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class="wpb_wrapper"> <div class='gf_browser_chrome gform_wrapper gravity-theme gform-theme--no-framework qforms2_wrapper' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_199' style='display:none;'><form method='post' enctype='multipart/form-data' target='gform_ajax_frame_199' id='gform_199' class='qforms2' action='/team/q-directory/' data-formid='199' novalidate> <div class='gform-body gform_body'><div id='gform_fields_199' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id="field_199_6" class="gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_199_6"> <template data-nitro-marker-id="36267e9032fc6957ee04ffaaccbf8e28-1"></template> <template data-nitro-marker-id="5aadc9c24d3730d1a6fbe1b05693900e-1"></template></div><div id="field_199_1" class="gfield gfield--type-select gfield--input-type-select gfield--width-full acfw-agent gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_199_1"><label class='gfield_label gform-field-label' for='input_199_1'>Agent<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='gfield_description' id='gfield_description_199_1'>Please select your name from the list below. If you don't see your name, contact tech support prior to proceeding.</div><div class='ginput_container ginput_container_select'><select name='input_1' id='input_199_1' class='large gfield_select' aria-describedby="gfield_description_199_1" aria-required="true" aria-invalid="false"><option value='' selected='selected' class='gf_placeholder'>-- SELECT YOUR NAME --</option><option value='Addia Troyer'>Addia Troyer</option><option value='Alana Corcoran'>Alana Corcoran</option><option value='Brittany Philyaw'>Brittany Philyaw</option><option value='Catherine Smith'>Catherine Smith</option><option value='Charlie Arthur'>Charlie Arthur</option><option value='Christopher Dawson'>Christopher Dawson</option><option value='Claudia Tolson'>Claudia Tolson</option><option value='Debby Dawson'>Debby Dawson</option><option value='Echo Zen'>Echo Zen</option><option value='Elizabeth Espinal'>Elizabeth Espinal</option><option value='Emily Watson'>Emily Watson</option><option value='Geena Dacy'>Geena Dacy</option><option value='Hannah Busch'>Hannah Busch</option><option value='Isabel Salazar'>Isabel Salazar</option><option value='Jared Ray'>Jared Ray</option><option value='Jill Hightower'>Jill Hightower</option><option value='Jo Bains'>Jo Bains</option><option value='Jordan Lee Knape'>Jordan Lee Knape</option><option value='Jules Hall'>Jules Hall</option><option value='Karen Kane'>Karen Kane</option><option value='Kevin DeBacker'>Kevin DeBacker</option><option value='Kris Medina'>Kris Medina</option><option value='Kristi Patron'>Kristi Patron</option><option value='Lana Horning'>Lana Horning</option><option value='LaToya Greene'>LaToya Greene</option><option value='Lauren Bristow'>Lauren Bristow</option><option value='Lorraine Singh'>Lorraine Singh</option><option value='Maggie Dransfield'>Maggie Dransfield</option><option value='Marla Cook'>Marla Cook</option><option value='Mattison May'>Mattison May</option><option value='Michelle Turner'>Michelle Turner</option><option value='Rebecca Stewart'>Rebecca Stewart</option><option value='Rosalynn Karstens'>Rosalynn Karstens</option><option value='Starla Mulder'>Starla Mulder</option><option value='Tamisha Jones'>Tamisha Jones</option><option value='Tori Troyer'>Tori Troyer</option><option value='Vanessa Johnson'>Vanessa Johnson</option></select></div></div><div id="field_199_2" class="gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_199_2"><label class='gfield_label gform-field-label' for='input_199_2'>Case Type or Campaign<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='gfield_description' id='gfield_description_199_2'>Please select from the list below. If you don't see the case type or campaign you need, contact tech support prior to proceeding. </div><div class='ginput_container ginput_container_select'><select name='input_2' id='input_199_2' class='large gfield_select' aria-describedby="gfield_description_199_2" aria-required="true" aria-invalid="false"><option value='' selected='selected' class='gf_placeholder'>-- SELECT --</option><option value='https://www.acaseforwomen.com/q/sexual-abuse-questions/team/'>Abuse of Power</option><option value='https://www.acaseforjustice.com/q/afff-questions/team/'>AFFF [Firefighting Foam]</option><option value='https://www.acaseforwomen.com/q/baby-food-questions/team/'>Baby Food</option><option value='https://www.acaseforwomen.com/q/baby-food-questions/add/'>Baby Food Phase 2</option><option value='https://www.acaseforjustice.com/q/camp-lejeune-questions/team/'>Camp Lejeune</option><option value='https://www.acaseforwomen.com/q/depo-provera-questions/team/'>Depo-Provera</option><option value='https://www.acaseforwomen.com/q/dexcom-questions/team/'>Dexcom</option><option value='https://www.acaseforwomen.com/q/dr-broadbent-assault-questions/team/'>Dr Broadbent Assault</option><option value='https://www.acaseforwomen.com/dr-barry-brock-sexual-assault-lawsuit/'>Dr Brock Assault</option><option value='https://www.acaseforwomen.com/q/dr-kumar-assault-questions/team/'>Dr Kumar Assault</option><option value='https://www.acaseforwomen.com/q/dr-lee-assault-questions/team/'>Dr Lee Assault</option><option value='https://www.acaseforwomen.com/q/dr-ortega-abuse-questions/team/'>Dr Ortega Abuse</option><option value='https://www.acaseforwomen.com/q/elmiron-questions/'>Elmiron</option><option value='https://www.acaseforwomen.com/q/essure-questions/'>Essure</option><option value='https://www.acaseforwomen.com/q/general-questions/team/'>Evergreen</option><option value='https://www.acaseforwomen.com/q/hair-relaxer-questions/team/'>Hair Relaxer</option><option value='https://www.acaseforjustice.com/q/huck-abuse-questions/team/'>Huck Abuse</option><option value='https://www.acaseforjustice.com/q/illinois-clergy-abuse-questions/team/'>Illinois Clergy Abuse</option><option value='https://www.acaseforjustice.com/q/juvenile-detention-center-questions/team/'>Juvenile Detention Center</option><option value='https://www.acaseforwomen.com/q/latter-day-saints-questions/team/'>Latter-day Saints</option><option value='https://www.acaseforjustice.com/q/maryland-church-abuse-questions/team/'>Maryland Church Abuse</option><option value='https://www.acaseforjustice.com/q/maui-fire-questions/team/'>Maui Fire</option><option value='https://www.acaseforwomen.com/q/nec-questions/team/'>NEC (Baby Formula)</option><option value='https://www.acaseforjustice.com/q/ohio-train-derailment-questions/team/'>Ohio Train Derailment</option><option value='https://www.acaseforwomen.com/q/ozempic-questions/team/'>Ozempic</option><option value='https://www.acaseforjustice.com/q/paraquat-questions/team/'>Paraquat</option><option value='https://www.acaseforjustice.com/q/paraquat-questions/add/'>Paraquat Phase 2</option><option value='https://www.acaseforwomen.com/q/rideshare-questions/team/'>Rideshare [Uber/Lyft]</option><option value='https://www.acaseforjustice.com/q/roblox-questions/team/'>Roblox Sextortion</option><option value='https://www.acaseforjustice.com/q/roundup-questions/team/'>Roundup</option><option value='https://www.acaseforwomen.com/q/sexual-abuse-questions/team/'>Sexual Abuse</option><option value='https://www.acaseforjustice.com/q/stiiizy-questions/team/'>STIIIZY</option><option value='https://www.acaseforwomen.com/q/talc-questions/team/'>Talcum Powder</option><option value='https://www.acaseforwomen.com/q/trafficking-questions/team/'>Trafficking</option><option value='https://www.acaseforwomen.com/q/troubled-teen-industry-questions/team/'>Troubled Teen Industry</option><option value='https://www.acaseforwomen.com/q/uv-gel-nail-questions/team/'>UV Gel Nail Cancer</option><option value='https://www.acaseforwomen.com/q/ymca-abuse-questions/team/'>YMCA Abuse</option><option value='https://www.acaseforjustice.com/q/yrtc-assault-questions/team/'>YRTC Assault</option></select></div></div><fieldset id="field_199_4" class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full new-existing gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_199_4"><legend class='gfield_label gform-field-label'>Which of the following apply?<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_199_4'> <div class='gchoice gchoice_199_4_0'> <input class='gfield-choice-input' name='input_4' type='radio' value='new' id='choice_199_4_0' onchange='gformToggleRadioOther( this )' /> <label for='choice_199_4_0' id='label_199_4_0' class='gform-field-label gform-field-label--type-inline'>NEW - I want to create a new deal in PipeDrive</label> </div> <div class='gchoice gchoice_199_4_1'> <input class='gfield-choice-input' name='input_4' type='radio' value='existing' id='choice_199_4_1' onchange='gformToggleRadioOther( this )' /> <label for='choice_199_4_1' id='label_199_4_1' class='gform-field-label gform-field-label--type-inline'>EXISTING - I am working on an existing deal in PipeDrive</label> </div></div></div></fieldset><div id="field_199_9" class="gfield gfield--type-text gfield--input-type-text gfield--width-full deal_id_input gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_199_9"><label class='gfield_label gform-field-label' for='input_199_9'>What is the existing Deal ID from PipeDrive?<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_199_9' type='text' value='' maxlength='6' aria-required="true" aria-invalid="false" class="large nitro-lazy" /></div></div><div id="field_199_7" class="gfield gfield--type-text gfield--input-type-text gfield--width-full deal_id_title field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_199_7"><label class='gfield_label gform-field-label' for='input_199_7'>Title from the Deal ID you entered.</label><div class='gfield_description' id='gfield_description_199_7'>If this is not the correct deal, please re-enter the correct Deal ID above.</div><div class='ginput_container ginput_container_text'><input readonly='readonly' name='input_7' id='input_199_7' type='text' value='' class='large' aria-describedby="gfield_description_199_7" aria-invalid="false" /></div></div><div id="field_199_11" class="gfield gfield--type-text gfield--input-type-text gfield--width-full deal_id field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_199_11"><label class='gfield_label gform-field-label' for='input_199_11'>Deal ID</label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_199_11' type='text' value='' class='large' aria-invalid="false" /></div></div><div id="field_199_12" class="gfield gfield--type-text gfield--input-type-text gfield--width-full person_id field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_199_12"><label class='gfield_label gform-field-label' for='input_199_12'>Person Id</label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_199_12' type='text' value='' class='large' aria-invalid="false" /></div></div><div id="field_199_13" class="gfield gfield--type-text gfield--input-type-text gfield--width-full ep_token field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_199_13"><label class='gfield_label gform-field-label' for='input_199_13'>ep_token</label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_199_13' type='text' value='' class='large' aria-invalid="false" /></div></div><fieldset id="field_199_10" class="gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full confirm_chk gfield_contains_required field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible" data-js-reload="field_199_10"><legend class='gfield_label gform-field-label gfield_label_before_complex'>Confirm<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_199_10'><div class='gchoice gchoice_199_10_1'> <input class='gfield-choice-input' name='input_10.1' type='checkbox' value='Confirm deal title is correct.' id='choice_199_10_1' /> <label for='choice_199_10_1' id='label_199_10_1' class='gform-field-label gform-field-label--type-inline'>Confirm deal title is correct.</label> </div></div></div></fieldset><div id="field_199_2023" class="gfield gfield--type-text hide ipqs field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_199_2023"><label class='gfield_label gform-field-label' for='input_199_2023'>IPQS</label><div class='ginput_container ginput_container_text'><input name='input_2023' id='input_199_2023' 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