{"id":10660,"date":"2020-06-18T18:23:00","date_gmt":"2020-06-18T18:23:00","guid":{"rendered":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/?page_id=10660"},"modified":"2020-06-18T18:29:04","modified_gmt":"2020-06-18T18:29:04","slug":"ballad-health-cooperative-agreement-public-comment-online-form","status":"publish","type":"page","link":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/cooperative-agreement\/public-comment\/ballad-health-cooperative-agreement-public-comment-online-form\/","title":{"rendered":"Ballad Health Cooperative Agreement Public Comment Form"},"content":{"rendered":"<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_4' style='display:none'>\n                        <div class='gform_heading'>\n                            <h3 class=\"gform_title\">Ballad Health Cooperative Agreement Public Comment Form<\/h3>\n                            <p class='gform_description'>The Virginia Department of Health (VDH) Office of Licensure and Certification (OLC) is tasked with reviewing feedback about Ballad Health\u2019s compliance with the terms of the cooperative agreement, including the Virginia Order and Letter Authorizing a Cooperative Agreement. If you have questions, comments, or complaints about Ballad Health's compliance with the terms of the cooperative agreement and\/or VDH's active supervision of the cooperative agreement, please complete this form. If you wish for VDH to contact you regarding your feedback, or for VDH to provide you with a response, please provide your name and contact information in the fields below. Alternatively, you may choose to submit this form anonymously. Please note that if you choose to submit this form anonymously, VDH will have no way to respond directly to you.<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_4'  action='\/licensure-and-certification\/wp-json\/wp\/v2\/pages\/10660' data-formid='4' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_4_43\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_43'>Facebook<\/label><div class='ginput_container'><input name='input_43' id='input_4_43' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_4_43'>This field is for validation purposes and should be left unchanged.<\/div><\/li><li id=\"field_4_37\" class=\"gfield gfield--type-multiselect gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_37'>Would you like to submit this feedback form anonymously?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_multiselect'><select multiple='multiple'  size='7' name='input_37[]' id='input_4_37' class='medium gfield_select'   aria-invalid=\"false\" aria-required=\"true\" aria-describedby=\"gfield_description_4_37\"><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><div class='gfield_description' id='gfield_description_4_37'>If you select \"yes\" VDH will not be able to contact you regarding your feedback. <\/div><\/li><li id=\"field_4_6\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_4_6'>Please provide your name.<\/div><div class='ginput_complex ginput_container ginput_container--name has_prefix has_first_name has_middle_name has_last_name has_suffix gf_name_has_5 ginput_container_name gform-grid-row' id='input_4_6'>\n                            <span id='input_4_6_2_container' class='name_prefix name_prefix_select gform-grid-col gform-grid-col--size-auto' >\n                                                    <select name='input_6.2' id='input_4_6_2'    aria-required='false'   >\n                          <option value=''><\/option><option value='Mr.' >Mr.<\/option><option value='Mrs.' >Mrs.<\/option><option value='Miss' >Miss<\/option><option value='Ms.' >Ms.<\/option><option value='Dr.' >Dr.<\/option><option value='Prof.' >Prof.<\/option><option value='Rev.' >Rev.<\/option>\n                      <\/select>\n                                                    <label for='input_4_6_2' class='gform-field-label gform-field-label--type-sub '>Prefix<\/label>\n                                                  <\/span>\n                            <span id='input_4_6_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_6.3' id='input_4_6_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_4_6_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            <span id='input_4_6_4_container' class='name_middle gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_6.4' id='input_4_6_4' value=''   aria-required='false'     \/>\n                                                    <label for='input_4_6_4' class='gform-field-label gform-field-label--type-sub '>Middle<\/label>\n                                                <\/span>\n                            <span id='input_4_6_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_6.6' id='input_4_6_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_4_6_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            <span id='input_4_6_8_container' class='name_suffix  gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_6.8' id='input_4_6_8' value=''   aria-required='false'     \/>\n                                                    <label for='input_4_6_8' class='gform-field-label gform-field-label--type-sub '>Suffix<\/label>\n                                                <\/span>\n                        <\/div><\/li><li id=\"field_4_4\" class=\"gfield gfield--type-email field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Email<\/label><div class='gfield_description' id='gfield_description_4_4'>Please enter an email address that we may use to contact you regarding your feedback. <\/div><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_4_4_container'>\n                                <span id='input_4_4_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_4' id='input_4_4' value=''     aria-invalid=\"false\" aria-describedby=\"gfield_description_4_4\" \/>\n                                    <label for='input_4_4' class='gform-field-label gform-field-label--type-sub '>Enter Email<\/label>\n                                <\/span>\n                                <span id='input_4_4_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_4_2' id='input_4_4_2' value=''     aria-invalid=\"false\" aria-describedby=\"gfield_description_4_4\" \/>\n                                    <label for='input_4_4_2' class='gform-field-label gform-field-label--type-sub '>Confirm Email<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/li><li id=\"field_4_5\" class=\"gfield gfield--type-phone field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_5'>Phone<\/label><div class='gfield_description' id='gfield_description_4_5'>Please enter a phone number that we may use to contact you regarding your feedback. <\/div><div class='ginput_container ginput_container_phone'><input name='input_5' id='input_4_5' type='tel' value='' class='medium'    aria-invalid=\"false\" aria-describedby=\"gfield_description_4_5\"  \/><\/div><\/li><li id=\"field_4_17\" class=\"gfield gfield--type-address field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Address<\/label><div class='gfield_description' id='gfield_description_4_17'>Please enter a mailing address that we may use to contact you regarding your feedback. <\/div>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_4_17' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_4_17_1_container' >\n                                        <input type='text' name='input_17.1' id='input_4_17_1' value=''    aria-required='false'    \/>\n                                        <label for='input_4_17_1' id='input_4_17_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_4_17_2_container' >\n                                        <input type='text' name='input_17.2' id='input_4_17_2' value=''     aria-required='false'   \/>\n                                        <label for='input_4_17_2' id='input_4_17_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_4_17_3_container' >\n                                    <input type='text' name='input_17.3' id='input_4_17_3' value=''    aria-required='false'    \/>\n                                    <label for='input_4_17_3' id='input_4_17_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_4_17_4_container' >\n                                        <select name='input_17.4' id='input_4_17_4'     aria-required='false'    ><option value='' selected='selected'><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_4_17_4' id='input_4_17_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_4_17_5_container' >\n                                    <input type='text' name='input_17.5' id='input_4_17_5' value=''    aria-required='false'    \/>\n                                    <label for='input_4_17_5' id='input_4_17_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_17.6' id='input_4_17_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_4_38\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Please let us know what type(s) of feedback you&#039;d like to provide.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_4_38'>I have a...\n<\/div><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_4_38'><li class='gchoice gchoice_4_38_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.1' type='checkbox'  value='Question'  id='choice_4_38_1'   aria-describedby=\"gfield_description_4_38\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_4_38_1' id='label_4_38_1' class='gform-field-label gform-field-label--type-inline'>Question<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_4_38_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.2' type='checkbox'  value='Comment'  id='choice_4_38_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_38_2' id='label_4_38_2' class='gform-field-label gform-field-label--type-inline'>Comment<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_4_38_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.3' type='checkbox'  value='Complaint'  id='choice_4_38_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_38_3' id='label_4_38_3' class='gform-field-label gform-field-label--type-inline'>Complaint<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_4_26\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Is your feedback about a specific facility or specific facilities operated by Ballad Health?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_4_26'>\n\t\t\t<li class='gchoice gchoice_4_26_0'>\n\t\t\t\t<input name='input_26' type='radio' value='Yes'  id='choice_4_26_0'    \/>\n\t\t\t\t<label for='choice_4_26_0' id='label_4_26_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_4_26_1'>\n\t\t\t\t<input name='input_26' type='radio' value='No'  id='choice_4_26_1'    \/>\n\t\t\t\t<label for='choice_4_26_1' id='label_4_26_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_4_42\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_42'>Please provide the name(s) of the Ballad Health facility(ies) you are referencing:<\/label><div class='ginput_container ginput_container_text'><input name='input_42' id='input_4_42' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_4_13\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_13'>Questions\/Comments\/Complaints:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_4_13'>Please provide as much detail as possible. <\/div><div class='ginput_container ginput_container_textarea'><div id=\"wp-input_4_13-wrap\" class=\"wp-core-ui wp-editor-wrap tmce-active\"><link rel='stylesheet' id='dashicons-css' href='https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/wp-includes\/css\/dashicons.min.css?ver=7.0' media='all' \/>\n<link rel='stylesheet' id='editor-buttons-css' href='https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/wp-includes\/css\/editor.min.css?ver=7.0' media='all' \/>\n<div id=\"wp-input_4_13-editor-container\" class=\"wp-editor-container\"><textarea class=\"medium wp-editor-area\" style=\"height: 180px\" autocomplete=\"off\" cols=\"40\" name=\"input_13\" id=\"input_4_13\"><\/textarea><\/div>\n<\/div>\n\n<\/div><\/li><li id=\"field_4_10\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Consent<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_consent'><input name='input_10.1' id='input_4_10_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_4_10_1' >I agree to the privacy policy (http:\/\/www.vdh.virginia.gov\/privacy-policy\/).<\/label><input type='hidden' name='input_10.2' value='I agree to the privacy policy (http:\/\/www.vdh.virginia.gov\/privacy-policy\/).' class='gform_hidden' \/><input type='hidden' name='input_10.3' value='3' class='gform_hidden' \/><\/div><\/li><\/ul><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_4' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Submit'  \/> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_4' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_4' id='gform_theme_4' value='legacy' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_4' id='gform_style_settings_4' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_4' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='4' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='IZhowH8Op8ybkPBsEQC7b7QS3WMuUxJIujGPPH6Ki3aQ0paggFCt53vYYyFWDG2N508n2QHRh19wf2273ds13dd4lSEsgvwqqGni53LqFnFXhoI=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_4' value='WyJ7XCIxMC4xXCI6XCIyYjE5NzU0MDU5ODQxZmU1MDEyMGY1ZjEzOGVhZWY2ZlwiLFwiMTAuMlwiOlwiMWZhYmRiMmEyNjFmNzE4NGFjZjNmZGRiMmFhNGY0NDJcIixcIjEwLjNcIjpcImYzNDFiZjcwNGVmZjQ1NzRlYjM5YzNmZDM4NDE1MTM3XCJ9IiwiMWE0M2YwYjMzY2I3ZjM3YmNjOTU5NGRkYzNjZjhhODQiXQ==' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_4' id='gform_target_page_number_4' value='0' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_4' id='gform_source_page_number_4' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/form>\n                        <\/div><script>\ngform.initializeOnLoaded( function() {gformInitSpinner( 4, 'https:\/\/www.vdh.virginia.gov\/content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery('#gform_ajax_frame_4').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_4');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_4').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){form_content.find('form').css('opacity', 0);jQuery('#gform_wrapper_4').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_4').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_4').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_4').val();gformInitSpinner( 4, 'https:\/\/www.vdh.virginia.gov\/content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery(document).trigger('gform_page_loaded', [4, current_page]);window['gf_submitting_4'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}jQuery('#gform_wrapper_4').replaceWith(confirmation_content);jQuery(document).trigger('gform_confirmation_loaded', [4]);window['gf_submitting_4'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_4').text());}else{jQuery('#gform_4').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger(\"gform_pre_post_render\", [{ formId: \"4\", currentPage: \"current_page\", abort: function() { this.preventDefault(); } }]);        if (event && event.defaultPrevented) {                return;        }        const gformWrapperDiv = document.getElementById( \"gform_wrapper_4\" );        if ( gformWrapperDiv ) {            const visibilitySpan = document.createElement( \"span\" );            visibilitySpan.id = \"gform_visibility_test_4\";            gformWrapperDiv.insertAdjacentElement( \"afterend\", visibilitySpan );        }        const visibilityTestDiv = document.getElementById( \"gform_visibility_test_4\" );        let postRenderFired = false;        function triggerPostRender() {            if ( postRenderFired ) {                return;            }            postRenderFired = true;            gform.core.triggerPostRenderEvents( 4, 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\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":273,"featured_media":0,"parent":10154,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"tags":[],"class_list":["post-10660","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.7 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Ballad Health Cooperative Agreement Public Comment Form - Licensure And Certification<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/cooperative-agreement\/public-comment\/ballad-health-cooperative-agreement-public-comment-online-form\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Ballad Health Cooperative Agreement Public Comment Form - Licensure And Certification\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/cooperative-agreement\/public-comment\/ballad-health-cooperative-agreement-public-comment-online-form\/\" \/>\n<meta property=\"og:site_name\" content=\"Licensure And Certification\" \/>\n<meta property=\"article:modified_time\" content=\"2020-06-18T18:29:04+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.vdh.virginia.gov\\\/licensure-and-certification\\\/cooperative-agreement\\\/public-comment\\\/ballad-health-cooperative-agreement-public-comment-online-form\\\/\",\"url\":\"https:\\\/\\\/www.vdh.virginia.gov\\\/licensure-and-certification\\\/cooperative-agreement\\\/public-comment\\\/ballad-health-cooperative-agreement-public-comment-online-form\\\/\",\"name\":\"Ballad Health Cooperative Agreement Public Comment Form - Licensure And Certification\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.vdh.virginia.gov\\\/licensure-and-certification\\\/#website\"},\"datePublished\":\"2020-06-18T18:23:00+00:00\",\"dateModified\":\"2020-06-18T18:29:04+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/www.vdh.virginia.gov\\\/licensure-and-certification\\\/cooperative-agreement\\\/public-comment\\\/ballad-health-cooperative-agreement-public-comment-online-form\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/www.vdh.virginia.gov\\\/licensure-and-certification\\\/cooperative-agreement\\\/public-comment\\\/ballad-health-cooperative-agreement-public-comment-online-form\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/www.vdh.virginia.gov\\\/licensure-and-certification\\\/cooperative-agreement\\\/public-comment\\\/ballad-health-cooperative-agreement-public-comment-online-form\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/www.vdh.virginia.gov\\\/licensure-and-certification\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Ballad Health Cooperative Agreement\",\"item\":\"https:\\\/\\\/www.vdh.virginia.gov\\\/licensure-and-certification\\\/cooperative-agreement\\\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Cooperative Agreement Public Comment\",\"item\":\"https:\\\/\\\/www.vdh.virginia.gov\\\/licensure-and-certification\\\/cooperative-agreement\\\/public-comment\\\/\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"Ballad Health Cooperative Agreement Public Comment Form\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/www.vdh.virginia.gov\\\/licensure-and-certification\\\/#website\",\"url\":\"https:\\\/\\\/www.vdh.virginia.gov\\\/licensure-and-certification\\\/\",\"name\":\"Licensure And Certification\",\"description\":\"\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/www.vdh.virginia.gov\\\/licensure-and-certification\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Ballad Health Cooperative Agreement Public Comment Form - Licensure And Certification","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/cooperative-agreement\/public-comment\/ballad-health-cooperative-agreement-public-comment-online-form\/","og_locale":"en_US","og_type":"article","og_title":"Ballad Health Cooperative Agreement Public Comment Form - Licensure And Certification","og_url":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/cooperative-agreement\/public-comment\/ballad-health-cooperative-agreement-public-comment-online-form\/","og_site_name":"Licensure And Certification","article_modified_time":"2020-06-18T18:29:04+00:00","twitter_card":"summary_large_image","schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/cooperative-agreement\/public-comment\/ballad-health-cooperative-agreement-public-comment-online-form\/","url":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/cooperative-agreement\/public-comment\/ballad-health-cooperative-agreement-public-comment-online-form\/","name":"Ballad Health Cooperative Agreement Public Comment Form - Licensure And Certification","isPartOf":{"@id":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/#website"},"datePublished":"2020-06-18T18:23:00+00:00","dateModified":"2020-06-18T18:29:04+00:00","breadcrumb":{"@id":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/cooperative-agreement\/public-comment\/ballad-health-cooperative-agreement-public-comment-online-form\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/cooperative-agreement\/public-comment\/ballad-health-cooperative-agreement-public-comment-online-form\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/cooperative-agreement\/public-comment\/ballad-health-cooperative-agreement-public-comment-online-form\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/"},{"@type":"ListItem","position":2,"name":"Ballad Health Cooperative Agreement","item":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/cooperative-agreement\/"},{"@type":"ListItem","position":3,"name":"Cooperative Agreement Public Comment","item":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/cooperative-agreement\/public-comment\/"},{"@type":"ListItem","position":4,"name":"Ballad Health Cooperative Agreement Public Comment Form"}]},{"@type":"WebSite","@id":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/#website","url":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/","name":"Licensure And Certification","description":"","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"}]}},"_links":{"self":[{"href":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/wp-json\/wp\/v2\/pages\/10660","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/wp-json\/wp\/v2\/users\/273"}],"replies":[{"embeddable":true,"href":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/wp-json\/wp\/v2\/comments?post=10660"}],"version-history":[{"count":3,"href":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/wp-json\/wp\/v2\/pages\/10660\/revisions"}],"predecessor-version":[{"id":10665,"href":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/wp-json\/wp\/v2\/pages\/10660\/revisions\/10665"}],"up":[{"embeddable":true,"href":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/wp-json\/wp\/v2\/pages\/10154"}],"wp:attachment":[{"href":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/wp-json\/wp\/v2\/media?parent=10660"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/wp-json\/wp\/v2\/tags?post=10660"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}