[{"command":"settings","settings":{"basePath":"\/","pathPrefix":"","ajaxPageState":{"theme":"cgh_2015","theme_token":"JqPrYAouuD-i6VCIz9YMKjGNq2YAoN2TvwB-YraPxdQ"},"urlIsAjaxTrusted":{"\/qualify\/modal\/nojs":true}},"merge":true},{"command":"modal_display","title":"Do you qualify?","output":"\u003Cform action=\u0022\/qualify\/modal\/nojs\u0022 method=\u0022post\u0022 id=\u0022cgh-qualifier-qualification-form\u0022 accept-charset=\u0022UTF-8\u0022\u003E\u003Cdiv\u003E\u003Cdiv class=\u0022item-list\u0022\u003E\u003Col class=\u0022progress-bar step-1\u0022\u003E\u003Cli class=\u0022first\u0022\u003E1\u003C\/li\u003E\n\u003Cli\u003E2\u003C\/li\u003E\n\u003Cli\u003E3\u003C\/li\u003E\n\u003Cli\u003E4\u003C\/li\u003E\n\u003Cli\u003E5\u003C\/li\u003E\n\u003Cli class=\u0022last\u0022\u003E6\u003C\/li\u003E\n\u003C\/ol\u003E\u003C\/div\u003E\u003Cdiv class=\u0022form-item form-type-radios form-item-user\u0022\u003E\n \u003Clabel for=\u0022edit-user\u0022\u003EWho is looking for care? \u003Cspan class=\u0022form-required\u0022 title=\u0022This field is required.\u0022\u003E*\u003C\/span\u003E\u003C\/label\u003E\n \u003Cdiv id=\u0022edit-user\u0022 class=\u0022form-radios\u0022\u003E\u003Cdiv class=\u0022form-item form-type-radio form-item-user\u0022\u003E\n \u003Cinput type=\u0022radio\u0022 id=\u0022edit-user-me\u0022 name=\u0022user\u0022 value=\u0022me\u0022 class=\u0022form-radio\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022edit-user-me\u0022\u003EMe \u003C\/label\u003E\n\n\u003C\/div\u003E\n\u003Cdiv class=\u0022form-item form-type-radio form-item-user\u0022\u003E\n \u003Cinput type=\u0022radio\u0022 id=\u0022edit-user-loved-one\u0022 name=\u0022user\u0022 value=\u0022loved_one\u0022 class=\u0022form-radio\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022edit-user-loved-one\u0022\u003ELoved One \u003C\/label\u003E\n\n\u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\n\u003Cdiv class=\u0027referral-step0\u0027\u003EIf you\u2019re a healthcare professional seeking to refer a client to Caregiver Homes, please visit \u003Ca href=\u0022http:\/\/www.caregiverhomes.com\/referral\u0022\u003Ewww.caregiverhomes.com\/referral\u003C\/a\u003E\u003C\/div\u003E\u003Cinput class=\u0022btn btn-muted btn-prev notranslate form-submit form-button-disabled\u0022 disabled=\u0022disabled\u0022 type=\u0022submit\u0022 id=\u0022edit-previous\u0022 name=\u0022op\u0022 value=\u0022Back\u0022 \/\u003E\u003Cinput class=\u0022btn btn-primary btn-next notranslate form-submit\u0022 type=\u0022submit\u0022 id=\u0022edit-next\u0022 name=\u0022op\u0022 value=\u0022Next\u0022 \/\u003E\u003Cinput type=\u0022hidden\u0022 name=\u0022form_build_id\u0022 value=\u0022form-SoqefYq1oXD999ka81N9Dv1taE28kP5gaL0At7gMFCs\u0022 \/\u003E\n\u003Cinput type=\u0022hidden\u0022 name=\u0022form_id\u0022 value=\u0022cgh_qualifier_qualification_form\u0022 \/\u003E\n\u003C\/div\u003E\u003C\/form\u003E"}]