bhl-forms 0.6.10 → 0.6.12
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 +7 -7
- package/dist/bhl-forms.modern.umd.js +1 -1
- package/dist/bhl-forms.umd.js +1 -1
- package/dist/forms/accidentsAndInjuries.es.js +29 -28
- package/dist/forms/accidentsAndInjuries.iife.js +1 -1
- package/dist/forms/business.es.js +38 -36
- package/dist/forms/business.iife.js +1 -1
- package/dist/forms/business.json +1 -1
- package/dist/forms/childAndFamily.es.js +29 -28
- package/dist/forms/childAndFamily.iife.js +1 -1
- package/dist/forms/childAndFamilySingle.es.js +38 -36
- package/dist/forms/childAndFamilySingle.iife.js +1 -1
- package/dist/forms/childAndFamilySingle.json +1 -1
- package/dist/forms/civilLawsuit.es.js +45 -43
- package/dist/forms/civilLawsuit.iife.js +1 -1
- package/dist/forms/civilLawsuit.json +1 -1
- package/dist/forms/contracts.es.js +29 -28
- package/dist/forms/contracts.iife.js +1 -1
- package/dist/forms/criminal.es.js +39 -37
- package/dist/forms/criminal.iife.js +1 -1
- package/dist/forms/criminal.json +1 -1
- package/dist/forms/divorce.es.js +38 -36
- package/dist/forms/divorce.iife.js +1 -1
- package/dist/forms/divorce.json +1 -1
- package/dist/forms/employmentAndWorkplace.es.js +44 -42
- package/dist/forms/employmentAndWorkplace.iife.js +1 -1
- package/dist/forms/employmentAndWorkplace.json +1 -1
- package/dist/forms/generalLegal.es.js +29 -28
- package/dist/forms/generalLegal.iife.js +1 -1
- package/dist/forms/generalLegalPopUnder.es.js +29 -28
- package/dist/forms/generalLegalPopUnder.iife.js +1 -1
- package/dist/forms/generalLegalPopUnderSingle.es.js +45 -43
- package/dist/forms/generalLegalPopUnderSingle.iife.js +1 -1
- package/dist/forms/generalLegalPopUnderSingle.json +1 -1
- package/dist/forms/generalLegalSingle.es.js +45 -43
- package/dist/forms/generalLegalSingle.iife.js +1 -1
- package/dist/forms/generalLegalSingle.json +1 -1
- package/dist/forms/generalLegalThankYou.es.js +19 -20
- package/dist/forms/generalLegalThankYou.iife.js +1 -1
- package/dist/forms/harassmentAndDiscrimination.es.js +29 -28
- package/dist/forms/harassmentAndDiscrimination.iife.js +1 -1
- package/dist/forms/landlordTenant.es.js +38 -36
- package/dist/forms/landlordTenant.iife.js +1 -1
- package/dist/forms/landlordTenant.json +1 -1
- package/dist/forms/malpractice.es.js +29 -28
- package/dist/forms/malpractice.iife.js +1 -1
- package/dist/forms/mechanics.es.js +824 -34
- package/dist/forms/mechanics.iife.js +1 -1
- package/dist/forms/mechanics.json +1 -1
- package/dist/forms/patentsAndIP.es.js +38 -36
- package/dist/forms/patentsAndIP.iife.js +1 -1
- package/dist/forms/patentsAndIP.json +1 -1
- package/dist/forms/realEstate.es.js +29 -28
- package/dist/forms/realEstate.iife.js +1 -1
- package/dist/forms/repossession.es.js +29 -28
- package/dist/forms/repossession.iife.js +1 -1
- package/dist/forms/ssdi.es.js +25 -25
- package/dist/forms/ssdi.iife.js +1 -1
- package/dist/forms/ssdi.json +1 -1
- package/dist/forms/testForm.es.js +18 -19
- package/dist/forms/testForm.iife.js +1 -1
- package/dist/forms/testRedirects.es.js +8 -2
- package/dist/forms/testRedirects.iife.js +1 -1
- package/dist/forms/testRedirects.json +1 -1
- package/dist/forms/willsAndTrusts.es.js +29 -28
- package/dist/forms/willsAndTrusts.iife.js +1 -1
- package/dist/main.css +1 -1
- package/package.json +1 -1
|
@@ -104,7 +104,7 @@ const sbsYesNoRadio = (updates) => {
|
|
|
104
104
|
|
|
105
105
|
const verticalButtonRadio = (updates) => {
|
|
106
106
|
updates.legendClass = 'legend-left';
|
|
107
|
-
updates.fieldsetClass = '$reset t-flex t-justify-center t-items-center';
|
|
107
|
+
updates.fieldsetClass = '$reset t-flex t-justify-center t-flex-col-reverse t-items-center';
|
|
108
108
|
if (typeof updates.optionsClass === 'undefined') {
|
|
109
109
|
updates.optionsClass = 't-flex t-flex-col sm:t-flex-row t-justify-center t-my-3';
|
|
110
110
|
}
|
|
@@ -113,6 +113,7 @@ const verticalButtonRadio = (updates) => {
|
|
|
113
113
|
updates.labelClass = 't-font-semibold t-text-[#1e448f] t-w-[100%]';
|
|
114
114
|
updates.decoratorIcon = false;
|
|
115
115
|
updates.messagesClass = 't-flex t-justify-center';
|
|
116
|
+
updates.helpClass = 't-mt-2.5 !t-text-sm t-text-center';
|
|
116
117
|
return radio(updates)
|
|
117
118
|
};
|
|
118
119
|
|
|
@@ -414,13 +415,13 @@ const doctorTreatment$1 = (scope) => sbsYesNoRadio({
|
|
|
414
415
|
label: 'Have You Recently Been Treated by a Doctor, Hospital or Clinic?',
|
|
415
416
|
});
|
|
416
417
|
|
|
417
|
-
const doctorTreatmentCenter = () => verticalYesNoRadio({
|
|
418
|
-
name: 'Doctor_Treatment',
|
|
418
|
+
const doctorTreatmentCenter = (scope) => verticalYesNoRadio({
|
|
419
|
+
name: scope ? scope + ':' + 'Doctor_Treatment' : 'Doctor_Treatment',
|
|
419
420
|
});
|
|
420
421
|
|
|
421
|
-
const email = () => sbsText({
|
|
422
|
+
const email = (scope) => sbsText({
|
|
422
423
|
$formkit: 'email',
|
|
423
|
-
name: 'Email',
|
|
424
|
+
name: scope ? scope + ':' + 'Email' : 'Email',
|
|
424
425
|
label: 'Email Address:',
|
|
425
426
|
placeholder: 'email@domain.com',
|
|
426
427
|
autocomplete: 'email',
|
|
@@ -476,11 +477,11 @@ const estateLegalServicesNeeded = (scope) => sbsSelect({
|
|
|
476
477
|
]
|
|
477
478
|
});
|
|
478
479
|
|
|
479
|
-
const firstName = () => sbsText({
|
|
480
|
+
const firstName = (scope) => sbsText({
|
|
480
481
|
$formkit: 'text',
|
|
481
482
|
label: 'First Name:',
|
|
482
483
|
placeholder: 'First',
|
|
483
|
-
name: 'First_Name',
|
|
484
|
+
name: scope ? scope + ':' + 'First_Name' : 'First_Name',
|
|
484
485
|
autocomplete: "given-name",
|
|
485
486
|
validationMessages: {
|
|
486
487
|
required: 'First Name is required'
|
|
@@ -492,8 +493,8 @@ const haveAttorney$1 = (scope) => sbsYesNoRadio({
|
|
|
492
493
|
label: 'Already Working with An Attorney?'
|
|
493
494
|
});
|
|
494
495
|
|
|
495
|
-
const haveAttorneyCenter = () => verticalYesNoRadio({
|
|
496
|
-
name: 'Have_Attorney',
|
|
496
|
+
const haveAttorneyCenter = (scope) => verticalYesNoRadio({
|
|
497
|
+
name: scope ? scope + ':' + 'Have_Attorney' : 'Have_Attorney',
|
|
497
498
|
});
|
|
498
499
|
|
|
499
500
|
const haveChildren = (scope) => sbsYesNoRadio({
|
|
@@ -510,11 +511,11 @@ const incidentDateCenter = (scope) => verticalDate({
|
|
|
510
511
|
name: scope ? scope + ':' + 'Incident_Date' : 'Incident_Date',
|
|
511
512
|
});
|
|
512
513
|
|
|
513
|
-
const lastName = () => sbsText({
|
|
514
|
+
const lastName = (scope) => sbsText({
|
|
514
515
|
$formkit: 'text',
|
|
515
516
|
label: 'Last Name:',
|
|
516
517
|
placeholder: 'Last',
|
|
517
|
-
name: 'Last_Name',
|
|
518
|
+
name: scope ? scope + ':' + 'Last_Name' : 'Last_Name',
|
|
518
519
|
autocomplete: "family-name",
|
|
519
520
|
validationMessages: {
|
|
520
521
|
required: 'Last Name is required'
|
|
@@ -637,9 +638,9 @@ const pendingCharges = (scope) => sbsYesNoRadio({
|
|
|
637
638
|
label: 'Do you currently have any pending charges?'
|
|
638
639
|
});
|
|
639
640
|
|
|
640
|
-
const phone = () => sbsText({
|
|
641
|
+
const phone = (scope) => sbsText({
|
|
641
642
|
$formkit: 'tel',
|
|
642
|
-
name: 'Primary_Phone',
|
|
643
|
+
name: scope ? scope + ':' + 'Primary_Phone' : 'Primary_Phone',
|
|
643
644
|
label: 'Phone Number:',
|
|
644
645
|
placeholder: '###-###-####',
|
|
645
646
|
maxlength: 12,
|
|
@@ -721,10 +722,10 @@ const socialSecurityDisabilityReceivingBenefits = (scope) => sbsYesNoRadio({
|
|
|
721
722
|
label: 'Are You Currently Receiving Social Security Disability Benefits?'
|
|
722
723
|
});
|
|
723
724
|
|
|
724
|
-
const TCPAConsent = () => ({
|
|
725
|
+
const TCPAConsent = (scope) => ({
|
|
725
726
|
$formkit: 'checkbox',
|
|
726
727
|
label: '$meta.tcpaLanguage',
|
|
727
|
-
name: 'TCPA_Opt_In',
|
|
728
|
+
name: scope ? scope + ':' + 'TCPA_Opt_In' : 'TCPA_Opt_In',
|
|
728
729
|
'data-tf-sensitive': 'false',
|
|
729
730
|
validation: 'required|accepted',
|
|
730
731
|
validationMessages: {
|
|
@@ -776,10 +777,10 @@ const valueOfAssets = (scope) => sbsSelect({
|
|
|
776
777
|
]
|
|
777
778
|
});
|
|
778
779
|
|
|
779
|
-
const zipcodeCenter = (updates = {}) => text({
|
|
780
|
+
const zipcodeCenter = (updates = {}, scope) => text({
|
|
780
781
|
placeholder: '#####',
|
|
781
782
|
help: updates.help ?? "We try to match you with local legal help",
|
|
782
|
-
name: 'Zip',
|
|
783
|
+
name: scope ? scope + ':' + 'Zip' : 'Zip',
|
|
783
784
|
maxlength: 5,
|
|
784
785
|
inputmode: "numeric",
|
|
785
786
|
autocomplete: 'postal-code',
|
|
@@ -1181,7 +1182,8 @@ function commentsWithBankruptcy(updates = {}) {
|
|
|
1181
1182
|
label: typeof updates.label === 'undefined' ? DEFAULT_COMMENTS_LABEL : updates.label,
|
|
1182
1183
|
placeholder: updates.placeholder || DEFAULT_COMMENTS_PLACEHOLDER_DYNAMIC,
|
|
1183
1184
|
inputClass: typeof updates.inputClass === 'undefined' ? '!t-h-32' : updates.inputClass,
|
|
1184
|
-
}),
|
|
1185
|
+
}, updates.scope),
|
|
1186
|
+
// TODO: needs scope support
|
|
1185
1187
|
bankruptcyCrossSell(),
|
|
1186
1188
|
{
|
|
1187
1189
|
$el: 'div',
|
|
@@ -1206,16 +1208,16 @@ function contactInfo(updates = {}) {
|
|
|
1206
1208
|
contactStepHeadline(updates),
|
|
1207
1209
|
contactStepSubHeadline(updates),
|
|
1208
1210
|
trustedFormScript(),
|
|
1209
|
-
email(),
|
|
1210
|
-
phone(),
|
|
1211
|
-
TCPAConsent(),
|
|
1211
|
+
email(updates.scope),
|
|
1212
|
+
phone(updates.scope),
|
|
1213
|
+
TCPAConsent(updates.scope),
|
|
1212
1214
|
secureIcon()
|
|
1213
1215
|
],
|
|
1214
1216
|
false, // nextOnEnter
|
|
1215
1217
|
)
|
|
1216
1218
|
}
|
|
1217
1219
|
|
|
1218
|
-
function firstAndLastV3(updates = {}) {
|
|
1220
|
+
function firstAndLastV3(updates = {}, scope) {
|
|
1219
1221
|
return step(
|
|
1220
1222
|
'firstAndLast',
|
|
1221
1223
|
[
|
|
@@ -1227,8 +1229,8 @@ function firstAndLastV3(updates = {}) {
|
|
|
1227
1229
|
subheadline: updates.subheadline ?? 'Note: we never share info without consent',
|
|
1228
1230
|
subheadlineClass: '!t-text-sm !t-text-gray-500'
|
|
1229
1231
|
}),
|
|
1230
|
-
firstName(),
|
|
1231
|
-
lastName()
|
|
1232
|
+
firstName(scope),
|
|
1233
|
+
lastName(scope)
|
|
1232
1234
|
],
|
|
1233
1235
|
updates.nextOnEnter
|
|
1234
1236
|
)
|
|
@@ -1446,7 +1448,7 @@ function legalCrossSells(updates = {}) {
|
|
|
1446
1448
|
function zipcode(updates = {}) {
|
|
1447
1449
|
return sqstep(
|
|
1448
1450
|
'zipcode',
|
|
1449
|
-
zipcodeCenter(updates),
|
|
1451
|
+
zipcodeCenter(updates, updates.scope),
|
|
1450
1452
|
'Please verify your Zip Code',
|
|
1451
1453
|
updates
|
|
1452
1454
|
)
|
|
@@ -1455,7 +1457,7 @@ function zipcode(updates = {}) {
|
|
|
1455
1457
|
function haveAttorney(updates = {}) {
|
|
1456
1458
|
return sqstep(
|
|
1457
1459
|
'haveAttorney',
|
|
1458
|
-
haveAttorneyCenter(),
|
|
1460
|
+
haveAttorneyCenter(updates.scope),
|
|
1459
1461
|
'Already working with an attorney?',
|
|
1460
1462
|
updates
|
|
1461
1463
|
)
|
|
@@ -1473,7 +1475,7 @@ function degreeOfInterest(updates = {}) {
|
|
|
1473
1475
|
function incidentDate(updates = {}) {
|
|
1474
1476
|
return sqstep(
|
|
1475
1477
|
'incidentDate',
|
|
1476
|
-
incidentDateCenter(),
|
|
1478
|
+
incidentDateCenter(updates.scope),
|
|
1477
1479
|
'When did the incident occur?',
|
|
1478
1480
|
updates
|
|
1479
1481
|
)
|
|
@@ -1482,7 +1484,7 @@ function incidentDate(updates = {}) {
|
|
|
1482
1484
|
function doctorTreatment(updates = {}) {
|
|
1483
1485
|
return sqstep(
|
|
1484
1486
|
'doctorTreatment',
|
|
1485
|
-
doctorTreatmentCenter(),
|
|
1487
|
+
doctorTreatmentCenter(updates.scope),
|
|
1486
1488
|
'Have you seen a doctor about this?',
|
|
1487
1489
|
updates
|
|
1488
1490
|
)
|
|
@@ -1491,7 +1493,7 @@ function doctorTreatment(updates = {}) {
|
|
|
1491
1493
|
function atFault(updates = {}) {
|
|
1492
1494
|
return sqstep(
|
|
1493
1495
|
'atFault',
|
|
1494
|
-
atFaultCenter(),
|
|
1496
|
+
atFaultCenter(updates.scope),
|
|
1495
1497
|
'Were you at fault?',
|
|
1496
1498
|
updates
|
|
1497
1499
|
)
|
|
@@ -1500,7 +1502,7 @@ function atFault(updates = {}) {
|
|
|
1500
1502
|
function primaryInjury(updates = {}) {
|
|
1501
1503
|
return sqstep(
|
|
1502
1504
|
'primaryInjury',
|
|
1503
|
-
primaryInjuryCenter(),
|
|
1505
|
+
primaryInjuryCenter(updates.scope),
|
|
1504
1506
|
'What was the primary injury?',
|
|
1505
1507
|
updates
|
|
1506
1508
|
)
|
|
@@ -1578,9 +1580,7 @@ function criminalChargesFiled(updates = {}) {
|
|
|
1578
1580
|
)
|
|
1579
1581
|
}
|
|
1580
1582
|
|
|
1581
|
-
|
|
1582
|
-
|
|
1583
|
-
const formNavigation = () => ({
|
|
1583
|
+
const formNavigation = (updates = {}) => ({
|
|
1584
1584
|
$el: 'div',
|
|
1585
1585
|
attrs: {
|
|
1586
1586
|
class: 'step-nav'
|
|
@@ -1618,7 +1618,7 @@ const formNavigation = () => ({
|
|
|
1618
1618
|
{
|
|
1619
1619
|
$formkit: 'submit',
|
|
1620
1620
|
name: 'submit_button',
|
|
1621
|
-
label: 'Submit',
|
|
1621
|
+
label: updates.submitLabel || 'Submit',
|
|
1622
1622
|
if: '$activeStep === $lastStep()',
|
|
1623
1623
|
style: {
|
|
1624
1624
|
if: '$activeStep !== $lastStep()',
|
|
@@ -1753,14 +1753,16 @@ function defaultMetaProps(tolps = null) {
|
|
|
1753
1753
|
})
|
|
1754
1754
|
}
|
|
1755
1755
|
|
|
1756
|
-
|
|
1757
|
-
|
|
1758
|
-
|
|
1759
|
-
|
|
1760
|
-
|
|
1761
|
-
|
|
1756
|
+
function dynamicSchemaNode(field = 'Type_Of_Legal_Problem') {
|
|
1757
|
+
return {
|
|
1758
|
+
$cmp: 'FormKitSchema',
|
|
1759
|
+
if: '$get(' + field + ').value',
|
|
1760
|
+
props: {
|
|
1761
|
+
schema: '$meta.dynamicSchema',
|
|
1762
|
+
data: '$buildData($meta)'
|
|
1763
|
+
}
|
|
1762
1764
|
}
|
|
1763
|
-
}
|
|
1765
|
+
}
|
|
1764
1766
|
|
|
1765
1767
|
const formAnchorDefaults = {
|
|
1766
1768
|
$el: 'div',
|
|
@@ -2670,7 +2672,7 @@ const schema = [
|
|
|
2670
2672
|
nextOnInput: false,
|
|
2671
2673
|
nextStepMap: nextStepsMapEmploymentAndWorkplaceTOLPDisplay
|
|
2672
2674
|
}),
|
|
2673
|
-
dynamicSchemaNode,
|
|
2675
|
+
dynamicSchemaNode(),
|
|
2674
2676
|
contactInfo(),
|
|
2675
2677
|
formNavigation(),
|
|
2676
2678
|
formDetails()
|
|
@@ -1 +1 @@
|
|
|
1
|
-
var employmentAndWorkplace=function(){"use strict";function e(){return Object.assign({},...arguments)}const t='$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, $meta.defaultFinalSubHeadline)',n=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"checkbox",validation:"required",validationMessages:{required:"Field is required"}},t)),i=e=>(e&&e.legendClass||(e.legendClass="required"),e.fieldsetClass="$reset",e.optionsClass="t-pl-8 md:t-pl-2 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2",e.innerClass="t-items-start",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",n(e)),s=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"radio",validation:"required",validationMessages:{required:"Field is required"},optionsClass:"t-pt-3 t-pl-1",legendClass:"required"},t)),o=e=>(e.legendClass="required t-w-[100%] t-text-center",void 0===e.fieldsetClass&&(e.fieldsetClass="$reset t-flex t-justify-center"),e.optionsClass="t-pl-4 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2",e.innerClass="t-items-start",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",e.optionClass="t-pl-4 md:t-pl-8 md:t-min-w-[200px]",e.messagesClass="t-flex t-justify-center",e.helpClass="t-mt-0 t-mb-4 !t-text-sm t-text-center",s(e)),l=e=>(e.options=["Yes","No"],(e=>(e.legendClass="legend-left t-pb-1 required",e.fieldsetClass="$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",s(e)))(e)),d=e=>(e.options=["Yes","No"],e.optionsClass="t-flex t-justify-center t-my-3",(e=>(e.legendClass="legend-left",e.fieldsetClass="$reset t-flex t-justify-center t-items-center",void 0===e.optionsClass&&(e.optionsClass="t-flex t-flex-col sm:t-flex-row t-justify-center t-my-3"),e.optionClass="radiobtn t-my-2 sm:t-my-0 t-mx-2 md:t-mx-5",e.wrapperClass="$reset formkit-wrapper t-mb-0 t-flex t-items-center t-h-[100%]",e.labelClass="t-font-semibold t-text-[#1e448f] t-w-[100%]",e.decoratorIcon=!1,e.messagesClass="t-flex t-justify-center",s(e)))(e)),u=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=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"select",placeholder:"Please Select",validation:"required",validationMessages:{required:"Field is required"},inputClass:"t-bg-white",labelClass:"required"},t)))(t)),c=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"text",validation:"required",validationMessages:{required:"Field is required"},labelClass:"required"},t)),p=e=>(e.wrapperClass="side-by-side t-items-center",c(e)),m=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"DatePicker",validation:"required",validationMessages:{required:"Field is required"},labelClass:"required t-block t-mb-3 t-font-semibold t-text-base formkit-invalid:t-text-red-500",innerClass:"t-border t-border-gray-400 formkit-invalid:t-border-red-500 t-rounded t-mb-1 focus-within:t-border-blue-500"},t)),f=e=>p({name:e?e+":Applicant_Age":"Applicant_Age",label:"Age of Applicant?",placeholder:"Age between 18 and 65",maxlength:2,inputmode:"numeric",validation:"required|min:18,max:65",validationMessages:{required:"Applicant Age is required",min:"Invalid Age - must be between 18 and 65",max:"Invalid Age - must be between 18 and 65"}}),y=e=>l({name:e?e+":At_Fault":"At_Fault",label:"Were You at Fault?"}),h=()=>{return(e={label:"I'd also like a consult for bankruptcy or debt elimination (optional)",help:"Note: you will be contacted separately by a bankruptcy/debt expert",name:"CrossSell_Bankruptcy",id:"CrossSell_Bankruptcy",if:'$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"}).legendClass="legend-left required",e.fieldsetClass="$reset side-by-side",e.optionsClass="t-pl-1",e.innerClass="t-flex t-items-center",e.wrapperClass="t-mb-3",n(e);var e},_=e=>u({name:e?e+":Blood_Alcohol_Content_Test":"Blood_Alcohol_Content_Test",label:"Blood Alcohol Content Measured by Test:",options:["No Test","0.00% - 0.04%","0.05% - 0.08%","0.09% - 0.12%","0.13% - 0.16%","0.17% - 0.20%","More than 0.20%","Don't know"]}),g=e=>u({name:e?e+":Cause_Of_Injury":"Cause_Of_Injury",label:"Cause of Injury:",options:["Traumatic Physical Injury (Accident)","Repeated Trauma Injury","Mental Injury","Occupational Disease","Not Sure"]}),b=e=>u({name:e?e+":Child_Home":"Child_Home",label:"With Whom Do the Children Currently Live?",options:["Mother","Father","Grandparents","Other"]}),C=e=>u({name:e?e+":Child_Primary_Caregiver":"Child_Primary_Caregiver",label:"Who is the Primary Caregiver?",options:["Mother","Father","Other"]}),v=e=>u({name:e?e+":Child_Relationship":"Child_Relationship",label:"Your Relationship to Child(ren):",options:["Father","Mother","Grandparent","Aunt/Uncle","Other"]}),P=e=>u({name:e?e+":Claim_Status":"Claim_Status",label:"Status of Claim:",options:["No action taken yet","Demand for compensation made","Lawsuit filed","Other"]}),w=(t,a)=>(t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"textarea",rows:5,maxlength:500,validation:"required",validationMessages:{required:"Field is required"},innerClass:"t-max-w-xl",labelClass:"required"},t)))(e({name:a?a+":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"'},t)),x=()=>{return(e={name:"Criminal_Charges_Filed",options:["Yes","No","Not Sure"]}).legendClass="required",e.fieldsetClass="$reset t-flex t-justify-center",e.optionsClass="t-pl-2 t-pt-3",e.innerClass="t-items-center",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",e.optionClass="t-pl-4 md:t-pl-12",e.messagesClass="t-flex t-justify-center",s(e);var e},I=(e,t)=>u({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"]}),T=e=>I(e,"No payment necessary to speak with lawyers."),S=e=>l({name:e?e+":Disability_Condition_Stop_Work":"Disability_Condition_Stop_Work",label:"Do You Expect To Be Out Of Work For At Least a Year Due To Your Health?"}),O=e=>l({name:e?e+":Disability_Work_History":"Disability_Work_History",label:"Have You Had a Full-Time Job Within the Past 5 Years?"}),D=e=>l({name:e?e+":Doctor_Treatment":"Doctor_Treatment",label:"Have You Recently Been Treated by a Doctor, Hospital or Clinic?"}),k=t=>o(e({name:"Type_Of_Legal_Problem_Display",options:["Workplace Harassment","Workplace Discrimination","Wrongful Termination","Payment Disputes","Workers Compensation","Personal Injury","Unemployment","Other Workplace Issues"]},t)),L=e=>u({name:e?e+":Estate_Legal_Services_Needed":"Estate_Legal_Services_Needed",label:"Legal Services Needed for Your Estate:",options:["Charitable Giving","Contested Wills","Drafting Wills or Trust","Estate Administration","Asset Protection","Other"]}),A=e=>l({name:e?e+":Have_Attorney":"Have_Attorney",label:"Already Working with An Attorney?"}),$=e=>l({name:e?e+":Have_Children":"Have_Children",label:"Do You Have Children?"}),E=e=>{return(t={name:e?e+":Incident_Date":"Incident_Date",label:"Date of Incident:"}).wrapperClass="side-by-side t-items-center",m(t);var t},W=e=>{return(t={name:e?e+":Incident_Date":"Incident_Date"}).wrapperClass="t-flex t-justify-center",t.inputClass="t-text-center",t.messagesClass="t-flex t-justify-center",m(t);var t},j=e=>u({name:e?e+":Lawyer_Payment_Method":"Lawyer_Payment_Method",label:"How Will You Pay for Legal Fees if You Hire a Lawyer?",help:"No payment necessary to speak with lawyers.",options:["Cash","Check","Credit Card","Friend","Family","Other"]}),B=e=>u({name:e?e+":Marital_Status":"Marital_Status",label:"Marital Status:",options:["Unmarried, Living Together","Unmarried, Do Not Live Together","Married, Living Together","Separated","Divorced","Other"]}),M=e=>l({name:e?e+":Pending_Charges":"Pending_Charges",label:"Do you currently have any pending charges?"}),F=e=>{return(t={name:e?e+":Primary_Injury":"Primary_Injury",label:"Primary Injury:",options:["Anxiety","Back or Neck Pain","Broken Bones","Cuts and Bruises","Headaches","Memory Loss","Loss of Limb","Not Sure or Other"]}).legendClass="legend-left-flex md:t-max-w-[40%] required",t.fieldsetClass="$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="$reset t-flex t-cursor-pointer t-mb-3",s(t);var t},N=e=>l({name:e?e+":Prior_Alcohol_Offenses":"Prior_Alcohol_Offenses",label:"Any Prior Alcohol Related Offenses?"}),q=e=>l({name:e?e+":Police_Report_Filed":"Police_Report_Filed",label:"Was a Police Report Filed?"}),R=e=>u({name:e?e+":Role_In_Matter_Probate":"Role_In_Matter_Probate",label:"What Is Your Role in this Matter?",options:["Preparing My Will","Executor","Heir","Other"]}),Y=e=>l({name:e?e+":Social_Security_Disability_Receiving_Benefits":"Social_Security_Disability_Receiving_Benefits",label:"Are You Currently Receiving Social Security Disability Benefits?"}),H=e=>u({name:e?e+":Type_Of_Alcohol_Test":"Type_Of_Alcohol_Test",label:"Type of Alcohol Test Performed?",options:["No Test","Refused Test","Breath Test","Blood Test","Urine Test","Don't Know"]}),U=e=>i({name:e?e+":Type_Of_Assets":"Type_Of_Assets",label:"Type of Assets:",options:["Business Interests","Cash","Life Insurance Policies","Pensions/Retirement","Personal Possessions","Property","Stock/Bonds"]}),V=e=>u({name:e?e+":Value_Of_Assets":"Value_Of_Assets",label:"Value of Your Assets?",options:["Less than 50K","50K to 100K","100K to 250K","250K to 500K","500K to 1M","More than 1M"]}),Q=(t,a)=>e({$cmp:"FormKit",props:{type:"group",key:t,id:t,name:t}},a),K="$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",z="$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",G=e=>"group"!==e.type&&"section"!==e.type&&"form"!==e.type&&"hidden"!==e.$formkit&&!e.children,Z=e=>{if(G(e))return e;for(var t=e.children.length-1;t>=0;t--){if("string"==typeof e.children)continue;const a=e.children[t];if(G(a))return a;const r=Z(a);if(r)return r}return null},J={$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"}},{$el:"span",children:"Secure & Encrypted",attrs:{class:"t-pl-2 t-pt-1 t-font-medium"}}]};function X(t){return e(J,t)}function ee(e){return{$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 te(e){return{$el:"h5",children:e.subheadline||"Tell us about your situation:",attrs:{class:"t-flex t-justify-center t-text-dark t-text-center !t-text-lg t-font-semibold t-pb-4 t-pt-0 t-px-3"}}}function ae(e){return{$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-dark t-pb-5 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function re(e){return{$el:"h5",children:e.subheadline||"",attrs:{class:"t-flex t-justify-center t-text-center !t-text-lg t-font-normal t-text-dark t-pb-5 t-pt-0 t-px-1 "+(e.subheadlineClass||"")}}}function ne(e){return{$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 ie(e){return{$el:"h3",children:e.headline||"Please Provide a Contact Name",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function se(e){return{$el:"h3",children:e.headline||"Do any of the following situations apply?",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 oe(e){return{$el:"h3",children:e.headline||a,attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-3 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function le(e){return{$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 de="(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 ue=(e,t)=>({$el:"section",if:'$stepEnabled("'+e+'")',attrs:{hidden:'$activeStep !== "'+e+'"',key:t||e}});function ce(t,a,r=!0,n=!1,i=void 0,s=void 0,o=void 0){if(void 0===r&&(r=!0),a&&a.length&&(r||n)){const e=Z(a[a.length-1]);e&&!0===r&&(e.onKeypress=K),e&&!0===n&&(e.onInput=z)}return e(ue(t,i),{children:[{$formkit:"group",id:t,name:t,nextStepMap:s,autoFocus:o,children:a}]})}function pe(e,t,a,r={}){return ce(e,[ae({headline:r.headline??a,headlineClass:r.headlineClass}),...Array.isArray(t)?t:[t]],r.nextOnEnter,void 0===r.nextOnInput||r.nextOnInput,r.stepKey,r.nextStepMap)}const me={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]"};function fe(e,t){return Object.fromEntries(Object.entries(e).filter((([e])=>t.includes(e))))}const ye={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 he={$el:"div",children:[{$el:"div",attrs:{id:"form-anchor",class:"t-absolute",style:{top:"-30px",left:0}}}],attrs:{class:"t-relative"}};const _e={$el:"div",attrs:{class:"t-mt-7 t-mb-5 t-w-full t-flex t-flex-col t-justify-center t-items-center",style:{if:"$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:[{$el:"div",attrs:{id:"progress-bar",class:"t-flex t-flex-col t-justify-center t-text-center t-whitespace-nowrap t-w-[10%] t-h-1.5 t-rounded t-text-white t-bg-[#007bff]",style:{transition:"width 0.5s ease"}}}]}]};const ge=[{$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},{$formkit:"hidden",name:"s",value:null}],be={"*":"https://listings.ziplawyer.com/api/v1/redirect?zone_id=4&vertical=Legal&category=${properties.Type_Of_Legal_Problem}&Degree_Of_Interest=${properties.Degree_Of_Interest}&zip_code=${properties.Zip}&sub_id=${properties.vid}"};const Ce={Civil_Defense:{Yes:{Type_Of_Legal_Problem:"Defend a Lawsuit"},No:{Type_Of_Legal_Problem:"File a Lawsuit"}},businessServicesOverrideMap:{Business_Services_Display:{"Business Formation":{Business_Services:"Business Formation"},Contracts:{Business_Services:"Contracts"},"Insurance and Liability":{Business_Services:"Insurance and Liability"},"Mergers and Acquisition":{Business_Services:"Mergers and Acquisition"},"Regulatory Compliance":{Business_Services:"Regulatory Compliance"},"Employee Dispute":{Business_Services:"Employee Dispute"},"Advice and Consulting":{Business_Services:"Other"},Other:{Business_Services:"Other"}}},Type_Of_Legal_Problem_Display:{Copyrights:{Type_Of_Legal_Problem:"Copyrights and Trademarks"},Trademarks:{Type_Of_Legal_Problem:"Copyrights and Trademarks"},Patents:{Type_Of_Legal_Problem:"Patents and Intellectual Property"},"Business Lawyers":{Type_Of_Legal_Problem:"Business Lawyers"},"Business Consulting":{Type_Of_Legal_Problem:"Business Lawyers"},"Not Sure or Other":{Type_Of_Legal_Problem:"Not Sure or Other"},"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 Lawyers",Business_Services:"Contracts"},"Other Contract Issues":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Criminal Defense":{Type_Of_Legal_Problem:"Criminal and Felony"},"Victim of a Crime":{Type_Of_Legal_Problem:"Victim of a Crime"},"DUI and DWI":{Type_Of_Legal_Problem:"DUI and DWI"},Expungement:{Type_Of_Legal_Problem:"Expungement"},Harassment:{Type_Of_Legal_Problem:"Criminal and Felony"},"Not Sure or Other":{Type_Of_Legal_Problem:"Not Sure or Other"},"Workplace Harassment":{Type_Of_Legal_Problem:"Workplace Harassment"},"Workplace Discrimination":{Type_Of_Legal_Problem:"Workplace Discrimination"},"Wrongful Termination":{Type_Of_Legal_Problem:"Wrongful Termination"},"Payment Disputes":{Type_Of_Legal_Problem:"Employment and Workplace"},"Workers Compensation":{Type_Of_Legal_Problem:"Workers Compensation"},Unemployment:{Type_Of_Legal_Problem:"Unemployment"},"Other Workplace Issues":{Type_Of_Legal_Problem:"Employment and Workplace"},"Attorney Malpractice":{Type_Of_Legal_Problem:"Civil Lawsuit"},"Other Malpractice Issues":{Type_Of_Legal_Problem:"Not Sure or Other"},"Vehicle Repossession":{Type_Of_Legal_Problem:"Bankruptcy"},"Property Repossession":{Type_Of_Legal_Problem:"Bankruptcy"},"Other Repossession Issues":{Type_Of_Legal_Problem:"Not Sure or Other"},"Contracts and Agreements":{Type_Of_Legal_Problem:"Real Estate"},"Deeds, Liens, and Titles":{Type_Of_Legal_Problem:"Real Estate"},Foreclosure:{Type_Of_Legal_Problem:"Foreclosure"},Insurance:{Type_Of_Legal_Problem:"Insurance"},"Landlord and Tenant":{Type_Of_Legal_Problem:"Landlord and Tenant"},"Loans and Mortgages":{Type_Of_Legal_Problem:"Real Estate"},"Wills, Trusts, and Estates":{Type_Of_Legal_Problem:"Wills and Trusts"},"Property Damage":{Type_Of_Legal_Problem:"Property Damage"},"Other Real Estate Issues":{Type_Of_Legal_Problem:"Real Estate"}}},ve={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"'},Pe={},we={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."},xe=["haveAttorney","degreeOfInterest","commentsWithBankruptcy","zipcode","legalCrossSells","firstAndLast","contactInfo"],Ie=["haveAttorney","degreeOfInterest","lawyerPaymentMethod","commentsWithBankruptcy","zipcode","legalCrossSells","firstAndLast","contactInfo"],Te=["haveAttorney","commentsWithBankruptcy","zipcode","legalCrossSells","firstAndLast","contactInfo"],Se={Type_Of_Legal_Problem:{Adoption:["maritalStatus","haveChildren",...Ie],"Asbestos and Mesothelioma":["incidentDate","doctorTreatment",...xe],"Auto and Car Accidents":["incidentDate","atFault","primaryInjury","doctorTreatment","policeReportFiled",...Te],Bankruptcy:["totalMonthlyIncome","totalDebt","ownRealEstate","valueOfAssets",...xe],"Business Lawyers":["businessServices","businessType","numEmployeesOfBusiness",...xe],"Child Custody":["childRelationship","childHome","childPrimaryCaregiver",...Ie],"Child Support":["childRelationship","childHome","childPrimaryCaregiver",...Ie],"Civil Rights and Discrimination":["civilRightsType",...xe],"Civil Lawsuit":["civilDefense","lawsuitOtherParty",...xe],"File a Lawsuit":["civilLawsuitTOLPDisplay","lawsuitOtherParty",...xe],"Defend a Lawsuit":["lawsuitOtherParty",...xe],"Consumer Lawyers":["consumerLawyerType","incidentDate","lawsuitOtherParty",...xe],"Criminal and Felony":["criminalTOLPDisplay","crimeCommittedDate","roleInMatterCriminal","pendingCharges",...Ie],"Debt and Collections":["totalMonthlyIncome","totalDebt","ownRealEstate","valueOfAssets",...xe],"Divorce and Separation":["maritalStatus","haveChildren",...Ie],"DUI and DWI":["incidentDate","priorAlcoholOffenses","typeOfAlcoholTest","bloodContentAlcoholTest","pendingCharges",...xe],"Employment and Workplace":["employmentAndWorkplaceTOLPDisplay","numEmployeesOfBusiness","employerType","employeeAtCompany",...xe],Expungement:["incidentDate","criminalChargeType",...Ie],"Family Issues":["maritalStatus","haveChildren",...Ie],Foreclosure:["ownRealEstate","typeOfProperty","amountPaymentsPastDue","loanAmount","defaultNotice",...xe],Guardianship:["maritalStatus","haveChildren",...Ie],"Immigration and Visas":["countryOfCitizenship","immigrationLocation","immigrationEntry","immigrationType","immigrationStatus","immigrationDetails",...xe],"Landlord and Tenant":["landlordTenantIssue","landlordTenantParty",...xe],"Lemon Law":["incidentDate","lawsuitOtherParty",...xe],"Long Term Disability":["applicantOccupation","applicantAge","applicantLTDisabilityPolicy","applicantDisabilityHowObtain","applicantPreviouslyAppliedLtdBenefits","applicantReceivedDisabilityBenefits","applicantMonthlySalary",...Te],"Medical Malpractice":["incidentDate","claimStatus","doctorTreatment","medicalMalpracticeInjuries",...xe],"Patents and Intellectual Property":["patentAssistanceType","patentFor",...xe],"Personal Injury":["incidentDate","claimStatus","atFault","primaryInjury","doctorTreatment",...Te],"Probate and Estates":["valueOfAssets","typeOfAssets","roleInMatterProbate","estateLegalServicesNeeded",...xe],"Property Damage":["realEstateArea","wouldLikeLawyerTo",...xe],"Real Estate":["realEstateTOLPDisplay","realEstateArea","wouldLikeLawyerTo",...xe],"Social Security Disability and Insurance":["applicantAge","disabilityConditionStopWork","disabilityWorkHistory","socialSecurityDisabilityReceivingBenefits","doctorTreatment",...Te],"Tax and IRS":["totalDebt","taxProblemDetails","taxLevel","taxIssueType",...xe],"Traffic and Tickets":["driversLicenseType","trafficViolations","haveCourtDate",...xe],Unemployment:["numEmployeesOfBusiness","employerType","degreeOfInterest","commentsWithBankruptcy","zipcode","legalCrossSells","firstAndLast","contactInfo"],"Victim of a Crime":["crimeCommittedDate","roleInMatterCriminal","pendingCharges",...Ie],"Wills and Trusts":["valueOfAssets","typeOfAssets","roleInMatterProbate","estateLegalServicesNeeded",...xe],"Workers Compensation":["incidentDate","claimStatus","primaryInjury","causeOfInjury","doctorTreatment",...Te],"Workplace Harassment":["numEmployeesOfBusiness","employerType","employeeAtCompany",...xe],"Workplace Discrimination":["numEmployeesOfBusiness","employerType","employeeAtCompany",...xe],"Wrongful Death":["incidentDate","relationshipToVictim","criminalChargesFiled","causeOfDeath",...Te],"Wrongful Termination":["numEmployeesOfBusiness","employerType",...xe]},"*":xe}.Type_Of_Legal_Problem,Oe={Type_Of_Legal_Problem_Display:{"Wrongful Termination":Se["Wrongful Termination"],"Workers Compensation":Se["Workers Compensation"],"Personal Injury":Se["Personal Injury"],Unemployment:Se.Unemployment},"*":["numEmployeesOfBusiness","employerType","employeeAtCompany",...xe]},De=function(a=null){let r=ve,n=Pe,i=we;return a&&(r=fe(ve,a),n=fe(Pe,a),i=fe(we,a)),{type:"meta",data:e(ye,{defaultCommentsPlaceholder:t,commentsPlaceholders:r,defaultFinalHeadline:"Submit Your Case",finalHeadlines:n,defaultFinalSubHeadline:"You may benefit from speaking with a legal professional. Please verify your contact information.",finalSubHeadlines:i})}}();De.data.dynamicSchema=[function(e={}){return pe("atFault",d({name:t?t+":At_Fault":"At_Fault"}),"Were you at fault?",e);var t}(),function(e={}){return pe("causeOfDeath",o({name:"Cause_Of_Death",options:["Vehicle Accident","Negligent/Careless Act","Reckless Act","Other"]}),"What was the cause of death?",e)}(),function(e={}){return pe("causeOfInjury",o({name:t?t+":Cause_Of_Injury":"Cause_Of_Injury",options:["Traumatic Physical Injury (Accident)","Repeated Trauma Injury","Mental Injury","Occupational Disease","Not Sure"]}),"What was the cause of the injury?",e);var t}(),function(e={}){return pe("claimStatus",o({name:t?t+":Claim_Status":"Claim_Status",options:["No action taken yet","Demand for compensation made","Lawsuit filed","Other"]}),"What is the status of the claim?",e);var t}(),function(e={}){return pe("criminalChargesFiled",x(),"Have criminal charges been filed?",e)}(),function(e={}){return pe("degreeOfInterest",o({name:t?t+":Degree_Of_Interest":"Degree_Of_Interest",id:t?t+":Degree_Of_Interest":"Degree_Of_Interest",help:a,options:["Definitely","Probably","Maybe","Absolutely Can't Afford"]}),"Could you pay if your issue could be resolved?",e);var t,a}(),function(e={}){return pe("doctorTreatment",d({name:"Doctor_Treatment"}),"Have you seen a doctor about this?",e)}(),function(e={}){return pe("employerType",o({name:"Employer_Type",options:["Sole proprietorship (mom and pop)","Partnership","Franchise","Privately held company","Public corporation","Government Agency","Don't know"]}),"What type of employer is it?",e)}(),function(e={}){return pe("employeeAtCompany",d({name:t?t+":Employee_At_Company":"Employee_At_Company"}),"Do you/they still work at the company?",e);var t}(),function(e={}){return pe("haveAttorney",d({name:"Have_Attorney"}),"Already working with an attorney?",e)}(),function(e={}){return pe("incidentDate",W(),"When did the incident occur?",e)}({nextOnInput:!1}),function(e={}){return pe("numEmployeesOfBusiness",o({name:"Num_Employees_Of_Business",options:["1-5","6-20","21-50","51-100","101-500","501-1,000","More than 1,000"]}),"How many employees does the business have?",e)}(),function(e={}){return pe("primaryInjury",o({name:t?t+":Primary_Injury":"Primary_Injury",options:["Anxiety","Back or Neck Pain","Broken Bones","Cuts and Bruises","Headaches","Memory Loss","Loss of Limb","Not Sure or Other"]}),"What was the primary injury?",e);var t}(),function(e={}){return pe("relationshipToVictim",o({name:"Relationship_To_Victim",options:["Parent","Spouse","Sibling","Friend","Other"]}),"What is your relationship to the victim?",e)}(),function(e={}){return pe("zipcode",((e={})=>c({placeholder:"#####",help:e.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"}))(e),"Please verify your Zip Code",e)}(),function(e={}){return ce("commentsWithBankruptcy",[ne(e),w({label:void 0===e.label?"Please briefly describe your legal issue in a few words:":e.label,placeholder:e.placeholder||t,inputClass:void 0===e.inputClass?"!t-h-32":e.inputClass}),h(),{$el:"div",if:"$get(CrossSell_Bankruptcy).value == true",children:[w({label:"Bankruptcy or debt details:",placeholder:"Please describe your bankrtupcy or debt situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Bankruptcy")]}],!1)}({label:null,headline:"Please briefly describe your situation:",headlineClass:"!t-text-dark"}),function(e={}){return ce("legalCrossSells",[se(e),i({id:"Legal_CrossSells",name:"Legal_CrossSells",help:'Just hit "Next" if none apply',helpClass:"t-text-center !t-text-sm",validation:null,options:{if:'$getVal($get(form), "Type_Of_Legal_Problem") === "Auto and Car Accidents"',then:{"Social Security Disability and Insurance":"Interest in Disability Benefits","Wills and Trusts":"Need a Will or Trust","Workers Compensation":"Workplace Injury","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},else:{if:'$getVal($get(form), "Type_Of_Legal_Problem") === "Personal Injury" || $getVal($get(form), "Type_Of_Legal_Problem") === "Workers Compensation"',then:{"DUI and DWI":"Involved in a DUI/DWI","Wills and Trusts":"Need a Will or Trust","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},else:{if:'$getVal($get(form), "Type_Of_Legal_Problem") === "DUI and DWI"',then:{"Personal Injury":"Personal or Workplace Injury","Wills and Trusts":"Need a Will or Trust","Social Security Disability and Insurance":"Interest in Disability Benefits","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},else:{if:'$getVal($get(form), "Type_Of_Legal_Problem") === "Wills and Trusts" || $getVal($get(form), "Type_Of_Legal_Problem") === "Probate and Estates" || $getVal($get(form), "Type_Of_Legal_Problem") === "Power of Attorney"',then:{"Auto and Car Accidents":"Injured in a Car Accident","Personal Injury":"Personal or Workplace Injury","DUI and DWI":"Involved in a DUI/DWI","Social Security Disability and Insurance":"Interest in Disability Benefits","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},else:{if:'$getVal($get(form), "Type_Of_Legal_Problem") === "Long Term Disability" || $getVal($get(form), "Type_Of_Legal_Problem") === "Social Security Disability and Insurance"',then:{"Auto and Car Accidents":"Injured in a Car Accident","DUI and DWI":"Involved in a DUI/DWI","Wills and Trusts":"Need a Will or Trust","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},else:{"Auto and Car Accidents":"Injured in a Car Accident","Personal Injury":"Personal or Workplace Injury","DUI and DWI":"Involved in a DUI/DWI","Wills and Trusts":"Need a Will or Trust","Power of Attorney":"Update Power of Attorney","Social Security Disability and Insurance":"Interest in Disability Benefits"}}}}}}})],e.nextOnEnter,!1,"$get(Type_Of_Legal_Problem).value")}({headlineClass:"!t-text-dark"}),function(e={}){return ce("autoAndCarAccidentCrossSellQuestions",[ee({headline:"You May Be Entitled To Compensation"}),te({subheadline:"Tell us about your accident:"}),(t="true",a="CrossSell:Auto_and_Car_Accidents",Q("AutoAndCarAccidentsQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Auto and Car Accidents"',children:[A(a),E(a),y(a),F(a),D(a),q(a)]})),w({label:"Accident Description:",placeholder:"Please describe your accident in a few words...",inputClass:"!t-h-16"},"CrossSell:Auto_and_Car_Accidents")],e.nextOnEnter);var t,a}(),function(e={}){return ce("personalInjuryCrossSellQuestions",[ee({headline:"You May Be Entitled To Compensation"}),te({subheadline:"Tell us about your injury:"}),(t="true",a="CrossSell:Personal_Injury",Q("PersonalInjuryQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Personal Injury"',children:[A(a),E(a),P(a),y(a),F(a),D(a)]})),w({label:"Injury Description:",placeholder:"Please describe your injury in a few words...",inputClass:"!t-h-16"},"CrossSell:Personal_Injury")],e.nextOnEnter);var t,a}(),function(e={}){return ce("workersCompensationCrossSellQuestions",[ee({headline:"You May Be Entitled To Benefits"}),te({subheadline:"Tell us about your injury:"}),(t="true",a="CrossSell:Workers_Compensation",Q("WorkersCompensationQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Workers Compensation"',children:[A(a),E(a),P(a),F(a),g(a),D(a)]})),w({label:"Injury Description:",placeholder:"Please describe your injury in a few words...",inputClass:"!t-h-16"},"CrossSell:Workers_Compensation")],e.nextOnEnter);var t,a}(),function(e={}){return ce("duiAndDWICrossSellQuestions",[ee({headline:"About Your DUI/DWI"}),(t="true",a="CrossSell:DUI_and_DWI",Q("DUIAndDWIQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "DUI and DWI"',children:[A(a),E(a),N(a),H(a),_(a),M(a),T(a)]})),w({label:"Incident Description:",placeholder:"Please describe your incident in a few words...",inputClass:"!t-h-16"},"CrossSell:DUI_and_DWI")],e.nextOnEnter);var t,a}(),function(e={}){return ce("ssdiCrossSellQuestions",[ee({headline:"You May Be Entitled To Benefits"}),te({subheadline:"Tell us about your disability:"}),(t="true",a="CrossSell:Social_Security_Disability_and_Insurance",Q("SocialSecurityDisabilityAndInsuranceQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Social Security Disability and Insurance"',children:[A(a),f(a),S(a),O(a),Y(a),D(a)]})),w({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Social_Security_Disability_and_Insurance")],e.nextOnEnter);var t,a}(),function(e={}){return ce("powerOfAttorneyCrossSellQuestions",[ee({headline:"Power of Attorney Information"}),(t="true",a="CrossSell:Power_of_Attorney",Q("PowerofAttorneyQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Power of Attorney"',children:[A(a),T(a)]})),w({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Power_of_Attorney")],e.nextOnEnter);var t,a}(),function(e={}){return ce("willsAndTrustsCrossSellQuestions",[ee({headline:"Will or Trust Information"}),(t="true",a="CrossSell:Wills_and_Trusts",Q("WillsAndTrustsQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Wills and Trusts"',children:[A(a),V(a),U(a),R(a),L(a),T(a)]})),w({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Wills_and_Trusts")],e.nextOnEnter);var t,a}(),function(e={}){return ce("divorceAndSeparationCrossSellQuestions",[ee({headline:"Divorce or Separation Information"}),(t="true",a="CrossSell:Divorce_and_Separation",Q("DivorceQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Divorce and Separation"',children:[A(a),B(a),$(a),I(a),j(a)]})),w({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Divorce_and_Separation")],e.nextOnEnter);var t,a}(),function(e={}){return ce("childCustodyCrossSellQuestions",[ee({headline:"Child Custody Information"}),(t="true",a="CrossSell:Child_Custody",Q("ChildCustodyQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Child Custody"',children:[A(a),v(a),b(a),C(a),I(a),j(a)]})),w({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Child_Custody")],e.nextOnEnter);var t,a}(),function(e={}){return ce("firstAndLast",[ie({headline:e.headline??"Who is looking for help?",headlineClass:e.headlineClass}),re({subheadline:e.subheadline??"Note: we never share info without consent",subheadlineClass:"!t-text-sm !t-text-gray-500"}),p({$formkit:"text",label:"First Name:",placeholder:"First",name:"First_Name",autocomplete:"given-name",validationMessages:{required:"First Name is required"}}),p({$formkit:"text",label:"Last Name:",placeholder:"Last",name:"Last_Name",autocomplete:"family-name",validationMessages:{required:"Last Name is required"}})],e.nextOnEnter)}({headlineClass:"!t-text-dark"})];const ke=[De,e(he,Le),{$cmp:"FormKit",props:function(t){const a=e(me,t);return a.formId&&!a.name&&(a.name=a.formId),a}({formId:"employmentAndWorkplace",redirectMap:function(t){return e(be,t)}(),valueOverrideMap:Ce}),children:[function(t){return e(_e,t)}(),function(t={}){return e(function(e={}){return{$el:"h1",attrs:{class:"t-flex t-justify-center t-text-center !t-text-[2rem] t-font-semibold t-pt-5 t-px-7 md:t-px-3 "+(e.headlineClass||"")}}}(t),t)}({children:'$urlParam("hl", "Start Here For a Free Consultation")',if:"$activeStep === $firstStep()"}),function(t={}){return e(function(e={}){return{$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 "+(e.subheadlineClass||"")}}}(t),t)}({children:'$urlParam("shl", "Select a Category Below to Get Started!")',if:"$activeStep === $firstStep()"}),...ge,{$el:"div",attrs:{class:"form-body"},children:[function(e={}){return ce("employmentAndWorkplaceTOLP",[{$formkit:"hidden",name:"Type_Of_Legal_Problem",id:"Type_Of_Legal_Problem",value:"Employment and Workplace"},k()],e.nextOnEnter,e.nextOnInput,e.stepKey,e.nextStepMap)}({nextOnInput:!1,nextStepMap:Oe}),{$cmp:"FormKitSchema",if:"$get(Type_Of_Legal_Problem).value",props:{schema:"$meta.dynamicSchema",data:"$buildData($meta)"}},function(e={}){return ce("contactInfo",[oe(e),le(e),{$el:"script",if:"$activeStep === $lastStep()",children:de},p({$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"}}),p({$formkit:"tel",name:"Primary_Phone",label:"Phone Number:",placeholder:"###-###-####",maxlength:12,help:"10-digit phone number, hyphens optional",autocomplete:"tel-national","data-tf-sensitive":"false",validation:"required|matches:/^[0-9]{3}-?[0-9]{3}-?[0-9]{4}$/|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]"}),{$formkit:"checkbox",label:"$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"}},X()],!1)}(),{$el:"div",attrs:{class:"step-nav"},children:[{$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: ","$stepKeys()"],attrs:{class:"t-text-xs",style:"overflow: scroll"}}]}]}]}];var Le;return ke}();
|
|
1
|
+
var employmentAndWorkplace=function(){"use strict";function e(){return Object.assign({},...arguments)}const t='$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, $meta.defaultFinalSubHeadline)',n=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"checkbox",validation:"required",validationMessages:{required:"Field is required"}},t)),i=e=>(e&&e.legendClass||(e.legendClass="required"),e.fieldsetClass="$reset",e.optionsClass="t-pl-8 md:t-pl-2 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2",e.innerClass="t-items-start",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",n(e)),s=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"radio",validation:"required",validationMessages:{required:"Field is required"},optionsClass:"t-pt-3 t-pl-1",legendClass:"required"},t)),o=e=>(e.legendClass="required t-w-[100%] t-text-center",void 0===e.fieldsetClass&&(e.fieldsetClass="$reset t-flex t-justify-center"),e.optionsClass="t-pl-4 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2",e.innerClass="t-items-start",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",e.optionClass="t-pl-4 md:t-pl-8 md:t-min-w-[200px]",e.messagesClass="t-flex t-justify-center",e.helpClass="t-mt-0 t-mb-4 !t-text-sm t-text-center",s(e)),l=e=>(e.options=["Yes","No"],(e=>(e.legendClass="legend-left t-pb-1 required",e.fieldsetClass="$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",s(e)))(e)),d=e=>(e.options=["Yes","No"],e.optionsClass="t-flex t-justify-center t-my-3",(e=>(e.legendClass="legend-left",e.fieldsetClass="$reset t-flex t-justify-center t-flex-col-reverse t-items-center",void 0===e.optionsClass&&(e.optionsClass="t-flex t-flex-col sm:t-flex-row t-justify-center t-my-3"),e.optionClass="radiobtn t-my-2 sm:t-my-0 t-mx-2 md:t-mx-5",e.wrapperClass="$reset formkit-wrapper t-mb-0 t-flex t-items-center t-h-[100%]",e.labelClass="t-font-semibold t-text-[#1e448f] t-w-[100%]",e.decoratorIcon=!1,e.messagesClass="t-flex t-justify-center",e.helpClass="t-mt-2.5 !t-text-sm t-text-center",s(e)))(e)),c=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=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"select",placeholder:"Please Select",validation:"required",validationMessages:{required:"Field is required"},inputClass:"t-bg-white",labelClass:"required"},t)))(t)),u=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"text",validation:"required",validationMessages:{required:"Field is required"},labelClass:"required"},t)),p=e=>(e.wrapperClass="side-by-side t-items-center",u(e)),m=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"DatePicker",validation:"required",validationMessages:{required:"Field is required"},labelClass:"required t-block t-mb-3 t-font-semibold t-text-base formkit-invalid:t-text-red-500",innerClass:"t-border t-border-gray-400 formkit-invalid:t-border-red-500 t-rounded t-mb-1 focus-within:t-border-blue-500"},t)),f=e=>p({name:e?e+":Applicant_Age":"Applicant_Age",label:"Age of Applicant?",placeholder:"Age between 18 and 65",maxlength:2,inputmode:"numeric",validation:"required|min:18,max:65",validationMessages:{required:"Applicant Age is required",min:"Invalid Age - must be between 18 and 65",max:"Invalid Age - must be between 18 and 65"}}),y=e=>l({name:e?e+":At_Fault":"At_Fault",label:"Were You at Fault?"}),h=()=>{return(e={label:"I'd also like a consult for bankruptcy or debt elimination (optional)",help:"Note: you will be contacted separately by a bankruptcy/debt expert",name:"CrossSell_Bankruptcy",id:"CrossSell_Bankruptcy",if:'$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"}).legendClass="legend-left required",e.fieldsetClass="$reset side-by-side",e.optionsClass="t-pl-1",e.innerClass="t-flex t-items-center",e.wrapperClass="t-mb-3",n(e);var e},_=e=>c({name:e?e+":Blood_Alcohol_Content_Test":"Blood_Alcohol_Content_Test",label:"Blood Alcohol Content Measured by Test:",options:["No Test","0.00% - 0.04%","0.05% - 0.08%","0.09% - 0.12%","0.13% - 0.16%","0.17% - 0.20%","More than 0.20%","Don't know"]}),g=e=>c({name:e?e+":Cause_Of_Injury":"Cause_Of_Injury",label:"Cause of Injury:",options:["Traumatic Physical Injury (Accident)","Repeated Trauma Injury","Mental Injury","Occupational Disease","Not Sure"]}),b=e=>c({name:e?e+":Child_Home":"Child_Home",label:"With Whom Do the Children Currently Live?",options:["Mother","Father","Grandparents","Other"]}),C=e=>c({name:e?e+":Child_Primary_Caregiver":"Child_Primary_Caregiver",label:"Who is the Primary Caregiver?",options:["Mother","Father","Other"]}),v=e=>c({name:e?e+":Child_Relationship":"Child_Relationship",label:"Your Relationship to Child(ren):",options:["Father","Mother","Grandparent","Aunt/Uncle","Other"]}),P=e=>c({name:e?e+":Claim_Status":"Claim_Status",label:"Status of Claim:",options:["No action taken yet","Demand for compensation made","Lawsuit filed","Other"]}),x=(t,a)=>(t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"textarea",rows:5,maxlength:500,validation:"required",validationMessages:{required:"Field is required"},innerClass:"t-max-w-xl",labelClass:"required"},t)))(e({name:a?a+":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"'},t)),w=()=>{return(e={name:"Criminal_Charges_Filed",options:["Yes","No","Not Sure"]}).legendClass="required",e.fieldsetClass="$reset t-flex t-justify-center",e.optionsClass="t-pl-2 t-pt-3",e.innerClass="t-items-center",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",e.optionClass="t-pl-4 md:t-pl-12",e.messagesClass="t-flex t-justify-center",s(e);var e},I=(e,t)=>c({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"]}),T=e=>I(e,"No payment necessary to speak with lawyers."),S=e=>l({name:e?e+":Disability_Condition_Stop_Work":"Disability_Condition_Stop_Work",label:"Do You Expect To Be Out Of Work For At Least a Year Due To Your Health?"}),O=e=>l({name:e?e+":Disability_Work_History":"Disability_Work_History",label:"Have You Had a Full-Time Job Within the Past 5 Years?"}),D=e=>l({name:e?e+":Doctor_Treatment":"Doctor_Treatment",label:"Have You Recently Been Treated by a Doctor, Hospital or Clinic?"}),k=t=>o(e({name:"Type_Of_Legal_Problem_Display",options:["Workplace Harassment","Workplace Discrimination","Wrongful Termination","Payment Disputes","Workers Compensation","Personal Injury","Unemployment","Other Workplace Issues"]},t)),L=e=>c({name:e?e+":Estate_Legal_Services_Needed":"Estate_Legal_Services_Needed",label:"Legal Services Needed for Your Estate:",options:["Charitable Giving","Contested Wills","Drafting Wills or Trust","Estate Administration","Asset Protection","Other"]}),A=e=>p({$formkit:"text",label:"First Name:",placeholder:"First",name:e?e+":First_Name":"First_Name",autocomplete:"given-name",validationMessages:{required:"First Name is required"}}),$=e=>l({name:e?e+":Have_Attorney":"Have_Attorney",label:"Already Working with An Attorney?"}),E=e=>l({name:e?e+":Have_Children":"Have_Children",label:"Do You Have Children?"}),W=e=>{return(t={name:e?e+":Incident_Date":"Incident_Date",label:"Date of Incident:"}).wrapperClass="side-by-side t-items-center",m(t);var t},j=e=>{return(t={name:e?e+":Incident_Date":"Incident_Date"}).wrapperClass="t-flex t-justify-center",t.inputClass="t-text-center",t.messagesClass="t-flex t-justify-center",m(t);var t},B=e=>p({$formkit:"text",label:"Last Name:",placeholder:"Last",name:e?e+":Last_Name":"Last_Name",autocomplete:"family-name",validationMessages:{required:"Last Name is required"}}),M=e=>c({name:e?e+":Lawyer_Payment_Method":"Lawyer_Payment_Method",label:"How Will You Pay for Legal Fees if You Hire a Lawyer?",help:"No payment necessary to speak with lawyers.",options:["Cash","Check","Credit Card","Friend","Family","Other"]}),F=e=>c({name:e?e+":Marital_Status":"Marital_Status",label:"Marital Status:",options:["Unmarried, Living Together","Unmarried, Do Not Live Together","Married, Living Together","Separated","Divorced","Other"]}),N=e=>l({name:e?e+":Pending_Charges":"Pending_Charges",label:"Do you currently have any pending charges?"}),q=e=>p({$formkit:"tel",name:e?e+":Primary_Phone":"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}$/|valid_phone",validationMessages:{required:"Field is required",matches:"Invalid Phone Format, use ###-###-####",valid_phone:"Invalid Phone Number"},helpClass:"t-mt-2.5 md:t-text-right md:t-mt-[-2px]"}),R=e=>{return(t={name:e?e+":Primary_Injury":"Primary_Injury",label:"Primary Injury:",options:["Anxiety","Back or Neck Pain","Broken Bones","Cuts and Bruises","Headaches","Memory Loss","Loss of Limb","Not Sure or Other"]}).legendClass="legend-left-flex md:t-max-w-[40%] required",t.fieldsetClass="$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="$reset t-flex t-cursor-pointer t-mb-3",s(t);var t},Y=e=>l({name:e?e+":Prior_Alcohol_Offenses":"Prior_Alcohol_Offenses",label:"Any Prior Alcohol Related Offenses?"}),H=e=>l({name:e?e+":Police_Report_Filed":"Police_Report_Filed",label:"Was a Police Report Filed?"}),U=e=>c({name:e?e+":Role_In_Matter_Probate":"Role_In_Matter_Probate",label:"What Is Your Role in this Matter?",options:["Preparing My Will","Executor","Heir","Other"]}),V=e=>l({name:e?e+":Social_Security_Disability_Receiving_Benefits":"Social_Security_Disability_Receiving_Benefits",label:"Are You Currently Receiving Social Security Disability Benefits?"}),Q=e=>({$formkit:"checkbox",label:"$meta.tcpaLanguage",name:e?e+":TCPA_Opt_In":"TCPA_Opt_In","data-tf-sensitive":"false",validation:"required|accepted",validationMessages:{required:"Consent is required",accepted:"Consent is required"},classes:{label:"t-text-xs t-text-slate-500 t-font-normal"}}),K=e=>c({name:e?e+":Type_Of_Alcohol_Test":"Type_Of_Alcohol_Test",label:"Type of Alcohol Test Performed?",options:["No Test","Refused Test","Breath Test","Blood Test","Urine Test","Don't Know"]}),z=e=>i({name:e?e+":Type_Of_Assets":"Type_Of_Assets",label:"Type of Assets:",options:["Business Interests","Cash","Life Insurance Policies","Pensions/Retirement","Personal Possessions","Property","Stock/Bonds"]}),G=e=>c({name:e?e+":Value_Of_Assets":"Value_Of_Assets",label:"Value of Your Assets?",options:["Less than 50K","50K to 100K","100K to 250K","250K to 500K","500K to 1M","More than 1M"]}),Z=(t,a)=>e({$cmp:"FormKit",props:{type:"group",key:t,id:t,name:t}},a),J="$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",X="$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",ee=e=>"group"!==e.type&&"section"!==e.type&&"form"!==e.type&&"hidden"!==e.$formkit&&!e.children,te=e=>{if(ee(e))return e;for(var t=e.children.length-1;t>=0;t--){if("string"==typeof e.children)continue;const a=e.children[t];if(ee(a))return a;const r=te(a);if(r)return r}return null},ae={$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"}},{$el:"span",children:"Secure & Encrypted",attrs:{class:"t-pl-2 t-pt-1 t-font-medium"}}]};function re(t){return e(ae,t)}function ne(e){return{$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 ie(e){return{$el:"h5",children:e.subheadline||"Tell us about your situation:",attrs:{class:"t-flex t-justify-center t-text-dark t-text-center !t-text-lg t-font-semibold t-pb-4 t-pt-0 t-px-3"}}}function se(e){return{$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-dark t-pb-5 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function oe(e){return{$el:"h5",children:e.subheadline||"",attrs:{class:"t-flex t-justify-center t-text-center !t-text-lg t-font-normal t-text-dark t-pb-5 t-pt-0 t-px-1 "+(e.subheadlineClass||"")}}}function le(e){return{$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 de(e){return{$el:"h3",children:e.headline||"Please Provide a Contact Name",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function ce(e){return{$el:"h3",children:e.headline||"Do any of the following situations apply?",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 ue(e){return{$el:"h3",children:e.headline||a,attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-3 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function pe(e){return{$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 me="(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 fe=(e,t)=>({$el:"section",if:'$stepEnabled("'+e+'")',attrs:{hidden:'$activeStep !== "'+e+'"',key:t||e}});function ye(t,a,r=!0,n=!1,i=void 0,s=void 0,o=void 0){if(void 0===r&&(r=!0),a&&a.length&&(r||n)){const e=te(a[a.length-1]);e&&!0===r&&(e.onKeypress=J),e&&!0===n&&(e.onInput=X)}return e(fe(t,i),{children:[{$formkit:"group",id:t,name:t,nextStepMap:s,autoFocus:o,children:a}]})}function he(e,t,a,r={}){return ye(e,[se({headline:r.headline??a,headlineClass:r.headlineClass}),...Array.isArray(t)?t:[t]],r.nextOnEnter,void 0===r.nextOnInput||r.nextOnInput,r.stepKey,r.nextStepMap)}const _e={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]"};function ge(e,t){return Object.fromEntries(Object.entries(e).filter((([e])=>t.includes(e))))}const be={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 Ce={$el:"div",children:[{$el:"div",attrs:{id:"form-anchor",class:"t-absolute",style:{top:"-30px",left:0}}}],attrs:{class:"t-relative"}};const ve={$el:"div",attrs:{class:"t-mt-7 t-mb-5 t-w-full t-flex t-flex-col t-justify-center t-items-center",style:{if:"$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:[{$el:"div",attrs:{id:"progress-bar",class:"t-flex t-flex-col t-justify-center t-text-center t-whitespace-nowrap t-w-[10%] t-h-1.5 t-rounded t-text-white t-bg-[#007bff]",style:{transition:"width 0.5s ease"}}}]}]};const Pe=[{$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},{$formkit:"hidden",name:"s",value:null}],xe={"*":"https://listings.ziplawyer.com/api/v1/redirect?zone_id=4&vertical=Legal&category=${properties.Type_Of_Legal_Problem}&Degree_Of_Interest=${properties.Degree_Of_Interest}&zip_code=${properties.Zip}&sub_id=${properties.vid}"};const we={Civil_Defense:{Yes:{Type_Of_Legal_Problem:"Defend a Lawsuit"},No:{Type_Of_Legal_Problem:"File a Lawsuit"}},businessServicesOverrideMap:{Business_Services_Display:{"Business Formation":{Business_Services:"Business Formation"},Contracts:{Business_Services:"Contracts"},"Insurance and Liability":{Business_Services:"Insurance and Liability"},"Mergers and Acquisition":{Business_Services:"Mergers and Acquisition"},"Regulatory Compliance":{Business_Services:"Regulatory Compliance"},"Employee Dispute":{Business_Services:"Employee Dispute"},"Advice and Consulting":{Business_Services:"Other"},Other:{Business_Services:"Other"}}},Type_Of_Legal_Problem_Display:{Copyrights:{Type_Of_Legal_Problem:"Copyrights and Trademarks"},Trademarks:{Type_Of_Legal_Problem:"Copyrights and Trademarks"},Patents:{Type_Of_Legal_Problem:"Patents and Intellectual Property"},"Business Lawyers":{Type_Of_Legal_Problem:"Business Lawyers"},"Business Consulting":{Type_Of_Legal_Problem:"Business Lawyers"},"Not Sure or Other":{Type_Of_Legal_Problem:"Not Sure or Other"},"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 Lawyers",Business_Services:"Contracts"},"Other Contract Issues":{Type_Of_Legal_Problem:"Business Lawyers",Business_Services:"Contracts"},"Criminal Defense":{Type_Of_Legal_Problem:"Criminal and Felony"},"Victim of a Crime":{Type_Of_Legal_Problem:"Victim of a Crime"},"DUI and DWI":{Type_Of_Legal_Problem:"DUI and DWI"},Expungement:{Type_Of_Legal_Problem:"Expungement"},Harassment:{Type_Of_Legal_Problem:"Criminal and Felony"},"Not Sure or Other":{Type_Of_Legal_Problem:"Not Sure or Other"},"Workplace Harassment":{Type_Of_Legal_Problem:"Workplace Harassment"},"Workplace Discrimination":{Type_Of_Legal_Problem:"Workplace Discrimination"},"Wrongful Termination":{Type_Of_Legal_Problem:"Wrongful Termination"},"Payment Disputes":{Type_Of_Legal_Problem:"Employment and Workplace"},"Workers Compensation":{Type_Of_Legal_Problem:"Workers Compensation"},Unemployment:{Type_Of_Legal_Problem:"Unemployment"},"Other Workplace Issues":{Type_Of_Legal_Problem:"Employment and Workplace"},"Attorney Malpractice":{Type_Of_Legal_Problem:"Civil Lawsuit"},"Other Malpractice Issues":{Type_Of_Legal_Problem:"Not Sure or Other"},"Vehicle Repossession":{Type_Of_Legal_Problem:"Bankruptcy"},"Property Repossession":{Type_Of_Legal_Problem:"Bankruptcy"},"Other Repossession Issues":{Type_Of_Legal_Problem:"Not Sure or Other"},"Contracts and Agreements":{Type_Of_Legal_Problem:"Real Estate"},"Deeds, Liens, and Titles":{Type_Of_Legal_Problem:"Real Estate"},Foreclosure:{Type_Of_Legal_Problem:"Foreclosure"},Insurance:{Type_Of_Legal_Problem:"Insurance"},"Landlord and Tenant":{Type_Of_Legal_Problem:"Landlord and Tenant"},"Loans and Mortgages":{Type_Of_Legal_Problem:"Real Estate"},"Wills, Trusts, and Estates":{Type_Of_Legal_Problem:"Wills and Trusts"},"Property Damage":{Type_Of_Legal_Problem:"Property Damage"},"Other Real Estate Issues":{Type_Of_Legal_Problem:"Real Estate"}}},Ie={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"'},Te={},Se={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."},Oe=["haveAttorney","degreeOfInterest","commentsWithBankruptcy","zipcode","legalCrossSells","firstAndLast","contactInfo"],De=["haveAttorney","degreeOfInterest","lawyerPaymentMethod","commentsWithBankruptcy","zipcode","legalCrossSells","firstAndLast","contactInfo"],ke=["haveAttorney","commentsWithBankruptcy","zipcode","legalCrossSells","firstAndLast","contactInfo"],Le={Type_Of_Legal_Problem:{Adoption:["maritalStatus","haveChildren",...De],"Asbestos and Mesothelioma":["incidentDate","doctorTreatment",...Oe],"Auto and Car Accidents":["incidentDate","atFault","primaryInjury","doctorTreatment","policeReportFiled",...ke],Bankruptcy:["totalMonthlyIncome","totalDebt","ownRealEstate","valueOfAssets",...Oe],"Business Lawyers":["businessServices","businessType","numEmployeesOfBusiness",...Oe],"Child Custody":["childRelationship","childHome","childPrimaryCaregiver",...De],"Child Support":["childRelationship","childHome","childPrimaryCaregiver",...De],"Civil Rights and Discrimination":["civilRightsType",...Oe],"Civil Lawsuit":["civilDefense","lawsuitOtherParty",...Oe],"File a Lawsuit":["civilLawsuitTOLPDisplay","lawsuitOtherParty",...Oe],"Defend a Lawsuit":["lawsuitOtherParty",...Oe],"Consumer Lawyers":["consumerLawyerType","incidentDate","lawsuitOtherParty",...Oe],"Criminal and Felony":["criminalTOLPDisplay","crimeCommittedDate","roleInMatterCriminal","pendingCharges",...De],"Debt and Collections":["totalMonthlyIncome","totalDebt","ownRealEstate","valueOfAssets",...Oe],"Divorce and Separation":["maritalStatus","haveChildren",...De],"DUI and DWI":["incidentDate","priorAlcoholOffenses","typeOfAlcoholTest","bloodContentAlcoholTest","pendingCharges",...Oe],"Employment and Workplace":["employmentAndWorkplaceTOLPDisplay","numEmployeesOfBusiness","employerType","employeeAtCompany",...Oe],Expungement:["incidentDate","criminalChargeType",...De],"Family Issues":["maritalStatus","haveChildren",...De],Foreclosure:["ownRealEstate","typeOfProperty","amountPaymentsPastDue","loanAmount","defaultNotice",...Oe],Guardianship:["maritalStatus","haveChildren",...De],"Immigration and Visas":["countryOfCitizenship","immigrationLocation","immigrationEntry","immigrationType","immigrationStatus","immigrationDetails",...Oe],"Landlord and Tenant":["landlordTenantIssue","landlordTenantParty",...Oe],"Lemon Law":["incidentDate","lawsuitOtherParty",...Oe],"Long Term Disability":["applicantOccupation","applicantAge","applicantLTDisabilityPolicy","applicantDisabilityHowObtain","applicantPreviouslyAppliedLtdBenefits","applicantReceivedDisabilityBenefits","applicantMonthlySalary",...ke],"Medical Malpractice":["incidentDate","claimStatus","doctorTreatment","medicalMalpracticeInjuries",...Oe],"Patents and Intellectual Property":["patentAssistanceType","patentFor",...Oe],"Personal Injury":["incidentDate","claimStatus","atFault","primaryInjury","doctorTreatment",...ke],"Probate and Estates":["valueOfAssets","typeOfAssets","roleInMatterProbate","estateLegalServicesNeeded",...Oe],"Property Damage":["realEstateArea","wouldLikeLawyerTo",...Oe],"Real Estate":["realEstateTOLPDisplay","realEstateArea","wouldLikeLawyerTo",...Oe],"Social Security Disability and Insurance":["applicantAge","disabilityConditionStopWork","disabilityWorkHistory","socialSecurityDisabilityReceivingBenefits","doctorTreatment",...ke],"Tax and IRS":["totalDebt","taxProblemDetails","taxLevel","taxIssueType",...Oe],"Traffic and Tickets":["driversLicenseType","trafficViolations","haveCourtDate",...Oe],Unemployment:["numEmployeesOfBusiness","employerType","degreeOfInterest","commentsWithBankruptcy","zipcode","legalCrossSells","firstAndLast","contactInfo"],"Victim of a Crime":["crimeCommittedDate","roleInMatterCriminal","pendingCharges",...De],"Wills and Trusts":["valueOfAssets","typeOfAssets","roleInMatterProbate","estateLegalServicesNeeded",...Oe],"Workers Compensation":["incidentDate","claimStatus","primaryInjury","causeOfInjury","doctorTreatment",...ke],"Workplace Harassment":["numEmployeesOfBusiness","employerType","employeeAtCompany",...Oe],"Workplace Discrimination":["numEmployeesOfBusiness","employerType","employeeAtCompany",...Oe],"Wrongful Death":["incidentDate","relationshipToVictim","criminalChargesFiled","causeOfDeath",...ke],"Wrongful Termination":["numEmployeesOfBusiness","employerType",...Oe]},"*":Oe}.Type_Of_Legal_Problem,Ae={Type_Of_Legal_Problem_Display:{"Wrongful Termination":Le["Wrongful Termination"],"Workers Compensation":Le["Workers Compensation"],"Personal Injury":Le["Personal Injury"],Unemployment:Le.Unemployment},"*":["numEmployeesOfBusiness","employerType","employeeAtCompany",...Oe]},$e=function(a=null){let r=Ie,n=Te,i=Se;return a&&(r=ge(Ie,a),n=ge(Te,a),i=ge(Se,a)),{type:"meta",data:e(be,{defaultCommentsPlaceholder:t,commentsPlaceholders:r,defaultFinalHeadline:"Submit Your Case",finalHeadlines:n,defaultFinalSubHeadline:"You may benefit from speaking with a legal professional. Please verify your contact information.",finalSubHeadlines:i})}}();$e.data.dynamicSchema=[function(e={}){return he("atFault",(t=e.scope,d({name:t?t+":At_Fault":"At_Fault"})),"Were you at fault?",e);var t}(),function(e={}){return he("causeOfDeath",o({name:"Cause_Of_Death",options:["Vehicle Accident","Negligent/Careless Act","Reckless Act","Other"]}),"What was the cause of death?",e)}(),function(e={}){return he("causeOfInjury",o({name:t?t+":Cause_Of_Injury":"Cause_Of_Injury",options:["Traumatic Physical Injury (Accident)","Repeated Trauma Injury","Mental Injury","Occupational Disease","Not Sure"]}),"What was the cause of the injury?",e);var t}(),function(e={}){return he("claimStatus",o({name:t?t+":Claim_Status":"Claim_Status",options:["No action taken yet","Demand for compensation made","Lawsuit filed","Other"]}),"What is the status of the claim?",e);var t}(),function(e={}){return he("criminalChargesFiled",w(),"Have criminal charges been filed?",e)}(),function(e={}){return he("degreeOfInterest",o({name:t?t+":Degree_Of_Interest":"Degree_Of_Interest",id:t?t+":Degree_Of_Interest":"Degree_Of_Interest",help:a,options:["Definitely","Probably","Maybe","Absolutely Can't Afford"]}),"Could you pay if your issue could be resolved?",e);var t,a}(),function(e={}){return he("doctorTreatment",(t=e.scope,d({name:t?t+":Doctor_Treatment":"Doctor_Treatment"})),"Have you seen a doctor about this?",e);var t}(),function(e={}){return he("employerType",o({name:"Employer_Type",options:["Sole proprietorship (mom and pop)","Partnership","Franchise","Privately held company","Public corporation","Government Agency","Don't know"]}),"What type of employer is it?",e)}(),function(e={}){return he("employeeAtCompany",d({name:t?t+":Employee_At_Company":"Employee_At_Company"}),"Do you/they still work at the company?",e);var t}(),function(e={}){return he("haveAttorney",(t=e.scope,d({name:t?t+":Have_Attorney":"Have_Attorney"})),"Already working with an attorney?",e);var t}(),function(e={}){return he("incidentDate",j(e.scope),"When did the incident occur?",e)}({nextOnInput:!1}),function(e={}){return he("numEmployeesOfBusiness",o({name:"Num_Employees_Of_Business",options:["1-5","6-20","21-50","51-100","101-500","501-1,000","More than 1,000"]}),"How many employees does the business have?",e)}(),function(e={}){return he("primaryInjury",(t=e.scope,o({name:t?t+":Primary_Injury":"Primary_Injury",options:["Anxiety","Back or Neck Pain","Broken Bones","Cuts and Bruises","Headaches","Memory Loss","Loss of Limb","Not Sure or Other"]})),"What was the primary injury?",e);var t}(),function(e={}){return he("relationshipToVictim",o({name:"Relationship_To_Victim",options:["Parent","Spouse","Sibling","Friend","Other"]}),"What is your relationship to the victim?",e)}(),function(e={}){return he("zipcode",((e={},t)=>u({placeholder:"#####",help:e.help??"We try to match you with local legal help",name:t?t+":Zip":"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"}))(e,e.scope),"Please verify your Zip Code",e)}(),function(e={}){return ye("commentsWithBankruptcy",[le(e),x({label:void 0===e.label?"Please briefly describe your legal issue in a few words:":e.label,placeholder:e.placeholder||t,inputClass:void 0===e.inputClass?"!t-h-32":e.inputClass},e.scope),h(),{$el:"div",if:"$get(CrossSell_Bankruptcy).value == true",children:[x({label:"Bankruptcy or debt details:",placeholder:"Please describe your bankrtupcy or debt situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Bankruptcy")]}],!1)}({label:null,headline:"Please briefly describe your situation:",headlineClass:"!t-text-dark"}),function(e={}){return ye("legalCrossSells",[ce(e),i({id:"Legal_CrossSells",name:"Legal_CrossSells",help:'Just hit "Next" if none apply',helpClass:"t-text-center !t-text-sm",validation:null,options:{if:'$getVal($get(form), "Type_Of_Legal_Problem") === "Auto and Car Accidents"',then:{"Social Security Disability and Insurance":"Interest in Disability Benefits","Wills and Trusts":"Need a Will or Trust","Workers Compensation":"Workplace Injury","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},else:{if:'$getVal($get(form), "Type_Of_Legal_Problem") === "Personal Injury" || $getVal($get(form), "Type_Of_Legal_Problem") === "Workers Compensation"',then:{"DUI and DWI":"Involved in a DUI/DWI","Wills and Trusts":"Need a Will or Trust","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},else:{if:'$getVal($get(form), "Type_Of_Legal_Problem") === "DUI and DWI"',then:{"Personal Injury":"Personal or Workplace Injury","Wills and Trusts":"Need a Will or Trust","Social Security Disability and Insurance":"Interest in Disability Benefits","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},else:{if:'$getVal($get(form), "Type_Of_Legal_Problem") === "Wills and Trusts" || $getVal($get(form), "Type_Of_Legal_Problem") === "Probate and Estates" || $getVal($get(form), "Type_Of_Legal_Problem") === "Power of Attorney"',then:{"Auto and Car Accidents":"Injured in a Car Accident","Personal Injury":"Personal or Workplace Injury","DUI and DWI":"Involved in a DUI/DWI","Social Security Disability and Insurance":"Interest in Disability Benefits","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},else:{if:'$getVal($get(form), "Type_Of_Legal_Problem") === "Long Term Disability" || $getVal($get(form), "Type_Of_Legal_Problem") === "Social Security Disability and Insurance"',then:{"Auto and Car Accidents":"Injured in a Car Accident","DUI and DWI":"Involved in a DUI/DWI","Wills and Trusts":"Need a Will or Trust","Power of Attorney":"Update Power of Attorney","Divorce and Separation":"Need a Divorce or Separation","Child Custody":"Need help with Child Custody"},else:{"Auto and Car Accidents":"Injured in a Car Accident","Personal Injury":"Personal or Workplace Injury","DUI and DWI":"Involved in a DUI/DWI","Wills and Trusts":"Need a Will or Trust","Power of Attorney":"Update Power of Attorney","Social Security Disability and Insurance":"Interest in Disability Benefits"}}}}}}})],e.nextOnEnter,!1,"$get(Type_Of_Legal_Problem).value")}({headlineClass:"!t-text-dark"}),function(e={}){return ye("autoAndCarAccidentCrossSellQuestions",[ne({headline:"You May Be Entitled To Compensation"}),ie({subheadline:"Tell us about your accident:"}),(t="true",a="CrossSell:Auto_and_Car_Accidents",Z("AutoAndCarAccidentsQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Auto and Car Accidents"',children:[$(a),W(a),y(a),R(a),D(a),H(a)]})),x({label:"Accident Description:",placeholder:"Please describe your accident in a few words...",inputClass:"!t-h-16"},"CrossSell:Auto_and_Car_Accidents")],e.nextOnEnter);var t,a}(),function(e={}){return ye("personalInjuryCrossSellQuestions",[ne({headline:"You May Be Entitled To Compensation"}),ie({subheadline:"Tell us about your injury:"}),(t="true",a="CrossSell:Personal_Injury",Z("PersonalInjuryQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Personal Injury"',children:[$(a),W(a),P(a),y(a),R(a),D(a)]})),x({label:"Injury Description:",placeholder:"Please describe your injury in a few words...",inputClass:"!t-h-16"},"CrossSell:Personal_Injury")],e.nextOnEnter);var t,a}(),function(e={}){return ye("workersCompensationCrossSellQuestions",[ne({headline:"You May Be Entitled To Benefits"}),ie({subheadline:"Tell us about your injury:"}),(t="true",a="CrossSell:Workers_Compensation",Z("WorkersCompensationQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Workers Compensation"',children:[$(a),W(a),P(a),R(a),g(a),D(a)]})),x({label:"Injury Description:",placeholder:"Please describe your injury in a few words...",inputClass:"!t-h-16"},"CrossSell:Workers_Compensation")],e.nextOnEnter);var t,a}(),function(e={}){return ye("duiAndDWICrossSellQuestions",[ne({headline:"About Your DUI/DWI"}),(t="true",a="CrossSell:DUI_and_DWI",Z("DUIAndDWIQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "DUI and DWI"',children:[$(a),W(a),Y(a),K(a),_(a),N(a),T(a)]})),x({label:"Incident Description:",placeholder:"Please describe your incident in a few words...",inputClass:"!t-h-16"},"CrossSell:DUI_and_DWI")],e.nextOnEnter);var t,a}(),function(e={}){return ye("ssdiCrossSellQuestions",[ne({headline:"You May Be Entitled To Benefits"}),ie({subheadline:"Tell us about your disability:"}),(t="true",a="CrossSell:Social_Security_Disability_and_Insurance",Z("SocialSecurityDisabilityAndInsuranceQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Social Security Disability and Insurance"',children:[$(a),f(a),S(a),O(a),V(a),D(a)]})),x({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Social_Security_Disability_and_Insurance")],e.nextOnEnter);var t,a}(),function(e={}){return ye("powerOfAttorneyCrossSellQuestions",[ne({headline:"Power of Attorney Information"}),(t="true",a="CrossSell:Power_of_Attorney",Z("PowerofAttorneyQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Power of Attorney"',children:[$(a),T(a)]})),x({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Power_of_Attorney")],e.nextOnEnter);var t,a}(),function(e={}){return ye("willsAndTrustsCrossSellQuestions",[ne({headline:"Will or Trust Information"}),(t="true",a="CrossSell:Wills_and_Trusts",Z("WillsAndTrustsQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Wills and Trusts"',children:[$(a),G(a),z(a),U(a),L(a),T(a)]})),x({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Wills_and_Trusts")],e.nextOnEnter);var t,a}(),function(e={}){return ye("divorceAndSeparationCrossSellQuestions",[ne({headline:"Divorce or Separation Information"}),(t="true",a="CrossSell:Divorce_and_Separation",Z("DivorceQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Divorce and Separation"',children:[$(a),F(a),E(a),I(a),M(a)]})),x({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Divorce_and_Separation")],e.nextOnEnter);var t,a}(),function(e={}){return ye("childCustodyCrossSellQuestions",[ne({headline:"Child Custody Information"}),(t="true",a="CrossSell:Child_Custody",Z("ChildCustodyQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Child Custody"',children:[$(a),v(a),b(a),C(a),I(a),M(a)]})),x({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Child_Custody")],e.nextOnEnter);var t,a}(),function(e={},t){return ye("firstAndLast",[de({headline:e.headline??"Who is looking for help?",headlineClass:e.headlineClass}),oe({subheadline:e.subheadline??"Note: we never share info without consent",subheadlineClass:"!t-text-sm !t-text-gray-500"}),A(t),B(t)],e.nextOnEnter)}({headlineClass:"!t-text-dark"})];const Ee=[$e,e(Ce,We),{$cmp:"FormKit",props:function(t){const a=e(_e,t);return a.formId&&!a.name&&(a.name=a.formId),a}({formId:"employmentAndWorkplace",redirectMap:function(t){return e(xe,t)}(),valueOverrideMap:we}),children:[function(t){return e(ve,t)}(),function(t={}){return e(function(e={}){return{$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 "+(e.headlineClass||"")}}}(t),t)}({children:'$urlParam("hl", "Start Here For a Free Consultation")',if:"$activeStep === $firstStep()"}),function(t={}){return e(function(e={}){return{$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 "+(e.subheadlineClass||"")}}}(t),t)}({children:'$urlParam("shl", "Select a Category Below to Get Started!")',if:"$activeStep === $firstStep()"}),...Pe,{$el:"div",attrs:{class:"form-body"},children:[function(e={}){return ye("employmentAndWorkplaceTOLP",[{$formkit:"hidden",name:"Type_Of_Legal_Problem",id:"Type_Of_Legal_Problem",value:"Employment and Workplace"},k()],e.nextOnEnter,e.nextOnInput,e.stepKey,e.nextStepMap)}({nextOnInput:!1,nextStepMap:Ae}),function(e="Type_Of_Legal_Problem"){return{$cmp:"FormKitSchema",if:"$get("+e+").value",props:{schema:"$meta.dynamicSchema",data:"$buildData($meta)"}}}(),function(e={}){return ye("contactInfo",[ue(e),pe(e),{$el:"script",if:"$activeStep === $lastStep()",children:me},(t=e.scope,p({$formkit:"email",name:t?t+":Email":"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"}})),q(e.scope),Q(e.scope),re()],!1);var t}(),((e={})=>({$el:"div",attrs:{class:"step-nav"},children:[{$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:e.submitLabel||"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"}}]}]}]}];var We;return Ee}();
|