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{"id":27,"date":"2020-06-24T15:43:15","date_gmt":"2020-06-24T22:43:15","guid":{"rendered":"https:\/\/medassuresolutions.com\/?page_id=27"},"modified":"2021-02-22T22:54:53","modified_gmt":"2021-02-23T06:54:53","slug":"contact","status":"publish","type":"page","link":"https:\/\/redphoenixglobal.com\/insurance-website\/contact\/","title":{"rendered":"Contact"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.4.8&#8243; custom_margin=&#8221;75px||75px||true|false&#8221; custom_padding=&#8221;0px||0px||true|false&#8221;][et_pb_row use_custom_gutter=&#8221;on&#8221; gutter_width=&#8221;1&#8243; make_equal=&#8221;on&#8221; _builder_version=&#8221;4.4.8&#8243; background_color=&#8221;#e8eaec&#8221; custom_padding=&#8221;0px||0px||true|false&#8221; animation_style=&#8221;slide&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.4.8&#8243; background_enable_color=&#8221;off&#8221;][et_pb_image src=&#8221;https:\/\/redphoenixglobal.com\/insurance-website\/wp-content\/uploads\/contact-background.jpg&#8221; title_text=&#8221;contact-background&#8221; _builder_version=&#8221;4.4.8&#8243;][\/et_pb_image][et_pb_text _builder_version=&#8221;4.5.3&#8243; text_font=&#8221;|300|||||||&#8221; text_font_size=&#8221;21px&#8221; header_2_font=&#8221;Roboto|300|||||||&#8221; header_2_text_align=&#8221;center&#8221; header_2_font_size=&#8221;55px&#8221; text_orientation=&#8221;center&#8221; module_alignment=&#8221;center&#8221; custom_padding=&#8221;75px|30px|0px|30px|false|true&#8221; hover_enabled=&#8221;0&#8243;]<\/p>\n<h2>Get in Touch<\/h2>\n<p>Have questions about Insurance Coverage?<\/p>\n<p>Please give us a call or fill out the form and will be in touch with you shortly.<\/p>\n<p>Email. info@berwickinsurance.com<\/p>\n<p>Phone. 888-745-2320<\/p>\n<p><em>*This is a solicitation for insurance<\/em><\/p>\n<p>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.4.8&#8243; text_font=&#8221;|300|||||||&#8221; width=&#8221;65%&#8221; module_alignment=&#8221;center&#8221; custom_padding=&#8221;0px|30px|75px|30px|false|true&#8221;]<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\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\/* ]]> *\/\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_1' ><div id='gf_1' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_1' id='gform_1'  action='\/insurance-website\/wp-json\/wp\/v2\/pages\/27#gf_1' data-formid='1' novalidate> \r\n <input type='hidden' class='gforms-pum' value='{\"closepopup\":false,\"closedelay\":0,\"openpopup\":false,\"openpopup_id\":0}' \/>\n                        <div class='gform-body gform_body'><ul id='gform_fields_1' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_1_1\" class=\"gfield gfield--type-name field_sublabel_hidden_label gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Name<\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_1_1'>\n                            \n                            <span id='input_1_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_1_1_3' value=''   aria-required='false'   placeholder='First Name'  \/>\n                                                    <label for='input_1_1_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_1_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_1_1_6' value=''   aria-required='false'   placeholder='Last Name'  \/>\n                                                    <label for='input_1_1_6' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_1_2\" class=\"gfield gfield--type-email gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_2'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_2' id='input_1_2' type='email' value='' class='large'   placeholder='Email' aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_1_3\" class=\"gfield gfield--type-phone gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_3'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_3' id='input_1_3' type='tel' value='' class='large'  placeholder='Phone Number' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_1_10\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Preferred Method of Contact<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_1_10'>\n\t\t\t<li class='gchoice gchoice_1_10_0'>\n\t\t\t\t<input name='input_10' type='radio' value='Email'  id='choice_1_10_0'    \/>\n\t\t\t\t<label for='choice_1_10_0' id='label_1_10_0' class='gform-field-label gform-field-label--type-inline'>Email<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_10_1'>\n\t\t\t\t<input name='input_10' type='radio' value='Phone'  id='choice_1_10_1'    \/>\n\t\t\t\t<label for='choice_1_10_1' id='label_1_10_1' class='gform-field-label gform-field-label--type-inline'>Phone<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_1_8\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_8'>Subject<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_1_8' type='text' value='' class='large'    placeholder='Subject' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_1_4\" class=\"gfield gfield--type-select field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_4'>What would you like to do?<\/label><div class='ginput_container ginput_container_select'><select name='input_4' id='input_1_4' class='large gfield_select'     aria-invalid=\"false\" ><option value='Request a call back' >Request a call back<\/option><option value='Schedule an appointment' >Schedule an appointment<\/option><option value='RSVP for an event' >RSVP for an event<\/option><option value='Ask a question' >Ask a question<\/option><option value='Interested in becoming an agent' >Interested in becoming an agent<\/option><\/select><\/div><\/li><li id=\"field_1_5\" class=\"gfield gfield--type-checkbox gfield--type-choice gf_list_2col 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' >Which service(s) would you like to request more information about?<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_1_5'><li class='gchoice gchoice_1_5_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.1' type='checkbox'  value='Medicare Supplement Insurance'  id='choice_1_5_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_5_1' id='label_1_5_1' class='gform-field-label gform-field-label--type-inline'>Medicare Supplement Insurance<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_5_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.2' type='checkbox'  value='Medicare Advantage Plans'  id='choice_1_5_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_5_2' id='label_1_5_2' class='gform-field-label gform-field-label--type-inline'>Medicare Advantage Plans<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_5_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.3' type='checkbox'  value='Prescription Drug Plans'  id='choice_1_5_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_5_3' id='label_1_5_3' class='gform-field-label gform-field-label--type-inline'>Prescription Drug Plans<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_5_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.4' type='checkbox'  value='Individual Health Insurance'  id='choice_1_5_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_5_4' id='label_1_5_4' class='gform-field-label gform-field-label--type-inline'>Individual Health Insurance<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_5_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.5' type='checkbox'  value='Life Insurance'  id='choice_1_5_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_5_5' id='label_1_5_5' class='gform-field-label gform-field-label--type-inline'>Life Insurance<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_5_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.6' type='checkbox'  value='Long-term Care Insurance'  id='choice_1_5_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_5_6' id='label_1_5_6' class='gform-field-label gform-field-label--type-inline'>Long-term Care Insurance<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_5_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.7' type='checkbox'  value='Final Expense Insurance'  id='choice_1_5_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_5_7' id='label_1_5_7' class='gform-field-label gform-field-label--type-inline'>Final Expense Insurance<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_1_6\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_6'>Message<span 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Please give us a call or fill out the form and will be in touch with you shortly. Email. info@berwickinsurance.com Phone. 888-745-2320 *This is a solicitation for insurance \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_1' ><div id='gf_1' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_1' id='gform_1'  action='\/insurance-website\/wp-json\/wp\/v2\/pages\/27#gf_1' data-formid='1' novalidate> \r\n <input type='hidden' class='gforms-pum' value='{\"closepopup\":false,\"closedelay\":0,\"openpopup\":false,\"openpopup_id\":0}' \/>\n                        <div class='gform-body gform_body'><ul id='gform_fields_1' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_1_1\" class=\"gfield gfield--type-name field_sublabel_hidden_label gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Name<\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_1_1'>\n                            \n                            <span id='input_1_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_1_1_3' value=''   aria-required='false'   placeholder='First Name'  \/>\n                                                    <label for='input_1_1_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_1_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_1_1_6' value=''   aria-required='false'   placeholder='Last Name'  \/>\n                                                    <label for='input_1_1_6' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_1_2\" class=\"gfield gfield--type-email gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_2'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_2' id='input_1_2' type='email' value='' class='large'   placeholder='Email' aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_1_3\" class=\"gfield gfield--type-phone gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_3'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_3' id='input_1_3' type='tel' value='' class='large'  placeholder='Phone Number' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_1_10\" class=\"gfield gfield--type-radio gfield--type-choice gf_list_inline field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Preferred Method of Contact<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_1_10'>\n\t\t\t<li class='gchoice gchoice_1_10_0'>\n\t\t\t\t<input name='input_10' type='radio' value='Email'  id='choice_1_10_0'    \/>\n\t\t\t\t<label for='choice_1_10_0' id='label_1_10_0' class='gform-field-label gform-field-label--type-inline'>Email<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_10_1'>\n\t\t\t\t<input name='input_10' type='radio' value='Phone'  id='choice_1_10_1'    \/>\n\t\t\t\t<label for='choice_1_10_1' id='label_1_10_1' class='gform-field-label gform-field-label--type-inline'>Phone<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_1_8\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_8'>Subject<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_1_8' type='text' value='' class='large'    placeholder='Subject' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_1_4\" class=\"gfield gfield--type-select field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_4'>What would you like to do?<\/label><div class='ginput_container ginput_container_select'><select name='input_4' id='input_1_4' class='large gfield_select'     aria-invalid=\"false\" ><option value='Request a call back' >Request a call back<\/option><option value='Schedule an appointment' >Schedule an appointment<\/option><option value='RSVP for an event' >RSVP for an event<\/option><option value='Ask a question' >Ask a question<\/option><option value='Interested in becoming an agent' >Interested in becoming an agent<\/option><\/select><\/div><\/li><li id=\"field_1_5\" class=\"gfield gfield--type-checkbox gfield--type-choice gf_list_2col 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' >Which service(s) would you like to request more information about?<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_1_5'><li class='gchoice gchoice_1_5_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.1' type='checkbox'  value='Medicare Supplement Insurance'  id='choice_1_5_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_5_1' id='label_1_5_1' class='gform-field-label gform-field-label--type-inline'>Medicare Supplement Insurance<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_5_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.2' type='checkbox'  value='Medicare Advantage Plans'  id='choice_1_5_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_5_2' id='label_1_5_2' class='gform-field-label gform-field-label--type-inline'>Medicare Advantage Plans<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_5_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.3' type='checkbox'  value='Prescription Drug Plans'  id='choice_1_5_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_5_3' id='label_1_5_3' class='gform-field-label gform-field-label--type-inline'>Prescription Drug Plans<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_5_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.4' type='checkbox'  value='Individual Health Insurance'  id='choice_1_5_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_5_4' id='label_1_5_4' class='gform-field-label gform-field-label--type-inline'>Individual Health Insurance<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_5_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.5' type='checkbox'  value='Life Insurance'  id='choice_1_5_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_5_5' id='label_1_5_5' class='gform-field-label gform-field-label--type-inline'>Life Insurance<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_5_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.6' type='checkbox'  value='Long-term Care Insurance'  id='choice_1_5_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_5_6' id='label_1_5_6' class='gform-field-label gform-field-label--type-inline'>Long-term Care Insurance<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_1_5_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_5.7' type='checkbox'  value='Final Expense Insurance'  id='choice_1_5_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_5_7' id='label_1_5_7' class='gform-field-label gform-field-label--type-inline'>Final Expense Insurance<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_1_6\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_6'>Message<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_6' id='input_1_6' class='textarea small'    placeholder='Type your message here...' aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_1_7\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below 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