{"id":4005,"date":"2020-12-12T23:48:30","date_gmt":"2020-12-12T15:48:30","guid":{"rendered":"http:\/\/mysenses.winners1313.com\/?page_id=4005"},"modified":"2020-12-12T23:49:22","modified_gmt":"2020-12-12T15:49:22","slug":"mobile-sleep-survey","status":"publish","type":"page","link":"https:\/\/mysensesworld.com\/cn\/mobile-sleep-survey\/","title":{"rendered":"Mobile Sleep Survey"},"content":{"rendered":"<div data-elementor-type=\"wp-page\" data-elementor-id=\"4005\" class=\"elementor elementor-4005\" data-elementor-settings=\"[]\">\n\t\t\t\t\t\t<div class=\"elementor-inner\">\n\t\t\t\t\t\t\t<div class=\"elementor-section-wrap\">\n\t\t\t\t\t\t\t<section data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-section elementor-top-section elementor-element elementor-element-36a4e26 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"36a4e26\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t\t\t<div class=\"elementor-row\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-8034d1b\" data-id=\"8034d1b\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-column-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5a3b25d eael-gravity-form-button-custom elementor-widget elementor-widget-eael-gravity-form\" data-id=\"5a3b25d\" data-element_type=\"widget\" data-widget_type=\"eael-gravity-form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t            <div class=\"eael-contact-form eael-gravity-form eael-contact-form-align-default\">\n                                \n                <div class='gf_browser_gecko gform_wrapper' id='gform_wrapper_6' style='display:none'><div id='gf_6' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data'  id='gform_6'  action='\/cn\/wp-json\/wp\/v2\/pages\/4005#gf_6' data-trp-original-action=\"\/cn\/wp-json\/wp\/v2\/pages\/4005#gf_6\">\n                        <div class='gform_heading'>\n                            <h3 class='gform_title'>Sleep Quality Survey \u7761\u7720\u54c1\u8d28\u8c03\u67e5\u95ee\u5377<\/h3>\n                            <span class='gform_description'>Sleep Well, Live Well<\/span>\n                        <\/div>\n        <div id='gf_progressbar_wrapper_6' class='gf_progressbar_wrapper'>\n            <h3 class='gf_progressbar_title'>\u6b65\u9aa4 1 \u5b57\uff0c\u6700\u591a 2\n        <\/h3>\n            <div class='gf_progressbar' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_50' style='width:50%;'><span>50%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform_body'><div id='gform_page_6_1' class='gform_page' >\n                                    <div class='gform_page_fields'><ul id='gform_fields_6' class='gform_fields top_label form_sublabel_below description_below'><li id='field_6_1'  class='gfield gsection field_sublabel_below field_description_below gfield_visibility_visible' ><h2 class='gsection_title'>\u60a8\u7684\u4e2a\u4eba\u8d44\u6599 YOUR DETAILS:<\/h2><\/li><li id='field_6_2'  class='gfield gfield_contains_required field_sublabel_hidden_label field_description_below gfield_visibility_visible' ><label class='gfield_label gfield_label_before_complex'  >\u60a8\u7684\u540d\u5b57 Your Name:<span class='gfield_required'>*<\/span><\/label><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name no_last_name no_suffix gf_name_has_1 ginput_container_name' id='input_6_2'>\n                            \n                            <span id='input_6_2_3_container' class='name_first' >\n                                                    <input type='text' name='input_2.3' id='input_6_2_3' value='' aria-label='\u540d\u5b57'   aria-required=\"true\" aria-invalid=\"false\" \/>\n                                                    <label for='input_6_2_3' class='hidden_sub_label screen-reader-text'>Name<\/label>\n                                                <\/span>\n                            \n                            \n                            \n                        <\/div><\/li><li id='field_6_3'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_6_3' >\u60a8\u7684\u624b\u673a\u53f7\u7801 Your Contact No:<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_3' id='input_6_3' type='text' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/li><li id='field_6_4'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_6_4' >\u60a8\u7684\u7535\u90ae Your Email:<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_4' id='input_6_4' type='text' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\" \/>\n                        <\/div><\/li><li id='field_6_5'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_6_5' >\u8bf7\u95ee\u662f\u8c01\u9080\u8bf7\u4f60\u505a\u8fd9\u8c03\u67e5\u95ee\u5377\uff1fWho invited you to do this Survey?<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_6_5' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_6_6'  class='gfield gsection field_sublabel_below field_description_below gfield_visibility_visible' ><h2 class='gsection_title'>\ud83d\ude34\u3010\u7761\u7720\u8d28\u91cf\u3011\u9996\u5148\uff0c\u5708\u51fa\u6bcf\u4e2a\u95ee\u9898\u7684\u6700\u51c6\u786e\u7b54\u6848\u3002\u6700\u540e\uff0c\u5c06\u6240\u6709\u5206\u6570\u52a0\u8d77\u6765\uff0c\u4ee5\u83b7\u5f97\u7761\u7720\u8bc4\u4f30\u4ee5\u53ca\u6539\u5584\u6280\u5de7\u3002<\/h2><div class='gsection_description' id='gfield_description_6_6'>\ud83d\ude34 [Sleep Quality Survey] First, select the most accurate answer to each question. Finally, add up your scores to get a sleep assessment and improvement skills.<\/div><\/li><li id='field_6_16'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label'  >1.\u60a8\u9700\u8981\u591a\u957f\u65f6\u95f4\u624d\u80fd\u5165\u7761\uff1fHow long it takes for you to fall asleep?<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_16'><li class='gchoice_6_16_0'><input name='input_16' type='radio' value='4'  id='choice_6_16_0'    \/><label for='choice_6_16_0' id='label_6_16_0'>0-15 minutes (4 points)<\/label><\/li><li class='gchoice_6_16_1'><input name='input_16' type='radio' value='3'  id='choice_6_16_1'    \/><label for='choice_6_16_1' id='label_6_16_1'>16-30 minutes (3 points)<\/label><\/li><li class='gchoice_6_16_2'><input name='input_16' type='radio' value='2'  id='choice_6_16_2'    \/><label for='choice_6_16_2' id='label_6_16_2'>31\u201345 minutes (2 points)<\/label><\/li><li class='gchoice_6_16_3'><input name='input_16' type='radio' value='1'  id='choice_6_16_3'    \/><label for='choice_6_16_3' id='label_6_16_3'>46\u201360 minutes (1 point)<\/label><\/li><li class='gchoice_6_16_4'><input name='input_16' type='radio' value='0'  id='choice_6_16_4'    \/><label for='choice_6_16_4' id='label_6_16_4'>>60 minutes (0 point)<\/label><\/li><\/ul><\/div><\/li><li id='field_6_18'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label'  >2.\u5982\u679c\u60a8\u7761\u540e\uff0c\u4f1a\u518d\u9192\u6765\u4e00\u6b21\u6216\u591a\u6b21\uff0c\u90a3\u4e48\u60a8\u603b\u5171\u9192\u4e86\u591a\u957f\u65f6\u95f4\uff1f\u5c06\u60a8\u7761\u540e\u518d\u9192\u6765\u7684\u6e05\u9192\u7684\u6240\u6709\u65f6\u95f4\u52a0\u8d77\u6765\u3002If you wake up one or more times after sleeping, how long have you been awake in total? Add up all the awake time you wake up after sleeping.<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_18'><li class='gchoice_6_18_0'><input name='input_18' type='radio' value='4'  id='choice_6_18_0'    \/><label for='choice_6_18_0' id='label_6_18_0'>0-15 minutes (4 points)<\/label><\/li><li class='gchoice_6_18_1'><input name='input_18' type='radio' value='3'  id='choice_6_18_1'    \/><label for='choice_6_18_1' id='label_6_18_1'>16-30 minutes (3 points)<\/label><\/li><li class='gchoice_6_18_2'><input name='input_18' type='radio' value='2'  id='choice_6_18_2'    \/><label for='choice_6_18_2' id='label_6_18_2'>31\u201345 minutes (2 points)<\/label><\/li><li class='gchoice_6_18_3'><input name='input_18' type='radio' value='1'  id='choice_6_18_3'    \/><label for='choice_6_18_3' id='label_6_18_3'>46\u201360 minutes (1 point)<\/label><\/li><li class='gchoice_6_18_4'><input name='input_18' type='radio' value='0'  id='choice_6_18_4'    \/><label for='choice_6_18_4' id='label_6_18_4'>>60 minutes (0 point)<\/label><\/li><\/ul><\/div><\/li><li id='field_6_19'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label'  >3. \u5982\u679c\u60a8\u7684\u6700\u7ec8\u7761\u9192\u65f6\u95f4\u662f\u5728\u60a8\u6253\u7b97\u7761\u9192\u4e4b\u524d\u53d1\u751f\u7684\uff08\u63d0\u65e9\u7761\u9192\uff09\uff0c\u90a3\u4e48\u8fd9\u662f\u8981\u65e9\u9192\u591a\u5c11\u65f6\u95f4\uff1fIf your final wake-up time occurs before you intend to wake up (waking up early), how much time do you have to wake up early?<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_19'><li class='gchoice_6_19_0'><input name='input_19' type='radio' value='4'  id='choice_6_19_0'    \/><label for='choice_6_19_0' id='label_6_19_0'>\u6211\u9192\u5f97\u4e0d\u4f1a\u592a\u65e9\u9192\uff0c\u6700\u591a15\u5206\u949f\uff084 points)<\/label><\/li><li class='gchoice_6_19_1'><input name='input_19' type='radio' value='3'  id='choice_6_19_1'    \/><label for='choice_6_19_1' id='label_6_19_1'>16-30\u5206\u949f (3 points)<\/label><\/li><li class='gchoice_6_19_2'><input name='input_19' type='radio' value='2'  id='choice_6_19_2'    \/><label for='choice_6_19_2' id='label_6_19_2'>31-45\u5206\u949f\u524d (2 points)<\/label><\/li><li class='gchoice_6_19_3'><input name='input_19' type='radio' value='1'  id='choice_6_19_3'    \/><label for='choice_6_19_3' id='label_6_19_3'>46-60\u5206\u949f (1 point)<\/label><\/li><li class='gchoice_6_19_4'><input name='input_19' type='radio' value='0'  id='choice_6_19_4'    \/><label for='choice_6_19_4' id='label_6_19_4'>> 60\u5206\u949f (0 point)<\/label><\/li><\/ul><\/div><\/li><li id='field_6_20'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label'  >4. \u60a8\u6bcf\u5468\u6709\u51e0\u4e2a\u665a\u4e0a\u4f1a\u6709\u7761\u7720\u95ee\u9898\uff1fHow many nights a week do you have sleep problems?<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_20'><li class='gchoice_6_20_0'><input name='input_20' type='radio' value='4'  id='choice_6_20_0'    \/><label for='choice_6_20_0' id='label_6_20_0'>0\u20131\u6b21 time (4 points\uff09<\/label><\/li><li class='gchoice_6_20_1'><input name='input_20' type='radio' value='3'  id='choice_6_20_1'    \/><label for='choice_6_20_1' id='label_6_20_1'>2\u6b21 times (3 point)<\/label><\/li><li class='gchoice_6_20_2'><input name='input_20' type='radio' value='2'  id='choice_6_20_2'    \/><label for='choice_6_20_2' id='label_6_20_2'>3\u6b21 times (2 point)<\/label><\/li><li class='gchoice_6_20_3'><input name='input_20' type='radio' value='1'  id='choice_6_20_3'    \/><label for='choice_6_20_3' id='label_6_20_3'>4\u6b21 times (1 point)<\/label><\/li><li class='gchoice_6_20_4'><input name='input_20' type='radio' value='0'  id='choice_6_20_4'    \/><label for='choice_6_20_4' id='label_6_20_4'>5\u20137\u6b21 times (0 point)<\/label><\/li><\/ul><\/div><\/li><li id='field_6_21'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label'  >5. \u60a8\u5982\u4f55\u8bc4\u4ef7\u81ea\u5df1\u7684\u7761\u7720\u8d28\u91cf\uff1f How would you rate your quality of sleep?<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_21'><li class='gchoice_6_21_0'><input name='input_21' type='radio' value='4'  id='choice_6_21_0'    \/><label for='choice_6_21_0' id='label_6_21_0'>\u5f88\u597d \/ Very Good (4 points)<\/label><\/li><li class='gchoice_6_21_1'><input name='input_21' type='radio' value='3'  id='choice_6_21_1'    \/><label for='choice_6_21_1' id='label_6_21_1'>\u597d \/ Good (3 points)<\/label><\/li><li class='gchoice_6_21_2'><input name='input_21' type='radio' value='2'  id='choice_6_21_2'    \/><label for='choice_6_21_2' id='label_6_21_2'>\u4e00\u822c \/ OK (2 points)<\/label><\/li><li class='gchoice_6_21_3'><input name='input_21' type='radio' value='1'  id='choice_6_21_3'    \/><label for='choice_6_21_3' id='label_6_21_3'>\u5dee \/ Poor (1 point)<\/label><\/li><li class='gchoice_6_21_4'><input name='input_21' type='radio' value='0'  id='choice_6_21_4'    \/><label for='choice_6_21_4' id='label_6_21_4'>\u5f88\u5dee \/ Very Poor (0 point)<\/label><\/li><\/ul><\/div><\/li><li id='field_6_22'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label'  >6. \u60f3\u4e00\u60f3\u8fc7\u53bb\u7684\u4e00\u4e2a\u6708\uff0c\u7761\u7720\u5dee\u5230\u4ec0\u4e48\u7a0b\u5ea6.. \u5f71\u54cd\u4e86\u60a8\u7684\u60c5\u7eea\uff0c\u7cbe\u529b\u6216\u4eba\u9645\u5173\u7cfb\uff1fThink about how poor your sleep was in the past month... Has it affected your mood, energy or relationships?<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_22'><li class='gchoice_6_22_0'><input name='input_22' type='radio' value='4'  id='choice_6_22_0'    \/><label for='choice_6_22_0' id='label_6_22_0'>\u6ca1\u6709\u5f71\u54cd Not affected (4 points)<\/label><\/li><li class='gchoice_6_22_1'><input name='input_22' type='radio' value='3'  id='choice_6_22_1'    \/><label for='choice_6_22_1' id='label_6_22_1'>\u6709\u4e00\u70b9\u70b9\u5f71\u54cd A little bit affected (3 points)<\/label><\/li><li class='gchoice_6_22_2'><input name='input_22' type='radio' value='2'  id='choice_6_22_2'    \/><label for='choice_6_22_2' id='label_6_22_2'>\u6709\u5f71\u54cd Affected (2 points)<\/label><\/li><li class='gchoice_6_22_3'><input name='input_22' type='radio' value='1'  id='choice_6_22_3'    \/><label for='choice_6_22_3' id='label_6_22_3'>\u5f88\u6709\u5f71\u54cd Very affected (1 point)<\/label><\/li><li class='gchoice_6_22_4'><input name='input_22' type='radio' value='0'  id='choice_6_22_4'    \/><label for='choice_6_22_4' id='label_6_22_4'>\u5f71\u54cd\u975e\u5e38\u5927 Badly affected (0 point)<\/label><\/li><\/ul><\/div><\/li><li id='field_6_23'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label'  >7. \u7761\u7720\u95ee\u9898\u5f71\u54cd\u4e86\u60a8\u7684\u6ce8\u610f\u529b\uff0c\u751f\u4ea7\u529b\u6216\u4fdd\u6301\u6e05\u9192\u7684\u80fd\u529b\uff1f Has sleep problems affected your concentration, productivity, or ability to stay awake?<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_23'><li class='gchoice_6_23_0'><input name='input_23' type='radio' value='4'  id='choice_6_23_0'    \/><label for='choice_6_23_0' id='label_6_23_0'>\u6ca1\u6709\u5f71\u54cd Not affected (4 points)<\/label><\/li><li class='gchoice_6_23_1'><input name='input_23' type='radio' value='3'  id='choice_6_23_1'    \/><label for='choice_6_23_1' id='label_6_23_1'>\u6709\u4e00\u70b9\u70b9\u5f71\u54cd A little bit affected (3 points)<\/label><\/li><li class='gchoice_6_23_2'><input name='input_23' type='radio' value='2'  id='choice_6_23_2'    \/><label for='choice_6_23_2' id='label_6_23_2'>\u6709\u5f71\u54cd Affected (2 points)<\/label><\/li><li class='gchoice_6_23_3'><input name='input_23' type='radio' value='1'  id='choice_6_23_3'    \/><label for='choice_6_23_3' id='label_6_23_3'>\u5f88\u6709\u5f71\u54cd Very affected (1 point)<\/label><\/li><li class='gchoice_6_23_4'><input name='input_23' type='radio' value='0'  id='choice_6_23_4'    \/><label for='choice_6_23_4' id='label_6_23_4'>\u5f71\u54cd\u975e\u5e38\u5927 Badly affected (0 point)<\/label><\/li><\/ul><\/div><\/li><li id='field_6_24'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label'  >8. \u603b\u7684\u6765\u8bf4\uff0c\u4ee5\u4e0a\u7684\u95ee\u9898\u4f1a\u56f0\u6270\u4f60\u5417\uff1f In general, will the above problems bother you?<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_24'><li class='gchoice_6_24_0'><input name='input_24' type='radio' value='4'  id='choice_6_24_0'    \/><label for='choice_6_24_0' id='label_6_24_0'>\u6ca1\u6709\u5f71\u54cd Not affected (4 points)<\/label><\/li><li class='gchoice_6_24_1'><input name='input_24' type='radio' value='3'  id='choice_6_24_1'    \/><label for='choice_6_24_1' id='label_6_24_1'>\u6709\u4e00\u70b9\u70b9\u5f71\u54cd A little bit affected (3 points)<\/label><\/li><li class='gchoice_6_24_2'><input name='input_24' type='radio' value='2'  id='choice_6_24_2'    \/><label for='choice_6_24_2' id='label_6_24_2'>\u6709\u5f71\u54cd Affected (2 points)<\/label><\/li><li class='gchoice_6_24_3'><input name='input_24' type='radio' value='1'  id='choice_6_24_3'    \/><label for='choice_6_24_3' id='label_6_24_3'>\u5f88\u6709\u5f71\u54cd Very affected (1 point)<\/label><\/li><li class='gchoice_6_24_4'><input name='input_24' type='radio' value='0'  id='choice_6_24_4'    \/><label for='choice_6_24_4' id='label_6_24_4'>\u5f71\u54cd\u975e\u5e38\u5927 Badly affected (0 point)<\/label><\/li><\/ul><\/div><\/li><li id='field_6_25'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label'  >9. \u60a8\u7684\u7761\u7720\u95ee\u9898\u591a\u4e45\u4e86\uff1f How long have you had sleep problems?<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_25'><li class='gchoice_6_25_0'><input name='input_25' type='radio' value='4'  id='choice_6_25_0'    \/><label for='choice_6_25_0' id='label_6_25_0'>\u6211\u6ca1\u95ee\u9898\/ \u5c11\u8fc71\u4e2a\u6708 Less than 1 month (4 points)<\/label><\/li><li class='gchoice_6_25_1'><input name='input_25' type='radio' value='3'  id='choice_6_25_1'    \/><label for='choice_6_25_1' id='label_6_25_1'>1-2\u4e2a\u6708 month (3 points)<\/label><\/li><li class='gchoice_6_25_2'><input name='input_25' type='radio' value='2'  id='choice_6_25_2'    \/><label for='choice_6_25_2' id='label_6_25_2'>3\u20136\u4e2a\u6708 month (2 points)<\/label><\/li><li class='gchoice_6_25_3'><input name='input_25' type='radio' value='1'  id='choice_6_25_3'    \/><label for='choice_6_25_3' id='label_6_25_3'>7\u201312\u4e2a\u6708 month (1 point)<\/label><\/li><li class='gchoice_6_25_4'><input name='input_25' type='radio' value='0'  id='choice_6_25_4'    \/><label for='choice_6_25_4' id='label_6_25_4'>> 1\u5e74 year (0 point)<\/label><\/li><\/ul><\/div><\/li><li id='field_6_26'  class='gfield gfield_calculation field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_6_26' >\u60a8\u7684\u603b\u5206 Your total points:<\/label><div class='ginput_container ginput_container_number'><input name='input_26' id='input_6_26' type='text'    value='' class='medium'  readonly=\"readonly\"    aria-invalid=\"false\" \/><\/div><\/li><li id='field_6_28'  class='gfield gsection field_sublabel_below field_description_below gfield_visibility_visible' ><h2 class='gsection_title'>\u60a8\u7684\u5206\u6570\u7ed3\u679c\u662f Your score result is :<\/h2><div class='gsection_description' id='gfield_description_6_28'>0\u20139 points : \u60a8\u7684\u7761\u7720\u95ee\u9898\u4f3c\u4e4e\u5f88\u4e25\u91cd\u3002\u60a8\u7edd\u5bf9\u5e94\u8be5\u5c1d\u8bd5\u83b7\u5f97\u4e00\u4e9b\u5e2e\u52a9\u3002Your sleep problems seem to be severe. You should definitely try to get some help.<\/div><\/li><li id='field_6_29'  class='gfield gsection field_sublabel_below field_description_below gfield_visibility_visible' ><h2 class='gsection_title'>\u60a8\u7684\u5206\u6570\u7ed3\u679c\u662f Your score result is :<\/h2><div class='gsection_description' id='gfield_description_6_29'>10\u201318 points : \u60a8\u6709\u4e00\u4e9b\u7761\u7720\u95ee\u9898\u3002\u91cd\u8981\u7684\u662f\u8981\u68c0\u67e5\u60a8\u7684\u7761\u7720\u4e60\u60ef\uff0c\u5e76\u4e86\u89e3\u5982\u4f55\u8fdb\u884c\u66f4\u6539\u3002You have some sleep problems. It\u2019s important to examine your sleep habits and see how you can make changes.<\/div><\/li><li id='field_6_30'  class='gfield gsection field_sublabel_below field_description_below gfield_visibility_visible' ><h2 class='gsection_title'>\u60a8\u7684\u5206\u6570\u7ed3\u679c\u662f Your score result is :<\/h2><div class='gsection_description' id='gfield_description_6_30'>19\u201327 points : \u60a8\u7684\u7761\u7720\u72b6\u51b5\u826f\u597d\uff0c\u4f46\u662f\u60a8\u4ecd\u7136\u53ef\u4ee5\u91c7\u53d6\u8bb8\u591a\u6b65\u9aa4\u6765\u6539\u5584\u7761\u7720\u8d28\u91cf\u3002Your sleep is in good shape, but there are still many steps you can take to make it even better.<\/div><\/li><li id='field_6_31'  class='gfield gsection field_sublabel_below field_description_below gfield_visibility_visible' ><h2 class='gsection_title'>\u60a8\u7684\u5206\u6570\u7ed3\u679c\u662f Your score result is :<\/h2><div class='gsection_description' id='gfield_description_6_31'>28\u201336 points : \u60a8\u7684\u7761\u7720\u72b6\u51b5\u826f\u597d\u3002\u7ee7\u7eed\u505a\u81ea\u5df1\u5728\u505a\u7684\u4e8b\u60c5\uff01Your sleep is in great shape. Keep doing what you\u2019re doing and spread the word!<\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer'>\n                         <input type='button' id='gform_next_button_6_32' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"2\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"2\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_6_2' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_6_2' class='gform_fields top_label form_sublabel_below description_below'><li id='field_6_33'  class='gfield gsection field_sublabel_below field_description_below gfield_visibility_visible' ><h2 class='gsection_title'>\u3010\u8212\u7720\u7cbe\u6cb9\u95ee\u5377\u3011Feedbacks on Sleep Well Essential Oil<\/h2><\/li><li id='field_6_44'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label'  >1) \u60a8\u5c1d\u8bd5\u7684\u662f\u54ea\u4e00\u6b3e\u52a0\u6cb9? (\u4e00\u6b3e\u7cbe\u6cb9\u4e00\u4efd\u8c03\u67e5) Which formula you tried? (one formula one survey)<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_6_44'><li class='gchoice_6_44_1'>\n\t\t\t\t\t\t\t\t<input name='input_44.1' type='checkbox'  value='Good Night Blend \u665a\u5b89\u8212\u7720'  id='choice_6_44_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_44_1' id='label_6_44_1'>Good Night Blend \u665a\u5b89\u8212\u7720<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_6_44_2'>\n\t\t\t\t\t\t\t\t<input name='input_44.2' type='checkbox'  value='Lavender \u85b0\u8863\u8349'  id='choice_6_44_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_44_2' id='label_6_44_2'>Lavender \u85b0\u8863\u8349<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_6_44_3'>\n\t\t\t\t\t\t\t\t<input name='input_44.3' type='checkbox'  value='Clary Sage \u9f20\u5c3e\u9999'  id='choice_6_44_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_44_3' id='label_6_44_3'>Clary Sage \u9f20\u5c3e\u9999<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_6_44_4'>\n\t\t\t\t\t\t\t\t<input name='input_44.4' type='checkbox'  value='Frankincense \u4e73\u9999'  id='choice_6_44_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_44_4' id='label_6_44_4'>Frankincense \u4e73\u9999<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_6_44_5'>\n\t\t\t\t\t\t\t\t<input name='input_44.5' type='checkbox'  value='Geranium \u5929\u7afa\u8475'  id='choice_6_44_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_44_5' id='label_6_44_5'>Geranium \u5929\u7afa\u8475<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_6_44_6'>\n\t\t\t\t\t\t\t\t<input name='input_44.6' type='checkbox'  value='Patchouli \u5e7f\u9999'  id='choice_6_44_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_44_6' id='label_6_44_6'>Patchouli \u5e7f\u9999<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_6_44_7'>\n\t\t\t\t\t\t\t\t<input name='input_44.7' type='checkbox'  value='Peppermint \u8584\u8377'  id='choice_6_44_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_44_7' id='label_6_44_7'>Peppermint \u8584\u8377<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_6_44_8'>\n\t\t\t\t\t\t\t\t<input name='input_44.8' type='checkbox'  value='Ylang Ylang \u4f9d\u5170'  id='choice_6_44_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_44_8' id='label_6_44_8'>Ylang Ylang \u4f9d\u5170<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_6_44_9'>\n\t\t\t\t\t\t\t\t<input name='input_44.9' type='checkbox'  value='\u5176\u5b83 Others'  id='choice_6_44_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_44_9' id='label_6_44_9'>\u5176\u5b83 Others<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id='field_6_45'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_6_45' >\u5176\u5b83 Others<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_45' id='input_6_45' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_6_35'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label'  >2) \u4f60\u5982\u4f55\u4f7f\u7528\uff1fHow do you use it?<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_6_35'><li class='gchoice_6_35_1'>\n\t\t\t\t\t\t\t\t<input name='input_35.1' type='checkbox'  value='\u653e\u8fdb\u9999\u82ac\u5668 Diffuser \/ Nebulizer'  id='choice_6_35_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_35_1' id='label_6_35_1'>\u653e\u8fdb\u9999\u82ac\u5668 Diffuser \/ Nebulizer<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_6_35_2'>\n\t\t\t\t\t\t\t\t<input name='input_35.2' type='checkbox'  value='\u6ef4\u5728\u6795\u5934 Drop on pillow'  id='choice_6_35_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_35_2' id='label_6_35_2'>\u6ef4\u5728\u6795\u5934 Drop on pillow<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_6_35_3'>\n\t\t\t\t\t\t\t\t<input name='input_35.3' type='checkbox'  value='\u7a00\u91ca\u540e\u64e6\u5728\u8138\u3001\u9888\u3001\u8eab\u4e0a Put on the face &amp; body after dilution'  id='choice_6_35_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_35_3' id='label_6_35_3'>\u7a00\u91ca\u540e\u64e6\u5728\u8138\u3001\u9888\u3001\u8eab\u4e0a Put on the face & body after dilution<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_6_35_4'>\n\t\t\t\t\t\t\t\t<input name='input_35.4' type='checkbox'  value='\u5176\u5b83 Others'  id='choice_6_35_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_35_4' id='label_6_35_4'>\u5176\u5b83 Others<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id='field_6_37'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_6_37' >\u5176\u5b83 Others<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_37' id='input_6_37' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_6_38'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_6_38' >3) \u4f60\u6bcf\u6b21\u4f7f\u7528\u591a\u5c11\u6ef4\uff1fHow many drops you put each time?<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_38' id='input_6_38' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_6_39'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label'  >4) \u4f60\u6bcf\u6b21\u4f7f\u7528\u591a\u4e45\u65f6\u95f4\uff1fHow long you use each time?<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_39'><li class='gchoice_6_39_0'><input name='input_39' type='radio' value='1 hour'  id='choice_6_39_0'    \/><label for='choice_6_39_0' id='label_6_39_0'>1 hour<\/label><\/li><li class='gchoice_6_39_1'><input name='input_39' type='radio' value='2 hour'  id='choice_6_39_1'    \/><label for='choice_6_39_1' id='label_6_39_1'>2 hour<\/label><\/li><li class='gchoice_6_39_2'><input name='input_39' type='radio' value='3 hour'  id='choice_6_39_2'    \/><label for='choice_6_39_2' id='label_6_39_2'>3 hour<\/label><\/li><li class='gchoice_6_39_3'><input name='input_39' type='radio' value='4 hour'  id='choice_6_39_3'    \/><label for='choice_6_39_3' id='label_6_39_3'>4 hour<\/label><\/li><li class='gchoice_6_39_4'><input name='input_39' type='radio' value='5 hour'  id='choice_6_39_4'    \/><label for='choice_6_39_4' id='label_6_39_4'>5 hour<\/label><\/li><li class='gchoice_6_39_5'><input name='input_39' type='radio' value='6 hour'  id='choice_6_39_5'    \/><label for='choice_6_39_5' id='label_6_39_5'>6 hour<\/label><\/li><li class='gchoice_6_39_6'><input name='input_39' type='radio' value='7 hour'  id='choice_6_39_6'    \/><label for='choice_6_39_6' id='label_6_39_6'>7 hour<\/label><\/li><li class='gchoice_6_39_7'><input name='input_39' type='radio' value='8 hour'  id='choice_6_39_7'    \/><label for='choice_6_39_7' id='label_6_39_7'>8 hour<\/label><\/li><\/ul><\/div><\/li><li id='field_6_40'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_6_40' >5) \u4f60\u5c1d\u8bd5\u4e86\u8fd9\u6b3e\u7cbe\u6cb9\u591a\u5c11\u5929\uff1f How many days have you tried?<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_40' id='input_6_40' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_6_41'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label'  >6) \u7cbe\u6cb9\u7684\u5473\u9053 The smell of the E.O.<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_41'><li class='gchoice_6_41_0'><input name='input_41' type='radio' value='\u5f88\u559c\u6b22 Like it so much'  id='choice_6_41_0'    \/><label for='choice_6_41_0' id='label_6_41_0'>\u5f88\u559c\u6b22 Like it so much<\/label><\/li><li class='gchoice_6_41_1'><input name='input_41' type='radio' value='\u559c\u6b22 Like it'  id='choice_6_41_1'    \/><label for='choice_6_41_1' id='label_6_41_1'>\u559c\u6b22 Like it<\/label><\/li><li class='gchoice_6_41_2'><input name='input_41' type='radio' value='\u8fd8\u597d\uff0c\u53ef\u4ee5\u63a5\u53d7 Ok can accept'  id='choice_6_41_2'    \/><label for='choice_6_41_2' id='label_6_41_2'>\u8fd8\u597d\uff0c\u53ef\u4ee5\u63a5\u53d7 Ok can accept<\/label><\/li><li class='gchoice_6_41_3'><input name='input_41' type='radio' value='\u4e0d\u559c\u6b22 Don&#039;t like it'  id='choice_6_41_3'    \/><label for='choice_6_41_3' id='label_6_41_3'>\u4e0d\u559c\u6b22 Don't like it<\/label><\/li><li class='gchoice_6_41_4'><input name='input_41' type='radio' value='\u5f88\u4e0d\u559c\u6b22 Very dislike it'  id='choice_6_41_4'    \/><label for='choice_6_41_4' id='label_6_41_4'>\u5f88\u4e0d\u559c\u6b22 Very dislike it<\/label><\/li><\/ul><\/div><\/li><li id='field_6_42'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label'  >7) \u8fd9\u6b3e\u7cbe\u6cb9\u53ef\u4ee5\u5e2e\u52a9\u4f60\uff08\u53ef\u9009\u62e9\u591a\u9879\uff09This essential oil can help you (can choose multiple answers):<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_6_42'><li class='gchoice_6_42_1'>\n\t\t\t\t\t\t\t\t<input name='input_42.1' type='checkbox'  value='\u9759\u5fc3 calm'  id='choice_6_42_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_42_1' id='label_6_42_1'>\u9759\u5fc3 calm<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_6_42_2'>\n\t\t\t\t\t\t\t\t<input name='input_42.2' type='checkbox'  value='\u5b89\u795e quiet down the mind'  id='choice_6_42_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_42_2' id='label_6_42_2'>\u5b89\u795e quiet down the mind<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_6_42_3'>\n\t\t\t\t\t\t\t\t<input name='input_42.3' type='checkbox'  value='\u8212\u670d comfortable'  id='choice_6_42_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_42_3' id='label_6_42_3'>\u8212\u670d comfortable<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_6_42_4'>\n\t\t\t\t\t\t\t\t<input name='input_42.4' type='checkbox'  value='\u653e\u677e relax'  id='choice_6_42_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_42_4' id='label_6_42_4'>\u653e\u677e relax<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_6_42_5'>\n\t\t\t\t\t\t\t\t<input name='input_42.5' type='checkbox'  value='\u5b89\u5168\u611f sense of security'  id='choice_6_42_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_42_5' id='label_6_42_5'>\u5b89\u5168\u611f sense of security<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_6_42_6'>\n\t\t\t\t\t\t\t\t<input name='input_42.6' type='checkbox'  value='\u5165\u7720 help me sleep'  id='choice_6_42_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_42_6' id='label_6_42_6'>\u5165\u7720 help me sleep<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id='field_6_43'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_6_43' >8) \u603b\u7ed3\u4e00\u4e0b\u4f60\u5bf9\u8fd9\u6b3e\u7cbe\u6cb9\u7684\u611f\u89c9\u548c\u8bc4\u4ef7 Summarise 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