bhl-forms 0.2.0 → 0.2.1

package/dist/forms/ssdi.es.js

@@ -94,30 +94,90 @@ function formAnchor(updates) {
   )
 }
 
-const headlineDefaults = {
-  $el: 'h1',
+const progressBarDefaults = {
+  $el: 'div',
   attrs: {
-    class: 't-flex t-justify-center t-text-center !t-text-[2rem] t-font-semibold t-pt-5 t-px-7 md:t-px-3'
-  }
+    class: 't-mt-7 t-mb-5 t-w-full t-flex t-flex-col t-justify-center t-items-center',
+    style: {
+      if: '$fns.eq($activeStep, $firstStep()) || $fns.eq($activeStep, $lastStep())',
+      then: 'display: none'
+    },
+  },
+  children: [
+    {
+      $el: 'div',
+      attrs: {
+        class: 't-flex t-justify-center'
+      },
+      children: [
+        {
+          $el: 'span',
+          attrs: {
+            id: 'progress-bar-text',
+            class: 't-text-sm t-mb-1'
+          },
+          children: [
+            "0% Complete"
+          ]
+        },
+      ]
+    },
+    {
+      $el: 'div',
+      attrs: {
+        class: 't-bg-gray-100 t-w-9/12 t-rounded'
+      },
+      children: [
+        {
+          $el: 'div',
+          attrs: {
+            id: 'progress-bar',
+            class: 't-flex t-flex-col t-justify-center t-text-center t-whitespace-nowrap t-w-[10%] t-h-1.5 t-rounded t-text-white t-bg-[#007bff]',
+            style: {
+              transition: 'width 0.5s ease'
+            },
+          },
+        }
+      ]
+    }
+  ]
 };
 
-function headline(updates) {
+function progressBar(updates) {
   return merge(
-    headlineDefaults,
+    progressBarDefaults,
     updates
   )
 }
 
-const subHeadlineDefaults = {
-  $el: 'h3',
-  attrs: {
-    class: 't-flex t-justify-center t-text-center !t-text-[1.2rem] t-font-medium t-text-blue-500 t-px-10'
+function headlineDefaults(updates = {}) {
+  return {
+    $el: 'h1',
+    attrs: {
+      class: 't-flex t-justify-center t-text-center !t-text-[2rem] t-font-semibold t-pt-5 t-px-7 md:t-px-3' + ' ' + (updates.headlineClass || '')
+    }
   }
-};
+}
 
-function subHeadline(updates) {
+function headline(updates = {}) {
   return merge(
-    subHeadlineDefaults,
+    headlineDefaults(updates),
+    updates
+  )
+}
+
+function subHeadlineDefaults(updates = {}) {
+  return {
+    $el: 'h3',
+    attrs: {
+      class: 't-flex t-justify-center t-text-center !t-text-[1.2rem] t-font-medium t-text-blue-500 t-px-10' + ' ' + (updates.subHeadlineClass || '')
+    }
+  }
+}
+
+function subHeadline(updates = {}) {
+  return merge(
+    subHeadlineDefaults(updates),
     updates
   )
 }
@@ -400,18 +460,21 @@ const radio = (updates) => {
   }, updates)
 };
 
-const sbs2ItemRadio = (updates) => {
-  updates.legendClass = 'legend-left t-pb-1 required';
-  updates.fieldsetClass = '$reset side-by-side t-items-center';
-  updates.optionsClass = 't-mt-1 t-grid t-grid-cols-1 md:t-grid-cols-2-125 t-items-center';
-  updates.innerClass = 't-flex t-items-center';
-  updates.optionClass = 't-pr-1';
+const vertical2ItemRadio = (updates) => {
+  updates.legendClass = 'legend-left';
+  updates.fieldsetClass = '$reset vertical t-items-center';
+  updates.optionsClass = 't-flex t-justify-center t-my-4';
+  updates.optionClass = 'radiobtn t-mx-5';
+  updates.wrapperClass = '$reset formkit-wrapper t-mb-0';
+  updates.labelClass = 't-font-semibold t-text-[#1e448f]';
+  updates.decoratorIcon = false;
+  updates.messagesClass = 't-flex t-justify-center';
   return radio(updates)
 };
 
-const sbsYesNoRadio = (updates) => {
+const verticalYesNoRadio = (updates) => {
   updates.options = ['Yes', 'No'];
-  return sbs2ItemRadio(updates)
+  return vertical2ItemRadio(updates)
 };
 
 const select = (updates) => {
@@ -427,14 +490,14 @@ const select = (updates) => {
   }, updates)
 };
 
-const sbsSelect = (updates) => {
+const verticalSelect = (updates) => {
   updates.labelClass = 'required';
-  updates.wrapperClass = 'side-by-side t-items-center';
-  updates.innerClass = 'select-height-content';
-  updates.helpClass = 't-mt-2.5 md:t-text-right md:t-mt-[-5px]';
+  updates.wrapperClass = 't-flex t-justify-center';
+  updates.messagesClass = 't-flex t-justify-center';
   return select(updates)
 };
 
+
 const text = (updates) => {
   return merge({
     $formkit: 'text',
@@ -465,10 +528,9 @@ const textArea = (updates) => {
   }, updates)
 };
 
-
-const applicantAge = () => sbsSelect({
-  label: 'Age of Applicant?',
+const applicantAgeVertical = () => verticalSelect({
   name: 'Applicant_Age',
+  value: "50",
   options: [
     "18",
     "19",
@@ -538,19 +600,19 @@ const comments = (updates) => textArea(
   }, updates)
 );
 
-const disabilityConditionStopWork = () => sbsYesNoRadio({
+const disabilityConditionStopWorkVertical = () => verticalYesNoRadio({
   name: 'Disability_Condition_Stop_Work',
-  label: 'Do You Expect To Be Out Of Work For At Least a Year Due To Your Health?'
+  // label: 'Do You Expect To Be Out Of Work For At Least a Year Due To Your Health?'
 });
 
-const disabilityWorkHistory = () => sbsYesNoRadio({
+const disabilityWorkHistoryVertical = () => verticalYesNoRadio({
   name: 'Disability_Work_History',
-  label: 'Have You Had a Full-Time Job Within the Past 5 Years?'
+  // label: 'Have You Had a Full-Time Job Within the Past 5 Years?'
 });
 
-const doctorTreatment = () => sbsYesNoRadio({
+const doctorTreatmentVertical = () => verticalYesNoRadio({
   name: 'Doctor_Treatment',
-  label: 'Have You Recently Been Treated by a Doctor, Hospital or Clinic?'
+  // label: 'Have You Recently Been Treated by a Doctor, Hospital or Clinic?'
 });
 
 const email = () => sbsText({
@@ -577,9 +639,9 @@ const firstName = () => sbsText({
   }
 });
 
-const haveAttorney = () => sbsYesNoRadio({
+const haveAttorneyVertical = () => verticalYesNoRadio({
   name: 'Have_Attorney',
-  label: 'Already Working with An Attorney?'
+  // label: 'Already Working with An Attorney?'
 });
 
 const lastName = () => sbsText({
@@ -610,9 +672,9 @@ const phone = () => sbsText({
   helpClass: "t-mt-2.5 md:t-text-right md:t-mt-[-2px]"
 });
 
-const socialSecurityDisabilityReceivingBenefits = () => sbsYesNoRadio({
+const socialSecurityDisabilityReceivingBenefitsVertical = () => verticalYesNoRadio({
   name: 'Social_Security_Disability_Receiving_Benefits',
-  label: 'Are You Currently Receiving Social Security Disability Benefits?'
+  // label: 'Are You Currently Receiving Social Security Disability Benefits?'
 });
 
 const TCPAConsent = () => ({
@@ -630,9 +692,8 @@ const TCPAConsent = () => ({
   }
 });
 
-const zipcode = () => sbsText({
-  label: 'Zip Code:',
-  placeholder: '#####',
+const zipcodeCenter = () => text({
+  placeholder: 'Please Enter Your Zip Code',
   name: 'Zip',
   maxlength: 5,
   inputmode: "numeric",
@@ -641,10 +702,13 @@ const zipcode = () => sbsText({
   validationMessages: {
     required: 'Zip Code is required',
     matches: 'Invalid Zip Code'
-  }
+  },
+  wrapperClass: 't-flex t-justify-center',
+  messagesClass: 't-flex t-justify-center'
 });
 
 const NEXT_ON_ENTER = '$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))';
+const NEXT_ON_INPUT = '$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))';
 
 const isInput = (n) => { return (n.type !== 'group' && n.type !== 'section' && n.type !== 'form' && n.$formkit !== 'hidden' && !n.children) };
 
@@ -679,22 +743,23 @@ const stepDefaults = (step) => ({
   }
 });
 
-function questionsStepHeadline(updates) {
+function verticalStepHeadline(updates) {
   return {
     $el: 'h3',
     children: updates.headline || 'Tell Us About Your Case',
     attrs: {
-      class: 't-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-3'
+      class: 't-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-dark t-pb-5 t-pt-0 t-px-3'
     }
   }
 }
 
+
 function commentsStepHeadline(updates) {
   return {
     $el: 'h3',
     children: updates.headline || 'Additional Case Details',
     attrs: {
-      class: 't-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-3'
+      class: 't-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-3' + ' ' + (updates.headlineClass || '')
     }
   }
 }
@@ -704,7 +769,7 @@ function firstAndLastStepHeadline(updates) {
     $el: 'h3',
     children: updates.headline || 'Please Provide a Contact Name',
     attrs: {
-      class: 't-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-3'
+      class: 't-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-3' + ' ' + (updates.headlineClass || '')
     }
   }
 }
@@ -755,13 +820,18 @@ function trustedFormScript() {
   }
 }
 
-function step(name, inputs, nextOnEnter = true) {
+function step(name, inputs, nextOnEnter = true, nextOnInput = false) {
   if (typeof nextOnEnter === 'undefined') {
     nextOnEnter = true;
   }
-  if (inputs && inputs.length && nextOnEnter) {
+  if (inputs && inputs.length && (nextOnEnter || nextOnInput)) {
     const lastInput = findLastInput(inputs[inputs.length - 1]);
-    lastInput.onKeypress = NEXT_ON_ENTER;
+    if (nextOnEnter === true) {
+      lastInput.onKeypress = NEXT_ON_ENTER;
+    }
+    if (nextOnInput === true) {
+      lastInput.onInput = NEXT_ON_INPUT;
+    }
   }
 
   return merge(
@@ -785,7 +855,7 @@ function commentsWithBankruptcyV2(updates = {}) {
     [
       commentsStepHeadline(updates),
       comments({
-        label: updates.label || DEFAULT_COMMENTS_LABEL,
+        label: updates.label === undefined ? DEFAULT_COMMENTS_LABEL : updates.label,
         placeholder: updates.placeholder || DEFAULT_COMMENTS_PLACEHOLDER_DYNAMIC
       }),
       bankruptcyCrossSell()
@@ -833,9 +903,10 @@ function ssdiTOLPAndZip(updates = {}) {
         id: "Type_Of_Legal_Problem",
         value: "Social Security Disability and Insurance"
       },
-      zipcode()
+      zipcodeCenter()
     ],
-    updates.nextOnEnter
+    updates.nextOnEnter,
+    updates.nextOnInput
   )
 }
 
@@ -843,10 +914,11 @@ function ssdiApplicantAge(updates = {}) {
   return step(
     'ssdiApplicantAge',
     [
-      questionsStepHeadline(updates),
-      applicantAge(),
+      verticalStepHeadline(updates),
+      applicantAgeVertical(),
     ],
-    updates.nextOnEnter
+    updates.nextOnEnter,
+    updates.nextOnInput
   )
 }
 
@@ -854,10 +926,11 @@ function ssdiDisabilityConditionStopWork(updates = {}) {
   return step(
     'ssdiDisabilityConditionStopWork',
     [
-      questionsStepHeadline(updates),
-      disabilityConditionStopWork(),
+      verticalStepHeadline(updates),
+      disabilityConditionStopWorkVertical(),
     ],
-    updates.nextOnEnter
+    updates.nextOnEnter,
+    updates.nextOnInput
   )
 }
 
@@ -865,10 +938,11 @@ function ssdiDisabilityWorkHistory(updates = {}) {
   return step(
     'ssdiDisabilityWorkHistory',
     [
-      questionsStepHeadline(updates),
-      disabilityWorkHistory(),
+      verticalStepHeadline(updates),
+      disabilityWorkHistoryVertical(),
     ],
-    updates.nextOnEnter
+    updates.nextOnEnter,
+    updates.nextOnInput
   )
 }
 
@@ -876,10 +950,11 @@ function ssdiSocialSecurityDisabilityReceivingBenefits(updates = {}) {
   return step(
     'ssdiSocialSecurityDisabilityReceivingBenefits',
     [
-      questionsStepHeadline(updates),
-      socialSecurityDisabilityReceivingBenefits(),
+      verticalStepHeadline(updates),
+      socialSecurityDisabilityReceivingBenefitsVertical(),
     ],
-    updates.nextOnEnter
+    updates.nextOnEnter,
+    updates.nextOnInput
   )
 }
 
@@ -887,10 +962,11 @@ function ssdiDoctorTreatment(updates = {}) {
   return step(
     'ssdiDoctorTreatment',
     [
-      questionsStepHeadline(updates),
-      doctorTreatment(),
+      verticalStepHeadline(updates),
+      doctorTreatmentVertical(),
     ],
-    updates.nextOnEnter
+    updates.nextOnEnter,
+    updates.nextOnInput
   )
 }
 
@@ -899,10 +975,11 @@ function ssdiHaveAttorney(updates = {}) {
   return step(
     'ssdiHaveAttorney',
     [
-      questionsStepHeadline(updates),
-      haveAttorney(),
+      verticalStepHeadline(updates),
+      haveAttorneyVertical(),
     ],
-    updates.nextOnEnter
+    updates.nextOnEnter,
+    updates.nextOnInput
   )
 }
 
@@ -915,7 +992,7 @@ const formNavigationV2 = () => ({
     {
       $formkit: 'button',
       name: 'back_button',
-      onClick: '$setPreviousStep($scrollAnchor($get(form)))',
+      onClick: '$setPreviousStep($prevStepFunc($get(form)))',
       children: 'Back',
       style: {
         if: '$activeStep === $firstStep()',
@@ -1005,13 +1082,15 @@ const schema = [
       },
     }),
     children: [
+      progressBar(),
       headline({
         children: '$urlParam("hl", "Start Your FREE Case Application Now")',
-        if: '$activeStep === $firstStep()'
+        if: '$activeStep === $firstStep()',
+        headlineClass: '!t-text-dark'
       }),
       subHeadline({
         children: '$urlParam("shl", "Find Out If We Can Assist You in Obtaining $3,148 Per Month in Disability Benefits")',
-        if: '$activeStep === $firstStep()'
+        if: '$activeStep === $firstStep()',
       }),
       ...hiddenInputsLegal,
       {
@@ -1021,16 +1100,39 @@ const schema = [
         },
         children: [
           ssdiTOLPAndZip(),
-          ssdiApplicantAge(),
-          ssdiDisabilityConditionStopWork(),
-          ssdiDisabilityWorkHistory(),
-          ssdiSocialSecurityDisabilityReceivingBenefits(),
-          ssdiDoctorTreatment(),
-          ssdiHaveAttorney(),
+          ssdiApplicantAge({
+            nextOnInput: true,
+            headline: 'What is the Age of the Applicant?'
+          }),
+          ssdiDisabilityConditionStopWork({
+            nextOnInput: true,
+            headline: "Do You Expect To Be Out Of Work For At Least a Year Due To Your Health?"
+          }),
+          ssdiDisabilityWorkHistory({
+            nextOnInput: true,
+            headline: "Have You Had a Full-Time Job Within the Past 5 Years?"
+          }),
+          ssdiSocialSecurityDisabilityReceivingBenefits({
+            nextOnInput: true,
+            headline: "Are You Currently Receiving Social Security Disability Benefits?"
+          }),
+          ssdiDoctorTreatment({
+            nextOnInput: true,
+            headline: "Have You Recently Been Treated by a Doctor, Hospital or Clinic?"
+          }),
+          ssdiHaveAttorney({
+            nextOnInput: true,
+            headline: "Already Working with An Attorney?"
+          }),
           commentsWithBankruptcyV2({
-            nextOnEnter: false
+            nextOnEnter: false,
+            label: null,
+            headline: 'Please briefly describe your situation:',
+            headlineClass: '!t-text-dark'
+          }),
+          firstAndLastV2({
+            headlineClass: '!t-text-dark'
           }),
-          firstAndLastV2(),
           contactInfoV2({
             headline: 'Submit Your Free Application',
             subheadline: 'Based on your input you may qualify for SSDI benefits. Please verify your contact information.',

package/dist/forms/ssdi.iife.js

@@ -1 +1 @@
-var ssdi=function(){"use strict";function e(){return Object.assign({},...arguments)}const t='$getKey($meta, "commentsPlaceholders." + $get(Type_Of_Legal_Problem).value, $meta.defaultCommentsPlaceholder)',a="Please briefly describe your legal issue in a few words:",i='$getKey($meta, "finalHeadlines." + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalHeadline)',n='$getKey($meta, "finalSubHeadlines." + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalSubHeadline)',r={type:"form",id:"form",config:{validationVisibility:"submit"},onSubmit:'$submit($submitUrl, $prepData, $handleRedirect, "text/plain; charset=UTF-8")',plugins:"$plugins",actions:!1,anchorElement:"form-anchor",prepop:{fromURL:!0},errorCodes:{403:{message:"An Error Occurred",abort:!1},409:{abort:!1},429:"An Error Occurred",504:{message:"An Error Occurred",abort:!1}},formClass:"!t-max-w-[40rem]"};const o={tcpaLanguage:"By checking this box, I a) agree to the Terms of Use, and b) consent to be contacted by lawyers, lawyer networks, and partners of this website using live, autodialed, pre-recorded, or artificial voice calls, as well as text messages. Your consent is not required as a condition of purchasing any goods or services. To submit this request without this consent, call 878-213-4937."};const l={$el:"div",children:[{$el:"div",attrs:{id:"form-anchor",class:"t-absolute",style:{top:"-30px",left:0}}}],attrs:{class:"t-relative"}};const s={$el:"h1",attrs:{class:"t-flex t-justify-center t-text-center !t-text-[2rem] t-font-semibold t-pt-5 t-px-7 md:t-px-3"}};const d={$el:"h3",attrs:{class:"t-flex t-justify-center t-text-center !t-text-[1.2rem] t-font-medium t-text-blue-500 t-px-10"}};const m={$el:"div",if:"$activeStep === $lastStep()",attrs:{class:"t-flex t-justify-center t-items-center t-text-sm t-text-gray-500"},children:[{$el:"img",attrs:{loading:"lazy",alt:"",style:{border:0},width:"25",height:"25",src:"https://d27hmee62k45vz.cloudfront.net/lock_icon_1.jpeg"}},{$el:"span",children:"Secure & Encrypted",attrs:{class:"t-pl-2 t-pt-1 t-font-medium"}}]};function c(t){return e(m,t)}const p=[{$formkit:"hidden",name:"vertical",value:"Legal"},{$formkit:"hidden",name:"TCPA_Language",value:"$meta.tcpaLanguage"},{$formkit:"hidden",name:"gclid",value:null},{$formkit:"hidden",name:"campaignid",value:null},{$formkit:"hidden",name:"s",value:null}],u=t=>(t.legendClass="legend-left required",t.fieldsetClass="$reset side-by-side",t.optionsClass="t-pl-1",t.innerClass="t-flex t-items-center",t.wrapperClass="t-mb-3",(t=>e({$formkit:"checkbox",validation:"required",validationMessages:{required:"Field is required"}},t))(t)),f=t=>(t.legendClass="legend-left t-pb-1 required",t.fieldsetClass="$reset side-by-side t-items-center",t.optionsClass="t-mt-1 t-grid t-grid-cols-1 md:t-grid-cols-2-125 t-items-center",t.innerClass="t-flex t-items-center",t.optionClass="t-pr-1",(t=>e({$formkit:"radio",validation:"required",validationMessages:{required:"Field is required"},optionsClass:"t-pt-3 t-pl-1",legendClass:"required"},t))(t)),y=e=>(e.options=["Yes","No"],f(e)),h=t=>(t.labelClass="required",t.wrapperClass="side-by-side t-items-center",t.innerClass="select-height-content",t.helpClass="t-mt-2.5 md:t-text-right md:t-mt-[-5px]",(t=>e({$formkit:"select",placeholder:"Please Select",validation:"required",validationMessages:{required:"Field is required"},inputClass:"t-bg-white",labelClass:"required"},t))(t)),g=t=>(t.wrapperClass="side-by-side t-items-center",(t=>e({$formkit:"text",validation:"required",validationMessages:{required:"Field is required"},labelClass:"required"},t))(t)),b=()=>h({label:"Age of Applicant?",name:"Applicant_Age",options:["18","19","20","21","22","23","24","25","26","27","28","29","30","31","32","33","34","35","36","37","38","39","40","41","42","43","44","45","46","47","48","49","50","51","52","53","54","55","56","57","58","59","60","61","62","63","64","65"]}),x=()=>u({label:"I'd also like a separate consultation for bankruptcy and debt elimination",help:"Please note: you will be contacted separately by a bankruptcy expert",name:"CrossSell_Bankruptcy",if:'$getVal($get(form), "Type_Of_Legal_Problem") != "Bankruptcy" && ($getVal($get(form), "Degree_Of_Interest") == "Absolutely Can\'t Afford" || $getVal($get(form), "Degree_Of_Interest") == "Maybe" || $getVal($get(form), "Degree_Of_Interest") == "Probably")',validation:null,helpClass:"!t-text-sm"}),v=t=>(t=>e({$formkit:"textarea",rows:5,maxlength:500,validation:"required",validationMessages:{required:"Field is required"},innerClass:"t-max-w-xl",labelClass:"required"},t))(e({label:"Please briefly describe your situation in a few words:",name:"Comments",placeholder:'For Example: "I would like help with child support payments" or "I need help with visitation rights"'},t)),w=()=>y({name:"Disability_Condition_Stop_Work",label:"Do You Expect To Be Out Of Work For At Least a Year Due To Your Health?"}),$=()=>y({name:"Disability_Work_History",label:"Have You Had a Full-Time Job Within the Past 5 Years?"}),k=()=>y({name:"Doctor_Treatment",label:"Have You Recently Been Treated by a Doctor, Hospital or Clinic?"}),I=()=>g({$formkit:"email",name:"Email",label:"Email Address:",placeholder:"email@domain.com",autocomplete:"email","data-tf-sensitive":"false",validation:"required|email",validationMessages:{required:"Email is required",email:"Invalid Email"}}),E=()=>g({$formkit:"text",label:"First Name:",name:"First_Name",autocomplete:"given-name",validationMessages:{required:"First Name is required"}}),S=()=>y({name:"Have_Attorney",label:"Already Working with An Attorney?"}),C=()=>g({$formkit:"text",label:"Last Name:",name:"Last_Name",autocomplete:"family-name",validationMessages:{required:"Last Name is required"}}),P=()=>g({$formkit:"tel",name:"Primary_Phone",label:"Phone Number:",placeholder:"###-###-####",maxlength:12,help:"10-digit phone number, hyphens optional",autocomplete:"tel-national","data-tf-sensitive":"false",validation:"required|matches:/^[0-9]{3}-?[0-9]{3}-?[0-9]{4}$/|valid_phone",validationMessages:{required:"Field is required",matches:"Invalid Phone Format, use ###-###-####",valid_phone:"Invalid Phone Number"},helpClass:"t-mt-2.5 md:t-text-right md:t-mt-[-2px]"}),_=()=>y({name:"Social_Security_Disability_Receiving_Benefits",label:"Are You Currently Receiving Social Security Disability Benefits?"}),D=()=>({$formkit:"checkbox",label:"$meta.tcpaLanguage",name:"TCPA_Opt_In","data-tf-sensitive":"false",validation:"required|accepted",validationMessages:{required:"Consent is required",accepted:"Consent is required"},classes:{label:"t-text-xs t-text-slate-500 t-font-normal"}}),A=()=>g({label:"Zip Code:",placeholder:"#####",name:"Zip",maxlength:5,inputmode:"numeric",autocomplete:"postal-code",validation:"required|matches:/^[0-9]{5}$/",validationMessages:{required:"Zip Code is required",matches:"Invalid Zip 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Please verify your contact information.",Guardianship:"You may benefit from speaking with a guardianship professional. Please verify your contact information.","Immigration and Visas":"You may benefit from speaking with a immigration professional. Please verify your contact information.","Landlord and Tenant":"You may benefit from speaking with a landlord and tenant legal professional. Please verify your contact information.","Long Term Disability":"You may benefit from speaking with a disability legal professional. Please verify your contact information.","Medical Malpractice":"You may benefit from speaking with a malpractice professional. Please verify your contact information.","Patents and Intellectual Property":"You may benefit from speaking with a patent professional. Please verify your contact information.","Personal Injury":"You may benefit from speaking with a personal injury professional. 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