$consent_fields = array();
$consent_fields[] = new PMProRH_Field(
    "cform0",
    "html",
    array(
        "label"=>" ",
        "showmainlabel"=> false,
        "levels"=> array(1,2,3),
        "profile"=>true,
        "required"=>false,
        "name"=>"cform0",
        "html" => "<div><h4>CONSENT FOR RELEASE OF MEDICAL RECORDS</h4><p>I hereby request and authorize the release of the requested medical/vaccination information for my pet (s) to mypetrecordsonline.com. I release the Veterinarian and staff from any legal responsibility or liability for the release of information to the extent indicated as authorized herein. I understand I may revoke this authorization, but the revocation may not be applied retroactively once the information specified herein has been released.</p>"
       ),$atts));

$consent_fields[] = new PMProRH_Field(
    "cform1",
    "html",
    array(
        "label"=>" ",
        "showmainlabel"=> false,
        "levels"=> array(1,2,3),
        "profile"=>true,
        "required"=>false,
        "name"=>"cform1",
        "html" => "<p> Owners Initials "
    ));
$consent_fields[] = new PMProRH_Field(
"cinitials",
"text",
array(
    "label"=>" ",
    "maxlength" => 3,
    "showmainlabel"=> false,
    "levels"=> array(1,2,3),
    "profile"=>true,
    "required"=>false,
    "class"=>"harry-inline",
    "name"=>"cinitials",
     ));
 $consent_fields[] = new PMProRH_Field(
    "cform2",
    "html",
    array(
        "label"=>" ",
        "showmainlabel"=> false,
        "levels"=> array(1,2,3),
        "profile"=>true,
        "required"=>false,
        "name"=>"cform2",
        "html" => "</p></div>",
         ));

$consent_fields[] = new PMProRH_Field(
    "tos",
    "checkbox",
    array(
        "label"=>"<p>I accept the <a href="http://mpo.itsod.com/mypetrecordsonline/terms-of-use/" target="_blank">Terms of Service</a></p>",
        //"levels"=> array(1,2,3,4),
        "profile"=>false,
        "required"=>true
    ));