{"id":2784,"date":"2021-08-04T13:11:36","date_gmt":"2021-08-04T17:11:36","guid":{"rendered":"https:\/\/www.manhattanalternative.com\/?page_id=2784"},"modified":"2024-04-17T11:53:30","modified_gmt":"2024-04-17T15:53:30","slug":"listing-update-form","status":"publish","type":"page","link":"https:\/\/www.manhattanalternative.com\/listing-update-form\/","title":{"rendered":"Listing Update Form"},"content":{"rendered":"\n<p><strong>Please fill out the form below if you currently have a profile on ManhattanAlternative.com and would like to make updates to your profile (please fill out only what you&#8217;d like updated).<\/strong><\/p>\n\n\n\n<p>This website and community are maintained through contributions by the community. <strong>If you haven&#8217;t already, please sign up for a monthly donation of $5 or more to support our community via <a href=\"http:\/\/GiveButter.com\/MA-Contributions\" data-type=\"link\" data-id=\"GiveButter.com\/MA-Contributions\">GiveButter.com\/MA-Contributions<\/a>, or using the form on the page you&#8217;ll be redirected to after filling out the update form.<\/strong> Thank you! (Don&#8217;t forget to write it off your taxes as an advertising deduction!)<\/p>\n\n\n<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_safari gform_wrapper gform-theme gform-theme--foundation gform-theme--framework gform-theme--orbital' data-form-theme='orbital' data-form-index='0' id='gform_wrapper_3' ><style>#gform_wrapper_3[data-form-index=\"0\"].gform-theme,[data-parent-form=\"3_0\"]{--gf-color-primary: #204ce5;--gf-color-primary-rgb: 32, 76, 229;--gf-color-primary-contrast: #fff;--gf-color-primary-contrast-rgb: 255, 255, 255;--gf-color-primary-darker: #001AB3;--gf-color-primary-lighter: #527EFF;--gf-color-secondary: #fff;--gf-color-secondary-rgb: 255, 255, 255;--gf-color-secondary-contrast: #112337;--gf-color-secondary-contrast-rgb: 17, 35, 55;--gf-color-secondary-darker: #F5F5F5;--gf-color-secondary-lighter: #FFFFFF;--gf-color-out-ctrl-light: rgba(17, 35, 55, 0.1);--gf-color-out-ctrl-light-rgb: 17, 35, 55;--gf-color-out-ctrl-light-darker: rgba(104, 110, 119, 0.35);--gf-color-out-ctrl-light-lighter: #F5F5F5;--gf-color-out-ctrl-dark: #585e6a;--gf-color-out-ctrl-dark-rgb: 88, 94, 106;--gf-color-out-ctrl-dark-darker: #112337;--gf-color-out-ctrl-dark-lighter: rgba(17, 35, 55, 0.65);--gf-color-in-ctrl: #fff;--gf-color-in-ctrl-rgb: 255, 255, 255;--gf-color-in-ctrl-contrast: #112337;--gf-color-in-ctrl-contrast-rgb: 17, 35, 55;--gf-color-in-ctrl-darker: #F5F5F5;--gf-color-in-ctrl-lighter: #FFFFFF;--gf-color-in-ctrl-primary: #204ce5;--gf-color-in-ctrl-primary-rgb: 32, 76, 229;--gf-color-in-ctrl-primary-contrast: #fff;--gf-color-in-ctrl-primary-contrast-rgb: 255, 255, 255;--gf-color-in-ctrl-primary-darker: #001AB3;--gf-color-in-ctrl-primary-lighter: #527EFF;--gf-color-in-ctrl-light: rgba(17, 35, 55, 0.1);--gf-color-in-ctrl-light-rgb: 17, 35, 55;--gf-color-in-ctrl-light-darker: rgba(104, 110, 119, 0.35);--gf-color-in-ctrl-light-lighter: #F5F5F5;--gf-color-in-ctrl-dark: #585e6a;--gf-color-in-ctrl-dark-rgb: 88, 94, 106;--gf-color-in-ctrl-dark-darker: #112337;--gf-color-in-ctrl-dark-lighter: rgba(17, 35, 55, 0.65);--gf-radius: 3px;--gf-font-size-secondary: 14px;--gf-font-size-tertiary: 13px;--gf-icon-ctrl-number: url(\"data:image\/svg+xml,%3Csvg width='8' height='14' viewBox='0 0 8 14' fill='none' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath fill-rule='evenodd' clip-rule='evenodd' d='M4 0C4.26522 5.96046e-08 4.51957 0.105357 4.70711 0.292893L7.70711 3.29289C8.09763 3.68342 8.09763 4.31658 7.70711 4.70711C7.31658 5.09763 6.68342 5.09763 6.29289 4.70711L4 2.41421L1.70711 4.70711C1.31658 5.09763 0.683417 5.09763 0.292893 4.70711C-0.0976311 4.31658 -0.097631 3.68342 0.292893 3.29289L3.29289 0.292893C3.48043 0.105357 3.73478 0 4 0ZM0.292893 9.29289C0.683417 8.90237 1.31658 8.90237 1.70711 9.29289L4 11.5858L6.29289 9.29289C6.68342 8.90237 7.31658 8.90237 7.70711 9.29289C8.09763 9.68342 8.09763 10.3166 7.70711 10.7071L4.70711 13.7071C4.31658 14.0976 3.68342 14.0976 3.29289 13.7071L0.292893 10.7071C-0.0976311 10.3166 -0.0976311 9.68342 0.292893 9.29289Z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-icon-ctrl-select: url(\"data:image\/svg+xml,%3Csvg width='10' height='6' viewBox='0 0 10 6' fill='none' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath fill-rule='evenodd' clip-rule='evenodd' d='M0.292893 0.292893C0.683417 -0.097631 1.31658 -0.097631 1.70711 0.292893L5 3.58579L8.29289 0.292893C8.68342 -0.0976311 9.31658 -0.0976311 9.70711 0.292893C10.0976 0.683417 10.0976 1.31658 9.70711 1.70711L5.70711 5.70711C5.31658 6.09763 4.68342 6.09763 4.29289 5.70711L0.292893 1.70711C-0.0976311 1.31658 -0.0976311 0.683418 0.292893 0.292893Z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-icon-ctrl-search: url(\"data:image\/svg+xml,%3Csvg version='1.1' xmlns='http:\/\/www.w3.org\/2000\/svg' width='640' height='640'%3E%3Cpath d='M256 128c-70.692 0-128 57.308-128 128 0 70.691 57.308 128 128 128 70.691 0 128-57.309 128-128 0-70.692-57.309-128-128-128zM64 256c0-106.039 85.961-192 192-192s192 85.961 192 192c0 41.466-13.146 79.863-35.498 111.248l154.125 154.125c12.496 12.496 12.496 32.758 0 45.254s-32.758 12.496-45.254 0L367.248 412.502C335.862 434.854 297.467 448 256 448c-106.039 0-192-85.962-192-192z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-label-space-y-secondary: var(--gf-label-space-y-md-secondary);--gf-ctrl-border-color: #686e77;--gf-ctrl-size: var(--gf-ctrl-size-md);--gf-ctrl-label-color-primary: #112337;--gf-ctrl-label-color-secondary: #112337;--gf-ctrl-choice-size: var(--gf-ctrl-choice-size-md);--gf-ctrl-checkbox-check-size: var(--gf-ctrl-checkbox-check-size-md);--gf-ctrl-radio-check-size: var(--gf-ctrl-radio-check-size-md);--gf-ctrl-btn-font-size: var(--gf-ctrl-btn-font-size-md);--gf-ctrl-btn-padding-x: var(--gf-ctrl-btn-padding-x-md);--gf-ctrl-btn-size: var(--gf-ctrl-btn-size-md);--gf-ctrl-btn-border-color-secondary: #686e77;--gf-ctrl-file-btn-bg-color-hover: #EBEBEB;--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style>\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_3'  action='\/wp-json\/wp\/v2\/pages\/2784' data-formid='3' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_3' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_3_36\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_36\" ><label class='gfield_label gform-field-label' for='input_3_36'>Name (as you would like it to appear on the site)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_36' id='input_3_36' type='text' value='' class='large' maxlength='50'    aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_3_48\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_48\" ><label class='gfield_label gform-field-label' for='input_3_48'>Pronouns (if you would like them to appear on the site)<\/label><div class='ginput_container ginput_container_text'><input name='input_48' id='input_3_48' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_3_49\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_49\" ><legend class='gfield_label gform-field-label' >Honorific (if you would like it to appear on the site)<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_49'>\n\t\t\t<div class='gchoice gchoice_3_49_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='Dr.'  id='choice_3_49_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_49_0' id='label_3_49_0' class='gform-field-label gform-field-label--type-inline'>Dr.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_49_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='Mx.'  id='choice_3_49_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_49_1' id='label_3_49_1' class='gform-field-label gform-field-label--type-inline'>Mx.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_49_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='Ms.'  id='choice_3_49_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_49_2' id='label_3_49_2' class='gform-field-label gform-field-label--type-inline'>Ms.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_49_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='Mr.'  id='choice_3_49_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_49_3' id='label_3_49_3' class='gform-field-label gform-field-label--type-inline'>Mr.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_49_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='Mrs.'  id='choice_3_49_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_49_4' id='label_3_49_4' class='gform-field-label gform-field-label--type-inline'>Mrs.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_49_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='gf_other_choice'  id='choice_3_49_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_49_5' id='label_3_49_5' class='gform-field-label gform-field-label--type-inline'>Other<\/label><br \/><input id='input_3_49_other' class='gchoice_other_control' name='input_49_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3_10\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_10\" ><label class='gfield_label gform-field-label' for='input_3_10'>Degrees\/Licenses\/Certifications (must be directly associated with\/in support of the profession you are listing)<\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_3_10' type='text' value='' class='medium' maxlength='20'     aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_3_34\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_34\" ><label class='gfield_label gform-field-label' for='input_3_34'>If your license requires that you practice under supervision (e.g., LMSW), please indicate the name and email address of your supervisor for confirmation (only if this has changed):<\/label><div class='ginput_container ginput_container_text'><input name='input_34' id='input_3_34' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_3_11\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_11\" ><label class='gfield_label gform-field-label' for='input_3_11'>Title (this will appear under your name on the main page; e.g., psychotherapist, psychologist, psychiatrist, etc)<\/label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_3_11' type='text' value='' class='medium' maxlength='30'     aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_3_23\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_23\" ><label class='gfield_label gform-field-label' for='input_3_23'>Subtitle\/Specialization (this will appear under your title on the main page; usually keywords indicating your areas of focus, specific populations, treatment approaches, etc; see other profiles on the main page for examples)\u2014please note that this line has a maximum of about 29 characters including spaces<\/label><div class='ginput_container ginput_container_text'><input name='input_23' id='input_3_23' type='text' value='' class='medium' maxlength='36'     aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_3_12\" class=\"gfield gfield--type-phone gfield--input-type-phone field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_12\" ><label class='gfield_label gform-field-label' for='input_3_12'>Phone (must be a direct phone number, not a general practice phone number; if you&#039;d rather not list your phone number on your profile, please include something else for this field in order to fit the template, such as another page on your website, a different website, or a social media handle)<\/label><div class='ginput_container ginput_container_phone'><input name='input_12' id='input_3_12' type='tel' value='' class='medium'    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_13\" class=\"gfield gfield--type-email gfield--input-type-email field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_13\" ><label class='gfield_label gform-field-label' for='input_3_13'>Email (messages must go directly to you, rather than admin staff at a general practice (unless you&#039;re the only person at the practice))<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_13' id='input_3_13' type='email' value='' class='medium'     aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_3_14\" class=\"gfield gfield--type-website gfield--input-type-website field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_14\" ><label class='gfield_label gform-field-label' for='input_3_14'>Website (must be to your web page, not a general practice page (unless you&#039;re the only person at the practice))<\/label><div class='ginput_container ginput_container_website'>\n                    <input name='input_14' id='input_3_14' type='url' value='' class='medium'      aria-invalid=\"false\"\/>\n                <\/div><\/div><div id=\"field_3_19\" class=\"gfield gfield--type-website gfield--input-type-website field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_19\" ><label class='gfield_label gform-field-label' for='input_3_19'>Facebook Page (optional)<\/label><div class='ginput_container ginput_container_website'>\n                    <input name='input_19' id='input_3_19' type='url' value='' class='medium'      aria-invalid=\"false\"\/>\n                <\/div><\/div><div id=\"field_3_20\" class=\"gfield gfield--type-website gfield--input-type-website field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_20\" ><label class='gfield_label gform-field-label' for='input_3_20'>LinkedIn Profile URL (optional)<\/label><div class='ginput_container ginput_container_website'>\n                    <input name='input_20' id='input_3_20' type='url' value='' class='medium'      aria-invalid=\"false\"\/>\n                <\/div><\/div><div id=\"field_3_50\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_50\" ><label class='gfield_label gform-field-label' for='input_3_50'>Instagram Handle (optional)<\/label><div class='ginput_container ginput_container_text'><input name='input_50' id='input_3_50' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_3_8\" class=\"gfield gfield--type-textarea gfield--input-type-textarea field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_8\" ><label class='gfield_label gform-field-label' for='input_3_8'>If you would like to update your bio, please enter  100 (minimum) to 125 (maximum) words here:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_8' id='input_3_8' class='textarea medium'   maxlength='800'   aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_3_15\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_15\" ><label class='gfield_label gform-field-label' for='input_3_15'>Upload Photo: Must be a minimum of 640&#215;640 dpi, and maximum 64 MB file size.  It&#039;s fine to submit photos larger than 640&#215;640 (and up to 64 MB); they will be cropped and downsized to fit.  Please do not submit photos with original dimensions smaller than 640&#215;640, as they may be blurry\/too pixelated.<\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='52428800' \/><input name='input_15' id='input_3_15' type='file' class='medium' aria-describedby=\"gfield_upload_rules_3_15\" onchange='javascript:gformValidateFileSize( this, 52428800 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_3_15'>Accepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 50 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_3_15'><\/div><\/div><\/div><fieldset id=\"field_3_29\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_29\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Please indicate the Provider Type filter(s) you would like to be included in (must have related credentials to be included in the therapist, psychiatrist\/medication management, and health care provider categories):<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_3_29'><div class='gchoice gchoice_3_29_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_29.1' type='checkbox'  value='Psychotherapist'  id='choice_3_29_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_29_1' id='label_3_29_1' class='gform-field-label gform-field-label--type-inline'>Psychotherapist<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_29_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_29.2' type='checkbox'  value='Sex Therapist'  id='choice_3_29_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_29_2' id='label_3_29_2' class='gform-field-label gform-field-label--type-inline'>Sex Therapist<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_29_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_29.3' type='checkbox'  value='Trainer\/Coach'  id='choice_3_29_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_29_3' id='label_3_29_3' class='gform-field-label gform-field-label--type-inline'>Trainer\/Coach<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_29_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_29.4' type='checkbox'  value='Body Worker'  id='choice_3_29_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_29_4' id='label_3_29_4' class='gform-field-label gform-field-label--type-inline'>Body Worker<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_29_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_29.5' type='checkbox'  value='Doula'  id='choice_3_29_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_29_5' id='label_3_29_5' class='gform-field-label gform-field-label--type-inline'>Doula<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_29_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_29.6' type='checkbox'  value='Energy Worker'  id='choice_3_29_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_29_6' id='label_3_29_6' class='gform-field-label gform-field-label--type-inline'>Energy Worker<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_29_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_29.7' type='checkbox'  value='Physical Health Care Provider'  id='choice_3_29_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_29_7' id='label_3_29_7' class='gform-field-label gform-field-label--type-inline'>Physical Health Care Provider<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_29_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_29.8' type='checkbox'  value='Psychiatrist\/Medication Management'  id='choice_3_29_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_29_8' id='label_3_29_8' class='gform-field-label gform-field-label--type-inline'>Psychiatrist\/Medication Management<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_29_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_29.9' type='checkbox'  value='Supervisor'  id='choice_3_29_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_29_9' id='label_3_29_9' class='gform-field-label gform-field-label--type-inline'>Supervisor<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_29_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_29.11' type='checkbox'  value='Gender Affirming Voice Trainer'  id='choice_3_29_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_29_11' id='label_3_29_11' class='gform-field-label gform-field-label--type-inline'>Gender Affirming Voice Trainer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_29_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_29.12' type='checkbox'  value='Bilingual\/Multilingual Provider'  id='choice_3_29_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_29_12' id='label_3_29_12' class='gform-field-label gform-field-label--type-inline'>Bilingual\/Multilingual Provider<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_29_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_29.13' type='checkbox'  value='BIPOC\/PGM Provider'  id='choice_3_29_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_29_13' id='label_3_29_13' class='gform-field-label gform-field-label--type-inline'>BIPOC\/PGM Provider<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_29_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_29.14' type='checkbox'  value='Trans\/Non-Binary Provider'  id='choice_3_29_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_29_14' id='label_3_29_14' class='gform-field-label gform-field-label--type-inline'>Trans\/Non-Binary Provider<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_3_43\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_43\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Please indicate the Provider Availability filter(s) you would like to be included in:<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_3_43'><div class='gchoice gchoice_3_43_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.1' type='checkbox'  value='Currently Accepting Inquiries (e.g., waitlists, drop-ins, letters, referrals)'  id='choice_3_43_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_43_1' id='label_3_43_1' class='gform-field-label gform-field-label--type-inline'>Currently Accepting Inquiries (e.g., waitlists, drop-ins, letters, referrals)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_43_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.2' type='checkbox'  value='Currently Accepting New Clients'  id='choice_3_43_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_43_2' id='label_3_43_2' class='gform-field-label gform-field-label--type-inline'>Currently Accepting New Clients<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_43_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.3' type='checkbox'  value='In-person'  id='choice_3_43_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_43_3' id='label_3_43_3' class='gform-field-label gform-field-label--type-inline'>In-person<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_43_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.4' type='checkbox'  value='Remote\/Telehealth'  id='choice_3_43_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_43_4' id='label_3_43_4' class='gform-field-label gform-field-label--type-inline'>Remote\/Telehealth<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_43_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.5' type='checkbox'  value='Insurance (must be in-network with insurance)'  id='choice_3_43_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_43_5' id='label_3_43_5' class='gform-field-label gform-field-label--type-inline'>Insurance (must be in-network with insurance)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_43_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.6' type='checkbox'  value='Sliding Scale'  id='choice_3_43_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_43_6' id='label_3_43_6' class='gform-field-label gform-field-label--type-inline'>Sliding Scale<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3_22\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_22\" ><label class='gfield_label gform-field-label' for='input_3_22'>If you are in-network with any insurance plans or have stopped accepting insurance, please list which insurance plans you&#039;d like added or removed:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_22' id='input_3_22' class='textarea medium'   maxlength='200'   aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_3_45\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_45\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Please indicate the client age populations you work with:<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_3_45'><div class='gchoice gchoice_3_45_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.1' type='checkbox'  value='Adolescents'  id='choice_3_45_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_45_1' id='label_3_45_1' class='gform-field-label gform-field-label--type-inline'>Adolescents<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_45_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.2' type='checkbox'  value='Adults'  id='choice_3_45_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_45_2' id='label_3_45_2' class='gform-field-label gform-field-label--type-inline'>Adults<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_45_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.3' type='checkbox'  value='Children'  id='choice_3_45_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_45_3' id='label_3_45_3' class='gform-field-label gform-field-label--type-inline'>Children<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_45_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.4' type='checkbox'  value='Older Adults'  id='choice_3_45_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_45_4' id='label_3_45_4' class='gform-field-label gform-field-label--type-inline'>Older Adults<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_3_44\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_44\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >The following category filters are to help clients narrow down their search for providers, please indicate the category filter(s) you would like to be included in (in other words, these categories indicate providers&#039; therapeutic specializations, not necessarily providers&#039; identities):<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_3_44'><div class='gchoice gchoice_3_44_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.1' type='checkbox'  value='BDSM\/Kink'  id='choice_3_44_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_44_1' id='label_3_44_1' class='gform-field-label gform-field-label--type-inline'>BDSM\/Kink<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_44_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.2' type='checkbox'  value='CNM\/Poly'  id='choice_3_44_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_44_2' id='label_3_44_2' class='gform-field-label gform-field-label--type-inline'>CNM\/Poly<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_44_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.3' type='checkbox'  value='LGB\/Queer\/Non-Straight'  id='choice_3_44_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_44_3' id='label_3_44_3' class='gform-field-label gform-field-label--type-inline'>LGB\/Queer\/Non-Straight<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_44_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.4' type='checkbox'  value='Trans\/TGE\/GNC'  id='choice_3_44_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_44_4' id='label_3_44_4' class='gform-field-label gform-field-label--type-inline'>Trans\/TGE\/GNC<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_44_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.5' type='checkbox'  value='Disability Justice'  id='choice_3_44_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_44_5' id='label_3_44_5' class='gform-field-label gform-field-label--type-inline'>Disability Justice<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_44_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.6' type='checkbox'  value='Fat Liberation\/Body Liberation'  id='choice_3_44_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_44_6' id='label_3_44_6' class='gform-field-label gform-field-label--type-inline'>Fat Liberation\/Body Liberation<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_44_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.7' type='checkbox'  value='Immigration'  id='choice_3_44_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_44_7' id='label_3_44_7' class='gform-field-label gform-field-label--type-inline'>Immigration<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_44_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.8' type='checkbox'  value='Neurodiversity Affirming'  id='choice_3_44_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_44_8' id='label_3_44_8' class='gform-field-label gform-field-label--type-inline'>Neurodiversity Affirming<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_44_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.9' type='checkbox'  value='Sex Worker Friendly'  id='choice_3_44_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_44_9' id='label_3_44_9' class='gform-field-label gform-field-label--type-inline'>Sex Worker Friendly<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_3_53\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_53\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >The following category filters are to help clients narrow down their search for providers, please indicate the Issues filter(s) you would like to be included in:<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_3_53'><div class='gchoice gchoice_3_53_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.1' type='checkbox'  value='ADHD'  id='choice_3_53_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_53_1' id='label_3_53_1' class='gform-field-label gform-field-label--type-inline'>ADHD<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_53_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.2' type='checkbox'  value='Anger Management'  id='choice_3_53_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_53_2' id='label_3_53_2' class='gform-field-label gform-field-label--type-inline'>Anger Management<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_53_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.3' type='checkbox'  value='Anxiety'  id='choice_3_53_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_53_3' id='label_3_53_3' class='gform-field-label gform-field-label--type-inline'>Anxiety<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_53_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.4' type='checkbox'  value='ASD\/Neurodivergence'  id='choice_3_53_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_53_4' id='label_3_53_4' class='gform-field-label gform-field-label--type-inline'>ASD\/Neurodivergence<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_53_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.5' type='checkbox'  value='Bipolar 1 or 2'  id='choice_3_53_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_53_5' id='label_3_53_5' class='gform-field-label gform-field-label--type-inline'>Bipolar 1 or 2<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_53_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.6' type='checkbox'  value='Borderline PD'  id='choice_3_53_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_53_6' id='label_3_53_6' class='gform-field-label gform-field-label--type-inline'>Borderline PD<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_53_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.7' type='checkbox'  value='Chronic Illness'  id='choice_3_53_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_53_7' id='label_3_53_7' class='gform-field-label gform-field-label--type-inline'>Chronic Illness<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_53_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.8' type='checkbox'  value='Complex Trauma'  id='choice_3_53_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_53_8' id='label_3_53_8' class='gform-field-label gform-field-label--type-inline'>Complex Trauma<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_53_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.9' type='checkbox'  value='Conflict Avoidance'  id='choice_3_53_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_53_9' id='label_3_53_9' class='gform-field-label gform-field-label--type-inline'>Conflict Avoidance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_53_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.11' type='checkbox'  value='Depression'  id='choice_3_53_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_53_11' id='label_3_53_11' class='gform-field-label gform-field-label--type-inline'>Depression<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_53_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.12' type='checkbox'  value='Disordered Eating'  id='choice_3_53_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_53_12' id='label_3_53_12' class='gform-field-label gform-field-label--type-inline'>Disordered Eating<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_53_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.13' type='checkbox'  value='Grief\/Bereavement'  id='choice_3_53_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_53_13' id='label_3_53_13' class='gform-field-label gform-field-label--type-inline'>Grief\/Bereavement<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_53_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.14' type='checkbox'  value='HIV+\/Poz'  id='choice_3_53_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_53_14' id='label_3_53_14' class='gform-field-label gform-field-label--type-inline'>HIV+\/Poz<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_53_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.15' type='checkbox'  value='Intimate Partner Violence'  id='choice_3_53_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_53_15' id='label_3_53_15' class='gform-field-label gform-field-label--type-inline'>Intimate Partner Violence<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_53_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.16' type='checkbox'  value='Minor-Attracted People'  id='choice_3_53_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_53_16' id='label_3_53_16' class='gform-field-label gform-field-label--type-inline'>Minor-Attracted People<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_53_17'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.17' type='checkbox'  value='OCD'  id='choice_3_53_17'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_53_17' id='label_3_53_17' class='gform-field-label gform-field-label--type-inline'>OCD<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_53_18'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.18' type='checkbox'  value='Pregnancy Planning\/Post-Partum\/Loss'  id='choice_3_53_18'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_53_18' id='label_3_53_18' class='gform-field-label gform-field-label--type-inline'>Pregnancy Planning\/Post-Partum\/Loss<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_53_19'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.19' type='checkbox'  value='PTSD'  id='choice_3_53_19'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_53_19' id='label_3_53_19' class='gform-field-label gform-field-label--type-inline'>PTSD<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_53_21'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.21' type='checkbox'  value='Relationship Conflict'  id='choice_3_53_21'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_53_21' id='label_3_53_21' class='gform-field-label gform-field-label--type-inline'>Relationship Conflict<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_53_22'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.22' type='checkbox'  value='Self-Harm'  id='choice_3_53_22'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_53_22' id='label_3_53_22' class='gform-field-label gform-field-label--type-inline'>Self-Harm<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_53_23'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.23' type='checkbox'  value='Sexual Assault\/Abuse'  id='choice_3_53_23'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_53_23' id='label_3_53_23' class='gform-field-label gform-field-label--type-inline'>Sexual Assault\/Abuse<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_53_24'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.24' type='checkbox'  value='Substance\/Alcohol Use\/Misuse'  id='choice_3_53_24'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_53_24' id='label_3_53_24' class='gform-field-label gform-field-label--type-inline'>Substance\/Alcohol Use\/Misuse<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_53_25'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.25' type='checkbox'  value='Suicidal Ideation'  id='choice_3_53_25'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_53_25' id='label_3_53_25' class='gform-field-label gform-field-label--type-inline'>Suicidal Ideation<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_3_46\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_46\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >The following category filters allow clients to identify providers who practice particular modalities or types of therapy\/assessments:<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_3_46'><div class='gchoice gchoice_3_46_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.1' type='checkbox'  value='Couples Therapy\/Multi-Partner Therapy\/Relationship Therapy'  id='choice_3_46_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_46_1' id='label_3_46_1' class='gform-field-label gform-field-label--type-inline'>Couples Therapy\/Multi-Partner Therapy\/Relationship Therapy<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_46_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.2' type='checkbox'  value='Family Therapy'  id='choice_3_46_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_46_2' id='label_3_46_2' class='gform-field-label gform-field-label--type-inline'>Family Therapy<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_46_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.3' type='checkbox'  value='Group Therapy'  id='choice_3_46_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_46_3' id='label_3_46_3' class='gform-field-label gform-field-label--type-inline'>Group Therapy<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_46_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.4' type='checkbox'  value='Neuropsych Assessments'  id='choice_3_46_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_46_4' id='label_3_46_4' class='gform-field-label gform-field-label--type-inline'>Neuropsych Assessments<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_46_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.5' type='checkbox'  value='Gender Affirming Care Letters'  id='choice_3_46_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_46_5' id='label_3_46_5' class='gform-field-label gform-field-label--type-inline'>Gender Affirming Care Letters<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_46_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.6' type='checkbox'  value='CBT'  id='choice_3_46_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_46_6' id='label_3_46_6' class='gform-field-label gform-field-label--type-inline'>CBT<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_46_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.7' type='checkbox'  value='Creative Arts Therapy'  id='choice_3_46_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_46_7' id='label_3_46_7' class='gform-field-label gform-field-label--type-inline'>Creative Arts Therapy<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_46_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.8' type='checkbox'  value='DBT'  id='choice_3_46_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_46_8' id='label_3_46_8' class='gform-field-label gform-field-label--type-inline'>DBT<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_46_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.9' type='checkbox'  value='EMDR'  id='choice_3_46_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_46_9' id='label_3_46_9' class='gform-field-label gform-field-label--type-inline'>EMDR<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_46_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.11' type='checkbox'  value='Harm Reduction'  id='choice_3_46_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_46_11' id='label_3_46_11' class='gform-field-label gform-field-label--type-inline'>Harm Reduction<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_46_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.12' type='checkbox'  value='Hypnotherapy'  id='choice_3_46_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_46_12' id='label_3_46_12' class='gform-field-label gform-field-label--type-inline'>Hypnotherapy<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_46_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.13' type='checkbox'  value='Internal Family Systems'  id='choice_3_46_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_46_13' id='label_3_46_13' class='gform-field-label gform-field-label--type-inline'>Internal Family Systems<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_46_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.14' type='checkbox'  value='Ketamine-Assisted Psychotherapy'  id='choice_3_46_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_46_14' id='label_3_46_14' class='gform-field-label gform-field-label--type-inline'>Ketamine-Assisted Psychotherapy<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_46_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.15' type='checkbox'  value='Palliative'  id='choice_3_46_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_46_15' id='label_3_46_15' class='gform-field-label gform-field-label--type-inline'>Palliative<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_46_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.16' type='checkbox'  value='Pleasure-Informed'  id='choice_3_46_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_46_16' id='label_3_46_16' class='gform-field-label gform-field-label--type-inline'>Pleasure-Informed<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_46_17'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.17' type='checkbox'  value='Psychedelic Integration Support'  id='choice_3_46_17'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_46_17' id='label_3_46_17' class='gform-field-label gform-field-label--type-inline'>Psychedelic Integration Support<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_46_18'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.18' type='checkbox'  value='Psychodynamic'  id='choice_3_46_18'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_46_18' id='label_3_46_18' class='gform-field-label gform-field-label--type-inline'>Psychodynamic<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_46_19'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.19' type='checkbox'  value='Somatic'  id='choice_3_46_19'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_46_19' id='label_3_46_19' class='gform-field-label gform-field-label--type-inline'>Somatic<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_46_21'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.21' type='checkbox'  value='Trauma-Informed'  id='choice_3_46_21'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_46_21' id='label_3_46_21' class='gform-field-label gform-field-label--type-inline'>Trauma-Informed<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_3_52\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_52\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >In which state(s)\/territory(ies) are you licensed and able to work with clients?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_3_52'><div class='gchoice gchoice_3_52_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.1' type='checkbox'  value='Alabama'  id='choice_3_52_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_1' id='label_3_52_1' class='gform-field-label gform-field-label--type-inline'>Alabama<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.2' type='checkbox'  value='Alaska'  id='choice_3_52_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_2' id='label_3_52_2' class='gform-field-label gform-field-label--type-inline'>Alaska<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.3' type='checkbox'  value='Arizona'  id='choice_3_52_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_3' id='label_3_52_3' class='gform-field-label gform-field-label--type-inline'>Arizona<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.4' type='checkbox'  value='Arkansas'  id='choice_3_52_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_4' id='label_3_52_4' class='gform-field-label gform-field-label--type-inline'>Arkansas<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.5' type='checkbox'  value='California'  id='choice_3_52_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_5' id='label_3_52_5' class='gform-field-label gform-field-label--type-inline'>California<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.6' type='checkbox'  value='Colorado'  id='choice_3_52_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_6' id='label_3_52_6' class='gform-field-label gform-field-label--type-inline'>Colorado<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.7' type='checkbox'  value='Connecticut'  id='choice_3_52_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_7' id='label_3_52_7' class='gform-field-label gform-field-label--type-inline'>Connecticut<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.8' type='checkbox'  value='Delaware'  id='choice_3_52_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_8' id='label_3_52_8' class='gform-field-label gform-field-label--type-inline'>Delaware<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.9' type='checkbox'  value='District of Columbia'  id='choice_3_52_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_9' id='label_3_52_9' class='gform-field-label gform-field-label--type-inline'>District of Columbia<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.11' type='checkbox'  value='Florida'  id='choice_3_52_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_11' id='label_3_52_11' class='gform-field-label gform-field-label--type-inline'>Florida<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.12' type='checkbox'  value='Georgia'  id='choice_3_52_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_12' id='label_3_52_12' class='gform-field-label gform-field-label--type-inline'>Georgia<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.13' type='checkbox'  value='Hawaii'  id='choice_3_52_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_13' id='label_3_52_13' class='gform-field-label gform-field-label--type-inline'>Hawaii<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.14' type='checkbox'  value='Idaho'  id='choice_3_52_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_14' id='label_3_52_14' class='gform-field-label gform-field-label--type-inline'>Idaho<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.15' type='checkbox'  value='Illinois'  id='choice_3_52_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_15' id='label_3_52_15' class='gform-field-label gform-field-label--type-inline'>Illinois<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.16' type='checkbox'  value='Indiana'  id='choice_3_52_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_16' id='label_3_52_16' class='gform-field-label gform-field-label--type-inline'>Indiana<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_17'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.17' type='checkbox'  value='Iowa'  id='choice_3_52_17'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_17' id='label_3_52_17' class='gform-field-label gform-field-label--type-inline'>Iowa<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_18'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.18' type='checkbox'  value='Kansas'  id='choice_3_52_18'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_18' id='label_3_52_18' class='gform-field-label gform-field-label--type-inline'>Kansas<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_19'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.19' type='checkbox'  value='Kentucky'  id='choice_3_52_19'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_19' id='label_3_52_19' class='gform-field-label gform-field-label--type-inline'>Kentucky<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_21'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.21' type='checkbox'  value='Louisiana'  id='choice_3_52_21'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_21' id='label_3_52_21' class='gform-field-label gform-field-label--type-inline'>Louisiana<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_22'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.22' type='checkbox'  value='Maine'  id='choice_3_52_22'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_22' id='label_3_52_22' class='gform-field-label gform-field-label--type-inline'>Maine<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_23'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.23' type='checkbox'  value='Maryland'  id='choice_3_52_23'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_23' id='label_3_52_23' class='gform-field-label gform-field-label--type-inline'>Maryland<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_24'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.24' type='checkbox'  value='Massachusetts'  id='choice_3_52_24'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_24' id='label_3_52_24' class='gform-field-label gform-field-label--type-inline'>Massachusetts<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_25'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.25' type='checkbox'  value='Michigan'  id='choice_3_52_25'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_25' id='label_3_52_25' class='gform-field-label gform-field-label--type-inline'>Michigan<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_26'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.26' type='checkbox'  value='Minnesota'  id='choice_3_52_26'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_26' id='label_3_52_26' class='gform-field-label gform-field-label--type-inline'>Minnesota<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_27'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.27' type='checkbox'  value='Mississippi'  id='choice_3_52_27'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_27' id='label_3_52_27' class='gform-field-label gform-field-label--type-inline'>Mississippi<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_28'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.28' type='checkbox'  value='Missouri'  id='choice_3_52_28'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_28' id='label_3_52_28' class='gform-field-label gform-field-label--type-inline'>Missouri<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_29'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.29' type='checkbox'  value='Montana'  id='choice_3_52_29'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_29' id='label_3_52_29' class='gform-field-label gform-field-label--type-inline'>Montana<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_31'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.31' type='checkbox'  value='Nebraska'  id='choice_3_52_31'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_31' id='label_3_52_31' class='gform-field-label gform-field-label--type-inline'>Nebraska<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_32'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.32' type='checkbox'  value='Nevada'  id='choice_3_52_32'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_32' id='label_3_52_32' class='gform-field-label gform-field-label--type-inline'>Nevada<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_33'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.33' type='checkbox'  value='New Hampshire'  id='choice_3_52_33'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_33' id='label_3_52_33' class='gform-field-label gform-field-label--type-inline'>New Hampshire<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_34'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.34' type='checkbox'  value='New Jersey'  id='choice_3_52_34'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_34' id='label_3_52_34' class='gform-field-label gform-field-label--type-inline'>New Jersey<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_35'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.35' type='checkbox'  value='New Mexico'  id='choice_3_52_35'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_35' id='label_3_52_35' class='gform-field-label gform-field-label--type-inline'>New Mexico<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_36'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.36' type='checkbox'  value='New York'  id='choice_3_52_36'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_36' id='label_3_52_36' class='gform-field-label gform-field-label--type-inline'>New York<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_37'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.37' type='checkbox'  value='North Carolina'  id='choice_3_52_37'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_37' id='label_3_52_37' class='gform-field-label gform-field-label--type-inline'>North Carolina<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_38'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.38' type='checkbox'  value='North Dakota'  id='choice_3_52_38'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_38' id='label_3_52_38' class='gform-field-label gform-field-label--type-inline'>North Dakota<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_39'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.39' type='checkbox'  value='Ohio'  id='choice_3_52_39'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_39' id='label_3_52_39' class='gform-field-label gform-field-label--type-inline'>Ohio<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_41'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.41' type='checkbox'  value='Oklahoma'  id='choice_3_52_41'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_41' id='label_3_52_41' class='gform-field-label gform-field-label--type-inline'>Oklahoma<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_42'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.42' type='checkbox'  value='Oregon'  id='choice_3_52_42'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_42' id='label_3_52_42' class='gform-field-label gform-field-label--type-inline'>Oregon<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_43'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.43' type='checkbox'  value='Pennsylvania'  id='choice_3_52_43'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_43' id='label_3_52_43' class='gform-field-label gform-field-label--type-inline'>Pennsylvania<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_44'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.44' type='checkbox'  value='Puerto Rico'  id='choice_3_52_44'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_44' id='label_3_52_44' class='gform-field-label gform-field-label--type-inline'>Puerto Rico<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_45'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.45' type='checkbox'  value='Rhode Island'  id='choice_3_52_45'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_45' id='label_3_52_45' class='gform-field-label gform-field-label--type-inline'>Rhode Island<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_46'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.46' type='checkbox'  value='South Carolina'  id='choice_3_52_46'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_46' id='label_3_52_46' class='gform-field-label gform-field-label--type-inline'>South Carolina<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_47'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.47' type='checkbox'  value='South Dakota'  id='choice_3_52_47'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_47' id='label_3_52_47' class='gform-field-label gform-field-label--type-inline'>South Dakota<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_48'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.48' type='checkbox'  value='Tennessee'  id='choice_3_52_48'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_48' id='label_3_52_48' class='gform-field-label gform-field-label--type-inline'>Tennessee<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_49'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.49' type='checkbox'  value='Texas'  id='choice_3_52_49'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_49' id='label_3_52_49' class='gform-field-label gform-field-label--type-inline'>Texas<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_51'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.51' type='checkbox'  value='Utah'  id='choice_3_52_51'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_51' id='label_3_52_51' class='gform-field-label gform-field-label--type-inline'>Utah<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_52'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.52' type='checkbox'  value='Vermont'  id='choice_3_52_52'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_52' id='label_3_52_52' class='gform-field-label gform-field-label--type-inline'>Vermont<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_53'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.53' type='checkbox'  value='Virginia'  id='choice_3_52_53'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_53' id='label_3_52_53' class='gform-field-label gform-field-label--type-inline'>Virginia<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_54'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.54' type='checkbox'  value='Virgin Islands'  id='choice_3_52_54'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_54' id='label_3_52_54' class='gform-field-label gform-field-label--type-inline'>Virgin Islands<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_55'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.55' type='checkbox'  value='Washington'  id='choice_3_52_55'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_55' id='label_3_52_55' class='gform-field-label gform-field-label--type-inline'>Washington<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_56'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.56' type='checkbox'  value='West Virginia'  id='choice_3_52_56'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_56' id='label_3_52_56' class='gform-field-label gform-field-label--type-inline'>West Virginia<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_57'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.57' type='checkbox'  value='Wisconsin'  id='choice_3_52_57'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_57' id='label_3_52_57' class='gform-field-label gform-field-label--type-inline'>Wisconsin<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_52_58'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.58' type='checkbox'  value='Wyoming'  id='choice_3_52_58'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_52_58' id='label_3_52_58' class='gform-field-label gform-field-label--type-inline'>Wyoming<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3_37\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_37\" ><label class='gfield_label gform-field-label' for='input_3_37'>New listserv email (if you would like to update your listserv email, enter the new email here):<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_37' id='input_3_37' type='email' value='' class='large'     aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_3_38\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_38\" ><label class='gfield_label gform-field-label' for='input_3_38'>Remove listserv email (if you would like to remove your previous listserv email, enter it here):<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_38' id='input_3_38' type='email' value='' class='large'     aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_3_40\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_40\" ><label class='gfield_label gform-field-label' for='input_3_40'>Questions, comments, clarifications:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_40' id='input_3_40' class='textarea large'   maxlength='800'   aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_3_39\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_39\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Anti-racist agreement<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_39.1' id='input_3_39_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_3_39\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_3_39_1' >I am anti-racist, and I am committed to dismantling white supremacy.<\/label><input type='hidden' name='input_39.2' value='I am anti-racist, and I am committed to dismantling white supremacy.' class='gform_hidden' \/><input type='hidden' name='input_39.3' value='6' class='gform_hidden' \/><\/div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_3_39'>Please read and follow ManhattanAlternative.com\/community-guidelines; if the guidelines are not followed, you will be removed from the site.<\/div><\/fieldset><fieldset id=\"field_3_42\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_42\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Non-exploitation agreement<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_42.1' id='input_3_42_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_3_42\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_3_42_1' >I agree to follow Community Guidelines, and to avoid any behavior that would  exploit community members, supervisees, employees, and colleagues.<\/label><input type='hidden' name='input_42.2' value='I agree to follow Community Guidelines, and to avoid any behavior that would  exploit community members, supervisees, employees, and colleagues.' class='gform_hidden' \/><input type='hidden' name='input_42.3' value='6' class='gform_hidden' \/><\/div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_3_42'>Please read and follow ManhattanAlternative.com\/community-guidelines; if the guidelines are not followed, you will be removed from the site.<\/div><\/fieldset><fieldset id=\"field_3_41\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_41\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Consent<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_41.1' id='input_3_41_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_3_41\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_3_41_1' >I agree to the privacy policy.<\/label><input type='hidden' name='input_41.2' value='I agree to the privacy policy.' class='gform_hidden' \/><input type='hidden' name='input_41.3' value='6' class='gform_hidden' \/><\/div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_3_41'>Please read ManhattanAlternative.com\/privacy-protocol to learn about steps taken to ensure your information is kept private.<\/div><\/fieldset><div id=\"field_3_54\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_54\" ><label class='gfield_label gform-field-label' for='input_3_54'>Comments<\/label><div class='ginput_container'><input name='input_54' id='input_3_54' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_3_54'>This field is for validation purposes and should be left unchanged.<\/div><\/div><\/div><\/div>\n        <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_3' class='gform_button button' value='Submit'  onclick='if(window[\"gf_submitting_3\"]){return false;}  if( !jQuery(\"#gform_3\")[0].checkValidity || jQuery(\"#gform_3\")[0].checkValidity()){window[\"gf_submitting_3\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_3\"]){return false;} if( !jQuery(\"#gform_3\")[0].checkValidity || jQuery(\"#gform_3\")[0].checkValidity()){window[\"gf_submitting_3\"]=true;}  jQuery(\"#gform_3\").trigger(\"submit\",[true]); }' \/> \n            <input type='hidden' class='gform_hidden' name='is_submit_3' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='3' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_3' value='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' \/>\n            <input type='hidden' class='gform_hidden' name='gform_target_page_number_3' id='gform_target_page_number_3' value='0' \/>\n            <input type='hidden' class='gform_hidden' name='gform_source_page_number_3' id='gform_source_page_number_3' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/form>\n                        <\/div><script>\ngform.initializeOnLoaded( function() {gformInitSpinner( 3, 'https:\/\/www.manhattanalternative.com\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', false );jQuery('#gform_ajax_frame_3').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_3');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_3').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){jQuery('#gform_wrapper_3').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_3').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_3').removeClass('gform_validation_error');}setTimeout( function() { \/* delay the scroll by 50 milliseconds to fix a bug in chrome *\/  }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_3').val();gformInitSpinner( 3, 'https:\/\/www.manhattanalternative.com\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', false );jQuery(document).trigger('gform_page_loaded', [3, current_page]);window['gf_submitting_3'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}setTimeout(function(){jQuery('#gform_wrapper_3').replaceWith(confirmation_content);jQuery(document).trigger('gform_confirmation_loaded', [3]);window['gf_submitting_3'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_3').text());}, 50);}else{jQuery('#gform_3').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger(\"gform_pre_post_render\", [{ formId: \"3\", currentPage: \"current_page\", abort: function() { this.preventDefault(); } }]);                if (event.defaultPrevented) {                return;         }        const gformWrapperDiv = document.getElementById( \"gform_wrapper_3\" );        if ( gformWrapperDiv ) {            const visibilitySpan = document.createElement( \"span\" );            visibilitySpan.id = \"gform_visibility_test_3\";            gformWrapperDiv.insertAdjacentElement( \"afterend\", visibilitySpan );        }        const visibilityTestDiv = document.getElementById( \"gform_visibility_test_3\" );        let postRenderFired = false;                function triggerPostRender() {            if ( postRenderFired ) {                return;            }            postRenderFired = true;            jQuery( document ).trigger( 'gform_post_render', [3, current_page] );            gform.utils.trigger( { event: 'gform\/postRender', native: false, data: { formId: 3, currentPage: current_page } } );            if ( visibilityTestDiv ) {                visibilityTestDiv.parentNode.removeChild( visibilityTestDiv );            }        }        function debounce( func, wait, immediate ) {            var timeout;            return function() {                var context = this, args = arguments;                var later = function() {                    timeout = null;                    if ( !immediate ) func.apply( context, args );                };                var callNow = immediate && !timeout;                clearTimeout( timeout );                timeout = setTimeout( later, wait );                if ( callNow ) func.apply( context, args );            };        }        const debouncedTriggerPostRender = debounce( function() {            triggerPostRender();        }, 200 );        if ( visibilityTestDiv && visibilityTestDiv.offsetParent === null ) {            const observer = new MutationObserver( ( mutations ) => {                mutations.forEach( ( mutation ) => {                    if ( mutation.type === 'attributes' && visibilityTestDiv.offsetParent !== null ) {                        debouncedTriggerPostRender();                        observer.disconnect();                    }                });            });            observer.observe( document.body, {                attributes: true,                childList: false,                subtree: true,                attributeFilter: [ 'style', 'class' ],            });        } else {            triggerPostRender();        }    } );} );\n<\/script>\n","protected":false},"excerpt":{"rendered":"<p>Please fill out the form below if you currently have a profile on ManhattanAlternative.com and would like to make updates to your profile (please fill out only what you&#8217;d like updated). This website and community are maintained through contributions by the community. If you haven&#8217;t already, please sign up for a monthly donation of $5&hellip;&nbsp;<a href=\"https:\/\/www.manhattanalternative.com\/listing-update-form\/\" class=\"\" rel=\"bookmark\">Read More &raquo;<span class=\"screen-reader-text\">Listing Update Form<\/span><\/a><\/p>\n","protected":false},"author":18,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_seopress_robots_primary_cat":"","_seopress_titles_title":"","_seopress_titles_desc":"","_seopress_robots_index":"","inline_featured_image":false,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"","neve_meta_content_width":0,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","neve_meta_reading_time":"","footnotes":""},"acf":[],"_links":{"self":[{"href":"https:\/\/www.manhattanalternative.com\/wp-json\/wp\/v2\/pages\/2784"}],"collection":[{"href":"https:\/\/www.manhattanalternative.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.manhattanalternative.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.manhattanalternative.com\/wp-json\/wp\/v2\/users\/18"}],"replies":[{"embeddable":true,"href":"https:\/\/www.manhattanalternative.com\/wp-json\/wp\/v2\/comments?post=2784"}],"version-history":[{"count":2,"href":"https:\/\/www.manhattanalternative.com\/wp-json\/wp\/v2\/pages\/2784\/revisions"}],"predecessor-version":[{"id":8582,"href":"https:\/\/www.manhattanalternative.com\/wp-json\/wp\/v2\/pages\/2784\/revisions\/8582"}],"wp:attachment":[{"href":"https:\/\/www.manhattanalternative.com\/wp-json\/wp\/v2\/media?parent=2784"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}