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jerome24

counselling xform

jerome24
May 24th, 2024
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  1. <Form id="67">
  2. <Page Text="Page1" fontWeight="normal" fontSize="12px" fontFamily="Verdana, 'Lucida Grande', 'Trebuchet MS', Arial, Sans-Serif" Binding="Page1" Width="900px" Height="2173px" backgroundColor="">
  3. <Item WidgetType="TextBox" HelpText="MEDICAL RECORD NUMBER" Binding="patient/patient.medical_record_number" Left="672px" Top="51px" Width="200px" Height="25px" TabIndex="4" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  4. <Item WidgetType="Label" Text=" Visit Datetime" HelpText="ENCOUNTER DATETIME" Binding="encounter/encounter.encounter_datetime" Left="547px" Top="89px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  5. <Item WidgetType="DateTimeWidget" Binding="encounter/encounter.encounter_datetime" Left="672px" Top="87px" Width="200px" Height="25px" TabIndex="7" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  6. <Item WidgetType="Label" Text=" Counselling Form" HelpText="Label" Binding="LEFT51pxTOP30px-null" Left="51px" Top="30px" TabIndex="0" fontWeight="bold" fontSize="24px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  7. <Item WidgetType="Label" Text=" NACP Number" HelpText="MEDICAL RECORD NUMBER" Binding="patient/patient.medical_record_number" Left="547px" Top="55px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  8. <Item WidgetType="GroupBox" Binding="LEFT46pxTOP335px-null" Left="46px" Top="456px" Width="822px" Height="500px" TabIndex="0" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="dashed" borderWidth="1px" borderColor="rgb(26, 172, 155)">
  9. <Item WidgetType="Label" Text=" Counselling" HelpText="Header Label" Binding="LEFT46pxTOP335px-null" Left="null" Top="null" Width="100%" Height="20px" TabIndex="0" color="white" fontWeight="bold" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" backgroundColor="rgb(26, 172, 155)" textAlign="center" HeaderLabel="true"/>
  10. <Item WidgetType="RadioButton" Text="1st Session" HelpText="First Session" Binding="162789^First Session^99DCT" ParentBinding="obs/enhanced_adherence_counselling/value" Left="459px" Top="117px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  11. <Item WidgetType="RadioButton" Text="2nd Session" HelpText="Second Session" Binding="162790^Second Session^99DCT" ParentBinding="obs/enhanced_adherence_counselling/value" Left="598px" Top="119px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  12. <Item WidgetType="RadioButton" Text="3rd Session" HelpText="Third Session" Binding="162791^Third Session^99DCT" ParentBinding="obs/enhanced_adherence_counselling/value" Left="708px" Top="119px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  13. <Item WidgetType="RadioButton" Text="Done" HelpText="Done" Binding="162787^Done^99DCT" ParentBinding="obs/adherence_counselling/value" Left="459px" Top="156px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  14. <Item WidgetType="RadioButton" Text="Not done" HelpText="Not done" Binding="1118^Not done^99DCT" ParentBinding="obs/adherence_counselling/value" Left="598px" Top="152px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  15. <Item WidgetType="Label" Text="Lay Counselling" HelpText="Lay Counselling" Binding="obs/lay_counselling/value" Left="224px" Top="197px" TabIndex="0" fontWeight="normal" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  16. <Item WidgetType="RadioButton" Text="Done" HelpText="Done" Binding="162787^Done^99DCT" ParentBinding="obs/lay_counselling/value" Left="459px" Top="189px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  17. <Item WidgetType="RadioButton" Text="Not done" HelpText="Not done" Binding="1118^Not done^99DCT" ParentBinding="obs/lay_counselling/value" Left="598px" Top="185px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  18. <Item WidgetType="Label" Text="PMTCT Counselling" HelpText="PMTCT Counselling" Binding="obs/pmtct_counselling/value" Left="224px" Top="233px" TabIndex="0" fontWeight="normal" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  19. <Item WidgetType="RadioButton" Text="Done" HelpText="Done" Binding="162787^Done^99DCT" ParentBinding="obs/pmtct_counselling/value" Left="459px" Top="229px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  20. <Item WidgetType="RadioButton" Text="Not done" HelpText="Not done" Binding="1118^Not done^99DCT" ParentBinding="obs/pmtct_counselling/value" Left="598px" Top="229px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  21. <Item WidgetType="Label" Text="Disclosure Counselling" HelpText="Disclosure Counselling" Binding="obs/disclosure_counselling/value" Left="224px" Top="269px" TabIndex="0" fontWeight="normal" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  22. <Item WidgetType="RadioButton" Text="Partial Disclosure" HelpText="Partial Disclosure" Binding="162797^Partial Disclosure^99DCT" ParentBinding="obs/disclosure_counselling/value" Left="459px" Top="265px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  23. <Item WidgetType="RadioButton" Text="Full Disclosure" HelpText="Full Disclosure" Binding="162798^Full Disclosure^99DCT" ParentBinding="obs/disclosure_counselling/value" Left="598px" Top="271px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  24. <Item WidgetType="VerticalLine" Binding="LEFT197pxTOP51px-null" Left="197px" Top="51px" Height="447px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  25. <Item WidgetType="Label" Text="PrEP Counselling" HelpText="PrEP Counselling" Binding="obs/prep_counselling/value" Left="224px" Top="308px" TabIndex="0" fontWeight="normal" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  26. <Item WidgetType="RadioButton" Text="Done" HelpText="Done" Binding="162787^Done^99DCT" ParentBinding="obs/prep_counselling/value" Left="459px" Top="308px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  27. <Item WidgetType="RadioButton" Text="Not done" HelpText="Not done" Binding="1118^Not done^99DCT" ParentBinding="obs/prep_counselling/value" Left="598px" Top="302px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  28. <Item WidgetType="Label" Text="Other Counselling Purpose" HelpText="Other Counselling Purpose" Binding="obs/other_counselling_purpose/value" Left="224px" Top="346px" TabIndex="0" fontWeight="normal" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  29. <Item WidgetType="RadioButton" Text="Done" HelpText="Done" Binding="162787^Done^99DCT" ParentBinding="obs/other_counselling_purpose/value" Left="459px" Top="346px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  30. <Item WidgetType="RadioButton" Text="Not done" HelpText="Not done" Binding="1118^Not done^99DCT" ParentBinding="obs/other_counselling_purpose/value" Left="598px" Top="342px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  31. <Item WidgetType="Label" Text="If other, Specify" HelpText="Specify other counsellings" Binding="obs/others_-_counselling_section/value" Left="224px" Top="377px" TabIndex="0" fontWeight="normal" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  32. <Item WidgetType="HorizontalLine" Binding="LEFT2pxTOP417px-null" Left="2px" Top="417px" Width="821px" Height="0px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  33. <Item WidgetType="TextBox" HelpText="Specify other counsellings" Binding="obs/others_-_counselling_section/value" Left="409px" Top="377px" Width="200px" Height="25px" TabIndex="32" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  34. <Item WidgetType="RadioButton" Text="Not done" HelpText="Not done" Binding="1118^Not done^99DCT" ParentBinding="obs/counselling_status/value" Left="187px" Top="22px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  35. <Item WidgetType="Label" Text="Pre-ART Counselling" HelpText="Counselling before starting ART" Binding="obs/pre-art_counselling/value" Left="224px" Top="79px" TabIndex="0" fontWeight="normal" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  36. <Item WidgetType="Label" Text="Adherence Counselling" HelpText="Adherence Counselling" Binding="obs/adherence_counselling/value" Left="224px" Top="160px" TabIndex="0" fontWeight="normal" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  37. <Item WidgetType="Label" Text=" What counselling has" HelpText="What counselling has been done today?" Binding="LEFT4pxTOP98px-null" Left="0px" Top="148px" Height="34px" TabIndex="0" fontWeight="bold" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" textAlign="left"/>
  38. <Item WidgetType="Label" Text=" been done today?" HelpText="Label" Binding="LEFT31pxTOP184px-null" Left="4px" Top="183px" TabIndex="0" fontWeight="bold" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  39. <Item WidgetType="Label" Text="Enhanced Adherence Counselling" HelpText="Enhanced Adherence Counselling" Binding="obs/enhanced_adherence_counselling/value" Left="224px" Top="117px" TabIndex="0" fontWeight="normal" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  40. <Item WidgetType="RadioButton" Text="3rd Session" HelpText="Third Session" Binding="162791^Third Session^99DCT" ParentBinding="obs/pre-art_counselling/value" Left="708px" Top="81px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  41. <Item WidgetType="RadioButton" Text=" 2nd Session" HelpText="Second Session" Binding="162790^Second Session^99DCT" ParentBinding="obs/pre-art_counselling/value" Left="598px" Top="79px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  42. <Item WidgetType="RadioButton" Text=" 1st Session" HelpText="First Session" Binding="162789^First Session^99DCT" ParentBinding="obs/pre-art_counselling/value" Left="459px" Top="77px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  43. <Item WidgetType="Label" Text=" Notes/Observations" HelpText="Label" Binding="LEFT3pxTOP455px-null" Left="3px" Top="455px" TabIndex="0" fontWeight="bold" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  44. <Item WidgetType="Label" Text=" Current" HelpText="Label" Binding="LEFT6pxTOP434px-null" Left="2px" Top="434px" TabIndex="0" fontWeight="bold" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  45. <Item WidgetType="TextArea" HelpText="Notes/Observations taken in the Counselling section" Binding="obs/counselling_notes/value" Left="207px" Top="424px" Width="288px" Height="60px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  46. <Item WidgetType="HorizontalLine" Binding="LEFT-1pxTOP51px-null" Left="-1px" Top="51px" Width="827px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  47. <Item WidgetType="RadioButton" Text="Done" HelpText="Done" Binding="162787^Done^99DCT" ParentBinding="obs/counselling_status/value" Left="98px" Top="24px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  48. </Item>
  49. <Item WidgetType="GroupBox" Binding="LEFT51pxTOP134px-null" Left="46px" Top="129px" Width="822px" Height="172px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="dashed" borderWidth="1px" borderColor="rgb(26, 172, 155)">
  50. <Item WidgetType="Label" Text=" Demographics" HelpText="Header Label" Binding="LEFT51pxTOP134px-null" Left="null" Top="null" Width="100%" Height="20px" TabIndex="0" color="white" fontWeight="bold" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" backgroundColor="rgb(26, 172, 155)" textAlign="center" HeaderLabel="true"/>
  51. <Item WidgetType="TextBox" HelpText="FAMILY NAME" Binding="patient/patient.family_name" Left="591px" Top="57px" Width="200px" Height="25px" TabIndex="2" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  52. <Item WidgetType="Label" Text=" Last Name" HelpText="FAMILY NAME" Binding="patient/patient.family_name" Left="588px" Top="32px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  53. <Item WidgetType="TextBox" HelpText="MIDDLE NAME" Binding="patient/patient.middle_name" Left="313px" Top="57px" Width="200px" Height="25px" TabIndex="5" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  54. <Item WidgetType="TextBox" HelpText="GIVEN NAME" Binding="patient/patient.given_name" Left="24px" Top="57px" Width="200px" Height="25px" TabIndex="3" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  55. <Item WidgetType="Label" Text=" First Name" HelpText="GIVEN NAME" Binding="patient/patient.given_name" Left="24px" Top="32px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  56. <Item WidgetType="Label" Text=" Middle Name" HelpText="MIDDLE NAME" Binding="patient/patient.middle_name" Left="313px" Top="37px" Height="0px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  57. <Item WidgetType="DatePicker" HelpText="BIRTHDATE" Binding="patient/patient.birthdate" Left="22px" Top="126px" Width="200px" Height="25px" TabIndex="1" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  58. <Item WidgetType="Label" Text=" Date of Birth" HelpText="BIRTHDATE" Binding="patient/patient.birthdate" Left="26px" Top="104px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  59. <Item WidgetType="Label" Text=" Sex" HelpText="SEX" Binding="patient/patient.sex" Left="313px" Top="104px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  60. <Item WidgetType="TextBox" HelpText="SEX" Binding="patient/patient.sex" Left="313px" Top="126px" Width="200px" Height="25px" TabIndex="6" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  61. </Item>
  62. <Item WidgetType="GroupBox" Binding="LEFT46pxTOP312px-null" Left="45px" Top="315px" Width="823px" Height="124px" TabIndex="0" fontWeight="normal" fontStyle="normal" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="dashed" borderWidth="1px" borderColor="rgb(26, 172, 155)">
  63. <Item WidgetType="Label" Text=" Visitect" HelpText="Header Label" Binding="LEFT46pxTOP312px-null" Left="null" Top="null" Width="100%" Height="20px" TabIndex="0" color="white" fontWeight="bold" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" backgroundColor="rgb(26, 172, 155)" textAlign="center" HeaderLabel="true"/>
  64. <Item WidgetType="RadioButton" Text=" Yes" HelpText="YES" Binding="1065^YES^99DCT" ParentBinding="obs/visitect/value" Left="658px" Top="33px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  65. <Item WidgetType="HorizontalLine" Binding="LEFT-1pxTOP51px-null" Left="-2px" Top="68px" Width="827px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  66. <Item WidgetType="RadioButton" Text="Invalid result" HelpText="Invalid result" Binding="163118^Invalid result^99DCT" ParentBinding="obs/visitect_res/value" Left="693px" Top="83px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  67. <Item WidgetType="RadioButton" Text="> 200 CD4 T cells/microL" HelpText="> 200 CD4 T cells/microL" Binding="163117^&gt; 200 CD4 T cells/microL^99DCT" ParentBinding="obs/visitect_res/value" Left="472px" Top="83px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  68. <Item WidgetType="RadioButton" Text="<= 200 CD4 T cells/microL" HelpText="<= 200 CD4 T cells/microL" Binding="163116^&lt;= 200 CD4 T cells/microL^99DCT" ParentBinding="obs/visitect_res/value" Left="261px" Top="84px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  69. <Item WidgetType="RadioButton" Text=" No" HelpText="NO" Binding="1066^NO^99DCT" ParentBinding="obs/visitect/value" Left="471px" Top="34px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  70. <Item WidgetType="Label" Text=" Was Visitect (Rapid CD4) done today?" HelpText="Was Visitect (Rapid CD4) done today?" Binding="obs/visitect/value" Left="19px" Top="37px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  71. <Item WidgetType="Label" Text=" Visitect (Rapid CD4) results" HelpText="Visitect (Rapid CD4) results" Binding="obs/visitect_res/value" Left="22px" Top="86px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  72. </Item>
  73. <Item WidgetType="Label" Text=" Go to the top of the page, and click page 2" HelpText="Label" Binding="LEFT40pxTOP1746px-null" Left="45px" Top="2094px" TabIndex="0" fontWeight="bold" fontSize="20px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
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  75. <Item WidgetType="Label" Text="Group Therapy" HelpText="Header Label" Binding="LEFT44pxTOP1471px-null" Left="null" Top="null" Width="100%" Height="20px" TabIndex="0" color="white" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" backgroundColor="rgb(26, 172, 155)" textAlign="center" HeaderLabel="true"/>
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  78. <Item WidgetType="VerticalLine" Binding="LEFT207pxTOP58px-null" Left="207px" Top="58px" Height="200px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  79. <Item WidgetType="RadioButton" Text="Done" HelpText="Done" Binding="162787^Done^99DCT" ParentBinding="obs/group_therapy_status/value" Left="98px" Top="26px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  80. <Item WidgetType="TextBox" HelpText="Number of sessions at 6-12 months" Binding="obs/number_of_sessions_-_group_therapy/value" Left="231px" Top="82px" Width="200px" Height="25px" TabIndex="7" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  81. <Item WidgetType="RadioButton" Text="Not done" HelpText="Not done" Binding="1118^Not done^99DCT" ParentBinding="obs/group_therapy_status/value" Left="187px" Top="26px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  82. <Item WidgetType="Label" Text=" If done, number of" HelpText="Number of sessions at 6-12 months" Binding="obs/number_of_sessions_-_group_therapy/value" Left="5px" Top="74px" TabIndex="0" fontWeight="bold" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  83. <Item WidgetType="Label" Text=" sessions at 6-12 months" HelpText="Label" Binding="LEFT39pxTOP108px-null" Left="0px" Top="96px" TabIndex="0" fontWeight="bold" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  84. <Item WidgetType="Label" Text=" Current" HelpText="Group Therapy - Notes" Binding="obs/group_therapy_-_notes/value" Left="6px" Top="168px" TabIndex="0" fontWeight="bold" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  85. <Item WidgetType="Label" Text="Notes/Observations" HelpText="Label" Binding="LEFT5pxTOP188px-null" Left="5px" Top="188px" TabIndex="0" fontWeight="bold" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  86. <Item WidgetType="TextArea" HelpText="Group Therapy - Notes" Binding="obs/group_therapy_-_notes/value" Left="229px" Top="144px" Width="274px" Height="84px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  87. </Item>
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  89. <Item WidgetType="Label" Text=" Stigma Video" HelpText="Header Label" Binding="LEFT43pxTOP1329px-null" Left="null" Top="null" Width="100%" Height="20px" TabIndex="0" color="white" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" backgroundColor="rgb(26, 172, 155)" textAlign="center" HeaderLabel="true"/>
  90. <Item WidgetType="HorizontalLine" Binding="LEFT-2pxTOP59px-null" Left="-2px" Top="59px" Width="827px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  91. <Item WidgetType="VerticalLine" Binding="LEFT207pxTOP59px-null" Left="207px" Top="59px" Height="72px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  92. <Item WidgetType="RadioButton" Text=" Shown" HelpText="Done" Binding="162787^Done^99DCT" ParentBinding="obs/stigma_video_status/value" Left="98px" Top="26px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  93. <Item WidgetType="RadioButton" Text=" Not Shown" HelpText="Not done" Binding="1118^Not done^99DCT" ParentBinding="obs/stigma_video_status/value" Left="187px" Top="26px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  94. <Item WidgetType="Label" Text=" Current" HelpText="Label" Binding="LEFT15pxTOP85px-null" Left="15px" Top="73px" TabIndex="0" fontWeight="bold" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  95. <Item WidgetType="Label" Text=" Notes/Observations" HelpText="Label" Binding="LEFT8pxTOP91px-null" Left="8px" Top="91px" TabIndex="0" fontWeight="bold" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  96. <Item WidgetType="TextArea" HelpText="Stigma Video - Notes" Binding="obs/stigma_video_-_notes/value" Left="228px" Top="67px" Width="279px" Height="60px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  97. </Item>
  98. <Item WidgetType="GroupBox" Binding="LEFT44pxTOP852px-null" Left="44px" Top="1192px" Width="822px" Height="467px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="dashed" borderWidth="1px" borderColor="rgb(26, 172, 155)">
  99. <Item WidgetType="Label" Text="Questionnaires" HelpText="Header Label" Binding="LEFT44pxTOP852px-null" Left="null" Top="null" Width="100%" Height="20px" TabIndex="0" color="white" fontWeight="bold" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" backgroundColor="rgb(26, 172, 155)" textAlign="center" HeaderLabel="true"/>
  100. <Item WidgetType="RadioButton" Text="Done" HelpText="Done" Binding="162787^Done^99DCT" ParentBinding="obs/questionnaires_status/value" Left="98px" Top="20px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  101. <Item WidgetType="RadioButton" Text="Not done" HelpText="Not done" Binding="1118^Not done^99DCT" ParentBinding="obs/questionnaires_status/value" Left="187px" Top="17px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  102. <Item WidgetType="GroupBox" Binding="LEFT6pxTOP48px-null" Left="5px" Top="46px" Width="811px" Height="190px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="dashed" borderWidth="1px" borderColor="rgb(26, 172, 155)">
  103. <Item WidgetType="Label" Text=" Stigma Questionnaire(Berger 2001 adapted)" HelpText="Header Label" Binding="LEFT6pxTOP48px-null" Left="-2px" Top="-2px" Width="100%" Height="20px" TabIndex="0" color="white" fontWeight="bold" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" backgroundColor="rgb(26, 172, 155)" textAlign="center" HeaderLabel="true"/>
  104. <Item WidgetType="HorizontalLine" Binding="LEFT-3pxTOP52px-null" Left="-3px" Top="52px" Width="808px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  105. <Item WidgetType="VerticalLine" Binding="LEFT199pxTOP51px-null" Left="199px" Top="51px" Height="200px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  106. <Item WidgetType="RadioButton" Text="Not done" HelpText="Not done" Binding="1118^Not done^99DCT" ParentBinding="obs/stigma_questionnaires_status/value" Left="187px" Top="20px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  107. <Item WidgetType="RadioButton" Text="Done" HelpText="Done" Binding="162787^Done^99DCT" ParentBinding="obs/stigma_questionnaires_status/value" Left="98px" Top="20px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  108. <Item WidgetType="Label" Text=" Total Score" HelpText="Total score - Stigma questionnaire" Binding="obs/total_score_-_stigma_questionnaire/value" Left="208px" Top="75px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  109. <Item WidgetType="Label" Text=" (2 - 35 points)" HelpText="Label" Binding="LEFT519pxTOP72px-null" Left="519px" Top="72px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  110. <Item WidgetType="TextBox" HelpText="Total score - Stigma questionnaire" Binding="obs/total_score_-_stigma_questionnaire/value" Left="303px" Top="67px" Width="200px" Height="25px" TabIndex="7" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  111. <Item WidgetType="HorizontalLine" Binding="LEFT-3pxTOP112px-null" Left="-3px" Top="112px" Width="811px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  112. <Item WidgetType="Label" Text=" Result" HelpText="Label" Binding="LEFT26pxTOP76px-null" Left="26px" Top="76px" TabIndex="0" fontWeight="bold" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  113. <Item WidgetType="Label" Text=" Current" HelpText="Label" Binding="LEFT7pxTOP145px-null" Left="7px" Top="129px" TabIndex="0" fontWeight="bold" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  114. <Item WidgetType="Label" Text=" Notes/Observations" HelpText="Label" Binding="LEFT4pxTOP147px-null" Left="4px" Top="147px" TabIndex="0" fontWeight="bold" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  115. <Item WidgetType="TextArea" HelpText="Stigma Questionnaire - Notes" Binding="obs/stigma_questionnaire_-_notes/value" Left="210px" Top="122px" Width="288px" Height="57px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  116. </Item>
  117. <Item WidgetType="GroupBox" Binding="LEFT6pxTOP253px-null" Left="7px" Top="249px" Width="808px" Height="206px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="dashed" borderWidth="1px" borderColor="rgb(26, 172, 155)">
  118. <Item WidgetType="Label" Text=" Depression Questionnaire (PHQ-9)" HelpText="Header Label" Binding="LEFT6pxTOP253px-null" Left="-2px" Top="-2px" Width="100%" Height="20px" TabIndex="0" color="white" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" backgroundColor="rgb(26, 172, 155)" textAlign="center" HeaderLabel="true"/>
  119. <Item WidgetType="HorizontalLine" Binding="LEFT-3pxTOP55px-null" Left="-3px" Top="55px" Width="809px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  120. <Item WidgetType="HorizontalLine" Binding="LEFT-1pxTOP111px-null" Left="-1px" Top="111px" Width="806px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  121. <Item WidgetType="RadioButton" Text="Done" HelpText="Done" Binding="162787^Done^99DCT" ParentBinding="obs/depression_questionnaires_status/value" Left="98px" Top="25px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  122. <Item WidgetType="VerticalLine" Binding="LEFT200pxTOP57px-null" Left="200px" Top="57px" Height="200px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  123. <Item WidgetType="Label" Text=" Total Score" HelpText="Total score - Depression" Binding="obs/depression_score/value" Left="212px" Top="76px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  124. <Item WidgetType="Label" Text=" (0 - 27 points)" HelpText="Label" Binding="LEFT527pxTOP80px-null" Left="527px" Top="80px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  125. <Item WidgetType="RadioButton" Text="Not done" HelpText="Not done" Binding="1118^Not done^99DCT" ParentBinding="obs/depression_questionnaires_status/value" Left="187px" Top="25px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  126. <Item WidgetType="TextBox" HelpText="Total score - Depression" Binding="obs/depression_score/value" Left="314px" Top="76px" Width="200px" Height="25px" TabIndex="8" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  127. <Item WidgetType="Label" Text=" Result" HelpText="Label" Binding="LEFT25pxTOP77px-null" Left="25px" Top="77px" TabIndex="0" fontWeight="bold" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  128. <Item WidgetType="Label" Text=" Notes/Observations" HelpText="Label" Binding="LEFT2pxTOP152px-null" Left="2px" Top="152px" TabIndex="0" fontWeight="bold" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  129. <Item WidgetType="Label" Text=" Current" HelpText="Label" Binding="LEFT11pxTOP151px-null" Left="6px" Top="132px" TabIndex="0" fontWeight="bold" fontSize="14px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  130. <Item WidgetType="TextArea" HelpText="Depression Questionnaire - Notes" Binding="obs/depression_questionnaire_-_notes/value" Left="212px" Top="121px" Width="288px" Height="75px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  131. </Item>
  132. </Item>
  133. <Item WidgetType="GroupBox" Binding="LEFT45pxTOP971px-null" Left="45px" Top="971px" Width="823px" Height="200px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="dashed" borderWidth="1px" borderColor="rgb(26, 172, 155)">
  134. <Item WidgetType="Label" Text=" PrEP" HelpText="Header Label" Binding="LEFT45pxTOP971px-null" Left="-1px" Top="0px" Width="100%" Height="20px" TabIndex="0" color="white" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" backgroundColor="rgb(26, 172, 155)" textAlign="center" HeaderLabel="true"/>
  135. <Item WidgetType="RadioButton" Text=" Yes" HelpText="YES" Binding="1065^YES^99DCT" ParentBinding="obs/partner_tested/value" Left="115px" Top="36px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  136. <Item WidgetType="RadioButton" Text=" No" HelpText="NO" Binding="1066^NO^99DCT" ParentBinding="obs/partner_tested/value" Left="175px" Top="36px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  137. <Item WidgetType="Label" Text="Partner tested" HelpText="Partner tested" Binding="obs/partner_tested/value" Left="12px" Top="38px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  138. <Item WidgetType="RadioButton" Text=" Negative" HelpText="NEGATIVE" Binding="664^NEGATIVE^99DCT" ParentBinding="obs/partner_result/value" Left="523px" Top="36px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  139. <Item WidgetType="RadioButton" Text=" Positive" HelpText="POSITIVE" Binding="703^POSITIVE^99DCT" ParentBinding="obs/partner_result/value" Left="627px" Top="36px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  140. <Item WidgetType="Label" Text="If Partner is tested Negative, PrEP service" HelpText="If Partner is tested Negative, PrEP service" Binding="obs/if_partner_is_tested_negative_prep_service/value" Left="14px" Top="176px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  141. <Item WidgetType="RadioButton" Text="Started" HelpText="Started" Binding="163186^Started^99DCT" ParentBinding="obs/if_partner_is_tested_negative_prep_service/value" Left="300px" Top="173px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  142. <Item WidgetType="RadioButton" Text="Not started" HelpText="Not started" Binding="163187^Not started^99DCT" ParentBinding="obs/if_partner_is_tested_negative_prep_service/value" Left="398px" Top="173px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  143. <Item WidgetType="Label" Text="If Positive, does he or she enrolled in KIULARCO?" HelpText="If Positive, does he or she enrolled in KIULARCO?" Binding="obs/if_positive_does_he_or_she_enrolled_in_kiularco/value" Left="15px" Top="86px" Height="5px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  144. <Item WidgetType="RadioButton" Text=" No" HelpText="NO" Binding="1066^NO^99DCT" ParentBinding="obs/if_positive_does_he_or_she_enrolled_in_kiularco/value" Left="463px" Top="72px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  145. <Item WidgetType="RadioButton" Text=" Yes" HelpText="YES" Binding="1065^YES^99DCT" ParentBinding="obs/if_positive_does_he_or_she_enrolled_in_kiularco/value" Left="392px" Top="72px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  146. <Item WidgetType="HorizontalLine" Binding="LEFT1pxTOP109px-null" Left="1px" Top="109px" Width="820px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  147. <Item WidgetType="Label" Text="If Yes, enter the NACP number" HelpText="If Yes, enter the NACP number" Binding="obs/if_yes_enter_the_nacp_number/value" Left="7px" Top="126px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  148. <Item WidgetType="TextBox" HelpText="If Yes, enter the NACP number" Binding="obs/if_yes_enter_the_nacp_number/value" Left="244px" Top="122px" Width="200px" Height="25px" TabIndex="12" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  149. <Item WidgetType="HorizontalLine" Binding="LEFT1pxTOP156px-null" Left="1px" Top="156px" Width="820px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  150. <Item WidgetType="HorizontalLine" Binding="LEFT1pxTOP64px-null" Left="1px" Top="64px" Width="820px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  151. <Item WidgetType="Label" Text="Partner result" HelpText="Partner result" Binding="obs/partner_result/value" Left="394px" Top="43px" Height="7px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  152. </Item>
  153. </Page>
  154. <Page Text="Page2" fontWeight="normal" fontSize="12px" fontFamily="Verdana, 'Lucida Grande', 'Trebuchet MS', Arial, Sans-Serif" Binding="Page2" Width="900px" Height="1600px" backgroundColor="">
  155. <Item WidgetType="Label" Text=" Provider Name" HelpText="PROVIDER ID" Binding="encounter/encounter.provider_id" Left="49px" Top="1483px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  156. <Item WidgetType="ListBox" HelpText="PROVIDER ID" Binding="encounter/encounter.provider_id" Left="179px" Top="1481px" Width="200px" Height="25px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  157. <Item WidgetType="Button" Text="Submit" HelpText="submit" Binding="submit" Left="650px" Top="1486px" Width="70px" Height="30px" TabIndex="34" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  158. <Item WidgetType="Button" Text="Cancel" HelpText="cancel" Binding="cancel" Left="797px" Top="1485px" Width="70px" Height="30px" TabIndex="35" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  159. <Item WidgetType="GroupBox" Binding="LEFT36pxTOP58px-null" Left="48px" Top="51px" Width="822px" Height="1406px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="dashed" borderWidth="1px" borderColor="rgb(26, 172, 155)">
  160. <Item WidgetType="Label" Text=" GBV QUESTIONS" HelpText="Header Label" Binding="LEFT36pxTOP58px-null" Left="null" Top="null" Width="100%" Height="20px" TabIndex="0" color="white" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" backgroundColor="rgb(26, 172, 155)" textAlign="center" HeaderLabel="true"/>
  161. <Item WidgetType="RadioButton" Text=" No" HelpText="NO" Binding="1066^NO^99DCT" ParentBinding="obs/gbv_screen/value" Left="560px" Top="31px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  162. <Item WidgetType="HorizontalLine" Binding="LEFT-1pxTOP175px-null" Left="-1px" Top="147px" Width="824px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  163. <Item WidgetType="HorizontalLine" Binding="LEFT-1pxTOP84px-null" Left="-1px" Top="76px" Width="824px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  164. <Item WidgetType="HorizontalLine" Binding="LEFT-4pxTOP251px-null" Left="0px" Top="217px" Width="824px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  165. <Item WidgetType="HorizontalLine" Binding="LEFT-3pxTOP327px-null" Left="-2px" Top="287px" Width="824px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  166. <Item WidgetType="RadioButton" Text=" No" HelpText="NO" Binding="1066^NO^99DCT" ParentBinding="obs/emotional/value" Left="560px" Top="157px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  167. <Item WidgetType="RadioButton" Text=" No" HelpText="NO" Binding="1066^NO^99DCT" ParentBinding="obs/gbv_any/value" Left="560px" Top="85px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  168. <Item WidgetType="HorizontalLine" Binding="LEFT-3pxTOP327px-null" Left="-1px" Top="361px" Width="824px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  169. <Item WidgetType="HorizontalLine" Binding="LEFT-3pxTOP327px-null" Left="-1px" Top="429px" Width="824px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  170. <Item WidgetType="HorizontalLine" Binding="LEFT-3pxTOP327px-null" Left="-2px" Top="497px" Width="824px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  171. <Item WidgetType="HorizontalLine" Binding="LEFT-3pxTOP327px-null" Left="-1px" Top="563px" Width="824px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  172. <Item WidgetType="RadioButton" Text=" No" HelpText="NO" Binding="1066^NO^99DCT" ParentBinding="obs/physical/value" Left="560px" Top="300px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  173. <Item WidgetType="RadioButton" Text=" No" HelpText="NO" Binding="1066^NO^99DCT" ParentBinding="obs/unwill_sex/value" Left="560px" Top="438px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  174. <Item WidgetType="Label" Text=" If yes, by whom (relationship not a name)" HelpText="If yes, by whom (relationship not a name)" Binding="obs/yes_unwill_sex/value" Left="16px" Top="509px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  175. <Item WidgetType="RadioButton" Text=" No" HelpText="NO" Binding="1066^NO^99DCT" ParentBinding="obs/danger_sex/value" Left="560px" Top="575px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  176. <Item WidgetType="HorizontalLine" Binding="LEFT-3pxTOP327px-null" Left="-3px" Top="639px" Width="824px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  177. <Item WidgetType="HorizontalLine" Binding="LEFT-3pxTOP327px-null" Left="-1px" Top="788px" Width="824px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  178. <Item WidgetType="HorizontalLine" Binding="LEFT-3pxTOP327px-null" Left="-3px" Top="711px" Width="824px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  179. <Item WidgetType="HorizontalLine" Binding="LEFT-3pxTOP327px-null" Left="-1px" Top="859px" Width="824px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  180. <Item WidgetType="Label" Text=" If yes, by whom (relationship not a name)" HelpText="If yes, by whom (relationship not a name)" Binding="obs/yes_danger_sex/value" Left="14px" Top="656px" Height="2px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  181. <Item WidgetType="RadioButton" Text=" No" HelpText="NO" Binding="1066^NO^99DCT" ParentBinding="obs/unwill_preg/value" Left="560px" Top="724px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  182. <Item WidgetType="Label" Text=" If yes, by whom (relationship not a name)" HelpText="If yes, by whom (relationship not a name)" Binding="obs/yes_unwill_preg/value" Left="13px" Top="798px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  183. <Item WidgetType="RadioButton" Text=" No" HelpText="NO" Binding="1066^NO^99DCT" ParentBinding="obs/forced_marriage/value" Left="560px" Top="867px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  184. <Item WidgetType="HorizontalLine" Binding="LEFT-3pxTOP327px-null" Left="-2px" Top="921px" Width="824px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  185. <Item WidgetType="HorizontalLine" Binding="LEFT-3pxTOP327px-null" Left="-3px" Top="983px" Width="824px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  186. <Item WidgetType="HorizontalLine" Binding="LEFT-3pxTOP327px-null" Left="-1px" Top="1048px" Width="824px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  187. <Item WidgetType="HorizontalLine" Binding="LEFT-3pxTOP327px-null" Left="-2px" Top="1119px" Width="824px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  188. <Item WidgetType="HorizontalLine" Binding="LEFT-3pxTOP327px-null" Left="0px" Top="1185px" Width="824px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  189. <Item WidgetType="Label" Text=" If yes, by whom (relationship not a name)" HelpText="If yes, by whom (relationship not a name)" Binding="obs/yes_force_marriage/value" Left="12px" Top="932px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  190. <Item WidgetType="RadioButton" Text=" No" HelpText="NO" Binding="1066^NO^99DCT" ParentBinding="obs/force_abort/value" Left="560px" Top="996px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  191. <Item WidgetType="TextBox" HelpText="If yes, by whom (relationship not a name)" Binding="obs/yes_force_abort/value" Left="553px" Top="1054px" Width="261px" Height="58px" TabIndex="62" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  192. <Item WidgetType="Label" Text=" If yes, by whom (relationship not a name)" HelpText="If yes, by whom (relationship not a name)" Binding="obs/yes_force_abort/value" Left="14px" Top="1061px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  193. <Item WidgetType="RadioButton" Text=" No" HelpText="NO" Binding="1066^NO^99DCT" ParentBinding="obs/verbal/value" Left="560px" Top="1133px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  194. <Item WidgetType="Label" Text=" If yes, by whom (relationship not a name)" HelpText="If yes, by whom (relationship not a name)" Binding="obs/yes_verbal/value" Left="17px" Top="1197px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  195. <Item WidgetType="HorizontalLine" Binding="LEFT-3pxTOP327px-null" Left="-1px" Top="1251px" Width="824px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  196. <Item WidgetType="HorizontalLine" Binding="LEFT-3pxTOP327px-null" Left="-1px" Top="1342px" Width="824px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  197. <Item WidgetType="VerticalLine" Binding="LEFT545pxTOP18px-null" Left="545px" Top="18px" Height="1385px" TabIndex="0" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif" borderStyle="solid none none solid" borderWidth="1px"/>
  198. <Item WidgetType="Label" Text=" Are you afraid of anyone of the people you mention above?" HelpText="Are you afraid of anyone of the people you mention above?" Binding="obs/yes_controlling/value" Left="15px" Top="1357px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  199. <Item WidgetType="Label" Text=" If yes, by whom (relationship not a name)" HelpText="If yes, by whom (relationship not a name)" Binding="obs/yes_physical/value" Left="15px" Top="369px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  200. <Item WidgetType="Label" Text=" In the past 12 months, have you been hit, punched, kicked, slapped, choked, hurt with a weapon, or otherwise physically hurt by someone in your home or outside of your house?" HelpText="In the past 12 months, have you been hit, punched, kicked, slapped, choked, hurt with a weapon, or otherwise physically hurt by someone in your home or outside of your house?" Binding="obs/physical/value" Left="15px" Top="300px" Width="512px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  201. <Item WidgetType="Label" Text=" In the past 12 months, were you forced to have sex against your will?" HelpText="In the past 12 months, were you forced to have sex against your will?" Binding="obs/unwill_sex/value" Left="11px" Top="438px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  202. <Item WidgetType="Label" Text=" In the past 12 months, were you forced to have sex to be able to eat, have shelter, or have sex for essential services (such as protection or school) because you or someone in your family would be in physical danger if you refused?" HelpText="In the past 12 months, were you forced to have sex to be able to eat, have shelter, or have sex for essential services (such as protection or school) because you or someone in your family would be in physical danger if you refused?" Binding="obs/danger_sex/value" Left="14px" Top="575px" Width="515px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  203. <Item WidgetType="Label" Text=" In the past 12 months, were you physically forced or made to feel that you had to become pregnant against your will?" HelpText="In the past 12 months, were you physically forced or made to feel that you had to become pregnant against your will?" Binding="obs/unwill_preg/value" Left="12px" Top="724px" Width="515px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  204. <Item WidgetType="Label" Text=" In the past 12 months, were you coerced or forced into marriage?" HelpText="In the past 12 months, were you coerced or forced into marriage?" Binding="obs/forced_marriage/value" Left="11px" Top="867px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  205. <Item WidgetType="Label" Text=" In the past 12 months, were you coerced or forced to have an abortion?" HelpText="In the past 12 months, were you coerced or forced to have an abortion?" Binding="obs/force_abort/value" Left="12px" Top="996px" Height="0px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  206. <Item WidgetType="Label" Text=" In the past 12 months, have anyone insulted or humiliated or yelled at you or verbally threated to hurt you or someone you care about?" HelpText="In the past 12 months, have anyone insulted or humiliated or yelled at you or verbally threated to hurt you or someone you care about?" Binding="obs/verbal/value" Left="17px" Top="1133px" Width="508px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  207. <Item WidgetType="Label" Text=" In the past 12 months, has your (current or most recent) husband/partner controlled who to see or talk to, restricted contact with your family and where to go or what to do, forcing you to do anything you do not want to do or controlled your sources of income?" HelpText="In the past 12 months, has your (current or most recent) husband/partner controlled who to see or talk to, restricted contact with your family and where to go or what to do, forcing you to do anything you do not want to do or controlled your sources of income?" Binding="obs/controlling/value" Left="17px" Top="1259px" Width="509px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  208. <Item WidgetType="RadioButton" Text=" No" HelpText="NO" Binding="1066^NO^99DCT" ParentBinding="obs/controlling/value" Left="560px" Top="1259px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  209. <Item WidgetType="Label" Text=" Patient screen for GBV?" HelpText="Patient screened for GBV? If yes, respond YES/NO to the following questions" Binding="obs/gbv_screen/value" Left="12px" Top="31px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  210. <Item WidgetType="Label" Text=" In the past 12 months did you experience any GBV?" HelpText="In the past 12 months did you experience any GBV?" Binding="obs/gbv_any/value" Left="16px" Top="85px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  211. <Item WidgetType="Label" Text=" In the past 12 months, have you been emotionally or threatened with physical or sexual violence by someone in your home or outside of your home?" HelpText="In the past 12 months, have you been emotionally or threatened with physical or sexual violence by someone in your home or outside of your home?" Binding="obs/emotional/value" Left="10px" Top="157px" Width="519px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  212. <Item WidgetType="Label" Text=" If yes, by whom (relationship not a name)" HelpText="If yes, by whom (relationship not a name)" Binding="obs/yes_emotional/value" Left="14px" Top="228px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  213. <Item WidgetType="RadioButton" Text=" Yes" HelpText="YES" Binding="1065^YES^99DCT" ParentBinding="obs/gbv_screen/value" Left="720px" Top="31px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  214. <Item WidgetType="RadioButton" Text=" Yes" HelpText="YES" Binding="1065^YES^99DCT" ParentBinding="obs/gbv_any/value" Left="720px" Top="85px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  215. <Item WidgetType="RadioButton" Text=" Yes" HelpText="YES" Binding="1065^YES^99DCT" ParentBinding="obs/emotional/value" Left="720px" Top="157px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  216. <Item WidgetType="RadioButton" Text=" Yes" HelpText="YES" Binding="1065^YES^99DCT" ParentBinding="obs/physical/value" Left="720px" Top="300px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  217. <Item WidgetType="RadioButton" Text=" Yes" HelpText="YES" Binding="1065^YES^99DCT" ParentBinding="obs/unwill_sex/value" Left="720px" Top="438px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  218. <Item WidgetType="RadioButton" Text=" Yes" HelpText="YES" Binding="1065^YES^99DCT" ParentBinding="obs/danger_sex/value" Left="720px" Top="575px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  219. <Item WidgetType="RadioButton" Text=" Yes" HelpText="YES" Binding="1065^YES^99DCT" ParentBinding="obs/unwill_preg/value" Left="720px" Top="724px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  220. <Item WidgetType="RadioButton" Text=" Yes" HelpText="YES" Binding="1065^YES^99DCT" ParentBinding="obs/forced_marriage/value" Left="720px" Top="867px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  221. <Item WidgetType="RadioButton" Text=" Yes" HelpText="YES" Binding="1065^YES^99DCT" ParentBinding="obs/force_abort/value" Left="720px" Top="996px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  222. <Item WidgetType="RadioButton" Text=" Yes" HelpText="YES" Binding="1065^YES^99DCT" ParentBinding="obs/verbal/value" Left="720px" Top="1133px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  223. <Item WidgetType="RadioButton" Text=" Yes" HelpText="YES" Binding="1065^YES^99DCT" ParentBinding="obs/controlling/value" Left="720px" Top="1259px" TabIndex="0" fontWeight="bold" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  224. <Item WidgetType="TextBox" HelpText="If yes, by whom (relationship not a name)" Binding="obs/yes_emotional/value" Left="553px" Top="224px" Width="260px" Height="52px" TabIndex="17" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  225. <Item WidgetType="TextBox" HelpText="If yes, by whom (relationship not a name)" Binding="obs/yes_physical/value" Left="553px" Top="368px" Width="260px" Height="52px" TabIndex="27" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  226. <Item WidgetType="TextBox" HelpText="If yes, by whom (relationship not a name)" Binding="obs/yes_unwill_sex/value" Left="553px" Top="503px" Width="260px" Height="52px" TabIndex="32" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  227. <Item WidgetType="TextBox" HelpText="If yes, by whom (relationship not a name)" Binding="obs/yes_danger_sex/value" Left="553px" Top="646px" Width="260px" Height="52px" TabIndex="40" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  228. <Item WidgetType="TextBox" HelpText="If yes, by whom (relationship not a name)" Binding="obs/yes_unwill_preg/value" Left="553px" Top="794px" Width="260px" Height="52px" TabIndex="45" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  229. <Item WidgetType="TextBox" HelpText="If yes, by whom (relationship not a name)" Binding="obs/yes_force_marriage/value" Left="553px" Top="926px" Width="260px" Height="52px" TabIndex="57" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  230. <Item WidgetType="TextBox" HelpText="If yes, by whom (relationship not a name)" Binding="obs/yes_verbal/value" Left="553px" Top="1191px" Width="260px" Height="52px" TabIndex="67" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  231. <Item WidgetType="TextBox" HelpText="Are you afraid of anyone of the people you mention above?" Binding="obs/yes_controlling/value" Left="553px" Top="1347px" Width="260px" Height="52px" TabIndex="71" fontSize="12px" fontFamily="Verdana, "Lucida Grande", "Trebuchet MS", Arial, sans-serif"/>
  232. </Item>
  233. </Page>
  234. </Form>
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