{% load static %}
<div class="form-group">
    <div style="white-space: pre-wrap"
         id="question_{{ form_name }}"
         data-toggle="collapse"
         data-target="#periodic_{{ form_name }}"
         {% if collapsible %}style="cursor: pointer" onclick="toggle_details(this)"{% endif %}>
        {% if collapsible %}
            <span class="glyphicon glyphicon-chevron-{% if collapsed %}right{% else %}down{% endif %} pull-left chevron"></span>
        {% endif %}
        {{ question_title|safe }}{{ required_span|safe }}
        {# Add a invisible checkbox to control when this is required #}
        <input aria-label="hidden field used for required answer"
               id="required_{{ form_name }}"
               type="checkbox"
               style="opacity: 0;
                      width: 1px;
                      height: 1px"
               {% if required_span %}required{% endif %} />
    </div>
    <div id="periodic_{{ form_name }}" class="collapse {% if not collapsed %}in{% endif %}">
        <table class="periodic-table">
            <tr>
                <td class="element non-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="H">
                        H
                    </label>
                </td>
                <td colspan="17"></td>
                <td class="element noble-gas">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="He">
                        He
                    </label>
                </td>
            </tr>
            <tr>
                <td class="element alkali-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Li">
                        Li
                    </label>
                </td>
                <td class="element alkaline-earth-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Be">
                        Be
                    </label>
                </td>
                <td colspan="11"></td>
                <td class="element metalloid">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="B">
                        B
                    </label>
                </td>
                <td class="element non-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="C">
                        C
                    </label>
                </td>
                <td class="element non-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="N">
                        N
                    </label>
                </td>
                <td class="element non-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="O">
                        O
                    </label>
                </td>
                <td class="element non-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="F">
                        F
                    </label>
                </td>
                <td class="element noble-gas">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Ne">
                        Ne
                    </label>
                </td>
            </tr>
            <tr>
                <td class="element alkali-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Na">
                        Na
                    </label>
                </td>
                <td class="element alkaline-earth-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}"onclick="check_required('{{ form_name }}')" value="Mg">
                        Mg
                    </label>
                </td>
                <td colspan="11"></td>
                <td class="element post-transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Al">
                        Al
                    </label>
                </td>
                <td class="element metalloid">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Si">
                        Si
                    </label>
                </td>
                <td class="element non-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="P">
                        P
                    </label>
                </td>
                <td class="element non-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="S">
                        S
                    </label>
                </td>
                <td class="element non-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Cl">
                        Cl
                    </label>
                </td>
                <td class="element noble-gas">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Ar">
                        Ar
                    </label>
                </td>
            </tr>
            <tr>
                <td class="element alkali-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="K">
                        K
                    </label>
                </td>
                <td class="element alkaline-earth-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Ca">
                        Ca
                    </label>
                </td>
                <td></td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Sc">
                        Sc
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Ti">
                        Ti
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="V">
                        V
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Cr">
                        Cr
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Mn">
                        Mn
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Fe">
                        Fe
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Co">
                        Co
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Ni">
                        Ni
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Cu">
                        Cu
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Zn">
                        Zn
                    </label>
                </td>
                <td class="element post-transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Ga">
                        Ga
                    </label>
                </td>
                <td class="element metalloid">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Ge">
                        Ge
                    </label>
                </td>
                <td class="element metalloid">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="As">
                        As
                    </label>
                </td>
                <td class="element non-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Se">
                        Se
                    </label>
                </td>
                <td class="element non-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Br">
                        Br
                    </label>
                </td>
                <td class="element noble-gas">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Kr">
                        Kr
                    </label>
                </td>
            </tr>
            <tr>
                <td class="element alkali-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Rb">
                        Rb
                    </label>
                </td>
                <td class="element alkaline-earth-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Sr">
                        Sr
                    </label>
                </td>
                <td style="width: 7px"></td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Y">
                        Y
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Zr">
                        Zr
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Nb">
                        Nb
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Mo">
                        Mo
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Tc">
                        Tc
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Ru">
                        Ru
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Rh">
                        Rh
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Pd">
                        Pd
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Ag">
                        Ag
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Cd">
                        Cd
                    </label>
                </td>
                <td class="element post-transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="In">
                        In
                    </label>
                </td>
                <td class="element post-transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Sn">
                        Sn
                    </label>
                </td>
                <td class="element metalloid">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Sb">
                        Sb
                    </label>
                </td>
                <td class="element metalloid">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Te">
                        Te
                    </label>
                </td>
                <td class="element non-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="I">
                        I
                    </label>
                </td>
                <td class="element noble-gas">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Xe">
                        Xe
                    </label>
                </td>
            </tr>
            <tr>
                <td class="element alkali-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Cs">
                        Cs
                    </label>
                </td>
                <td class="element alkaline-earth-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Ba">
                        Ba
                    </label>
                </td>
                <td></td>
                <td class="element lanthanide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Lu">
                        Lu
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Hf">
                        Hf
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Ta">
                        Ta
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="W">
                        W
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Re">
                        Re
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Os">
                        Os
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Ir">
                        Ir
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Pt">
                        Pt
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Au">
                        Au
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Hg">
                        Hg
                    </label>
                </td>
                <td class="element post-transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Tl">
                        Tl
                    </label>
                </td>
                <td class="element post-transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Pb">
                        Pb
                    </label>
                </td>
                <td class="element post-transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Bi">
                        Bi
                    </label>
                </td>
                <td class="element post-transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Po">
                        Po
                    </label>
                </td>
                <td class="element post-transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="At">
                        At
                    </label>
                </td>
                <td class="element noble-gas">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Rn">
                        Rn
                    </label>
                </td>
            </tr>
            <tr>
                <td class="element alkali-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Fr">
                        Fr
                    </label>
                </td>
                <td class="element alkaline-earth-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Ra">
                        Ra
                    </label>
                </td>
                <td></td>
                <td class="element actinide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Lr">
                        Lr
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Rf">
                        Rf
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Db">
                        Db
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Sg">
                        Sg
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Bh">
                        Bh
                    </label>
                </td>
                <td class="element transition-metal">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Hs">
                        Hs
                    </label>
                </td>
                <td class="element unknown">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Mt">
                        Mt
                    </label>
                </td>
                <td class="element unknown">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Ds">
                        Ds
                    </label>
                </td>
                <td class="element unknown">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Rg">
                        Rg
                    </label>
                </td>
                <td class="element unknown">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Cn">
                        Cn
                    </label>
                </td>
                <td class="element unknown">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Nh">
                        Nh
                    </label>
                </td>
                <td class="element unknown">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Fl">
                        Fl
                    </label>
                </td>
                <td class="element unknown">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Mc">
                        Mc
                    </label>
                </td>
                <td class="element unknown">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Lv">
                        Lv
                    </label>
                </td>
                <td class="element unknown">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Ts">
                        Ts
                    </label>
                </td>
                <td class="element unknown">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Og">
                        Og
                    </label>
                </td>
            </tr>
            <tr>
                <td colspan="18" style="height: 7px"></td>
            </tr>
            <tr>
                <td colspan="3"></td>
                <td class="element lanthanide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="La">
                        La
                    </label>
                </td>
                <td class="element lanthanide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Ce">
                        Ce
                    </label>
                </td>
                <td class="element lanthanide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Pr">
                        Pr
                    </label>
                </td>
                <td class="element lanthanide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Nd">
                        Nd
                    </label>
                </td>
                <td class="element lanthanide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Pm">
                        Pm
                    </label>
                </td>
                <td class="element lanthanide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Sm">
                        Sm
                    </label>
                </td>
                <td class="element lanthanide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Eu">
                        Eu
                    </label>
                </td>
                <td class="element lanthanide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Gd">
                        Gd
                    </label>
                </td>
                <td class="element lanthanide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Tb">
                        Tb
                    </label>
                </td>
                <td class="element lanthanide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Dy">
                        Dy
                    </label>
                </td>
                <td class="element lanthanide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Ho">
                        Ho
                    </label>
                </td>
                <td class="element lanthanide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Er">
                        Er
                    </label>
                </td>
                <td class="element lanthanide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Tm">
                        Tm
                    </label>
                </td>
                <td class="element lanthanide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Yb">
                        Yb
                    </label>
                </td>
                <td colspan="2"></td>
            </tr>
            <tr>
                <td colspan="3"></td>
                <td class="element actinide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Ac">
                        Ac
                    </label>
                </td>
                <td class="element actinide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Th">
                        Th
                    </label>
                </td>
                <td class="element actinide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Pa">
                        Pa
                    </label>
                </td>
                <td class="element actinide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="U">
                        U
                    </label>
                </td>
                <td class="element actinide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Np">
                        Np
                    </label>
                </td>
                <td class="element actinide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Pu">
                        Pu
                    </label>
                </td>
                <td class="element actinide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Am">
                        Am
                    </label>
                </td>
                <td class="element actinide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Cm">
                        Cm
                    </label>
                </td>
                <td class="element actinide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Bk">
                        Bk
                    </label>
                </td>
                <td class="element actinide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Cf">
                        Cf
                    </label>
                </td>
                <td class="element actinide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Es">
                        Es
                    </label>
                </td>
                <td class="element actinide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Fm">
                        Fm
                    </label>
                </td>
                <td class="element actinide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="Md">
                        Md
                    </label>
                </td>
                <td class="element actinide">
                    <label>
                        <input type="checkbox" name="{{ form_name }}" onclick="check_required('{{ form_name }}')" value="No">
                        No
                    </label>
                </td>
                <td colspan="2"></td>
            </tr>
        </table>
        {% if help %}<div style="font-size:smaller;color:#999;max-width: 600px;">{{ help }}</div>{% endif %}
    </div>
</div>
<script>
	if (!$) { $ = django.jQuery; }
    if (!$('link[href="{% static "NEMO_periodic_table_question/periodic_table.css" %}"]').length)
    {
        $('<link href="{% static "NEMO_periodic_table_question/periodic_table.css" %}" rel="stylesheet">').appendTo("head");
    }
    $(".periodic-table input[type=checkbox]").on("change", function()
	{
		$(this).closest("td").toggleClass("checked", this.checked);
	});
    function check_required(form_name)
    {
        if ($("input[name=" + form_name + "]:checkbox:checked").length > 0)
        {
            $("#required_" + form_name).prop("checked", true).change();
		}
        else
        {
            $("#required_" + form_name).prop("checked", false).change();
		}
	}

    $(function()
	{
        {% for default_val in default_value %}
			$("input[name={{ form_name }}][value={{ default_val }}]").prop("checked", true).change();
            check_required('{{ form_name }}');
        {% endfor %}
	});
</script>