<div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_27' >
                        <div class='gform_heading'>
                            <h3 class="gform_title"> (1)</h3>
                            <p class='gform_description'></p>
                        </div><form method='post' enctype='multipart/form-data'  id='gform_27'  action='/meeting-regform-2/' data-formid='27' novalidate>
                        <div class='gform-body gform_body'><ul id='gform_fields_27' class='gform_fields top_label form_sublabel_below description_below'><li id="field_27_26" class="gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"  data-js-reload="field_27_26" ><label class='gfield_label gform-field-label' for='input_27_26'>שם מלא<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_26' id='input_27_26' type='text' value='' class='medium'     aria-required="true" aria-invalid="false"   /> </div></li><li id="field_27_27" class="gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"  data-js-reload="field_27_27" ><label class='gfield_label gform-field-label' for='input_27_27'>טלפון נייד<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_27' id='input_27_27' type='text' value='' class='medium'     aria-required="true" aria-invalid="false"   /> </div></li><li id="field_27_17" class="gfield gfield--type-email gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"  data-js-reload="field_27_17" ><label class='gfield_label gform-field-label' for='input_27_17'>אימייל:<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_email'>
                            <input name='input_17' id='input_27_17' type='email' value='' class='medium'    aria-required="true" aria-invalid="false"  />
                        </div></li><li id="field_27_10" class="gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"  data-js-reload="field_27_10" ><label class='gfield_label gform-field-label' for='input_27_10'>מקום מגורים</label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_27_10' type='text' value='' class='medium'      aria-invalid="false"   /> </div></li><li id="field_27_21" class="gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"  data-js-reload="field_27_21" ><label class='gfield_label gform-field-label' for='input_27_21'>תחום עיסוק</label><div class='ginput_container ginput_container_text'><input name='input_21' id='input_27_21' type='text' value='' class='medium'      aria-invalid="false"   /> </div></li><li id="field_27_28" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"  data-js-reload="field_27_28" ><label class='gfield_label gform-field-label' for='input_27_28'>גיל</label><div class='ginput_container ginput_container_text'><input name='input_28' id='input_27_28' type='text' value='' class='medium'      aria-invalid="false"   /> </div></li><li id="field_27_4" class="gfield gfield--type-text gf_right_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"  data-js-reload="field_27_4" ><label class='gfield_label gform-field-label' for='input_27_4'>האם מדובר בפרידה או גירושים?</label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_27_4' type='text' value='' class='medium'      aria-invalid="false"   /> </div></li><li id="field_27_5" class="gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"  data-js-reload="field_27_5" ><label class='gfield_label gform-field-label' for='input_27_5'>מתי הייתה הפרידה הסופית?</label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_27_5' type='text' value='' class='medium'      aria-invalid="false"   /> </div></li><li id="field_27_23" class="gfield gfield--type-text gf_right_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"  data-js-reload="field_27_23" ><label class='gfield_label gform-field-label' for='input_27_23'>כמה זמן הייתם ביחד?</label><div class='ginput_container ginput_container_text'><input name='input_23' id='input_27_23' type='text' value='' class='medium'      aria-invalid="false"   /> </div></li><li id="field_27_22" class="gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"  data-js-reload="field_27_22" ><label class='gfield_label gform-field-label' for='input_27_22'>האם יש לכם ילדים משותפים?</label><div class='ginput_container ginput_container_text'><input name='input_22' id='input_27_22' type='text' value='' class='medium'      aria-invalid="false"   /> </div></li><li id="field_27_11" class="gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"  data-js-reload="field_27_11" ><label class='gfield_label gform-field-label' for='input_27_11'>מה בעצם קרה? כאן אפשר לכתוב חופשי מה חשוב לך שאדע</label><div class='ginput_container ginput_container_textarea'><textarea name='input_11' id='input_27_11' class='textarea medium'      aria-invalid="false"   rows='10' cols='50'></textarea></div></li><li id="field_27_12" class="gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"  data-js-reload="field_27_12" ><label class='gfield_label gform-field-label' for='input_27_12'>מה הסיבה שהחלטת להגיע לפגישה אישית? מה המטרה שלך? מה חשוב לך לשנות?</label><div class='ginput_container ginput_container_textarea'><textarea name='input_12' id='input_27_12' class='textarea medium'      aria-invalid="false"   rows='10' cols='50'></textarea></div></li><li id="field_27_25" class="gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"  data-js-reload="field_27_25" ><label class='gfield_label gform-field-label' for='input_27_25'>האם עד היום הלכת לטיפול או ייעוץ כדי להתגבר על הפרידה? אם כן, איזה טיפול ומה לא עובד עבורך בטיפול וחשוב לך כן להצליח לפתור</label><div class='ginput_container ginput_container_textarea'><textarea name='input_25' id='input_27_25' class='textarea medium'      aria-invalid="false"   rows='10' cols='50'></textarea></div></li><li id="field_27_24" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"  data-js-reload="field_27_24" ><label class='gfield_label gform-field-label' for='input_27_24'>מה הדבר האחד המשמעותי ביותר שאם יקרה אז מבחינתך הבחירה להגיע לפגישה אישית או לסדרת פגישות היה שווה את זה?</label><div class='ginput_container ginput_container_text'><input name='input_24' id='input_27_24' type='text' value='' class='medium'      aria-invalid="false"   /> </div></li></ul></div>
        <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_27' class='gform_button button' value='שליחת הטופס'  onclick='if(window["gf_submitting_27"]){return false;}  if( !jQuery("#gform_27")[0].checkValidity || jQuery("#gform_27")[0].checkValidity()){window["gf_submitting_27"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window["gf_submitting_27"]){return false;} if( !jQuery("#gform_27")[0].checkValidity || jQuery("#gform_27")[0].checkValidity()){window["gf_submitting_27"]=true;}  jQuery("#gform_27").trigger("submit",[true]); }' /> 
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            <input type='hidden' class='gform_hidden' name='gform_target_page_number_27' id='gform_target_page_number_27' value='0' />
            <input type='hidden' class='gform_hidden' name='gform_source_page_number_27' id='gform_source_page_number_27' value='1' />
            <input type='hidden' name='gform_field_values' value='' />
            
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                        </form>
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