{"id":1908,"date":"2017-04-11T16:13:50","date_gmt":"2017-04-11T20:13:50","guid":{"rendered":"https:\/\/med.virginia.edu\/gme\/?page_id=1908"},"modified":"2021-04-01T13:08:33","modified_gmt":"2021-04-01T17:08:33","slug":"education-resource-center-room-request","status":"publish","type":"page","link":"https:\/\/med.virginia.edu\/gme\/education-resource-center-room-request\/","title":{"rendered":"Education Resource Center Room Request"},"content":{"rendered":"<p><b><span style=\"color: #ff0000\">\u00a0<\/span><\/b><\/p>\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 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gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_44' style='display:none'><form method='post' enctype='multipart\/form-data'  id='gform_44'  action='\/gme\/wp-json\/wp\/v2\/pages\/1908' data-formid='44' novalidate><div class='gf_invisible ginput_recaptchav3' data-sitekey='6LebeGYrAAAAAP5BASaCDpdLeg5wBa6YY3ZS7nZh' data-tabindex='0'><input id=\"input_32dbe4e8737b37928a2010a050f170a2\" class=\"gfield_recaptcha_response\" type=\"hidden\" name=\"input_32dbe4e8737b37928a2010a050f170a2\" value=\"\"\/><\/div>\n                        <div class='gform-body gform_body'><ul id='gform_fields_44' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_44_69\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_44_69'>Facebook<\/label><div class='ginput_container'><input name='input_69' id='input_44_69' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_44_69'>This field is for validation purposes and should be left unchanged.<\/div><\/li><li id=\"field_44_25\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio 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' >Which space would you like to request?<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_44_25'>\n\t\t\t<li class='gchoice gchoice_44_25_0'>\n\t\t\t\t<input name='input_25' type='radio' value='Meeting Rooms'  id='choice_44_25_0'    \/>\n\t\t\t\t<label for='choice_44_25_0' id='label_44_25_0' class='gform-field-label gform-field-label--type-inline'>Meeting Rooms<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_25_1'>\n\t\t\t\t<input name='input_25' type='radio' value='Simulation Lab'  id='choice_44_25_1'    \/>\n\t\t\t\t<label for='choice_44_25_1' id='label_44_25_1' class='gform-field-label gform-field-label--type-inline'>Simulation Lab<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_1\" class=\"gfield gfield--type-text gfield--input-type-text gf_left_half 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_44_1'>Name of Event<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_1' id='input_44_1' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_44_19\" class=\"gfield gfield--type-number gfield--input-type-number gf_right_half 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_44_19'>Approximate Number of Attendees<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_19' id='input_44_19' type='text' step='any'   value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_44_22\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gf_left_half gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Who will be attending your event?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_44_22'><li class='gchoice gchoice_44_22_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.1' type='checkbox'  value='Administrative Staff'  id='choice_44_22_1'   aria-describedby=\"gfield_description_44_22\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_44_22_1' id='label_44_22_1' class='gform-field-label gform-field-label--type-inline'>Administrative Staff<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_44_22_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.2' type='checkbox'  value='Attending Physicians'  id='choice_44_22_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_44_22_2' id='label_44_22_2' class='gform-field-label gform-field-label--type-inline'>Attending Physicians<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_44_22_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.3' type='checkbox'  value='Medical Students'  id='choice_44_22_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_44_22_3' id='label_44_22_3' class='gform-field-label gform-field-label--type-inline'>Medical Students<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_44_22_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.4' type='checkbox'  value='Nurses'  id='choice_44_22_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_44_22_4' id='label_44_22_4' class='gform-field-label gform-field-label--type-inline'>Nurses<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_44_22_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.5' type='checkbox'  value='Outside Speaker\/Guest'  id='choice_44_22_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_44_22_5' id='label_44_22_5' class='gform-field-label gform-field-label--type-inline'>Outside Speaker\/Guest<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_44_22_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.6' type='checkbox'  value='Resident\/Fellow'  id='choice_44_22_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_44_22_6' id='label_44_22_6' class='gform-field-label gform-field-label--type-inline'>Resident\/Fellow<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_44_22_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.7' type='checkbox'  value='Other (provide details in description box below)'  id='choice_44_22_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_44_22_7' id='label_44_22_7' class='gform-field-label gform-field-label--type-inline'>Other (provide details in description box below)<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_44_22'>(Please check all that apply)<\/div><\/li><li id=\"field_44_9\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_right_half 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' >What is your room preference?<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_44_9'>\n\t\t\t<li class='gchoice gchoice_44_9_0'>\n\t\t\t\t<input name='input_9' type='radio' value='Room A (lecture setup, seats up to 126)'  id='choice_44_9_0'    \/>\n\t\t\t\t<label for='choice_44_9_0' id='label_44_9_0' class='gform-field-label gform-field-label--type-inline'>Room A (lecture setup, seats up to 126)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_9_1'>\n\t\t\t\t<input name='input_9' type='radio' value='Room B (boardroom setup, seats up to 50)'  id='choice_44_9_1'    \/>\n\t\t\t\t<label for='choice_44_9_1' id='label_44_9_1' class='gform-field-label gform-field-label--type-inline'>Room B (boardroom setup, seats up to 50)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_9_2'>\n\t\t\t\t<input name='input_9' type='radio' value='Either Room A or Room B will work'  id='choice_44_9_2'    \/>\n\t\t\t\t<label for='choice_44_9_2' id='label_44_9_2' class='gform-field-label gform-field-label--type-inline'>Either Room A or Room B will work<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_9_3'>\n\t\t\t\t<input name='input_9' type='radio' value='Both Rooms A &amp; B, as two separate spaces'  id='choice_44_9_3'    \/>\n\t\t\t\t<label for='choice_44_9_3' id='label_44_9_3' class='gform-field-label gform-field-label--type-inline'>Both Rooms A &amp; B, as two separate spaces<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_9_4'>\n\t\t\t\t<input name='input_9' type='radio' value='Both Rooms A &amp; B, combined into one large space'  id='choice_44_9_4'    \/>\n\t\t\t\t<label for='choice_44_9_4' id='label_44_9_4' class='gform-field-label gform-field-label--type-inline'>Both Rooms A &amp; B, combined into one large space<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_20\" class=\"gfield gfield--type-textarea gfield--input-type-textarea 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_44_20'>Please provide a brief description of your event.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_20' id='input_44_20' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_44_37\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Will you be requesting an alteration to setup of the room?<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_44_37'>\n\t\t\t<li class='gchoice gchoice_44_37_0'>\n\t\t\t\t<input name='input_37' type='radio' value='No'  id='choice_44_37_0'    \/>\n\t\t\t\t<label for='choice_44_37_0' id='label_44_37_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_37_1'>\n\t\t\t\t<input name='input_37' type='radio' value='Yes'  id='choice_44_37_1'    \/>\n\t\t\t\t<label for='choice_44_37_1' id='label_44_37_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_44_37'><p><strong>Please note<\/strong>, room reconfiguration may impact whether we can confirm your request depending on the other meetings scheduled in the space that day.<\/p><p>For a description of how our spaces are configured, visit: <a href=\"https:\/\/med.virginia.edu\/gme\/erc-meeting-rooms\/\">med.virginia.edu\/erc-meeting-rooms\/<\/a><\/p><\/div><\/li><li id=\"field_44_35\" class=\"gfield gfield--type-textarea gfield--input-type-textarea 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_44_35'>Please provide a description of the reconfiguration alteration you are requesting:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_35' id='input_44_35' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_44_12\" class=\"gfield gfield--type-name gfield--input-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' >Contact 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_44_12'>\n                            \n                            <span id='input_44_12_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_12.3' id='input_44_12_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_44_12_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_44_12_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_12.6' id='input_44_12_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_44_12_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_44_53\" class=\"gfield gfield--type-text gfield--input-type-text 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_44_53'>Department<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_53' id='input_44_53' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_44_13\" class=\"gfield gfield--type-phone gfield--input-type-phone gf_left_half 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_44_13'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_13' id='input_44_13' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_44_14\" class=\"gfield gfield--type-email gfield--input-type-email gf_right_half 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_44_14'>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_14' id='input_44_14' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_44_4\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_left_half 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' >Is this a multi-day event?<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_44_4'>\n\t\t\t<li class='gchoice gchoice_44_4_0'>\n\t\t\t\t<input name='input_4' type='radio' value='No'  id='choice_44_4_0'    \/>\n\t\t\t\t<label for='choice_44_4_0' id='label_44_4_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_4_1'>\n\t\t\t\t<input name='input_4' type='radio' value='Yes'  id='choice_44_4_1'    \/>\n\t\t\t\t<label for='choice_44_4_1' id='label_44_4_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_10\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_right_half 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' >Will this be a recurring event?<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_44_10'>\n\t\t\t<li class='gchoice gchoice_44_10_0'>\n\t\t\t\t<input name='input_10' type='radio' value='No'  id='choice_44_10_0'    \/>\n\t\t\t\t<label for='choice_44_10_0' id='label_44_10_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_10_1'>\n\t\t\t\t<input name='input_10' type='radio' value='Yes'  id='choice_44_10_1'    \/>\n\t\t\t\t<label for='choice_44_10_1' id='label_44_10_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_55\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_right_half 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' >Will this be a recurring event in the Sim Lab?<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_44_55'>\n\t\t\t<li class='gchoice gchoice_44_55_0'>\n\t\t\t\t<input name='input_55' type='radio' value='No'  id='choice_44_55_0'    \/>\n\t\t\t\t<label for='choice_44_55_0' id='label_44_55_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_55_1'>\n\t\t\t\t<input name='input_55' type='radio' value='Yes'  id='choice_44_55_1'    \/>\n\t\t\t\t<label for='choice_44_55_1' id='label_44_55_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_15\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio 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' >Frequency<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_44_15'>\n\t\t\t<li class='gchoice gchoice_44_15_0'>\n\t\t\t\t<input name='input_15' type='radio' value='Weekly'  id='choice_44_15_0'    \/>\n\t\t\t\t<label for='choice_44_15_0' id='label_44_15_0' class='gform-field-label gform-field-label--type-inline'>Weekly<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_15_1'>\n\t\t\t\t<input name='input_15' type='radio' value='Bi-weekly'  id='choice_44_15_1'    \/>\n\t\t\t\t<label for='choice_44_15_1' id='label_44_15_1' class='gform-field-label gform-field-label--type-inline'>Bi-weekly<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_15_2'>\n\t\t\t\t<input name='input_15' type='radio' value='Monthly'  id='choice_44_15_2'    \/>\n\t\t\t\t<label for='choice_44_15_2' id='label_44_15_2' class='gform-field-label gform-field-label--type-inline'>Monthly<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_15_3'>\n\t\t\t\t<input name='input_15' type='radio' value='Quarterly'  id='choice_44_15_3'    \/>\n\t\t\t\t<label for='choice_44_15_3' id='label_44_15_3' class='gform-field-label gform-field-label--type-inline'>Quarterly<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_17\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio 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' >Week of the month<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_44_17'>\n\t\t\t<li class='gchoice gchoice_44_17_0'>\n\t\t\t\t<input name='input_17' type='radio' value='First week'  id='choice_44_17_0'    \/>\n\t\t\t\t<label for='choice_44_17_0' id='label_44_17_0' class='gform-field-label gform-field-label--type-inline'>First week<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_17_1'>\n\t\t\t\t<input name='input_17' type='radio' value='2nd week'  id='choice_44_17_1'    \/>\n\t\t\t\t<label for='choice_44_17_1' id='label_44_17_1' class='gform-field-label gform-field-label--type-inline'>2nd week<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_17_2'>\n\t\t\t\t<input name='input_17' type='radio' value='3rd week'  id='choice_44_17_2'    \/>\n\t\t\t\t<label for='choice_44_17_2' id='label_44_17_2' class='gform-field-label gform-field-label--type-inline'>3rd week<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_17_3'>\n\t\t\t\t<input name='input_17' type='radio' value='4th week'  id='choice_44_17_3'    \/>\n\t\t\t\t<label for='choice_44_17_3' id='label_44_17_3' class='gform-field-label gform-field-label--type-inline'>4th week<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_17_4'>\n\t\t\t\t<input name='input_17' type='radio' value='5th week'  id='choice_44_17_4'    \/>\n\t\t\t\t<label for='choice_44_17_4' id='label_44_17_4' class='gform-field-label gform-field-label--type-inline'>5th week<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_17_5'>\n\t\t\t\t<input name='input_17' type='radio' value='Last week'  id='choice_44_17_5'    \/>\n\t\t\t\t<label for='choice_44_17_5' id='label_44_17_5' class='gform-field-label gform-field-label--type-inline'>Last week<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_16\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox 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' >Day<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_44_16'><li class='gchoice gchoice_44_16_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.1' type='checkbox'  value='Monday'  id='choice_44_16_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_44_16_1' id='label_44_16_1' class='gform-field-label gform-field-label--type-inline'>Monday<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_44_16_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.2' type='checkbox'  value='Tuesday'  id='choice_44_16_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_44_16_2' id='label_44_16_2' class='gform-field-label gform-field-label--type-inline'>Tuesday<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_44_16_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.3' type='checkbox'  value='Wednesday'  id='choice_44_16_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_44_16_3' id='label_44_16_3' class='gform-field-label gform-field-label--type-inline'>Wednesday<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_44_16_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.4' type='checkbox'  value='Thursday'  id='choice_44_16_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_44_16_4' id='label_44_16_4' class='gform-field-label gform-field-label--type-inline'>Thursday<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_44_16_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.5' type='checkbox'  value='Friday'  id='choice_44_16_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_44_16_5' id='label_44_16_5' class='gform-field-label gform-field-label--type-inline'>Friday<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_59\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-full 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_44_59'>Start Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_59' id='input_44_59' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_44_59_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_44_59_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_44_59' class='gform_hidden' value='https:\/\/med.virginia.edu\/gme\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_44_60\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-full 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_44_60'>End Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_60' id='input_44_60' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_44_60_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_44_60_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_44_60' class='gform_hidden' value='https:\/\/med.virginia.edu\/gme\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_44_66\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_44_66'>End Date<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_66' id='input_44_66' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_44_66_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_44_66_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_44_66' class='gform_hidden' value='https:\/\/med.virginia.edu\/gme\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_44_61\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-full 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_44_61'>Event Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_61' id='input_44_61' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_44_61_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_44_61_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_44_61' class='gform_hidden' value='https:\/\/med.virginia.edu\/gme\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_44_65\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-full 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_44_65'>Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_65' id='input_44_65' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_44_65_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_44_65_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_44_65' class='gform_hidden' value='https:\/\/med.virginia.edu\/gme\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_44_64\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-full 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_44_64'>Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_64' id='input_44_64' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_44_64_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_44_64_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_44_64' class='gform_hidden' value='https:\/\/med.virginia.edu\/gme\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_44_3\" class=\"gfield gfield--type-time gfield--input-type-time gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >What time do you want your RESERVATION to start?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class=\"ginput_container ginput_complex gform-grid-row\"><div class=\"clear-multi\">\n                        <div class='gfield_time_hour ginput_container ginput_container_time gform-grid-col' id='input_44_3'>\n                            <input type='number' maxlength='2' name='input_3[]' id='input_44_3_1' value=''  min='0' max='12' step='1'  placeholder='HH' aria-required='true'   aria-describedby=\"gfield_description_44_3\"\/> <i>:<\/i>\n                            <label class='gform-field-label gform-field-label--type-sub hour_label screen-reader-text' for='input_44_3_1'>Hours<\/label>\n                        <\/div>\n                        \n                        <div class='gfield_time_minute ginput_container ginput_container_time gform-grid-col'>\n                            <input type='number' maxlength='2' name='input_3[]' id='input_44_3_2' value=''  min='0' max='59' step='1'  placeholder='MM' aria-required='true'  \/>\n                            <label class='gform-field-label gform-field-label--type-sub minute_label screen-reader-text' for='input_44_3_2'>Minutes<\/label>\n                        <\/div>\n                        <div class='gfield_time_ampm ginput_container ginput_container_time below gform-grid-col' >\n                                \n                                <select name='input_3[]' id='input_44_3_3'  >\n                                    <option value='am' >AM<\/option>\n                                    <option value='pm' >PM<\/option>\n                                <\/select> \n                                <label class='gform-field-label gform-field-label--type-sub am_pm_label screen-reader-text' for='input_44_3_3'>AM\/PM<\/label>                                \n                           <\/div>\n                    <\/div><\/div><div class='gfield_description' id='gfield_description_44_3'><p>This is the time you'll have access to the room. Build in any setup time you need; most bookings require 15-30 minutes ahead of the event\/meeting start time.<\/p><\/div><\/li><li id=\"field_44_7\" class=\"gfield gfield--type-time gfield--input-type-time gf_right_half gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >What time will your RESERVATION end?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class=\"ginput_container ginput_complex gform-grid-row\"><div class=\"clear-multi\">\n                        <div class='gfield_time_hour ginput_container ginput_container_time gform-grid-col' id='input_44_7'>\n                            <input type='number' maxlength='2' name='input_7[]' id='input_44_7_1' value=''  min='0' max='12' step='1'  placeholder='HH' aria-required='true'   aria-describedby=\"gfield_description_44_7\"\/> <i>:<\/i>\n                            <label class='gform-field-label gform-field-label--type-sub hour_label screen-reader-text' for='input_44_7_1'>Hours<\/label>\n                        <\/div>\n                        \n                        <div class='gfield_time_minute ginput_container ginput_container_time gform-grid-col'>\n                            <input type='number' maxlength='2' name='input_7[]' id='input_44_7_2' value=''  min='0' max='59' step='1'  placeholder='MM' aria-required='true'  \/>\n                            <label class='gform-field-label gform-field-label--type-sub minute_label screen-reader-text' for='input_44_7_2'>Minutes<\/label>\n                        <\/div>\n                        <div class='gfield_time_ampm ginput_container ginput_container_time below gform-grid-col' >\n                                \n                                <select name='input_7[]' id='input_44_7_3'  >\n                                    <option value='am' >AM<\/option>\n                                    <option value='pm' >PM<\/option>\n                                <\/select> \n                                <label class='gform-field-label gform-field-label--type-sub am_pm_label screen-reader-text' for='input_44_7_3'>AM\/PM<\/label>                                \n                           <\/div>\n                    <\/div><\/div><div class='gfield_description' id='gfield_description_44_7'><p>Please include time needed for clean-up, etc.<\/p><\/div><\/li><li id=\"field_44_8\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_left_half gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Will you need A\/V tools or IT support?<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_44_8'>\n\t\t\t<li class='gchoice gchoice_44_8_0'>\n\t\t\t\t<input name='input_8' type='radio' value='No'  id='choice_44_8_0'    \/>\n\t\t\t\t<label for='choice_44_8_0' id='label_44_8_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_8_1'>\n\t\t\t\t<input name='input_8' type='radio' value='Yes'  id='choice_44_8_1'    \/>\n\t\t\t\t<label for='choice_44_8_1' id='label_44_8_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_44_8'><p>If you need access to any audio\/video equipment, we will provide you with setup support and a brief training based on your event needs. <strong>Please note<\/strong> that in compliance with UVA HIT, USB external storage devices (e.g., \u201cthumb\u201d drives, external hard drives, etc.) are not allowed.<\/b><\/div><\/li><li id=\"field_44_38\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_right_half gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Will you need A\/V tools or IT support?<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_44_38'>\n\t\t\t<li class='gchoice gchoice_44_38_0'>\n\t\t\t\t<input name='input_38' type='radio' value='No'  id='choice_44_38_0'    \/>\n\t\t\t\t<label for='choice_44_38_0' id='label_44_38_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_38_1'>\n\t\t\t\t<input name='input_38' type='radio' value='Yes'  id='choice_44_38_1'    \/>\n\t\t\t\t<label for='choice_44_38_1' id='label_44_38_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_44_38'><p>If you need access to any audio\/video equipment, we will provide you with setup support and a brief training based on your event needs. <strong>Please note<\/strong> that in compliance with UVA HIT, USB external storage devices (e.g., \u201cthumb\u201d drives, external hard drives, etc.) are not allowed.<\/p><\/div><\/li><li id=\"field_44_51\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_44_51'>Please provide a description of the A\/V support you need.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_51' id='input_44_51' class='textarea medium'  aria-describedby=\"gfield_description_44_51\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_44_51'><p><strong>Examples:<\/strong> PowerPoint presentation, microphones, etc.<\/p><\/div><\/li><li id=\"field_44_57\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Will you be having a virtual component with your event? (Zoom\/Webex\/Teams etc.),<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_44_57'>\n\t\t\t<li class='gchoice gchoice_44_57_0'>\n\t\t\t\t<input name='input_57' type='radio' value='No'  id='choice_44_57_0'    \/>\n\t\t\t\t<label for='choice_44_57_0' id='label_44_57_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_57_1'>\n\t\t\t\t<input name='input_57' type='radio' value='Yes'  id='choice_44_57_1'    \/>\n\t\t\t\t<label for='choice_44_57_1' id='label_44_57_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_44_57'>For all Virtual Meetings (Zoom\/Webex\/Teams etc.), a Host must be available to moderate a Meeting<\/div><\/li><li id=\"field_44_58\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full 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_44_58'>If available, please list the contact name of your host.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_58' id='input_44_58' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_44_67\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Will special equipment be delivered to the Sim Lab for your event?<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_44_67'>\n\t\t\t<li class='gchoice gchoice_44_67_0'>\n\t\t\t\t<input name='input_67' type='radio' value='Yes'  id='choice_44_67_0'    \/>\n\t\t\t\t<label for='choice_44_67_0' id='label_44_67_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_67_1'>\n\t\t\t\t<input name='input_67' type='radio' value='No'  id='choice_44_67_1'    \/>\n\t\t\t\t<label for='choice_44_67_1' id='label_44_67_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_67_2'>\n\t\t\t\t<input name='input_67' type='radio' value='Possibly'  id='choice_44_67_2'    \/>\n\t\t\t\t<label for='choice_44_67_2' id='label_44_67_2' class='gform-field-label gform-field-label--type-inline'>Possibly<\/label>\n\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_44_67'>The ERC is not responsible for the delivery, reception, setup, maintenance, or departure of any non-UVA HS equipment.<\/div><\/li><li id=\"field_44_68\" 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\"  ><label class='gfield_label gform-field-label' for='input_44_68'>What equipment is arriving and who will be at the Sim Lab for delivery and depature?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_68' id='input_44_68' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_44_28\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_left_half 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' >Will there be vendors, sales or service representatives participating in your event?<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_44_28'>\n\t\t\t<li class='gchoice gchoice_44_28_0'>\n\t\t\t\t<input name='input_28' type='radio' value='No'  id='choice_44_28_0'    \/>\n\t\t\t\t<label for='choice_44_28_0' id='label_44_28_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_28_1'>\n\t\t\t\t<input name='input_28' type='radio' value='Yes'  id='choice_44_28_1'    \/>\n\t\t\t\t<label for='choice_44_28_1' id='label_44_28_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_29\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_right_half gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Please confirm that you have read the UVA Health System Policy on vendors and will be in compliance with all procedures.<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_44_29'>\n\t\t\t<li class='gchoice gchoice_44_29_0'>\n\t\t\t\t<input name='input_29' type='radio' value='I have read, understood and will comply with the policy'  id='choice_44_29_0'    \/>\n\t\t\t\t<label for='choice_44_29_0' id='label_44_29_0' class='gform-field-label gform-field-label--type-inline'>I have read, understood and will comply with the policy<\/label>\n\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_44_29'>UVA Health System vendor policy: <a href=\"http:\/\/www.healthsystem.virginia.edu\/docs\/manuals\/policies\/mc\/A70A3BD0-110A-2E68-14FB8E6F74343C47\/A70A3F89-110A-2E68-14B7153207741A23\/interactions-with-vendors-sales-and-service-representatives\">Policy 0013: Vendors, Sales and Service Representatives at the Medical Center<\/a> <\/div><\/li><li id=\"field_44_24\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_left_half 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' >Will you have catering at this event?<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_44_24'>\n\t\t\t<li class='gchoice gchoice_44_24_0'>\n\t\t\t\t<input name='input_24' type='radio' value='No'  id='choice_44_24_0'    \/>\n\t\t\t\t<label for='choice_44_24_0' id='label_44_24_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_24_1'>\n\t\t\t\t<input name='input_24' type='radio' value='Yes'  id='choice_44_24_1'    \/>\n\t\t\t\t<label for='choice_44_24_1' id='label_44_24_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_31\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_right_half 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' >Will your event require parking?<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_44_31'>\n\t\t\t<li class='gchoice gchoice_44_31_0'>\n\t\t\t\t<input name='input_31' type='radio' value='No'  id='choice_44_31_0'    \/>\n\t\t\t\t<label for='choice_44_31_0' id='label_44_31_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_44_31_1'>\n\t\t\t\t<input name='input_31' type='radio' value='Yes'  id='choice_44_31_1'    \/>\n\t\t\t\t<label for='choice_44_31_1' id='label_44_31_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_44_50\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Contact Health System Parking Office<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_44_50'>\n\t\t\t<li class='gchoice gchoice_44_50_0'>\n\t\t\t\t<input name='input_50' type='radio' value='I understand'  id='choice_44_50_0'    \/>\n\t\t\t\t<label for='choice_44_50_0' id='label_44_50_0' class='gform-field-label gform-field-label--type-inline'>I understand<\/label>\n\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_44_50'>The GME office does not have access to parking. Please contact the <b>Health System Parking Office<\/b> and complete an Event Parking Request Form and receive approval in advance.\n<br>\n&#187; <a href=\"https:\/\/parking.virginia.edu\/event-parking-request\">parking.virginia.edu\/event-parking-request<\/a>\n<br>\n&#187; <a href=\"mailto:healthsystemparking@virginia.edu\">healthsystemparking@virginia.edu<\/a>\n<br>\n&#187; (434) 924-5147 \n<br><br>\nParking is very limited as parking resources are already committed to patients receiving their care here. There is no guarantee you will be approved for parking validations.<\/div><\/li><li id=\"field_44_54\" class=\"gfield gfield--type-captcha gfield--input-type-captcha field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_44_54'>CAPTCHA<\/label><div id='input_44_54' class='ginput_container ginput_recaptcha' data-sitekey='6LeiTCoUAAAAABsq7sprJHEJjUv9obv9HfoLFK6K'  data-theme='light' data-tabindex='0'  data-badge=''><\/div><\/li><li id=\"field_44_26\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\"><\/h2><div class='gsection_description' id='gfield_description_44_26'>Room assistance is available for scheduled events between the hours of 7:00 am &amp; 7:00 pm.\n<\/div><\/li><\/ul><\/div>\n        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