[text name="variable_1" default="Name"] is currnetly looking for [checkbox name="variable_1" value="Housing|Vocational Assistance|Fincial Assistance|Mental Health Service"]. Client currently stuggles with [checkbox name="variable_2" value="Filling out and submiited applications|identifying or acessing community resources|approriate community interactions|communicating or advocating to providered effectivly"] due to there mental health disgnosis.
There are 3 form elements.
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