{"id":153,"date":"2016-02-19T17:58:34","date_gmt":"2016-02-19T17:58:34","guid":{"rendered":"https:\/\/www.palomar.edu\/drc\/?page_id=153"},"modified":"2016-06-09T17:55:45","modified_gmt":"2016-06-09T17:55:45","slug":"access-barrier-report","status":"publish","type":"page","link":"https:\/\/www.palomar.edu\/drc\/drc-forms\/access-barrier-report\/","title":{"rendered":"Access Barrier Report 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' >\n                        <div class='gform_heading'>\n                            <p class='gform_description'>Have you experienced an access barrier on campus? If so, we want to hear from you.<\/br><\/br>\r\nPlease complete this form with a detailed description of where and what type of barrier you have encountered. We may need to contact you, so be sure to complete all required fields. Thank you for your time and attention. <\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_4'  action='\/drc\/wp-json\/wp\/v2\/pages\/153' 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_1\" class=\"gfield gfield--type-name 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' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/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_4_1'>\n                            \n                            <span id='input_4_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_4_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_4_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_4_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_4_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_4_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_4_3\" class=\"gfield gfield--type-phone 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_3'>Phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_3' id='input_4_3' type='tel' value='' class='medium'    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_4_4\" class=\"gfield gfield--type-email 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' for='input_4_4'>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_4' id='input_4_4' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_4_2\" class=\"gfield gfield--type-radio gfield--type-choice 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' >Status<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_2'>\n\t\t\t<li class='gchoice gchoice_4_2_0'>\n\t\t\t\t<input name='input_2' type='radio' value='Student'  id='choice_4_2_0'    \/>\n\t\t\t\t<label for='choice_4_2_0' id='label_4_2_0' class='gform-field-label gform-field-label--type-inline'>Student<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_4_2_1'>\n\t\t\t\t<input name='input_2' type='radio' value='Faculty\/Staff'  id='choice_4_2_1'    \/>\n\t\t\t\t<label for='choice_4_2_1' id='label_4_2_1' class='gform-field-label gform-field-label--type-inline'>Faculty\/Staff<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_4_2_2'>\n\t\t\t\t<input name='input_2' type='radio' value='Campus Visitor'  id='choice_4_2_2'    \/>\n\t\t\t\t<label for='choice_4_2_2' id='label_4_2_2' class='gform-field-label gform-field-label--type-inline'>Campus Visitor<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_4_5\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Describe the Access Barrier<\/h2><\/li><li id=\"field_4_6\" class=\"gfield gfield--type-radio gfield--type-choice 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' >Type of Barrier<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_6'>\n\t\t\t<li class='gchoice gchoice_4_6_0'>\n\t\t\t\t<input name='input_6' type='radio' value='Physical'  id='choice_4_6_0'    \/>\n\t\t\t\t<label for='choice_4_6_0' id='label_4_6_0' class='gform-field-label gform-field-label--type-inline'>Physical<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_4_6_1'>\n\t\t\t\t<input name='input_6' type='radio' value='Technology\/Web Based'  id='choice_4_6_1'    \/>\n\t\t\t\t<label for='choice_4_6_1' id='label_4_6_1' class='gform-field-label gform-field-label--type-inline'>Technology\/Web Based<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_4_6_2'>\n\t\t\t\t<input name='input_6' type='radio' value='Other'  id='choice_4_6_2'    \/>\n\t\t\t\t<label for='choice_4_6_2' id='label_4_6_2' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_4_10\" 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' >Location of Barrier<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_10'>\n\t\t\t<li class='gchoice gchoice_4_10_0'>\n\t\t\t\t<input name='input_10' type='radio' value='San Marcos'  id='choice_4_10_0'    \/>\n\t\t\t\t<label for='choice_4_10_0' id='label_4_10_0' class='gform-field-label gform-field-label--type-inline'>San Marcos<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_4_10_1'>\n\t\t\t\t<input name='input_10' type='radio' value='Escondido'  id='choice_4_10_1'    \/>\n\t\t\t\t<label for='choice_4_10_1' id='label_4_10_1' class='gform-field-label gform-field-label--type-inline'>Escondido<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_4_10_2'>\n\t\t\t\t<input name='input_10' type='radio' value='Camp Pendleton'  id='choice_4_10_2'    \/>\n\t\t\t\t<label for='choice_4_10_2' id='label_4_10_2' class='gform-field-label gform-field-label--type-inline'>Camp Pendleton<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_4_10_3'>\n\t\t\t\t<input name='input_10' type='radio' value='Fallbrook'  id='choice_4_10_3'    \/>\n\t\t\t\t<label for='choice_4_10_3' id='label_4_10_3' class='gform-field-label gform-field-label--type-inline'>Fallbrook<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_4_10_4'>\n\t\t\t\t<input name='input_10' type='radio' value='Mt. Carmel'  id='choice_4_10_4'    \/>\n\t\t\t\t<label for='choice_4_10_4' id='label_4_10_4' class='gform-field-label gform-field-label--type-inline'>Mt. Carmel<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_4_10_5'>\n\t\t\t\t<input name='input_10' type='radio' value='Pauma'  id='choice_4_10_5'    \/>\n\t\t\t\t<label for='choice_4_10_5' id='label_4_10_5' class='gform-field-label gform-field-label--type-inline'>Pauma<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_4_10_6'>\n\t\t\t\t<input name='input_10' type='radio' value='Online'  id='choice_4_10_6'    \/>\n\t\t\t\t<label for='choice_4_10_6' id='label_4_10_6' class='gform-field-label gform-field-label--type-inline'>Online<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_4_8\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text' for='input_4_8'>Please provide the specific location. If it is an online barrier provide a link.<\/label><div class='gfield_description' id='gfield_description_4_8'>Please provide the specific location. If it is an online barrier provide a link.<\/div><div class='ginput_container ginput_container_text'><input name='input_8' id='input_4_8' type='text' value='' class='large'  aria-describedby=\"gfield_description_4_8\"    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_4_9\" class=\"gfield gfield--type-textarea 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_9'>Description of Barrier<\/label><div class='gfield_description' id='gfield_description_4_9'>Please provide as detailed a description of the barrier as possible. 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