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    Using your terrific service but unable to get emails sent to client.

    Asked by deschutes on March 11, 2016 at 07:42 PM

    Does not seem to be their spam folder, and in my form builder their email is listed.

    Here is the code in my Dreamweaver created website

    email in question is clientcontacts@deschutesanimalclinic.com

    website page - http://deschutesanimalclinic.com/form_drop-off_questionaire.htm


    <div id="apDiv11"><!--[if lt IE 9]><script src="https://cdn.jotfor.ms/js/vendor/flashcanvas.js?3.3.11932" type="text/javascript"></script><![endif]-->
    <script src="https://cdn.jotfor.ms/js/vendor/jquery-1.8.0.min.js?v=3.3.11932" type="text/javascript"></script>
    <script src="https://cdn.jotfor.ms/js/vendor/jSignature.min.noconflict.js?3.3.11932" type="text/javascript"></script>
    <script src="https://cdn.jotfor.ms/js/vendor/jotform.signaturepad.js?3.3.11932" type="text/javascript"></script>
    <script src="https://cdn.jotfor.ms/static/prototype.forms.js" type="text/javascript"></script>
    <script src="https://cdn.jotfor.ms/static/jotform.forms.js?3.3.11932" type="text/javascript"></script>
    <script type="text/javascript">
       JotForm.init(function(){
          JotForm.initCaptcha('input_55');
        JotForm.clearFieldOnHide="disable";
        JotForm.onSubmissionError="jumpToFirstError";
       });
    </script>
    <link target="_blank" href="https://cdn.jotfor.ms/static/formCss.css?3.3.11932" rel="nofollow" rel="stylesheet" type="text/css" />
    <link type="text/css" rel="stylesheet" target="_blank" href="https://cdn.jotfor.ms/css/styles/nova.css?3.3.11932" rel="nofollow" />
    <link type="text/css" media="print" rel="stylesheet" target="_blank" href="https://cdn.jotfor.ms/css/printForm.css?3.3.11932" rel="nofollow" />
    <style type="text/css">
        .form-label-left{
            width:150px !important;
        }
        .form-line{
            padding-top:12px;
            padding-bottom:12px;
        }
        .form-label-right{
            width:150px !important;
        }
        .form-all{
            width:690px;
            color:#555 !important;
            font-family:"Lucida Grande", "Lucida Sans Unicode", "Lucida Sans", Verdana, sans-serif;
            font-size:14px;
        }
    </style>

    <link type="text/css" rel="stylesheet" target="_blank" href="https://cdn.jotfor.ms/css/styles/buttons/form-submit-button-simple_grey.css?3.3.11932" rel="nofollow"/>
    <form class="jotform-form" action="https://submit.jotform.us/submit/30717141893152/" method="post" name="form_30717141893152" id="30717141893152" accept-charset="utf-8">
      <input type="hidden" name="formID" value="30717141893152" />
      <div class="form-all">
        <ul class="form-section page-section">
          <li id="cid_1" class="form-input-wide" data-type="control_head">
            <div class="form-header-group">
              <div class="header-text httal htvam">
                <h2 id="header_1" class="form-header">
                  Drop-off Questionnaire
                </h2>
              </div>
            </div>
          </li>
          <li class="form-line" data-type="control_fullname" id="id_3">
            <label class="form-label form-label-left form-label-auto" id="label_3" for="input_3"> Full Name </label>
            <div id="cid_3" class="form-input jf-required">
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="text" size="10" name="q3_fullName3[first]" id="first_3" />
                <label class="form-sub-label" for="first_3" id="sublabel_first" style="min-height: 13px;"> First Name </label>
              </span>
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="text" size="15" name="q3_fullName3[last]" id="last_3" />
                <label class="form-sub-label" for="last_3" id="sublabel_last" style="min-height: 13px;"> Last Name </label>
              </span>
            </div>
          </li>
          <li class="form-line" data-type="control_textbox" id="id_4">
            <label class="form-label form-label-left form-label-auto" id="label_4" for="input_4"> Date </label>
            <div id="cid_4" class="form-input jf-required">
              <input type="text" class=" form-textbox" data-type="input-textbox" id="input_4" name="q4_date" size="20" value="" />
            </div>
          </li>
          <li class="form-line" data-type="control_phone" id="id_5">
            <label class="form-label form-label-left form-label-auto" id="label_5" for="input_5"> Home Phone </label>
            <div id="cid_5" class="form-input jf-required">
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="tel" name="q5_homePhone[area]" id="input_5_area" size="3">
                <span class="phone-separate">
                  &nbsp;-
                </span>
                <label class="form-sub-label" for="input_5_area" id="sublabel_area" style="min-height: 13px;"> Area Code </label>
              </span>
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="tel" name="q5_homePhone[phone]" id="input_5_phone" size="8">
                <label class="form-sub-label" for="input_5_phone" id="sublabel_phone" style="min-height: 13px;"> Phone Number </label>
              </span>
            </div>
          </li>
          <li class="form-line" data-type="control_phone" id="id_6">
            <label class="form-label form-label-left form-label-auto" id="label_6" for="input_6"> Cell Phone </label>
            <div id="cid_6" class="form-input jf-required">
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="tel" name="q6_cellPhone[area]" id="input_6_area" size="3">
                <span class="phone-separate">
                  &nbsp;-
                </span>
                <label class="form-sub-label" for="input_6_area" id="sublabel_area" style="min-height: 13px;"> Area Code </label>
              </span>
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="tel" name="q6_cellPhone[phone]" id="input_6_phone" size="8">
                <label class="form-sub-label" for="input_6_phone" id="sublabel_phone" style="min-height: 13px;"> Phone Number </label>
              </span>
            </div>
          </li>
          <li class="form-line" data-type="control_phone" id="id_7">
            <label class="form-label form-label-left form-label-auto" id="label_7" for="input_7"> Work Phone </label>
            <div id="cid_7" class="form-input jf-required">
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="tel" name="q7_workPhone[area]" id="input_7_area" size="3">
                <span class="phone-separate">
                  &nbsp;-
                </span>
                <label class="form-sub-label" for="input_7_area" id="sublabel_area" style="min-height: 13px;"> Area Code </label>
              </span>
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="tel" name="q7_workPhone[phone]" id="input_7_phone" size="8">
                <label class="form-sub-label" for="input_7_phone" id="sublabel_phone" style="min-height: 13px;"> Phone Number </label>
              </span>
            </div>
          </li>
          <li class="form-line" data-type="control_phone" id="id_8">
            <label class="form-label form-label-left form-label-auto" id="label_8" for="input_8"> Additional Phone </label>
            <div id="cid_8" class="form-input jf-required">
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="tel" name="q8_additionalPhone[area]" id="input_8_area" size="3">
                <span class="phone-separate">
                  &nbsp;-
                </span>
                <label class="form-sub-label" for="input_8_area" id="sublabel_area" style="min-height: 13px;"> Area Code </label>
              </span>
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="tel" name="q8_additionalPhone[phone]" id="input_8_phone" size="8">
                <label class="form-sub-label" for="input_8_phone" id="sublabel_phone" style="min-height: 13px;"> Phone Number </label>
              </span>
            </div>
          </li>
          <li class="form-line" data-type="control_textbox" id="id_9">
            <label class="form-label form-label-left form-label-auto" id="label_9" for="input_9"> Pet's Name </label>
            <div id="cid_9" class="form-input jf-required">
              <input type="text" class=" form-textbox" data-type="input-textbox" id="input_9" name="q9_petsName" size="20" value="" />
            </div>
          </li>
          <li class="form-line" data-type="control_fullname" id="id_10">
            <label class="form-label form-label-left form-label-auto" id="label_10" for="input_10"> Pet's species and breed </label>
            <div id="cid_10" class="form-input jf-required">
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="text" size="10" name="q10_petsSpecies[first]" id="first_10" />
                <label class="form-sub-label" for="first_10" id="sublabel_first" style="min-height: 13px;"> Species </label>
              </span>
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="text" size="15" name="q10_petsSpecies[last]" id="last_10" />
                <label class="form-sub-label" for="last_10" id="sublabel_last" style="min-height: 13px;"> Breed </label>
              </span>
            </div>
          </li>
          <li class="form-line" data-type="control_fullname" id="id_11">
            <label class="form-label form-label-left form-label-auto" id="label_11" for="input_11"> Pet's color and weight </label>
            <div id="cid_11" class="form-input jf-required">
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="text" size="10" name="q11_petsColor[first]" id="first_11" />
                <label class="form-sub-label" for="first_11" id="sublabel_first" style="min-height: 13px;"> Color </label>
              </span>
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="text" size="15" name="q11_petsColor[last]" id="last_11" />
                <label class="form-sub-label" for="last_11" id="sublabel_last" style="min-height: 13px;"> Weight </label>
              </span>
            </div>
          </li>
          <li class="form-line" data-type="control_checkbox" id="id_13">
            <label class="form-label form-label-left form-label-auto" id="label_13" for="input_13"> Pet's Sex: </label>
            <div id="cid_13" class="form-input jf-required">
              <div class="form-single-column">
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_13_0" name="q13_petsSex[]" value="Male" />
                  <label id="label_input_13_0" for="input_13_0"> Male </label>
                </span>
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_13_1" name="q13_petsSex[]" value="Female" />
                  <label id="label_input_13_1" for="input_13_1"> Female </label>
                </span>
              </div>
            </div>
          </li>
          <li class="form-line" data-type="control_textbox" id="id_12">
            <label class="form-label form-label-left form-label-auto" id="label_12" for="input_12"> What is your pet's health problem today? </label>
            <div id="cid_12" class="form-input jf-required">
              <input type="text" class=" form-textbox" data-type="input-textbox" id="input_12" name="q12_whatIs" size="45" value="" />
            </div>
          </li>
          <li class="form-line" data-type="control_checkbox" id="id_14">
            <label class="form-label form-label-left form-label-auto" id="label_14" for="input_14"> Has this been a problem for your pet before? </label>
            <div id="cid_14" class="form-input jf-required">
              <div class="form-single-column">
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_14_0" name="q14_hasThis[]" value="Yes" />
                  <label id="label_input_14_0" for="input_14_0"> Yes </label>
                </span>
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_14_1" name="q14_hasThis[]" value="No" />
                  <label id="label_input_14_1" for="input_14_1"> No </label>
                </span>
              </div>
            </div>
          </li>
          <li class="form-line" data-type="control_checkbox" id="id_15">
            <label class="form-label form-label-left form-label-auto" id="label_15" for="input_15"> Is your pet currently on medication? </label>
            <div id="cid_15" class="form-input jf-required">
              <div class="form-single-column">
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_15_0" name="q15_isYour[]" value="Yes" />
                  <label id="label_input_15_0" for="input_15_0"> Yes </label>
                </span>
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_15_1" name="q15_isYour[]" value="No" />
                  <label id="label_input_15_1" for="input_15_1"> No </label>
                </span>
              </div>
            </div>
          </li>
          <li class="form-line" data-type="control_textbox" id="id_16">
            <label class="form-label form-label-left form-label-auto" id="label_16" for="input_16"> Medication #1 </label>
            <div id="cid_16" class="form-input jf-required">
              <input type="text" class=" form-textbox" data-type="input-textbox" id="input_16" name="q16_medication1" size="20" value="" />
            </div>
          </li>
          <li class="form-line" data-type="control_fullname" id="id_20">
            <label class="form-label form-label-left form-label-auto" id="label_20" for="input_20"> Medication #1 </label>
            <div id="cid_20" class="form-input jf-required">
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="text" size="10" name="q20_medication20[first]" id="first_20" />
                <label class="form-sub-label" for="first_20" id="sublabel_first" style="min-height: 13px;"> Strength </label>
              </span>
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="text" size="15" name="q20_medication20[last]" id="last_20" />
                <label class="form-sub-label" for="last_20" id="sublabel_last" style="min-height: 13px;"> How Often Given </label>
              </span>
            </div>
          </li>
          <li class="form-line" data-type="control_fullname" id="id_21">
            <label class="form-label form-label-left form-label-auto" id="label_21" for="input_21"> Medication #1 </label>
            <div id="cid_21" class="form-input jf-required">
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="text" size="10" name="q21_medication21[first]" id="first_21" />
                <label class="form-sub-label" for="first_21" id="sublabel_first" style="min-height: 13px;"> How Much Given </label>
              </span>
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="text" size="15" name="q21_medication21[last]" id="last_21" />
                <label class="form-sub-label" for="last_21" id="sublabel_last" style="min-height: 13px;"> Time of Last Dose </label>
              </span>
            </div>
          </li>
          <li class="form-line" data-type="control_textbox" id="id_19">
            <label class="form-label form-label-left form-label-auto" id="label_19" for="input_19"> Medication #2 </label>
            <div id="cid_19" class="form-input jf-required">
              <input type="text" class=" form-textbox" data-type="input-textbox" id="input_19" name="q19_medication2" size="20" value="" />
            </div>
          </li>
          <li class="form-line" data-type="control_fullname" id="id_23">
            <label class="form-label form-label-left form-label-auto" id="label_23" for="input_23"> Medication #2 </label>
            <div id="cid_23" class="form-input jf-required">
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="text" size="10" name="q23_medication23[first]" id="first_23" />
                <label class="form-sub-label" for="first_23" id="sublabel_first" style="min-height: 13px;"> Strength </label>
              </span>
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="text" size="15" name="q23_medication23[last]" id="last_23" />
                <label class="form-sub-label" for="last_23" id="sublabel_last" style="min-height: 13px;"> How Often Given </label>
              </span>
            </div>
          </li>
          <li class="form-line" data-type="control_fullname" id="id_18">
            <label class="form-label form-label-left form-label-auto" id="label_18" for="input_18"> Medication #2 </label>
            <div id="cid_18" class="form-input jf-required">
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="text" size="10" name="q18_medication218[first]" id="first_18" />
                <label class="form-sub-label" for="first_18" id="sublabel_first" style="min-height: 13px;"> How Much Given </label>
              </span>
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="text" size="15" name="q18_medication218[last]" id="last_18" />
                <label class="form-sub-label" for="last_18" id="sublabel_last" style="min-height: 13px;"> Time of Last Dose </label>
              </span>
            </div>
          </li>
          <li class="form-line" data-type="control_textbox" id="id_22">
            <label class="form-label form-label-left form-label-auto" id="label_22" for="input_22"> Medication #3 </label>
            <div id="cid_22" class="form-input jf-required">
              <input type="text" class=" form-textbox" data-type="input-textbox" id="input_22" name="q22_medication3" size="20" value="" />
            </div>
          </li>
          <li class="form-line" data-type="control_fullname" id="id_17">
            <label class="form-label form-label-left form-label-auto" id="label_17" for="input_17"> Medication #3 </label>
            <div id="cid_17" class="form-input jf-required">
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="text" size="10" name="q17_medication317[first]" id="first_17" />
                <label class="form-sub-label" for="first_17" id="sublabel_first" style="min-height: 13px;"> Strength </label>
              </span>
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="text" size="15" name="q17_medication317[last]" id="last_17" />
                <label class="form-sub-label" for="last_17" id="sublabel_last" style="min-height: 13px;"> How Often Given </label>
              </span>
            </div>
          </li>
          <li class="form-line" data-type="control_fullname" id="id_24">
            <label class="form-label form-label-left form-label-auto" id="label_24" for="input_24"> Medication #3 </label>
            <div id="cid_24" class="form-input jf-required">
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="text" size="10" name="q24_medication324[first]" id="first_24" />
                <label class="form-sub-label" for="first_24" id="sublabel_first" style="min-height: 13px;"> How Much Given </label>
              </span>
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="text" size="15" name="q24_medication324[last]" id="last_24" />
                <label class="form-sub-label" for="last_24" id="sublabel_last" style="min-height: 13px;"> Time of Last Dose </label>
              </span>
            </div>
          </li>
          <li class="form-line" data-type="control_textbox" id="id_25">
            <label class="form-label form-label-left form-label-auto" id="label_25" for="input_25"> When did your pet last eat and what did he/she eat? </label>
            <div id="cid_25" class="form-input jf-required">
              <input type="text" class=" form-textbox" data-type="input-textbox" id="input_25" name="q25_whenDid25" size="45" value="" />
            </div>
          </li>
          <li class="form-line" data-type="control_checkbox" id="id_26">
            <label class="form-label form-label-left form-label-auto" id="label_26" for="input_26"> Is you pet on a special diet? </label>
            <div id="cid_26" class="form-input jf-required">
              <div class="form-single-column">
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_26_0" name="q26_isYou[]" value="Yes" />
                  <label id="label_input_26_0" for="input_26_0"> Yes </label>
                </span>
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_26_1" name="q26_isYou[]" value="No" />
                  <label id="label_input_26_1" for="input_26_1"> No </label>
                </span>
              </div>
            </div>
          </li>
          <li class="form-line" data-type="control_text" id="id_27">
            <div id="cid_27" class="form-input-wide">
              <div id="text_27" class="form-html">
                <p><span style="text-decoration:underline;"><strong>Please check any that apply to your pet:</strong></span></p>
              </div>
            </div>
          </li>
          <li class="form-line" data-type="control_checkbox" id="id_28">
            <label class="form-label form-label-left form-label-auto" id="label_28" for="input_28"> Water Consumption </label>
            <div id="cid_28" class="form-input jf-required">
              <div class="form-single-column">
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_28_0" name="q28_waterConsumption[]" value="More" />
                  <label id="label_input_28_0" for="input_28_0"> More </label>
                </span>
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_28_1" name="q28_waterConsumption[]" value="Less" />
                  <label id="label_input_28_1" for="input_28_1"> Less </label>
                </span>
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_28_2" name="q28_waterConsumption[]" value="No Change" />
                  <label id="label_input_28_2" for="input_28_2"> No Change </label>
                </span>
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_28_3" name="q28_waterConsumption[]" value="Unknown" />
                  <label id="label_input_28_3" for="input_28_3"> Unknown </label>
                </span>
              </div>
            </div>
          </li>
          <li class="form-line" data-type="control_checkbox" id="id_29">
            <label class="form-label form-label-left form-label-auto" id="label_29" for="input_29"> Urination: Have you noticed any change? </label>
            <div id="cid_29" class="form-input jf-required">
              <div class="form-single-column">
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_29_0" name="q29_urinationHave[]" value="Yes" />
                  <label id="label_input_29_0" for="input_29_0"> Yes </label>
                </span>
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_29_1" name="q29_urinationHave[]" value="No" />
                  <label id="label_input_29_1" for="input_29_1"> No </label>
                </span>
              </div>
            </div>
          </li>
          <li class="form-line" data-type="control_textbox" id="id_30">
            <label class="form-label form-label-left form-label-auto" id="label_30" for="input_30"> If yes, please describe </label>
            <div id="cid_30" class="form-input jf-required">
              <input type="text" class=" form-textbox" data-type="input-textbox" id="input_30" name="q30_ifYes" size="45" value="" />
            </div>
          </li>
          <li class="form-line" data-type="control_checkbox" id="id_31">
            <label class="form-label form-label-left form-label-auto" id="label_31" for="input_31"> Vomiting </label>
            <div id="cid_31" class="form-input jf-required">
              <div class="form-single-column">
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_31_0" name="q31_vomiting[]" value="Yes" />
                  <label id="label_input_31_0" for="input_31_0"> Yes </label>
                </span>
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_31_1" name="q31_vomiting[]" value="No" />
                  <label id="label_input_31_1" for="input_31_1"> No </label>
                </span>
              </div>
            </div>
          </li>
          <li class="form-line" data-type="control_textbox" id="id_32">
            <label class="form-label form-label-left form-label-auto" id="label_32" for="input_32"> If yes, how many episodes, how often, how long? </label>
            <div id="cid_32" class="form-input jf-required">
              <input type="text" class=" form-textbox" data-type="input-textbox" id="input_32" name="q32_ifYes32" size="45" value="" />
            </div>
          </li>
          <li class="form-line" data-type="control_textbox" id="id_33">
            <label class="form-label form-label-left form-label-auto" id="label_33" for="input_33"> The most recent time was? </label>
            <div id="cid_33" class="form-input jf-required">
              <input type="text" class=" form-textbox" data-type="input-textbox" id="input_33" name="q33_theMost" size="20" value="" />
            </div>
          </li>
          <li class="form-line" data-type="control_textbox" id="id_34">
            <label class="form-label form-label-left form-label-auto" id="label_34" for="input_34"> What color? </label>
            <div id="cid_34" class="form-input jf-required">
              <input type="text" class=" form-textbox" data-type="input-textbox" id="input_34" name="q34_whatColor" size="20" value="" />
            </div>
          </li>
          <li class="form-line" data-type="control_checkbox" id="id_35">
            <label class="form-label form-label-left form-label-auto" id="label_35" for="input_35"> Any diarrhea or loose stools? </label>
            <div id="cid_35" class="form-input jf-required">
              <div class="form-single-column">
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_35_0" name="q35_anyDiarrhea[]" value="Yes" />
                  <label id="label_input_35_0" for="input_35_0"> Yes </label>
                </span>
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_35_1" name="q35_anyDiarrhea[]" value="No" />
                  <label id="label_input_35_1" for="input_35_1"> No </label>
                </span>
              </div>
            </div>
          </li>
          <li class="form-line" data-type="control_textbox" id="id_36">
            <label class="form-label form-label-left form-label-auto" id="label_36" for="input_36"> If yes, how many episodes, how often, how long? </label>
            <div id="cid_36" class="form-input jf-required">
              <input type="text" class=" form-textbox" data-type="input-textbox" id="input_36" name="q36_ifYes36" size="45" value="" />
            </div>
          </li>
          <li class="form-line" data-type="control_checkbox" id="id_37">
            <label class="form-label form-label-left form-label-auto" id="label_37" for="input_37"> Consistency of stools? </label>
            <div id="cid_37" class="form-input jf-required">
              <div class="form-single-column">
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_37_0" name="q37_consistencyOf[]" value="Soft" />
                  <label id="label_input_37_0" for="input_37_0"> Soft </label>
                </span>
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_37_1" name="q37_consistencyOf[]" value="Cow-pie" />
                  <label id="label_input_37_1" for="input_37_1"> Cow-pie </label>
                </span>
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_37_2" name="q37_consistencyOf[]" value="Bloody" />
                  <label id="label_input_37_2" for="input_37_2"> Bloody </label>
                </span>
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_37_3" name="q37_consistencyOf[]" value="Liquid" />
                  <label id="label_input_37_3" for="input_37_3"> Liquid </label>
                </span>
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_37_4" name="q37_consistencyOf[]" value="Mucus/Jelly" />
                  <label id="label_input_37_4" for="input_37_4"> Mucus/Jelly </label>
                </span>
              </div>
            </div>
          </li>
          <li class="form-line" data-type="control_textbox" id="id_38">
            <label class="form-label form-label-left form-label-auto" id="label_38" for="input_38"> The most recent one was? </label>
            <div id="cid_38" class="form-input jf-required">
              <input type="text" class=" form-textbox" data-type="input-textbox" id="input_38" name="q38_theMost38" size="20" value="" />
            </div>
          </li>
          <li class="form-line" data-type="control_textbox" id="id_39">
            <label class="form-label form-label-left form-label-auto" id="label_39" for="input_39"> What color? </label>
            <div id="cid_39" class="form-input jf-required">
              <input type="text" class=" form-textbox" data-type="input-textbox" id="input_39" name="q39_whatColor39" size="20" value="" />
            </div>
          </li>
          <li class="form-line" data-type="control_checkbox" id="id_40">
            <label class="form-label form-label-left form-label-auto" id="label_40" for="input_40"> Any coughing or sneezing? </label>
            <div id="cid_40" class="form-input jf-required">
              <div class="form-single-column">
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_40_0" name="q40_anyCoughing[]" value="Yes" />
                  <label id="label_input_40_0" for="input_40_0"> Yes </label>
                </span>
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_40_1" name="q40_anyCoughing[]" value="No" />
                  <label id="label_input_40_1" for="input_40_1"> No </label>
                </span>
              </div>
            </div>
          </li>
          <li class="form-line" data-type="control_textbox" id="id_41">
            <label class="form-label form-label-left form-label-auto" id="label_41" for="input_41"> Which? </label>
            <div id="cid_41" class="form-input jf-required">
              <input type="text" class=" form-textbox" data-type="input-textbox" id="input_41" name="q41_which" size="20" value="" />
            </div>
          </li>
          <li class="form-line" data-type="control_checkbox" id="id_42">
            <label class="form-label form-label-left form-label-auto" id="label_42" for="input_42"> If coughing describe: </label>
            <div id="cid_42" class="form-input jf-required">
              <div class="form-single-column">
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_42_0" name="q42_ifCoughing[]" value="Soft loud" />
                  <label id="label_input_42_0" for="input_42_0"> Soft loud </label>
                </span>
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_42_1" name="q42_ifCoughing[]" value="Hacking" />
                  <label id="label_input_42_1" for="input_42_1"> Hacking </label>
                </span>
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_42_2" name="q42_ifCoughing[]" value="Gagging/choking" />
                  <label id="label_input_42_2" for="input_42_2"> Gagging/choking </label>
                </span>
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_42_3" name="q42_ifCoughing[]" value="Dry" />
                  <label id="label_input_42_3" for="input_42_3"> Dry </label>
                </span>
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_42_4" name="q42_ifCoughing[]" value="Fluid/wet" />
                  <label id="label_input_42_4" for="input_42_4"> Fluid/wet </label>
                </span>
              </div>
            </div>
          </li>
          <li class="form-line" data-type="control_text" id="id_43">
            <div id="cid_43" class="form-input-wide">
              <div id="text_43" class="form-html">
                <p><span style="text-decoration:underline;font-size:medium;"><strong>Permission</strong></span></p>
                <p>By law, we are unable to proceed with any diagnostics or treatments without your approval. If you have limitations as to what you wish to be done please state so on the lines below.</p>
              </div>
            </div>
          </li>
          <li class="form-line" data-type="control_textarea" id="id_45">
            <label class="form-label form-label-left form-label-auto" id="label_45" for="input_45"> Please write here: </label>
            <div id="cid_45" class="form-input jf-required">
              <textarea id="input_45" class="form-textarea" name="q45_pleaseWrite" cols="40" rows="6"></textarea>
            </div>
          </li>
          <li class="form-line" data-type="control_text" id="id_46">
            <div id="cid_46" class="form-input-wide">
              <div id="text_46" class="form-html">
                <p><span style="font-size:small;">I consent to the following test and or lab work <span style="text-decoration:underline;"><strong>before</strong></span> contacting me: (Please Check)</span></p>
              </div>
            </div>
          </li>
          <li class="form-line" data-type="control_checkbox" id="id_47">
            <label class="form-label form-label-left form-label-auto" id="label_47" for="input_47"> Please Check </label>
            <div id="cid_47" class="form-input jf-required">
              <div class="form-single-column">
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_47_0" name="q47_pleaseCheck[]" value="Blood Testing (Costs range from $50.00-$150.00)" />
                  <label id="label_input_47_0" for="input_47_0"> Blood Testing (Costs range from $50.00-$150.00) </label>
                </span>
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_47_1" name="q47_pleaseCheck[]" value="Urine Testing (Costs range from $38.00-$75.00)" />
                  <label id="label_input_47_1" for="input_47_1"> Urine Testing (Costs range from $38.00-$75.00) </label>
                </span>
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_47_2" name="q47_pleaseCheck[]" value="X-rays (Costs for first 2 views $110 and up for additional views)" />
                  <label id="label_input_47_2" for="input_47_2"> X-rays (Costs for first 2 views $110 and up for additional views) </label>
                </span>
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_47_3" name="q47_pleaseCheck[]" value="Ear Swab and Cytology (Cost from $16.00-$32.00)" />
                  <label id="label_input_47_3" for="input_47_3"> Ear Swab and Cytology (Cost from $16.00-$32.00) </label>
                </span>
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_47_4" name="q47_pleaseCheck[]" value="Fecal Analysis (Costs range from $7.50-$30.00)" />
                  <label id="label_input_47_4" for="input_47_4"> Fecal Analysis (Costs range from $7.50-$30.00) </label>
                </span>
              </div>
            </div>
          </li>
          <li class="form-line" data-type="control_checkbox" id="id_48">
            <label class="form-label form-label-left form-label-auto" id="label_48" for="input_48">  </label>
            <div id="cid_48" class="form-input jf-required">
              <div class="form-single-column">
                <span class="form-checkbox-item" style="clear:left;">
                  <span class="dragger-item">
                  </span>
                  <input type="checkbox" class="form-checkbox" id="input_48_0" name="q48_48[]" value="I would prefer to be contacted before any tests are performed." />
                  <label id="label_input_48_0" for="input_48_0"> I would prefer to be contacted before any tests are performed. </label>
                </span>
              </div>
            </div>
          </li>
          <li class="form-line" data-type="control_text" id="id_49">
            <div id="cid_49" class="form-input-wide">
              <div id="text_49" class="form-html">
                <p><strong>In the event we cannot reach you, no treatments will be performed, except in the event of a life threatening condition.</strong></p>
              </div>
            </div>
          </li>
          <li class="form-line" data-type="control_textbox" id="id_50">
            <label class="form-label form-label-left form-label-auto" id="label_50" for="input_50"> The best time to contact me would be? </label>
            <div id="cid_50" class="form-input jf-required">
              <input type="text" class=" form-textbox" data-type="input-textbox" id="input_50" name="q50_theBest" size="45" value="" />
            </div>
          </li>
          <li class="form-line" data-type="control_phone" id="id_51">
            <label class="form-label form-label-left form-label-auto" id="label_51" for="input_51"> The best contact number for me today is? </label>
            <div id="cid_51" class="form-input jf-required">
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="tel" name="q51_theBest51[area]" id="input_51_area" size="3">
                <span class="phone-separate">
                  &nbsp;-
                </span>
                <label class="form-sub-label" for="input_51_area" id="sublabel_area" style="min-height: 13px;"> Area Code </label>
              </span>
              <span class="form-sub-label-container" style="vertical-align: top">
                <input class="form-textbox" type="tel" name="q51_theBest51[phone]" id="input_51_phone" size="8">
                <label class="form-sub-label" for="input_51_phone" id="sublabel_phone" style="min-height: 13px;"> Phone Number </label>
              </span>
            </div>
          </li>
          <li class="form-line" data-type="control_text" id="id_52">
            <div id="cid_52" class="form-input-wide">
              <div id="text_52" class="form-html">
                <p>By signing below, I am authorizing an exam and treatment limited to what is written above. I understand that this is a drop-off appointment and that in the event of a life-threatening condition, the doctor or designated staff may need to perform other treatments than the above listed and I am solely responsible for all charges incurred.</p>
              </div>
            </div>
          </li>
          <li class="form-line" data-type="control_signature" id="id_53">
            <label class="form-label form-label-left form-label-auto" id="label_53" for="input_53"> Signature </label>
            <div id="cid_53" class="form-input jf-required">
              <div id="signature_pad_53" class="signature-pad-wrapper" style="width:402px;height:202px;">
                <!--[if IE 7]>
                  <script type="text/javascript" src="/js/vendor/json2.js"></script>
                <![endif]-->
                <div class="signature-line signature-wrapper" style="width:402px;height:202px;">
                  <div id="sig_pad_53" data-width="400" data-height="200" data-id="53" data-required="false" class="pad">
                  </div>
                  <input type="hidden" name="q53_signature53" class="output4" id="sig_pad_53">
                </div>
                <span class="clear-pad-btn clear-pad">
                  Clear
                </span>
              </div>
              <script type="text/javascript">
              window.signatureForm = true
              </script>
            </div>
          </li>
          <li class="form-line" data-type="control_textbox" id="id_54">
            <label class="form-label form-label-left form-label-auto" id="label_54" for="input_54"> Date </label>
            <div id="cid_54" class="form-input jf-required">
              <input type="text" class=" form-textbox" data-type="input-textbox" id="input_54" name="q54_date54" size="20" value="" />
            </div>
          </li>
          <li class="form-line jf-required" data-type="control_captcha" id="id_55">
            <label class="form-label form-label-left form-label-auto" id="label_55" for="input_55">
              Enter the message as it's shown
              <span class="form-required">
                *
              </span>
            </label>
            <div id="cid_55" class="form-input jf-required">
              <div class="form-captcha">
                <label for="input_55"> <img alt="Captcha - Reload if it's not displayed" id="input_55_captcha" class="form-captcha-image" style="background:url(https://cdn.jotfor.ms/images/loader-big.gif) no-repeat center;" src="https://cdn.jotfor.ms/images/blank.gif" width="150" height="41" /> </label>
                <div style="white-space:nowrap;">
                  <input type="text" id="input_55" class="form-textbox validate[required]" name="captcha" style="width:130px;" />
                  <img src="https://cdn.jotfor.ms/images/reload.png" alt="Reload" align="absmiddle" style="cursor:pointer" onclick="JotForm.reloadCaptcha('input_55');" />
                  <input type="hidden" name="captcha_id" id="input_55_captcha_id" value="0" />
                </div>
              </div>
            </div>
          </li>
          <li class="form-line" data-type="control_button" id="id_2">
            <div id="cid_2" class="form-input-wide">
              <div style="text-align:center" class="form-buttons-wrapper">
                <button id="input_2" type="submit" class="form-submit-button form-submit-button-simple_grey">
                  Submit
                </button>
              </div>
            </div>
          </li>
          <li style="display:none">
            Should be Empty:
            <input type="text" name="website" value="" />
          </li>
        </ul>
      </div>
      <input type="hidden" id="simple_spc" name="simple_spc" value="30717141893152" />
      <script type="text/javascript">
      document.getElementById("si" + "mple" + "_spc").value = "30717141893152-30717141893152";
      </script>
    </form>
    <script type="text/javascript">JotForm.ownerView=true;</script></div>

    Page URL:
    websitepage-http://deschutesanimalclinic.com/form_drop-off_questionair<br/>e.htm

    Emails emails sent sent client
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    JotForm Support

    Answered by Mike_G on March 11, 2016 at 09:24 PM

    I have made some test submission directly from your form(stand-alone) and on your form that is embedded on your website and both tests were successful.

    Here's how you can also check your mail logs from your account: How-to-view-all-your-form-Email-History

    Are you still having issues receiving the email notifications? If yes, please feel free to get back to us with more details of the process you're taking to reproduce the issue.

    Thank you.