YesNo
    YesNo
    Full-timePart-time




    YesNo


    YesNo
    YesNo


    [checkbox checkbox-copypetrecords? "Yes" "No"]
    [text text-exp?]
    [text text-allergy?]

    YesNo
    [checkbox checkbox-grad? "Yes" "No"]
    [text text-student?]
    [text text-plancollege?]