If it's for work and the users all have access to Word 2010, the entire form can be done with content controls (Word 2010 introduced the checkbox content control) and without forms protection.

FWIW, your Yes/No checkboxes allow both options to be chosen (or not), which is undesirable. I'd suggest replacing both with a single dropdown allowing the user to choose either Yes or No. That way, you'll know whether and what choice has been made.

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Cheers,
Paul Edstein
[Fmr MS MVP - Word]