bhl-forms 0.6.1 → 0.6.3

package/dist/forms/ssdi.es.js

@@ -0,0 +1,1079 @@
+function merge() {
+  return Object.assign({}, ...arguments)
+}
+
+function LegalRedirectUrl() {
+  return 'https://listings.ziplawyer.com/api/v1/redirect?zone_id=4&vertical=Legal&category=${properties.Type_Of_Legal_Problem}&Degree_Of_Interest=${properties.Degree_Of_Interest}&zip_code=${properties.Zip}&sub_id=${properties.vid}'
+}
+
+var TCPA_LANGUAGE = "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 DEFAULT_COMMENTS_PLACEHOLDER_DYNAMIC = '$getKey($meta, "commentsPlaceholders." + $get(Type_Of_Legal_Problem).value, $meta.defaultCommentsPlaceholder)';
+const DEFAULT_COMMENTS_LABEL = 'Please briefly describe your legal issue in a few words:';
+const DEFAULT_FINAL_HEADLINE = 'Submit Your Case';
+const DEFAULT_FINAL_HEADLINE_DYNAMIC = '$getKey($meta, "finalHeadlines." + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalHeadline)';
+const DEFAULT_FINAL_SUBHEADLINE = 'You may benefit from speaking with a legal professional. Please verify your contact information.';
+const DEFAULT_FINAL_SUBHEADLINE_DYNAMIC = '$getKey($meta, "finalSubHeadlines." + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalSubHeadline)';
+
+const formPropDefaults = {
+  type: 'form',
+  id: 'form',
+  config: { validationVisibility: 'submit' },
+  onSubmit: '$submit($submitUrl, $prepData, $handleRedirect, "text/plain; charset=UTF-8")',
+  plugins: '$plugins',
+  actions: false,
+  anchorElement: 'form-anchor',
+  useLocalStorage: true,
+  prepop: {
+    fromURL: true
+  },
+  errorCodes: {
+    403: { message: "An Error Occurred", abort: false },
+    409: { abort: false },
+    429: "An Error Occurred",
+    504: { message: "An Error Occurred", abort: false },
+  },
+  formClass: '!t-max-w-[40rem]'
+};
+
+function formProps(updates) {
+  const props = merge(
+    formPropDefaults,
+    updates
+  );
+  if (props.formId && !props.name) {
+    props.name = props.formId;
+  }
+  return props
+}
+
+const metaDefaults = {
+  tcpaLanguage: TCPA_LANGUAGE
+};
+
+function metaProps(updates) {
+  const data = merge(
+    metaDefaults,
+    updates
+  );
+  return {
+    type: 'meta',
+    data
+  }
+}
+
+function defaultMetaProps() {
+  return metaProps({
+    defaultCommentsPlaceholder: DEFAULT_COMMENTS_PLACEHOLDER_DYNAMIC,
+    commentsPlaceholders: TOLPCommentsPlaceholders,
+    defaultFinalHeadline: DEFAULT_FINAL_HEADLINE,
+    finalHeadlines: TOLPFinalHeadlines,
+    defaultFinalSubHeadline: DEFAULT_FINAL_SUBHEADLINE,
+    finalSubHeadlines: TOLPFinalSubHeadlines,
+    // Added everywhere for now
+    // trustedFormTOLPs: trustedFormTOLPs
+  })
+}
+
+const formAnchorDefaults = {
+  $el: 'div',
+  children: [
+    {
+      $el: 'div',
+      attrs: {
+        id: 'form-anchor',
+        class: 't-absolute',
+        style: { top: '-30px', left: 0 }
+      }
+    }
+  ],
+  attrs: {
+    class: 't-relative'
+  }
+};
+
+function formAnchor(updates) {
+  return merge(
+    formAnchorDefaults,
+    updates
+  )
+}
+
+const progressBarDefaults = {
+  $el: 'div',
+  attrs: {
+    class: 't-mt-7 t-mb-5 t-w-full t-flex t-flex-col t-justify-center t-items-center',
+    style: {
+      if: '$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 progressBar(updates) {
+  return merge(
+    progressBarDefaults,
+    updates
+  )
+}
+
+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 headline(updates = {}) {
+  return merge(
+    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
+  )
+}
+
+const secureIconDefault = {
+  $el: 'div',
+  if: '$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 secureIcon(updates) {
+  return merge(
+    secureIconDefault,
+    updates
+  )
+}
+
+const hiddenInputsBase = [
+  {
+    $formkit: 'hidden',
+    name: "gclid",
+    value: null
+  },
+  {
+    $formkit: 'hidden',
+    name: "campaignid",
+    value: null
+  },
+  {
+    $formkit: 'hidden',
+    name: "s",
+    value: null
+  }
+];
+
+const hiddenInputsLegal = [
+  {
+    $formkit: 'hidden',
+    name: "vertical",
+    value: "Legal"
+  },
+  {
+    $formkit: 'hidden',
+    name: "TCPA_Language",
+    value: "$meta.tcpaLanguage"
+  },
+  ...hiddenInputsBase
+];
+
+const TOLPCommentsPlaceholders = {
+  '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"'
+};
+
+const TOLPFinalHeadlines = {
+  // 'Adoption': '',
+};
+
+const TOLPFinalSubHeadlines = {
+  'Adoption': 'You may benefit from speaking with an adoption professional. Please verify your contact information.',
+  // 'Asbestos and Mesothelioma': '',
+  '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.',
+  // 'Birth Certificate and Name Change': '',
+  // 'Business Lawyers': '',
+  // 'Child Custody and Support': '',
+  // 'Civil Rights and Discrimination': '',
+  // 'Civil Lawsuit': '',
+  // 'Consumer Lawyers': '',
+  'Copyrights and Trademarks': 'You may benefit from speaking with a copyright and trademark professional. Please verify your contact information.',
+  // 'Criminal and Felony': '',
+  // 'Debt and Collections': '',
+  '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.',
+  // 'Employment and Workplace': '',
+  // 'Expungement': '',
+  // 'Family Issues': '',
+  '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.',
+  // 'Harassment and Discrimination': '',
+  // 'Identity Theft': '',
+  'Immigration and Visas': 'You may benefit from speaking with a immigration professional. Please verify your contact information.',
+  // 'Insurance': '',
+  'Landlord and Tenant': 'You may benefit from speaking with a landlord and tenant legal professional. Please verify your contact information.',
+  // '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.',
+  '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': '',
+  'Probate and Estates': 'You may benefit from speaking with a probate and estate professional. Please verify your contact information.',
+  // 'Product Liability': '',
+  // 'Property Damage': '',
+  '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.',
+  // 'Traffic and Tickets': '',
+  'Unemployment': 'You may benefit from speaking with an unemployment 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.',
+  // 'Wrongful Death': '',
+  // 'Wrongful Termination': '',
+  // 'Not Sure or Other': ''
+  // 'Sexual Harassment': '',
+  // 'Workplace Harassment': '',
+  // 'Non-Workplace Harassment': '',
+  // 'Workplace Discrimination': '',
+  // 'Non-Workplace Discrimination': '',
+};
+
+// ------ Common Base Settings
+
+const checkbox = (updates) => {
+  if (updates.name && !updates.id) {
+    updates.id = updates.name;
+  }
+  return merge({
+    $formkit: 'checkbox',
+    validation: 'required',
+    validationMessages: {
+      required: 'Field is required'
+    }
+  }, updates)
+};
+
+const sbsCheckbox = (updates) => {
+  updates.legendClass = 'legend-left required';
+  updates.fieldsetClass = '$reset side-by-side';
+  updates.optionsClass = 't-pl-1';
+  updates.innerClass = 't-flex t-items-center';
+  updates.wrapperClass = 't-mb-3';
+  return checkbox(updates)
+};
+
+const radio = (updates) => {
+  if (updates.name && !updates.id) {
+    updates.id = updates.name;
+  }
+  return merge({
+    $formkit: 'radio',
+    validation: 'required',
+    validationMessages: {
+      required: 'Field is required'
+    },
+    optionsClass: 't-pt-3 t-pl-1',
+    legendClass: 'required'
+  }, updates)
+};
+
+const vertical2ItemRadio = (updates) => {
+  updates.legendClass = 'legend-left';
+  updates.fieldsetClass = '$reset vertical t-items-center';
+  updates.optionsClass = 't-flex t-justify-center t-my-4';
+  updates.optionClass = 'radiobtn t-mx-2 md:t-mx-5';
+  updates.wrapperClass = '$reset formkit-wrapper t-mb-0 t-flex t-items-center t-h-[100%]';
+  updates.labelClass = 't-font-semibold t-text-[#1e448f] t-w-[100%]';
+  updates.decoratorIcon = false;
+  updates.messagesClass = 't-flex t-justify-center';
+  return radio(updates)
+};
+
+const verticalYesNoRadio = (updates) => {
+  updates.options = ['Yes', 'No'];
+  return vertical2ItemRadio(updates)
+};
+
+const text = (updates) => {
+  if (updates.name && !updates.id) {
+    updates.id = updates.name;
+  }
+  return merge({
+    $formkit: 'text',
+    validation: 'required',
+    validationMessages: {
+      required: 'Field is required'
+    },
+    labelClass: 'required'
+  }, updates)
+};
+
+const sbsText = (updates) => {
+  updates.wrapperClass = 'side-by-side t-items-center';
+  return text(updates)
+};
+
+const verticalText = (updates) => {
+  updates.wrapperClass = 't-flex t-justify-center';
+  updates.messagesClass = 't-flex t-justify-center';
+  updates.inputClass = 't-text-center';
+  return text(updates)
+};
+
+const textArea = (updates) => {
+  if (updates.name && !updates.id) {
+    updates.id = updates.name;
+  }
+  return merge({
+    $formkit: 'textarea',
+    rows: 5,
+    maxlength: 500,
+    validation: 'required',
+    validationMessages: {
+      required: 'Field is required'
+    },
+    innerClass: 't-max-w-xl',
+    labelClass: 'required'
+  }, updates)
+};
+
+const applicantAgeCenter = (scope) => verticalText({
+  name: scope ? scope + ':' + 'Applicant_Age' : 'Applicant_Age',
+  value: "50",
+  placeholder: 'Age between 18 and 65',
+  maxlength: 2,
+  inputmode: "numeric",
+  validation: "required|min:18,max:65",
+  validationMessages: {
+    required: 'Applicant Age is required',
+    min: 'Invalid Age - must be between 18 and 65',
+    max: 'Invalid Age - must be between 18 and 65',
+  },
+});
+
+const bankruptcyCrossSell = () => sbsCheckbox({
+  label: "I'd also like a consultation for bankruptcy or debt elimination (optional)",
+  help: "Note: you will be contacted separately by a bankruptcy/debt expert",
+  name: 'CrossSell_Bankruptcy',
+  id: 'CrossSell_Bankruptcy',
+  if: '$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"
+});
+
+const comments = (updates, scope) => textArea(
+  merge({
+    name: scope ? scope + ':' + 'Comments' : 'Comments',
+    label: 'Please briefly describe your situation in a few words:',
+    placeholder: 'For Example: "I would like help with child support payments" or "I need help with visitation rights"'
+  }, updates)
+);
+
+const disabilityConditionStopWorkCenter = (scope) => verticalYesNoRadio({
+  name: scope ? scope + ':' + 'Disability_Condition_Stop_Work' : 'Disability_Condition_Stop_Work',
+});
+
+const disabilityWorkHistoryCenter = (scope) => verticalYesNoRadio({
+  name: scope ? scope + ':' + 'Disability_Work_History' : 'Disability_Work_History',
+});
+
+const doctorTreatmentCenter = () => verticalYesNoRadio({
+  name: 'Doctor_Treatment',
+});
+
+const email = () => sbsText({
+  $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'
+  }
+});
+
+const firstName = () => sbsText({
+  $formkit: 'text',
+  label: 'First Name:',
+  placeholder: 'First',
+  name: 'First_Name',
+  autocomplete: "given-name",
+  validationMessages: {
+    required: 'First Name is required'
+  }
+});
+
+const haveAttorneyCenter = () => verticalYesNoRadio({
+  name: 'Have_Attorney',
+});
+
+const lastName = () => sbsText({
+  $formkit: 'text',
+  label: 'Last Name:',
+  placeholder: 'Last',
+  name: 'Last_Name',
+  autocomplete: "family-name",
+  validationMessages: {
+    required: 'Last Name is required'
+  }
+});
+
+const phone = () => sbsText({
+  $formkit: 'tel',
+  name: 'Primary_Phone',
+  label: 'Phone Number:',
+  placeholder: '###-###-####',
+  maxlength: 12,
+  help: '10-digit phone number, hyphens optional',
+  autocomplete: 'tel-national',
+  'data-tf-sensitive': 'false',
+  validation: 'required|matches:/^[0-9]{3}-?[0-9]{3}-?[0-9]{4}$/|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]"
+});
+
+const socialSecurityDisabilityReceivingBenefitsCenter = (scope) => verticalYesNoRadio({
+  name: scope ? scope + ':' + 'Social_Security_Disability_Receiving_Benefits' : 'Social_Security_Disability_Receiving_Benefits',
+});
+
+const TCPAConsent = () => ({
+  $formkit: 'checkbox',
+  label: '$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"
+  }
+});
+
+const zipcodeCenter = () => text({
+  placeholder: '#####',
+  help: "We try to match you with local legal help.",
+  name: 'Zip',
+  maxlength: 5,
+  inputmode: "numeric",
+  autocomplete: 'postal-code',
+  validation: 'required|matches:/^[0-9]{5}$/',
+  validationMessages: {
+    required: 'Zip Code is required',
+    matches: 'Invalid Zip Code'
+  },
+  wrapperClass: 't-flex t-justify-center',
+  messagesClass: 't-flex t-justify-center',
+  inputClass: 't-text-center',
+  helpClass: 't-mt-2.5 !t-text-sm t-text-center'
+});
+
+const NEXT_ON_ENTER = '$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) };
+
+const findLastInput = (n) => {
+  if (isInput(n)) {
+    return n
+  }
+  for (var i = n.children.length - 1; i >= 0; i--) {
+    if (typeof n.children === 'string') {
+      continue
+    }
+    const child = n.children[i];
+    if (isInput(child)) {
+      return child
+    }
+    const res = findLastInput(child);
+    if (res) {
+      return res
+    }
+  }
+  return null
+};
+
+function verticalStepHeadline(updates) {
+  return {
+    $el: 'h3',
+    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-dark t-pb-5 t-pt-0 t-px-1' + ' ' + (updates.headlineClass || '')
+    }
+  }
+}
+
+
+
+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-1' + ' ' + (updates.headlineClass || '')
+    }
+  }
+}
+
+function firstAndLastStepHeadline(updates) {
+  return {
+    $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-1' + ' ' + (updates.headlineClass || '')
+    }
+  }
+}
+
+function contactStepHeadline(updates) {
+  return {
+    $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-1' + ' ' + (updates.headlineClass || '')
+    }
+  }
+}
+
+function contactStepSubHeadline(updates) {
+  return {
+    $el: 'h5',
+    children: updates.subheadline || DEFAULT_FINAL_SUBHEADLINE_DYNAMIC,
+    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' + ' ' + (updates.subheadlineClass || '')
+    }
+  }
+}
+
+const TRUSTED_FORM_JS = `(function() {
+  if (window.xxTrustedFormLoaded) {
+    return
+  }
+  var vid = '';
+  if (typeof window.zar !== 'undefined') {
+    vid = window.zar.getVID();
+  }
+  window.xxTrustedFormLoaded = true;
+  var sandbox = document.location.hostname.indexOf('localhost') > -1 ? 'true' : 'false'
+  var tf = document.createElement('script');
+  tf.type = 'text/javascript'; tf.async = true;
+  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();
+  var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(tf, s);
+})();`;
+
+function trustedFormScript() {
+  return {
+    $el: 'script',
+    if: '$activeStep === $lastStep()',
+    children: TRUSTED_FORM_JS
+  }
+}
+
+const stepDefaults = (step, stepKey) => ({
+  $el: 'section',
+  if: '$stepEnabled("' + step + '")',
+  attrs: {
+    hidden: '$activeStep !== "' + step + '"',
+    key: stepKey ? stepKey : step
+  }
+});
+
+function step(name, inputs, nextOnEnter = true, nextOnInput = false, stepKey = undefined, nextStepMap = undefined, autoFocus = undefined) {
+  if (typeof nextOnEnter === 'undefined') {
+    nextOnEnter = true;
+  }
+  if (inputs && inputs.length && (nextOnEnter || nextOnInput)) {
+    const lastInput = findLastInput(inputs[inputs.length - 1]);
+    if (lastInput && nextOnEnter === true) {
+      lastInput.onKeypress = NEXT_ON_ENTER;
+    }
+    if (lastInput && nextOnInput === true) {
+      lastInput.onInput = NEXT_ON_INPUT;
+    }
+  }
+
+  return merge(
+    stepDefaults(name, stepKey),
+    {
+      children: [
+        {
+          $formkit: 'group',
+          id: name,
+          name: name,
+          nextStepMap: nextStepMap,
+          autoFocus: autoFocus,
+          children: inputs
+        }
+      ]
+    }
+  )
+}
+
+function commentsWithBankruptcyV2(updates = {}) {
+  return step(
+    'commentsWithBankruptcy',
+    [
+      commentsStepHeadline(updates),
+      comments({
+        label: typeof updates.label === 'undefined' ? DEFAULT_COMMENTS_LABEL : updates.label,
+        placeholder: updates.placeholder || DEFAULT_COMMENTS_PLACEHOLDER_DYNAMIC,
+        inputClass: typeof updates.inputClass === 'undefined' ? '!t-h-40' : updates.inputClass,
+      }),
+      bankruptcyCrossSell(),
+      {
+        $el: 'div',
+        if: '$get(CrossSell_Bankruptcy).value == true',
+        children: [
+          comments({
+            label: 'Bankruptcy or debt details:',
+            placeholder: 'Please describe your bankrtupcy or debt situation in a few words...',
+            inputClass: '!t-h-16'
+          }, 'CrossSell:Bankruptcy')
+        ],
+      }
+    ],
+    // TODO: UGLY: use named params!
+    updates.nextOnEnter,
+    false,
+    undefined,
+    undefined,
+    false
+  )
+}
+
+function contactInfoV2(updates = {}) {
+  return step(
+    'contactInfo',
+    [
+      contactStepHeadline(updates),
+      contactStepSubHeadline(updates),
+      // Added TF everywhere
+      trustedFormScript(),
+      email(),
+      phone(),
+      TCPAConsent(),
+      secureIcon()
+    ],
+    updates.nextOnEnter
+  )
+}
+
+function firstAndLastV2(updates = {}) {
+  return step(
+    'firstAndLast',
+    [
+      firstAndLastStepHeadline(updates),
+      firstName(),
+      lastName()
+    ],
+    updates.nextOnEnter
+  )
+}
+
+function ssdiTOLPAndZip(updates = {}) {
+  return step(
+    'ssdiTOLPAndZip',
+    [
+      {
+        $formkit: 'hidden',
+        name: "Type_Of_Legal_Problem",
+        id: "Type_Of_Legal_Problem",
+        value: "Social Security Disability and Insurance"
+      },
+      zipcodeCenter()
+    ],
+    updates.nextOnEnter,
+    updates.nextOnInput
+  )
+}
+
+function ssdiApplicantAge(updates = {}) {
+  return step(
+    'ssdiApplicantAge',
+    [
+      verticalStepHeadline(updates),
+      applicantAgeCenter(),
+    ],
+    updates.nextOnEnter,
+    updates.nextOnInput
+  )
+}
+
+function ssdiDisabilityConditionStopWork(updates = {}) {
+  return step(
+    'ssdiDisabilityConditionStopWork',
+    [
+      verticalStepHeadline(updates),
+      disabilityConditionStopWorkCenter(),
+    ],
+    updates.nextOnEnter,
+    updates.nextOnInput
+  )
+}
+
+function ssdiDisabilityWorkHistory(updates = {}) {
+  return step(
+    'ssdiDisabilityWorkHistory',
+    [
+      verticalStepHeadline(updates),
+      disabilityWorkHistoryCenter(),
+    ],
+    updates.nextOnEnter,
+    updates.nextOnInput
+  )
+}
+
+function ssdiSocialSecurityDisabilityReceivingBenefits(updates = {}) {
+  return step(
+    'ssdiSocialSecurityDisabilityReceivingBenefits',
+    [
+      verticalStepHeadline(updates),
+      socialSecurityDisabilityReceivingBenefitsCenter(),
+    ],
+    updates.nextOnEnter,
+    updates.nextOnInput
+  )
+}
+
+function ssdiDoctorTreatment(updates = {}) {
+  return step(
+    'ssdiDoctorTreatment',
+    [
+      verticalStepHeadline(updates),
+      doctorTreatmentCenter(),
+    ],
+    updates.nextOnEnter,
+    updates.nextOnInput
+  )
+}
+
+
+function ssdiHaveAttorney(updates = {}) {
+  return step(
+    'ssdiHaveAttorney',
+    [
+      verticalStepHeadline(updates),
+      haveAttorneyCenter(),
+    ],
+    updates.nextOnEnter,
+    updates.nextOnInput
+  )
+}
+
+const formNavigationV2 = () => ({
+  $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;'
+      }
+    }
+  ]
+});
+
+const formDetails = () => ({
+  $el: 'pre',
+  if: '$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'
+      }
+    }
+  ]
+});
+
+const schema = [
+  defaultMetaProps(),
+  formAnchor(),
+  {
+    $cmp: 'FormKit',
+    props: formProps({
+      formId: 'ssdi',
+      redirectMap: {
+        '*': LegalRedirectUrl()
+      },
+    }),
+    children: [
+      progressBar(),
+      headline({
+        children: '$urlParam("hl", "Start Your FREE Case Evaluation")',
+        if: '$activeStep === $firstStep()',
+        headlineClass: '!t-text-dark'
+      }),
+      subHeadline({
+        children: '$urlParam("shl", "You Could Receive up to $3,148 Per Month!")',
+        if: '$activeStep === $firstStep()',
+        subheadlineClass: '!t-text-[#00428A]'
+      }),
+      ...hiddenInputsLegal,
+      {
+        $el: 'div',
+        attrs: {
+          class: 'form-body'
+        },
+        children: [
+          ssdiTOLPAndZip(),
+          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,
+            label: null,
+            headline: 'Please briefly describe your situation:',
+            headlineClass: '!t-text-dark'
+          }),
+          firstAndLastV2({
+            headlineClass: '!t-text-dark'
+          }),
+          contactInfoV2({
+            headline: 'Submit Your Free Application',
+            headlineClass: '!t-text-[#00428A]',
+            subheadline: 'Based on your input you may qualify for SSDI benefits. Please verify your contact information.',
+            nextOnEnter: false
+          }),
+          formNavigationV2(),
+          formDetails()
+        ]
+      }
+    ]
+  }
+];
+
+export { schema as default };