<% if(typeof preferredCity !== 'undefined') { %>
City <%- preferredCity %>
<% } %>
<% if(typeof preferredState !== 'undefined') { %>
State <%- preferredState %>
<% } %>
<% if(typeof preferredZipCode !== 'undefined') { %>
Zip Code <%- preferredZipCode %>
<% } %>
How many miles away from this ZIP code are you willing to travel? <%- distanceWillingToTravel === 100 ? '100 or more' : distanceWillingToTravel%>
Preferred Language Spoken <%- preferredLanguage %>
Office Hours <%- officeHours.join(', ') %>
<% if(typeof preferredProviders !== 'undefined') { %>
<% for(var i = 0; i < preferredProviders.length; i++) { %>
Provider Choice # <%- i + 1%>
<%= preferredProviders[i].display %>
<% } %>
<% } %>
<% if (typeof additionalInformation !== 'undefined' && objectType === "CCAppointmentRequest") { %>
Other Provider Preferences <%- additionalInformation %>
<% } %>