{"id":1771,"date":"2025-05-28T12:16:05","date_gmt":"2025-05-28T16:16:05","guid":{"rendered":"https:\/\/www.bu.edu\/shs\/?page_id=1771"},"modified":"2025-05-28T12:16:05","modified_gmt":"2025-05-28T16:16:05","slug":"stress-kit-request-form","status":"publish","type":"page","link":"https:\/\/www.bu.edu\/shs\/stress-kit-request-form\/","title":{"rendered":"Stress Kit Request Form"},"content":{"rendered":"<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <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_23' style='display:none'>\n                        <div class='gform_heading'>\n                            <h3 class=\"gform_title\">Stress Kit Request Form<\/h3>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_23'  action='\/shs\/wp-json\/wp\/v2\/pages\/1771' data-formid='23' >\n                        <div class='gform-body gform_body'><ul id='gform_fields_23' class='gform_fields top_label form_sublabel_below description_below'><li id=\"field_23_1\"  class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_23_1\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_23_1'>\n                            \n                            <span id='input_23_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_23_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_23_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_23_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_23_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_23_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_23_2\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_23_2\"><label class='gfield_label gform-field-label' for='input_23_2' >BU ID<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_2' id='input_23_2' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_23_13\"  class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_23_13\"><label class='gfield_label gform-field-label' for='input_23_13' >BU Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_13' id='input_23_13' type='text' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_23_4\"  class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_23_4\"><label class='gfield_label gform-field-label' for='input_23_4' >School or College<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_4' id='input_23_4' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='College of Arts &amp; Sciences' >College of Arts &amp; Sciences<\/option><option value='College of Communication' >College of Communication<\/option><option value='College of Engineering' >College of Engineering<\/option><option value='College of Fine Arts' >College of Fine Arts<\/option><option value='College of General Studies' >College of General Studies<\/option><option value='Faculty of Computing &amp; Data Sciences' >Faculty of Computing &amp; Data Sciences<\/option><option value='Frederick S. Pardee School of Global Studies' >Frederick S. Pardee School of Global Studies<\/option><option value='Goldman School of Dental Medicine' >Goldman School of Dental Medicine<\/option><option value='Graduate Medical Sciences' >Graduate Medical Sciences<\/option><option value='Graduate School of Arts &amp; Sciences' >Graduate School of Arts &amp; Sciences<\/option><option value='Kilachand Honors College' >Kilachand Honors College<\/option><option value='Metropolitan College &amp; Extended Education' >Metropolitan College &amp; Extended Education<\/option><option value='Questrom School of Business' >Questrom School of Business<\/option><option value='Sargent College' >Sargent College<\/option><option value='School of Hospitality Administration' >School of Hospitality Administration<\/option><option value='School of Law' >School of Law<\/option><option value='School of Medicine' >School of Medicine<\/option><option value='School of Public Health' >School of Public Health<\/option><option value='School of Social Work' >School of Social Work<\/option><option value='School of Theology' >School of Theology<\/option><option value='Wheelock College of Education &amp; Human Development' >Wheelock College of Education &amp; Human Development<\/option><option value='' ><\/option><\/select><\/div><\/li><li id=\"field_23_5\"  class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_23_5\"><label class='gfield_label gform-field-label' for='input_23_5' >Student status<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_5' id='input_23_5' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Undergraduate Student' >Undergraduate Student<\/option><option value='Graduate Student' >Graduate Student<\/option><option value='Non-degree student' >Non-degree student<\/option><\/select><\/div><\/li><li id=\"field_23_7\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_23_7\"><label class='gfield_label gform-field-label'  >Would you like to pick up your kit or have it delivered? (Please note that we are only delivering to on-campus mailboxes currently).<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_23_7'>For on-campus delivery, please allow 7- 10 days for your order to arrive. For pick up, please allow 2-3 days for your order to be prepared. <\/div><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_23_7'>\n\t\t\t<li class='gchoice gchoice_23_7_0'>\n\t\t\t\t<input name='input_7' type='radio' value='Deliver to my on-campus mailbox'  id='choice_23_7_0'    \/>\n\t\t\t\t<label for='choice_23_7_0' id='label_23_7_0' class='gform-field-label gform-field-label--type-inline'>Deliver to my on-campus mailbox<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_23_7_1'>\n\t\t\t\t<input name='input_7' type='radio' value='Pick up at Health Promotion &amp; Prevention, 930 Commonwealth Ave., Tues-Friday, 9am-5pm'  id='choice_23_7_1'    \/>\n\t\t\t\t<label for='choice_23_7_1' id='label_23_7_1' class='gform-field-label gform-field-label--type-inline'>Pick up at Health Promotion &amp; Prevention, 930 Commonwealth Ave., Tues-Friday, 9am-5pm<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_23_8\"  class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_23_8\"><label class='gfield_label gform-field-label' for='input_23_8' >My on-campus address:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_8' id='input_23_8' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='273 Babcock Street, Claflin Hall' >273 Babcock Street, Claflin Hall<\/option><option value='275 Babcock Street, Sleeper Hall' >275 Babcock Street, Sleeper Hall<\/option><option value='277 Babcock Street, Rich Hall' >277 Babcock Street, Rich Hall<\/option><option value='79 Bay State Road' >79 Bay State Road<\/option><option value='81-83 Bay State Road' >81-83 Bay State Road<\/option><option value='91 Bay State Road, Kilachand Hall' >91 Bay State Road, Kilachand Hall<\/option><option value='90-92 Bay State Road' >90-92 Bay State Road<\/option><option value='117 Bay State Road, Kilachand Honors House' >117 Bay State Road, Kilachand Honors House<\/option><option value='135 Bay State Road' >135 Bay State Road<\/option><option value='140 Bay State Road, The Towers' >140 Bay State Road, The Towers<\/option><option value='153 Bay State Road' >153 Bay State Road<\/option><option value='157 Bay State Road, Limited Parietal House' >157 Bay State Road, Limited Parietal House<\/option><option value='158-160 Bay State Road, Common Ground House' >158-160 Bay State Road, Common Ground House<\/option><option value='159 Bay State Road' >159 Bay State Road<\/option><option value='161 Bay State Road, Management House' >161 Bay State Road, Management House<\/option><option value='162-164 Bay State Road' >162-164 Bay State Road<\/option><option value='163 Bay State Road, WISE-Up' >163 Bay State Road, WISE-Up<\/option><option value='166-168 Bay State Road, College of General Studies House' >166-168 Bay State Road, College of General Studies House<\/option><option value='167-169 Bay State Road' >167-169 Bay State Road<\/option><option value='172 Bay State Road' >172 Bay State Road<\/option><option value='175 Bay State Road' >175 Bay State Road<\/option><option value='176 Bay State Road, Classics House' >176 Bay State Road, Classics House<\/option><option value='177 Bay State Road' >177 Bay State Road<\/option><option value='178 Bay State Road' >178 Bay State Road<\/option><option value='179 Bay State Road, Education House' >179 Bay State Road, Education House<\/option><option value='180 Bay State Road' >180 Bay State Road<\/option><option value='181 Bay State Road' >181 Bay State Road<\/option><option value='182 Bay State Road' >182 Bay State Road<\/option><option value='184-186 Bay State Road' >184-186 Bay State Road<\/option><option value='188-190 Bay State Road' >188-190 Bay State Road<\/option><option value='192 Bay State Road' >192 Bay State Road<\/option><option value='193 Bay State Road' >193 Bay State Road<\/option><option value='194 Bay State Road' >194 Bay State Road<\/option><option value='196 Bay State Road' >196 Bay State Road<\/option><option value='195-197 Bay State Road' >195-197 Bay State Road<\/option><option value='199 Bay State Road' >199 Bay State Road<\/option><option value='200 Bay State Road, Trustee Scholars House (Boyd House)' >200 Bay State Road, Trustee Scholars House (Boyd House)<\/option><option value='201 Bay State Road' >201 Bay State Road<\/option><option value='202 Bay State Road' >202 Bay State Road<\/option><option value='203 Bay State Road' >203 Bay State Road<\/option><option value='204 Bay State Road, Thissen House' >204 Bay State Road, Thissen House<\/option><option value='205 Bay State Road, Sargent College House' >205 Bay State Road, Sargent College House<\/option><option value='206 Bay State Road' >206 Bay State Road<\/option><option value='207 Bay State Road, Music House' >207 Bay State Road, Music House<\/option><option value='208 Bay State Road' >208 Bay State Road<\/option><option value='209 Bay State Road' >209 Bay State Road<\/option><option value='210-212 Bay State Road' >210-212 Bay State Road<\/option><option value='512 Beacon Street, Danielsen Hall' >512 Beacon Street, Danielsen Hall<\/option><option value='517-521 Beacon Street' >517-521 Beacon Street<\/option><option value='531 Beacon Street' >531 Beacon Street<\/option><option value='610 Beacon Street, Myles Standish Hall' >610 Beacon Street, Myles Standish Hall<\/option><option value='1053 Beacon Street' >1053 Beacon Street<\/option><option value='10 Buick Street, The Student Residence' >10 Buick Street, The Student Residence<\/option><option value='1 Buswell Street, Engineering House' >1 Buswell Street, Engineering House<\/option><option value='7 Buswell Street, Earth House' >7 Buswell Street, Earth House<\/option><option value='11 Buswell Street' >11 Buswell Street<\/option><option value='29 Buswell Street' >29 Buswell Street<\/option><option value='31 Buswell Street, Community Service House' >31 Buswell Street, Community Service House<\/option><option value='33 Buswell Street' >33 Buswell Street<\/option><option value='37 Buswell Street' >37 Buswell Street<\/option><option value='40 Buswell Street' >40 Buswell Street<\/option><option value='42 Buswell Street' >42 Buswell Street<\/option><option value='43 Buswell Street' >43 Buswell Street<\/option><option value='44 Buswell Street' >44 Buswell Street<\/option><option value='45 Buswell Street' >45 Buswell Street<\/option><option value='47 Buswell Street' >47 Buswell Street<\/option><option value='48 Buswell Street' >48 Buswell Street<\/option><option value='37-39 Carlton Street' >37-39 Carlton Street<\/option><option value='141 Carlton Street, Core Curriculum House' >141 Carlton Street, Core Curriculum House<\/option><option value='481-483 Commonwealth Avenue' >481-483 Commonwealth Avenue<\/option><option value='575 Commonwealth Avenue' >575 Commonwealth Avenue<\/option><option value='625 Commonwealth Avenue' >625 Commonwealth Avenue<\/option><option value='700 Commonwealth Avenue, Fairfield Tower' >700 Commonwealth Avenue, Fairfield Tower<\/option><option value='700 Commonwealth Avenue, Marshall Tower' >700 Commonwealth Avenue, Marshall Tower<\/option><option value='700 Commonwealth Avenue, Shields Tower' >700 Commonwealth Avenue, Shields Tower<\/option><option value='1019 Commonwealth Avenue' >1019 Commonwealth Avenue<\/option><option value='33 Harry Agganis Way' >33 Harry Agganis Way<\/option><option value='514 Park Drive' >514 Park Drive<\/option><option value='516 Park Drive' >516 Park Drive<\/option><option value='518 Park Drive' >518 Park Drive<\/option><option value='520 Park Drive' >520 Park Drive<\/option><option value='522 Park Drive' >522 Park Drive<\/option><option value='37 Pilgrim Road, Pilgrim House' >37 Pilgrim Road, Pilgrim House<\/option><option value='2 Raleigh Street, Theology House' >2 Raleigh Street, Theology House<\/option><option value='150 Riverway, Campus Center Residence' >150 Riverway, Campus Center Residence<\/option><option value='162 Riverway, Riverway House' >162 Riverway, Riverway House<\/option><option value='580 Commonwealth Avenue' >580 Commonwealth Avenue<\/option><\/select><\/div><\/li><li id=\"field_23_9\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_23_9\"><label class='gfield_label gform-field-label' for='input_23_9' >Mailbox number (Not your room number)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_23_9' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_23_10\"  class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_23_10\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Why are you requesting a stress kit? Check all that apply.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_23_10'><li class='gchoice gchoice_23_10_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.1' type='checkbox'  value='To get a free journal, stress relief tea, and more'  id='choice_23_10_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_10_1' id='label_23_10_1' class='gform-field-label gform-field-label--type-inline'>To get a free journal, stress relief tea, and more<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_23_10_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.2' type='checkbox'  value='To learn about stress'  id='choice_23_10_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_10_2' id='label_23_10_2' class='gform-field-label gform-field-label--type-inline'>To learn about stress<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_23_10_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.3' type='checkbox'  value='To improve my stress management'  id='choice_23_10_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_10_3' id='label_23_10_3' class='gform-field-label gform-field-label--type-inline'>To improve my stress management<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_23_12\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_23_12\"><label class='gfield_label gform-field-label'  >How did you hear about our stress kits?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_23_12'>\n\t\t\t<li class='gchoice gchoice_23_12_0'>\n\t\t\t\t<input name='input_12' type='radio' value='Email'  id='choice_23_12_0'    \/>\n\t\t\t\t<label for='choice_23_12_0' id='label_23_12_0' class='gform-field-label gform-field-label--type-inline'>Email<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_23_12_1'>\n\t\t\t\t<input name='input_12' type='radio' value='Another BU student'  id='choice_23_12_1'    \/>\n\t\t\t\t<label for='choice_23_12_1' id='label_23_12_1' class='gform-field-label gform-field-label--type-inline'>Another BU student<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_23_12_2'>\n\t\t\t\t<input name='input_12' type='radio' value='Resident Assistant'  id='choice_23_12_2'    \/>\n\t\t\t\t<label for='choice_23_12_2' id='label_23_12_2' class='gform-field-label gform-field-label--type-inline'>Resident Assistant<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_23_12_3'>\n\t\t\t\t<input name='input_12' type='radio' value='Provider at Student Health Services'  id='choice_23_12_3'    \/>\n\t\t\t\t<label for='choice_23_12_3' id='label_23_12_3' class='gform-field-label gform-field-label--type-inline'>Provider at Student Health Services<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_23_12_4'>\n\t\t\t\t<input name='input_12' type='radio' value='BU staff member'  id='choice_23_12_4'    \/>\n\t\t\t\t<label for='choice_23_12_4' id='label_23_12_4' class='gform-field-label gform-field-label--type-inline'>BU staff member<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_23_12_5'>\n\t\t\t\t<input name='input_12' type='radio' value='Professor'  id='choice_23_12_5'    \/>\n\t\t\t\t<label for='choice_23_12_5' id='label_23_12_5' class='gform-field-label gform-field-label--type-inline'>Professor<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_23_12_6'>\n\t\t\t\t<input name='input_12' type='radio' value='Social media'  id='choice_23_12_6'    \/>\n\t\t\t\t<label for='choice_23_12_6' id='label_23_12_6' class='gform-field-label gform-field-label--type-inline'>Social media<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_23_12_7'>\n\t\t\t\t<input name='input_12' type='radio' value='gf_other_choice'  id='choice_23_12_7'   onfocus=\"jQuery(this).next('input').focus();\" \/>\n\t\t\t\t<input class='small' id='input_23_12_other' name='input_12_other' type='text' value='Other' aria-label='Other' onfocus='jQuery(this).prev(\"input\")[0].click(); 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