Share your information with Dina Farmer

Dina Farmer

Spectrum Getaways

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    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h1" label="Spectrum Getaways Itinerary-Only Request Form"/>&#13;
		<field type="paragraph" subtype="p" label="If you&#39;ve already booked your own flights and accommodations — whether through cash or points and miles — and you&#39;re looking for a personalized, autism-friendly itinerary, this is the right form for you!"/>&#13;
		<field type="paragraph" subtype="p" label="This itinerary-only service includes:"/>&#13;
		<field type="paragraph" subtype="p" label="- A detailed day-by-day itinerary customized to your family’s needs&amp;nbsp;"/>&#13;
		<field type="paragraph" subtype="p" label="- Recommendations for tours, attractions, and autism-friendly restaurants-&amp;nbsp;"/>&#13;
		<field type="paragraph" subtype="p" label="- Suggestions that support sensory needs, food preferences, and accessibility"/>&#13;
		<field type="paragraph" subtype="p" label="- One revision (included in the fee), additional revisions will incur a $50 fee."/>&#13;
		<field type="paragraph" subtype="p" label="I understand this service is for complete vacation packages only (not for using points, tours only, or hotel-only bookings)"/>&#13;
		<field type="paragraph" subtype="p" label="🚫 I will not manage, monitor, or assist with bookings or issues during your trip."/>&#13;
		<field type="paragraph" subtype="p" label="🔁 Only one revision is included; additional revisions may incur a $50 fee"/>&#13;
		<field type="paragraph" subtype="p" label="💰 Fee: $125 — due before the itinerary is delivered"/>&#13;
		<field type="header" subtype="h1" label="✅ Agreement &amp;amp; Expectations:"/>&#13;
		<field type="checkbox-group" required="true" label="I understand this is an itinerary-only service and I am responsible for booking, managing, and troubleshooting my own travel." name="consent">&#13;
			<option label="I understand" value="i-understand">I understand</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="I agree to pay the $125 itinerary fee in advance." name="checkbox-group-1752189256034">&#13;
			<option label="I agree" value="i-agree">I agree</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="I understand that only one revision is included. Additional revisions may require an additional fee." name="checkbox-group-1752189279861">&#13;
			<option label="I understand" value="i-understand">I understand</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="I will provide accurate and complete trip information so the itinerary suits my needs." name="checkbox-group-1752189314734">&#13;
			<option label="I agree to provide accurate and complete trip information for my trip." value="i-agree-to-provide-accurate-and-complete-trip-information-for-my-trip">I agree to provide accurate and complete trip information for my trip.</option>&#13;
		</field>&#13;
		<field type="paragraph" subtype="p" label="Looking for premade itineraries?&amp;nbsp; Visit https://spectrumgetaways.com/itineraries/ to get them!"/>&#13;
		<field type="header" subtype="h1" label="👤 Contact Info:"/>&#13;
		<field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Middle name" name="middle-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Suffix" name="suffix" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="✈️ Basic Trip Details:"/>&#13;
		<field type="textarea" required="true" label="Where are you going?" name="tell-me-all-about-your-trip-where-would-you-like-to-travel-to-where-are-you-traveling-fromt-what-time-frame-are-you-looking-at-do-you-have-any-one-in-your-travel-party-with-a-disablity-or-food-allergies-if-so-please-share-it-with-me-what-are-you-hoping-your-travel-experience-will-look-like-give-me-all-the-details-" className="form-control"/>&#13;
		<field type="textarea" required="true" label="Travel Dates (Include Travel Days):" name="textarea-1752186778985" className="form-control"/>&#13;
		<field type="text" required="true" label="How many people are traveling?* Include number of adults and children (and their ages)" name="what-are-your-travel-dates" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Flight Numbers (if known):* This helps me organize the timing of the itinerary. (If not known yet, please provide as soon as possible.)" name="what-major-airport-do-you-live-near-where-are-you-traveling-from" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Where are you staying? (Hotel, resort, Airbnb, etc.):* Name and address if available." description="Orlando International Airport (MCO)" name="text-1752186887600" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Are you open to connecting flights if they help your budget?" name="radio-group-1752186856255">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Are there any specific attractions or activities you’d like included in your package? (e.g., private tours, sensory-friendly experiences, cultural stops, theme parks)" name="does-anyone-have-food-allergies-or-disabilities-i-should-be-aware-of-if-so-what-are-they" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="🧩 Accessibility &amp;amp; Sensory Needs:"/>&#13;
		<field type="paragraph" subtype="p" label="I specialize in planning for families with neurodivergent and disabled travelers. Please tell me about any specific needs your family has so I can create an itinerary that works for everyone."/>&#13;
		<field type="text" required="true" label="Are there any disabilities (hidden or physical) or sensory needs I should be aware of if so what are they?" name="text-1752187663340" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Any food allergies, special diets, or medical needs?&amp;nbsp;" name="text-1752187809351" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="What would help make this trip smoother for your family?* (e.g., sensory breaks, calm spaces, specific pacing)" name="text-1752192827813" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="💡 Preferences &amp;amp; Personalization:"/>&#13;
		<field type="checkbox-group" required="true" label="What kind of experiences would you like to include?" name="what-kind-of-vibe-are-you-looking-for">&#13;
			<option label="Sightseeing" value="sightseeing">Sightseeing</option>&#13;
			<option label="Relaxation" value="relaxation">Relaxation</option>&#13;
			<option label="Museums/Cultural experiences" value="museumscultural-experiences">Museums/Cultural experiences</option>&#13;
			<option label="Beach" value="beach">Beach</option>&#13;
			<option label="Mountains/nature" value="mountainsnature">Mountains/nature</option>&#13;
			<option label="Theme Parks" value="theme-parks">Theme Parks</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Would you like me to include restaurant recommendations that suit your family’s needs?" name="whats-most-important-to-you-on-this-trip">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Would you like me to include tour or activity recommendations that you can book on your own?" name="what-is-your-total-vacation-budget-including-flights-hotel-tours-etc">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Are there any must-do activities or absolute no-gos for your family?" name="text-1752188251663" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="📞 Communication:"/>&#13;
		<field type="checkbox-group" required="true" label="Would you like to schedule a 15-minute Explore Call before we start planning?" name="would-you-like-to-schedule-a-30minute-explore-call-before-we-start-planning">&#13;
			<option label="Yes — Please send me a calendar link" value="yes-please-send-me-a-calendar-link">Yes — Please send me a calendar link</option>&#13;
			<option label="No — I’m ready to move forward via email" value="no-im-ready-to-move-forward-via-email">No — I’m ready to move forward via email</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="How did you hear about Spectrum Getaways?" name="how-did-you-hear-about-spectrum-getaways">&#13;
			<option label="Instagram" value="instagram">Instagram</option>&#13;
			<option label="Facebook" value="facebook">Facebook</option>&#13;
			<option label="Google" value="google">Google</option>&#13;
			<option label="Pinterest" value="pinterest">Pinterest</option>&#13;
			<option label="YouTube" value="youtube">YouTube</option>&#13;
			<option label="Referral" value="referral">Referral</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="text" label="If you heard of me from a Referral or other please tell me who to thank or how you heard of me.&amp;nbsp;" name="if-you-heard-of-me-from-a-referral-or-other-please-tell-me-who-to-thank-or-how-you-heard-of-me-" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
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