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
|
@@ -333,9 +333,9 @@ const doctorTreatment = (scope) => sbsYesNoRadio({
|
|
|
333
333
|
label: 'Have You Recently Been Treated by a Doctor, Hospital or Clinic?',
|
|
334
334
|
});
|
|
335
335
|
|
|
336
|
-
const email = () => sbsText({
|
|
336
|
+
const email = (scope) => sbsText({
|
|
337
337
|
$formkit: 'email',
|
|
338
|
-
name: 'Email',
|
|
338
|
+
name: scope ? scope + ':' + 'Email' : 'Email',
|
|
339
339
|
label: 'Email Address:',
|
|
340
340
|
placeholder: 'email@domain.com',
|
|
341
341
|
autocomplete: 'email',
|
|
@@ -360,11 +360,11 @@ const estateLegalServicesNeeded = (scope) => sbsSelect({
|
|
|
360
360
|
]
|
|
361
361
|
});
|
|
362
362
|
|
|
363
|
-
const firstName = () => sbsText({
|
|
363
|
+
const firstName = (scope) => sbsText({
|
|
364
364
|
$formkit: 'text',
|
|
365
365
|
label: 'First Name:',
|
|
366
366
|
placeholder: 'First',
|
|
367
|
-
name: 'First_Name',
|
|
367
|
+
name: scope ? scope + ':' + 'First_Name' : 'First_Name',
|
|
368
368
|
autocomplete: "given-name",
|
|
369
369
|
validationMessages: {
|
|
370
370
|
required: 'First Name is required'
|
|
@@ -386,11 +386,11 @@ const incidentDate = (scope) => sbsDate({
|
|
|
386
386
|
label: 'Date of Incident:',
|
|
387
387
|
});
|
|
388
388
|
|
|
389
|
-
const lastName = () => sbsText({
|
|
389
|
+
const lastName = (scope) => sbsText({
|
|
390
390
|
$formkit: 'text',
|
|
391
391
|
label: 'Last Name:',
|
|
392
392
|
placeholder: 'Last',
|
|
393
|
-
name: 'Last_Name',
|
|
393
|
+
name: scope ? scope + ':' + 'Last_Name' : 'Last_Name',
|
|
394
394
|
autocomplete: "family-name",
|
|
395
395
|
validationMessages: {
|
|
396
396
|
required: 'Last Name is required'
|
|
@@ -500,9 +500,9 @@ const pendingCharges = (scope) => sbsYesNoRadio({
|
|
|
500
500
|
label: 'Do you currently have any pending charges?'
|
|
501
501
|
});
|
|
502
502
|
|
|
503
|
-
const phone = () => sbsText({
|
|
503
|
+
const phone = (scope) => sbsText({
|
|
504
504
|
$formkit: 'tel',
|
|
505
|
-
name: 'Primary_Phone',
|
|
505
|
+
name: scope ? scope + ':' + 'Primary_Phone' : 'Primary_Phone',
|
|
506
506
|
label: 'Phone Number:',
|
|
507
507
|
placeholder: '###-###-####',
|
|
508
508
|
maxlength: 12,
|
|
@@ -559,10 +559,10 @@ const socialSecurityDisabilityReceivingBenefits = (scope) => sbsYesNoRadio({
|
|
|
559
559
|
label: 'Are You Currently Receiving Social Security Disability Benefits?'
|
|
560
560
|
});
|
|
561
561
|
|
|
562
|
-
const TCPAConsent = () => ({
|
|
562
|
+
const TCPAConsent = (scope) => ({
|
|
563
563
|
$formkit: 'checkbox',
|
|
564
564
|
label: '$meta.tcpaLanguage',
|
|
565
|
-
name: 'TCPA_Opt_In',
|
|
565
|
+
name: scope ? scope + ':' + 'TCPA_Opt_In' : 'TCPA_Opt_In',
|
|
566
566
|
'data-tf-sensitive': 'false',
|
|
567
567
|
validation: 'required|accepted',
|
|
568
568
|
validationMessages: {
|
|
@@ -614,10 +614,10 @@ const valueOfAssets = (scope) => sbsSelect({
|
|
|
614
614
|
]
|
|
615
615
|
});
|
|
616
616
|
|
|
617
|
-
const zipcode = () => sbsText({
|
|
617
|
+
const zipcode = (scope) => sbsText({
|
|
618
618
|
label: 'Zip Code:',
|
|
619
619
|
placeholder: '#####',
|
|
620
|
-
name: 'Zip',
|
|
620
|
+
name: scope ? scope + ':' + 'Zip' : 'Zip',
|
|
621
621
|
maxlength: 5,
|
|
622
622
|
inputmode: "numeric",
|
|
623
623
|
autocomplete: 'postal-code',
|
|
@@ -1025,7 +1025,8 @@ function commentsWithBankruptcy(updates = {}) {
|
|
|
1025
1025
|
label: typeof updates.label === 'undefined' ? DEFAULT_COMMENTS_LABEL : updates.label,
|
|
1026
1026
|
placeholder: updates.placeholder || DEFAULT_COMMENTS_PLACEHOLDER_DYNAMIC,
|
|
1027
1027
|
inputClass: typeof updates.inputClass === 'undefined' ? '!t-h-32' : updates.inputClass,
|
|
1028
|
-
}),
|
|
1028
|
+
}, updates.scope),
|
|
1029
|
+
// TODO: needs scope support
|
|
1029
1030
|
bankruptcyCrossSell(),
|
|
1030
1031
|
{
|
|
1031
1032
|
$el: 'div',
|
|
@@ -1050,9 +1051,9 @@ function contactInfo(updates = {}) {
|
|
|
1050
1051
|
contactStepHeadline(updates),
|
|
1051
1052
|
contactStepSubHeadline(updates),
|
|
1052
1053
|
trustedFormScript(),
|
|
1053
|
-
email(),
|
|
1054
|
-
phone(),
|
|
1055
|
-
TCPAConsent(),
|
|
1054
|
+
email(updates.scope),
|
|
1055
|
+
phone(updates.scope),
|
|
1056
|
+
TCPAConsent(updates.scope),
|
|
1056
1057
|
secureIcon()
|
|
1057
1058
|
],
|
|
1058
1059
|
false, // nextOnEnter
|
|
@@ -1220,9 +1221,7 @@ function legalCrossSells(updates = {}) {
|
|
|
1220
1221
|
)
|
|
1221
1222
|
}
|
|
1222
1223
|
|
|
1223
|
-
|
|
1224
|
-
|
|
1225
|
-
const formNavigation = () => ({
|
|
1224
|
+
const formNavigation = (updates = {}) => ({
|
|
1226
1225
|
$el: 'div',
|
|
1227
1226
|
attrs: {
|
|
1228
1227
|
class: 'step-nav'
|
|
@@ -1260,7 +1259,7 @@ const formNavigation = () => ({
|
|
|
1260
1259
|
{
|
|
1261
1260
|
$formkit: 'submit',
|
|
1262
1261
|
name: 'submit_button',
|
|
1263
|
-
label: 'Submit',
|
|
1262
|
+
label: updates.submitLabel || 'Submit',
|
|
1264
1263
|
if: '$activeStep === $lastStep()',
|
|
1265
1264
|
style: {
|
|
1266
1265
|
if: '$activeStep !== $lastStep()',
|
|
@@ -1395,14 +1394,16 @@ function defaultMetaProps(tolps = null) {
|
|
|
1395
1394
|
})
|
|
1396
1395
|
}
|
|
1397
1396
|
|
|
1398
|
-
|
|
1399
|
-
|
|
1400
|
-
|
|
1401
|
-
|
|
1402
|
-
|
|
1403
|
-
|
|
1397
|
+
function dynamicSchemaNode(field = 'Type_Of_Legal_Problem') {
|
|
1398
|
+
return {
|
|
1399
|
+
$cmp: 'FormKitSchema',
|
|
1400
|
+
if: '$get(' + field + ').value',
|
|
1401
|
+
props: {
|
|
1402
|
+
schema: '$meta.dynamicSchema',
|
|
1403
|
+
data: '$buildData($meta)'
|
|
1404
|
+
}
|
|
1404
1405
|
}
|
|
1405
|
-
}
|
|
1406
|
+
}
|
|
1406
1407
|
|
|
1407
1408
|
const formAnchorDefaults = {
|
|
1408
1409
|
$el: 'div',
|
|
@@ -1917,7 +1918,7 @@ const schema = [
|
|
|
1917
1918
|
accidentsAndInjuriesTOLPAndZip({
|
|
1918
1919
|
nextStepMap: nextStepsMapLegalLegacy
|
|
1919
1920
|
}),
|
|
1920
|
-
dynamicSchemaNode,
|
|
1921
|
+
dynamicSchemaNode(),
|
|
1921
1922
|
contactInfo(),
|
|
1922
1923
|
formNavigation(),
|
|
1923
1924
|
formDetails()
|
|
@@ -1 +1 @@
|
|
|
1
|
-
var accidentsAndInjuries=function(){"use strict";function e(){return Object.assign({},...arguments)}const t='$getKey($meta, "commentsPlaceholders." + $get(Type_Of_Legal_Problem).value, $meta.defaultCommentsPlaceholder)',a='$getKey($meta, "finalHeadlines." + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalHeadline)',r='$getKey($meta, "finalSubHeadlines." + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalSubHeadline)',i=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"checkbox",validation:"required",validationMessages:{required:"Field is required"}},t)),n=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",i(e)),o=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"radio",validation:"required",validationMessages:{required:"Field is required"},optionsClass:"t-pt-3 t-pl-1",legendClass:"required"},t)),l=e=>(e.options=["Yes","No"],(e=>(e.legendClass="legend-left t-pb-1 required",e.fieldsetClass="$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",o(e)))(e)),s=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({$formkit:"select",placeholder:"Please Select",validation:"required",validationMessages:{required:"Field is required"},inputClass:"t-bg-white",labelClass:"required"},t)))(t)),d=t=>(t.wrapperClass="side-by-side t-items-center",(t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"text",validation:"required",validationMessages:{required:"Field is required"},labelClass:"required"},t)))(t)),u=t=>(t.wrapperClass="side-by-side t-items-center",(t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"DatePicker",validation:"required",validationMessages:{required:"Field is required"},labelClass:"required t-block t-mb-3 t-font-semibold t-text-base formkit-invalid:t-text-red-500",innerClass:"t-border t-border-gray-400 formkit-invalid:t-border-red-500 t-rounded t-mb-1 focus-within:t-border-blue-500"},t)))(t)),c=t=>(e=>(e.legendClass="required",e.fieldsetClass="$reset",e.optionsClass="t-pl-2 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2",e.innerClass="t-items-start",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",o(e)))(e({name:"Type_Of_Legal_Problem_Display",if:'$get(Type_Of_Legal_Problem).value == "Auto and Car Accidents"',label:"Select The Issue:",options:["Auto Accident","Workplace Injury","Dog Bite","Slip and Fall","Trucking Accident","Motorcycle Accident","Other Accidents or Injuries"]},t)),p=e=>d({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"}}),m=e=>l({name:e?e+":At_Fault":"At_Fault",label:"Were You at Fault?"}),f=()=>{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="$reset side-by-side",e.optionsClass="t-pl-1",e.innerClass="t-flex t-items-center",e.wrapperClass="t-mb-3",i(e);var e},y=e=>s({name:e?e+":Blood_Alcohol_Content_Test":"Blood_Alcohol_Content_Test",label:"Blood Alcohol Content Measured by Test:",options:["No Test","0.00% - 0.04%","0.05% - 0.08%","0.09% - 0.12%","0.13% - 0.16%","0.17% - 0.20%","More than 0.20%","Don't know"]}),_=e=>s({name:e?e+":Cause_Of_Injury":"Cause_Of_Injury",label:"Cause of Injury:",options:["Traumatic Physical Injury (Accident)","Repeated Trauma Injury","Mental Injury","Occupational Disease","Not Sure"]}),h=e=>s({name:e?e+":Child_Home":"Child_Home",label:"With Whom Do the Children Currently Live?",options:["Mother","Father","Grandparents","Other"]}),g=e=>s({name:e?e+":Child_Primary_Caregiver":"Child_Primary_Caregiver",label:"Who is the Primary Caregiver?",options:["Mother","Father","Other"]}),b=e=>s({name:e?e+":Child_Relationship":"Child_Relationship",label:"Your Relationship to Child(ren):",options:["Father","Mother","Grandparent","Aunt/Uncle","Other"]}),C=e=>s({name:e?e+":Claim_Status":"Claim_Status",label:"Status of Claim:",options:["No action taken yet","Demand for compensation made","Lawsuit filed","Other"]}),v=(t,a)=>(t=>(t.name&&!t.id&&(t.id=t.name),e({$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)),P=(e,t)=>s({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"]}),I=e=>P(e,"No payment necessary to speak with lawyers."),w=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?"}),x=e=>l({name:e?e+":Disability_Work_History":"Disability_Work_History",label:"Have You Had a Full-Time Job Within the Past 5 Years?"}),T=e=>l({name:e?e+":Doctor_Treatment":"Doctor_Treatment",label:"Have You Recently Been Treated by a Doctor, Hospital or Clinic?"}),S=e=>s({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"]}),$=e=>l({name:e?e+":Have_Attorney":"Have_Attorney",label:"Already Working with An Attorney?"}),k=e=>l({name:e?e+":Have_Children":"Have_Children",label:"Do You Have Children?"}),O=e=>u({name:e?e+":Incident_Date":"Incident_Date",label:"Date of Incident:"}),L=e=>s({name:e?e+":Lawyer_Payment_Method":"Lawyer_Payment_Method",label:"How Will You Pay for Legal Fees if You Hire a Lawyer?",help:"No payment necessary to speak with lawyers.",options:["Cash","Check","Credit Card","Friend","Family","Other"]}),D=e=>s({name:e?e+":Marital_Status":"Marital_Status",label:"Marital Status:",options:["Unmarried, Living Together","Unmarried, Do Not Live Together","Married, Living Together","Separated","Divorced","Other"]}),A=e=>l({name:e?e+":Pending_Charges":"Pending_Charges",label:"Do you currently have any pending charges?"}),E=e=>{return(t={name:e?e+":Primary_Injury":"Primary_Injury",label:"Primary Injury:",options:["Anxiety","Back or Neck Pain","Broken Bones","Cuts and Bruises","Headaches","Memory Loss","Loss of Limb","Not Sure or Other"]}).legendClass="legend-left-flex md:t-max-w-[40%] required",t.fieldsetClass="$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="$reset t-flex t-cursor-pointer t-mb-3",o(t);var t},W=e=>l({name:e?e+":Prior_Alcohol_Offenses":"Prior_Alcohol_Offenses",label:"Any Prior Alcohol Related Offenses?"}),B=e=>l({name:e?e+":Police_Report_Filed":"Police_Report_Filed",label:"Was a Police Report Filed?"}),j=e=>s({name:e?e+":Role_In_Matter_Probate":"Role_In_Matter_Probate",label:"What Is Your Role in this Matter?",options:["Preparing My Will","Executor","Heir","Other"]}),M=e=>l({name:e?e+":Social_Security_Disability_Receiving_Benefits":"Social_Security_Disability_Receiving_Benefits",label:"Are You Currently Receiving Social Security Disability Benefits?"}),F=e=>s({name:e?e+":Type_Of_Alcohol_Test":"Type_Of_Alcohol_Test",label:"Type of Alcohol Test Performed?",options:["No Test","Refused Test","Breath Test","Blood Test","Urine Test","Don't Know"]}),N=e=>n({name:e?e+":Type_Of_Assets":"Type_Of_Assets",label:"Type of Assets:",options:["Business Interests","Cash","Life Insurance Policies","Pensions/Retirement","Personal Possessions","Property","Stock/Bonds"]}),q=e=>s({name:e?e+":Value_Of_Assets":"Value_Of_Assets",label:"Value of Your Assets?",options:["Less than 50K","50K to 100K","100K to 250K","250K to 500K","500K to 1M","More than 1M"]}),Y=(t,a)=>e({$cmp:"FormKit",props:{type:"group",key:t,id:t,name:t}},a),U=(e,t)=>Y("PersonalInjuryQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "Personal Injury"',children:[$(t),O(t),C(t),m(t),E(t),T(t)]}),R=(e,t)=>Y("WorkersCompensationQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "Workers Compensation"',children:[$(t),O(t),C(t),E(t),_(t),T(t)]}),H="$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",V="$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",Q=e=>"group"!==e.type&&"section"!==e.type&&"form"!==e.type&&"hidden"!==e.$formkit&&!e.children,K=e=>{if(Q(e))return e;for(var t=e.children.length-1;t>=0;t--){if("string"==typeof e.children)continue;const a=e.children[t];if(Q(a))return a;const r=K(a);if(r)return r}return null},z={$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"}},{$el:"span",children:"Secure & Encrypted",attrs:{class:"t-pl-2 t-pt-1 t-font-medium"}}]};function G(t){return e(z,t)}function Z(e){return{$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 J(e){return{$el:"h3",children:e.headline||"Tell Us About Your Situation",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1"}}}function X(e){return{$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 ee(e){return{$el:"h3",children:e.headline||"Additional Case Details",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function te(e){return{$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 ae(e){return{$el:"h3",children:e.headline||"Do any of the following situations apply?",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1 "+(e.headlineClass||"")}}}function re(e){return{$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 ie(e){return{$el:"h5",children:e.subheadline||r,attrs:{class:"t-flex t-justify-center t-text-center !t-text-lg t-font-semibold t-pb-7 t-pt-0 t-px-3 "+(e.subheadlineClass||"")}}}const ne="(function() {\n if (window.xxTrustedFormLoaded) {\n return\n }\n var vid = '';\n if (typeof window.zar !== 'undefined') {\n vid = window.zar.getVID();\n }\n window.xxTrustedFormLoaded = true;\n var sandbox = document.location.hostname.indexOf('localhost') > -1 ? 'true' : 'false'\n var tf = document.createElement('script');\n tf.type = 'text/javascript'; tf.async = true;\n tf.src = (\"https:\" == document.location.protocol ? 'https' : 'http') + \"://api.trustedform.com/trustedform.js?field=xxTrustedFormCertUrl&identifier=\" + vid + \"&ping_field=xxTrustedFormPingUrl&provideReferrer=false&invert_field_sensitivity=true&sandbox=\" + sandbox + \"&l=\" + new Date().getTime() + Math.random();\n var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(tf, s);\n})();";const oe=(e,t)=>({$el:"section",if:'$stepEnabled("'+e+'")',attrs:{hidden:'$activeStep !== "'+e+'"',key:t||e}});function le(t,a,r=!0,i=!1,n=void 0,o=void 0,l=void 0){if(void 0===r&&(r=!0),a&&a.length&&(r||i)){const e=K(a[a.length-1]);e&&!0===r&&(e.onKeypress=H),e&&!0===i&&(e.onInput=V)}return e(oe(t,n),{children:[{$formkit:"group",id:t,name:t,nextStepMap:o,autoFocus:l,children:a}]})}const se={type:"form",id:"form",config:{validationVisibility:"submit"},onSubmit:'$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 de(e,t){return Object.fromEntries(Object.entries(e).filter((([e])=>t.includes(e))))}const ue={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 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}],me={"*":"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 fe={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"}}},ye={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"'},_e={},he={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."},ge=function(a=null){let r=ye,i=_e,n=he;return a&&(r=de(ye,a),i=de(_e,a),n=de(he,a)),{type:"meta",data:e(ue,{defaultCommentsPlaceholder:t,commentsPlaceholders:r,defaultFinalHeadline:"Submit Your Case",finalHeadlines:i,defaultFinalSubHeadline:"You may benefit from speaking with a legal professional. Please verify your contact information.",finalSubHeadlines:n})}}();ge.data.dynamicSchema=[function(e={}){return le("TOLPQuestions",[Z(e),Y("AutoAndCarAccidentsQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Auto and Car Accidents"',children:[$(a),O(a),m(a),E(a),T(a),B(a)]}),U(),R()],e.nextOnEnter);var t,a}(),function(e={}){return le("commentsWithBankruptcy",[ee(e),v({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}),f(),{$el:"div",if:"$get(CrossSell_Bankruptcy).value == true",children:[v({label:"Bankruptcy or debt details:",placeholder:"Please describe your bankrtupcy or debt situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Bankruptcy")]}],!1)}({inputClass:"!t-h-28"}),function(e={}){return le("legalCrossSells",[ae(e),n({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,"$get(Type_Of_Legal_Problem).value")}(),function(e={}){return le("workersCompensationCrossSellQuestions",[J({headline:"You May Be Entitled To Benefits"}),X({subheadline:"Tell us about your injury:"}),R("true","CrossSell:Workers_Compensation"),v({label:"Injury Description:",placeholder:"Please describe your injury in a few words...",inputClass:"!t-h-16"},"CrossSell:Workers_Compensation")],e.nextOnEnter)}(),function(e={}){return le("duiAndDWICrossSellQuestions",[J({headline:"About Your DUI/DWI"}),(t="true",a="CrossSell:DUI_and_DWI",Y("DUIAndDWIQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "DUI and DWI"',children:[$(a),O(a),W(a),F(a),y(a),A(a),I(a)]})),v({label:"Incident Description:",placeholder:"Please describe your incident in a few words...",inputClass:"!t-h-16"},"CrossSell:DUI_and_DWI")],e.nextOnEnter);var t,a}(),function(e={}){return le("ssdiCrossSellQuestions",[J({headline:"You May Be Entitled To Benefits"}),X({subheadline:"Tell us about your disability:"}),(t="true",a="CrossSell:Social_Security_Disability_and_Insurance",Y("SocialSecurityDisabilityAndInsuranceQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Social Security Disability and Insurance"',children:[$(a),p(a),w(a),x(a),M(a),T(a)]})),v({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Social_Security_Disability_and_Insurance")],e.nextOnEnter);var t,a}(),function(e={}){return le("powerOfAttorneyCrossSellQuestions",[J({headline:"Power of Attorney Information"}),(t="true",a="CrossSell:Power_of_Attorney",Y("PowerofAttorneyQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Power of Attorney"',children:[$(a),I(a)]})),v({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Power_of_Attorney")],e.nextOnEnter);var t,a}(),function(e={}){return le("willsAndTrustsCrossSellQuestions",[J({headline:"Will or Trust Information"}),(t="true",a="CrossSell:Wills_and_Trusts",Y("WillsAndTrustsQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Wills and Trusts"',children:[$(a),q(a),N(a),j(a),S(a),I(a)]})),v({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Wills_and_Trusts")],e.nextOnEnter);var t,a}(),function(e={}){return le("divorceAndSeparationCrossSellQuestions",[J({headline:"Divorce or Separation Information"}),(t="true",a="CrossSell:Divorce_and_Separation",Y("DivorceQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Divorce and Separation"',children:[$(a),D(a),k(a),P(a),L(a)]})),v({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Divorce_and_Separation")],e.nextOnEnter);var t,a}(),function(e={}){return le("childCustodyCrossSellQuestions",[J({headline:"Child Custody Information"}),(t="true",a="CrossSell:Child_Custody",Y("ChildCustodyQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Child Custody"',children:[$(a),b(a),h(a),g(a),P(a),L(a)]})),v({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Child_Custody")],e.nextOnEnter);var t,a}(),function(e={}){return le("firstAndLast",[te(e),d({$formkit:"text",label:"First Name:",placeholder:"First",name:"First_Name",autocomplete:"given-name",validationMessages:{required:"First Name is required"}}),d({$formkit:"text",label:"Last Name:",placeholder:"Last",name:"Last_Name",autocomplete:"family-name",validationMessages:{required:"Last Name is required"}})],e.nextOnEnter)}()];const be=[ge,e(ce,Ce),{$cmp:"FormKit",props:function(t){const a=e(se,t);return a.formId&&!a.name&&(a.name=a.formId),a}({formId:"accidentsAndInjuries",redirectMap:function(t){return e(me,t)}(),valueOverrideMap:fe}),children:[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", "Get Accident & Injury Help Now")',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:'$urlParam("shl", "Our Service is Fast and Free!")',if:"$activeStep === $firstStep()"}),...pe,{$el:"div",attrs:{class:"form-body"},children:[function(e={}){return le("accidentsAndInjuriesTOLPAndZip",[{$formkit:"hidden",name:"Type_Of_Legal_Problem",id:"Type_Of_Legal_Problem",value:"Auto and Car Accidents"},c({if:"true"}),d({label:"Zip Code:",placeholder:"#####",name:"Zip",maxlength:5,inputmode:"numeric",autocomplete:"postal-code",validation:"required|matches:/^[0-9]{5}$/",validationMessages:{required:"Zip Code is required",matches:"Invalid Zip Code"}})],e.nextOnEnter,e.nextOnInput,e.stepKey,e.nextStepMap)}({nextStepMap:{"*":["TOLPQuestions","commentsWithBankruptcy","legalCrossSells","firstAndLast","contactInfo"]}}),{$cmp:"FormKitSchema",if:"$get(Type_Of_Legal_Problem).value",props:{schema:"$meta.dynamicSchema",data:"$buildData($meta)"}},function(e={}){return le("contactInfo",[re(e),ie(e),{$el:"script",if:"$activeStep === $lastStep()",children:ne},d({$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"}}),d({$formkit:"tel",name:"Primary_Phone",label:"Phone Number:",placeholder:"###-###-####",maxlength:12,help:"10-digit phone number, hyphens optional",autocomplete:"tel-national","data-tf-sensitive":"false",validation:"required|matches:/^[0-9]{3}-?[0-9]{3}-?[0-9]{4}$/|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"}},G()],!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: ","$stepKeys()"],attrs:{class:"t-text-xs",style:"overflow: scroll"}}]}]}]}];var Ce;return be}();
|
|
1
|
+
var accidentsAndInjuries=function(){"use strict";function e(){return Object.assign({},...arguments)}const t='$getKey($meta, "commentsPlaceholders." + $get(Type_Of_Legal_Problem).value, $meta.defaultCommentsPlaceholder)',a='$getKey($meta, "finalHeadlines." + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalHeadline)',r='$getKey($meta, "finalSubHeadlines." + $get(Type_Of_Legal_Problem).value, $meta.defaultFinalSubHeadline)',i=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"checkbox",validation:"required",validationMessages:{required:"Field is required"}},t)),n=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",i(e)),o=t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"radio",validation:"required",validationMessages:{required:"Field is required"},optionsClass:"t-pt-3 t-pl-1",legendClass:"required"},t)),l=e=>(e.options=["Yes","No"],(e=>(e.legendClass="legend-left t-pb-1 required",e.fieldsetClass="$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",o(e)))(e)),s=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({$formkit:"select",placeholder:"Please Select",validation:"required",validationMessages:{required:"Field is required"},inputClass:"t-bg-white",labelClass:"required"},t)))(t)),d=t=>(t.wrapperClass="side-by-side t-items-center",(t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"text",validation:"required",validationMessages:{required:"Field is required"},labelClass:"required"},t)))(t)),c=t=>(t.wrapperClass="side-by-side t-items-center",(t=>(t.name&&!t.id&&(t.id=t.name),e({$formkit:"DatePicker",validation:"required",validationMessages:{required:"Field is required"},labelClass:"required t-block t-mb-3 t-font-semibold t-text-base formkit-invalid:t-text-red-500",innerClass:"t-border t-border-gray-400 formkit-invalid:t-border-red-500 t-rounded t-mb-1 focus-within:t-border-blue-500"},t)))(t)),u=t=>(e=>(e.legendClass="required",e.fieldsetClass="$reset",e.optionsClass="t-pl-2 t-pt-3 t-grid t-grid-cols-1 md:t-grid-cols-2",e.innerClass="t-items-start",e.wrapperClass="$reset t-flex t-cursor-pointer t-mb-3",o(e)))(e({name:"Type_Of_Legal_Problem_Display",if:'$get(Type_Of_Legal_Problem).value == "Auto and Car Accidents"',label:"Select The Issue:",options:["Auto Accident","Workplace Injury","Dog Bite","Slip and Fall","Trucking Accident","Motorcycle Accident","Other Accidents or Injuries"]},t)),p=e=>d({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"}}),m=e=>l({name:e?e+":At_Fault":"At_Fault",label:"Were You at Fault?"}),f=()=>{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="$reset side-by-side",e.optionsClass="t-pl-1",e.innerClass="t-flex t-items-center",e.wrapperClass="t-mb-3",i(e);var e},y=e=>s({name:e?e+":Blood_Alcohol_Content_Test":"Blood_Alcohol_Content_Test",label:"Blood Alcohol Content Measured by Test:",options:["No Test","0.00% - 0.04%","0.05% - 0.08%","0.09% - 0.12%","0.13% - 0.16%","0.17% - 0.20%","More than 0.20%","Don't know"]}),_=e=>s({name:e?e+":Cause_Of_Injury":"Cause_Of_Injury",label:"Cause of Injury:",options:["Traumatic Physical Injury (Accident)","Repeated Trauma Injury","Mental Injury","Occupational Disease","Not Sure"]}),h=e=>s({name:e?e+":Child_Home":"Child_Home",label:"With Whom Do the Children Currently Live?",options:["Mother","Father","Grandparents","Other"]}),g=e=>s({name:e?e+":Child_Primary_Caregiver":"Child_Primary_Caregiver",label:"Who is the Primary Caregiver?",options:["Mother","Father","Other"]}),b=e=>s({name:e?e+":Child_Relationship":"Child_Relationship",label:"Your Relationship to Child(ren):",options:["Father","Mother","Grandparent","Aunt/Uncle","Other"]}),C=e=>s({name:e?e+":Claim_Status":"Claim_Status",label:"Status of Claim:",options:["No action taken yet","Demand for compensation made","Lawsuit filed","Other"]}),v=(t,a)=>(t=>(t.name&&!t.id&&(t.id=t.name),e({$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)),P=(e,t)=>s({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"]}),I=e=>P(e,"No payment necessary to speak with lawyers."),w=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?"}),x=e=>l({name:e?e+":Disability_Work_History":"Disability_Work_History",label:"Have You Had a Full-Time Job Within the Past 5 Years?"}),T=e=>l({name:e?e+":Doctor_Treatment":"Doctor_Treatment",label:"Have You Recently Been Treated by a Doctor, Hospital or Clinic?"}),S=e=>s({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"]}),$=e=>l({name:e?e+":Have_Attorney":"Have_Attorney",label:"Already Working with An Attorney?"}),k=e=>l({name:e?e+":Have_Children":"Have_Children",label:"Do You Have Children?"}),L=e=>c({name:e?e+":Incident_Date":"Incident_Date",label:"Date of Incident:"}),O=e=>d({$formkit:"text",label:"Last Name:",placeholder:"Last",name:e?e+":Last_Name":"Last_Name",autocomplete:"family-name",validationMessages:{required:"Last Name is required"}}),D=e=>s({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"]}),A=e=>s({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"]}),E=e=>l({name:e?e+":Pending_Charges":"Pending_Charges",label:"Do you currently have any pending charges?"}),W=e=>d({$formkit:"tel",name:e?e+":Primary_Phone":"Primary_Phone",label:"Phone Number:",placeholder:"###-###-####",maxlength:12,help:"10-digit phone number, hyphens optional",autocomplete:"tel-national","data-tf-sensitive":"false",validation:"required|matches:/^[0-9]{3}-?[0-9]{3}-?[0-9]{4}$/|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]"}),B=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",o(t);var t},j=e=>l({name:e?e+":Prior_Alcohol_Offenses":"Prior_Alcohol_Offenses",label:"Any Prior Alcohol Related Offenses?"}),M=e=>l({name:e?e+":Police_Report_Filed":"Police_Report_Filed",label:"Was a Police Report Filed?"}),F=e=>s({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"]}),N=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"}}),Y=e=>s({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=>n({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"]}),R=e=>s({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"]}),H=(t,a)=>e({$cmp:"FormKit",props:{type:"group",key:t,id:t,name:t}},a),V=(e,t)=>H("PersonalInjuryQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "Personal Injury"',children:[$(t),L(t),C(t),m(t),B(t),T(t)]}),Q=(e,t)=>H("WorkersCompensationQuestions",{if:e||'$get(Type_Of_Legal_Problem).value == "Workers Compensation"',children:[$(t),L(t),C(t),B(t),_(t),T(t)]}),K="$onEnter($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",z="$onInput($setNextStep($fireStepEvent($get(form)), $preStepFunc($get(form))))",Z=e=>"group"!==e.type&&"section"!==e.type&&"form"!==e.type&&"hidden"!==e.$formkit&&!e.children,G=e=>{if(Z(e))return e;for(var t=e.children.length-1;t>=0;t--){if("string"==typeof e.children)continue;const a=e.children[t];if(Z(a))return a;const r=G(a);if(r)return r}return null},J={$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{$el:"h3",children:e.headline||"Tell Us About Your Situation",attrs:{class:"t-flex t-justify-center t-text-center t-text-2xl t-font-bold t-text-blue-500 t-pb-5 t-pt-0 t-px-1"}}}function ae(e){return{$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 re(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 ne(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{$el:"h5",children:e.subheadline||r,attrs:{class:"t-flex t-justify-center t-text-center !t-text-lg t-font-semibold t-pb-7 t-pt-0 t-px-3 "+(e.subheadlineClass||"")}}}const se="(function() {\n if (window.xxTrustedFormLoaded) {\n return\n }\n var vid = '';\n if (typeof window.zar !== 'undefined') {\n vid = window.zar.getVID();\n }\n window.xxTrustedFormLoaded = true;\n var sandbox = document.location.hostname.indexOf('localhost') > -1 ? 'true' : 'false'\n var tf = document.createElement('script');\n tf.type = 'text/javascript'; tf.async = true;\n tf.src = (\"https:\" == document.location.protocol ? 'https' : 'http') + \"://api.trustedform.com/trustedform.js?field=xxTrustedFormCertUrl&identifier=\" + vid + \"&ping_field=xxTrustedFormPingUrl&provideReferrer=false&invert_field_sensitivity=true&sandbox=\" + sandbox + \"&l=\" + new Date().getTime() + Math.random();\n var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(tf, s);\n})();";const de=(e,t)=>({$el:"section",if:'$stepEnabled("'+e+'")',attrs:{hidden:'$activeStep !== "'+e+'"',key:t||e}});function ce(t,a,r=!0,i=!1,n=void 0,o=void 0,l=void 0){if(void 0===r&&(r=!0),a&&a.length&&(r||i)){const e=G(a[a.length-1]);e&&!0===r&&(e.onKeypress=K),e&&!0===i&&(e.onInput=z)}return e(de(t,n),{children:[{$formkit:"group",id:t,name:t,nextStepMap:o,autoFocus:l,children:a}]})}const ue={type:"form",id:"form",config:{validationVisibility:"submit"},onSubmit:'$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 pe(e,t){return Object.fromEntries(Object.entries(e).filter((([e])=>t.includes(e))))}const me={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 fe={$el:"div",children:[{$el:"div",attrs:{id:"form-anchor",class:"t-absolute",style:{top:"-30px",left:0}}}],attrs:{class:"t-relative"}};const ye=[{$formkit:"hidden",name:"vertical",value:"Legal"},{$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}],_e={"*":"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 he={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"}}},ge={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"'},be={},Ce={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."},ve=function(a=null){let r=ge,i=be,n=Ce;return a&&(r=pe(ge,a),i=pe(be,a),n=pe(Ce,a)),{type:"meta",data:e(me,{defaultCommentsPlaceholder:t,commentsPlaceholders:r,defaultFinalHeadline:"Submit Your Case",finalHeadlines:i,defaultFinalSubHeadline:"You may benefit from speaking with a legal professional. Please verify your contact information.",finalSubHeadlines:n})}}();ve.data.dynamicSchema=[function(e={}){return ce("TOLPQuestions",[ee(e),H("AutoAndCarAccidentsQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Auto and Car Accidents"',children:[$(a),L(a),m(a),B(a),T(a),M(a)]}),V(),Q()],e.nextOnEnter);var t,a}(),function(e={}){return ce("commentsWithBankruptcy",[re(e),v({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),f(),{$el:"div",if:"$get(CrossSell_Bankruptcy).value == true",children:[v({label:"Bankruptcy or debt details:",placeholder:"Please describe your bankrtupcy or debt situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Bankruptcy")]}],!1)}({inputClass:"!t-h-28"}),function(e={}){return ce("legalCrossSells",[ne(e),n({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,"$get(Type_Of_Legal_Problem).value")}(),function(e={}){return ce("workersCompensationCrossSellQuestions",[te({headline:"You May Be Entitled To Benefits"}),ae({subheadline:"Tell us about your injury:"}),Q("true","CrossSell:Workers_Compensation"),v({label:"Injury Description:",placeholder:"Please describe your injury in a few words...",inputClass:"!t-h-16"},"CrossSell:Workers_Compensation")],e.nextOnEnter)}(),function(e={}){return ce("duiAndDWICrossSellQuestions",[te({headline:"About Your DUI/DWI"}),(t="true",a="CrossSell:DUI_and_DWI",H("DUIAndDWIQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "DUI and DWI"',children:[$(a),L(a),j(a),Y(a),y(a),E(a),I(a)]})),v({label:"Incident Description:",placeholder:"Please describe your incident in a few words...",inputClass:"!t-h-16"},"CrossSell:DUI_and_DWI")],e.nextOnEnter);var t,a}(),function(e={}){return ce("ssdiCrossSellQuestions",[te({headline:"You May Be Entitled To Benefits"}),ae({subheadline:"Tell us about your disability:"}),(t="true",a="CrossSell:Social_Security_Disability_and_Insurance",H("SocialSecurityDisabilityAndInsuranceQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Social Security Disability and Insurance"',children:[$(a),p(a),w(a),x(a),N(a),T(a)]})),v({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Social_Security_Disability_and_Insurance")],e.nextOnEnter);var t,a}(),function(e={}){return ce("powerOfAttorneyCrossSellQuestions",[te({headline:"Power of Attorney Information"}),(t="true",a="CrossSell:Power_of_Attorney",H("PowerofAttorneyQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Power of Attorney"',children:[$(a),I(a)]})),v({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Power_of_Attorney")],e.nextOnEnter);var t,a}(),function(e={}){return ce("willsAndTrustsCrossSellQuestions",[te({headline:"Will or Trust Information"}),(t="true",a="CrossSell:Wills_and_Trusts",H("WillsAndTrustsQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Wills and Trusts"',children:[$(a),R(a),U(a),F(a),S(a),I(a)]})),v({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Wills_and_Trusts")],e.nextOnEnter);var t,a}(),function(e={}){return ce("divorceAndSeparationCrossSellQuestions",[te({headline:"Divorce or Separation Information"}),(t="true",a="CrossSell:Divorce_and_Separation",H("DivorceQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Divorce and Separation"',children:[$(a),A(a),k(a),P(a),D(a)]})),v({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Divorce_and_Separation")],e.nextOnEnter);var t,a}(),function(e={}){return ce("childCustodyCrossSellQuestions",[te({headline:"Child Custody Information"}),(t="true",a="CrossSell:Child_Custody",H("ChildCustodyQuestions",{if:t||'$get(Type_Of_Legal_Problem).value == "Child Custody"',children:[$(a),b(a),h(a),g(a),P(a),D(a)]})),v({label:"Description:",placeholder:"Please describe your situation in a few words...",inputClass:"!t-h-16"},"CrossSell:Child_Custody")],e.nextOnEnter);var t,a}(),function(e={}){return ce("firstAndLast",[ie(e),d({$formkit:"text",label:"First Name:",placeholder:"First",name:t?t+":First_Name":"First_Name",autocomplete:"given-name",validationMessages:{required:"First Name is required"}}),O()],e.nextOnEnter);var t}()];const Pe=[ve,e(fe,Ie),{$cmp:"FormKit",props:function(t){const a=e(ue,t);return a.formId&&!a.name&&(a.name=a.formId),a}({formId:"accidentsAndInjuries",redirectMap:function(t){return e(_e,t)}(),valueOverrideMap:he}),children:[function(t={}){return e(function(e={}){return{$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:'$urlParam("hl", "Get Accident & Injury Help Now")',if:"$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:'$urlParam("shl", "Our Service is Fast and Free!")',if:"$activeStep === $firstStep()"}),...ye,{$el:"div",attrs:{class:"form-body"},children:[function(e={}){return ce("accidentsAndInjuriesTOLPAndZip",[{$formkit:"hidden",name:"Type_Of_Legal_Problem",id:"Type_Of_Legal_Problem",value:"Auto and Car Accidents"},u({if:"true"}),d({label:"Zip Code:",placeholder:"#####",name:t?t+":Zip":"Zip",maxlength:5,inputmode:"numeric",autocomplete:"postal-code",validation:"required|matches:/^[0-9]{5}$/",validationMessages:{required:"Zip Code is required",matches:"Invalid Zip Code"}})],e.nextOnEnter,e.nextOnInput,e.stepKey,e.nextStepMap);var t}({nextStepMap:{"*":["TOLPQuestions","commentsWithBankruptcy","legalCrossSells","firstAndLast","contactInfo"]}}),function(e="Type_Of_Legal_Problem"){return{$cmp:"FormKitSchema",if:"$get("+e+").value",props:{schema:"$meta.dynamicSchema",data:"$buildData($meta)"}}}(),function(e={}){return ce("contactInfo",[oe(e),le(e),{$el:"script",if:"$activeStep === $lastStep()",children:se},(t=e.scope,d({$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"}})),W(e.scope),q(e.scope),X()],!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: ","$stepKeys()"],attrs:{class:"t-text-xs",style:"overflow: scroll"}}]}]}]}];var Ie;return Pe}();
|
|
@@ -109,7 +109,7 @@ const sbsYesNoRadio = (updates) => {
|
|
|
109
109
|
|
|
110
110
|
const verticalButtonRadio = (updates) => {
|
|
111
111
|
updates.legendClass = 'legend-left';
|
|
112
|
-
updates.fieldsetClass = '$reset t-flex t-justify-center t-items-center';
|
|
112
|
+
updates.fieldsetClass = '$reset t-flex t-justify-center t-flex-col-reverse t-items-center';
|
|
113
113
|
if (typeof updates.optionsClass === 'undefined') {
|
|
114
114
|
updates.optionsClass = 't-flex t-flex-col sm:t-flex-row t-justify-center t-my-3';
|
|
115
115
|
}
|
|
@@ -118,6 +118,7 @@ const verticalButtonRadio = (updates) => {
|
|
|
118
118
|
updates.labelClass = 't-font-semibold t-text-[#1e448f] t-w-[100%]';
|
|
119
119
|
updates.decoratorIcon = false;
|
|
120
120
|
updates.messagesClass = 't-flex t-justify-center';
|
|
121
|
+
updates.helpClass = 't-mt-2.5 !t-text-sm t-text-center';
|
|
121
122
|
return radio(updates)
|
|
122
123
|
};
|
|
123
124
|
|
|
@@ -380,9 +381,9 @@ const doctorTreatment = (scope) => sbsYesNoRadio({
|
|
|
380
381
|
label: 'Have You Recently Been Treated by a Doctor, Hospital or Clinic?',
|
|
381
382
|
});
|
|
382
383
|
|
|
383
|
-
const email = () => sbsText({
|
|
384
|
+
const email = (scope) => sbsText({
|
|
384
385
|
$formkit: 'email',
|
|
385
|
-
name: 'Email',
|
|
386
|
+
name: scope ? scope + ':' + 'Email' : 'Email',
|
|
386
387
|
label: 'Email Address:',
|
|
387
388
|
placeholder: 'email@domain.com',
|
|
388
389
|
autocomplete: 'email',
|
|
@@ -407,11 +408,11 @@ const estateLegalServicesNeeded = (scope) => sbsSelect({
|
|
|
407
408
|
]
|
|
408
409
|
});
|
|
409
410
|
|
|
410
|
-
const firstName = () => sbsText({
|
|
411
|
+
const firstName = (scope) => sbsText({
|
|
411
412
|
$formkit: 'text',
|
|
412
413
|
label: 'First Name:',
|
|
413
414
|
placeholder: 'First',
|
|
414
|
-
name: 'First_Name',
|
|
415
|
+
name: scope ? scope + ':' + 'First_Name' : 'First_Name',
|
|
415
416
|
autocomplete: "given-name",
|
|
416
417
|
validationMessages: {
|
|
417
418
|
required: 'First Name is required'
|
|
@@ -423,8 +424,8 @@ const haveAttorney$1 = (scope) => sbsYesNoRadio({
|
|
|
423
424
|
label: 'Already Working with An Attorney?'
|
|
424
425
|
});
|
|
425
426
|
|
|
426
|
-
const haveAttorneyCenter = () => verticalYesNoRadio({
|
|
427
|
-
name: 'Have_Attorney',
|
|
427
|
+
const haveAttorneyCenter = (scope) => verticalYesNoRadio({
|
|
428
|
+
name: scope ? scope + ':' + 'Have_Attorney' : 'Have_Attorney',
|
|
428
429
|
});
|
|
429
430
|
|
|
430
431
|
const haveChildren = (scope) => sbsYesNoRadio({
|
|
@@ -437,11 +438,11 @@ const incidentDate = (scope) => sbsDate({
|
|
|
437
438
|
label: 'Date of Incident:',
|
|
438
439
|
});
|
|
439
440
|
|
|
440
|
-
const lastName = () => sbsText({
|
|
441
|
+
const lastName = (scope) => sbsText({
|
|
441
442
|
$formkit: 'text',
|
|
442
443
|
label: 'Last Name:',
|
|
443
444
|
placeholder: 'Last',
|
|
444
|
-
name: 'Last_Name',
|
|
445
|
+
name: scope ? scope + ':' + 'Last_Name' : 'Last_Name',
|
|
445
446
|
autocomplete: "family-name",
|
|
446
447
|
validationMessages: {
|
|
447
448
|
required: 'Last Name is required'
|
|
@@ -564,9 +565,9 @@ const pendingCharges = (scope) => sbsYesNoRadio({
|
|
|
564
565
|
label: 'Do you currently have any pending charges?'
|
|
565
566
|
});
|
|
566
567
|
|
|
567
|
-
const phone = () => sbsText({
|
|
568
|
+
const phone = (scope) => sbsText({
|
|
568
569
|
$formkit: 'tel',
|
|
569
|
-
name: 'Primary_Phone',
|
|
570
|
+
name: scope ? scope + ':' + 'Primary_Phone' : 'Primary_Phone',
|
|
570
571
|
label: 'Phone Number:',
|
|
571
572
|
placeholder: '###-###-####',
|
|
572
573
|
maxlength: 12,
|
|
@@ -623,10 +624,10 @@ const socialSecurityDisabilityReceivingBenefits = (scope) => sbsYesNoRadio({
|
|
|
623
624
|
label: 'Are You Currently Receiving Social Security Disability Benefits?'
|
|
624
625
|
});
|
|
625
626
|
|
|
626
|
-
const TCPAConsent = () => ({
|
|
627
|
+
const TCPAConsent = (scope) => ({
|
|
627
628
|
$formkit: 'checkbox',
|
|
628
629
|
label: '$meta.tcpaLanguage',
|
|
629
|
-
name: 'TCPA_Opt_In',
|
|
630
|
+
name: scope ? scope + ':' + 'TCPA_Opt_In' : 'TCPA_Opt_In',
|
|
630
631
|
'data-tf-sensitive': 'false',
|
|
631
632
|
validation: 'required|accepted',
|
|
632
633
|
validationMessages: {
|
|
@@ -678,10 +679,10 @@ const valueOfAssets = (scope) => sbsSelect({
|
|
|
678
679
|
]
|
|
679
680
|
});
|
|
680
681
|
|
|
681
|
-
const zipcodeCenter = (updates = {}) => text({
|
|
682
|
+
const zipcodeCenter = (updates = {}, scope) => text({
|
|
682
683
|
placeholder: '#####',
|
|
683
684
|
help: updates.help ?? "We try to match you with local legal help",
|
|
684
|
-
name: 'Zip',
|
|
685
|
+
name: scope ? scope + ':' + 'Zip' : 'Zip',
|
|
685
686
|
maxlength: 5,
|
|
686
687
|
inputmode: "numeric",
|
|
687
688
|
autocomplete: 'postal-code',
|
|
@@ -1083,7 +1084,8 @@ function commentsWithBankruptcy(updates = {}) {
|
|
|
1083
1084
|
label: typeof updates.label === 'undefined' ? DEFAULT_COMMENTS_LABEL : updates.label,
|
|
1084
1085
|
placeholder: updates.placeholder || DEFAULT_COMMENTS_PLACEHOLDER_DYNAMIC,
|
|
1085
1086
|
inputClass: typeof updates.inputClass === 'undefined' ? '!t-h-32' : updates.inputClass,
|
|
1086
|
-
}),
|
|
1087
|
+
}, updates.scope),
|
|
1088
|
+
// TODO: needs scope support
|
|
1087
1089
|
bankruptcyCrossSell(),
|
|
1088
1090
|
{
|
|
1089
1091
|
$el: 'div',
|
|
@@ -1108,16 +1110,16 @@ function contactInfo(updates = {}) {
|
|
|
1108
1110
|
contactStepHeadline(updates),
|
|
1109
1111
|
contactStepSubHeadline(updates),
|
|
1110
1112
|
trustedFormScript(),
|
|
1111
|
-
email(),
|
|
1112
|
-
phone(),
|
|
1113
|
-
TCPAConsent(),
|
|
1113
|
+
email(updates.scope),
|
|
1114
|
+
phone(updates.scope),
|
|
1115
|
+
TCPAConsent(updates.scope),
|
|
1114
1116
|
secureIcon()
|
|
1115
1117
|
],
|
|
1116
1118
|
false, // nextOnEnter
|
|
1117
1119
|
)
|
|
1118
1120
|
}
|
|
1119
1121
|
|
|
1120
|
-
function firstAndLastV3(updates = {}) {
|
|
1122
|
+
function firstAndLastV3(updates = {}, scope) {
|
|
1121
1123
|
return step(
|
|
1122
1124
|
'firstAndLast',
|
|
1123
1125
|
[
|
|
@@ -1129,8 +1131,8 @@ function firstAndLastV3(updates = {}) {
|
|
|
1129
1131
|
subheadline: updates.subheadline ?? 'Note: we never share info without consent',
|
|
1130
1132
|
subheadlineClass: '!t-text-sm !t-text-gray-500'
|
|
1131
1133
|
}),
|
|
1132
|
-
firstName(),
|
|
1133
|
-
lastName()
|
|
1134
|
+
firstName(scope),
|
|
1135
|
+
lastName(scope)
|
|
1134
1136
|
],
|
|
1135
1137
|
updates.nextOnEnter
|
|
1136
1138
|
)
|
|
@@ -1329,7 +1331,7 @@ function legalCrossSells(updates = {}) {
|
|
|
1329
1331
|
function zipcode(updates = {}) {
|
|
1330
1332
|
return sqstep(
|
|
1331
1333
|
'zipcode',
|
|
1332
|
-
zipcodeCenter(updates),
|
|
1334
|
+
zipcodeCenter(updates, updates.scope),
|
|
1333
1335
|
'Please verify your Zip Code',
|
|
1334
1336
|
updates
|
|
1335
1337
|
)
|
|
@@ -1338,7 +1340,7 @@ function zipcode(updates = {}) {
|
|
|
1338
1340
|
function haveAttorney(updates = {}) {
|
|
1339
1341
|
return sqstep(
|
|
1340
1342
|
'haveAttorney',
|
|
1341
|
-
haveAttorneyCenter(),
|
|
1343
|
+
haveAttorneyCenter(updates.scope),
|
|
1342
1344
|
'Already working with an attorney?',
|
|
1343
1345
|
updates
|
|
1344
1346
|
)
|
|
@@ -1402,9 +1404,7 @@ function numEmployeesOfBusiness(updates = {}) {
|
|
|
1402
1404
|
)
|
|
1403
1405
|
}
|
|
1404
1406
|
|
|
1405
|
-
|
|
1406
|
-
|
|
1407
|
-
const formNavigation = () => ({
|
|
1407
|
+
const formNavigation = (updates = {}) => ({
|
|
1408
1408
|
$el: 'div',
|
|
1409
1409
|
attrs: {
|
|
1410
1410
|
class: 'step-nav'
|
|
@@ -1442,7 +1442,7 @@ const formNavigation = () => ({
|
|
|
1442
1442
|
{
|
|
1443
1443
|
$formkit: 'submit',
|
|
1444
1444
|
name: 'submit_button',
|
|
1445
|
-
label: 'Submit',
|
|
1445
|
+
label: updates.submitLabel || 'Submit',
|
|
1446
1446
|
if: '$activeStep === $lastStep()',
|
|
1447
1447
|
style: {
|
|
1448
1448
|
if: '$activeStep !== $lastStep()',
|
|
@@ -1577,14 +1577,16 @@ function defaultMetaProps(tolps = null) {
|
|
|
1577
1577
|
})
|
|
1578
1578
|
}
|
|
1579
1579
|
|
|
1580
|
-
|
|
1581
|
-
|
|
1582
|
-
|
|
1583
|
-
|
|
1584
|
-
|
|
1585
|
-
|
|
1580
|
+
function dynamicSchemaNode(field = 'Type_Of_Legal_Problem') {
|
|
1581
|
+
return {
|
|
1582
|
+
$cmp: 'FormKitSchema',
|
|
1583
|
+
if: '$get(' + field + ').value',
|
|
1584
|
+
props: {
|
|
1585
|
+
schema: '$meta.dynamicSchema',
|
|
1586
|
+
data: '$buildData($meta)'
|
|
1587
|
+
}
|
|
1586
1588
|
}
|
|
1587
|
-
}
|
|
1589
|
+
}
|
|
1588
1590
|
|
|
1589
1591
|
const formAnchorDefaults = {
|
|
1590
1592
|
$el: 'div',
|
|
@@ -1981,7 +1983,7 @@ const schema = [
|
|
|
1981
1983
|
headlineClass: 't-text-lg',
|
|
1982
1984
|
nextStepMap: nextStepsMapBusinessServicesDisplay
|
|
1983
1985
|
}),
|
|
1984
|
-
dynamicSchemaNode,
|
|
1986
|
+
dynamicSchemaNode(),
|
|
1985
1987
|
contactInfo({
|
|
1986
1988
|
headline: 'Connect Today - Final Step',
|
|
1987
1989
|
subheadline: 'You may benefit from speaking with a professional. Please verify your contact information.'
|