf7-response-output wpcf7-display-none\"><\/div><\/form><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-6","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.swinefluclassaction.com\/index.php?rest_route=\/wp\/v2\/pages\/6","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.swinefluclassaction.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.swinefluclassaction.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.swinefluclassaction.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.swinefluclassaction.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=6"}],"version-history":[{"count":2,"href":"https:\/\/www.swinefluclassaction.com\/index.php?rest_route=\/wp\/v2\/pages\/6\/revisions"}],"predecessor-version":[{"id":20,"href":"https:\/\/www.swinefluclassaction.com\/index.php?rest_route=\/wp\/v2\/pages\/6\/revisions\/20"}],"wp:attachment":[{"href":"https:\/\/www.swinefluclassaction.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=6"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}