form_title= Civic Bumper form_header= Have an expert fix your
bumper. Has there been any damage to the bumper previously?*= ()
Yes () No How many accidents have you been in?*= {1, 2, 3, 4, 5,
More than 5} Would you rather get a bumper for your Civic from the
junk yard?*= () Yes () No Has your bumper on your Civic been
replaced before?*= () Yes () No