{"id":23710,"date":"2026-04-06T17:04:16","date_gmt":"2026-04-06T17:04:16","guid":{"rendered":"https:\/\/longevityhealthplans.com\/?page_id=23710"},"modified":"2026-04-06T19:24:26","modified_gmt":"2026-04-06T19:24:26","slug":"solicitud-de-asociacion-farmaceutica","status":"publish","type":"page","link":"https:\/\/longevityhealthplans.com\/es\/pharmacy-partnership-application\/","title":{"rendered":"Solicitud de Asociaci\u00f3n con Farmacia"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"23710\" class=\"elementor elementor-23710\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-291797b e-flex e-con-boxed e-con e-parent\" data-id=\"291797b\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-bb60216 e-con-full e-flex e-con e-child\" data-id=\"bb60216\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-b16b44b e-con-full e-flex e-con e-child\" data-id=\"b16b44b\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-10d506b elementor-widget elementor-widget-html\" data-id=\"10d506b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"status-pill\">\r\n  \r\n \r\n  \r\n  <span class=\"status-text\">Apply to Partner With Us<\/span><\/span>\r\n  \r\n  <span class=\"status-dot\"><\/span>\r\n\r\n<\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fab5533 elementor-widget elementor-widget-heading\" data-id=\"fab5533\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">For 503A \/ 503B Pharmacies<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-94e46b1 elementor-widget elementor-widget-heading\" data-id=\"94e46b1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Partner Within a Controlled Clinical Infrastructure<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-136d7d9 e-con-full e-flex e-con e-child\" data-id=\"136d7d9\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-8bb15f2 elementor-widget elementor-widget-text-editor\" data-id=\"8bb15f2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Longevity Health Plans partners with a select group of certified 503A compounding pharmacies and 503B outsourcing facilities to support a growing network of clinical offices across the United States and Mexico.<\/p><p>We are not seeking vendors.<br \/>We build long-term infrastructure partnerships.<\/p><p>Our model is designed to align pharmaceutical partners with a controlled, compliance-driven ecosystem where quality, consistency, and scalability are foundational.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-296f815 e-con-full e-flex e-con e-child\" data-id=\"296f815\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-9e315f2 e-con-full e-flex e-con e-child\" data-id=\"9e315f2\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t<div class=\"elementor-element elementor-element-d41e011 e-flex e-con-boxed e-con e-child\" data-id=\"d41e011\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-fab2898 e-con-full e-flex e-con e-child\" data-id=\"fab2898\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-553f31d elementor-widget elementor-widget-heading\" data-id=\"553f31d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Registered here <\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e8263c1 elementor-widget elementor-widget-metform\" data-id=\"e8263c1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"metform.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div id=\"mf-response-props-id-23757\" data-previous-steps-style=\"\" data-editswitchopen=\"\" data-response_type=\"alert\" data-erroricon=\"fas fa-exclamation-triangle\" data-successicon=\"fas fa-check\" data-messageposition=\"top\" class=\"   mf-scroll-top-no\">\n\t\t<div class=\"formpicker_warper formpicker_warper_editable\" data-metform-formpicker-key=\"23757\" >\n\t\t\t\t\n\t\t\t<div class=\"mf-widget-container\">\n\t\t\t\t\r\n\t\t<div\r\n\t\t\tid=\"metform-wrap-e8263c1-23757\"\r\n\t\t\tclass=\"mf-form-wrapper\"\r\n\t\t\tdata-form-id=\"23757\"\r\n\t\t\tdata-action=\"https:\/\/longevityhealthplans.com\/es\/wp-json\/metform\/v1\/entries\/insert\/23757\"\r\n\t\t\tdata-wp-nonce=\"9de4844620\"\r\n\t\t\tdata-form-nonce=\"968c0bf4d9\"\r\n\t\t\tdata-quiz-summery = \"false\"\r\n\t\t\tdata-save-progress = \"false\"\r\n\t\t\tdata-form-type=\"general-form\"\r\n\t\t\tdata-stop-vertical-effect=\"\"\r\n\t\t\t><\/div>\r\n\r\n\r\n\t\t<!----------------------------- \r\n\t\t\t* controls_data : find the the props passed indie of data attribute\r\n\t\t\t* props.SubmitResponseMarkup : contains the markup of error or success message\r\n\t\t\t* https:\/\/developer.mozilla.org\/en-US\/docs\/Web\/JavaScript\/Reference\/Template_literals\r\n\t\t--------------------------- -->\r\n\r\n\t\t\t\t<script type=\"text\/mf\" class=\"mf-template\">\r\n\t\t\tfunction controls_data (value){\r\n\t\t\t\tlet currentWrapper = \"mf-response-props-id-23757\";\r\n\t\t\t\tlet currentEl = document.getElementById(currentWrapper);\r\n\t\t\t\t\r\n\t\t\t\treturn currentEl ? currentEl.dataset[value] : false\r\n\t\t\t}\r\n\r\n\r\n\t\t\tlet is_edit_mode = '' ? true : false;\r\n\t\t\tlet message_position = controls_data('messageposition') || 'top';\r\n\r\n\t\t\t\r\n\t\t\tlet message_successIcon = controls_data('successicon') || '';\r\n\t\t\tlet message_errorIcon = controls_data('erroricon') || '';\r\n\t\t\tlet message_editSwitch = controls_data('editswitchopen') === 'yes' ? true : false;\r\n\t\t\tlet message_proClass = controls_data('editswitchopen') === 'yes' ? 'mf_pro_activated' : '';\r\n\t\t\t\r\n\t\t\tlet is_dummy_markup = is_edit_mode && message_editSwitch ? true : false;\r\n\r\n\t\t\t\r\n\t\t\treturn html`\r\n\t\t\t\t<form\r\n\t\t\t\t\tclassName=\"metform-form-content\"\r\n\t\t\t\t\tref=${parent.formContainerRef}\r\n\t\t\t\t\tonSubmit=${ validation.handleSubmit( parent.handleFormSubmit ) }\r\n\t\t\t\t\r\n\t\t\t\t\t>\r\n\t\t\t\r\n\t\t\t\r\n\t\t\t\t\t${is_dummy_markup ? message_position === 'top' ?  props.ResponseDummyMarkup(message_successIcon, message_proClass) : '' : ''}\r\n\t\t\t\t\t${is_dummy_markup ? ' ' :  message_position === 'top' ? props.SubmitResponseMarkup`${parent}${state}${message_successIcon}${message_errorIcon}${message_proClass}` : ''}\r\n\r\n\t\t\t\t\t<!--------------------------------------------------------\r\n\t\t\t\t\t*** IMPORTANT \/ DANGEROUS ***\r\n\t\t\t\t\t${html``} must be used as in immediate child of \"metform-form-main-wrapper\"\r\n\t\t\t\t\tclass otherwise multistep form will not run at all\r\n\t\t\t\t\t---------------------------------------------------------->\r\n\r\n\t\t\t\t\t<div className=\"metform-form-main-wrapper\" key=${'hide-form-after-submit'} ref=${parent.formRef}>\r\n\t\t\t\t\t${html`\r\n\t\t\t\t\t\t\t\t<div data-elementor-type=\"wp-post\" key=\"2\" data-elementor-id=\"23757\" className=\"elementor elementor-23757\" data-elementor-post-type=\"metform-form\">\n\t\t\t\t<div className=\"elementor-element elementor-element-961fed5 e-flex e-con-boxed e-con e-parent\" data-id=\"961fed5\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div className=\"e-con-inner\">\n\t\t<div className=\"elementor-element elementor-element-a86cf31 e-con-full e-flex e-con e-child\" data-id=\"a86cf31\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-ab132ec elementor-widget elementor-widget-heading\" data-id=\"ab132ec\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t<h2 className=\"elementor-heading-title elementor-size-default\">Company Overview<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-f0c0aae e-con-full e-flex e-con e-child\" data-id=\"f0c0aae\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-b711531 elementor-widget__width-inherit elementor-widget elementor-widget-mf-text\" data-id=\"b711531\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf_pharmacy_name&quot;}\" data-widget_type=\"mf-text.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-text-b711531\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Pharmacy Name`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input\r\n\t\t\t\ttype=\"text\"\r\n\t\t\t\tclassName=\"mf-input \"\r\n\t\t\t\tid=\"mf-input-text-b711531\"\r\n\t\t\t\tname=\"mf_pharmacy_name\"\r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(``) } \"\r\n\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\r\n\t\t\t\t\tonBlur=${parent.handleChange}\r\n\t\t\t\t\taria-invalid=${validation.errors['mf_pharmacy_name'] ? 'true' : 'false'}\r\n\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true,\"expression\":\"null\"}, el)\r\n\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf_pharmacy_name\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div className=\"elementor-element elementor-element-ab08d7f elementor-widget__width-inherit elementor-widget elementor-widget-mf-url\" data-id=\"ab08d7f\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf_website_url&quot;}\" data-widget_type=\"mf-url.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-url-ab08d7f\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Website URL`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input type=\"url\" className=\"mf-input \" id=\"mf-input-url-ab08d7f\" \r\n\t\t\t\tname=\"mf_website_url\" \r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(``) } \"\r\n\t\t\t\t\t\t\t\t\tonInput=${ parent.handleChange }\r\n\t\t\t\t\taria-invalid=${validation.errors['mf_website_url'] ? 'true' : 'false'}\r\n\t\t\t\t\tref=${ el => parent.activateValidation({\"message\":\"This field is required.\",\"urlMessage\":\"Please enter a valid URL starting with http:\\\/\\\/ or https:\\\/\\\/\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true,\"expression\":\"null\"}, el)}\r\n\t\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf_website_url\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-179e303 e-con-full e-flex e-con e-child\" data-id=\"179e303\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-8b30c9d elementor-widget__width-inherit elementor-widget elementor-widget-mf-text\" data-id=\"8b30c9d\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf_primary_contact_name&quot;}\" data-widget_type=\"mf-text.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-text-8b30c9d\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Primary Contact Name`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input\r\n\t\t\t\ttype=\"text\"\r\n\t\t\t\tclassName=\"mf-input \"\r\n\t\t\t\tid=\"mf-input-text-8b30c9d\"\r\n\t\t\t\tname=\"mf_primary_contact_name\"\r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(``) } \"\r\n\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\r\n\t\t\t\t\tonBlur=${parent.handleChange}\r\n\t\t\t\t\taria-invalid=${validation.errors['mf_primary_contact_name'] ? 'true' : 'false'}\r\n\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true,\"expression\":\"null\"}, el)\r\n\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf_primary_contact_name\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div className=\"elementor-element elementor-element-bbf0cea elementor-widget__width-inherit elementor-widget elementor-widget-mf-email\" data-id=\"bbf0cea\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf_email_address&quot;}\" data-widget_type=\"mf-email.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-email-bbf0cea\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Email Address`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input \r\n\t\t\t\ttype=\"email\" \r\n\t\t\t\t \r\n\t\t\t\tdefaultValue=\"\" \r\n\t\t\t\tclassName=\"mf-input \" \r\n\t\t\t\tid=\"mf-input-email-bbf0cea\" \r\n\t\t\t\tname=\"mf_email_address\" \r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(``) } \" \r\n\t\t\t\t \r\n\t\t\t\tonBlur=${parent.handleChange} onFocus=${parent.handleChange} aria-invalid=${validation.errors['mf_email_address'] ? 'true' : 'false' } \r\n\t\t\t\tref=${el=> parent.activateValidation({\"message\":\"This field is required.\",\"emailMessage\":\"Please enter a valid Email address\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true,\"expression\":\"null\"}, el)}\r\n\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t<${validation.ErrorMessage} \r\n\t\t\t\terrors=${validation.errors} \r\n\t\t\t\tname=\"mf_email_address\" \r\n\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-94b7a48 e-con-full e-flex e-con e-child\" data-id=\"94b7a48\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-344efb4 elementor-widget__width-inherit elementor-widget elementor-widget-mf-telephone\" data-id=\"344efb4\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf_phone_number&quot;}\" data-widget_type=\"mf-telephone.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\n\t\t<div className=\"mf-input-wrapper\">\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-telephone-344efb4\">\n\t\t\t\t\t${ parent.decodeEntities(`Phone Number`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\n\t\t\t\t<\/label>\n\t\t\t\n\t\t\t<input\n\t\t\t\ttype=\"tel\"\n\t\t\t\tclassName=\"mf-input \"\n\t\t\t\tid=\"mf-input-telephone-344efb4\" \n\t\t\t\tname=\"mf_phone_number\"\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(``) } \"\n\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\n\t\t\t\t\taria-invalid=${validation.errors['mf_phone_number'] ? 'true' : 'false'}\n\t\t\t\t\tref=${el => parent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true,\"expression\":\"null\"}, el)}\n\t\t\t\t\t\t\t\t\/>\n\t\t\t\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\n\t\t\t\t\terrors=${validation.errors}\n\t\t\t\t\tname=\"mf_phone_number\"\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\n\t\t\t\t\t\/>\n\t\t\t\n\t\t\t\n\t\t<\/div>\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-3c59f12 e-con-full e-flex e-con e-child\" data-id=\"3c59f12\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-506ce39 elementor-widget elementor-widget-heading\" data-id=\"506ce39\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t<h2 className=\"elementor-heading-title elementor-size-default\">Address<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-7f16a6b e-con-full e-flex e-con e-child\" data-id=\"7f16a6b\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-9ddacfd elementor-widget__width-inherit elementor-widget elementor-widget-mf-text\" data-id=\"9ddacfd\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf_country&quot;}\" data-widget_type=\"mf-text.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-text-9ddacfd\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Country`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input\r\n\t\t\t\ttype=\"text\"\r\n\t\t\t\tclassName=\"mf-input \"\r\n\t\t\t\tid=\"mf-input-text-9ddacfd\"\r\n\t\t\t\tname=\"mf_country\"\r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(``) } \"\r\n\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\r\n\t\t\t\t\tonBlur=${parent.handleChange}\r\n\t\t\t\t\taria-invalid=${validation.errors['mf_country'] ? 'true' : 'false'}\r\n\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true,\"expression\":\"null\"}, el)\r\n\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf_country\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div className=\"elementor-element elementor-element-9054513 elementor-widget__width-inherit elementor-widget elementor-widget-mf-text\" data-id=\"9054513\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf_state_region&quot;}\" data-widget_type=\"mf-text.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-text-9054513\">\r\n\t\t\t\t\t${ parent.decodeEntities(`State \/ Region`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input\r\n\t\t\t\ttype=\"text\"\r\n\t\t\t\tclassName=\"mf-input \"\r\n\t\t\t\tid=\"mf-input-text-9054513\"\r\n\t\t\t\tname=\"mf_state_region\"\r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(``) } \"\r\n\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\r\n\t\t\t\t\tonBlur=${parent.handleChange}\r\n\t\t\t\t\taria-invalid=${validation.errors['mf_state_region'] ? 'true' : 'false'}\r\n\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true,\"expression\":\"null\"}, el)\r\n\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf_state_region\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-bb68f15 e-con-full e-flex e-con e-child\" data-id=\"bb68f15\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-dfdaca2 elementor-widget__width-inherit elementor-widget elementor-widget-mf-text\" data-id=\"dfdaca2\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf_city&quot;}\" data-widget_type=\"mf-text.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-text-dfdaca2\">\r\n\t\t\t\t\t${ parent.decodeEntities(`City`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input\r\n\t\t\t\ttype=\"text\"\r\n\t\t\t\tclassName=\"mf-input \"\r\n\t\t\t\tid=\"mf-input-text-dfdaca2\"\r\n\t\t\t\tname=\"mf_city\"\r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(``) } \"\r\n\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\r\n\t\t\t\t\tonBlur=${parent.handleChange}\r\n\t\t\t\t\taria-invalid=${validation.errors['mf_city'] ? 'true' : 'false'}\r\n\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true,\"expression\":\"null\"}, el)\r\n\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf_city\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-a8cc68f e-con-full e-flex e-con e-child\" data-id=\"a8cc68f\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-75ad073 elementor-widget elementor-widget-heading\" data-id=\"75ad073\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t<h2 className=\"elementor-heading-title elementor-size-default\">Licensing &amp; Compliance<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-74610ec e-con-full e-flex e-con e-child\" data-id=\"74610ec\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-54a7a15 elementor-widget__width-inherit elementor-widget elementor-widget-mf-select\" data-id=\"54a7a15\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf_facility_type&quot;,&quot;mf_input_list&quot;:[{&quot;mf_input_option_text&quot;:&quot;503A&quot;,&quot;mf_input_option_value&quot;:&quot;503A&quot;,&quot;_id&quot;:&quot;16e1667&quot;,&quot;mf_input_option_selected&quot;:&quot;selected&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;503B&quot;,&quot;mf_input_option_value&quot;:&quot;503B&quot;,&quot;_id&quot;:&quot;3c21d2e&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;}]}\" data-widget_type=\"mf-select.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\n\t\t\n\t\t<div className=\"mf-input-wrapper\">\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-select-54a7a15\">\n\t\t\t\t\t${ parent.decodeEntities(`Facility Type`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\n\t\t\t\t<\/label>\n            \n            <${props.Select}\n                className=${\"mf-input mf-input-select  \" + ( validation.errors['mf_facility_type'] ? 'mf-invalid' : '' )}\n                classNamePrefix=\"mf_select\"\n                name=\"mf_facility_type\"\n                placeholder=\"${ parent.decodeEntities(``) } \"\n                isSearchable=${false}\n                options=${[{\"label\":\"503A\",\"value\":\"503A\",\"isDisabled\":false},{\"label\":\"503B\",\"value\":\"503B\",\"isDisabled\":false}]}\n                value=${parent.getValue(\"mf_facility_type\") ? [{\"label\":\"503A\",\"value\":\"503A\",\"isDisabled\":false},{\"label\":\"503B\",\"value\":\"503B\",\"isDisabled\":false}].filter(item => item.value === parent.getValue(\"mf_facility_type\"))[0] : {\"label\":\"503A\",\"value\":\"503A\",\"isDisabled\":false}}\n                onChange=${(e)=> parent.handleSelect(e, \"mf_facility_type\")}\n                ref=${() => {\n\t\t\t\t                    register({ name: \"mf_facility_type\" }, parent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true}));\n                    if ( parent.getValue(\"mf_facility_type\") === '' && true ) {\n\t\t\t\t    parent.setValue( 'mf_facility_type', '503A', true );\n                        parent.handleChange({\n                            target: {\n                                name: 'mf_facility_type',\n                                value: '503A'\n                            }\n                        });\n                    }\n                }}\n                \/>\n\n            \t\t\t\t<${validation.ErrorMessage}\n\t\t\t\t\terrors=${validation.errors}\n\t\t\t\t\tname=\"mf_facility_type\"\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\n\t\t\t\t\t\/>\n\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div className=\"elementor-element elementor-element-e8bb4ac elementor-widget__width-inherit elementor-widget elementor-widget-mf-text\" data-id=\"e8bb4ac\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf_license_number&quot;}\" data-widget_type=\"mf-text.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-text-e8bb4ac\">\r\n\t\t\t\t\t${ parent.decodeEntities(`License Number`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input\r\n\t\t\t\ttype=\"text\"\r\n\t\t\t\tclassName=\"mf-input \"\r\n\t\t\t\tid=\"mf-input-text-e8bb4ac\"\r\n\t\t\t\tname=\"mf_license_number\"\r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(``) } \"\r\n\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\r\n\t\t\t\t\tonBlur=${parent.handleChange}\r\n\t\t\t\t\taria-invalid=${validation.errors['mf_license_number'] ? 'true' : 'false'}\r\n\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true,\"expression\":\"null\"}, el)\r\n\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf_license_number\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-f3dd8a7 e-con-full e-flex e-con e-child\" data-id=\"f3dd8a7\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-2700f71 elementor-widget__width-inherit elementor-widget elementor-widget-mf-text\" data-id=\"2700f71\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf_states_licensed_to_operate_in&quot;}\" data-widget_type=\"mf-text.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-text-2700f71\">\r\n\t\t\t\t\t${ parent.decodeEntities(`States Licensed To Operate In`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input\r\n\t\t\t\ttype=\"text\"\r\n\t\t\t\tclassName=\"mf-input \"\r\n\t\t\t\tid=\"mf-input-text-2700f71\"\r\n\t\t\t\tname=\"mf_states_licensed_to_operate_in\"\r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(``) } \"\r\n\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\r\n\t\t\t\t\tonBlur=${parent.handleChange}\r\n\t\t\t\t\taria-invalid=${validation.errors['mf_states_licensed_to_operate_in'] ? 'true' : 'false'}\r\n\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true,\"expression\":\"null\"}, el)\r\n\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf_states_licensed_to_operate_in\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div className=\"elementor-element elementor-element-60fdb9a elementor-widget__width-inherit elementor-widget elementor-widget-mf-select\" data-id=\"60fdb9a\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf_do_you_maintain_fda_compliance_standards&quot;,&quot;mf_input_list&quot;:[{&quot;mf_input_option_text&quot;:&quot;Yes&quot;,&quot;mf_input_option_value&quot;:&quot;Yes&quot;,&quot;_id&quot;:&quot;16e1667&quot;,&quot;mf_input_option_selected&quot;:&quot;selected&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;No&quot;,&quot;mf_input_option_value&quot;:&quot;No&quot;,&quot;_id&quot;:&quot;3c21d2e&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;}]}\" data-widget_type=\"mf-select.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\n\t\t\n\t\t<div className=\"mf-input-wrapper\">\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-select-60fdb9a\">\n\t\t\t\t\t${ parent.decodeEntities(`Do you maintain FDA compliance standards?`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\n\t\t\t\t<\/label>\n            \n            <${props.Select}\n                className=${\"mf-input mf-input-select  \" + ( validation.errors['mf_do_you_maintain_fda_compliance_standards'] ? 'mf-invalid' : '' )}\n                classNamePrefix=\"mf_select\"\n                name=\"mf_do_you_maintain_fda_compliance_standards\"\n                placeholder=\"${ parent.decodeEntities(``) } \"\n                isSearchable=${false}\n                options=${[{\"label\":\"Yes\",\"value\":\"Yes\",\"isDisabled\":false},{\"label\":\"No\",\"value\":\"No\",\"isDisabled\":false}]}\n                value=${parent.getValue(\"mf_do_you_maintain_fda_compliance_standards\") ? [{\"label\":\"Yes\",\"value\":\"Yes\",\"isDisabled\":false},{\"label\":\"No\",\"value\":\"No\",\"isDisabled\":false}].filter(item => item.value === parent.getValue(\"mf_do_you_maintain_fda_compliance_standards\"))[0] : {\"label\":\"Yes\",\"value\":\"Yes\",\"isDisabled\":false}}\n                onChange=${(e)=> parent.handleSelect(e, \"mf_do_you_maintain_fda_compliance_standards\")}\n                ref=${() => {\n\t\t\t\t                    register({ name: \"mf_do_you_maintain_fda_compliance_standards\" }, parent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true}));\n                    if ( parent.getValue(\"mf_do_you_maintain_fda_compliance_standards\") === '' && true ) {\n\t\t\t\t    parent.setValue( 'mf_do_you_maintain_fda_compliance_standards', 'Yes', true );\n                        parent.handleChange({\n                            target: {\n                                name: 'mf_do_you_maintain_fda_compliance_standards',\n                                value: 'Yes'\n                            }\n                        });\n                    }\n                }}\n                \/>\n\n            \t\t\t\t<${validation.ErrorMessage}\n\t\t\t\t\terrors=${validation.errors}\n\t\t\t\t\tname=\"mf_do_you_maintain_fda_compliance_standards\"\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\n\t\t\t\t\t\/>\n\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-801890a e-con-full e-flex e-con e-child\" data-id=\"801890a\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-827b1f2 elementor-widget__width-inherit elementor-widget elementor-widget-mf-select\" data-id=\"827b1f2\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf_any_past_regulatory_actions_or_violations&quot;,&quot;mf_input_list&quot;:[{&quot;mf_input_option_text&quot;:&quot;Yes&quot;,&quot;mf_input_option_value&quot;:&quot;Yes&quot;,&quot;_id&quot;:&quot;16e1667&quot;,&quot;mf_input_option_selected&quot;:&quot;selected&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;No&quot;,&quot;mf_input_option_value&quot;:&quot;No&quot;,&quot;_id&quot;:&quot;3c21d2e&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;}]}\" data-widget_type=\"mf-select.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\n\t\t\n\t\t<div className=\"mf-input-wrapper\">\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-select-827b1f2\">\n\t\t\t\t\t${ parent.decodeEntities(`Any past regulatory actions or violations?`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\n\t\t\t\t<\/label>\n            \n            <${props.Select}\n                className=${\"mf-input mf-input-select  \" + ( validation.errors['mf_any_past_regulatory_actions_or_violations'] ? 'mf-invalid' : '' )}\n                classNamePrefix=\"mf_select\"\n                name=\"mf_any_past_regulatory_actions_or_violations\"\n                placeholder=\"${ parent.decodeEntities(``) } \"\n                isSearchable=${false}\n                options=${[{\"label\":\"Yes\",\"value\":\"Yes\",\"isDisabled\":false},{\"label\":\"No\",\"value\":\"No\",\"isDisabled\":false}]}\n                value=${parent.getValue(\"mf_any_past_regulatory_actions_or_violations\") ? [{\"label\":\"Yes\",\"value\":\"Yes\",\"isDisabled\":false},{\"label\":\"No\",\"value\":\"No\",\"isDisabled\":false}].filter(item => item.value === parent.getValue(\"mf_any_past_regulatory_actions_or_violations\"))[0] : {\"label\":\"Yes\",\"value\":\"Yes\",\"isDisabled\":false}}\n                onChange=${(e)=> parent.handleSelect(e, \"mf_any_past_regulatory_actions_or_violations\")}\n                ref=${() => {\n\t\t\t\t                    register({ name: \"mf_any_past_regulatory_actions_or_violations\" }, parent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true}));\n                    if ( parent.getValue(\"mf_any_past_regulatory_actions_or_violations\") === '' && true ) {\n\t\t\t\t    parent.setValue( 'mf_any_past_regulatory_actions_or_violations', 'Yes', true );\n                        parent.handleChange({\n                            target: {\n                                name: 'mf_any_past_regulatory_actions_or_violations',\n                                value: 'Yes'\n                            }\n                        });\n                    }\n                }}\n                \/>\n\n            \t\t\t\t<${validation.ErrorMessage}\n\t\t\t\t\terrors=${validation.errors}\n\t\t\t\t\tname=\"mf_any_past_regulatory_actions_or_violations\"\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\n\t\t\t\t\t\/>\n\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-2367658 e-con-full e-flex e-con e-child\" data-id=\"2367658\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-4a5b69f elementor-widget elementor-widget-heading\" data-id=\"4a5b69f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t<h2 className=\"elementor-heading-title elementor-size-default\">Operational Capabilities<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-ff03418 e-con-full e-flex e-con e-child\" data-id=\"ff03418\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-087c1a0 elementor-widget__width-inherit elementor-widget elementor-widget-mf-select\" data-id=\"087c1a0\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf_average_monthly_production_capacity&quot;,&quot;mf_input_list&quot;:[{&quot;mf_input_option_text&quot;:&quot;&lt;1,000 units&quot;,&quot;mf_input_option_value&quot;:&quot;&lt;1,000 units&quot;,&quot;_id&quot;:&quot;16e1667&quot;,&quot;mf_input_option_selected&quot;:&quot;selected&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;1,000\\u20135,000&quot;,&quot;mf_input_option_value&quot;:&quot;1,000\\u20135,000&quot;,&quot;_id&quot;:&quot;3c21d2e&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;5,000\\u201310,000&quot;,&quot;mf_input_option_value&quot;:&quot;5,000\\u201310,000&quot;,&quot;_id&quot;:&quot;098966d&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;10,000+&quot;,&quot;mf_input_option_value&quot;:&quot;10,000+&quot;,&quot;_id&quot;:&quot;38d556f&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;}]}\" data-widget_type=\"mf-select.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\n\t\t\n\t\t<div className=\"mf-input-wrapper\">\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-select-087c1a0\">\n\t\t\t\t\t${ parent.decodeEntities(`Average Monthly Production Capacity`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\n\t\t\t\t<\/label>\n            \n            <${props.Select}\n                className=${\"mf-input mf-input-select  \" + ( validation.errors['mf_average_monthly_production_capacity'] ? 'mf-invalid' : '' )}\n                classNamePrefix=\"mf_select\"\n                name=\"mf_average_monthly_production_capacity\"\n                placeholder=\"${ parent.decodeEntities(``) } \"\n                isSearchable=${false}\n                options=${[{\"label\":\"<1,000 units\",\"value\":\"<1,000 units\",\"isDisabled\":false},{\"label\":\"1,000\\u20135,000\",\"value\":\"1,000\\u20135,000\",\"isDisabled\":false},{\"label\":\"5,000\\u201310,000\",\"value\":\"5,000\\u201310,000\",\"isDisabled\":false},{\"label\":\"10,000+\",\"value\":\"10,000+\",\"isDisabled\":false}]}\n                value=${parent.getValue(\"mf_average_monthly_production_capacity\") ? [{\"label\":\"<1,000 units\",\"value\":\"<1,000 units\",\"isDisabled\":false},{\"label\":\"1,000\\u20135,000\",\"value\":\"1,000\\u20135,000\",\"isDisabled\":false},{\"label\":\"5,000\\u201310,000\",\"value\":\"5,000\\u201310,000\",\"isDisabled\":false},{\"label\":\"10,000+\",\"value\":\"10,000+\",\"isDisabled\":false}].filter(item => item.value === parent.getValue(\"mf_average_monthly_production_capacity\"))[0] : {\"label\":\"<1,000 units\",\"value\":\"<1,000 units\",\"isDisabled\":false}}\n                onChange=${(e)=> parent.handleSelect(e, \"mf_average_monthly_production_capacity\")}\n                ref=${() => {\n\t\t\t\t                    register({ name: \"mf_average_monthly_production_capacity\" }, parent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true}));\n                    if ( parent.getValue(\"mf_average_monthly_production_capacity\") === '' && true ) {\n\t\t\t\t    parent.setValue( 'mf_average_monthly_production_capacity', '&lt;1,000 units', true );\n                        parent.handleChange({\n                            target: {\n                                name: 'mf_average_monthly_production_capacity',\n                                value: '&lt;1,000 units'\n                            }\n                        });\n                    }\n                }}\n                \/>\n\n            \t\t\t\t<${validation.ErrorMessage}\n\t\t\t\t\terrors=${validation.errors}\n\t\t\t\t\tname=\"mf_average_monthly_production_capacity\"\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\n\t\t\t\t\t\/>\n\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div className=\"elementor-element elementor-element-37c7d1b elementor-widget__width-inherit elementor-widget elementor-widget-mf-select\" data-id=\"37c7d1b\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf_average_turnaround_time&quot;,&quot;mf_input_list&quot;:[{&quot;mf_input_option_text&quot;:&quot;24\\u201348 hours&quot;,&quot;mf_input_option_value&quot;:&quot;24\\u201348 hours&quot;,&quot;_id&quot;:&quot;16e1667&quot;,&quot;mf_input_option_selected&quot;:&quot;selected&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;2\\u20135 days&quot;,&quot;mf_input_option_value&quot;:&quot;2\\u20135 days&quot;,&quot;_id&quot;:&quot;3c21d2e&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;5+ days&quot;,&quot;mf_input_option_value&quot;:&quot;5+ days&quot;,&quot;_id&quot;:&quot;c576602&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;}]}\" data-widget_type=\"mf-select.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\n\t\t\n\t\t<div className=\"mf-input-wrapper\">\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-select-37c7d1b\">\n\t\t\t\t\t${ parent.decodeEntities(`Average Turnaround Time`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\n\t\t\t\t<\/label>\n            \n            <${props.Select}\n                className=${\"mf-input mf-input-select  \" + ( validation.errors['mf_average_turnaround_time'] ? 'mf-invalid' : '' )}\n                classNamePrefix=\"mf_select\"\n                name=\"mf_average_turnaround_time\"\n                placeholder=\"${ parent.decodeEntities(``) } \"\n                isSearchable=${false}\n                options=${[{\"label\":\"24\\u201348 hours\",\"value\":\"24\\u201348 hours\",\"isDisabled\":false},{\"label\":\"2\\u20135 days\",\"value\":\"2\\u20135 days\",\"isDisabled\":false},{\"label\":\"5+ days\",\"value\":\"5+ days\",\"isDisabled\":false}]}\n                value=${parent.getValue(\"mf_average_turnaround_time\") ? [{\"label\":\"24\\u201348 hours\",\"value\":\"24\\u201348 hours\",\"isDisabled\":false},{\"label\":\"2\\u20135 days\",\"value\":\"2\\u20135 days\",\"isDisabled\":false},{\"label\":\"5+ days\",\"value\":\"5+ days\",\"isDisabled\":false}].filter(item => item.value === parent.getValue(\"mf_average_turnaround_time\"))[0] : {\"label\":\"24\\u201348 hours\",\"value\":\"24\\u201348 hours\",\"isDisabled\":false}}\n                onChange=${(e)=> parent.handleSelect(e, \"mf_average_turnaround_time\")}\n                ref=${() => {\n\t\t\t\t                    register({ name: \"mf_average_turnaround_time\" }, parent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true}));\n                    if ( parent.getValue(\"mf_average_turnaround_time\") === '' && true ) {\n\t\t\t\t    parent.setValue( 'mf_average_turnaround_time', '24\u201348 hours', true );\n                        parent.handleChange({\n                            target: {\n                                name: 'mf_average_turnaround_time',\n                                value: '24\u201348 hours'\n                            }\n                        });\n                    }\n                }}\n                \/>\n\n            \t\t\t\t<${validation.ErrorMessage}\n\t\t\t\t\terrors=${validation.errors}\n\t\t\t\t\tname=\"mf_average_turnaround_time\"\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\n\t\t\t\t\t\/>\n\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-3f1b141 e-con-full e-flex e-con e-child\" data-id=\"3f1b141\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-74772bf elementor-widget__width-inherit elementor-widget elementor-widget-mf-multi-select\" data-id=\"74772bf\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf_shipping_capabilities&quot;,&quot;mf_input_list&quot;:[{&quot;label&quot;:&quot;Nationwide (USA)&quot;,&quot;value&quot;:&quot;Nationwide (USA)&quot;,&quot;_id&quot;:&quot;220160f&quot;,&quot;mf_input_option_selected&quot;:&quot;selected&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;},{&quot;label&quot;:&quot;Mexico&quot;,&quot;value&quot;:&quot;Mexico&quot;,&quot;_id&quot;:&quot;d9f8322&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;label&quot;:&quot;International&quot;,&quot;value&quot;:&quot;International&quot;,&quot;_id&quot;:&quot;baf0dff&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;}]}\" data-widget_type=\"mf-multi-select.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n        \r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-multi-select-74772bf\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Shipping Capabilities`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n            <${props.Select}\r\n                isOptionDisabled=${option => option.mf_input_option_status === 'disabled'}\r\n                className=${\"mf-input mf-input-multiselect  \" + ( validation.errors['mf_shipping_capabilities'] ? 'mf-invalid' : '' )}\r\n                classNamePrefix=\"mf_multiselect\"\r\n                value=${parent.getValue(\"mf_shipping_capabilities\") && [{\"label\":\"Nationwide (USA)\",\"value\":\"Nationwide (USA)\",\"_id\":\"220160f\",\"mf_input_option_selected\":\"selected\",\"mf_input_option_status\":\"\"},{\"label\":\"Mexico\",\"value\":\"Mexico\",\"_id\":\"d9f8322\",\"mf_input_option_status\":\"\",\"mf_input_option_selected\":\"\"},{\"label\":\"International\",\"value\":\"International\",\"_id\":\"baf0dff\",\"mf_input_option_status\":\"\",\"mf_input_option_selected\":\"\"}].filter(item => {\r\n                    if(parent.state.formData['mf_shipping_capabilities'] && parent.state.formData['mf_shipping_capabilities'].indexOf(item.value) != -1 ){\r\n                        return item;\r\n                    }\r\n                })}\r\n                name='mf_shipping_capabilities'\r\n                placeholder=\"${ parent.decodeEntities(``) } \"\r\n                options=${[{\"label\":\"Nationwide (USA)\",\"value\":\"Nationwide (USA)\",\"_id\":\"220160f\",\"mf_input_option_selected\":\"selected\",\"mf_input_option_status\":\"\"},{\"label\":\"Mexico\",\"value\":\"Mexico\",\"_id\":\"d9f8322\",\"mf_input_option_status\":\"\",\"mf_input_option_selected\":\"\"},{\"label\":\"International\",\"value\":\"International\",\"_id\":\"baf0dff\",\"mf_input_option_status\":\"\",\"mf_input_option_selected\":\"\"}]}\r\n                onChange=${(el) => {\r\n                    setValue(\"mf_shipping_capabilities\", '');\r\n                    if(el != null){\r\n                        setValue(\"mf_shipping_capabilities\", el, true);\r\n                    }\r\n                    parent.multiSelectChange(el, 'mf_shipping_capabilities');\r\n                }}\r\n                ref=${() => {\r\n\t\t\t\t                    register({ name: \"mf_shipping_capabilities\" }, parent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true}));\r\n                    if(parent.state?.submitted !== true){\r\n                        if ( parent.getValue(\"mf_shipping_capabilities\") === '' && true ) {\r\n                            parent.setValue( 'mf_shipping_capabilities', '[\"Nationwide (USA)\"]');\r\n                            parent.multiSelectChange('[{\"label\":\"Nationwide (USA)\",\"value\":\"Nationwide (USA)\",\"_id\":\"220160f\",\"mf_input_option_selected\":\"selected\",\"mf_input_option_status\":\"\"}]', 'mf_shipping_capabilities');\r\n                        }\r\n                    }\r\n                }}\r\n                isMulti\r\n            \/>\r\n            \r\n            \t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf_shipping_capabilities\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t            \r\n        <\/div>\r\n\r\n\t\t\r\n        \t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div className=\"elementor-element elementor-element-f9f02ca elementor-widget__width-inherit elementor-widget elementor-widget-mf-select\" data-id=\"f9f02ca\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf_do_you_support_cold_chain_logistics&quot;,&quot;mf_input_list&quot;:[{&quot;mf_input_option_text&quot;:&quot;Yes&quot;,&quot;mf_input_option_value&quot;:&quot;Yes&quot;,&quot;_id&quot;:&quot;16e1667&quot;,&quot;mf_input_option_selected&quot;:&quot;selected&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;No&quot;,&quot;mf_input_option_value&quot;:&quot;No&quot;,&quot;_id&quot;:&quot;3c21d2e&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;}]}\" data-widget_type=\"mf-select.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\n\t\t\n\t\t<div className=\"mf-input-wrapper\">\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-select-f9f02ca\">\n\t\t\t\t\t${ parent.decodeEntities(`Do you support cold-chain logistics?`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\n\t\t\t\t<\/label>\n            \n            <${props.Select}\n                className=${\"mf-input mf-input-select  \" + ( validation.errors['mf_do_you_support_cold_chain_logistics'] ? 'mf-invalid' : '' )}\n                classNamePrefix=\"mf_select\"\n                name=\"mf_do_you_support_cold_chain_logistics\"\n                placeholder=\"${ parent.decodeEntities(``) } \"\n                isSearchable=${false}\n                options=${[{\"label\":\"Yes\",\"value\":\"Yes\",\"isDisabled\":false},{\"label\":\"No\",\"value\":\"No\",\"isDisabled\":false}]}\n                value=${parent.getValue(\"mf_do_you_support_cold_chain_logistics\") ? [{\"label\":\"Yes\",\"value\":\"Yes\",\"isDisabled\":false},{\"label\":\"No\",\"value\":\"No\",\"isDisabled\":false}].filter(item => item.value === parent.getValue(\"mf_do_you_support_cold_chain_logistics\"))[0] : {\"label\":\"Yes\",\"value\":\"Yes\",\"isDisabled\":false}}\n                onChange=${(e)=> parent.handleSelect(e, \"mf_do_you_support_cold_chain_logistics\")}\n                ref=${() => {\n\t\t\t\t                    register({ name: \"mf_do_you_support_cold_chain_logistics\" }, parent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true}));\n                    if ( parent.getValue(\"mf_do_you_support_cold_chain_logistics\") === '' && true ) {\n\t\t\t\t    parent.setValue( 'mf_do_you_support_cold_chain_logistics', 'Yes', true );\n                        parent.handleChange({\n                            target: {\n                                name: 'mf_do_you_support_cold_chain_logistics',\n                                value: 'Yes'\n                            }\n                        });\n                    }\n                }}\n                \/>\n\n            \t\t\t\t<${validation.ErrorMessage}\n\t\t\t\t\terrors=${validation.errors}\n\t\t\t\t\tname=\"mf_do_you_support_cold_chain_logistics\"\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\n\t\t\t\t\t\/>\n\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-8e2f6a5 e-con-full e-flex e-con e-child\" data-id=\"8e2f6a5\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-bcf79f4 elementor-widget elementor-widget-heading\" data-id=\"bcf79f4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t<h2 className=\"elementor-heading-title elementor-size-default\">Supply Chain &amp; Quality Standards<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-9eba0ea e-con-full e-flex e-con e-child\" data-id=\"9eba0ea\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-6fdd65c elementor-widget__width-inherit elementor-widget elementor-widget-mf-select\" data-id=\"6fdd65c\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf_do_you_perform_third_party_testing&quot;,&quot;mf_input_list&quot;:[{&quot;mf_input_option_text&quot;:&quot;Yes&quot;,&quot;mf_input_option_value&quot;:&quot;Yes&quot;,&quot;_id&quot;:&quot;16e1667&quot;,&quot;mf_input_option_selected&quot;:&quot;selected&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;No&quot;,&quot;mf_input_option_value&quot;:&quot;No&quot;,&quot;_id&quot;:&quot;3c21d2e&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;}]}\" data-widget_type=\"mf-select.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\n\t\t\n\t\t<div className=\"mf-input-wrapper\">\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-select-6fdd65c\">\n\t\t\t\t\t${ parent.decodeEntities(`Do you perform third-party testing?`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\n\t\t\t\t<\/label>\n            \n            <${props.Select}\n                className=${\"mf-input mf-input-select  \" + ( validation.errors['mf_do_you_perform_third_party_testing'] ? 'mf-invalid' : '' )}\n                classNamePrefix=\"mf_select\"\n                name=\"mf_do_you_perform_third_party_testing\"\n                placeholder=\"${ parent.decodeEntities(``) } \"\n                isSearchable=${false}\n                options=${[{\"label\":\"Yes\",\"value\":\"Yes\",\"isDisabled\":false},{\"label\":\"No\",\"value\":\"No\",\"isDisabled\":false}]}\n                value=${parent.getValue(\"mf_do_you_perform_third_party_testing\") ? [{\"label\":\"Yes\",\"value\":\"Yes\",\"isDisabled\":false},{\"label\":\"No\",\"value\":\"No\",\"isDisabled\":false}].filter(item => item.value === parent.getValue(\"mf_do_you_perform_third_party_testing\"))[0] : {\"label\":\"Yes\",\"value\":\"Yes\",\"isDisabled\":false}}\n                onChange=${(e)=> parent.handleSelect(e, \"mf_do_you_perform_third_party_testing\")}\n                ref=${() => {\n\t\t\t\t                    register({ name: \"mf_do_you_perform_third_party_testing\" }, parent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true}));\n                    if ( parent.getValue(\"mf_do_you_perform_third_party_testing\") === '' && true ) {\n\t\t\t\t    parent.setValue( 'mf_do_you_perform_third_party_testing', 'Yes', true );\n                        parent.handleChange({\n                            target: {\n                                name: 'mf_do_you_perform_third_party_testing',\n                                value: 'Yes'\n                            }\n                        });\n                    }\n                }}\n                \/>\n\n            \t\t\t\t<${validation.ErrorMessage}\n\t\t\t\t\terrors=${validation.errors}\n\t\t\t\t\tname=\"mf_do_you_perform_third_party_testing\"\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\n\t\t\t\t\t\/>\n\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div className=\"elementor-element elementor-element-fbda58b elementor-widget__width-inherit elementor-widget elementor-widget-mf-text\" data-id=\"fbda58b\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf_api_sourcing_method&quot;}\" data-widget_type=\"mf-text.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-text-fbda58b\">\r\n\t\t\t\t\t${ parent.decodeEntities(`API Sourcing Methods`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input\r\n\t\t\t\ttype=\"text\"\r\n\t\t\t\tclassName=\"mf-input \"\r\n\t\t\t\tid=\"mf-input-text-fbda58b\"\r\n\t\t\t\tname=\"mf_api_sourcing_method\"\r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(``) } \"\r\n\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\r\n\t\t\t\t\tonBlur=${parent.handleChange}\r\n\t\t\t\t\taria-invalid=${validation.errors['mf_api_sourcing_method'] ? 'true' : 'false'}\r\n\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true,\"expression\":\"null\"}, el)\r\n\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf_api_sourcing_method\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-a228dd1 e-con-full e-flex e-con e-child\" data-id=\"a228dd1\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-efde2ad elementor-widget__width-inherit elementor-widget elementor-widget-mf-text\" data-id=\"efde2ad\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf_certifications_accreditations&quot;}\" data-widget_type=\"mf-text.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-text-efde2ad\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Certifications \/ Accreditations`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input\r\n\t\t\t\ttype=\"text\"\r\n\t\t\t\tclassName=\"mf-input \"\r\n\t\t\t\tid=\"mf-input-text-efde2ad\"\r\n\t\t\t\tname=\"mf_certifications_accreditations\"\r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(``) } \"\r\n\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\r\n\t\t\t\t\tonBlur=${parent.handleChange}\r\n\t\t\t\t\taria-invalid=${validation.errors['mf_certifications_accreditations'] ? 'true' : 'false'}\r\n\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true,\"expression\":\"null\"}, el)\r\n\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf_certifications_accreditations\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div className=\"elementor-element elementor-element-3f1c8cd elementor-widget__width-inherit elementor-widget elementor-widget-mf-text\" data-id=\"3f1c8cd\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf_quality_control_protocols&quot;}\" data-widget_type=\"mf-text.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-text-3f1c8cd\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Quality Control Protocols`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input\r\n\t\t\t\ttype=\"text\"\r\n\t\t\t\tclassName=\"mf-input \"\r\n\t\t\t\tid=\"mf-input-text-3f1c8cd\"\r\n\t\t\t\tname=\"mf_quality_control_protocols\"\r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(``) } \"\r\n\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\r\n\t\t\t\t\tonBlur=${parent.handleChange}\r\n\t\t\t\t\taria-invalid=${validation.errors['mf_quality_control_protocols'] ? 'true' : 'false'}\r\n\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true,\"expression\":\"null\"}, el)\r\n\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf_quality_control_protocols\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-ac9e7ac e-con-full e-flex e-con e-child\" data-id=\"ac9e7ac\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-83ef791 elementor-widget elementor-widget-heading\" data-id=\"83ef791\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t<h2 className=\"elementor-heading-title elementor-size-default\">Partnership Alignment<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-f907309 e-con-full e-flex e-con e-child\" data-id=\"f907309\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-f55f64b elementor-widget__width-inherit elementor-widget elementor-widget-mf-select\" data-id=\"f55f64b\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf_experience_with_longevity_hormone_peptide_therapies&quot;,&quot;mf_input_list&quot;:[{&quot;mf_input_option_text&quot;:&quot;Yes&quot;,&quot;mf_input_option_value&quot;:&quot;Yes&quot;,&quot;_id&quot;:&quot;16e1667&quot;,&quot;mf_input_option_selected&quot;:&quot;selected&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;No&quot;,&quot;mf_input_option_value&quot;:&quot;No&quot;,&quot;_id&quot;:&quot;3c21d2e&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;}]}\" data-widget_type=\"mf-select.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\n\t\t\n\t\t<div className=\"mf-input-wrapper\">\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-select-f55f64b\">\n\t\t\t\t\t${ parent.decodeEntities(`Experience with Longevity \/ Hormone \/ Peptide Therapies`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\n\t\t\t\t<\/label>\n            \n            <${props.Select}\n                className=${\"mf-input mf-input-select  \" + ( validation.errors['mf_experience_with_longevity_hormone_peptide_therapies'] ? 'mf-invalid' : '' )}\n                classNamePrefix=\"mf_select\"\n                name=\"mf_experience_with_longevity_hormone_peptide_therapies\"\n                placeholder=\"${ parent.decodeEntities(``) } \"\n                isSearchable=${false}\n                options=${[{\"label\":\"Yes\",\"value\":\"Yes\",\"isDisabled\":false},{\"label\":\"No\",\"value\":\"No\",\"isDisabled\":false}]}\n                value=${parent.getValue(\"mf_experience_with_longevity_hormone_peptide_therapies\") ? [{\"label\":\"Yes\",\"value\":\"Yes\",\"isDisabled\":false},{\"label\":\"No\",\"value\":\"No\",\"isDisabled\":false}].filter(item => item.value === parent.getValue(\"mf_experience_with_longevity_hormone_peptide_therapies\"))[0] : {\"label\":\"Yes\",\"value\":\"Yes\",\"isDisabled\":false}}\n                onChange=${(e)=> parent.handleSelect(e, \"mf_experience_with_longevity_hormone_peptide_therapies\")}\n                ref=${() => {\n\t\t\t\t                    register({ name: \"mf_experience_with_longevity_hormone_peptide_therapies\" }, parent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true}));\n                    if ( parent.getValue(\"mf_experience_with_longevity_hormone_peptide_therapies\") === '' && true ) {\n\t\t\t\t    parent.setValue( 'mf_experience_with_longevity_hormone_peptide_therapies', 'Yes', true );\n                        parent.handleChange({\n                            target: {\n                                name: 'mf_experience_with_longevity_hormone_peptide_therapies',\n                                value: 'Yes'\n                            }\n                        });\n                    }\n                }}\n                \/>\n\n            \t\t\t\t<${validation.ErrorMessage}\n\t\t\t\t\terrors=${validation.errors}\n\t\t\t\t\tname=\"mf_experience_with_longevity_hormone_peptide_therapies\"\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\n\t\t\t\t\t\/>\n\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div className=\"elementor-element elementor-element-feb9d2a elementor-widget__width-inherit elementor-widget elementor-widget-mf-select\" data-id=\"feb9d2a\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf_current_client_base&quot;,&quot;mf_input_list&quot;:[{&quot;mf_input_option_text&quot;:&quot;Clinics&quot;,&quot;mf_input_option_value&quot;:&quot;Clinics&quot;,&quot;_id&quot;:&quot;16e1667&quot;,&quot;mf_input_option_selected&quot;:&quot;selected&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;Telehealth providers&quot;,&quot;mf_input_option_value&quot;:&quot;Telehealth providers&quot;,&quot;_id&quot;:&quot;3c21d2e&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;Mixed&quot;,&quot;mf_input_option_value&quot;:&quot;Mixed&quot;,&quot;_id&quot;:&quot;a137c61&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;Other&quot;,&quot;mf_input_option_value&quot;:&quot;Other&quot;,&quot;_id&quot;:&quot;37f24fa&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;}]}\" data-widget_type=\"mf-select.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\n\t\t\n\t\t<div className=\"mf-input-wrapper\">\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-select-feb9d2a\">\n\t\t\t\t\t${ parent.decodeEntities(`Current Client Base`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\n\t\t\t\t<\/label>\n            \n            <${props.Select}\n                className=${\"mf-input mf-input-select  \" + ( validation.errors['mf_current_client_base'] ? 'mf-invalid' : '' )}\n                classNamePrefix=\"mf_select\"\n                name=\"mf_current_client_base\"\n                placeholder=\"${ parent.decodeEntities(``) } \"\n                isSearchable=${false}\n                options=${[{\"label\":\"Clinics\",\"value\":\"Clinics\",\"isDisabled\":false},{\"label\":\"Telehealth providers\",\"value\":\"Telehealth providers\",\"isDisabled\":false},{\"label\":\"Mixed\",\"value\":\"Mixed\",\"isDisabled\":false},{\"label\":\"Other\",\"value\":\"Other\",\"isDisabled\":false}]}\n                value=${parent.getValue(\"mf_current_client_base\") ? [{\"label\":\"Clinics\",\"value\":\"Clinics\",\"isDisabled\":false},{\"label\":\"Telehealth providers\",\"value\":\"Telehealth providers\",\"isDisabled\":false},{\"label\":\"Mixed\",\"value\":\"Mixed\",\"isDisabled\":false},{\"label\":\"Other\",\"value\":\"Other\",\"isDisabled\":false}].filter(item => item.value === parent.getValue(\"mf_current_client_base\"))[0] : {\"label\":\"Clinics\",\"value\":\"Clinics\",\"isDisabled\":false}}\n                onChange=${(e)=> parent.handleSelect(e, \"mf_current_client_base\")}\n                ref=${() => {\n\t\t\t\t                    register({ name: \"mf_current_client_base\" }, parent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true}));\n                    if ( parent.getValue(\"mf_current_client_base\") === '' && true ) {\n\t\t\t\t    parent.setValue( 'mf_current_client_base', 'Clinics', true );\n                        parent.handleChange({\n                            target: {\n                                name: 'mf_current_client_base',\n                                value: 'Clinics'\n                            }\n                        });\n                    }\n                }}\n                \/>\n\n            \t\t\t\t<${validation.ErrorMessage}\n\t\t\t\t\terrors=${validation.errors}\n\t\t\t\t\tname=\"mf_current_client_base\"\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\n\t\t\t\t\t\/>\n\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-ce45b42 e-con-full e-flex e-con e-child\" data-id=\"ce45b42\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-e17924d elementor-widget__width-inherit elementor-widget elementor-widget-mf-select\" data-id=\"e17924d\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf_are_you_able_to_support_long_term_scalable_demand&quot;,&quot;mf_input_list&quot;:[{&quot;mf_input_option_text&quot;:&quot;Yes&quot;,&quot;mf_input_option_value&quot;:&quot;Yes&quot;,&quot;_id&quot;:&quot;16e1667&quot;,&quot;mf_input_option_selected&quot;:&quot;selected&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;No&quot;,&quot;mf_input_option_value&quot;:&quot;No&quot;,&quot;_id&quot;:&quot;3c21d2e&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;}]}\" data-widget_type=\"mf-select.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\n\t\t\n\t\t<div className=\"mf-input-wrapper\">\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-select-e17924d\">\n\t\t\t\t\t${ parent.decodeEntities(`Are you able to support long-term scalable demand?`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\n\t\t\t\t<\/label>\n            \n            <${props.Select}\n                className=${\"mf-input mf-input-select  \" + ( validation.errors['mf_are_you_able_to_support_long_term_scalable_demand'] ? 'mf-invalid' : '' )}\n                classNamePrefix=\"mf_select\"\n                name=\"mf_are_you_able_to_support_long_term_scalable_demand\"\n                placeholder=\"${ parent.decodeEntities(``) } \"\n                isSearchable=${false}\n                options=${[{\"label\":\"Yes\",\"value\":\"Yes\",\"isDisabled\":false},{\"label\":\"No\",\"value\":\"No\",\"isDisabled\":false}]}\n                value=${parent.getValue(\"mf_are_you_able_to_support_long_term_scalable_demand\") ? [{\"label\":\"Yes\",\"value\":\"Yes\",\"isDisabled\":false},{\"label\":\"No\",\"value\":\"No\",\"isDisabled\":false}].filter(item => item.value === parent.getValue(\"mf_are_you_able_to_support_long_term_scalable_demand\"))[0] : {\"label\":\"Yes\",\"value\":\"Yes\",\"isDisabled\":false}}\n                onChange=${(e)=> parent.handleSelect(e, \"mf_are_you_able_to_support_long_term_scalable_demand\")}\n                ref=${() => {\n\t\t\t\t                    register({ name: \"mf_are_you_able_to_support_long_term_scalable_demand\" }, parent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true}));\n                    if ( parent.getValue(\"mf_are_you_able_to_support_long_term_scalable_demand\") === '' && true ) {\n\t\t\t\t    parent.setValue( 'mf_are_you_able_to_support_long_term_scalable_demand', 'Yes', true );\n                        parent.handleChange({\n                            target: {\n                                name: 'mf_are_you_able_to_support_long_term_scalable_demand',\n                                value: 'Yes'\n                            }\n                        });\n                    }\n                }}\n                \/>\n\n            \t\t\t\t<${validation.ErrorMessage}\n\t\t\t\t\terrors=${validation.errors}\n\t\t\t\t\tname=\"mf_are_you_able_to_support_long_term_scalable_demand\"\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\n\t\t\t\t\t\/>\n\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div className=\"elementor-element elementor-element-c9048f8 elementor-widget__width-inherit elementor-widget elementor-widget-mf-text\" data-id=\"c9048f8\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf_why_are_you_interested_in_partnering_with_longevity_health_plans&quot;}\" data-widget_type=\"mf-text.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-text-c9048f8\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Why are you interested in partnering with Longevity Health Plans?`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input\r\n\t\t\t\ttype=\"text\"\r\n\t\t\t\tclassName=\"mf-input \"\r\n\t\t\t\tid=\"mf-input-text-c9048f8\"\r\n\t\t\t\tname=\"mf_why_are_you_interested_in_partnering_with_longevity_health_plans\"\r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(``) } \"\r\n\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\r\n\t\t\t\t\tonBlur=${parent.handleChange}\r\n\t\t\t\t\taria-invalid=${validation.errors['mf_why_are_you_interested_in_partnering_with_longevity_health_plans'] ? 'true' : 'false'}\r\n\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true,\"expression\":\"null\"}, el)\r\n\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf_why_are_you_interested_in_partnering_with_longevity_health_plans\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-5bcc4d0 e-con-full e-flex e-con e-child\" data-id=\"5bcc4d0\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-4e7a37a elementor-widget elementor-widget-heading\" data-id=\"4e7a37a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t<h2 className=\"elementor-heading-title elementor-size-default\">Supporting Documentation<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-53fa921 e-con-full e-flex e-con e-child\" data-id=\"53fa921\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-468f753 elementor-widget__width-inherit elementor-widget elementor-widget-mf-file-upload\" data-id=\"468f753\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf_upload_certifications&quot;}\" data-widget_type=\"mf-file-upload.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\r\n\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-file-upload-468f753\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Certification file`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<div className=\"mf-file-upload-container multi-option-input-type\">\r\n\t\t\t\t<input\r\n\t\t\t\t\ttype=\"file\"\r\n\t\t\t\t\tclassName=\"mf-input mf-input-file-upload \"\r\n\t\t\t\t\tid=\"mf-input-file-upload-468f753\" \r\n\t\t\t\t\tname=\"mf_upload_certifications\" \r\n\t\t\t\t\t\t\t\t\t\taccept=\".jpg, .jpeg, .gif, .png\"\r\n\t\t\t\t\tonInput=${ parent.handleFileUpload }\r\n\t\t\t\t\taria-invalid=${validation.errors['mf_upload_certifications'] ? 'true' : 'false'}\r\n\t\t\t\t\tref=${ el => parent.activateValidation({\"message\":\"This field is required.\",\"required\":false,\"file_types\":[\".jpg\",\".jpeg\",\".gif\",\".png\"],\"type_message\":\"Invalid file extension\",\"size_limit\":-1,\"limit_message\":\"This field is required.\"}, el) }\r\n\t\t\t\t\t\/>\r\n\t\t\t\t<label htmlFor=\"mf-input-file-upload-468f753\" className=\"mf-input-file-upload-label metform-btn\">\r\n\t\t\t\t\t<span>${ parent.decodeEntities(`Choose a file`) } <\/span>\t\t\t\t<\/label>\r\n\t\t\t\t<div className=\"mf-file-name\">\r\n\t\t\t\t\t${\r\n\t\t\t\t\t\t(parent.state.formData['mf_upload_certifications'] || []).length > 0\r\n\t\t\t\t\t\t? parent.state.formData['mf_upload_certifications'].map((file, idx) => html`\r\n\t\t\t\t\t\t\t<span className=\"mf-file-name-item\" key=${idx}>\r\n\t\t\t\t\t\t\t\t<span>${file.name}<\/span>\r\n\t\t\t\t\t\t\t\t<span \r\n\t\t\t\t\t\t\t\t\tclassName=\"mf-file-remove\" \r\n\t\t\t\t\t\t\t\t\tonClick=${() => parent.removeUploadedFile('mf_upload_certifications', idx)}\r\n\t\t\t\t\t\t\t\t\ttitle=\"Remove\"\r\n\t\t\t\t\t\t\t\t>\r\n\t\t\t\t\t\t\t\t\t<label className=\"mf-file-cross\">\u00d7<\/label>\r\n\t\t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t`)\r\n\t\t\t\t\t\t: html`<span>${parent.getFileLabel('mf_upload_certifications', 'No file chosen.')}<\/span>`\r\n\t\t\t\t\t}\r\n\t\t\t\t<\/div>\r\n\t\t\t\t\r\n\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf_upload_certifications\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div className=\"elementor-element elementor-element-1e74de5 elementor-widget__width-inherit elementor-widget elementor-widget-mf-file-upload\" data-id=\"1e74de5\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf_upload_licenses&quot;}\" data-widget_type=\"mf-file-upload.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\r\n\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-file-upload-1e74de5\">\r\n\t\t\t\t\t${ parent.decodeEntities(`License_file`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<div className=\"mf-file-upload-container multi-option-input-type\">\r\n\t\t\t\t<input\r\n\t\t\t\t\ttype=\"file\"\r\n\t\t\t\t\tclassName=\"mf-input mf-input-file-upload \"\r\n\t\t\t\t\tid=\"mf-input-file-upload-1e74de5\" \r\n\t\t\t\t\tname=\"mf_upload_licenses\" \r\n\t\t\t\t\t\t\t\t\t\taccept=\".jpg, .jpeg, .gif, .png, .pdf\"\r\n\t\t\t\t\tonInput=${ parent.handleFileUpload }\r\n\t\t\t\t\taria-invalid=${validation.errors['mf_upload_licenses'] ? 'true' : 'false'}\r\n\t\t\t\t\tref=${ el => parent.activateValidation({\"message\":\"This field is required.\",\"required\":false,\"file_types\":[\".jpg\",\".jpeg\",\".gif\",\".png\",\".pdf\"],\"type_message\":\"Invalid file extension\",\"size_limit\":2040,\"limit_message\":\"File size cannot exceed 2040 kb\"}, el) }\r\n\t\t\t\t\t\/>\r\n\t\t\t\t<label htmlFor=\"mf-input-file-upload-1e74de5\" className=\"mf-input-file-upload-label metform-btn\">\r\n\t\t\t\t\t<span>${ parent.decodeEntities(`Choose a file`) } <\/span>\t\t\t\t<\/label>\r\n\t\t\t\t<div className=\"mf-file-name\">\r\n\t\t\t\t\t${\r\n\t\t\t\t\t\t(parent.state.formData['mf_upload_licenses'] || []).length > 0\r\n\t\t\t\t\t\t? parent.state.formData['mf_upload_licenses'].map((file, idx) => html`\r\n\t\t\t\t\t\t\t<span className=\"mf-file-name-item\" key=${idx}>\r\n\t\t\t\t\t\t\t\t<span>${file.name}<\/span>\r\n\t\t\t\t\t\t\t\t<span \r\n\t\t\t\t\t\t\t\t\tclassName=\"mf-file-remove\" \r\n\t\t\t\t\t\t\t\t\tonClick=${() => parent.removeUploadedFile('mf_upload_licenses', idx)}\r\n\t\t\t\t\t\t\t\t\ttitle=\"Remove\"\r\n\t\t\t\t\t\t\t\t>\r\n\t\t\t\t\t\t\t\t\t<label className=\"mf-file-cross\">\u00d7<\/label>\r\n\t\t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t`)\r\n\t\t\t\t\t\t: html`<span>${parent.getFileLabel('mf_upload_licenses', 'No file chosen.')}<\/span>`\r\n\t\t\t\t\t}\r\n\t\t\t\t<\/div>\r\n\t\t\t\t\r\n\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf_upload_licenses\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-503c7fc e-con-full e-flex e-con e-child\" data-id=\"503c7fc\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-c24f64e elementor-widget__width-inherit elementor-widget elementor-widget-mf-file-upload\" data-id=\"c24f64e\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;mf-AdditionalDocumentsOptional&quot;}\" data-widget_type=\"mf-file-upload.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\r\n\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-file-upload-c24f64e\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Additional_Document`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<div className=\"mf-file-upload-container multi-option-input-type\">\r\n\t\t\t\t<input\r\n\t\t\t\t\ttype=\"file\"\r\n\t\t\t\t\tclassName=\"mf-input mf-input-file-upload \"\r\n\t\t\t\t\tid=\"mf-input-file-upload-c24f64e\" \r\n\t\t\t\t\tname=\"mf-AdditionalDocumentsOptional\" \r\n\t\t\t\t\t\t\t\t\t\taccept=\".jpg, .jpeg, .gif, .png\"\r\n\t\t\t\t\tonInput=${ parent.handleFileUpload }\r\n\t\t\t\t\taria-invalid=${validation.errors['mf-AdditionalDocumentsOptional'] ? 'true' : 'false'}\r\n\t\t\t\t\tref=${ el => parent.activateValidation({\"message\":\"This field is required.\",\"required\":false,\"file_types\":[\".jpg\",\".jpeg\",\".gif\",\".png\"],\"type_message\":\"Invalid file extension\",\"size_limit\":-1,\"limit_message\":\"This field is required.\"}, el) }\r\n\t\t\t\t\t\/>\r\n\t\t\t\t<label htmlFor=\"mf-input-file-upload-c24f64e\" className=\"mf-input-file-upload-label metform-btn\">\r\n\t\t\t\t\t<span>${ parent.decodeEntities(`Choose a file`) } <\/span>\t\t\t\t<\/label>\r\n\t\t\t\t<div className=\"mf-file-name\">\r\n\t\t\t\t\t${\r\n\t\t\t\t\t\t(parent.state.formData['mf-AdditionalDocumentsOptional'] || []).length > 0\r\n\t\t\t\t\t\t? parent.state.formData['mf-AdditionalDocumentsOptional'].map((file, idx) => html`\r\n\t\t\t\t\t\t\t<span className=\"mf-file-name-item\" key=${idx}>\r\n\t\t\t\t\t\t\t\t<span>${file.name}<\/span>\r\n\t\t\t\t\t\t\t\t<span \r\n\t\t\t\t\t\t\t\t\tclassName=\"mf-file-remove\" \r\n\t\t\t\t\t\t\t\t\tonClick=${() => parent.removeUploadedFile('mf-AdditionalDocumentsOptional', idx)}\r\n\t\t\t\t\t\t\t\t\ttitle=\"Remove\"\r\n\t\t\t\t\t\t\t\t>\r\n\t\t\t\t\t\t\t\t\t<label className=\"mf-file-cross\">\u00d7<\/label>\r\n\t\t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t`)\r\n\t\t\t\t\t\t: html`<span>${parent.getFileLabel('mf-AdditionalDocumentsOptional', 'No file chosen.')}<\/span>`\r\n\t\t\t\t\t}\r\n\t\t\t\t<\/div>\r\n\t\t\t\t\r\n\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"mf-AdditionalDocumentsOptional\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-88ae2e2 e-con-full e-flex e-con e-child\" data-id=\"88ae2e2\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-d8cc082 elementor-widget elementor-widget-mf-checkbox\" data-id=\"d8cc082\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;i_confirm&quot;,&quot;mf_input_list&quot;:[{&quot;mf_input_option_text&quot;:&quot;\\u201cI confirm that all information provided is accurate and that our facility operates in compliance with applicable regulatory standards.\\u201d&quot;,&quot;mf_input_option_value&quot;:&quot;\\u201cI confirm that all information provided is accurate and that our facility operates in compliance with applicable regulatory standards.\\u201d&quot;,&quot;_id&quot;:&quot;e26c5bb&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;}]}\" data-widget_type=\"mf-checkbox.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-checkbox-d8cc082\">\r\n\t\t\t\t\t${ parent.decodeEntities(``) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<div \r\n\t\t\t\t\t\t\t\t\tref=${el => parent.handleCheckbox(el, 'onLoad')}\r\n\t\t\t\t\t\t\t\t\tclassName=\"mf-checkbox multi-option-input-type\"\r\n\t\t\t\t\tid=\"mf-input-checkbox-d8cc082\">\r\n\t\t\t\t\t\t\t\t\t<div className=\"mf-checkbox-option \">\r\n\t\t\t\t\t\t<label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"checkbox\"\r\n\t\t\t\t\t\t\t\tclassName=\"mf-input mf-checkbox-input \"\r\n\t\t\t\t\t\t\t\tname=\"i_confirm\"\r\n\t\t\t\t\t\t\t\tvalue=\"\u201cI confirm that all information provided is accurate and that our facility operates in compliance with applicable regulatory standards.\u201d\"\r\n\t\t\t\t\t\t\t\tdefaultChecked=\"\"\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tonInput=${ el =>  parent.handleCheckbox(el.target, 'onClick') }\r\n\t\t\t\t\t\t\t\t\taria-invalid=${validation.errors['i_confirm'] ? 'true' : 'false'}\r\n\t\t\t\t\t\t\t\t\tref=${el => {\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":false,\"expression\":\"null\"}, el)}\r\n\t\t\t\t\t\t\t\t\t}\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t<span>\r\n\t\t\t\t\t\t\t\t${ parent.decodeEntities(`\u201cI confirm that all information provided is accurate and that our facility operates in compliance with applicable regulatory standards.\u201d`) } \t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t<\/label>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t<\/div>\r\n\t\t\t<input type=\"hidden\" name=\"i_confirm\" value=\"\" \/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"i_confirm\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div className=\"elementor-element elementor-element-d077df2 elementor-widget elementor-widget-mf-checkbox\" data-id=\"d077df2\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;by_submitting&quot;,&quot;mf_input_list&quot;:[{&quot;mf_input_option_text&quot;:&quot;By submitting this form, I consent to receive SMS messages from Longevity Health Plans regarding account updates, services, and follow-up communication. Message frequency may vary. Message and data rates may apply. Reply STOP to opt out.&quot;,&quot;mf_input_option_value&quot;:&quot;\\u201cI confirm that all information provided is accurate and that our facility operates in compliance with applicable regulatory standards.\\u201d&quot;,&quot;_id&quot;:&quot;e26c5bb&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;}]}\" data-widget_type=\"mf-checkbox.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-checkbox-d077df2\">\r\n\t\t\t\t\t${ parent.decodeEntities(``) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<div \r\n\t\t\t\t\t\t\t\t\tref=${el => parent.handleCheckbox(el, 'onLoad')}\r\n\t\t\t\t\t\t\t\t\tclassName=\"mf-checkbox multi-option-input-type\"\r\n\t\t\t\t\tid=\"mf-input-checkbox-d077df2\">\r\n\t\t\t\t\t\t\t\t\t<div className=\"mf-checkbox-option \">\r\n\t\t\t\t\t\t<label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"checkbox\"\r\n\t\t\t\t\t\t\t\tclassName=\"mf-input mf-checkbox-input \"\r\n\t\t\t\t\t\t\t\tname=\"by_submitting\"\r\n\t\t\t\t\t\t\t\tvalue=\"\u201cI confirm that all information provided is accurate and that our facility operates in compliance with applicable regulatory standards.\u201d\"\r\n\t\t\t\t\t\t\t\tdefaultChecked=\"\"\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tonInput=${ el =>  parent.handleCheckbox(el.target, 'onClick') }\r\n\t\t\t\t\t\t\t\t\taria-invalid=${validation.errors['by_submitting'] ? 'true' : 'false'}\r\n\t\t\t\t\t\t\t\t\tref=${el => {\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":false,\"expression\":\"null\"}, el)}\r\n\t\t\t\t\t\t\t\t\t}\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t<span>\r\n\t\t\t\t\t\t\t\t${ parent.decodeEntities(`By submitting this form, I consent to receive SMS messages from Longevity Health Plans regarding account updates, services, and follow-up communication. Message frequency may vary. Message and data rates may apply. Reply STOP to opt out.`) } \t\t\t\t\t\t\t<\/span>\r\n\t\t\t\t\t\t<\/label>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t<\/div>\r\n\t\t\t<input type=\"hidden\" name=\"by_submitting\" value=\"\" \/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"by_submitting\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div className=\"elementor-element elementor-element-7ff0ca0 e-con-full e-flex e-con e-child\" data-id=\"7ff0ca0\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div className=\"elementor-element elementor-element-d328d1a mf-btn--left elementor-widget elementor-widget-mf-button\" data-id=\"d328d1a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"mf-button.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div className=\"mf-btn-wraper \" data-mf-form-conditional-logic-requirement=\"\">\r\n\t\t\t\t\t\t\t<button type=\"submit\" className=\"metform-btn metform-submit-btn \" id=\"\">\r\n\t\t\t\t\t<span>${ parent.decodeEntities(`Apply for Partnership`) } <\/span>\r\n\t\t\t\t<\/button>\r\n\t\t\t        <\/div>\r\n        \t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t`}\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t${is_dummy_markup ? message_position === 'bottom' ? props.ResponseDummyMarkup(message_successIcon, message_proClass) : '' : ''}\r\n\t\t\t\t\t${is_dummy_markup ? ' ' : message_position === 'bottom' ? props.SubmitResponseMarkup`${parent}${state}${message_successIcon}${message_errorIcon}${message_proClass}` : ''}\r\n\t\t\t\t\r\n\t\t\t\t<\/form>\r\n\t\t\t`\r\n\t\t<\/script>\r\n\r\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-d17002f e-flex e-con-boxed e-con e-parent\" data-id=\"d17002f\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-dfcabf0 e-con-full e-flex e-con e-child\" data-id=\"dfcabf0\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-534a5c4 elementor-widget elementor-widget-heading\" data-id=\"534a5c4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">What We Provide<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-13de952 elementor-widget elementor-widget-heading\" data-id=\"13de952\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Pharmacy partners within our network gain access to:<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-172f3d5 e-con-full e-flex e-con e-child\" data-id=\"172f3d5\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-1ef4087 e-con-full e-flex e-con e-child\" data-id=\"1ef4087\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6933d2b elementor-widget elementor-widget-icon-box\" data-id=\"6933d2b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-box-wrapper\">\n\n\t\t\t\n\t\t\t\t\t\t<div class=\"elementor-icon-box-content\">\n\n\t\t\t\t\t\t\t\t\t<h3 class=\"elementor-icon-box-title\">\n\t\t\t\t\t\t<span  >\n\t\t\t\t\t\t\tA structured and expanding provider network \t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/h3>\n\t\t\t\t\n\t\t\t\t\n\t\t\t<\/div>\n\t\t\t\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3ab50db elementor-widget elementor-widget-icon-box\" data-id=\"3ab50db\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-box-wrapper\">\n\n\t\t\t\n\t\t\t\t\t\t<div class=\"elementor-icon-box-content\">\n\n\t\t\t\t\t\t\t\t\t<h3 class=\"elementor-icon-box-title\">\n\t\t\t\t\t\t<span  >\n\t\t\t\t\t\t\tConsistent clinical demand across multiple markets \t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/h3>\n\t\t\t\t\n\t\t\t\t\n\t\t\t<\/div>\n\t\t\t\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-328def9 elementor-widget elementor-widget-icon-box\" data-id=\"328def9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-box-wrapper\">\n\n\t\t\t\n\t\t\t\t\t\t<div class=\"elementor-icon-box-content\">\n\n\t\t\t\t\t\t\t\t\t<h3 class=\"elementor-icon-box-title\">\n\t\t\t\t\t\t<span  >\n\t\t\t\t\t\t\tIntegrated ordering pathways through our provider portal \t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/h3>\n\t\t\t\t\n\t\t\t\t\n\t\t\t<\/div>\n\t\t\t\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-900e891 elementor-widget elementor-widget-icon-box\" data-id=\"900e891\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-box-wrapper\">\n\n\t\t\t\n\t\t\t\t\t\t<div class=\"elementor-icon-box-content\">\n\n\t\t\t\t\t\t\t\t\t<h3 class=\"elementor-icon-box-title\">\n\t\t\t\t\t\t<span  >\n\t\t\t\t\t\t\tAlignment with a compliance-first operational framework \t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/h3>\n\t\t\t\t\n\t\t\t\t\n\t\t\t<\/div>\n\t\t\t\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-50125bb elementor-widget elementor-widget-icon-box\" data-id=\"50125bb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-box-wrapper\">\n\n\t\t\t\n\t\t\t\t\t\t<div class=\"elementor-icon-box-content\">\n\n\t\t\t\t\t\t\t\t\t<h3 class=\"elementor-icon-box-title\">\n\t\t\t\t\t\t<span  >\n\t\t\t\t\t\t\tLong-term, scalable growth opportunities \t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/h3>\n\t\t\t\t\n\t\t\t\t\n\t\t\t<\/div>\n\t\t\t\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-807b014 e-con-full e-flex e-con e-child\" data-id=\"807b014\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-28b9a43 elementor-widget elementor-widget-heading\" data-id=\"28b9a43\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Our Standards<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9f3cd7f elementor-widget elementor-widget-heading\" data-id=\"9f3cd7f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">We operate exclusively with partners who meet rigorous standards across:<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-8cfb1e5 e-con-full e-flex e-con e-child\" data-id=\"8cfb1e5\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-5f1fdee e-con-full e-flex e-con e-child\" data-id=\"5f1fdee\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-60ce3e5 elementor-widget elementor-widget-icon-box\" data-id=\"60ce3e5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-box-wrapper\">\n\n\t\t\t\n\t\t\t\t\t\t<div class=\"elementor-icon-box-content\">\n\n\t\t\t\t\t\t\t\t\t<h3 class=\"elementor-icon-box-title\">\n\t\t\t\t\t\t<span  >\n\t\t\t\t\t\t\tRegulatory compliance (503A \/ 503B certification) \t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/h3>\n\t\t\t\t\n\t\t\t\t\n\t\t\t<\/div>\n\t\t\t\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-faeef81 elementor-widget elementor-widget-icon-box\" data-id=\"faeef81\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-box-wrapper\">\n\n\t\t\t\n\t\t\t\t\t\t<div class=\"elementor-icon-box-content\">\n\n\t\t\t\t\t\t\t\t\t<h3 class=\"elementor-icon-box-title\">\n\t\t\t\t\t\t<span  >\n\t\t\t\t\t\t\tQuality control and compounding protocols \t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/h3>\n\t\t\t\t\n\t\t\t\t\n\t\t\t<\/div>\n\t\t\t\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ef7b356 elementor-widget elementor-widget-icon-box\" data-id=\"ef7b356\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-box-wrapper\">\n\n\t\t\t\n\t\t\t\t\t\t<div class=\"elementor-icon-box-content\">\n\n\t\t\t\t\t\t\t\t\t<h3 class=\"elementor-icon-box-title\">\n\t\t\t\t\t\t<span  >\n\t\t\t\t\t\t\tSupply chain integrity and transparency \t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/h3>\n\t\t\t\t\n\t\t\t\t\n\t\t\t<\/div>\n\t\t\t\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-538ea2b elementor-widget elementor-widget-icon-box\" data-id=\"538ea2b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-box-wrapper\">\n\n\t\t\t\n\t\t\t\t\t\t<div class=\"elementor-icon-box-content\">\n\n\t\t\t\t\t\t\t\t\t<h3 class=\"elementor-icon-box-title\">\n\t\t\t\t\t\t<span  >\n\t\t\t\t\t\t\tAPI sourcing and verification \t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/h3>\n\t\t\t\t\n\t\t\t\t\n\t\t\t<\/div>\n\t\t\t\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4e214d5 elementor-widget elementor-widget-icon-box\" data-id=\"4e214d5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-box-wrapper\">\n\n\t\t\t\n\t\t\t\t\t\t<div class=\"elementor-icon-box-content\">\n\n\t\t\t\t\t\t\t\t\t<h3 class=\"elementor-icon-box-title\">\n\t\t\t\t\t\t<span  >\n\t\t\t\t\t\t\tOperational reliability and consistency \t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/h3>\n\t\t\t\t\n\t\t\t\t\t\t\t\t\t<p class=\"elementor-icon-box-description\">\n\t\t\t\t\t\tWe operate exclusively with partners who meet rigorous standards across:\t\t\t\t\t<\/p>\n\t\t\t\t\n\t\t\t<\/div>\n\t\t\t\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-87d1f28 e-flex e-con-boxed e-con e-parent\" data-id=\"87d1f28\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-1b1c6a4 e-con-full e-flex e-con e-child\" data-id=\"1b1c6a4\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-9b25f70 elementor-widget elementor-widget-heading\" data-id=\"9b25f70\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Built for Scale<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-01b16c2 elementor-widget elementor-widget-text-editor\" data-id=\"01b16c2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>As our clinical footprint continues to expand, we are building a tightly aligned pharmaceutical network capable of supporting cross-border operations, standardized protocols, and increasing demand.<\/p><p>Our partners are positioned not as suppliers but as core components of a unified system.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-17e4184 e-flex e-con-boxed e-con e-parent\" data-id=\"17e4184\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-8e74ed3 e-con-full e-flex e-con e-child\" data-id=\"8e74ed3\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-43fe9b8 elementor-widget elementor-widget-heading\" data-id=\"43fe9b8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Partnership Philosophy<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b7e21bf elementor-widget elementor-widget-text-editor\" data-id=\"b7e21bf\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>We maintain a controlled network.<\/p><p>Partnerships are selective and structured to ensure alignment across clinical, operational, and regulatory standards.<\/p><p>This allows us to protect the integrity of the system and the outcomes it delivers.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Apply to Partner With Us For 503A \/ 503B Pharmacies Partner Within a Controlled Clinical Infrastructure Longevity Health Plans partners with a select group of certified 503A compounding pharmacies and 503B outsourcing facilities to support a growing network of clinical offices across the United States and Mexico. We are not seeking vendors.We build long-term infrastructure [&hellip;]<\/p>\n","protected":false},"author":607,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"pmpro_default_level":"","footnotes":""},"class_list":["post-23710","page","type-page","status-publish","hentry","pmpro-has-access"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Pharmacy Partnership Application - Longevity Health Plans<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/longevityhealthplans.com\/es\/solicitud-de-asociacion-farmaceutica\/\" \/>\n<meta property=\"og:locale\" content=\"es_MX\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Pharmacy Partnership Application - Longevity Health Plans\" \/>\n<meta property=\"og:description\" content=\"Apply to Partner With Us For 503A \/ 503B Pharmacies Partner Within a Controlled Clinical Infrastructure Longevity Health Plans partners with a select group of certified 503A compounding pharmacies and 503B outsourcing facilities to support a growing network of clinical offices across the United States and Mexico. 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