{"id":141,"date":"2015-03-07T12:41:05","date_gmt":"2015-03-07T12:41:05","guid":{"rendered":"https:\/\/phasevtechnologies.com\/pcori\/?page_id=141"},"modified":"2015-03-08T11:41:13","modified_gmt":"2015-03-08T11:41:13","slug":"signup","status":"publish","type":"page","link":"https:\/\/phasevtech.net\/pcori\/signup\/","title":{"rendered":"Sign Up"},"content":{"rendered":"        <form enctype=\"multipart\/form-data\" method=\"post\" id=\"wppb-register-user-stakeholders-and-partners-registration-form\" class=\"wppb-user-forms wppb-register-user\" action=\"\">\r\n\t\t\t<ul><li class=\"wppb-form-field wppb-default-username\" id=\"wppb-form-element-2\">\r\n\t\t\t<label for=\"username\">Username<span class=\"wppb-required\" title=\"This field is required\">*<\/span><\/label>\r\n\t\t\t<input class=\"text-input default_field_username\" name=\"username\" maxlength=\"70\" type=\"text\" id=\"username\" value=\"\"\/><\/li><li class=\"wppb-form-field wppb-default-first-name\" id=\"wppb-form-element-3\">\r\n\t\t\t<label for=\"first_name\">First Name<\/label>\r\n\t\t\t<input class=\"text-input default_field_firstname\" name=\"first_name\" maxlength=\"70\" type=\"text\" id=\"first_name\" value=\"\" \/><\/li><li class=\"wppb-form-field wppb-default-last-name\" id=\"wppb-form-element-4\">\r\n\t\t\t<label for=\"last_name\">Last Name<\/label>\r\n\t\t\t<input class=\"text-input default_field_lastname\" name=\"last_name\" maxlength=\"70\" type=\"text\" id=\"last_name\" value=\"\" \/><\/li><li class=\"wppb-form-field wppb-default-display-name-publicly-as\" id=\"wppb-form-element-6\"><\/li><li class=\"wppb-form-field wppb-default-e-mail\" id=\"wppb-form-element-8\">\r\n\t\t\t<label for=\"email\">E-mail<span class=\"wppb-required\" title=\"This field is required\">*<\/span><\/label>\r\n\t\t\t<input class=\"text-input default_field_email\" name=\"email\" maxlength=\"70\" type=\"text\" id=\"email\" value=\"\" \/><\/li><li class=\"wppb-form-field wppb-checkbox\" id=\"wppb-form-element-14\">\r\n\t\t\t\t<label for=\"cf_rel_diab\">What is your relationship with diabetes? (check all that apply)<span class=\"wppb-required\" title=\"This field is required\">*<\/span><\/label><ul class=\"wppb-checkboxes\"><li><input value=\"1\" class=\"custom_field_checkbox\" name=\"1_14\" id=\"1_14\" type=\"checkbox\" \/><label for=\"1_14\" class=\"wppb-rc-value\">I have diabetes<\/label><\/li><li><input value=\"2\" class=\"custom_field_checkbox\" name=\"2_14\" id=\"2_14\" type=\"checkbox\" \/><label for=\"2_14\" class=\"wppb-rc-value\">My child has diabetes<\/label><\/li><li><input value=\"3\" class=\"custom_field_checkbox\" name=\"3_14\" id=\"3_14\" type=\"checkbox\" \/><label for=\"3_14\" class=\"wppb-rc-value\">A close relative(s) of mine other than a child (spouse&#44; parent&#44; sister or brother&#44; aunt&#44; uncle) has diabetes<\/label><\/li><li><input value=\"4\" class=\"custom_field_checkbox\" name=\"4_14\" id=\"4_14\" type=\"checkbox\" \/><label for=\"4_14\" class=\"wppb-rc-value\">I am a physician<\/label><\/li><li><input value=\"5\" class=\"custom_field_checkbox\" name=\"5_14\" id=\"5_14\" type=\"checkbox\" \/><label for=\"5_14\" class=\"wppb-rc-value\">nurse or other type of clinician that takes care of persons with diabetes<\/label><\/li><li><input value=\"6\" class=\"custom_field_checkbox\" name=\"6_14\" id=\"6_14\" type=\"checkbox\" \/><label for=\"6_14\" class=\"wppb-rc-value\">I do research on health outcomes in diabetes<\/label><\/li><li><input value=\"7\" class=\"custom_field_checkbox\" name=\"7_14\" id=\"7_14\" type=\"checkbox\" \/><label for=\"7_14\" class=\"wppb-rc-value\">I work for a company that provides diabetes medications&#44; technologies&#44; or other types of purchased services<\/label><\/li><li><input value=\"8\" class=\"custom_field_checkbox\" name=\"8_14\" id=\"8_14\" type=\"checkbox\" \/><label for=\"8_14\" class=\"wppb-rc-value\">I am employed by a professional organization particularly focused on supporting diabetes (Clinic&#44; American Diabetes Association&#44; etc.)<\/label><\/li><li><input value=\"9\" class=\"custom_field_checkbox\" name=\"9_14\" id=\"9_14\" type=\"checkbox\" \/><label for=\"9_14\" class=\"wppb-rc-value\">I do not have any of the above relationships with diabetes&#44; however&#44; I am interested in learning more about diabetes<\/label><\/li><\/ul><\/li><li class=\"wppb-form-field wppb-default-password\" id=\"wppb-form-element-12\">\r\n\t\t\t<label for=\"passw1\">Password<span class=\"wppb-required\" title=\"This field is required\">*<\/span><\/label>\r\n\t\t\t<input class=\"text-input\" name=\"passw1\" maxlength=\"70\" type=\"password\" id=\"passw1\" value=\"\" autocomplete=\"off\" \/><span class=\"wppb-description-delimiter\">Minimum length of 6 characters<\/span><span id=\"pass-strength-result\">Strength indicator<\/span>\r\n        <input type=\"hidden\" value=\"\" name=\"wppb_password_strength\" id=\"wppb_password_strength\"\/><\/li><li class=\"wppb-form-field wppb-default-repeat-password\" id=\"wppb-form-element-13\">\r\n\t\t\t<label for=\"passw2\">Repeat Password<span class=\"wppb-required\" title=\"This field is required\">*<\/span><\/label>\r\n\t\t\t<input class=\"text-input\" name=\"passw2\" maxlength=\"70\" type=\"password\" id=\"passw2\" value=\"\" autocomplete=\"off\" \/><\/li><li class=\"wppb-form-field wppb-recaptcha\" id=\"wppb-form-element-15\"><style type=\"text\/css\">#recaptcha_area{line-height:0;}<\/style><label for=\"recaptcha_response_field\">Complete this question to screen for robots.<span class=\"wppb-required\" title=\"This field is required\">*<\/span><\/label>\r\n        <script src=\"https:\/\/www.google.com\/recaptcha\/api.js\" async defer><\/script>\r\n\t\t<div id=\"recaptcha_widget_div\" class=\"g-recaptcha\" data-sitekey=\"6LdWk_oSAAAAAP8gZ7M0SylymG7GCi3L878Tm88a\" data-theme=\"light\" ><\/div>\r\n\t\t<\/li><\/ul><ul><\/ul>\t\t\t<p class=\"form-submit\">\r\n\t\t\t\t\t\t\t\r\n\t\t\t\t<input name=\"register\" type=\"submit\" id=\"register\" class=\"submit button\" value=\"Register\" \/>\r\n\t\t\t\t<input name=\"action\" type=\"hidden\" id=\"action\" value=\"register\" \/>\r\n\t\t\t\t<input name=\"form_name\" type=\"hidden\" id=\"form_name\" value=\"stakeholders-and-partners-registration-form\" \/>\r\n\t\t\t<\/p><!-- .form-submit -->\r\n\t\t\t<input type=\"hidden\" id=\"register_nonce_field\" name=\"register_nonce_field\" value=\"1d88eff25f\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/pcori\/wp-json\/wp\/v2\/pages\/141\" \/>\t\t<\/form>\r\n\t\t\n","protected":false},"excerpt":{"rendered":"Username* First Name Last Name E-mail* What is your relationship with diabetes? (check all that apply)*I have diabetesMy child has diabetesA close relative(s) of mine other than a child (spouse&#44; parent&#44; sister or brother&#44; aunt&#44; uncle) has diabetesI am a physiciannurse or other type of clinician that takes care of persons with diabetesI do research on health outcomes in diabetesI work for a company that provides diabetes medications&#44; technologies&#44; or other types of purchased servicesI am employed by a professional organization particularly focused on supporting diabetes (Clinic&#44; American Diabetes Association&#44; etc.)I do not have any of the above relationships with diabetes&#44; however&#44; I am interested in learning more about diabetes Password* Minimum length of 6 charactersStrength indicator Repeat Password* #recaptcha_area{line-height:0;}Complete this question to screen for robots.*","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"open","ping_status":"open","template":"","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0},"_links":{"self":[{"href":"https:\/\/phasevtech.net\/pcori\/wp-json\/wp\/v2\/pages\/141"}],"collection":[{"href":"https:\/\/phasevtech.net\/pcori\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/phasevtech.net\/pcori\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/phasevtech.net\/pcori\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/phasevtech.net\/pcori\/wp-json\/wp\/v2\/comments?post=141"}],"version-history":[{"count":3,"href":"https:\/\/phasevtech.net\/pcori\/wp-json\/wp\/v2\/pages\/141\/revisions"}],"predecessor-version":[{"id":230,"href":"https:\/\/phasevtech.net\/pcori\/wp-json\/wp\/v2\/pages\/141\/revisions\/230"}],"wp:attachment":[{"href":"https:\/\/phasevtech.net\/pcori\/wp-json\/wp\/v2\/media?parent=141"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}