{"id":15738,"date":"2025-07-17T08:08:42","date_gmt":"2025-07-17T15:08:42","guid":{"rendered":"https:\/\/elixirmedical.com\/?page_id=15738"},"modified":"2025-07-17T08:51:45","modified_gmt":"2025-07-17T15:51:45","slug":"vietnamese-symptoms-quiz","status":"publish","type":"page","link":"https:\/\/elixirmedical.com\/vi\/vietnamese-symptoms-quiz\/","title":{"rendered":"Vietnamese Symptoms Quiz"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"15738\" class=\"elementor elementor-15738\" data-elementor-settings=\"{&quot;ha_cmc_init_switcher&quot;:&quot;no&quot;}\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-9d130a8 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"9d130a8\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-bec8843\" data-id=\"bec8843\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2aba19e elementor-widget elementor-widget-shortcode\" data-id=\"2aba19e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_8' ><div id='gf_8' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n                            <p class='gform_description'>Patient Eligibility Quiz for DynamX<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_8'  action='\/vi\/wp-json\/wp\/v2\/pages\/15738#gf_8' data-formid='8' novalidate><input id=partial_entry_id_8 class=\"partial_entry_id\" type=hidden name=\"partial_entry_id\" value=\"pending\" data-form_id=\"8\"\/> \r\n <input type='hidden' class='gforms-pum' value='{\"closepopup\":false,\"closedelay\":0,\"openpopup\":false,\"openpopup_id\":0}' \/>\n        <div id='gf_progressbar_wrapper_8' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<p class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>4<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_custom' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_custom percentbar_25' style='width:25%; color:#ffffff; background-color:#FA3F1E;'><span>25%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_8_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_8' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_8_31\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_31' id='input_8_31' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_8_32\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_32' id='input_8_32' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_8_33\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_33' id='input_8_33' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_8_34\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_34' id='input_8_34' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_8_35\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_35' id='input_8_35' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_8_36\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_36' id='input_8_36' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_8_37\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_37' id='input_8_37' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_8_38\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_38' id='input_8_38' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_8_23\" class=\"gfield gfield--type-handlfree_utm_source gfield--input-type-handlfree_utm_source gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_23' id='input_8_23' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_8_24\" class=\"gfield gfield--type-handlfree_utm_medium gfield--input-type-handlfree_utm_medium gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_24' id='input_8_24' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_8_25\" class=\"gfield gfield--type-handlfree_utm_term gfield--input-type-handlfree_utm_term gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_25' id='input_8_25' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_8_26\" class=\"gfield gfield--type-handlfree_utm_content gfield--input-type-handlfree_utm_content gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_26' id='input_8_26' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_8_27\" class=\"gfield gfield--type-handlfree_utm_campaign gfield--input-type-handlfree_utm_campaign gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_27' id='input_8_27' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_8_28\" class=\"gfield gfield--type-handlfree_gclid gfield--input-type-handlfree_gclid gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_28' id='input_8_28' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_8_20\" 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\"  ><h3>Tr\u1ea3 l\u1eddi m\u1ed9t s\u1ed1 c\u00e2u h\u1ecfi \u0111\u1ec3 xem x\u00e9t c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a qu\u00fd v\u1ecb<\/h3><\/div><fieldset id=\"field_8_14\" class=\"gfield gfield--type-quiz gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gquiz-field \"  data-field-class=\"gquiz-field\" ><legend class='gfield_label gform-field-label' >Qu\u00fd v\u1ecb c\u00f3 th\u1ec9nh tho\u1ea3ng ho\u1eb7c th\u01b0\u1eddng xuy\u00ean c\u1ea3m th\u1ea5y b\u1ecb \u00e9p, t\u1ee9c ho\u1eb7c th\u1eaft ch\u1eb7t \u1edf ng\u1ef1c kh\u00f4ng?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_8_14'>\n\t\t\t<div class='gchoice gchoice_8_14_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='gquiz163686b56'  id='choice_8_14_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_14_0' id='label_8_14_0' class='gform-field-label gform-field-label--type-inline'>C\u00f3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_14_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='gquiz18522c221'  id='choice_8_14_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_14_1' id='label_8_14_1' class='gform-field-label gform-field-label--type-inline'>Kh\u00f4ng<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_8_3\" class=\"gfield gfield--type-quiz gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gquiz-field \"  data-field-class=\"gquiz-field\" ><legend class='gfield_label gform-field-label' >Qu\u00fd v\u1ecb c\u00f3 c\u1ea3m th\u1ea5y \u0111au ng\u1ef1c ho\u1eb7c kh\u00f3 th\u1edf sau ho\u1ea1t \u0111\u1ed9ng nh\u1eb9, ch\u1eb3ng h\u1ea1n nh\u01b0 \u0111i b\u1ed9 ho\u1eb7c l\u00e0m v\u01b0\u1eddn kh\u00f4ng?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_8_3'>\n\t\t\t<div class='gchoice gchoice_8_3_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='gquiz163686b56'  id='choice_8_3_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_3_0' id='label_8_3_0' class='gform-field-label gform-field-label--type-inline'>C\u00f3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_3_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='gquiz18522c221'  id='choice_8_3_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_3_1' id='label_8_3_1' class='gform-field-label gform-field-label--type-inline'>Kh\u00f4ng<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_8_19' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_8_2' class='gform_page' data-js='page-field-id-19' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_8_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_8_12\" class=\"gfield gfield--type-quiz gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gquiz-field \"  data-field-class=\"gquiz-field\" ><legend class='gfield_label gform-field-label' >Vi\u1ec7c b\u1ecb \u0111au ng\u1ef1c ho\u1eb7c kh\u00f3 th\u1edf c\u00f3 c\u1ea3n tr\u1edf qu\u00fd v\u1ecb th\u1ef1c hi\u1ec7n hay t\u1eadn h\u01b0\u1edfng c\u00e1c ho\u1ea1t \u0111\u1ed9ng, ch\u1eb3ng h\u1ea1n nh\u01b0 d\u00e0nh th\u1eddi gian cho gia \u0111\u00ecnh, s\u1edf th\u00edch hay t\u1eadp th\u1ec3 d\u1ee5c kh\u00f4ng?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_8_12'>\n\t\t\t<div class='gchoice gchoice_8_12_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='gquiz163686b56'  id='choice_8_12_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_12_0' id='label_8_12_0' class='gform-field-label gform-field-label--type-inline'>C\u00f3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_12_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='gquiz18522c221'  id='choice_8_12_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_12_1' id='label_8_12_1' class='gform-field-label gform-field-label--type-inline'>Kh\u00f4ng<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_8_15\" class=\"gfield gfield--type-quiz gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gquiz-field \"  data-field-class=\"gquiz-field\" ><legend class='gfield_label gform-field-label' >Gia \u0111\u00ecnh qu\u00fd v\u1ecb c\u00f3 ai c\u00f3 ti\u1ec1n s\u1eed b\u1ec7nh tim kh\u00f4ng?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_8_15'>\n\t\t\t<div class='gchoice gchoice_8_15_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='gquiz163686b56'  id='choice_8_15_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_15_0' id='label_8_15_0' class='gform-field-label gform-field-label--type-inline'>C\u00f3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_15_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='gquiz18522c221'  id='choice_8_15_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_15_1' id='label_8_15_1' class='gform-field-label gform-field-label--type-inline'>Kh\u00f4ng<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_8_16' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Tr\u01b0\u1edbc \u0111\u00f3'  \/> <input type='button' id='gform_next_button_8_16' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Ti\u1ebfp theo'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_8_3' class='gform_page' data-js='page-field-id-16' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_8_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_8_4\" class=\"gfield gfield--type-quiz gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gquiz-field \"  data-field-class=\"gquiz-field\" ><legend class='gfield_label gform-field-label' >Qu\u00fd v\u1ecb c\u00f3 t\u1eebng th\u1ea3o lu\u1eadn v\u1edbi b\u00e1c s\u0129 v\u1ec1 b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh v\u00e0\/ho\u1eb7c th\u1ef1c hi\u1ec7n c\u00e1c x\u00e9t nghi\u1ec7m \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh kh\u00f4ng?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_8_4'>\n\t\t\t<div class='gchoice gchoice_8_4_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_4' type='radio' value='gquiz163686b56'  id='choice_8_4_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_4_0' id='label_8_4_0' class='gform-field-label gform-field-label--type-inline'>C\u00f3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_4_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_4' type='radio' value='gquiz18522c221'  id='choice_8_4_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_4_1' id='label_8_4_1' class='gform-field-label gform-field-label--type-inline'>Kh\u00f4ng<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_8_6\" class=\"gfield gfield--type-quiz 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 gquiz-field \"  data-field-class=\"gquiz-field\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >C\u00e1c lo\u1ea1i thu\u1ed1c qu\u00fd v\u1ecb \u0111ang d\u00f9ng l\u00e0 g\u00ec? Ch\u1ecdn t\u1ea5t c\u1ea3 c\u00e1c c\u00e2u tr\u1ea3 l\u1eddi \u0111\u00fang v\u1edbi qu\u00fd v\u1ecb.<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_8_6'><div class='gchoice gchoice_8_6_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_6.1' type='checkbox'  value='gquiz6afefa1ce'  id='choice_8_6_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_6_1' id='label_8_6_1' class='gform-field-label gform-field-label--type-inline'>Thu\u1ed1c ki\u1ec3m so\u00e1t huy\u1ebft \u00e1p<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_6_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_6.2' type='checkbox'  value='gquiz6e28a8100'  id='choice_8_6_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_6_2' id='label_8_6_2' class='gform-field-label gform-field-label--type-inline'>Thu\u1ed1c ki\u1ec3m so\u00e1t ho\u1eb7c h\u1ea1 choresterol<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_6_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_6.3' type='checkbox'  value='gquiz69a4838c4'  id='choice_8_6_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_6_3' id='label_8_6_3' class='gform-field-label gform-field-label--type-inline'>Thu\u1ed1c ki\u1ec3m so\u00e1t m\u1ee9c \u0111\u01b0\u1eddng huy\u1ebft<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_8_7' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Tr\u01b0\u1edbc \u0111\u00f3'  \/> <input type='button' id='gform_next_button_8_7' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Ti\u1ebfp theo'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_8_4' class='gform_page' data-js='page-field-id-7' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_8_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_8_8\" 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\"  ><p>S\u1eafp xong r\u1ed3i! N\u1ebfu qu\u00fd v\u1ecb mu\u1ed1n nh\u1eadn th\u00eam th\u00f4ng tin t\u1eeb ch\u00fang t\u00f4i trong t\u01b0\u01a1ng lai, h\u00e3y cung c\u1ea5p \u0111\u1ecba ch\u1ec9 email v\u00e0 ch\u00fang t\u00f4i s\u1ebd th\u00eam qu\u00fd v\u1ecb v\u00e0o danh s\u00e1ch g\u1eedi th\u01b0 c\u1ee7a ch\u00fang t\u00f4i. N\u1ebfu qu\u00fd v\u1ecb kh\u00f4ng mu\u1ed1n nh\u1eadn th\u00f4ng tin t\u1eeb ch\u00fang t\u00f4i trong t\u01b0\u01a1ng lai, ch\u1ec9 c\u1ea7n cu\u1ed9n xu\u1ed1ng v\u00e0 nh\u1ea5p v\u00e0o n\u00fat \u0111\u1ec3 xem k\u1ebft qu\u1ea3 c\u1ee7a qu\u00fd v\u1ecb.<\/p><\/div><fieldset id=\"field_8_9\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >T\u00ean<\/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_8_9'>\n                            \n                            <span id='input_8_9_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_9.3' id='input_8_9_3' value=''   aria-required='false'     \/>\n                                                    <label for='input_8_9_3' class='gform-field-label gform-field-label--type-sub '>T\u00ean \u0111\u1ea7u ti\u00ean<\/label>\n                                                <\/span>\n                            \n                            <span id='input_8_9_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_9.6' id='input_8_9_6' value=''   aria-required='false'     \/>\n                                                    <label for='input_8_9_6' class='gform-field-label gform-field-label--type-sub '>H\u1ecd<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_8_10\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_10'>Email<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_10' id='input_8_10' type='email' value='' class='large'     aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_8_22\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_22'>Qu\u1ed1c gia<\/label><div class='ginput_container ginput_container_select'><select name='input_22' id='input_8_22' class='large gfield_select'     aria-invalid=\"false\" ><option value='Ch\u1ecdn \u0110\u1ecba \u0110i\u1ec3m c\u1ee7a Qu\u00fd V\u1ecb' >Ch\u1ecdn \u0110\u1ecba \u0110i\u1ec3m c\u1ee7a Qu\u00fd V\u1ecb<\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua v\u00e0 Barbuda' >Antigua v\u00e0 Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='\u00dac' >\u00dac<\/option><option value='\u00c1o' >\u00c1o<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='B\u1ec9' >B\u1ec9<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius v\u00e0 Saba' >Bonaire, Sint Eustatius v\u00e0 Saba<\/option><option value='Bosnia v\u00e0 Herzegovina' >Bosnia v\u00e0 Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='\u0110\u1ea3o Bouvet' >\u0110\u1ea3o Bouvet<\/option><option value='Brazil' >Brazil<\/option><option value='L\u00e3nh Th\u1ed5 Anh t\u1ea1i \u1ea4n \u0110\u1ed9 D\u01b0\u01a1ng' >L\u00e3nh Th\u1ed5 Anh t\u1ea1i \u1ea4n \u0110\u1ed9 D\u01b0\u01a1ng<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cabo Verde' >Cabo Verde<\/option><option value='Campuchia' >Campuchia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Qu\u1ea7n \u0110\u1ea3o Cayman' >Qu\u1ea7n \u0110\u1ea3o Cayman<\/option><option value='C\u1ed9ng Ho\u00e0 Trung Phi' >C\u1ed9ng Ho\u00e0 Trung Phi<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='Trung Qu\u1ed1c' >Trung Qu\u1ed1c<\/option><option value='\u0110\u1ea3o Gi\u00e1ng Sinh' >\u0110\u1ea3o Gi\u00e1ng Sinh<\/option><option value='Qu\u1ea7n \u0110\u1ea3o Cocos' >Qu\u1ea7n \u0110\u1ea3o Cocos<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='C\u1ed9ng Ho\u00e0 D\u00e2n Ch\u1ee7 Congo' >C\u1ed9ng Ho\u00e0 D\u00e2n Ch\u1ee7 Congo<\/option><option value='Qu\u1ea7n \u0110\u1ea3o Cook' >Qu\u1ea7n \u0110\u1ea3o Cook<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='C\u1ed9ng H\u00f2a S\u00e9c' >C\u1ed9ng H\u00f2a S\u00e9c<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='\u0110an M\u1ea1ch' >\u0110an M\u1ea1ch<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='C\u1ed9ng Ho\u00e0 Dominica' >C\u1ed9ng Ho\u00e0 Dominica<\/option><option value='Ecuador' >Ecuador<\/option><option value='Ai C\u1eadp' >Ai C\u1eadp<\/option><option value='El Salvador' >El Salvador<\/option><option value='Guinea X\u00edch \u0111\u1ea1o' >Guinea X\u00edch \u0111\u1ea1o<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Qu\u1ea7n \u0110\u1ea3o Falkland' >Qu\u1ea7n \u0110\u1ea3o Falkland<\/option><option value='Qu\u1ea7n \u0110\u1ea3o Faroe' >Qu\u1ea7n \u0110\u1ea3o Faroe<\/option><option value='Fiji' >Fiji<\/option><option value='Ph\u1ea7n Lan' >Ph\u1ea7n Lan<\/option><option value='Ph\u00e1p' >Ph\u00e1p<\/option><option value='Guiana thu\u1ed9c \u0111\u1ecba Ph\u00e1p' >Guiana thu\u1ed9c \u0111\u1ecba Ph\u00e1p<\/option><option value='Polynesia thu\u1ed9c \u0111\u1ecba Ph\u00e1p' >Polynesia thu\u1ed9c \u0111\u1ecba Ph\u00e1p<\/option><option value='L\u00e3nh Th\u1ed5 Ph\u00eda Nam thu\u1ed9c \u0111\u1ecba Ph\u00e1p' >L\u00e3nh Th\u1ed5 Ph\u00eda Nam thu\u1ed9c \u0111\u1ecba Ph\u00e1p<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='\u0110\u1ee9c' >\u0110\u1ee9c<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Hy L\u1ea1p' >Hy L\u1ea1p<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Qu\u1ea7n \u0110\u1ea3o Heard v\u00e0 McDonald' >Qu\u1ea7n \u0110\u1ea3o Heard v\u00e0 McDonald<\/option><option value='Vatican' >Vatican<\/option><option value='Honduras' >Honduras<\/option><option value='H\u1ed3ng K\u00f4ng' >H\u1ed3ng K\u00f4ng<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='\u1ea4n \u0110\u1ed9' >\u1ea4n \u0110\u1ed9<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='\u0110\u1ea3o Man' >\u0110\u1ea3o Man<\/option><option value='Israel' >Israel<\/option><option value='\u00dd' >\u00dd<\/option><option value='Jamaica' >Jamaica<\/option><option value='Nh\u1eadt B\u1ea3n' >Nh\u1eadt B\u1ea3n<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Tri\u1ec1u Ti\u00ean' >Tri\u1ec1u Ti\u00ean<\/option><option value='H\u00e0n Qu\u1ed1c' >H\u00e0n Qu\u1ed1c<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='L\u00e0o' >L\u00e0o<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Qu\u1ea7n \u0110\u1ea3o Marshall' >Qu\u1ea7n \u0110\u1ea3o Marshall<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='M\u00f4ng C\u1ed5' >M\u00f4ng C\u1ed5<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Maroc' >Maroc<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='H\u00e0 Lan' >H\u00e0 Lan<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='\u0110\u1ea3o Norfolk' >\u0110\u1ea3o Norfolk<\/option><option value='B\u1eafc Macedonia' >B\u1eafc Macedonia<\/option><option value='Qu\u1ea7n \u0110\u1ea3o B\u1eafc Mariana' >Qu\u1ea7n \u0110\u1ea3o B\u1eafc Mariana<\/option><option value='Na Uy' >Na Uy<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine' >Palestine<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Ba Lan' >Ba Lan<\/option><option value='B\u1ed3 \u0110\u00e0o Nha' >B\u1ed3 \u0110\u00e0o Nha<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Li\u00ean Bang Nga' >Li\u00ean Bang Nga<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension v\u00e0 Tristan da Cunha' >Saint Helena, Ascension v\u00e0 Tristan da Cunha<\/option><option value='Saint Kitts v\u00e0 Nevis' >Saint Kitts v\u00e0 Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre v\u00e0 Miquelon' >Saint Pierre v\u00e0 Miquelon<\/option><option value='St. Vincent v\u00e0 Grenadines' >St. Vincent v\u00e0 Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome v\u00e0 Principe' >Sao Tome v\u00e0 Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Qu\u1ea7n \u0110\u1ea3o Solomon' >Qu\u1ea7n \u0110\u1ea3o Solomon<\/option><option value='Somalia' >Somalia<\/option><option value='Nam Phi' >Nam Phi<\/option><option value='Nam Georgia v\u00e0 Qu\u1ea7n \u0110\u1ea3o Nam Sandwich' >Nam Georgia v\u00e0 Qu\u1ea7n \u0110\u1ea3o Nam Sandwich<\/option><option value='Nam Sudan' >Nam Sudan<\/option><option value='T\u00e2y Ban Nha' >T\u00e2y Ban Nha<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard v\u00e0 Jan Mayen' >Svalbard v\u00e0 Jan Mayen<\/option><option value='Th\u1ee5y \u0110i\u1ec3n' >Th\u1ee5y \u0110i\u1ec3n<\/option><option value='Th\u1ee5y S\u0129' >Th\u1ee5y S\u0129<\/option><option value='Syria' >Syria<\/option><option value='\u0110\u00e0i Loan' >\u0110\u00e0i Loan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania' >Tanzania<\/option><option value='Th\u00e1i Lan' >Th\u00e1i Lan<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad v\u00e0 Tobago' >Trinidad v\u00e0 Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks v\u00e0 Qu\u1ea7n \u0110\u1ea3o Caicos' >Turks v\u00e0 Qu\u1ea7n \u0110\u1ea3o Caicos<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='Th\u1ed5 Nh\u0129 K\u1ef3' >Th\u1ed5 Nh\u0129 K\u1ef3<\/option><option value='C\u00e1c Ti\u1ec3u \u0110\u1ea3o Xa c\u1ee7a Hoa K\u1ef3' >C\u00e1c Ti\u1ec3u \u0110\u1ea3o Xa c\u1ee7a Hoa K\u1ef3<\/option><option value='Uganda' >Uganda<\/option><option value='Ucraina' >Ucraina<\/option><option value='C\u00e1c Ti\u1ec3u V\u01b0\u01a1ng Qu\u1ed1c \u1ea2 R\u1eadp Th\u1ed1ng nh\u1ea5t' >C\u00e1c Ti\u1ec3u V\u01b0\u01a1ng Qu\u1ed1c \u1ea2 R\u1eadp Th\u1ed1ng nh\u1ea5t<\/option><option value='V\u01b0\u01a1ng Qu\u1ed1c Anh' >V\u01b0\u01a1ng Qu\u1ed1c Anh<\/option><option value='H\u1ee3p Ch\u1ee7ng Qu\u1ed1c Hoa K\u1ef3' >H\u1ee3p Ch\u1ee7ng Qu\u1ed1c Hoa K\u1ef3<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Vi\u1ec7t Nam' >Vi\u1ec7t Nam<\/option><option value='Qu\u1ea7n \u0110\u1ea3o Virgin thu\u1ed9c Anh' >Qu\u1ea7n \u0110\u1ea3o Virgin thu\u1ed9c Anh<\/option><option value='Qu\u1ea7n \u0110\u1ea3o Virgin thu\u1ed9c Hoa K\u1ef3' >Qu\u1ea7n \u0110\u1ea3o Virgin thu\u1ed9c Hoa K\u1ef3<\/option><option value='Wallis v\u00e0 Futuna' >Wallis v\u00e0 Futuna<\/option><option value='T\u00e2y Sahara' >T\u00e2y Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='Qu\u1ea7n \u0110\u1ea3o \u00c5land' >Qu\u1ea7n \u0110\u1ea3o \u00c5land<\/option><\/select><\/div><\/div><fieldset id=\"field_8_39\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><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 gfield_label_before_complex' >Address<\/legend>    \n                    <div class='ginput_complex ginput_container has_country ginput_container_address gform-grid-row' id='input_8_39' >\n                        <input type='hidden' class='gform_hidden' name='input_39.4' id='input_8_39_4' value=''\/><span class='ginput_left address_country ginput_address_country gform-grid-col' id='input_8_39_6_container' >\n                                        <select name='input_39.6' id='input_8_39_6'   aria-required='false'    ><option value='' selected='selected'><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cabo Verde' >Cabo Verde<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' >United Kingdom<\/option><option value='United States' >United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option><\/select>\n                                        <label for='input_8_39_6' id='input_8_39_6_label' class='gform-field-label gform-field-label--type-sub '>Country<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_8_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\"  >B\u1eb1ng vi\u1ec7c cung c\u1ea5p \u0111\u1ecba ch\u1ec9 email c\u1ee7a m\u00ecnh trong bi\u1ec3u m\u1eabu n\u00e0y, t\u00f4i ch\u1ea5p thu\u1eadn cho Elixir Corporation (\u201cElixir\u201d) li\u00ean h\u1ec7 v\u1edbi t\u00f4i v\u1ec1 th\u00f4ng tin li\u00ean quan \u0111\u1ebfn nh\u1eefng s\u1ea3n ph\u1ea9m c\u1ee7a c\u00f4ng ty, th\u00f4ng b\u00e1o cho t\u00f4i v\u1ec1 c\u00e1c tin t\u1ee9c, s\u1ef1 ki\u1ec7n v\u00e0 c\u00f4ng tr\u00ecnh nghi\u00ean c\u1ee9u kh\u00e1c nhau v\u00e0 cho ph\u00e9p Elixir s\u1eed d\u1ee5ng th\u00f4ng tin n\u00e0y cho c\u00e1c m\u1ee5c \u0111\u00edch b\u1ed5 sung \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh trong <a href=\"\/privacy-policy\"  target=\"_blank\">Ch\u00ednh s\u00e1ch Quy\u1ec1n ri\u00eang t\u01b0<\/a>.<\/div><div id=\"field_8_29\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_29' 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