{"id":8,"date":"2022-07-18T13:01:05","date_gmt":"2022-07-18T10:01:05","guid":{"rendered":"https:\/\/form.caritas.ge\/?page_id=8"},"modified":"2022-07-18T13:49:15","modified_gmt":"2022-07-18T10:49:15","slug":"form-1","status":"publish","type":"page","link":"https:\/\/form.caritas.ge\/en\/","title":{"rendered":"Suspected abuse or exploitation of a child or vulnerable young person"},"content":{"rendered":"<div class=\"wp-block-contact-form-7-contact-form-selector\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f14-o1\" lang=\"ru-RU\" dir=\"ltr\" data-wpcf7-id=\"14\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/en\/wp-json\/wp\/v2\/pages\/8#wpcf7-f14-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"\u041a\u043e\u043d\u0442\u0430\u043a\u0442\u043d\u0430\u044f \u0444\u043e\u0440\u043c\u0430\" novalidate=\"novalidate\" data-status=\"init\" data-trp-original-action=\"\/en\/wp-json\/wp\/v2\/pages\/8#wpcf7-f14-o1\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"14\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.0.6\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"ru_RU\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f14-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/div>\n<div data-scrolltopdesktops=\"0\" data-scrolltopmobiles=\"0\" class=\"argmcf-wrapper wrapper-no-bkg tabs-default\"><ul class=\"argmcf-tabs-list tabs-equal-width four-tabs\"><li class=\"argmcf-tab-item current visited last\">\r\n\r\n\t\t\t\t<div class=\"argmcf-tab-item-outer\">\r\n\t\t\t\t\t<div class=\"argmcf-tab-item-inner\">\r\n\t\t\t\t\t\t<div class=\"argmcf-tab-number-wrapper\">\r\n\t\t\t\t\t\t\t<div class=\"argmcf-tab-number\">\r\n\t\t\t\t\t\t\t\t<span class=\"number-text\">1<span>.<\/span><\/span>\r\n\t\t\t\t\t\t\t\t<span class=\"tab-completed-icon\"><\/span>\r\n\t\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<div class=\"argmcf-tab-text\"><span>The Author<\/span><\/div>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t<\/div>\r\n\r\n\t\t\t<\/li><li class=\"argmcf-tab-item\">\r\n\r\n\t\t\t\t<div class=\"argmcf-tab-item-outer\">\r\n\t\t\t\t\t<div class=\"argmcf-tab-item-inner\">\r\n\t\t\t\t\t\t<div class=\"argmcf-tab-number-wrapper\">\r\n\t\t\t\t\t\t\t<div class=\"argmcf-tab-number\">\r\n\t\t\t\t\t\t\t\t<span class=\"number-text\">2<span>.<\/span><\/span>\r\n\t\t\t\t\t\t\t\t<span class=\"tab-completed-icon\"><\/span>\r\n\t\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<div class=\"argmcf-tab-text\"><span>Injured<\/span><\/div>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t<\/div>\r\n\r\n\t\t\t<\/li><li class=\"argmcf-tab-item\">\r\n\r\n\t\t\t\t<div class=\"argmcf-tab-item-outer\">\r\n\t\t\t\t\t<div class=\"argmcf-tab-item-inner\">\r\n\t\t\t\t\t\t<div class=\"argmcf-tab-number-wrapper\">\r\n\t\t\t\t\t\t\t<div class=\"argmcf-tab-number\">\r\n\t\t\t\t\t\t\t\t<span class=\"number-text\">3<span>.<\/span><\/span>\r\n\t\t\t\t\t\t\t\t<span class=\"tab-completed-icon\"><\/span>\r\n\t\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<div class=\"argmcf-tab-text\"><span>Educator \/ Guardian \/ Relative<\/span><\/div>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t<\/div>\r\n\r\n\t\t\t<\/li><li class=\"argmcf-tab-item\">\r\n\r\n\t\t\t\t<div class=\"argmcf-tab-item-outer\">\r\n\t\t\t\t\t<div class=\"argmcf-tab-item-inner\">\r\n\t\t\t\t\t\t<div class=\"argmcf-tab-number-wrapper\">\r\n\t\t\t\t\t\t\t<div class=\"argmcf-tab-number\">\r\n\t\t\t\t\t\t\t\t<span class=\"number-text\">4<span>.<\/span><\/span>\r\n\t\t\t\t\t\t\t\t<span class=\"tab-completed-icon\"><\/span>\r\n\t\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t\t<div class=\"argmcf-tab-text\"><span>Details of the incident<\/span><\/div>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t<\/div>\r\n\r\n\t\t\t<\/li><\/ul><!--argmcf-tabs-list--><div class=\"argmcf-form-steps-wrapper\"><div class=\"argmcf-form-steps argmcf-form-step-1 first current\"><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\r\n\r\n<label>Does the Reporter wish to be identified?<\/label> <span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-856\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-856\" value=\"\u10d3\u10d8\u10d0\u10ee\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-856\" value=\"\u10d0\u10e0\u10d0\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\r\n<br><br>\r\n<label><b>In case of a positive answer, the name and contact information of the author:<\/b> <\/label>\r\n\r\n<label>Name <span class=\"wpcf7-form-control-wrap\" data-name=\"text-153\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-153\" \/><\/span> <\/label>\r\n\r\n<label>last name: <span class=\"wpcf7-form-control-wrap\" data-name=\"text-154\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-154\" \/><\/span> <\/label>\r\n\r\n<label>Tel. Number (optional): <span class=\"wpcf7-form-control-wrap\" data-name=\"text-156\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-156\" \/><\/span> <\/label>\r\n\r\n<label>(alternative): <span class=\"wpcf7-form-control-wrap\" data-name=\"text-157\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-157\" \/><\/span> <\/label>\r\n\r\n<label>E-mail: <span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span> <\/label>\r\n\r\n<label>Name of the organization: <span class=\"wpcf7-form-control-wrap\" data-name=\"text-158\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-158\" \/><\/span> <\/label> \r\n\r\n<label>Position: <span class=\"wpcf7-form-control-wrap\" data-name=\"text-159\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-159\" \/><\/span> <\/label><\/div><div class=\"argmcf-form-steps argmcf-form-step-2\"><label>Is the victim a child or an adult?<\/label> <span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-857\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-857\" value=\"\u10d1\u10d0\u10d5\u10e8\u10d5\u10d8\" \/><span class=\"wpcf7-list-item-label\">Child<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-857\" value=\"\u10d6\u10e0\u10d3\u10d0\u10e1\u10e0\u10e3\u10da\u10d8\" \/><span class=\"wpcf7-list-item-label\">Adult<\/span><\/label><\/span><\/span><\/span>\r\n<br><br>\r\n<label><b>Name of the victim:<\/b> <\/label>\r\n\r\n<label>Name <span class=\"wpcf7-form-control-wrap\" data-name=\"text-160\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-160\" \/><\/span> <\/label>\r\n\r\n<label>last name: <span class=\"wpcf7-form-control-wrap\" data-name=\"text-161\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-161\" \/><\/span> <\/label>\r\n\r\n<label>Nickname: <span class=\"wpcf7-form-control-wrap\" data-name=\"text-162\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-162\" \/><\/span> <\/label>\r\n\r\n<label>Unknown<\/label> <span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-858\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"checkbox-858\" value=\"\" \/><span class=\"wpcf7-list-item-label\"><\/span><\/label><\/span><\/span><\/span>\r\n\r\n<label>(If you do not know the victim's name, mark unknown.) <\/label>\r\n\r\n<label>Estimated age: <span class=\"wpcf7-form-control-wrap\" data-name=\"text-163\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-163\" \/><\/span> <\/label>\r\n\r\n<label>Gender: <span class=\"wpcf7-form-control-wrap\" data-name=\"text-164\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-164\" \/><\/span> <\/label>\r\n\r\n<label><b>A child is a person under 18 years of age<\/b> <\/label>\r\n<br><br>\r\n<label>Provide us with any additional information: <span class=\"wpcf7-form-control-wrap\" data-name=\"text-165\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-165\" \/><\/span> <\/label> \r\n<\/div><div class=\"argmcf-form-steps argmcf-form-step-3\"><label><b>Identity:<\/b> <\/label>\r\n\r\n<label>Name <span class=\"wpcf7-form-control-wrap\" data-name=\"text-166\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-166\" \/><\/span> <\/label>\r\n\r\n<label>last name: <span class=\"wpcf7-form-control-wrap\" data-name=\"text-167\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-167\" \/><\/span> <\/label>\r\n\r\n<label>Unknown<\/label> <span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-860\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"checkbox-860\" value=\"\" \/><span class=\"wpcf7-list-item-label\"><\/span><\/label><\/span><\/span><\/span>\r\n\r\n<label>(If you do not know the name of the educator \/ guardian \/ relative, mark unknown.) <\/label>\r\n<br><br>\r\n<label>Actual address: <span class=\"wpcf7-form-control-wrap\" data-name=\"text-169\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-169\" \/><\/span> <\/label>\r\n\r\n<label>(example includes: village name, street name, city, house, building) <\/label>\r\n<br><br>\r\n<label>Tel. Number (optional): <span class=\"wpcf7-form-control-wrap\" data-name=\"text-170\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-170\" \/><\/span> <\/label>\r\n\r\n<label>(alternative): <span class=\"wpcf7-form-control-wrap\" data-name=\"text-171\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-171\" \/><\/span> <\/label>\r\n\r\n<label>E-mail: <span class=\"wpcf7-form-control-wrap\" data-name=\"text-202\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-202\" \/><\/span> <\/label>\r\n\r\n<label>Estimated age: <span class=\"wpcf7-form-control-wrap\" data-name=\"text-172\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-172\" \/><\/span> <\/label>\r\n\r\n<label>Gender: <span class=\"wpcf7-form-control-wrap\" data-name=\"text-173\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-173\" \/><\/span> <\/label>\r\n<\/div><div class=\"argmcf-form-steps argmcf-form-step-4\"><label><b>Incident Type (check all):<b> <\/label>\r\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-996\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-996[]\" value=\"\u10e1\u10d4\u10e5\u10e1\u10e3\u10d0\u10da\u10e3\u10e0\u10d8 \u10eb\u10d0\u10da\u10d0\u10d3\u10dd\u10d1\u10d0 (\u10db\u10d0\u10d2\u10d0\u10da\u10d8\u10d7\u10d0\u10d3, \u10db\u10dd\u10e4\u10d4\u10e0\u10d4\u10d1\u10d0, \u10d9\u10dd\u10ea\u10dc\u10d0, \u10d0\u10e0\u10d0\u10d9\u10dd\u10dc\u10e2\u10d0\u10e5\u10e2\u10e3\u10e0\u10d8 \u10e1\u10d4\u10e5\u10e1\u10e3\u10d0\u10da\u10e3\u10e0\u10d8 \u10d0\u10e5\u10e2\u10d8\u10d5\u10dd\u10d1\u10d0, \u10d2\u10d0\u10e3\u10de\u10d0\u10e2\u10d8\u10e3\u10e0\u10d4\u10d1\u10d0)\" \/><span class=\"wpcf7-list-item-label\">Sexual abuse (eg fondling, kissing, non-contact sexual activity, rape)<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"checkbox-996[]\" value=\"\u10d4\u10e5\u10e1\u10de\u10da\u10e3\u10d0\u10e2\u10d0\u10ea\u10d8\u10d0 (\u10db\u10d0\u10d2\u10d0\u10da\u10d8\u10d7\u10d0\u10d3, \u10e1\u10d4\u10e5\u10e1\u10e3\u10d0\u10da\u10e3\u10e0\u10d8 \u10e2\u10e0\u10d4\u10e4\u10d8\u10d9\u10d8\u10dc\u10d2\u10d8, \u10d8\u10eb\u10e3\u10da\u10d4\u10d1\u10d8\u10d7\u10d8 \u10de\u10e0\u10dd\u10e1\u10e2\u10d8\u10e2\u10e3\u10ea\u10d8\u10d0, \u10e1\u10d4\u10e5\u10e1\u10d8 \u10d0\u10e0\u10e1\u10d4\u10d1\u10dd\u10d1\u10d8\u10e1\u10d7\u10d5\u10d8\u10e1, \u10d1\u10d0\u10d5\u10e8\u10d5\u10d7\u10d0 \u10e8\u10e0\u10dd\u10db\u10d0)\" \/><span class=\"wpcf7-list-item-label\">Exploitation (eg sex trafficking, forced prostitution, sex for subsistence, child labour)<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"checkbox-996[]\" value=\"\u10d4\u10db\u10dd\u10ea\u10d8\u10e3\u10e0\u10d8 \u10eb\u10d0\u10da\u10d0\u10d3\u10dd\u10d1\u10d0 (\u10db\u10d0\u10d2\u10d0\u10da\u10d8\u10d7\u10d0\u10d3, \u10d3\u10d0\u10e8\u10d8\u10dc\u10d4\u10d1\u10d0, \u10db\u10e3\u10e5\u10d0\u10e0\u10d0, \u10d3\u10d0\u10db\u10ea\u10d8\u10e0\u10d4\u10d1\u10d0, \u10d1\u10e3\u10da\u10d8\u10dc\u10d2\u10d8)\" \/><span class=\"wpcf7-list-item-label\">Emotional abuse (eg bullying, threats, humiliation, bullying)<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"checkbox-996[]\" value=\"\u10e4\u10d8\u10d6\u10d8\u10d9\u10e3\u10e0\u10d8 \u10eb\u10d0\u10da\u10d0\u10d3\u10dd\u10d1\u10d0 (\u10db\u10d0\u10d2. \u10d3\u10d0\u10e0\u10e2\u10e7\u10db\u10d0, \u10ec\u10d8\u10ee\u10da\u10d8\u10d7 \u10ea\u10d4\u10db\u10d0, \u10e8\u10d4\u10dc\u10ef\u10e6\u10e0\u10d4\u10d5\u10d0)\" \/><span class=\"wpcf7-list-item-label\">Physical abuse (eg hitting, kicking, shaking)<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-996[]\" value=\"\u10e1\u10ee\u10d5\u10d0 (\u10db\u10d8\u10e3\u10d7\u10d8\u10d7\u10d4\u10d7 \u10e1\u10ee\u10d5\u10d0)\" \/><span class=\"wpcf7-list-item-label\">Other (specify other)<\/span><\/label><\/span><\/span><\/span>\r\n<br><br>\r\n<label>Location (examples include: village name, street name, city, house, building) <\/label>\r\n\r\n<label>Address \/ physical location of the incident: <span class=\"wpcf7-form-control-wrap\" data-name=\"text-181\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-181\" \/><\/span> <\/label>\r\n\r\n<label>Estimated date of incident: <span class=\"wpcf7-form-control-wrap\" data-name=\"date-7\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"date-7\" \/><\/span> <\/label>\r\n\r\n<label>Notification date: <span class=\"wpcf7-form-control-wrap\" data-name=\"date-8\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"date-8\" \/><\/span> <\/label>\r\n<br>\r\n<label><b>Physical and emotional condition of the victim (check all)<\/b> <\/label>\r\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-917\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-917[]\" value=\"\u10ed\u10e0\u10d8\u10da\u10dd\u10d1\u10d4\u10d1\u10d8, \u10e1\u10d8\u10e1\u10ee\u10da\u10e9\u10d0\u10e5\u10ea\u10d4\u10d5\u10d4\u10d1\u10d8, \u10d8\u10d0\u10e0\u10d0, \u10dc\u10d0\u10d9\u10d0\u10ec\u10e0\u10d4\u10d1\u10d8\" \/><span class=\"wpcf7-list-item-label\">Cuts, bruises, bruises, scratches<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"checkbox-917[]\" value=\"\u10e5\u10ea\u10d4\u10d5\u10d8\u10d7\u10d8 \u10ea\u10d5\u10da\u10d8\u10da\u10d4\u10d1\u10d4\u10d1\u10d8 (\u10db\u10d0\u10d2\u10d0\u10da\u10d8\u10d7\u10d0\u10d3, \u10e1\u10d8\u10d1\u10e0\u10d0\u10d6\u10d4, \u10e2\u10d8\u10e0\u10d8\u10da\u10d8, \u10d4\u10db\u10dd\u10ea\u10d8\u10d8\u10e1 \u10d2\u10d0\u10db\u10dd\u10ee\u10d0\u10e2\u10d5\u10d0, \u10d2\u10e3\u10da\u10e9\u10d0\u10d7\u10ee\u10e0\u10dd\u10d1\u10d0, \u10e3\u10d4\u10ea\u10d0\u10e0\u10d8 \u10d0\u10d5\u10d0\u10d3\u10db\u10e7\u10dd\u10e4\u10dd\u10d1\u10d0)\" \/><span class=\"wpcf7-list-item-label\">Behavioral changes (eg, anger, crying, emotional outbursts, depression, sudden illness)<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-917[]\" value=\"\u10e1\u10ee\u10d5\u10d0\" \/><span class=\"wpcf7-list-item-label\">Other<\/span><\/label><\/span><\/span><\/span>\r\n<br><br>\r\n<label>Please describe the physical and emotional state of the victim: <span class=\"wpcf7-form-control-wrap\" data-name=\"text-182\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-182\" \/><\/span> <\/label> \r\n\r\n\r\n<label><b>Identity:<\/b> <\/label>\r\n\r\n<label>Name <span class=\"wpcf7-form-control-wrap\" data-name=\"text-183\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-183\" \/><\/span> <\/label>\r\n\r\n<label>last name: <span class=\"wpcf7-form-control-wrap\" data-name=\"text-184\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-184\" \/><\/span> <\/label>\r\n\r\n<label>Unknown<\/label> <span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-260\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"checkbox-260\" value=\"\" \/><span class=\"wpcf7-list-item-label\"><\/span><\/label><\/span><\/span><\/span>\r\n\r\n<label>(If you cannot name the suspect, mark unknown.) <\/label>\r\n<br><br>\r\n<label>E-mail: <span class=\"wpcf7-form-control-wrap\" data-name=\"text-203\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-203\" \/><\/span> <\/label>\r\n\r\n<label>Estimated age: <span class=\"wpcf7-form-control-wrap\" data-name=\"text-189\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-189\" \/><\/span> <\/label>\r\n\r\n<label>Gender: <span class=\"wpcf7-form-control-wrap\" data-name=\"text-190\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-190\" \/><\/span> <\/label>\r\n\r\n<label>Actual address of the suspect: <span class=\"wpcf7-form-control-wrap\" data-name=\"text-185\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-185\" \/><\/span> <\/label>\r\n\r\n<label>(example includes: village name, street name, city, house, building) <\/label>\r\n<br><br>\r\n<label>Name of the organization: <span class=\"wpcf7-form-control-wrap\" data-name=\"text-186\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-186\" \/><\/span> <\/label>\r\n\r\n<label>Position: <span class=\"wpcf7-form-control-wrap\" data-name=\"text-187\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-187\" \/><\/span> <\/label>\r\n\r\n<input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send\" \/> <\/div><\/div><!--argmcf-form-steps-wrapper--><div class=\"argmcf-nav\">\r\n\t\t\t\t<div class=\"argmcf-nav-text\"><\/div>\r\n\t\t\t\t<div class=\"argmcf-nav-buttons\">\r\n\t\t\t\t\t<button class=\"button argmcf-previous hide-button\" type=\"button\"><span>Previous<\/span><\/button>\r\n\t\t\t\t\t<button class=\"button argmcf-next show-button\" type=\"button\"><span>Next<\/span><\/button>\r\n\t\t\t\t\t<button class=\"button argmcf-submit hide-button\" type=\"submit\"><span>Send<\/span><\/button>\r\n\t\t\t\t<\/div>\r\n\t\t\t<\/div><!--argmcf-nav-->\r\n\t\t\t<span class=\"tab-completed-icon preload-icon\"><\/span>\r\n\t\t<\/div><!--argmcf-wrapper--> \n<input type=\"hidden\" name=\"trp-form-language\" value=\"en\"\/><\/form>\n<\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-8","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/form.caritas.ge\/en\/wp-json\/wp\/v2\/pages\/8","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/form.caritas.ge\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/form.caritas.ge\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/form.caritas.ge\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/form.caritas.ge\/en\/wp-json\/wp\/v2\/comments?post=8"}],"version-history":[{"count":4,"href":"https:\/\/form.caritas.ge\/en\/wp-json\/wp\/v2\/pages\/8\/revisions"}],"predecessor-version":[{"id":17,"href":"https:\/\/form.caritas.ge\/en\/wp-json\/wp\/v2\/pages\/8\/revisions\/17"}],"wp:attachment":[{"href":"https:\/\/form.caritas.ge\/en\/wp-json\/wp\/v2\/media?parent=8"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}