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<div class='gform_heading'>
<h3 class='gform_title'>Fik du opfyldt dit formål med besøget i dag?</h3>
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Skriv fra hjertet, så jeg bedre kan hjælpe dig fremover...</label><div class='ginput_container ginput_container_textarea'><textarea name='input_2' id='input_11_2' class='textarea medium' maxlength='600' aria-invalid="false" rows='10' cols='50'></textarea></div></li><li id='field_11_4' class='gfield gform_validation_container field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_11_4' >Comments</label><div class='ginput_container'><input name='input_4' id='input_11_4' type='text' value='' autocomplete='off'/></div><div class='gfield_description' id='gfield_description__4'>Dette felt er til validering og bør ikke ændres.</div></li>
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<div class='gform_heading'>
<h3 class='gform_title'>Er du allerede i gang med Herbalife?</h3>
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<div class='gform_body'><ul id='gform_fields_10' class='gform_fields top_label form_sublabel_below description_below'><li id='field_10_3' class='gfield field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' >Anvender du Herbalifes Produkter i forvejen</label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_10_3'><li class='gchoice_10_3_0'><input name='input_3' type='radio' value='Ja' id='choice_10_3_0' /><label for='choice_10_3_0' id='label_10_3_0'>Ja</label></li><li class='gchoice_10_3_1'><input name='input_3' type='radio' value='Nej' id='choice_10_3_1' /><label for='choice_10_3_1' id='label_10_3_1'>Nej</label></li><li class='gchoice_10_3_2'><input name='input_3' type='radio' value='Ved ikke' id='choice_10_3_2' /><label for='choice_10_3_2' id='label_10_3_2'>Ved ikke</label></li></ul></div></li><li id='field_10_2' class='gfield field_sublabel_below field_description_below gfield_visibility_visible gsurvey-survey-field ' ><label class='gfield_label' for='input_10_2' >Hvad er dit formål med dit besøg i dag? Vær venligst meget specifik.</label><div class='ginput_container ginput_container_text'><input name='input_2' id='input_10_2' type='text' value='' class='medium' maxlength='250' aria-invalid="false" /></div></li><li id='field_10_4' class='gfield gform_validation_container field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_10_4' >Phone</label><div class='ginput_container'><input name='input_4' id='input_10_4' type='text' value='' autocomplete='off'/></div><div class='gfield_description' id='gfield_description__4'>Dette felt er til validering og bør ikke ændres.</div></li>
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