<div class="radio-group ">
<div class="radio-block margin-bottom">
<input type="radio" name="contacts" value="contacts-family" id="contacts-family" aria-describedby="ariaDescribedby">
<label class="radio-block_label" for="contacts-family">
Family member
</label>
</div>
<div class="radio-block margin-bottom">
<input type="radio" name="contacts" value="contacts-friend" id="contacts-friend" aria-describedby="ariaDescribedby">
<label class="radio-block_label" for="contacts-friend">
Friend
</label>
</div>
<div class="radio-block margin-bottom">
<input type="radio" name="contacts" value="contacts-social" id="contacts-social" aria-describedby="ariaDescribedby">
<label class="radio-block_label" for="contacts-social">
Social worker or housing counselor
</label>
</div>
<div class="radio-block margin-bottom">
<input type="radio" name="contacts" value="contacts-not" id="contacts-not" aria-describedby="ariaDescribedby">
<label class="radio-block_label" for="contacts-not">
I don’t have an alternate contact
</label>
</div>
</div>
<div class="radio-group {{ default classes "" }}">
{{#each inputs.contacts}}
<div class="radio-block margin-bottom">
<input type="radio" name="contacts" value="contacts-{{value}}" id="contacts-{{value}}" aria-describedby="ariaDescribedby">
<label class="radio-block_label" for="contacts-{{value}}">
{{name}}
</label>
</div>
{{/each}}
</div>
{
"inputs": {
"homeless": [
{
"name": "I’m renting a room, apartment, or house.",
"note": "This includes living in a supportive housing unit or SRO that you pay for.",
"value": "rent"
},
{
"name": "I live in an apartment or house that I own or a member of my household owns.",
"value": "own"
},
{
"name": "I have somewhere to stay but it isn’t permanent.",
"note": "This includes couchsurfing, or living in a motel/hotel that you pay for. It also includes people who have recieved an eviction notice, are living in a medical facility, a substance use treatment facility, or a jail.",
"value": "temporary"
},
{
"name": "I’m homeless.",
"note": "This includes living outside, living in your car, staying in a shelter or motel/hotel that is paid for by an emergency voucher.",
"value": "homeless"
}
],
"contacts": [
{
"name": "Family member",
"value": "family"
},
{
"name": "Friend",
"value": "friend"
},
{
"name": "Social worker or housing counselor",
"value": "social"
},
{
"name": "I don’t have an alternate contact",
"value": "not"
}
],
"income": [
{
"name": "per month",
"value": "month"
},
{
"name": "per year",
"value": "year"
}
],
"yesno": [
{
"name": "Yes",
"value": "yes"
},
{
"name": "No",
"value": "no"
}
]
}
}
There are no notes for this item.