{"id":5783,"date":"2022-04-19T16:58:58","date_gmt":"2022-04-19T15:58:58","guid":{"rendered":"https:\/\/www.sense.org.uk\/?page_id=5783"},"modified":"2026-01-07T11:29:37","modified_gmt":"2026-01-07T11:29:37","slug":"information-and-advice-online-enquiry","status":"publish","type":"page","link":"https:\/\/www.sense.org.uk\/our-services\/contact-us-about-our-services\/information-and-advice-online-enquiry\/","title":{"rendered":"Information and advice online enquiry"},"content":{"rendered":"\n<p>Sense Information and Advice can help you find the right support for you and your family. We are here to offer you free and impartial information about living with complex needs.\u00a0<\/p>\n\n\n\n<p>You can&nbsp;contact us at <a href=\"mailto:info@sense.org.uk\">info@sense.org.uk<\/a>, or use this form:<\/p>\n\n\n<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_unknown gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_11' style='display:none'>\n                        <div class='gform_heading'>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_11'  action='\/wp-json\/wp\/v2\/pages\/5783' data-formid='11' novalidate><div class='gf_invisible ginput_recaptchav3' data-sitekey='6LejreksAAAAAJiYXWDOrcZJ7jZpJmlNZiQ0scCj' data-tabindex='0'><input id=\"input_e85d73a21a0b46b4c09a843dddcafe5f\" class=\"gfield_recaptcha_response\" type=\"hidden\" name=\"input_e85d73a21a0b46b4c09a843dddcafe5f\" value=\"\"\/><\/div>\n                        <div class='gform-body gform_body'><div id='gform_fields_11' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_11_21\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<?xml encoding=\"utf-8\" ?><html><body><h3>Your contact details<\/h3><\/body><\/html>\n<\/div><fieldset id=\"field_11_1\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<?xml encoding=\"utf-8\" ?><html><body><legend class=\"gfield_label gform-field-label gfield_label_before_complex\">Your name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><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_11_1\">\n                            \n                            <span id=\"input_11_1_3_container\" class=\"name_first gform-grid-col gform-grid-col--size-auto\">\n                                                    <label for=\"input_11_1_3\" class=\"gform-field-label gform-field-label--type-sub \">First<\/label>\n                                                    <input type=\"text\" name=\"input_1.3\" id=\"input_11_1_3\" value=\"\" aria-required=\"true\" class=\"required  \">\n                                                <\/span>\n                            \n                            <span id=\"input_11_1_6_container\" class=\"name_last gform-grid-col gform-grid-col--size-auto\">\n                                                            <label for=\"input_11_1_6\" class=\"gform-field-label gform-field-label--type-sub \">Last<\/label>\n                                                            <input type=\"text\" name=\"input_1.6\" id=\"input_11_1_6\" value=\"\" aria-required=\"true\" class=\"required  \">\n                                                        <\/span>\n                            \n                        <\/div><\/body><\/html>\n<\/fieldset><div id=\"field_11_3\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<?xml encoding=\"utf-8\" ?><html><body><label class=\"gfield_label gform-field-label\" for=\"input_11_3\">Your email address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class=\"ginput_container ginput_container_email\">\n                            <input name=\"input_3\" id=\"input_11_3\" type=\"email\" value=\"\" aria-required=\"true\" aria-invalid=\"false\" class=\"required  large\">\n                        <\/div><\/body><\/html>\n<\/div><fieldset id=\"field_11_6\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<?xml encoding=\"utf-8\" ?><html><body><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><legend class=\"gfield_label gform-field-label\">Select a service<\/legend><div class=\"ginput_container ginput_container_radio\"><div class=\"gfield_radio\" id=\"input_11_6\">\n\t\t\t<div class=\"gchoice gchoice_11_6_0\">\n\t\t\t\t\t<input name=\"input_6\" type=\"radio\" value=\"buddying\" id=\"choice_11_6_0\" onchange=\"gformToggleRadioOther( this )\" class=\" gfield-choice-input\">\n\t\t\t\t\t<label for=\"choice_11_6_0\" id=\"label_11_6_0\" class=\"gform-field-label gform-field-label--type-inline\">Buddying<\/label>\n\t\t\t<\/div>\n\t\t\t<div class=\"gchoice gchoice_11_6_1\">\n\t\t\t\t\t<input name=\"input_6\" type=\"radio\" value=\"sibling\" id=\"choice_11_6_1\" onchange=\"gformToggleRadioOther( this )\" class=\" gfield-choice-input\">\n\t\t\t\t\t<label for=\"choice_11_6_1\" id=\"label_11_6_1\" class=\"gform-field-label gform-field-label--type-inline\">Sibling service<\/label>\n\t\t\t<\/div>\n\t\t\t<div class=\"gchoice gchoice_11_6_2\">\n\t\t\t\t\t<input name=\"input_6\" type=\"radio\" value=\"dance\" id=\"choice_11_6_2\" onchange=\"gformToggleRadioOther( this )\" class=\" gfield-choice-input\">\n\t\t\t\t\t<label for=\"choice_11_6_2\" id=\"label_11_6_2\" class=\"gform-field-label gform-field-label--type-inline\">Dance<\/label>\n\t\t\t<\/div>\n\t\t\t<div class=\"gchoice gchoice_11_6_3\">\n\t\t\t\t\t<input name=\"input_6\" type=\"radio\" value=\"employment\" id=\"choice_11_6_3\" onchange=\"gformToggleRadioOther( this )\" class=\" gfield-choice-input\">\n\t\t\t\t\t<label for=\"choice_11_6_3\" id=\"label_11_6_3\" class=\"gform-field-label gform-field-label--type-inline\">Employment<\/label>\n\t\t\t<\/div><\/div><\/div><\/body><\/html>\n<\/fieldset><fieldset id=\"field_11_14\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<?xml encoding=\"utf-8\" ?><html><body><legend class=\"gfield_label gform-field-label\">Is your question about you or someone else?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class=\"ginput_container ginput_container_radio\"><div class=\"gfield_radio\" id=\"input_11_14\">\n\t\t\t<div class=\"gchoice gchoice_11_14_0\">\n\t\t\t\t\t<input name=\"input_14\" type=\"radio\" value=\"It's about me\" id=\"choice_11_14_0\" onchange=\"gformToggleRadioOther( this )\" class=\"required  gfield-choice-input\">\n\t\t\t\t\t<label for=\"choice_11_14_0\" id=\"label_11_14_0\" class=\"gform-field-label gform-field-label--type-inline\">It&#8217;s about me<\/label>\n\t\t\t<\/div>\n\t\t\t<div class=\"gchoice gchoice_11_14_1\">\n\t\t\t\t\t<input name=\"input_14\" type=\"radio\" value=\"It's about someone else\" id=\"choice_11_14_1\" onchange=\"gformToggleRadioOther( this )\" class=\"required  gfield-choice-input\">\n\t\t\t\t\t<label for=\"choice_11_14_1\" id=\"label_11_14_1\" class=\"gform-field-label gform-field-label--type-inline\">It&#8217;s about someone else<\/label>\n\t\t\t<\/div><\/div><\/div><\/body><\/html>\n<\/fieldset><fieldset id=\"field_11_10\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<?xml encoding=\"utf-8\" ?><html><body><legend class=\"gfield_label gform-field-label\">Who is the Sense Sibling Service for?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class=\"ginput_container ginput_container_radio\"><div class=\"gfield_radio\" id=\"input_11_10\">\n\t\t\t<div class=\"gchoice gchoice_11_10_0\">\n\t\t\t\t\t<input name=\"input_10\" type=\"radio\" value=\"I want to sign up my child\" id=\"choice_11_10_0\" onchange=\"gformToggleRadioOther( this )\" class=\"required  gfield-choice-input\">\n\t\t\t\t\t<label for=\"choice_11_10_0\" id=\"label_11_10_0\" class=\"gform-field-label gform-field-label--type-inline\">I want to sign up my child<\/label>\n\t\t\t<\/div>\n\t\t\t<div class=\"gchoice gchoice_11_10_1\">\n\t\t\t\t\t<input name=\"input_10\" type=\"radio\" value=\"I want to sign up a child I'm working with\" id=\"choice_11_10_1\" onchange=\"gformToggleRadioOther( this )\" class=\"required  gfield-choice-input\">\n\t\t\t\t\t<label for=\"choice_11_10_1\" id=\"label_11_10_1\" class=\"gform-field-label gform-field-label--type-inline\">I want to sign up a child I&#8217;m working with<\/label>\n\t\t\t<\/div>\n\t\t\t<div class=\"gchoice gchoice_11_10_2\">\n\t\t\t\t\t<input name=\"input_10\" type=\"radio\" value=\"I'm a young carer and am signing up for myself\" id=\"choice_11_10_2\" onchange=\"gformToggleRadioOther( this )\" class=\"required  gfield-choice-input\">\n\t\t\t\t\t<label for=\"choice_11_10_2\" id=\"label_11_10_2\" class=\"gform-field-label gform-field-label--type-inline\">I&#8217;m a young carer and am signing up for myself<\/label>\n\t\t\t<\/div><\/div><\/div><\/body><\/html>\n<\/fieldset><div id=\"field_11_30\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<?xml encoding=\"utf-8\" ?><html><body><label class=\"gfield_label gform-field-label\" for=\"input_11_30\">Their age<\/label><div class=\"gfield_description\" id=\"gfield_description_11_30\">Age of the person you&#8217;re enquiring about, so we can direct you to the best services<\/div><div class=\"ginput_container ginput_container_select\"><select name=\"input_30\" id=\"input_11_30\" aria-describedby=\"gfield_description_11_30\" aria-invalid=\"false\" class=\" large gfield_select\"><option value=\"\" selected class=\"gf_placeholder\">Choose&#8230;<\/option><option value=\"Under 8\">Under 8<\/option><option value=\"Under 18\">Under 18<\/option><option value=\"18 to 25\">18 to 25<\/option><option value=\"25 to 65\">25 to 65<\/option><option value=\"65 and older\">65 and older<\/option><\/select><\/div><\/body><\/html>\n<\/div><div id=\"field_11_38\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<?xml encoding=\"utf-8\" ?><html><body><label class=\"gfield_label gform-field-label\" for=\"input_11_38\">Which UK town or county do they live in?<\/label><div class=\"gfield_description\" id=\"gfield_description_11_38\">So we can find the nearest service, if needed<\/div><div class=\"ginput_container ginput_container_text\"><input name=\"input_38\" id=\"input_11_38\" type=\"text\" value=\"\" aria-describedby=\"gfield_description_11_38\" aria-invalid=\"false\" class=\" large\"><\/div><\/body><\/html>\n<\/div><div id=\"field_11_31\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<?xml encoding=\"utf-8\" ?><html><body><label class=\"gfield_label gform-field-label\" for=\"input_11_31\">Your age<\/label><div class=\"gfield_description\" id=\"gfield_description_11_31\">So we can direct you to the best services<\/div><div class=\"ginput_container ginput_container_select\"><select name=\"input_31\" id=\"input_11_31\" aria-describedby=\"gfield_description_11_31\" aria-invalid=\"false\" class=\" large gfield_select\"><option value=\"\" selected class=\"gf_placeholder\">Choose&#8230;<\/option><option value=\"Under 18\">Under 18<\/option><option value=\"18 to 25\">18 to 25<\/option><option value=\"25 to 65\">25 to 65<\/option><option value=\"65 and over\">65 and over<\/option><\/select><\/div><\/body><\/html>\n<\/div><div id=\"field_11_27\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<?xml encoding=\"utf-8\" ?><html><body><label class=\"gfield_label gform-field-label\" for=\"input_11_27\">What is your age?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class=\"gfield_description\" id=\"gfield_description_11_27\">So we understand what type of dancing (and music!) you will want<\/div><div class=\"ginput_container ginput_container_select\"><select name=\"input_27\" id=\"input_11_27\" aria-describedby=\"gfield_description_11_27\" aria-required=\"true\" aria-invalid=\"false\" class=\"required  large gfield_select\"><option value=\"\" selected class=\"gf_placeholder\">Choose&#8230;<\/option><option value=\"0-10\">0-10<\/option><option value=\"11-17\">11-17<\/option><option value=\"18-25\">18-25<\/option><option value=\"26-49\">26-49<\/option><option value=\"50 and over\">50 and over<\/option><\/select><\/div><\/body><\/html>\n<\/div><div id=\"field_11_34\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<?xml encoding=\"utf-8\" ?><html><body><label class=\"gfield_label gform-field-label\" for=\"input_11_34\">Your gender<\/label><div class=\"gfield_description\" id=\"gfield_description_11_34\">Optional question, so we can understand who is using our services<\/div><div class=\"ginput_container ginput_container_select\"><select name=\"input_34\" id=\"input_11_34\" aria-describedby=\"gfield_description_11_34\" aria-invalid=\"false\" class=\" large gfield_select\"><option value=\"\" selected class=\"gf_placeholder\">Choose&#8230;<\/option><option value=\"Male\">Male<\/option><option value=\"Female\">Female<\/option><option value=\"Non-binary\">Non-binary<\/option><\/select><\/div><\/body><\/html>\n<\/div><div id=\"field_11_35\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<?xml encoding=\"utf-8\" ?><html><body><label class=\"gfield_label gform-field-label\" for=\"input_11_35\">Your ethnicity<\/label><div class=\"gfield_description\" id=\"gfield_description_11_35\">Optional question, so we can understand who is using our services<\/div><div class=\"ginput_container ginput_container_select\"><select name=\"input_35\" id=\"input_11_35\" aria-describedby=\"gfield_description_11_35\" aria-invalid=\"false\" class=\" large gfield_select\"><option value=\"\" selected class=\"gf_placeholder\">Choose&#8230;<\/option><option value=\"Arab\">Arab<\/option><option value=\"Asian or Asian British: Indian\">Asian or Asian British: Indian<\/option><option value=\"Asian or Asian British: Pakistani\">Asian or Asian British: Pakistani<\/option><option value=\"Asian or Asian British: Bangladeshi\">Asian or Asian British: Bangladeshi<\/option><option value=\"Asian or Asian British: Chinese\">Asian or Asian British: Chinese<\/option><option value=\"Asian or Asian British: Other\">Asian or Asian British: Other<\/option><option value=\"Black or Black British: African\">Black or Black British: African<\/option><option value=\"Black or Black British: Caribbean\">Black or Black British: Caribbean<\/option><option value=\"Black or Black British: Other\">Black or Black British: Other<\/option><option value=\"Mixed: White and Black Caribbean\">Mixed: White and Black Caribbean<\/option><option value=\"Mixed: White and Black African\">Mixed: White and Black African<\/option><option value=\"Mixed: White and Asian\">Mixed: White and Asian<\/option><option value=\"Mixed: Other\">Mixed: Other<\/option><option value=\"White: British\">White: British<\/option><option value=\"White: Irish\">White: Irish<\/option><option value=\"White: Gypsy or Irish Traveller\">White: Gypsy or Irish Traveller<\/option><option value=\"White: Other\">White: Other<\/option><option value=\"Prefer not to say\">Prefer not to say<\/option><option value=\"Other\">Other<\/option><\/select><\/div><\/body><\/html>\n<\/div><div id=\"field_11_37\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<?xml encoding=\"utf-8\" ?><html><body><label class=\"gfield_label gform-field-label\" for=\"input_11_37\">Which UK town or county do you live in?<\/label><div class=\"gfield_description\" id=\"gfield_description_11_37\">So we can find the nearest service, if needed<\/div><div class=\"ginput_container ginput_container_text\"><input name=\"input_37\" id=\"input_11_37\" type=\"text\" value=\"\" aria-describedby=\"gfield_description_11_37\" aria-invalid=\"false\" class=\" large\"><\/div><\/body><\/html>\n<\/div><fieldset id=\"field_11_19\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<?xml encoding=\"utf-8\" ?><html><body><legend class=\"gfield_label gform-field-label gfield_label_before_complex\">Does the person you are enquiring about have any of the following disabilities (click all that apply)?<\/legend><div class=\"ginput_container ginput_container_checkbox\"><div class=\"gfield_checkbox \" id=\"input_11_19\"><div class=\"gchoice gchoice_11_19_1\">\n\t\t\t\t\t\t\t\t<input name=\"input_19.1\" type=\"checkbox\" value=\"Deaf\/hearing condition\" id=\"choice_11_19_1\" class=\" gfield-choice-input\">\n\t\t\t\t\t\t\t\t<label for=\"choice_11_19_1\" id=\"label_11_19_1\" class=\"gform-field-label gform-field-label--type-inline\">Deaf\/hearing condition<\/label>\n\t\t\t\t\t\t\t<\/div><div class=\"gchoice gchoice_11_19_2\">\n\t\t\t\t\t\t\t\t<input name=\"input_19.2\" type=\"checkbox\" value=\"Vision condition\" id=\"choice_11_19_2\" class=\" gfield-choice-input\">\n\t\t\t\t\t\t\t\t<label for=\"choice_11_19_2\" id=\"label_11_19_2\" class=\"gform-field-label gform-field-label--type-inline\">Vision condition<\/label>\n\t\t\t\t\t\t\t<\/div><div class=\"gchoice gchoice_11_19_3\">\n\t\t\t\t\t\t\t\t<input name=\"input_19.3\" type=\"checkbox\" value=\"Physical disability\" id=\"choice_11_19_3\" class=\" gfield-choice-input\">\n\t\t\t\t\t\t\t\t<label for=\"choice_11_19_3\" id=\"label_11_19_3\" class=\"gform-field-label gform-field-label--type-inline\">Physical disability<\/label>\n\t\t\t\t\t\t\t<\/div><div class=\"gchoice gchoice_11_19_4\">\n\t\t\t\t\t\t\t\t<input name=\"input_19.4\" type=\"checkbox\" value=\"Autism\" id=\"choice_11_19_4\" class=\" gfield-choice-input\">\n\t\t\t\t\t\t\t\t<label for=\"choice_11_19_4\" id=\"label_11_19_4\" class=\"gform-field-label gform-field-label--type-inline\">Autism<\/label>\n\t\t\t\t\t\t\t<\/div><div class=\"gchoice gchoice_11_19_5\">\n\t\t\t\t\t\t\t\t<input name=\"input_19.5\" type=\"checkbox\" value=\"Learning disability\" id=\"choice_11_19_5\" class=\" gfield-choice-input\">\n\t\t\t\t\t\t\t\t<label for=\"choice_11_19_5\" id=\"label_11_19_5\" class=\"gform-field-label gform-field-label--type-inline\">Learning disability<\/label>\n\t\t\t\t\t\t\t<\/div><div class=\"gchoice gchoice_11_19_6\">\n\t\t\t\t\t\t\t\t<input name=\"input_19.6\" type=\"checkbox\" value=\"Other\" id=\"choice_11_19_6\" class=\" gfield-choice-input\">\n\t\t\t\t\t\t\t\t<label for=\"choice_11_19_6\" id=\"label_11_19_6\" class=\"gform-field-label gform-field-label--type-inline\">Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/body><\/html>\n<\/fieldset><div id=\"field_11_20\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<?xml encoding=\"utf-8\" ?><html><body><label class=\"gfield_label gform-field-label\" for=\"input_11_20\">Other<\/label><div class=\"gfield_description\" id=\"gfield_description_11_20\">if you answered &#8216;other needs&#8217;, let us know here<\/div><div class=\"ginput_container ginput_container_text\"><input name=\"input_20\" id=\"input_11_20\" type=\"text\" value=\"\" aria-describedby=\"gfield_description_11_20\" aria-invalid=\"false\" class=\" large\"><\/div><\/body><\/html>\n<\/div><fieldset id=\"field_11_32\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<?xml encoding=\"utf-8\" ?><html><body><legend class=\"gfield_label gform-field-label gfield_label_before_complex\">Do you have any of the following disabilities (click all that apply)?<\/legend><div class=\"ginput_container ginput_container_checkbox\"><div class=\"gfield_checkbox \" id=\"input_11_32\"><div class=\"gchoice gchoice_11_32_1\">\n\t\t\t\t\t\t\t\t<input name=\"input_32.1\" type=\"checkbox\" value=\"Deaf\/hearing impairment\" id=\"choice_11_32_1\" class=\" gfield-choice-input\">\n\t\t\t\t\t\t\t\t<label for=\"choice_11_32_1\" id=\"label_11_32_1\" class=\"gform-field-label gform-field-label--type-inline\">Deaf\/hearing impairment<\/label>\n\t\t\t\t\t\t\t<\/div><div class=\"gchoice gchoice_11_32_2\">\n\t\t\t\t\t\t\t\t<input name=\"input_32.2\" type=\"checkbox\" value=\"Vision impairment\" id=\"choice_11_32_2\" class=\" gfield-choice-input\">\n\t\t\t\t\t\t\t\t<label for=\"choice_11_32_2\" id=\"label_11_32_2\" class=\"gform-field-label gform-field-label--type-inline\">Vision impairment<\/label>\n\t\t\t\t\t\t\t<\/div><div class=\"gchoice gchoice_11_32_3\">\n\t\t\t\t\t\t\t\t<input name=\"input_32.3\" type=\"checkbox\" value=\"Physical disability\" id=\"choice_11_32_3\" class=\" gfield-choice-input\">\n\t\t\t\t\t\t\t\t<label for=\"choice_11_32_3\" id=\"label_11_32_3\" class=\"gform-field-label gform-field-label--type-inline\">Physical disability<\/label>\n\t\t\t\t\t\t\t<\/div><div class=\"gchoice gchoice_11_32_4\">\n\t\t\t\t\t\t\t\t<input name=\"input_32.4\" type=\"checkbox\" value=\"Autism\" id=\"choice_11_32_4\" class=\" gfield-choice-input\">\n\t\t\t\t\t\t\t\t<label for=\"choice_11_32_4\" id=\"label_11_32_4\" class=\"gform-field-label gform-field-label--type-inline\">Autism<\/label>\n\t\t\t\t\t\t\t<\/div><div class=\"gchoice gchoice_11_32_5\">\n\t\t\t\t\t\t\t\t<input name=\"input_32.5\" type=\"checkbox\" value=\"Learning disability\" id=\"choice_11_32_5\" class=\" gfield-choice-input\">\n\t\t\t\t\t\t\t\t<label for=\"choice_11_32_5\" id=\"label_11_32_5\" class=\"gform-field-label gform-field-label--type-inline\">Learning disability<\/label>\n\t\t\t\t\t\t\t<\/div><div class=\"gchoice gchoice_11_32_6\">\n\t\t\t\t\t\t\t\t<input name=\"input_32.6\" type=\"checkbox\" value=\"Other\" id=\"choice_11_32_6\" class=\" gfield-choice-input\">\n\t\t\t\t\t\t\t\t<label for=\"choice_11_32_6\" id=\"label_11_32_6\" class=\"gform-field-label gform-field-label--type-inline\">Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/body><\/html>\n<\/fieldset><div id=\"field_11_33\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<?xml encoding=\"utf-8\" ?><html><body><label class=\"gfield_label gform-field-label\" for=\"input_11_33\">Other<\/label><div class=\"gfield_description\" id=\"gfield_description_11_33\">if you answered &#8216;other needs&#8217;, let us know here<\/div><div class=\"ginput_container ginput_container_text\"><input name=\"input_33\" id=\"input_11_33\" type=\"text\" value=\"\" aria-describedby=\"gfield_description_11_33\" aria-invalid=\"false\" class=\" large\"><\/div><\/body><\/html>\n<\/div><div id=\"field_11_22\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<?xml encoding=\"utf-8\" ?><html><body><h2>Your question<\/h2><\/body><\/html>\n<\/div><div id=\"field_11_13\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<?xml encoding=\"utf-8\" ?><html><body><label class=\"gfield_label gform-field-label\" for=\"input_11_13\">What do you need help with?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class=\"ginput_container ginput_container_textarea\"><textarea name=\"input_13\" id=\"input_11_13\" placeholder=\"Tell us as little or as much as you want to tell us.\" aria-required=\"true\" aria-invalid=\"false\" rows=\"10\" cols=\"50\" class=\"required  textarea large\"><\/textarea><\/div><\/body><\/html>\n<\/div><div id=\"field_11_24\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<?xml encoding=\"utf-8\" ?><html><body><label class=\"gfield_label gform-field-label\" for=\"input_11_24\">How did you hear about Sense Virtual Buddying?<\/label><div class=\"ginput_container ginput_container_select\"><select name=\"input_24\" id=\"input_11_24\" aria-invalid=\"false\" class=\" large gfield_select\"><option value=\"\" selected class=\"gf_placeholder\">Choose&#8230;<\/option><option value=\"At a Sense charity event\">At a Sense charity event<\/option><option value=\"Social media\">Social media<\/option><option value=\"A poster or flyer\">A poster or flyer<\/option><option value=\"In a charity shop\">In a charity shop<\/option><option value=\"Sense website\">Sense website<\/option><option value=\"Word of mouth\">Word of mouth<\/option><option value=\"From a member of staff\">From a member of staff<\/option><option value=\"Other\">Other<\/option><\/select><\/div><\/body><\/html>\n<\/div><div id=\"field_11_25\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<?xml encoding=\"utf-8\" ?><html><body><label class=\"gfield_label gform-field-label\" for=\"input_11_25\">Can you tell us a bit more about where you heard about Sense Virtual Buddying?<\/label><div class=\"ginput_container ginput_container_text\"><input name=\"input_25\" id=\"input_11_25\" type=\"text\" value=\"\" aria-invalid=\"false\" class=\" large\"><\/div><\/body><\/html>\n<\/div><div id=\"field_11_26\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<?xml encoding=\"utf-8\" ?><html><body><label class=\"gfield_label gform-field-label\" for=\"input_11_26\">Where would you like the dance class?<\/label><div class=\"gfield_description\" id=\"gfield_description_11_26\">So we know where you&#8217;d like dance classes<\/div><div class=\"ginput_container ginput_container_select\"><select name=\"input_26\" id=\"input_11_26\" aria-describedby=\"gfield_description_11_26\" aria-invalid=\"false\" class=\" large gfield_select\"><option value=\"\" selected class=\"gf_placeholder\">Choose&#8230;<\/option><option value=\"Birmingham\">Birmingham<\/option><option value=\"Rotherham\">Rotherham<\/option><option value=\"London\">London<\/option><option value=\"Wales\">Wales<\/option><option value=\"Other\">Other<\/option><\/select><\/div><\/body><\/html>\n<\/div><div id=\"field_11_28\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<?xml encoding=\"utf-8\" ?><html><body><label class=\"gfield_label gform-field-label\" for=\"input_11_28\">Other<\/label><div class=\"ginput_container ginput_container_text\"><input name=\"input_28\" id=\"input_11_28\" type=\"text\" value=\"\" aria-invalid=\"false\" class=\" large\"><\/div><\/body><\/html>\n<\/div><div id=\"field_11_23\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<?xml encoding=\"utf-8\" ?><html><body><h2> Sense privacy policy<\/h2>\n<p> <a href=\"\/privacy\/\">More information about our privacy policy<\/a><\/p><\/body><\/html>\n<\/div><div id=\"field_11_40\" class=\"gfield gfield--type-turnstile gfield--input-type-turnstile gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<?xml encoding=\"utf-8\" ?><html><body><div class=\"ginput_container 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