{"id":7722,"date":"2019-07-26T02:58:07","date_gmt":"2019-07-26T09:58:07","guid":{"rendered":"https:\/\/shayneletford.com\/test-triumph\/newly-injured\/"},"modified":"2024-07-03T15:48:58","modified_gmt":"2024-07-03T22:48:58","slug":"newly-injured","status":"publish","type":"page","link":"https:\/\/triumph-foundation.org\/es\/newly-injured\/","title":{"rendered":"Newly-Injured Support"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><div id=\"no-float\" class=\"vc_row wpb_row vc_row-fluid\"><div class=\"wpb_column vc_column_container vc_col-sm-12\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\">\n\t<div class=\"wpb_text_column wpb_content_element\" >\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t<h2>Newly-Injured Support<\/h2>\n<p>Triumph Foundation\u2019s Newly Injured Support Program helps people that have suffered a spinal cord injury or other disorder that causes paralysis (SCI), as well as those living with neuromuscular diseases. We assist individuals in achieving a successful future with the provision of resources and education regarding community assets, health and wellness techniques, and dealing with the emotional and mental challenges of living with a disability.<\/p>\n<p>Triumph Foundation\u2019s goal is to help people maximize their recovery from life altering accidents and diagnosis. We find solutions to increase independence, encourage self-efficacy, and reintegrate individuals back into the community. Triumph Foundation also works to educate the general population about individuals living with disabilities to promote inclusiveness. Triumph specializes in motivating and inspiring all to live a life of purpose.<\/p>\n<p>A wonderful resource Triumph offers is the SCI First 90 Days book by Sam Maddox. It is a guide and roadmap for people with new spinal cord injuries and beyond. You can request a copy from us or <a href=\"https:\/\/triumph-foundation.org\/wp-content\/uploads\/2024\/07\/10-SCl-First-90-Days.pdf\">download the PDF version here<\/a>.<\/p>\n<h2>Care Packs<\/h2>\n<p>The cornerstone of our outreach is providing Care Packs full of resources to newly injured individuals throughout Southern California. Suffering a spinal cord injury is a life-changing event and our goal at Triumph is to provide a continuum of care to make the transition out of the hospital to home as smooth as possible.<\/p>\n<p><a href=\"https:\/\/triumph-foundation.org\/ambassador-program\">Triumph Ambassadors<\/a> are professionally trained peer mentors that make hospital visits to people that have recently had an injury or disorder causing paralysis. We provide mentorship to help newly injured people rebuild their lives. Our Care Packs are baskets or backpacks that are full of practical information about equipment, services, organizations, assistance programs, and activities that exist to help people with an SCI achieve the best possible health outcome and maximize their quality of life post injury. They also include small gift items, toiletries, personal care products, and edible goodies to make hospital life easier during this time of adversity.<\/p>\n<p>In addition, Triumph has created the 'Tragedy to Triumph Resource Guidebook' and Wristband Flash Drive that offers 20 chapters of resources, referrals and recommendations. We provide these to individuals throughout the disabled community, including doctors, social workers, hospital and rehabilitation staff, and numerous others that are affiliated and provide services to our community. Most of these Resources can be found on this website.<\/p>\n<p><a href=\"https:\/\/triumph-foundation.org\/donate\/\" target=\"_blank\" rel=\"noopener noreferrer\">Make a Gift<\/a><\/p>\n\n\t\t<\/div>\n\t<\/div>\n<\/div><\/div><\/div><\/div><section id=\"blue-section\" data-vc-full-width=\"true\" data-vc-full-width-temp=\"true\" data-vc-full-width-init=\"false\" class=\"vc_section\"><div class=\"vc_row wpb_row vc_row-fluid\"><div class=\"wpb_column vc_column_container vc_col-sm-12\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\">\n\t<div class=\"wpb_text_column wpb_content_element\" >\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t<div class=\"section-title-small\">Support Groups<div class=\"section-divider\"><\/div><\/div>\n<p>Triumph Foundation leads SCI Support Groups that address both practical and emotional needs of people dealing with paralysis. The purpose of our support groups is to enable the injured individual and their family members opportunities to receive candid advice and guidance from others who have faced similar circumstances.<\/p>\n<a class=\"btn-outline-white\" href=\"https:\/\/triumph-foundation.org\/outreach\/support-groups\">More Info<\/a>\n\n\t\t<\/div>\n\t<\/div>\n<\/div><\/div><\/div><\/div><\/section><div class=\"vc_row-full-width vc_clearfix\"><\/div><section class=\"vc_section vc_custom_1522281494653\"><div class=\"vc_row wpb_row vc_row-fluid\"><div class=\"wpb_column vc_column_container vc_col-sm-12 vc_col-lg-offset-1 vc_col-lg-10 vc_col-md-offset-0 vc_col-md-12 vc_col-xs-12\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\">\n\t<div class=\"wpb_text_column wpb_content_element\" >\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t<div class=\"section-title-large\">Need Support?<div class=\"section-subtitle\">Are you, or someone you know, injured?<\/div><div 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action='\/es\/wp-json\/wp\/v2\/pages\/7722#gf_2' data-formid='2' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_2_42\" class=\"gfield gfield--type-select gfield--input-type-select gform_show_label gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_42'>Form Preparer<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_42' id='input_2_42' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Form Preparer*<\/option><option value='I am injured' >I am injured<\/option><option value='I am a family member of the injured' >I am a family member of the injured<\/option><\/select><\/div><\/li><li id=\"field_2_48\" class=\"gfield gfield--type-select gfield--input-type-select field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_2_48'>Injured<\/label><div class='ginput_container ginput_container_select'><select name='input_48' id='input_2_48' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Injured*<\/option><option value='Yes' selected='selected'>Yes<\/option><\/select><\/div><\/li><li id=\"field_2_49\" class=\"gfield gfield--type-select gfield--input-type-select field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_2_49'>Family Member<\/label><div class='ginput_container ginput_container_select'><select name='input_49' id='input_2_49' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Family Member*<\/option><option value='Yes' selected='selected'>Yes<\/option><\/select><\/div><\/li><li id=\"field_2_21\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2>Form Preparer Information<\/h2><\/li><li id=\"field_2_43\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gform_show_label gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_43'>Your name and relationship<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_43' id='input_2_43' class='textarea medium'    placeholder='Your name and relationship*' aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_2_22\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 style=\"margin-top:20px; padding-top:40px; border-top:1px solid #f5f5f5;\">Injured Person Information<\/h2><\/li><li id=\"field_2_29\" class=\"gfield gfield--type-text gfield--input-type-text gf_left_half gform_show_label gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_29'>First Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_29' id='input_2_29' type='text' value='' class='large'    placeholder='First Name*' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_2_30\" class=\"gfield gfield--type-text gfield--input-type-text gf_right_half gform_show_label gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_30'>Last Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_30' id='input_2_30' type='text' value='' class='large'    placeholder='Last Name*' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_2_18\" class=\"gfield gfield--type-email gfield--input-type-email gf_left_half gform_show_label gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_18'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_18' id='input_2_18' type='email' value='' class='large'   placeholder='Email*' aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_2_4\" class=\"gfield gfield--type-text gfield--input-type-text gf_right_half gform_show_label gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_4'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_2_4' type='text' value='' class='large'    placeholder='Phone*' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_2_11\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style=\"width:100%; height:30px\" ><\/div><\/li><li id=\"field_2_5\" class=\"gfield gfield--type-text gfield--input-type-text gform_show_label field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_5'>Address<\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_2_5' type='text' value='' class='large'    placeholder='Address'  aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_2_31\" class=\"gfield gfield--type-text gfield--input-type-text gform_show_label field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_31'>Unit \/ Apt<\/label><div class='ginput_container ginput_container_text'><input name='input_31' id='input_2_31' type='text' value='' class='large'    placeholder='Unit \/ Apt'  aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_2_6\" class=\"gfield gfield--type-text gfield--input-type-text gf_left_third gform_show_label gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_6'>City<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_2_6' type='text' value='' class='large'    placeholder='City*' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_2_19\" class=\"gfield gfield--type-text gfield--input-type-text gf_middle_third gform_show_label gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_19'>State<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_2_19' type='text' value='' class='large'    placeholder='State*' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_2_7\" class=\"gfield gfield--type-text gfield--input-type-text gf_right_third gform_show_label gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_7'>Zip<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_7' id='input_2_7' type='text' value='' class='large'    placeholder='Zip*' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_2_12\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style=\"width:100%; height:30px\" ><\/div><\/li><li id=\"field_2_24\" class=\"gfield gfield--type-select gfield--input-type-select gform_show_label gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_24'>Gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_24' id='input_2_24' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Gender*<\/option><option value='Male' >Male<\/option><option value='Female' >Female<\/option><option value='I Choose Not To Disclose' >I Choose Not To Disclose<\/option><\/select><\/div><\/li><li id=\"field_2_25\" class=\"gfield gfield--type-select gfield--input-type-select gform_show_label gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_25'>Veteran<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_25' id='input_2_25' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Veteran*<\/option><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/li><li id=\"field_2_46\" class=\"gfield gfield--type-text gfield--input-type-text gform_show_label gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_46'>Hospital \/ Rehabilitation Center<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_46' id='input_2_46' type='text' value='' class='large'    placeholder='Hospital \/ Rehabilitation Center*' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_2_44\" class=\"gfield gfield--type-select gfield--input-type-select gform_show_label gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_44'>Injury Type<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_44' id='input_2_44' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Injury Type*<\/option><option value='Paraplegia' >Paraplegia<\/option><option value='Quadriplegia' >Quadriplegia<\/option><option value='Spinal Cord Injury' >Spinal Cord Injury<\/option><option value='Spinal Cord Disorder (TM\/GB\/Polio)' >Spinal Cord Disorder (TM\/GB\/Polio)<\/option><option value='Spina Bifida' >Spina Bifida<\/option><option value='Stroke' >Stroke<\/option><option value='Amputee' >Amputee<\/option><option value='Cerebral Palsy' >Cerebral Palsy<\/option><option value='Multiple Sclerosis' >Multiple Sclerosis<\/option><option value='Muscular Dystrophy' >Muscular Dystrophy<\/option><option value='TBI' >TBI<\/option><option value='Other' >Other<\/option><\/select><\/div><\/li><li id=\"field_2_45\" class=\"gfield gfield--type-text gfield--input-type-text gform_show_label field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_45'>Injury Description<\/label><div class='ginput_container ginput_container_text'><input name='input_45' id='input_2_45' type='text' value='' class='large'    placeholder='Injury Description'  aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_2_9\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datefield gform_show_label gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Date of Injury\/Diagnosis<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div id='input_2_9' class='ginput_container ginput_complex gform-grid-row'><div class=\"clear-multi\"><div class='gfield_date_month ginput_container ginput_container_date gform-grid-col' id='input_2_9_1_container'>\n                                            <input type='number' maxlength='2' name='input_9[]' id='input_2_9_1' value=''   aria-required='true'   placeholder='MM' min='1' max='12' step='1'\/>\n                                            <label for='input_2_9_1' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Month<\/label>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date gform-grid-col' id='input_2_9_2_container'>\n                                            <input type='number' maxlength='2' name='input_9[]' id='input_2_9_2' value=''   aria-required='true'   placeholder='DD' min='1' max='31' step='1'\/>\n                                            <label for='input_2_9_2' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Day<\/label>\n                                        <\/div><div class='gfield_date_year ginput_container ginput_container_date gform-grid-col' id='input_2_9_3_container'>\n                                            <input type='number' maxlength='4' name='input_9[]' id='input_2_9_3' value=''   aria-required='true'   placeholder='YYYY' min='1920' max='2027' step='1'\/>\n                                            <label for='input_2_9_3' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Year<\/label>\n                                       <\/div>\n                                   <\/div><\/div><\/li><li id=\"field_2_47\" class=\"gfield gfield--type-select gfield--input-type-select gform_show_label gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_47'>Cause of Injury<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_47' id='input_2_47' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Cause of Injury*<\/option><option value='Vehicular' >Vehicular<\/option><option value='Fall' >Fall<\/option><option value='Violence' >Violence<\/option><option value='Sports\/Recreation Activities' >Sports\/Recreation Activities<\/option><option value='Medical\/Surgical' >Medical\/Surgical<\/option><option value='Disease\/Disorder' >Disease\/Disorder<\/option><option value='Cancer' >Cancer<\/option><option value='Congenital' >Congenital<\/option><option value='Other' >Other<\/option><\/select><\/div><\/li><li id=\"field_2_13\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style=\"width:100%; height:30px\" ><\/div><\/li><li id=\"field_2_10\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gform_show_label gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Your Current Needs (check all that apply)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_2_10'><li class='gchoice gchoice_2_10_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.1' type='checkbox'  value='Information'  id='choice_2_10_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_10_1' id='label_2_10_1' class='gform-field-label gform-field-label--type-inline'>Information<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_10_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.2' type='checkbox'  value='Equipment\/Services'  id='choice_2_10_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_10_2' id='label_2_10_2' class='gform-field-label gform-field-label--type-inline'>Equipment\/Services<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_10_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.3' type='checkbox'  value='Encouragement'  id='choice_2_10_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_10_3' id='label_2_10_3' class='gform-field-label gform-field-label--type-inline'>Encouragement<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_10_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.4' type='checkbox'  value='Care Needs'  id='choice_2_10_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_10_4' id='label_2_10_4' class='gform-field-label gform-field-label--type-inline'>Care Needs<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_10_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.5' type='checkbox'  value='Transition Home'  id='choice_2_10_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_10_5' id='label_2_10_5' class='gform-field-label gform-field-label--type-inline'>Transition Home<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_10_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.6' type='checkbox'  value='Rehab'  id='choice_2_10_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_10_6' id='label_2_10_6' class='gform-field-label gform-field-label--type-inline'>Rehab<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_2_14\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style=\"width:100%; height:30px\" ><\/div><\/li><li id=\"field_2_15\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gform_show_label gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_15'>Tell Us About Your Situation<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_15' id='input_2_15' class='textarea medium'    placeholder='Tell Us About Your Situation*' aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_2_16\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gf_list_inline field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Newsletter Signup<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_2_16'><li class='gchoice gchoice_2_16_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.1' type='checkbox'  value='Sign me up! I want to join Triumph Foundation (you will receive a monthly newsletter and text messages with outreach updates, upcoming programs, volunteer opportunities and special event discounts)' checked='checked' id='choice_2_16_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_16_1' id='label_2_16_1' class='gform-field-label gform-field-label--type-inline'>Sign me up! I want to join Triumph Foundation (you will receive a monthly newsletter and text messages with outreach updates, upcoming programs, volunteer opportunities and special event discounts)<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_2_32\" class=\"gfield gfield--type-select gfield--input-type-select field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_32'>Hidden: Has a Disability?<\/label><div class='ginput_container ginput_container_select'><select name='input_32' id='input_2_32' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Hidden: Has a Disability?<\/option><option value='Yes' selected='selected'>Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/li><li id=\"field_2_36\" class=\"gfield gfield--type-select gfield--input-type-select field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_36'>Hidden: Tell us about your situation Note<\/label><div class='ginput_container ginput_container_select'><select name='input_36' id='input_2_36' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Hidden: Has a Disability?<\/option><option value='Tell us about your situation' selected='selected'>Tell us about your situation<\/option><\/select><\/div><\/li><li id=\"field_2_41\" class=\"gfield gfield--type-select gfield--input-type-select field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_41'>Hidden: Received support<\/label><div class='ginput_container ginput_container_select'><select name='input_41' id='input_2_41' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Hidden: Received support<\/option><option value='Email' selected='selected'>Email<\/option><\/select><\/div><\/li><li id=\"field_2_50\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_2_50'>Hidden: Form Date<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_50' id='input_2_50' type='text' value='05\/13\/2026' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_2_50_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_2_50_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_2_50' class='gform_hidden' value='https:\/\/triumph-foundation.org\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_2_17\" class=\"gfield gfield--type-text gfield--input-type-text bot-check field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_17'>Leave this field blank<\/label><div class='ginput_container ginput_container_text'><input name='input_17' id='input_2_17' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_2_51\" class=\"gfield gfield--type-turnstile gfield--input-type-turnstile gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_turnstile'><div class=\"cf-turnstile\" id=\"cf-turnstile_2\" data-js-turnstile data-response-field-name=\"cf-turnstile-response_2\" data-theme=\"auto\" data-size=\"\" data-sitekey=\"0x4AAAAAAAY83axIfvtpRenB\"><\/div><\/div><\/li><\/ul><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_2' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Submit'  \/> <input type='hidden' name='gform_ajax' value='form_id=2&amp;title=&amp;description=&amp;tabindex=0&amp;theme=legacy&amp;styles=[]&amp;hash=22ca2bfd9548cc863ae1d3e6a04028d1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_2' value='iframe' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_2' id='gform_theme_2' value='legacy' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_2' id='gform_style_settings_2' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_2' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='2' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='4V+qsXMmBF97039893\/+GwB51PO9eaw0pyy2gLFEx2DRdgOGQfNhpG9rKLn2tpDzd1UpMDjKA93aJg6fdygBKf\/plt8Pe0rOy89XyOWMQm40bDU=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_2' value='WyJbXSIsIjMyNjc1YmQxODE0ODlhNzM0YTIyMzA5ZGRlMmY1MDY2Il0=' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_2' id='gform_target_page_number_2' value='0' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_2' id='gform_source_page_number_2' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/form>\n                        <\/div>\n\t\t                <iframe style='display:none;width:0px;height:0px;' src='about:blank' name='gform_ajax_frame_2' id='gform_ajax_frame_2' title='This iframe contains the logic required to handle Ajax powered Gravity Forms.'><\/iframe>\n\t\t                <script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\n gform.initializeOnLoaded( function() {gformInitSpinner( 2, 'https:\/\/triumph-foundation.org\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery('#gform_ajax_frame_2').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_2');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_2').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){form_content.find('form').css('opacity', 0);jQuery('#gform_wrapper_2').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_2').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_2').removeClass('gform_validation_error');}setTimeout( function() { \/* delay the scroll by 50 milliseconds to fix a bug in chrome *\/ 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