bhl-forms 0.2.9 → 0.3.2

package/dist/forms/accidentsAndInjuries.es.js

@@ -434,7 +434,6 @@ const TOLPCommentsPlaceholders = {
   'Lemon Law': 'Example: "I purchased a new vehicle that broke down already and seller will not assist"',
   'Long Term Disability': 'Example: "I was injured on the job and would like to file for benefits" or "I need help filing for disability benefits"',
   'Medical Malpractice': 'Example: "A doctor performed surgery on the wrong limb and I would like to file a lawsuit"',
-  'Nursing Home Abuse': 'Example: "My mother\'s nursing home is physically abusing her"',
   'Patents and Intellectual Property': 'Example: "I would like to file for a patent" or "I need to copyright a name"',
   'Personal Injury': 'Example: "I was bit by the neighbor\'s dog" or "I fell in the icy grocery store parking lot"',
   'Power of Attorney': 'Example: "I need help with a limited or general power of attorney"',
@@ -446,8 +445,6 @@ const TOLPCommentsPlaceholders = {
   'Tax and IRS': 'Example: "I need help fighting an IRS tax claim" or "I need audit defense"',
   'Traffic and Tickets': 'Example: "I need help reinstating a supsended license" or "I would like to fight a traffic ticket"',
   'Unemployment': 'Example: "I need help filing for unemployment benefits"',
-  'Vaccination Injury': 'Example: "I was injured after receiving a vaccine and would like to file a lawsuit"',
-  'Veteran\'s Disability': 'Example: "I would like help filing for disability benefits"',
   'Victim of a Crime': 'Example: "I was assaulted in the store" or "I am being discriminated against at work"',
   'Wills and Trusts': 'Example: "I need a simple will created" or "I would like guidance on creating a trust fund"',
   'Workers Compensation': 'Example: "I was injured at work and would like to file for workers compensation benefits"',
@@ -458,59 +455,6 @@ const TOLPCommentsPlaceholders = {
 
 const TOLPFinalHeadlines = {
   // 'Adoption': '',
-  // 'Asbestos and Mesothelioma': '',
-  // 'Auto and Car Accidents': '',
-  // 'Bankruptcy': '',
-  // 'Birth Certificate and Name Change': '',
-  // 'Business Lawyers': '',
-  // 'Child Custody and Support': '',
-  // 'Civil Rights and Discrimination': '',
-  // 'Civil Lawsuit': '',
-  // 'Consumer Lawyers': '',
-  // 'Copyrights and Trademarks': '',
-  // 'Criminal and Felony': '',
-  // 'Debt and Collections': '',
-  // 'Divorce and Separation': '',
-  // 'DUI and DWI': '',
-  // 'Elder Law': '',
-  // 'Employment and Workplace': '',
-  // 'Expungement': '',
-  // 'Family Issues': '',
-  // 'Foreclosure': '',
-  // 'Guardianship': '',
-  // 'Harassment and Discrimination': '',
-  // 'Identity Theft': '',
-  // 'Immigration and Visas': '',
-  // 'Insurance': '',
-  // 'Landlord and Tenant': '',
-  // 'Lemon Law': '',
-  // 'Long Term Disability': '',
-  // 'Medical Malpractice': '',
-  // 'Nursing Home Abuse': '',
-  // 'Patents and Intellectual Property': '',
-  // 'Personal Injury': '',
-  // 'Power of Attorney': '',
-  // 'Probate and Estates': '',
-  // 'Product Liability': '',
-  // 'Property Damage': '',
-  // 'Real Estate': '',
-  // 'Social Security Disability and Insurance': '',
-  // 'Tax and IRS': '',
-  // 'Traffic and Tickets': '',
-  // 'Unemployment': '',
-  // 'Vaccination Injury': '',
-  // 'Veteran\'s Disability': '',
-  // 'Victim of a Crime': '',
-  // 'Wills and Trusts': '',
-  // 'Workers Compensation': '',
-  // 'Wrongful Death': '',
-  // 'Wrongful Termination': '',
-  // 'Not Sure or Other': ''
-  // 'Sexual Harassment': '',
-  // 'Workplace Harassment': '',
-  // 'Non-Workplace Harassment': '',
-  // 'Workplace Discrimination': '',
-  // 'Non-Workplace Discrimination': '',
 };
 
 const TOLPFinalSubHeadlines = {
@@ -543,7 +487,6 @@ const TOLPFinalSubHeadlines = {
   // 'Lemon Law': '',
   '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.',
-  // 'Nursing Home Abuse': '',
   '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. Please verify your contact information.',
   // 'Power of Attorney': '',
@@ -555,8 +498,6 @@ const TOLPFinalSubHeadlines = {
   'Tax and IRS': 'You may benefit from speaking with a tax professional. Please verify your contact information.',
   // 'Traffic and Tickets': '',
   'Unemployment': 'You may benefit from speaking with an unemployment professional. Please verify your contact information.',
-  // 'Vaccination Injury': '',
-  'Veteran\'s Disability': 'You may benefit from speaking with a disability legal professional. Please verify your contact information.',
   // 'Victim of a Crime': '',
   // 'Wills and Trusts': '',
   'Workers Compensation': 'You may benefit from speaking with a workers compensation professional. Please verify your contact information.',
@@ -656,7 +597,6 @@ const sbsSelect = (updates) => {
   return select(updates)
 };
 
-
 const text = (updates) => {
   return merge({
     $formkit: 'text',
@@ -722,8 +662,8 @@ const accidentsAndInjuriesTOLPDisplay = (updates) => col2Radio(merge({
   ]
 }, updates));
 
-const atFault = () => sbsYesNoRadio({
-  name: 'At_Fault',
+const atFault = (scope) => sbsYesNoRadio({
+  name: scope ? scope + ':' + 'At_Fault' : 'At_Fault',
   label: 'Were You at Fault?'
 });
 
@@ -736,9 +676,9 @@ const bankruptcyCrossSell = () => sbsCheckbox({
   helpClass: "!t-text-sm"
 });
 
-const causeOfInjury = () => sbsSelect({
+const causeOfInjury = (scope) => sbsSelect({
+  name: scope ? scope + ':' + 'Cause_Of_Injury' : 'Cause_Of_Injury',
   label: 'Cause of Injury:',
-  name: 'Cause_Of_Injury',
   options: [
     "Traumatic Physical Injury (Accident)",
     "Repeated Trauma Injury",
@@ -748,9 +688,9 @@ const causeOfInjury = () => sbsSelect({
   ]
 });
 
-const claimStatus = () => sbsSelect({
+const claimStatus = (scope) => sbsSelect({
+  name: scope ? scope + ':' + 'Claim_Status' : 'Claim_Status',
   label: "Status of Claim:",
-  name: 'Claim_Status',
   options: [
     "No action taken yet",
     "Demand for compensation made",
@@ -767,9 +707,9 @@ const comments = (updates) => textArea(
   }, updates)
 );
 
-const doctorTreatment = () => sbsYesNoRadio({
-  name: 'Doctor_Treatment',
-  label: 'Have You Recently Been Treated by a Doctor, Hospital or Clinic?'
+const doctorTreatment = (scope) => sbsYesNoRadio({
+  name: scope ? scope + ':' + 'Doctor_Treatment' : 'Doctor_Treatment',
+  label: 'Have You Recently Been Treated by a Doctor, Hospital or Clinic?',
 });
 
 const email = () => sbsText({
@@ -796,14 +736,14 @@ const firstName = () => sbsText({
   }
 });
 
-const haveAttorney = () => sbsYesNoRadio({
-  name: 'Have_Attorney',
+const haveAttorney = (scope) => sbsYesNoRadio({
+  name: scope ? scope + ':' + 'Have_Attorney' : 'Have_Attorney',
   label: 'Already Working with An Attorney?'
 });
 
-const incidentDate = () => sbsDate({
+const incidentDate = (scope) => sbsDate({
+  name: scope ? scope + ':' + 'Incident_Date' : 'Incident_Date',
   label: 'Date of Incident:',
-  name: 'Incident_Date'
 });
 
 const lastName = () => sbsText({
@@ -834,9 +774,9 @@ const phone = () => sbsText({
   helpClass: "t-mt-2.5 md:t-text-right md:t-mt-[-2px]"
 });
 
-const primaryInjury = () => sbs2ColRadio({
+const primaryInjury = (scope) => sbs2ColRadio({
+  name: scope ? scope + ':' + 'Primary_Injury' : 'Primary_Injury',
   label: 'Primary Injury:',
-  name: 'Primary_Injury',
   options: [
     "Anxiety",
     "Back or Neck Pain",
@@ -849,8 +789,8 @@ const primaryInjury = () => sbs2ColRadio({
   ]
 });
 
-const policeReportFiled = () => sbsYesNoRadio({
-  name: 'Police_Report_Filed',
+const policeReportFiled = (scope) => sbsYesNoRadio({
+  name: scope ? scope + ':' + 'Police_Report_Filed' : 'Police_Report_Filed',
   label: 'Was a Police Report Filed?'
 });
 
@@ -899,47 +839,47 @@ const group = (name, updates) => {
   }, updates)
 };
 
-const AutoAndCarAccidentsQuestions = () => group(
+const AutoAndCarAccidentsQuestions = (condition, scope) => group(
   'AutoAndCarAccidentsQuestions',
   {
-    if: '$get(Type_Of_Legal_Problem).value == "Auto and Car Accidents"',
+    if: (condition || '$get(Type_Of_Legal_Problem).value == "Auto and Car Accidents"'),
     children: [
-      haveAttorney(),
-      incidentDate(),
-      atFault(),
-      primaryInjury(),
-      doctorTreatment(),
-      policeReportFiled()
+      haveAttorney(scope),
+      incidentDate(scope),
+      atFault(scope),
+      primaryInjury(scope),
+      doctorTreatment(scope),
+      policeReportFiled(scope)
     ]
   }
 );
 
-const PersonalInjuryQuestions = () => group(
+const PersonalInjuryQuestions = (condition, scope) => group(
   'PersonalInjuryQuestions',
   {
-    if: '$get(Type_Of_Legal_Problem).value == "Personal Injury"',
+    if: (condition || '$get(Type_Of_Legal_Problem).value == "Personal Injury"'),
     children: [
-      haveAttorney(),
-      incidentDate(),
-      claimStatus(),
-      atFault(),
-      primaryInjury(),
-      doctorTreatment()
+      haveAttorney(scope),
+      incidentDate(scope),
+      claimStatus(scope),
+      atFault(scope),
+      primaryInjury(scope),
+      doctorTreatment(scope)
     ]
   }
 );
 
-const WorkersCompensationQuestions = () => group(
+const WorkersCompensationQuestions = (condition, scope) => group(
   'WorkersCompensationQuestions',
   {
-    if: '$get(Type_Of_Legal_Problem).value == "Workers Compensation"',
+    if: (condition || '$get(Type_Of_Legal_Problem).value == "Workers Compensation"'),
     children: [
-      haveAttorney(),
-      incidentDate(),
-      claimStatus(),
-      primaryInjury(),
-      causeOfInjury(),
-      doctorTreatment()
+      haveAttorney(scope),
+      incidentDate(scope),
+      claimStatus(scope),
+      primaryInjury(scope),
+      causeOfInjury(scope),
+      doctorTreatment(scope)
     ]
   }
 );
@@ -971,21 +911,17 @@ const findLastInput = (n) => {
 
 const stepDefaults = (step) => ({
   $el: 'section',
-  if: '$stepIsEnabled("' + step + '")',
   attrs: {
-    style: {
-      if: '$activeStep !== "' + step + '"',
-      then: 'display: none;'
-    }
+    hidden: '$activeStep !== "' + step + '"'
   }
 });
 
 function questionsStepHeadline(updates) {
   return {
     $el: 'h3',
-    children: updates.headline || 'Tell Us About Your Case',
+    children: updates.headline || 'Tell Us About Your Situation',
     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-1'
     }
   }
 }
@@ -996,7 +932,7 @@ function commentsStepHeadline(updates) {
     $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' + ' ' + (updates.headlineClass || '')
+      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-1' + ' ' + (updates.headlineClass || '')
     }
   }
 }
@@ -1006,7 +942,7 @@ 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' + ' ' + (updates.headlineClass || '')
+      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-1' + ' ' + (updates.headlineClass || '')
     }
   }
 }
@@ -1016,7 +952,7 @@ function contactStepHeadline(updates) {
     $el: 'h3',
     children: updates.headline || DEFAULT_FINAL_HEADLINE_DYNAMIC,
     attrs: {
-      class: 't-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-3 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-3 t-pt-0 t-px-1'
     }
   }
 }
@@ -1063,10 +999,10 @@ function step(name, inputs, nextOnEnter = true, nextOnInput = false) {
   }
   if (inputs && inputs.length && (nextOnEnter || nextOnInput)) {
     const lastInput = findLastInput(inputs[inputs.length - 1]);
-    if (nextOnEnter === true) {
+    if (lastInput && nextOnEnter === true) {
       lastInput.onKeypress = NEXT_ON_ENTER;
     }
-    if (nextOnInput === true) {
+    if (lastInput && nextOnInput === true) {
       lastInput.onInput = NEXT_ON_INPUT;
     }
   }

package/dist/forms/accidentsAndInjuries.iife.js

@@ -1 +1 @@
-var accidentsAndInjuries=function(){"use strict";function e(){return Object.assign({},...arguments)}const t='$getKey($meta, "commentsPlaceholders." + $get(Type_Of_Legal_Problem).value, $meta.defaultCommentsPlaceholder)',a='$getKey($meta, "finalHeadlines." + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalHeadline)',r='$getKey($meta, "finalSubHeadlines." + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalSubHeadline)',i={type:"form",id:"form",config:{validationVisibility:"submit"},onSubmit:'$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 n={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 o={$el:"div",children:[{$el:"div",attrs:{id:"form-anchor",class:"t-absolute",style:{top:"-30px",left:0}}}],attrs:{class:"t-relative"}};const l={$el:"div",if:"$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"}},{$el:"span",children:"Secure & Encrypted",attrs:{class:"t-pl-2 t-pt-1 t-font-medium"}}]};function s(t){return e(l,t)}const d=[{$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},{$formkit:"hidden",name:"s",value:null}],m={"*":"https://listings.ziplawyer.com/api/v1/redirect?zone_id=4&category=${properties.Type_Of_Legal_Problem}&Degree_Of_Interest=${properties.Degree_Of_Interest}&zip_code=${properties.Zip}&sub_id=${properties.vid}"};const c=t=>(t.legendClass="legend-left required",t.fieldsetClass="$reset side-by-side",t.optionsClass="t-pl-1",t.innerClass="t-flex t-items-center",t.wrapperClass="t-mb-3",(t=>e({$formkit:"checkbox",validation:"required",validationMessages:{required:"Field is required"}},t))(t)),p=t=>e({$formkit:"radio",validation:"required",validationMessages:{required:"Field is required"},optionsClass:"t-pt-3 t-pl-1",legendClass:"required"},t),u=e=>(e.options=["Yes","No"],(e=>(e.legendClass="legend-left t-pb-1 required",e.fieldsetClass="$reset side-by-side t-items-center",e.optionsClass="t-mt-1 t-grid t-grid-cols-1 md:t-grid-cols-2-125 t-items-center",e.innerClass="t-flex t-items-center",e.optionClass="t-pr-1",p(e)))(e)),f=t=>(t.labelClass="required",t.wrapperClass="side-by-side t-items-center",t.innerClass="select-height-content",t.helpClass="t-mt-2.5 md:t-text-right md:t-mt-[-5px]",(t=>e({$formkit:"select",placeholder:"Please Select",validation:"required",validationMessages:{required:"Field is required"},inputClass:"t-bg-white",labelClass:"required"},t))(t)),y=t=>(t.wrapperClass="side-by-side t-items-center",(t=>e({$formkit:"text",validation:"required",validationMessages:{required:"Field is required"},labelClass:"required"},t))(t)),g=t=>(t.wrapperClass="side-by-side t-items-center",(t=>e({$formkit:"DatePicker",validation:"required",validationMessages:{required:"Field is required"},labelClass:"required t-block t-mb-3 t-font-semibold t-text-base formkit-invalid:t-text-red-500",innerClass:"t-border t-border-gray-400 formkit-invalid:t-border-red-500 t-rounded t-mb-1 focus-within:t-border-blue-500"},t))(t)),h=t=>(e=>(e.legendClass="required",e.fieldsetClass="$reset",e.optionsClass="t-pl-2 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2",e.innerClass="t-items-start",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",p(e)))(e({name:"Type_Of_Legal_Problem_Display",if:'$get(Type_Of_Legal_Problem).value == "Auto and Car Accidents"',label:"Select The Issue:",options:["Auto Accident","Workplace Injury","Dog Bite","Slip and Fall","Trucking Accident","Motorcycle Accident","Other Accidents or Injuries"]},t)),b=()=>u({name:"At_Fault",label:"Were You at Fault?"}),_=()=>f({label:"Status of Claim:",name:"Claim_Status",options:["No action taken yet","Demand for compensation made","Lawsuit filed","Other"]}),x=t=>(t=>e({$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)),v=()=>u({name:"Doctor_Treatment",label:"Have You Recently Been Treated by a Doctor, Hospital or Clinic?"}),w=()=>u({name:"Have_Attorney",label:"Already Working with An Attorney?"}),P=()=>g({label:"Date of Incident:",name:"Incident_Date"}),k=()=>{return(e={label:"Primary Injury:",name:"Primary_Injury",options:["Anxiety","Back or Neck Pain","Broken Bones","Cuts and Bruises","Headaches","Memory Loss","Loss of Limb","Other (describe on next page)"]}).legendClass="legend-left-flex md:t-max-w-[40%] required",e.fieldsetClass="$reset side-by-side-flex",e.optionsClass="md:t-ml-4 md:t-mt-2 t-grid t-grid-cols-1 md:t-grid-cols-2-125",e.innerClass="t-flex t-items-start",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",p(e);var e},I=(t,a)=>e({$cmp:"FormKit",props:{type:"group",key:t,id:t,name:t}},a),$="$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",C="$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",L=e=>"group"!==e.type&&"section"!==e.type&&"form"!==e.type&&"hidden"!==e.$formkit&&!e.children,T=e=>{if(L(e))return e;for(var t=e.children.length-1;t>=0;t--){if("string"==typeof e.children)continue;const a=e.children[t];if(L(a))return a;const r=T(a);if(r)return r}return null},E=e=>({$el:"section",if:'$stepIsEnabled("'+e+'")',attrs:{style:{if:'$activeStep !== "'+e+'"',then:"display: none;"}}});function O(e){return{$el:"h3",children:e.headline||"Tell Us About Your Case",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-3"}}}function S(e){return{$el:"h3",children:e.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 "+(e.headlineClass||"")}}}function A(e){return{$el:"h3",children:e.headline||"Please Provide a Contact Name",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-3 "+(e.headlineClass||"")}}}function D(e){return{$el:"h3",children:e.headline||a,attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-3 t-pt-0 t-px-3"}}}function j(e){return{$el:"h5",children:e.subheadline||r,attrs:{class:"t-flex t-justify-center t-text-center !t-text-lg t-font-semibold t-pb-7 t-pt-0 t-px-3"}}}const q="(function() {\n  if (window.xxTrustedFormLoaded) {\n    return\n  }\n  var vid = '';\n  if (typeof window.zar !== 'undefined') {\n    vid = window.zar.getVID();\n  }\n  window.xxTrustedFormLoaded = true;\n  var sandbox = document.location.hostname.indexOf('localhost') > -1 ? 'true' : 'false'\n  var tf = document.createElement('script');\n  tf.type = 'text/javascript'; tf.async = true;\n  tf.src = (\"https:\" == document.location.protocol ? 'https' : 'http') + \"://api.trustedform.com/trustedform.js?field=xxTrustedFormCertUrl&identifier=\" + vid + \"&ping_field=xxTrustedFormPingUrl&provideReferrer=false&invert_field_sensitivity=true&sandbox=\" + sandbox + \"&l=\" + new Date().getTime() + Math.random();\n  var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(tf, s);\n})();";function F(t,a,r=!0,i=!1){if(void 0===r&&(r=!0),a&&a.length&&(r||i)){const e=T(a[a.length-1]);!0===r&&(e.onKeypress=$),!0===i&&(e.onInput=C)}return e(E(t),{children:[{$formkit:"group",id:t,name:t,children:a}]})}const M=[{type:"meta",data:e(n,{defaultCommentsPlaceholder:t,commentsPlaceholders:{Adoption:'Example: "I need help with adoption forms"',"Asbestos and Mesothelioma":'Example: "I was exposed to asbestos at work and would like to file a claim"',"Auto and Car Accidents":'Example: "A truck crashed into my car on the highway" or "I\'ve been involved in a hit and run accident"',Bankruptcy:'Example: "I need help filing for 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