diff --git a/app/javascript/submission_form/area.vue b/app/javascript/submission_form/area.vue
index 6fa0812e..a858450f 100644
--- a/app/javascript/submission_form/area.vue
+++ b/app/javascript/submission_form/area.vue
@@ -75,6 +75,26 @@
     >
   </div>
 
+  <!-- show my_check prefill -->
+  <div
+    v-else-if="field.type === 'my_check'"
+    class="flex absolute items-center h-full w-full justify-center"
+    :style="{ ...computedStyle, backgroundColor: 'transparent' }"
+    :class="{'cursor-default ': !submittable}"
+  >
+    <span
+      style="border-width: 2px; --tw-bg-opacity: 1; --tw-border-opacity: 0.2; font-size: 1.4rem"
+      class="w-full h-full"
+    >
+      <component
+        :is="fieldIcons[field.type]"
+        width="100%"
+        height="100%"
+        class="h-full"
+      />
+    </span>
+  </div>
+
   <div
     v-else
     class="flex absolute lg:text-base"
@@ -322,7 +342,8 @@ export default {
         my_text: 'Text',
         my_signature: 'My Signature',
         my_initials: 'My Initials',
-        my_date: 'Date'
+        my_date: 'Date',
+        my_check: 'Check'
       }
     },
     fieldIcons () {
@@ -339,7 +360,8 @@ export default {
         cells: IconColumns3,
         multiple: IconChecks,
         phone: IconPhoneCheck,
-        redact: IconBarrierBlock
+        redact: IconBarrierBlock,
+        my_check: IconCheck
       }
     },
     image () {
diff --git a/app/javascript/submission_form/form.vue b/app/javascript/submission_form/form.vue
index 704912b4..79fe130e 100644
--- a/app/javascript/submission_form/form.vue
+++ b/app/javascript/submission_form/form.vue
@@ -66,7 +66,7 @@
               @focus="$refs.areas.scrollIntoField(currentField)"
             />
           </div>
-          <div v-if="['my_text', 'my_signature', 'my_initials', 'my_date'].includes(currentField.type)">
+          <div v-if="['my_text', 'my_signature', 'my_initials', 'my_date', 'my_check'].includes(currentField.type)">
             <!-- do nothing on this side just chill for now -->
           </div>
           <DateStep
@@ -692,7 +692,7 @@ export default {
 
       stepPromise().then(async () => {
         const emptyRequiredField = this.stepFields.find((fields, index) => {
-          if (['redact', 'my_text', 'my_signature', 'my_initials', 'my_date'].includes(fields[0].type)) {
+          if (['redact', 'my_text', 'my_signature', 'my_initials', 'my_date', 'my_check'].includes(fields[0].type)) {
             fields[0].required = 'false'
             return false
           } else {
diff --git a/app/javascript/template_builder/area.vue b/app/javascript/template_builder/area.vue
index 8aadf0ff..72f6b28f 100644
--- a/app/javascript/template_builder/area.vue
+++ b/app/javascript/template_builder/area.vue
@@ -40,7 +40,7 @@
       @pointerdown.stop
     >
       <FieldSubmitter
-        v-if="!['my_text', 'my_signature', 'my_initials', 'my_date'].includes(field.type)"
+        v-if="!['my_text', 'my_signature', 'my_initials', 'my_date', 'my_check'].includes(field.type)"
         v-model="field.submitter_uuid"
         class="border-r"
         :compact="true"
@@ -51,7 +51,7 @@
         @click="selectedAreaRef.value = area"
       />
       <FieldType
-        v-if="!['my_text', 'my_signature', 'my_initials', 'my_date'].includes(field.type)"
+        v-if="!['my_text', 'my_signature', 'my_initials', 'my_date', 'my_check'].includes(field.type)"
         v-model="field.type"
         :button-width="27"
         :editable="editable"
@@ -71,7 +71,7 @@
         @blur="onNameBlur"
       >{{ optionIndexText }} {{ field.name || defaultName }}</span>
       <div
-        v-if="isNameFocus && !['checkbox', 'phone', 'redact', 'my_text', 'my_signature', 'my_initials', 'my_date'].includes(field.type)"
+        v-if="isNameFocus && !['checkbox', 'phone', 'redact', 'my_text', 'my_signature', 'my_initials', 'my_date', 'my_check'].includes(field.type)"
         class="flex items-center ml-1.5"
       >
         <input
@@ -171,6 +171,26 @@
         style="border-width: 2px; --tw-bg-opacity: 1; --tw-border-opacity: 0.2; background-color: transparent;"
       >
     </div>
+    <!-- show my_check prefill -->
+    <div
+      v-else-if="field.type === 'my_check'"
+      class="flex items-center h-full w-full justify-center"
+      style="border-width: 2px; --tw-bg-opacity: 1; --tw-border-opacity: 0.2; background-color: transparent;"
+      :class="{'cursor-default ': !submittable}"
+    >
+      <span
+        style="border-width: 2px; --tw-bg-opacity: 1; --tw-border-opacity: 0.2; font-size: 1.4rem"
+        class="w-full h-full"
+      >
+        <component
+          :is="fieldIcons[field.type]"
+          width="100%"
+          height="100%"
+          class="h-full"
+        />
+      </span>
+    </div>
+
     <div
       v-else
       class="flex items-center h-full w-full"
diff --git a/app/javascript/template_builder/builder.vue b/app/javascript/template_builder/builder.vue
index 8271a1cb..c072d5d1 100644
--- a/app/javascript/template_builder/builder.vue
+++ b/app/javascript/template_builder/builder.vue
@@ -452,7 +452,7 @@ export default {
         submitter_uuid: this.selectedSubmitter.uuid,
         type
       }
-      if (['redact', 'my_text', 'my_signature', 'my_initials', 'my_date'].includes(type)) {
+      if (['redact', 'my_text', 'my_signature', 'my_initials', 'my_date', 'my_check'].includes(type)) {
         field.required = false
       }
       if (['select', 'multiple', 'radio'].includes(type)) {
@@ -612,7 +612,7 @@ export default {
             submitter_uuid: this.selectedSubmitter.uuid,
             areas: [area]
           }
-          if (['redact', 'my_text', 'my_signature', 'my_initials'].includes(field.type)) {
+          if (['redact', 'my_text', 'my_signature', 'my_initials', 'my_date', 'my_check'].includes(field.type)) {
             field.required = false
           }
           this.template.fields.push(field)
@@ -632,7 +632,7 @@ export default {
         ...this.dragField
       }
 
-      if (['redact', 'my_text', 'my_signature', 'my_initials', 'my_date'].includes(field.type)) {
+      if (['redact', 'my_text', 'my_signature', 'my_initials', 'my_date', 'my_check'].includes(field.type)) {
         field.required = false
       }
       if (['select', 'multiple', 'radio'].includes(field.type)) {
@@ -655,7 +655,7 @@ export default {
       } else if (previousField?.areas?.length) {
         baseArea = previousField.areas[previousField.areas.length - 1]
       } else {
-        if (['checkbox'].includes(field.type)) {
+        if (['checkbox', 'my_check'].includes(field.type)) {
           baseArea = {
             w: area.maskW / 30 / area.maskW,
             h: area.maskW / 30 / area.maskW * (area.maskW / area.maskH)
diff --git a/app/javascript/template_builder/field.vue b/app/javascript/template_builder/field.vue
index c040f914..7478526c 100644
--- a/app/javascript/template_builder/field.vue
+++ b/app/javascript/template_builder/field.vue
@@ -31,7 +31,7 @@
           />
         </div>
         <div
-          v-if="isNameFocus && !['redact', 'my_text', 'my_signature', 'my_initials', 'my_date'].includes(field.type)"
+          v-if="isNameFocus && !['redact', 'my_text', 'my_signature', 'my_initials', 'my_date', 'my_check'].includes(field.type)"
           class="flex items-center relative"
         >
           <template v-if="field.type != 'phone'">
@@ -164,7 +164,7 @@
                   Draw New Area
                 </a>
               </li>
-              <li v-if="field.areas?.length === 1 && ['date', 'signature', 'initials', 'text', 'cells', 'my_text', 'redact', 'my_signature', 'my_initials', 'my_date'].includes(field.type)">
+              <li v-if="field.areas?.length === 1 && ['date', 'signature', 'initials', 'text', 'cells', 'my_text', 'redact', 'my_signature', 'my_initials', 'my_date', 'my_check'].includes(field.type)">
                 <a
                   href="#"
                   class="text-sm py-1 px-2"
diff --git a/app/javascript/template_builder/field_type.vue b/app/javascript/template_builder/field_type.vue
index 63c6aeea..3a26123f 100644
--- a/app/javascript/template_builder/field_type.vue
+++ b/app/javascript/template_builder/field_type.vue
@@ -46,7 +46,7 @@
 </template>
 
 <script>
-import { IconTextSize, IconWritingSign, IconCalendarEvent, IconPhoto, IconCheckbox, IconPaperclip, IconSelect, IconCircleDot, IconChecks, IconColumns3, IconPhoneCheck, IconBarrierBlock, IconLetterCaseUpper, IconTextResize } from '@tabler/icons-vue'
+import { IconTextSize, IconWritingSign, IconCalendarEvent, IconPhoto, IconCheckbox, IconPaperclip, IconSelect, IconCircleDot, IconChecks, IconColumns3, IconPhoneCheck, IconBarrierBlock, IconLetterCaseUpper, IconTextResize, IconCheck } from '@tabler/icons-vue'
 export default {
   name: 'FiledTypeDropdown',
   inject: ['withPhone'],
@@ -96,7 +96,8 @@ export default {
         my_text: 'Text',
         my_signature: 'My Signature',
         my_initials: 'My Initials',
-        my_date: 'Date'
+        my_date: 'Date',
+        my_check: 'check'
       }
     },
     fieldIcons () {
@@ -117,7 +118,8 @@ export default {
         my_text: IconTextResize,
         my_signature: IconWritingSign,
         my_initials: IconLetterCaseUpper,
-        my_date: IconCalendarEvent
+        my_date: IconCalendarEvent,
+        my_check: IconCheck
       }
     }
   },
diff --git a/app/javascript/template_builder/fields.vue b/app/javascript/template_builder/fields.vue
index a4f112b5..6caf6fb6 100644
--- a/app/javascript/template_builder/fields.vue
+++ b/app/javascript/template_builder/fields.vue
@@ -72,7 +72,7 @@
       :key="type"
     >
       <div
-        v-if="!['my_text', 'my_signature', 'my_initials', 'my_date'].includes(type)"
+        v-if="!['my_text', 'my_signature', 'my_initials', 'my_date', 'my_check'].includes(type)"
       >
         <button
           v-if="withPhone || type != 'phone'"
@@ -131,7 +131,7 @@
       :key="type"
     >
       <div
-        v-if="['my_text', 'my_signature', 'my_initials', 'my_date'].includes(type)"
+        v-if="['my_text', 'my_signature', 'my_initials', 'my_date', 'my_check'].includes(type)"
       >
         <button
           draggable="true"
@@ -303,7 +303,7 @@ export default {
         submitter_uuid: this.selectedSubmitter.uuid,
         type
       }
-      if (['redact', 'my_text', 'my_signature', 'my_initials', 'my_date'].includes(type)) {
+      if (['redact', 'my_text', 'my_signature', 'my_initials', 'my_date', 'my_check'].includes(type)) {
         field.required = false
       }
       if (['select', 'multiple', 'radio'].includes(type)) {
diff --git a/app/views/submissions/_value.html.erb b/app/views/submissions/_value.html.erb
index 7831c78f..9d8a41ab 100644
--- a/app/views/submissions/_value.html.erb
+++ b/app/views/submissions/_value.html.erb
@@ -10,7 +10,7 @@
         </a>
       <% end %>
     </div>
-  <% elsif field['type'] == 'checkbox' %>
+  <% elsif field['type'].in?(%w[checkbox my_check]) %>
     <div class="w-full flex items-center justify-center">
       <%= svg_icon('check', class: "aspect-square #{area['w'] > area['h'] ? '!w-auto !h-full' : '!w-full !h-auto'}") %>
     </div>
@@ -31,10 +31,7 @@
       <% end %>
     </div>
   <% elsif field['type'] == 'date' %>
-    <div class="flex items-center px-0.5">
-      <%= l(Date.parse(value), format: :long, locale: local_assigns[:locale]) %>
-    </div>
-  <% elsif field['type'] == 'my_date' %>
+  <% elsif ['data', 'my_date'].include?(field['type']) %>
     <div class="flex items-center px-0.5">
       <%= l(Date.parse(value), format: :long, locale: local_assigns[:locale]) %>
     </div>
diff --git a/app/views/submissions/show.html.erb b/app/views/submissions/show.html.erb
index e1b54c42..2c9e33a3 100644
--- a/app/views/submissions/show.html.erb
+++ b/app/views/submissions/show.html.erb
@@ -59,8 +59,9 @@
                   <%= render 'submissions/annotation', annot: %>
                 <% end %>
                 <% fields_index.dig(document.uuid, index)&.each do |(area, field)| %>
-                  <% if ['my_text', 'my_signature', 'my_initials', 'my_date'].include?(field['type']) %>
+                  <% if ['my_text', 'my_signature', 'my_initials', 'my_date', 'my_check'].include?(field['type']) %>
                     <% value = @submission.template.values[field['uuid']] %>
+                    <% value = 'my_check' if ['my_check'].include?(field['type']) %>
                   <% else %>
                     <% value = values[field['uuid']] %>
                   <% end %>
diff --git a/app/views/submit_form/_submission_form.html.erb b/app/views/submit_form/_submission_form.html.erb
index 9cc1fbcd..879a8ef6 100644
--- a/app/views/submit_form/_submission_form.html.erb
+++ b/app/views/submit_form/_submission_form.html.erb
@@ -1,5 +1,5 @@
 <% data_attachments = attachments_index.values.select { |e| e.record_id == submitter.id }.to_json(only: %i[uuid], methods: %i[url filename content_type]) %>
-<% data_fields = (submitter.submission.template_fields || submitter.submission.template.fields).select { |f| ['my_text', 'my_signature', 'my_initials', 'my_data'].include?(f['type']) || f['submitter_uuid'] == submitter.uuid }.to_json %>
+<% data_fields = (submitter.submission.template_fields || submitter.submission.template.fields).select { |f| ['my_text', 'my_signature', 'my_initials', 'my_data', 'my_check'].include?(f['type']) || f['submitter_uuid'] == submitter.uuid }.to_json %>
 <% completed_button_params = submitter.submission.template.account.account_configs.find_by(key: AccountConfig::FORM_COMPLETED_BUTTON_KEY)&.value || {} %>
 <% templateValues = submitter.submission.template.values %>
 <% template_attachments = ActiveStorage::Attachment.where(record: submitter.submission.template, name: :attachments).preload(:blob).index_by(&:uuid) %>
diff --git a/lib/submissions/generate_result_attachments.rb b/lib/submissions/generate_result_attachments.rb
index e86f763a..caa7c524 100644
--- a/lib/submissions/generate_result_attachments.rb
+++ b/lib/submissions/generate_result_attachments.rb
@@ -33,7 +33,7 @@ module Submissions
       pdfs_index = build_pdfs_index(submitter)
 
       submitter.submission.template_fields.each do |field|
-        unless ['my_text', 'my_signature', 'my_initials', 'my_date'].include?(field['type'])
+        unless ['my_text', 'my_signature', 'my_initials', 'my_date', 'my_check'].include?(field['type'])
           next if field['submitter_uuid'] != submitter.uuid
         end
         field.fetch('areas', []).each do |area|
@@ -146,7 +146,8 @@ module Submissions
             layouter.fit(items, area['w'] * width, height_diff.positive? ? box_height : area['h'] * height)
                     .draw(canvas, (area['x'] * width) + TEXT_LEFT_MARGIN,
                           height - (area['y'] * height) + height_diff - TEXT_TOP_MARGIN)
-          when ->(type) { type == 'checkbox' || (type.in?(%w[multiple radio]) && area['option_uuid'].present?) }
+          when ->(type) { type == 'checkbox' || type == 'my_check' || (type.in?(%w[multiple radio]) && area['option_uuid'].present?) }
+            value=true if field['type'] == 'my_check'
             if field['type'].in?(%w[multiple radio])
               option = field['options']&.find { |o| o['uuid'] == area['option_uuid'] }