bhl-forms 0.4.5 → 0.4.6
This diff represents the content of publicly available package versions that have been released to one of the supported registries. The information contained in this diff is provided for informational purposes only and reflects changes between package versions as they appear in their respective public registries.
- package/dist/bhl-forms.iife.js +1 -1
- package/dist/bhl-forms.modern.iife.js +1 -1
- package/dist/bhl-forms.modern.umd.js +1 -1
- package/dist/bhl-forms.umd.js +1 -1
- package/dist/forms/accidentsAndInjuries.es.js +2 -2
- package/dist/forms/accidentsAndInjuries.iife.js +1 -1
- package/dist/forms/accidentsAndInjuries.json +1 -1
- package/dist/forms/appraisals.es.js +2 -2
- package/dist/forms/appraisals.iife.js +1 -1
- package/dist/forms/appraisals.json +1 -1
- package/dist/forms/childAndFamily.es.js +50 -2
- package/dist/forms/childAndFamily.iife.js +1 -1
- package/dist/forms/childAndFamily.json +1 -1
- package/dist/forms/civilLawsuit.es.js +550 -2
- package/dist/forms/civilLawsuit.iife.js +1 -1
- package/dist/forms/civilLawsuit.json +1 -1
- package/dist/forms/coins.es.js +2 -2
- package/dist/forms/coins.iife.js +1 -1
- package/dist/forms/coins.json +1 -1
- package/dist/forms/contracts.es.js +2 -2
- package/dist/forms/contracts.iife.js +1 -1
- package/dist/forms/contracts.json +1 -1
- package/dist/forms/criminal.es.js +303 -2
- package/dist/forms/criminal.iife.js +1 -1
- package/dist/forms/criminal.json +1 -1
- package/dist/forms/employmentAndWorkplace.es.js +2 -2
- package/dist/forms/employmentAndWorkplace.iife.js +1 -1
- package/dist/forms/employmentAndWorkplace.json +1 -1
- package/dist/forms/generalLegal.es.js +74 -2
- package/dist/forms/generalLegal.iife.js +1 -1
- package/dist/forms/generalLegal.json +1 -1
- package/dist/forms/generalLegalPopUnder.es.js +74 -2
- package/dist/forms/generalLegalPopUnder.iife.js +1 -1
- package/dist/forms/generalLegalPopUnder.json +1 -1
- package/dist/forms/generalLegalPopUnderTF.es.js +2 -2
- package/dist/forms/generalLegalPopUnderTF.iife.js +1 -1
- package/dist/forms/generalLegalPopUnderTF.json +1 -1
- package/dist/forms/generalLegalThankYou.es.js +2 -2
- package/dist/forms/generalLegalThankYou.iife.js +1 -1
- package/dist/forms/generalLegalThankYou.json +1 -1
- package/dist/forms/harassmentAndDiscrimination.es.js +2 -2
- package/dist/forms/harassmentAndDiscrimination.iife.js +1 -1
- package/dist/forms/harassmentAndDiscrimination.json +1 -1
- package/dist/forms/malpractice.es.js +2 -2
- package/dist/forms/malpractice.iife.js +1 -1
- package/dist/forms/malpractice.json +1 -1
- package/dist/forms/mechanics.es.js +2 -2
- package/dist/forms/mechanics.iife.js +1 -1
- package/dist/forms/mechanics.json +1 -1
- package/dist/forms/realEstate.es.js +2 -2
- package/dist/forms/realEstate.iife.js +1 -1
- package/dist/forms/realEstate.json +1 -1
- package/dist/forms/repossession.es.js +2 -2
- package/dist/forms/repossession.iife.js +1 -1
- package/dist/forms/repossession.json +1 -1
- package/dist/forms/ssdi.es.js +2 -2
- package/dist/forms/ssdi.iife.js +1 -1
- package/dist/forms/ssdi.json +1 -1
- package/dist/forms/vets.es.js +2 -2
- package/dist/forms/vets.iife.js +1 -1
- package/dist/forms/vets.json +1 -1
- package/dist/forms/willsAndTrusts.es.js +2 -2
- package/dist/forms/willsAndTrusts.iife.js +1 -1
- package/dist/forms/willsAndTrusts.json +1 -1
- package/dist/main.css +1 -1
- package/package.json +1 -1
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@@ -693,10 +693,10 @@ const claimStatus = (scope) => sbsSelect({
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});
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const comments = (updates) => textArea(
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const comments = (updates, scope) => textArea(
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merge({
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name: scope ? scope + ':' + 'Comments' : 'Comments',
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label: 'Please briefly describe your situation in a few words:',
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name: 'Comments',
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placeholder: 'For Example: "I would like help with child support payments" or "I need help with visitation rights"'
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}, updates)
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);
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var employmentAndWorkplace=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, $meta.defaultFinalSubHeadline)',n={type:"form",id:"form",config:{validationVisibility:"submit"},onSubmit:'$submit($submitUrl, $prepData, $handleRedirect, "text/plain; charset=UTF-8")',plugins:"$plugins",actions:!1,anchorElement:"form-anchor",useLocalStorage:!0,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 i={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"}},{$el:"span",children:"Secure & Encrypted",attrs:{class:"t-pl-2 t-pt-1 t-font-medium"}}]};function s(t){return e(l,t)}const m=[{$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},{$formkit:"hidden",name:"s",value:null}],d={"*":"https://listings.ziplawyer.com/api/v1/redirect?zone_id=4&category=${properties.Type_Of_Legal_Problem}&Degree_Of_Interest=${properties.Degree_Of_Interest}&zip_code=${properties.Zip}&sub_id=${properties.vid}"};const p=t=>(t.legendClass="legend-left required",t.fieldsetClass="$reset side-by-side",t.optionsClass="t-pl-1",t.innerClass="t-flex t-items-center",t.wrapperClass="t-mb-3",(t=>e({$formkit:"checkbox",validation:"required",validationMessages:{required:"Field is required"}},t))(t)),c=t=>e({$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="$reset side-by-side t-items-center",e.optionsClass="t-mt-1 t-grid t-grid-cols-1 md:t-grid-cols-2-125 t-items-center",e.innerClass="t-flex t-items-center",e.optionClass="t-pr-1",c(e)))(e)),f=t=>(t.labelClass="required",t.wrapperClass="side-by-side t-items-center",t.innerClass="select-height-content",t.helpClass="t-mt-2.5 md:t-text-right md:t-mt-[-5px]",(t=>e({$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=e=>u({name:e?e+":At_Fault":"At_Fault",label:"Were You at Fault?"}),b=e=>f({name:e?e+":Cause_Of_Injury":"Cause_Of_Injury",label:"Cause of Injury:",options:["Traumatic Physical Injury (Accident)","Repeated Trauma Injury","Mental Injury","Occupational Disease","Not Sure"]}),_=e=>f({name:e?e+":Claim_Status":"Claim_Status",label:"Status of Claim:",options:["No action taken yet","Demand for compensation made","Lawsuit filed","Other"]}),x=t=>(t=>e({$formkit:"textarea",rows:5,maxlength:500,validation:"required",validationMessages:{required:"Field is required"},innerClass:"t-max-w-xl",labelClass:"required"},t))(e({label:"Please briefly describe your situation in a few words:",name:"Comments",placeholder:'For Example: "I would like help with child support payments" or "I need help with visitation rights"'},t)),v=e=>((e,t)=>f({name:e?e+":Degree_Of_Interest":"Degree_Of_Interest",id:e?e+":Degree_Of_Interest":"Degree_Of_Interest",label:"How Likely Are You to Pay if Your Issue Could be Resolved?",help:t,options:["Definitely","Probably","Maybe","Absolutely Can't Afford"]}))(e,"No payment necessary to speak with lawyers."),w=e=>u({name:e?e+":Doctor_Treatment":"Doctor_Treatment",label:"Have You Recently Been Treated by a Doctor, Hospital or Clinic?"}),k=()=>f({label:"The Employer Is a:",name:"Employer_Type",options:["Sole proprietorship (mom and pop)","Partnership","Franchise","Privately held company","Public corporation","Government Agency","Don't know"]}),P=t=>(e=>(e.legendClass="required",e.fieldsetClass="$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="$reset t-flex t-cursor-pointer t-mb-3",c(e)))(e({name:"Type_Of_Legal_Problem_Display",if:'$get(Type_Of_Legal_Problem).value == "Employment and Workplace"',label:"Select The Workplace Issue:",options:["Workplace Harassment","Workplace Discrimination","Wrongful Termination","Payment Disputes","Workers Compensation","Personal Injury","Unemployment","Other Workplace Issues"]},t)),I=e=>u({name:e?e+":Have_Attorney":"Have_Attorney",label:"Already Working with An Attorney?"}),$=e=>g({name:e?e+":Incident_Date":"Incident_Date",label:"Date of Incident:"}),C=()=>f({label:"Total Employees of Business? (estimated)",name:"Num_Employees_Of_Business",options:["1-5","6-20","21-50","51-100","101-500","501-1,000","More than 1,000"]}),L=e=>{return(t={name:e?e+":Primary_Injury":"Primary_Injury",label:"Primary Injury:",options:["Anxiety","Back or Neck Pain","Broken Bones","Cuts and Bruises","Headaches","Memory Loss","Loss of Limb","Other (describe on next page)"]}).legendClass="legend-left-flex md:t-max-w-[40%] required",t.fieldsetClass="$reset side-by-side-flex",t.optionsClass="md:t-ml-4 md:t-mt-2 t-grid t-grid-cols-1 md:t-grid-cols-2-125",t.innerClass="t-flex t-items-start",t.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",c(t);var t},O=(t,a)=>e({$cmp:"FormKit",props:{type:"group",key:t,id:t,name:t}},a),T=()=>[I(),v()],E=(e,t)=>O("PersonalInjuryQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "Personal Injury"',children:[I(t),$(t),_(t),h(t),L(t),w(t)]}),S="$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",D="$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",A=e=>"group"!==e.type&&"section"!==e.type&&"form"!==e.type&&"hidden"!==e.$formkit&&!e.children,W=e=>{if(A(e))return e;for(var t=e.children.length-1;t>=0;t--){if("string"==typeof e.children)continue;const a=e.children[t];if(A(a))return a;const r=W(a);if(r)return r}return null};function F(e){return{$el:"h3",children:e.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-1"}}}function q(e){return{$el:"h3",children:e.headline||"Additional Case Details",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function j(e){return{$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-1 "+(e.headlineClass||"")}}}function M(e){return{$el:"h3",children:e.headline||a,attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-3 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function B(e){return{$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 "+(e.subheadlineClass||"")}}}const N="(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})();";const Y=(e,t)=>({$el:"section",if:'$stepEnabled("'+e+'")',attrs:{hidden:'$activeStep !== "'+e+'"',key:t||e}});function H(t,a,r=!0,n=!1,i=undefined){if(void 0===r&&(r=!0),a&&a.length&&(r||n)){const e=W(a[a.length-1]);e&&!0===r&&(e.onKeypress=S),e&&!0===n&&(e.onInput=D)}return e(Y(t,i),{children:[{$formkit:"group",id:t,name:t,children:a}]})}const R=[{type:"meta",data:e(i,{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 bankruptcy"',"Birth Certificate and Name Change":'Example: "Just married and would like to change my last name"',"Business Lawyers":'Example: "I need help incorporating a business" or "I would like a legal contract reviewed"',"Child Custody and Support":'Example: "Need help getting custody" or "Issues with child support payments"',"Child Custody":'Example: "Need help getting custody"',"Child Support":'Example: "Issues with child support payments"',"Civil Rights and Discrimination":'Example: "Police brutality" or "Coworker keeps harassing me"',"Civil Lawsuit":'Example: "A contractor took my money and never completed the job" or "I am being sued by a neighbor"',"File a Lawsuit":'Example: "A contractor took my money and never completed the job"',"Defend a Lawsuit":'Example: "I am being sued by a neighbor"',"Consumer Lawyers":'Example: "Someone committed fraud against me" or "A contractor took my money and never completed the job"',"Copyrights and Trademarks":'Example: "I would like to register a trademark or copyright a name"',"Criminal and Felony":'Example: "I was arrested for DUI and need legal defense" or "I am being charged with assault"',"Debt and Collections":'Example: "I would like to consolidate my debt" or "A collection agency is harassing me"',"Divorce and Separation":'Example: "I would like to file for an uncontested divorce"',"DUI and DWI":'Example: "I was arrested for DUI and need legal defense"',"Elder Law":'Example: "I would like help with Estate Planning" or "I need help with a guardianship"',"Employment and Workplace":'Example: "I was injured while on the job" or "My company is discriminating against me"',Expungement:'Example: "I would like to file for an expungement and clear my record"',"Family Issues":'Example: "I need help with guardianship" or "I need a simple will created"',Foreclosure:'Example: "I need help to avoid foreclosure on my house"',Guardianship:'Example: "I need help with guardianship documents"',"Harassment and Discrimination":'Example: "I am being discriminated at work" or "My neighbor is harassing me"',"Sexual Harassment":'Example: "I am being sexually harassed by a coworker"',"Workplace Harassment":'Example: "My coworker is being aggressive towards me"',"Non-Workplace Harassment":'Example: "My neighbor is harassing me"',"Workplace Discrimination":'Example: "I am being discriminated at work based on my age"',"Non-Workplace Discrimination":'Example: "I am being discriminated against by a local official"',"Identity Theft":'Example: "Someone stole my identity and I need help fixing the issue"',"Immigration and Visas":'Example: "I need help filing for a visa" or "Help with a green card"',Insurance:'Example: "I need help filing an insurance claim for damage to my house"',"Landlord and Tenant":'Example: "I need help to fight an eviction" or "I would like a lawyer to review a rental contract"',"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"',"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"',"Probate and Estates":'Example: "I need help with planning for my estate" or "A family member passed without a will in place"',"Product Liability":'Example: "My car battery caught on fire" or "I purchased a faulty product"',"Property Damage":'Example: "The neighbor\'s tree fell on my fence" or "My car was hit in the parking lot"',"Real Estate":'Example: "I need help with a quitclaim deed" or "I need a lawyer to review a purchase and sales agreement"',"Social Security Disability and Insurance":'Example: "I would like help filing for disability benefits" or "I\'ve been denied for SSDI and would like to appeal"',"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"',"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"',"Wrongful Death":'Example: "A family member was killed on the job and we need legal representation"',"Wrongful Termination":'Example: "I was fired by my employer without cause"',"Not Sure or Other":'Example: "I was involved in a car accident" or "I need help setting up power of attorney"'},defaultFinalHeadline:"Submit Your Case",finalHeadlines:{},defaultFinalSubHeadline:"You may benefit from speaking with a legal professional. Please verify your contact information.",finalSubHeadlines:{Adoption:"You may benefit from speaking with an adoption professional. Please verify your contact information.","Auto and Car Accidents":"You may benefit from speaking with an accident professional. Please verify your contact information.",Bankruptcy:"You may benefit from speaking with a bankruptcy professional. Please verify your contact information.","Copyrights and Trademarks":"You may benefit from speaking with a copyright and trademark professional. Please verify your contact information.","Divorce and Separation":"You may benefit from speaking with a divorce professional. Please verify your contact information.","DUI and DWI":"You may benefit from speaking with a DUI professional. Please verify your contact information.","Elder Law":"You may benefit from speaking with an elder law professional. Please verify your contact information.",Foreclosure:"You may benefit from speaking with a foreclosure professional. 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. Please verify your contact information.","Probate and Estates":"You may benefit from speaking with a probate and estate professional. Please verify your contact information.","Real Estate":"You may benefit from speaking with a real estate professional. Please verify your contact information.","Social Security Disability and Insurance":"You may benefit from speaking with an SSDI professional. Please verify your contact information.","Tax and IRS":"You may benefit from speaking with a tax professional. Please verify your contact information.",Unemployment:"You may benefit from speaking with an unemployment professional. Please verify your contact information.","Workers Compensation":"You may benefit from speaking with a workers compensation professional. Please verify your contact information."}})},e(o,U),{$cmp:"FormKit",props:function(t){const a=e(n,t);return a.formId&&!a.name&&(a.name=a.formId),a}({formId:"employmentAndWorkplace",redirectMap:function(t){return e(d,t)}(),valueOverrideMap:{Civil_Defense:{Yes:{Type_Of_Legal_Problem:"Defend a Lawsuit"}},Type_Of_Legal_Problem_Display:{"Auto Accident":{Type_Of_Legal_Problem:"Auto and Car Accidents"},"Dog Bite":{Type_Of_Legal_Problem:"Personal Injury"},"Slip and Fall":{Type_Of_Legal_Problem:"Personal Injury"},"Workplace Injury":{Type_Of_Legal_Problem:"Workers Compensation"},"Trucking Accident":{Type_Of_Legal_Problem:"Auto and Car Accidents"},"Motorcycle Accident":{Type_Of_Legal_Problem:"Auto and Car Accidents"},"Other Accidents or Injuries":{Type_Of_Legal_Problem:"Personal Injury"},"Automobile Accident":{Type_Of_Legal_Problem:"Auto and Car Accidents"},"Contract Disputes":{Type_Of_Legal_Problem:"Business Lawyers"},"Defamation and Slander":{Type_Of_Legal_Problem:"File a Lawsuit"},"Dog Bite":{Type_Of_Legal_Problem:"Personal Injury"},"Employment and Workplace":{Type_Of_Legal_Problem:"Employment and Workplace"},Fraud:{Type_Of_Legal_Problem:"Consumer Lawyers"},"Medical Malpractice":{Type_Of_Legal_Problem:"Medical Malpractice"},"Personal Injury":{Type_Of_Legal_Problem:"Personal Injury"},"Property Damage":{Type_Of_Legal_Problem:"Property Damage"},"Small Claims":{Type_Of_Legal_Problem:"File a Lawsuit"},"Real Estate":{Type_Of_Legal_Problem:"Real Estate"},"Other (describe on next page)":{Type_Of_Legal_Problem:"Not Sure or Other"},"Contract Creation":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Contract Enforcement":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Contract Cancellation":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Contract Fraud":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Breach of Contract":{Type_Of_Legal_Problem:"Business 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required"},"labelClass":"required","label":"First Name:","name":"First_Name","autocomplete":"given-name","wrapperClass":"side-by-side t-items-center"},{"$formkit":"text","validation":"required","validationMessages":{"required":"Last Name is required"},"labelClass":"required","label":"Last Name:","name":"Last_Name","autocomplete":"family-name","wrapperClass":"side-by-side t-items-center","onKeypress":"$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))"}]}]},{"$el":"section","if":"$stepEnabled(\"contactInfo\")","attrs":{"hidden":"$activeStep !== \"contactInfo\"","key":"contactInfo"},"children":[{"$formkit":"group","id":"contactInfo","name":"contactInfo","children":[{"$el":"h3","children":"$getKey($meta, \"finalHeadlines.\" + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalHeadline)","attrs":{"class":"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-3 t-pt-0 t-px-1 "}},{"$el":"h5","children":"$getKey($meta, \"finalSubHeadlines.\" + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalSubHeadline)","attrs":{"class":"t-flex t-justify-center t-text-center !t-text-lg t-font-semibold t-pb-7 t-pt-0 t-px-3 "}},{"$el":"script","if":"$activeStep === $lastStep()","children":"(function() {\n if (window.xxTrustedFormLoaded) {\n return\n }\n var vid = '';\n if (typeof window.zar !== 'undefined') {\n vid = window.zar.getVID();\n }\n window.xxTrustedFormLoaded = true;\n var sandbox = document.location.hostname.indexOf('localhost') > -1 ? 'true' : 'false'\n var tf = document.createElement('script');\n tf.type = 'text/javascript'; tf.async = true;\n tf.src = (\"https:\" == document.location.protocol ? 'https' : 'http') + \"://api.trustedform.com/trustedform.js?field=xxTrustedFormCertUrl&identifier=\" + vid + \"&ping_field=xxTrustedFormPingUrl&provideReferrer=false&invert_field_sensitivity=true&sandbox=\" + sandbox + \"&l=\" + new Date().getTime() + Math.random();\n var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(tf, s);\n})();"},{"$formkit":"email","validation":"required|email","validationMessages":{"required":"Email is required","email":"Invalid Email"},"labelClass":"required","name":"Email","label":"Email Address:","placeholder":"email@domain.com","autocomplete":"email","data-tf-sensitive":"false","wrapperClass":"side-by-side t-items-center"},{"$formkit":"tel","validation":"required|matches:/^[0-9]{3}-?[0-9]{3}-?[0-9]{4}$/|valid_phone","validationMessages":{"required":"Field is required","matches":"Invalid Phone Format, use ###-###-####","valid_phone":"Invalid Phone Number"},"labelClass":"required","name":"Primary_Phone","label":"Phone Number:","placeholder":"###-###-####","maxlength":12,"help":"10-digit phone number, hyphens optional","autocomplete":"tel-national","data-tf-sensitive":"false","helpClass":"t-mt-2.5 md:t-text-right md:t-mt-[-2px]","wrapperClass":"side-by-side t-items-center"},{"$formkit":"checkbox","label":"$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"}},{"$el":"div","if":"$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"}},{"$el":"span","children":"Secure & Encrypted","attrs":{"class":"t-pl-2 t-pt-1 t-font-medium"}}]}]}]},{"$el":"div","attrs":{"class":"step-nav"},"children":[{"$formkit":"button","name":"back_button","onClick":"$setPreviousStep($prevStepFunc($get(form)))","children":"Back","style":{"if":"$activeStep === $firstStep()","then":"visibility: hidden;"}},{"$formkit":"button","name":"next_button","onClick":"$setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form)))","children":{"if":"$activeStep === $firstStep()","then":"Start","else":"Next"},"outerClass":{"if":"$activeStep === $lastStep()","then":"t-hidden","else":""},"style":{"if":"$activeStep === $lastStep()","then":"display: none;"}},{"$formkit":"submit","name":"submit_button","label":"Submit","if":"$activeStep === $lastStep()","style":{"if":"$activeStep !== $lastStep()","then":"display: none;"}}]},{"$el":"pre","if":"$urlParam(\"fdbg\", \"\") == 1","children":[{"$el":"pre","children":"$stringify( $get(form).value )","attrs":{"class":"t-text-xs","style":"overflow: scroll"}},{"$el":"pre","children":["activeStep: ","$activeStep"],"attrs":{"class":"t-text-xs","style":"overflow: scroll"}},{"$el":"pre","children":["stepHistory: ","$stepHistory"],"attrs":{"class":"t-text-xs","style":"overflow: scroll"}},{"$el":"pre","children":["stepQueue: ","$stepQueue"],"attrs":{"class":"t-text-xs","style":"overflow: scroll"}},{"$el":"pre","children":["steps: ","$stepKeys()"],"attrs":{"class":"t-text-xs","style":"overflow: scroll"}}]}]}]}]
|
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@@ -923,10 +923,10 @@ const claimStatus = (scope) => sbsSelect({
|
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923
923
|
]
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924
924
|
});
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925
925
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926
|
-
const comments = (updates) => textArea(
|
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926
|
+
const comments = (updates, scope) => textArea(
|
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|
merge({
|
|
928
|
+
name: scope ? scope + ':' + 'Comments' : 'Comments',
|
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928
929
|
label: 'Please briefly describe your situation in a few words:',
|
|
929
|
-
name: 'Comments',
|
|
930
930
|
placeholder: 'For Example: "I would like help with child support payments" or "I need help with visitation rights"'
|
|
931
931
|
}, updates)
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932
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);
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@@ -3018,6 +3018,14 @@ function autoAndCarAccidentCrossSellQuestions(updates = {}) {
|
|
|
3018
3018
|
crossSellQuestionsStepHeadline({ headline: 'You May Be Entitled To Compensation' }),
|
|
3019
3019
|
crossSellQuestionsStepSubHeadline({ subheadline: 'Tell us about your accident:' }),
|
|
3020
3020
|
AutoAndCarAccidentsQuestions("true", 'CrossSell:Auto_and_Car_Accidents'),
|
|
3021
|
+
comments(
|
|
3022
|
+
{
|
|
3023
|
+
label: 'Accident Description:',
|
|
3024
|
+
placeholder: 'Please describe your accident in a few words...',
|
|
3025
|
+
inputClass: '!t-h-16'
|
|
3026
|
+
},
|
|
3027
|
+
'CrossSell:Auto_and_Car_Accidents'
|
|
3028
|
+
)
|
|
3021
3029
|
],
|
|
3022
3030
|
updates.nextOnEnter
|
|
3023
3031
|
)
|
|
@@ -3029,6 +3037,14 @@ function childCustodyCrossSellQuestions(updates = {}) {
|
|
|
3029
3037
|
[
|
|
3030
3038
|
crossSellQuestionsStepHeadline({ headline: 'Child Custody Information' }),
|
|
3031
3039
|
ChildCustodyQuestions("true", 'CrossSell:Child_Custody'),
|
|
3040
|
+
comments(
|
|
3041
|
+
{
|
|
3042
|
+
label: 'Description:',
|
|
3043
|
+
placeholder: 'Please describe your situation in a few words...',
|
|
3044
|
+
inputClass: '!t-h-16'
|
|
3045
|
+
},
|
|
3046
|
+
'CrossSell:Child_Custody'
|
|
3047
|
+
)
|
|
3032
3048
|
],
|
|
3033
3049
|
updates.nextOnEnter
|
|
3034
3050
|
)
|
|
@@ -3040,6 +3056,14 @@ function divorceAndSeparationCrossSellQuestions(updates = {}) {
|
|
|
3040
3056
|
[
|
|
3041
3057
|
crossSellQuestionsStepHeadline({ headline: 'Divorce or Separation Information' }),
|
|
3042
3058
|
DivorceQuestions("true", 'CrossSell:Divorce_and_Separation'),
|
|
3059
|
+
comments(
|
|
3060
|
+
{
|
|
3061
|
+
label: 'Description:',
|
|
3062
|
+
placeholder: 'Please describe your situation in a few words...',
|
|
3063
|
+
inputClass: '!t-h-16'
|
|
3064
|
+
},
|
|
3065
|
+
'CrossSell:Divorce_and_Separation'
|
|
3066
|
+
)
|
|
3043
3067
|
],
|
|
3044
3068
|
updates.nextOnEnter
|
|
3045
3069
|
)
|
|
@@ -3051,6 +3075,14 @@ function duiAndDWICrossSellQuestions(updates = {}) {
|
|
|
3051
3075
|
[
|
|
3052
3076
|
crossSellQuestionsStepHeadline({ headline: 'About Your DUI/DWI' }),
|
|
3053
3077
|
DUIAndDWIQuestions("true", 'CrossSell:DUI_and_DWI'),
|
|
3078
|
+
comments(
|
|
3079
|
+
{
|
|
3080
|
+
label: 'Incident Description:',
|
|
3081
|
+
placeholder: 'Please describe your incident in a few words...',
|
|
3082
|
+
inputClass: '!t-h-16'
|
|
3083
|
+
},
|
|
3084
|
+
'CrossSell:DUI_and_DWI'
|
|
3085
|
+
)
|
|
3054
3086
|
],
|
|
3055
3087
|
updates.nextOnEnter
|
|
3056
3088
|
)
|
|
@@ -3063,6 +3095,14 @@ function longTermDisabilityCrossSellQuestions(updates = {}) {
|
|
|
3063
3095
|
crossSellQuestionsStepHeadline({ headline: 'You May Be Entitled To Benefits' }),
|
|
3064
3096
|
crossSellQuestionsStepSubHeadline({ subheadline: 'Tell us about your disability:' }),
|
|
3065
3097
|
LongTermDisabilityQuestions("true", 'CrossSell:Long_Term_Disability'),
|
|
3098
|
+
comments(
|
|
3099
|
+
{
|
|
3100
|
+
label: 'Description:',
|
|
3101
|
+
placeholder: 'Please describe your situation in a few words...',
|
|
3102
|
+
inputClass: '!t-h-16'
|
|
3103
|
+
},
|
|
3104
|
+
'CrossSell:Long_Term_Disability'
|
|
3105
|
+
)
|
|
3066
3106
|
],
|
|
3067
3107
|
updates.nextOnEnter
|
|
3068
3108
|
)
|
|
@@ -3075,6 +3115,14 @@ function personalInjuryCrossSellQuestions(updates = {}) {
|
|
|
3075
3115
|
crossSellQuestionsStepHeadline({ headline: 'You May Be Entitled To Compensation' }),
|
|
3076
3116
|
crossSellQuestionsStepSubHeadline({ subheadline: 'Tell us about your injury:' }),
|
|
3077
3117
|
PersonalInjuryQuestions("true", 'CrossSell:Personal_Injury'),
|
|
3118
|
+
comments(
|
|
3119
|
+
{
|
|
3120
|
+
label: 'Injury Description:',
|
|
3121
|
+
placeholder: 'Please describe your injury in a few words...',
|
|
3122
|
+
inputClass: '!t-h-16'
|
|
3123
|
+
},
|
|
3124
|
+
'CrossSell:Personal_Injury'
|
|
3125
|
+
)
|
|
3078
3126
|
],
|
|
3079
3127
|
updates.nextOnEnter
|
|
3080
3128
|
)
|
|
@@ -3086,6 +3134,14 @@ function powerOfAttorneyCrossSellQuestions(updates = {}) {
|
|
|
3086
3134
|
[
|
|
3087
3135
|
crossSellQuestionsStepHeadline({ headline: 'Power of Attorney Information' }),
|
|
3088
3136
|
PowerofAttorneyQuestions("true", 'CrossSell:Power_of_Attorney'),
|
|
3137
|
+
comments(
|
|
3138
|
+
{
|
|
3139
|
+
label: 'Description:',
|
|
3140
|
+
placeholder: 'Please describe your situation in a few words...',
|
|
3141
|
+
inputClass: '!t-h-16'
|
|
3142
|
+
},
|
|
3143
|
+
'CrossSell:Power_of_Attorney'
|
|
3144
|
+
)
|
|
3089
3145
|
],
|
|
3090
3146
|
updates.nextOnEnter
|
|
3091
3147
|
)
|
|
@@ -3097,6 +3153,14 @@ function willsAndTrustsCrossSellQuestions(updates = {}) {
|
|
|
3097
3153
|
[
|
|
3098
3154
|
crossSellQuestionsStepHeadline({ headline: 'Will or Trust Information' }),
|
|
3099
3155
|
WillsAndTrustsQuestions("true", 'CrossSell:Wills_and_Trusts'),
|
|
3156
|
+
comments(
|
|
3157
|
+
{
|
|
3158
|
+
label: 'Description:',
|
|
3159
|
+
placeholder: 'Please describe your situation in a few words...',
|
|
3160
|
+
inputClass: '!t-h-16'
|
|
3161
|
+
},
|
|
3162
|
+
'CrossSell:Wills_and_Trusts'
|
|
3163
|
+
)
|
|
3100
3164
|
],
|
|
3101
3165
|
updates.nextOnEnter
|
|
3102
3166
|
)
|
|
@@ -3109,6 +3173,14 @@ function workersCompensationCrossSellQuestions(updates = {}) {
|
|
|
3109
3173
|
crossSellQuestionsStepHeadline({ headline: 'You May Be Entitled To Benefits' }),
|
|
3110
3174
|
crossSellQuestionsStepSubHeadline({ subheadline: 'Tell us about your injury:' }),
|
|
3111
3175
|
WorkersCompensationQuestions("true", 'CrossSell:Workers_Compensation'),
|
|
3176
|
+
comments(
|
|
3177
|
+
{
|
|
3178
|
+
label: 'Injury Description:',
|
|
3179
|
+
placeholder: 'Please describe your injury in a few words...',
|
|
3180
|
+
inputClass: '!t-h-16'
|
|
3181
|
+
},
|
|
3182
|
+
'CrossSell:Workers_Compensation'
|
|
3183
|
+
)
|
|
3112
3184
|
],
|
|
3113
3185
|
updates.nextOnEnter
|
|
3114
3186
|
)
|