{"id":12397,"date":"2020-04-28T05:52:29","date_gmt":"2020-04-28T05:52:29","guid":{"rendered":"https:\/\/www.therapservices.net\/products\/?page_id=12397"},"modified":"2026-01-06T08:24:28","modified_gmt":"2026-01-06T08:24:28","slug":"new-york-evv-compliance","status":"publish","type":"page","link":"https:\/\/www.therapservices.net\/products\/new-york-evv-compliance\/","title":{"rendered":"New York State compliant EVV Software solution"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-color:#ffffff;--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:0px;--awb-padding-right:0px;--awb-padding-bottom:0px;--awb-padding-left:0px;--awb-margin-top:0px;--awb-margin-bottom:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_3_5 3_5 fusion-three-fifth fusion-column-first\" style=\"--awb-padding-top:0px;--awb-padding-right:0px;--awb-padding-bottom:0px;--awb-padding-left:0px;--awb-bg-color:#fff6db;--awb-bg-color-hover:#fff6db;--awb-bg-size:cover;--awb-border-color:#fdb913;--awb-border-top:1px;--awb-border-right:1px;--awb-border-bottom:1px;--awb-border-left:1px;--awb-border-style:solid;--awb-margin-bottom:0px;width:60%;width:calc(60% - ( ( 0% ) * 0.6 ) );margin-right: 0%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><img decoding=\"async\" aria-label=\"Mobile Device screens showing the therap evv mobile app\" alt=\"Mobile Device screens showing the therap evv mobile app\" width=\"100%\" height=\"100%\"  src=\"https:\/\/www.therapservices.net\/images\/funnel\/top-banner-NY-EVV-200428.webp\" ><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"margin-left: auto;margin-right: auto;margin-top:10px;margin-bottom:10px;width:100%;\"><\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-text fusion-text-1\"><h1 style=\"padding: 0px; margin: 0px; color: #db5a1b; font-size: 36px; margin-bottom: 12px; padding-left: 5%; padding-right: 5%; font-weight: bold;\">Available Now.<\/h1>\n<p style=\"font-size: 26px; padding: 0px; margin: 0px; margin-bottom: 22px; padding-left: 5%; padding-right: 5%;\">Your team can use Therap&#8217;s Scheduling &amp; EVV, along with other system features to address compliance, communication, documentation, reporting, billing, and more.<\/p>\n<h1 style=\"padding: 0px; margin: 0px; margin-bottom: 12px; color: #00437c; font-size: 27px; font-weight: bold; padding-left: 5%; padding-right: 5%;\">Our easy-to-use EVV solution gives your team the tools they need:<\/h1>\n<\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"margin-left: auto;margin-right: auto;margin-top:10px;margin-bottom:0px;width:100%;\"><\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-0 fusion_builder_column_inner_2_5 2_5 fusion-two-fifth fusion-column-first\" style=\"--awb-padding-top:0px;--awb-padding-right:0px;--awb-padding-bottom:0px;--awb-padding-left:12%;--awb-bg-size:cover;--awb-margin-bottom:0px;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-image-element in-legacy-container\" style=\"--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><span class=\" fusion-imageframe imageframe-none imageframe-1 hover-type-none\"><img decoding=\"async\" width=\"300\" height=\"500\" alt=\"Mobile screen showing the Therap EVV checkout \" title=\"Mobile screen showing the Therap EVV checkout\" src=\"https:\/\/www.therapservices.net\/products\/wp-content\/uploads\/sites\/60\/2020\/05\/mobile-NY-EVV-image.png\" class=\"img-responsive wp-image-12491\" srcset=\"https:\/\/www.therapservices.net\/products\/wp-content\/uploads\/sites\/60\/2020\/05\/mobile-NY-EVV-image-200x333.png 200w, https:\/\/www.therapservices.net\/products\/wp-content\/uploads\/sites\/60\/2020\/05\/mobile-NY-EVV-image.png 300w\" sizes=\"(max-width: 800px) 100vw, 300px\" \/><\/span><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-1 fusion_builder_column_inner_3_5 3_5 fusion-three-fifth fusion-column-last\" style=\"--awb-padding-top:0px;--awb-padding-right:5%;--awb-padding-bottom:0px;--awb-padding-left:5%;--awb-bg-size:cover;--awb-margin-bottom:0px;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><ul style=\"--awb-size:24px;--awb-iconcolor:#f49b32;--awb-line-height:40.8px;--awb-icon-width:40.8px;--awb-icon-height:40.8px;--awb-icon-margin:16.8px;--awb-content-margin:57.6px;\" class=\"fusion-checklist fusion-checklist-1 fusion-checklist-default type-icons\" id=\"bullets-left\"><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-no\"><i class=\"fusion-li-icon fa-check-circle fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p style=\"margin-bottom: 7px;\">Real-time Access for Schedulers and Staff<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-no\"><i class=\"fusion-li-icon fa-check-circle fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p style=\"margin-bottom: 7px;\">Single swipe Check-in\/out with Geolocation<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-no\"><i class=\"fusion-li-icon fa-check-circle fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p style=\"margin-bottom: 7px;\">Android, iOS, and Web Browser Compatible Functionality<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-no\"><i class=\"fusion-li-icon fa-check-circle fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p style=\"margin-bottom: 0px;\">Offline Capability<\/p>\n<\/div><\/li><\/ul><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"margin-left: auto;margin-right: auto;margin-top:10px;margin-bottom:50px;width:100%;\"><\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_2_5 2_5 fusion-two-fifth fusion-column-last\" style=\"--awb-padding-left:7%;--awb-bg-size:cover;width:40%;width:calc(40% - ( ( 0% ) * 0.4 ) );\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><!-- SF FORM -->\r\n<link rel=\"stylesheet\" href=\"https:\/\/therapservices.net\/jslib\/contact-form\/intlTelInput.css\" \/>\r\n<script src=\"https:\/\/therapservices.net\/jslib\/contact-form\/intlTelInput.min.js\"><\/script>\r\n<link rel=\"stylesheet\" href=\"https:\/\/therapservices.net\/jslib\/contact-form\/choices.min.css\" \/>\r\n<script src=\"https:\/\/therapservices.net\/jslib\/contact-form\/choices.min.js\" defer><\/script>\r\n<style>\r\n    \/* Minimal reset and form base styles *\/\r\n    *,\r\n    ::before,\r\n    ::after {\r\n        box-sizing: border-box !important;\r\n    }\r\n\r\n    .choices__list--dropdown .choices__item:first-child,\r\n    select option:first-child {\r\n        display: none !important;\r\n    }\r\n\r\n    select {\r\n        cursor: pointer;\r\n    }\r\n\r\n    .fusion-column-wrapper.fusion-column-has-shadow.fusion-flex-justify-content-flex-start.fusion-content-layout-column {\r\n        width: 100%;\r\n        margin: 0;\r\n    }\r\n\r\n    .fusion-layout-column.fusion_builder_column.fusion-builder-column-0 {\r\n        margin-bottom: 0 !important;\r\n    }\r\n\r\n    .custom-modal {\r\n        left: 0;\r\n    }\r\n\r\n    .choices[data-type*=select-one]::after {\r\n        z-index: 2;\r\n    }\r\n\r\n    input,\r\n    select,\r\n    textarea {\r\n        font-family: inherit !important;\r\n        font-size: 100% !important;\r\n        margin: 0 !important;\r\n        line-height: inherit !important;\r\n        color: inherit !important;\r\n        border-radius: 0 !important;\r\n    }\r\n\r\n    \/* Base styles for form elements *\/\r\n    .custom-form input[type=\"text\"],\r\n    .custom-form input[type=\"email\"],\r\n    .custom-form textarea,\r\n    .custom-form select {\r\n        -webkit-appearance: none !important;\r\n        -moz-appearance: none !important;\r\n        appearance: none !important;\r\n        border-width: 1px !important;\r\n        border-color: #ffaa00 !important;\r\n        border-radius: 0.375rem !important;\r\n        padding: 0.5rem 0.75rem !important;\r\n        background-color: #fff !important;\r\n        height: 50px;\r\n    }\r\n\r\n    .custom-form input[type=\"tel\"] {\r\n        -webkit-appearance: none !important;\r\n        -moz-appearance: none !important;\r\n        appearance: none !important;\r\n        border-width: 1px !important;\r\n        border-color: #ffaa00 !important;\r\n        border-radius: 0.375rem !important;\r\n        \/* padding: 0.5rem 0.75rem !important; *\/\r\n        background-color: #fff !important;\r\n        height: 50px;\r\n    }\r\n\r\n    .custom-form input[type=\"checkbox\"] {\r\n        \/* appearance: none !important; *\/\r\n        padding: 0 !important;\r\n        display: inline-block !important;\r\n        vertical-align: middle !important;\r\n        height: 1rem !important;\r\n        width: 1rem !important;\r\n        border-width: 1px !important;\r\n        border-color: #ffaa00 !important;\r\n        border-radius: 0.25rem !important;\r\n    }\r\n\r\n    .custom-form input[type=\"checkbox\"]:checked {\r\n        background-color: #2563eb !important;\r\n        border-color: #2563eb !important;\r\n        background-image: url(\"data:image\/svg+xml,svg viewBox='0 0 16 16' fill='white' xmlns='http:\/\/www.w3.org\/2000\/svg'path d='M12.207 4.793a1 1 0 0 1 0 1.414l-5 5a1 1 0 0 1-1.414 0l-2-2a1 1 0 0 1 1.414-1.414L6.5 9.086l4.293-4.293a1 1 0 0 1 1.414 0z'\/\/svg\") !important;\r\n        background-size: 100% 100% !important;\r\n        background-position: center !important;\r\n        background-repeat: no-repeat !important;\r\n    }\r\n\r\n    .custom-form select {\r\n        background-image: url(\"data:image\/svg+xml,svg xmlns='http:\/\/www.w3.org\/2000\/svg' fill='none' viewBox='0 0 20 20'path stroke='6b7280' stroke-linecap='round' stroke-linejoin='round' stroke-width='1.5' d='M6 8l4 4 4-4'\/\/svg\") !important;\r\n        background-position: right 0.5rem center !important;\r\n        background-repeat: no-repeat !important;\r\n        background-size: 1.5em 1.5em !important;\r\n        padding-right: 2.5rem !important;\r\n    }\r\n\r\n    \/* Page Body *\/\r\n    .form-page-body {\r\n        \/* --tw-gradient-from: #fff !important;\r\n                            --tw-gradient-stops: var(--tw-gradient-from),\r\n                                var(--tw-gradient-to, rgba(255, 255, 255, 0)) !important;\r\n                            --tw-gradient-to: #faf2c6 !important;\r\n                            background-image: linear-gradient(to bottom,\r\n                                    var(--tw-gradient-stops)) !important; *\/\r\n        display: flex !important;\r\n        align-items: start !important;\r\n        justify-content: center !important;\r\n        \/* min-height: 100vh !important; *\/\r\n        margin: 0 !important;\r\n        padding: 1rem !important;\r\n        padding-bottom: 5% !important;\r\n        padding-top: 4% !important;\r\n    }\r\n\r\n    .fusion-layout-column.fusion_builder_column.fusion-builder-column-0.fusion_builder_column_1_1.\\31 _1.fusion-flex-column {\r\n        margin-bottom: 0;\r\n    }\r\n\r\n    \/* Form Wrapper *\/\r\n    .custom-form {\r\n        width: 100% !important;\r\n        \/* margin-top: -10%; *\/\r\n    }\r\n\r\n    .custom-modal-dialog,\r\n    .custom-modal-2-dialog {\r\n        max-width: 750px;\r\n    }\r\n\r\n    .custom-modal .custom-modal-body,\r\n    .custom-modal-2 .custom-modal-body {\r\n        padding: 0;\r\n        \/* margin-top: 0; *\/\r\n    }\r\n\r\n    \/* Form Container *\/\r\n    .custom-form .contact-form-content {\r\n        \/* background-color: #fff !important; *\/\r\n        border-width: 1px !important;\r\n        \/* border: 1px solid #ffaa00 !important; *\/\r\n        \/* box-shadow: 0 1px 6px 2px rgb(0 0 0 \/ 23%) !important; *\/\r\n        border-radius: 0.375rem !important;\r\n        padding: 0rem !important;\r\n        padding-top: 2rem !important;\r\n        width: 100% !important;\r\n        max-width: 800px !important;\r\n        margin: 0 auto !important;\r\n    }\r\n\r\n    .custom-form .contact-form-content>*:not([hidden])~*:not([hidden]) {\r\n        margin-top: 1.25rem !important;\r\n    }\r\n\r\n    \/* Form Title *\/\r\n    .custom-form .title {\r\n        font-size: 2.5rem !important;\r\n        line-height: 3rem !important;\r\n        color: #000 !important;\r\n        font-weight: 600 !important;\r\n        text-align: center !important;\r\n        margin-bottom: 2rem !important;\r\n    }\r\n\r\n    \/* Form Row Layouts *\/\r\n    .custom-form .form-row {\r\n        width: 100% !important;\r\n    }\r\n\r\n    .custom-form .grid-2 {\r\n        display: grid !important;\r\n        grid-template-columns: repeat(1, minmax(0, 1fr)) !important;\r\n        gap: 1rem !important;\r\n    }\r\n\r\n    \/* === FLOATING LABEL STYLES START === *\/\r\n\r\n    \/* 1. Set form field container to relative *\/\r\n    .custom-form .form-field,\r\n    .custom-form .form-row {\r\n        position: relative !important;\r\n    }\r\n\r\n    \/* 2. Style the floating label *\/\r\n    .custom-form .form-label {\r\n        position: absolute !important;\r\n        top: 50% !important;\r\n        left: 0.75rem !important;\r\n        transform: translateY(-50%) !important;\r\n        font-size: 1rem !important;\r\n        color: #000 !important;\r\n        background-color: #fff !important;\r\n        pointer-events: none !important;\r\n        transition: all 0.2s ease !important;\r\n        padding: 0 0.25rem !important;\r\n        margin-bottom: 0 !important;\r\n        display: block !important;\r\n        width: 90%;\r\n    }\r\n\r\n    \/* 3. Adjust label for textareas *\/\r\n    .custom-form .form-textarea+.form-label {\r\n        top: 2.5rem !important;\r\n        transform: translateY(-50%) !important;\r\n    }\r\n\r\n    \/* 4. \"Float\" animation for ALL fields\r\n .custom-form .form-input:focus+.form-label,\r\n .custom-form .form-input:not(:placeholder-shown)+.form-label,\r\n .custom-form .form-textarea:focus+.form-label,\r\n .custom-form .form-textarea:not(:placeholder-shown)+.form-label,\r\n .custom-form .form-select:focus+.form-label,\r\n .custom-form .form-select:valid+.form-label,\r\n .custom-form .form-input.has-value+.form-label,\r\n .custom-form .form-textarea.has-value+.form-label,\r\n\r\n .custom-form .iti:has(.form-input:focus)+.form-label,\r\n .custom-form .iti:has(.form-input:not(:placeholder-shown))+.form-label,\r\n .custom-form .iti:has(.form-input.has-value)+.form-label {\r\n top: 0 !important;\r\n left: 0.5rem !important;\r\n font-size: 0.75rem !important;\r\n color: #6b7280 !important;\r\n transform: translateY(-50%) !important;\r\n display: none !important;\r\n } *\/\r\n\r\n    \/* This is the NEW rule - use this one *\/\r\n    .custom-form .form-input:focus+.form-label,\r\n    .custom-form .form-textarea:focus+.form-label,\r\n    .custom-form .iti:has(.form-input:focus)+.form-label,\r\n    .custom-form .form-input:not(:placeholder-shown)+.form-label,\r\n    .custom-form .form-textarea:not(:placeholder-shown)+.form-label,\r\n    .custom-form .form-select:valid+.form-label,\r\n    .custom-form .choices:has(.form-select:valid)+.form-label,\r\n    .custom-form .form-input.has-value+.form-label,\r\n    .custom-form .form-textarea.has-value+.form-label,\r\n    .custom-form .iti:has(.form-input:not(:placeholder-shown))+.form-label,\r\n    .custom-form .iti:has(.form-input.has-value)+.form-label {\r\n        display: none !important;\r\n    }\r\n\r\n    \/* === FLOATING LABEL STYLES END === *\/\r\n\r\n    .custom-form .required-asterisk {\r\n        color: #ef4444 !important;\r\n    }\r\n\r\n    .custom-form .form-input:not(#init_phone),\r\n    .custom-form .form-select,\r\n    .custom-form .form-textarea {\r\n        width: 100% !important;\r\n        border-color: #ffaa00 !important;\r\n        padding: 0.5rem 0.75rem !important;\r\n        outline: 2px solid transparent !important;\r\n        outline-offset: 2px !important;\r\n    }\r\n\r\n    .custom-form .form-textarea {\r\n        padding-top: 1rem !important;\r\n        padding-bottom: 1rem !important;\r\n        height: auto !important;\r\n    }\r\n\r\n    .custom-form .form-input:focus,\r\n    .custom-form .form-select:focus,\r\n    .custom-form .form-textarea:focus {\r\n        --tw-ring-color: #fde047 !important;\r\n        --tw-ring-offset-shadow: var(--tw-ring-inset) 0 0 0 var(--tw-ring-offset-width) var(--tw-ring-offset-color) !important;\r\n        --tw-ring-shadow: var(--tw-ring-inset) 0 0 0 calc(2px + var(--tw-ring-offset-width)) var(--tw-ring-color) !important;\r\n        box-shadow: var(--tw-ring-offset-shadow), var(--tw-ring-shadow),\r\n            var(--tw-shadow, 0 0 #0000) !important;\r\n    }\r\n\r\n    .custom-form .form-select {\r\n        background-color: #fff !important;\r\n    }\r\n\r\n    \/* Privacy Row *\/\r\n    .custom-form .privacy-row {\r\n        display: flex;\r\n        align-items: center !important;\r\n        justify-content: center !important;\r\n        margin: 0 auto !important;\r\n        position: static !important;\r\n        margin-top: 1.25rem !important;\r\n    }\r\n\r\n    .custom-form .privacy-row>*:not([hidden])~*:not([hidden]) {\r\n        margin-left: 0.5rem !important;\r\n    }\r\n\r\n    .form-row.privacy-row {\r\n        display: flex;\r\n        flex-flow: row wrap;\r\n        align-items: center;\r\n        align-items: center;\r\n        margin: 0 auto !important;\r\n        width: 100% !important;\r\n    }\r\n\r\n    .custom-form .form-checkbox {\r\n        margin-top: 0.25rem !important;\r\n        border-color: #ffaa00 !important;\r\n    }\r\n\r\n    .custom-form .privacy-label,\r\n    .custom-form .privacy-label a,\r\n    .trouble-login-info p,\r\n    .trouble-login-info a {\r\n        font-size: 1rem !important;\r\n        line-height: 1.9rem !important;\r\n        position: static !important;\r\n        transform: none !important;\r\n        color: inherit !important;\r\n        background-color: transparent !important;\r\n        padding: 0 !important;\r\n    }\r\n\r\n    .custom-form .privacy-label a,\r\n    .trouble-login-info a {\r\n        font-weight: 600 !important;\r\n        color: #0c4c7c !important;\r\n        text-decoration-line: none !important;\r\n    }\r\n\r\n    .custom-form .privacy-link {\r\n        \/* color: #0c4c7c !important; *\/\r\n        \/* text-decoration-line: underline !important; *\/\r\n    }\r\n\r\n    .custom-form .privacy-link:hover,\r\n    .trouble-login-info a:hover {\r\n        text-decoration-line: underline !important;\r\n        color: #0c4c7c !important;\r\n    }\r\n\r\n    \/* Submit Button *\/\r\n    .custom-form .submit-row {\r\n        text-align: center !important;\r\n        position: static !important;\r\n    }\r\n\r\n    .custom-form .submit-button {\r\n        display: flex;\r\n        margin: 0 auto !important;\r\n        background-color: #cfe99a !important;\r\n        color: #0c4c7c !important;\r\n        font-weight: 700 !important;\r\n        padding-top: 0.5rem !important;\r\n        padding-bottom: 0.5rem !important;\r\n        padding-left: 1.5rem !important;\r\n        padding-right: 1.5rem !important;\r\n        border-radius: 0.375rem !important;\r\n        transition-property: color, background-color, border-color,\r\n            text-decoration-color, fill, stroke !important;\r\n        transition-timing-function: cubic-bezier(0.4, 0, 0.2, 1) !important;\r\n        transition-duration: 150ms !important;\r\n        border: none !important;\r\n        cursor: pointer !important;\r\n        outline: none !important;\r\n    }\r\n\r\n    .custom-form .submit-button:hover {\r\n        background-color: #cfe99b !important;\r\n    }\r\n\r\n    .iti {\r\n        width: 100% !important;\r\n    }\r\n\r\n    .choices {\r\n        margin-bottom: 0 !important;\r\n    }\r\n\r\n    \/* This styles the 'closed' box to match your other inputs *\/\r\n    .choices[data-type*=\"select-one\"] .choices__inner {\r\n        border-width: 1px !important;\r\n        border-color: #ffaa00 !important;\r\n        border-radius: 0.375rem !important;\r\n        padding: 0.5rem 0.75rem !important;\r\n        background-color: #fff !important;\r\n        height: 50px;\r\n        font-size: 1rem;\r\n        display: flex;\r\n        align-items: center;\r\n    }\r\n\r\n    \/* This styles the 'open' dropdown list *\/\r\n    .choices__list--dropdown {\r\n        border-color: #ffaa00 !important;\r\n        border-radius: 0.375rem !important;\r\n    }\r\n\r\n    \/* This styles a single option in the list *\/\r\n    .choices__item--choice {\r\n        font-size: 1rem;\r\n        padding: 0.5rem 1rem;\r\n        background-color: #fff;\r\n        \/* Default background *\/\r\n        color: #333;\r\n        \/* Default text color *\/\r\n    }\r\n\r\n    \/* * HERE IS YOUR HOVER STYLE! \r\n * This styles the 'highlighted' (hovered) option \r\n *\/\r\n    .choices__list--dropdown .choices__item--choice.is-highlighted {\r\n        background-color: #fff8cb !important;\r\n        \/* Your submit button color *\/\r\n        color: #0c4c7c !important;\r\n        \/* Your submit button text color *\/\r\n    }\r\n\r\n    \/* START: MODIFIED - Hide conditional rows by default *\/\r\n    #county_row,\r\n    #trouble-login-info,\r\n    #message-row,\r\n    #how-many-individuals-row {\r\n        display: none;\r\n    }\r\n\r\n    #trouble-login-info {\r\n        text-align: center;\r\n    }\r\n\r\n    #zip_row {\r\n        display: none;\r\n    }\r\n\r\n    \/* END: MODIFIED *\/\r\n\r\n    input#init_phone {\r\n        \/* Adjust padding for the floating label *\/\r\n        \/* padding-left: 52px !important; *\/\r\n        \/* Default was 52px, but floating label needs more *\/\r\n    }\r\n\r\n    \/* Adjust label position for intl-tel-input *\/\r\n    .custom-form .iti+.form-label {\r\n        left: 75px !important;\r\n        width: 50%;\r\n        \/* Match the start of the number input *\/\r\n        \/* The 'top' and 'transform' are handled by the base .form-label rule *\/\r\n    }\r\n\r\n    #submit-case,\r\n    #submit-lead {\r\n        display: none !important;\r\n    }\r\n\r\n    \/* START: ADDED - Notification styles *\/\r\n    #custom-notification {\r\n        display: none;\r\n        position: fixed;\r\n        top: 20px;\r\n        left: 50%;\r\n        transform: translateX(-50%);\r\n        background-color: #fff;\r\n        border: 1px solid #ffaa00;\r\n        border-left-width: 5px;\r\n        padding: 1rem 1.5rem;\r\n        border-radius: 0.375rem;\r\n        box-shadow: 0 4px 12px rgba(0, 0, 0, 0.15);\r\n        z-index: 9999;\r\n        font-family: inherit;\r\n        font-size: 1rem;\r\n        color: #333;\r\n        max-width: 90%;\r\n        text-align: center;\r\n    }\r\n\r\n    #custom-notification-message {\r\n        margin: 0;\r\n    }\r\n\r\n    \/* END: ADDED *\/\r\n    .fusion-fullwidth.fullwidth-box.fusion-builder-row-1.fusion-flex-container.has-pattern-background.has-mask-background.hundred-percent-fullwidth.non-hundred-percent-height-scrolling {\r\n        padding-left: 0;\r\n        padding-right: 0;\r\n    }\r\n\r\n    .fusion-builder-row.fusion-row.fusion-flex-align-items-flex-start.fusion-flex-content-wrap {\r\n        margin-left: 0;\r\n        margin-right: 0;\r\n    }\r\n\r\n    .error-message {\r\n        display: none;\r\n        \/* Hide by default *\/\r\n        width: 100%;\r\n        margin-top: 0.25rem;\r\n        \/* 4px *\/\r\n        font-size: 0.875rem;\r\n        \/* 14px *\/\r\n        line-height: 1.25rem;\r\n        \/* 20px *\/\r\n        color: #ef4444;\r\n        \/* Red color *\/\r\n        text-align: left;\r\n    }\r\n\r\n    \/* Adjust for selects in a form-field *\/\r\n    .form-field .error-message {\r\n        padding-left: 0.25rem;\r\n    }\r\n\r\n    \/* Adjust for rows that are not form-fields *\/\r\n    .form-row.how-many-individuals-row .error-message,\r\n    .form-row.message-row .error-message {\r\n        padding-left: 0.75rem;\r\n    }\r\n\r\n    \/* Make privacy error centered *\/\r\n    .privacy-row {\r\n        flex-wrap: wrap;\r\n        \/* Allow wrapping *\/\r\n        justify-content: center;\r\n        \/* Center checkbox\/label *\/\r\n    }\r\n\r\n    .privacy-row .error-message {\r\n        width: 100%;\r\n        text-align: center;\r\n        margin-top: 0.5rem;\r\n    }\r\n\r\n    .form-row.has-error .form-label {\r\n        top: 35% !important;\r\n    }\r\n\r\n    \/* For the phone input *\/\r\n    .form-row.has-error .iti+.form-label {\r\n        top: 35% !important;\r\n    }\r\n\r\n    \/* For the textarea (which is in a .form-row) *\/\r\n    .form-row.has-error .form-textarea+.form-label {\r\n        top: 2.75rem !important;\r\n        \/* Adjust as needed, 35% won't look right here *\/\r\n    }\r\n\r\n    span#error-recaptcha {\r\n        text-align: center;\r\n    }\r\n\r\n    @media (max-width: 1100px) {\r\n        .form-page-body {\r\n            align-items: start !important;\r\n        }\r\n    }\r\n\r\n    @media (max-width: 900px) {\r\n        .custom-form .contact-form-content {\r\n            max-width: 600px !important;\r\n        }\r\n    }\r\n\r\n    \/* Responsive *\/\r\n    @media (min-width: 768px) {}\r\n\r\n    .custom-form .grid-2 {\r\n        grid-template-columns: repeat(1, minmax(0, 1fr)) !important;\r\n    }\r\n\r\n    .custom-modal {\r\n        padding-left: 1%;\r\n        padding-right: 1%;\r\n    }\r\n\r\n    .custom-form .title {\r\n        font-size: 2rem !important;\r\n    }\r\n\r\n    .custom-form .form-textarea+.form-label {\r\n        top: 3.5rem !important;\r\n        transform: translateY(-50%) !important;\r\n        width: 90%;\r\n    }\r\n\r\n    .form-row.privacy-row {\r\n        flex-flow: row;\r\n        justify-content: start !important;\r\n        align-items: start !important;\r\n    }\r\n\r\n    .form-row.how-many-individuals-row .choices[data-type*=\"select-one\"] .choices__inner {\r\n        \/*         height: 100px; *\/\r\n    }\r\n\r\n    .form-row.how-many-individuals-row label.form-label {\r\n        width: 90%;\r\n    }\r\n\r\n    .custom-form .privacy-label,\r\n    .custom-form .privacy-label a,\r\n    .trouble-login-info p,\r\n    .trouble-login-info a {\r\n        font-size: 1rem !important;\r\n        line-height: 1.5rem !important;\r\n    }\r\n\r\n    .custom-form .privacy-row>*:not([hidden])~*:not([hidden]) {\r\n        margin-top: -2px;\r\n    }\r\n\r\n    .form-row.has-error .iti+.form-label {\r\n        top: 50% !important;\r\n    }\r\n\r\n    @media screen and (min-width: 800px) and (max-width: 1400px) {\r\n        .form-row.how-many-individuals-row .choices[data-type*=\"select-one\"] .choices__inner {\r\n            height: 100px;\r\n        }\r\n    }\r\n<\/style>\r\n<div class=\"form-page-body\">\r\n\r\n    <!-- START: ADDED Notification Modal -->\r\n    <div id=\"custom-notification\">\r\n        <p id=\"custom-notification-message\"><\/p>\r\n    <\/div>\r\n    <!-- END: ADDED Notification Modal -->\r\n\r\n    <div class=\"custom-form\">\r\n        <!-- START: MODIFIED - Changed form back to div -->\r\n        <div id=\"contactForm\" class=\"contact-form-content\">\r\n            <!-- END: MODIFIED -->\r\n            <h2 class=\"title\">Contact our team<\/h2>\r\n\r\n            <div class=\"form-row grid-2\">\r\n                <div class=\"form-field\">\r\n                    <input type=\"text\" id=\"init_firstName\" name=\"firstName\" required class=\"form-input\">\r\n                    <label for=\"init_firstName\" class=\"form-label\">First Name <span\r\n                            class=\"required-asterisk\">*<\/span><\/label>\r\n                    <span class=\"error-message\" id=\"error-firstName\"><\/span>\r\n                <\/div>\r\n                <div class=\"form-field\">\r\n                    <input type=\"text\" id=\"init_lastName\" name=\"lastName\" required class=\"form-input\">\r\n                    <label for=\"init_lastName\" class=\"form-label\">Last Name <span\r\n                            class=\"required-asterisk\">*<\/span><\/label>\r\n                    <span class=\"error-message\" id=\"error-lastName\"><\/span>\r\n                <\/div>\r\n            <\/div>\r\n\r\n            <div class=\"form-row grid-2\">\r\n                <div class=\"form-field\">\r\n                    <input type=\"email\" id=\"init_email\" name=\"email\" required class=\"form-input\">\r\n                    <label for=\"init_email\" class=\"form-label\">Work Email <span\r\n                            class=\"required-asterisk\">*<\/span><\/label>\r\n                    <span class=\"error-message\" id=\"error-email\"><\/span>\r\n                <\/div>\r\n\r\n                <div class=\"form-field\">\r\n                    <input id=\"init_phone\" name=\"phone\" type=\"tel\" class=\"form-input\">\r\n                    <label for=\"init_phone\" class=\"form-label\">Phone Number<\/label>\r\n                    <span class=\"error-message\" id=\"error-phone\"><\/span>\r\n                <\/div>\r\n            <\/div>\r\n\r\n            <div class=\"form-row grid-2\">\r\n                <div class=\"form-field\">\r\n                    <input type=\"text\" id=\"init_company\" name=\"company\" required class=\"form-input\">\r\n                    <label for=\"init_company\" class=\"form-label\">Company Name <span\r\n                            class=\"required-asterisk\">*<\/span><\/label>\r\n                    <span class=\"error-message\" id=\"error-company\"><\/span>\r\n                <\/div>\r\n                <div class=\"form-field\">\r\n                    <input type=\"text\" id=\"init_jobTitle\" name=\"jobTitle\" required class=\"form-input\">\r\n                    <label for=\"init_jobTitle\" class=\"form-label\">Job Title <span\r\n                            class=\"required-asterisk\">*<\/span><\/label>\r\n                    <span class=\"error-message\" id=\"error-jobTitle\"><\/span>\r\n                <\/div>\r\n            <\/div>\r\n\r\n            <div class=\"form-row grid-2\">\r\n                <div class=\"form-field\">\r\n                    <select id=\"init_therapUser\" name=\"init_therapUser\" required class=\"form-select\" autocomplete=\"off\">\r\n                        <option value=\"\" style=\"display: none;\"><\/option>\r\n                        <option>Current Therap User<\/option>\r\n                        <option>Potential Therap User<\/option>\r\n                    <\/select>\r\n                    <label for=\"init_therapUser\" class=\"form-label\">Are you a Current Therap User?\r\n                        <span class=\"required-asterisk\">*<\/span><\/label>\r\n                    <span class=\"error-message\" id=\"error-therapUser\"><\/span>\r\n                <\/div>\r\n                <div class=\"form-field\">\r\n                    <select id=\"init_state\" name=\"init_state\" required class=\"form-select\" autocomplete=\"off\">\r\n                        <option value=\"\" style=\"display: none;\"><\/option>\r\n                        <option value=\"AL\">Alabama<\/option>\r\n                        <option value=\"AK\">Alaska<\/option>\r\n                        <option value=\"AZ\">Arizona<\/option>\r\n                        <option value=\"AR\">Arkansas<\/option>\r\n                        <option value=\"CA\">California<\/option>\r\n                        <option value=\"CO\">Colorado<\/option>\r\n                        <option value=\"CT\">Connecticut<\/option>\r\n                        <option value=\"DE\">Delaware<\/option>\r\n                        <option value=\"DC\">District Of Columbia<\/option>\r\n                        <option value=\"FL\">Florida<\/option>\r\n                        <option value=\"GA\">Georgia<\/option>\r\n                        <option value=\"HI\">Hawaii<\/option>\r\n                        <option value=\"ID\">Idaho<\/option>\r\n                        <option value=\"IL\">Illinois<\/option>\r\n                        <option value=\"IN\">Indiana<\/option>\r\n                        <option value=\"IA\">Iowa<\/option>\r\n                        <option value=\"KS\">Kansas<\/option>\r\n                        <option value=\"KY\">Kentucky<\/option>\r\n                        <option value=\"LA\">Louisiana<\/option>\r\n                        <option value=\"ME\">Maine<\/option>\r\n                        <option value=\"MD\">Maryland<\/option>\r\n                        <option value=\"MA\">Massachusetts<\/option>\r\n                        <option value=\"MI\">Michigan<\/option>\r\n                        <option value=\"MN\">Minnesota<\/option>\r\n                        <option value=\"MS\">Mississippi<\/option>\r\n                        <option value=\"MO\">Missouri<\/option>\r\n                        <option value=\"MT\">Montana<\/option>\r\n                        <option value=\"NE\">Nebraska<\/option>\r\n                        <option value=\"NV\">Nevada<\/option>\r\n                        <option value=\"NH\">New Hampshire<\/option>\r\n                        <option value=\"NJ\">New Jersey<\/option>\r\n                        <option value=\"NM\">New Mexico<\/option>\r\n                        <option value=\"NY\">New York<\/option>\r\n                        <option value=\"NC\">North Carolina<\/option>\r\n                        <option value=\"ND\">North Dakota<\/option>\r\n                        <option value=\"OH\">Ohio<\/option>\r\n                        <option value=\"OK\">Oklahoma<\/option>\r\n                        <option value=\"OR\">Oregon<\/option>\r\n                        <option value=\"PA\">Pennsylvania<\/option>\r\n                        <option value=\"RI\">Rhode Island<\/option>\r\n                        <option value=\"SC\">South Carolina<\/option>\r\n                        <option value=\"SD\">South Dakota<\/option>\r\n                        <option value=\"TN\">Tennessee<\/option>\r\n                        <option value=\"TX\">Texas<\/option>\r\n                        <option value=\"UT\">Utah<\/option>\r\n                        <option value=\"VT\">Vermont<\/option>\r\n                        <option value=\"VA\">Virginia<\/option>\r\n                        <option value=\"WA\">Washington<\/option>\r\n                        <option value=\"WV\">West Virginia<\/option>\r\n                        <option value=\"WI\">Wisconsin<\/option>\r\n                        <option value=\"WY\">Wyoming<\/option>\r\n                        <option value=\"Guam\">Guam<\/option>\r\n                        <option value=\"PR\">Puerto Rico<\/option>\r\n                        <option value=\"other\">Other (non-US)<\/option>\r\n                    <\/select>\r\n                    <label for=\"init_state\" class=\"form-label\">State\/Territory <span\r\n                            class=\"required-asterisk\">*<\/span><\/label>\r\n                    <span class=\"error-message\" id=\"error-state\"><\/span>\r\n                <\/div>\r\n            <\/div>\r\n\r\n            <div class=\"form-row how-can-we-assist-you-row\" id=\"how-can-we-assist-you-row\" style=\"display: none;\">\r\n                <select id=\"init_assistance\" name=\"init_assistance\" required class=\"form-select\" autocomplete=\"off\">\r\n                    <option value=\"\" style=\"display: none;\"><\/option>\r\n                    <option value=\"Having issues logging into my Therap account\">Having issues\r\n                        logging into my Therap\r\n                        account<\/option>\r\n                    <option value=\"Other\">Other<\/option>\r\n                <\/select>\r\n                <label for=\"init_assistance\" class=\"form-label\">How can we assist you? <span\r\n                        class=\"required-asterisk\">*<\/span><\/label>\r\n                <span class=\"error-message\" id=\"error-assistance\"><\/span>\r\n            <\/div>\r\n\r\n            <div class=\"form-row how-many-individuals-row\" id=\"how-many-individuals-row\">\r\n                <select id=\"init_individuals\" name=\"init_individuals\" required class=\"form-select\" autocomplete=\"off\">\r\n                    <option value=\"\" style=\"display: none;\"><\/option>\r\n                    <option>1-10<\/option>\r\n                    <option>11-50<\/option>\r\n                    <option>51-200<\/option>\r\n                    <option>200+<\/option>\r\n                <\/select>\r\n                <label for=\"init_individuals\" class=\"form-label\">How many Individuals does your\r\n                    agency support? <span class=\"required-asterisk\">*<\/span><\/label>\r\n                <span class=\"error-message\" id=\"error-individuals\"><\/span>\r\n            <\/div>\r\n\r\n            <!-- county dropdown -->\r\n            <!-- START: MODIFIED - Removed 'required' from select, will be added by JS -->\r\n            <div class=\"form-row\" id=\"county_row\">\r\n                <div class=\"form-field\">\r\n                    <select id=\"init_county\" name=\"init_county\" class=\"form-select\" autocomplete=\"off\">\r\n                        <!-- END: MODIFIED -->\r\n                        <option value=\"\" style=\"display: none;\"><\/option>\r\n                        <option value=\"Alameda\">Alameda<\/option>\r\n                        <option value=\"Alpine\">Alpine<\/option>\r\n                        <option value=\"Amador\">Amador<\/option>\r\n                        <option value=\"Butte\">Butte<\/option>\r\n                        <option value=\"Calaveras\">Calaveras<\/option>\r\n                        <option value=\"Colusa\">Colusa<\/option>\r\n                        <option value=\"Contra Costa\">Contra Costa<\/option>\r\n                        <option value=\"Del Norte\">Del Norte<\/option>\r\n                        <option value=\"El Dorado\">El Dorado<\/option>\r\n                        <option value=\"Fresno\">Fresno<\/option>\r\n                        <option value=\"Glenn\">Glenn<\/option>\r\n                        <option value=\"Humboldt\">Humboldt<\/option>\r\n                        <option value=\"Imperial\">Imperial<\/option>\r\n                        <option value=\"Inyo\">Inyo<\/option>\r\n                        <option value=\"Kern\">Kern<\/option>\r\n                        <option value=\"Kings\">Kings<\/option>\r\n                        <option value=\"Lake\">Lake<\/option>\r\n                        <option value=\"Lassen\">Lassen<\/option>\r\n                        <option value=\"Los Angeles\">Los Angeles<\/option>\r\n                        <option value=\"Madera\">Madera<\/option>\r\n                        <option value=\"Marin\">Marin<\/option>\r\n                        <option value=\"Mariposa\">Mariposa<\/option>\r\n                        <option value=\"Mendocino\">Mendocino<\/option>\r\n                        <option value=\"Merced\">Merced<\/option>\r\n                        <option value=\"Modoc\">Modoc<\/option>\r\n                        <option value=\"Mono\">Mono<\/option>\r\n                        <option value=\"Monterey\">Monterey<\/option>\r\n                        <option value=\"Napa\">Napa<\/option>\r\n                        <option value=\"Nevada\">Nevada<\/option>\r\n                        <option value=\"Orange\">Orange<\/option>\r\n                        <option value=\"Placer\">Placer<\/option>\r\n                        <option value=\"Plumas\">Plumas<\/option>\r\n                        <option value=\"Riverside\">Riverside<\/option>\r\n                        <option value=\"Sacramento\">Sacramento<\/option>\r\n                        <option value=\"San Benito\">San Benito<\/option>\r\n                        <option value=\"San Bernardino\">San Bernardino<\/option>\r\n                        <option value=\"San Diego\">San Diego<\/option>\r\n                        <option value=\"San Francisco\">San Francisco<\/option>\r\n                        <option value=\"San Joaquin\">San Joaquin<\/option>\r\n                        <option value=\"San Luis Obispo\">San Luis Obispo<\/option>\r\n                        <option value=\"San Mateo\">San Mateo<\/option>\r\n                        <option value=\"Santa Barbara\">Santa Barbara<\/option>\r\n                        <option value=\"Santa Clara\">Santa Clara<\/option>\r\n                        <option value=\"Santa Cruz\">Santa Cruz<\/option>\r\n                        <option value=\"Shasta\">Shasta<\/option>\r\n                        <option value=\"Sierra\">Sierra<\/option>\r\n                        <option value=\"Siskiyou\">Siskiyou<\/option>\r\n                        <option value=\"Solano\">Solano<\/option>\r\n                        <option value=\"Sonoma\">Sonoma<\/option>\r\n                        <option value=\"Stanislaus\">Stanislaus<\/option>\r\n                        <option value=\"Sutter\">Sutter<\/option>\r\n                        <option value=\"Tehama\">Tehama<\/option>\r\n                        <option value=\"Trinity\">Trinity<\/option>\r\n                        <option value=\"Tulare\">Tulare<\/option>\r\n                        <option value=\"Tuolumne\">Tuolumne<\/option>\r\n                        <option value=\"Ventura\">Ventura<\/option>\r\n                        <option value=\"Yolo\">Yolo<\/option>\r\n                        <option value=\"Yuba\">Yuba<\/option>\r\n                    <\/select>\r\n                    <label for=\"init_county\" class=\"form-label\">County <span class=\"required-asterisk\">*<\/span><\/label>\r\n                    <span class=\"error-message\" id=\"error-county\"><\/span>\r\n                <\/div>\r\n            <\/div>\r\n\r\n            <!-- START: ADDED ZIP ROW -->\r\n            <div class=\"form-row\" id=\"zip_row\" style=\"display: none;\">\r\n                <div class=\"form-field\">\r\n                    <input type=\"text\" id=\"init_zip\" name=\"init_zip\" class=\"form-input\">\r\n                    <label for=\"init_zip\" class=\"form-label\">Zip Code <span class=\"required-asterisk\">*<\/span><\/label>\r\n                    <span class=\"error-message\" id=\"error-zip\"><\/span>\r\n                <\/div>\r\n            <\/div>\r\n            <!-- END: ADDED ZIP ROW -->\r\n            <div class=\"form-row trouble-login-info\" id=\"trouble-login-info\" style=\"display: none;\">\r\n                <p>If you are having issues logging in to your Therap account,<br>please view the <a\r\n                        href=\"https:\/\/help.therapservices.net\/s\/article\/2035\"\r\n                        target=\"_blank\">Login&nbsp;Troubleshooting&nbsp;Guide<\/a>.<\/p>\r\n            <\/div>\r\n\r\n            <div class=\"form-row message-row\" id=\"message-row\">\r\n                <!-- START: MODIFIED - Added asterisk span, removed 'required' from textarea -->\r\n                <textarea id=\"init_message\" name=\"init_message\" rows=\"3\" class=\"form-textarea\"><\/textarea>\r\n                <label for=\"init_message\" class=\"form-label\">Please let us know how we can assist\r\n                    you.<span id=\"message-required-asterisk\" class=\"required-asterisk\"\r\n                        style=\"display: none;\">*<\/span><\/label>\r\n                <span class=\"error-message\" id=\"error-message\"><\/span>\r\n                <!-- END: MODIFIED -->\r\n            <\/div>\r\n\r\n            <div class=\"form-row privacy-row\" id=\"privacy-row\">\r\n                <input type=\"checkbox\" id=\"privacy\" required class=\"form-checkbox\" value=\"checked\">\r\n                <label for=\"privacy\" class=\"privacy-label\">\r\n                    <span class=\"required-asterisk\">*<\/span> I have read and acknowledged Therap's\r\n                    <a href=\"https:\/\/www.therapservices.net\/privacy-policy\/\" class=\"privacy-link\"\r\n                        target=\"_blank\">Privacy Policy<\/a>.\r\n                <\/label>\r\n                <span class=\"error-message\" id=\"error-privacy\"><\/span>\r\n            <\/div>\r\n\r\n            <div class=\"hidden_form\">\r\n                <form id=\"first-form-web-to-case\"\r\n                    action=\"https:\/\/webto.salesforce.com\/servlet\/servlet.WebToCase?encoding=UTF-8\" method=\"POST\"\r\n                    onsubmit=\"return validateForm2()\">\r\n\r\n                    <input type=hidden name='captcha_settings' id=\"captcha_web_to_case\"\r\n                        value='{\"keyname\":\"TherapReCaptchaNM\",\"fallback\":\"true\",\"orgId\":\"00Di0000000GyrQ\",\"ts\":\"\"}'>\r\n\r\n                    <input type=hidden name=\"orgid\" value=\"00Di0000000GyrQ\">\r\n                    <input type=hidden name=\"retURL\"\r\n                        value=\"https:\/\/www.therapservices.net\/thankyou\/landing-page-thank-you.php\">\r\n\r\n                    <input id=\"00N0H00000JoJtu\" maxlength=\"255\" name=\"00N0H00000JoJtu\" size=\"20\" type=\"hidden\"\r\n                        value=\"Contact Us - Request Form\" \/>\r\n                    <input id=\"subject\" maxlength=\"80\" name=\"subject\" size=\"20\" type=\"hidden\"\r\n                        value=\"Contact Us - Request Form\" \/>\r\n\r\n                    <input id=\"00N0H00000JoJtw\" maxlength=\"255\" name=\"00N0H00000JoJtw\" size=\"20\" value=\"ND\"\r\n                        type=\"hidden\" \/>\r\n\r\n                    <label for=\"wc-name\" style=\"display: none;\">Name<span class=\"required-star\">*<\/span><\/label>\r\n                    <input id=\"wc-name\" maxlength=\"80\" name=\"name\" size=\"20\" type=\"hidden\" \/>\r\n\r\n                    <input type=\"hidden\" name=\"description\" value='Job Title' \/>\r\n                    <label for=\"wc-title\" style=\"display: none;\">Job Title<span class=\"required-star\">*<\/span><\/label>\r\n                    <input id=\"wc-title\" maxlength=\"100\" name=\"description\" size=\"20\" type=\"hidden\" \/>\r\n\r\n                    <label for=\"wc-company\" style=\"display: none;\">Company<span class=\"required-star\">*<\/span><\/label>\r\n                    <input id=\"wc-company\" maxlength=\"80\" name=\"company\" size=\"20\" type=\"hidden\" \/>\r\n\r\n                    <label for=\"wc-email\" style=\"display: none;\">Email<span class=\"required-star\">*<\/span><\/label>\r\n                    <input id=\"wc-email\" maxlength=\"255\" name=\"email\" size=\"20\" type=\"hidden\" \/>\r\n\r\n                    <label for=\"phone\" style=\"display: none;\">Phone<\/label>\r\n                    <input id=\"phone\" maxlength=\"255\" name=\"phone\" size=\"20\" type=\"hidden\"\r\n                        placeholder=\"For example: xxxxxxxxxx or xxx-xxx-xxxx\" \/>\r\n\r\n                    <input type=\"hidden\" name=\"description\" value=\"You are a:\" \/>\r\n                    <!-- START: ADDED for showOptNew1 logic -->\r\n                    <span id=\"rn1_set\" style=\"display:none;\"><\/span>\r\n                    <!-- END: ADDED -->\r\n                    <div id=\"how-can-assist-you\" style=\"display: none;\">\r\n\r\n                    <\/div>\r\n                    <input type=\"hidden\" name=\"description\"\r\n                        value='Let us know how we can assist you. Please do NOT include any PHI data on this form.:' \/>\r\n                    <label for=\"indicate\" style=\"display: none;\">Let us know how we can assist you.\r\n                        Please do NOT\r\n                        include any PHI data on this form..<span class=\"required-star\">*<\/span><\/label>\r\n                    <input id=\"indicate\" maxlength=\"100\" name=\"description\" size=\"20\" type=\"hidden\" \/>\r\n                    <!-- START: Removed 'required' -->\r\n\r\n                    <!-- <input type=\"hidden\" name=\"hidden\" value=\"Description:\" style=\"display: none;\" \/> -->\r\n                    <!-- <label for=\"comments\" style=\"display: none;\">Description<\/label> -->\r\n                    <input id=\"comments\" name=\"description\" style=\"width:100%\" rows=\"10\" cols=\"50\"\r\n                        type=\"hidden\"><\/input>\r\n\r\n                    <input type=\"hidden\" name=\"description\"\r\n                        value=\" I have read and acknowledged Therap's Privacy Policy.\" \/>\r\n                    <label for=\"wc-privacy\" style=\"display: none;\">I have read and acknowledged\r\n                        Therap's Privacy\r\n                        Policy.<span class=\"required-star\">*<\/span><\/label>\r\n                    <input id=\"wc-privacy\" name=\"description\" size=\"20\" type=\"hidden\" \/>\r\n\r\n                    <input type=\"hidden\" id=\"external\" name=\"external\" value=\"1\" \/>\r\n\r\n                    <!-- START: ADDED hidden input for reCAPTCHA token -->\r\n                    <input type=\"hidden\" id=\"case-recaptcha-response\" name=\"g-recaptcha-response\" value=\"\">\r\n                    <!-- END: ADDED hidden input -->\r\n\r\n                    <label for=\"g-recaptcha-response\" title=\"\" style=\"display:none\">label<\/label>\r\n                    <!-- REMOVED: Old reCAPTCHA div\r\n                    <div id=\"g-recaptcha-1\" class=\"g-recaptcha\" data-sitekey=\"6LcS0L8bAAAAAAYp12xb0iAv0o2OHrMqx-vhd-Rj\"><\/div>\r\n                    -->\r\n\r\n                    <input id=\"submit-case\" type=\"submit\" class=\"submit-btn submit-button\" value=\"Submit\"\r\n                        name=\"submitButtonCase\">\r\n\r\n                <\/form>\r\n                <form id=\"second-form-web-to-lead\"\r\n                    action=\"https:\/\/webto.salesforce.com\/servlet\/servlet.WebToLead?encoding=UTF-8&orgId=00Di0000000GyrQ\"\r\n                    method=\"POST\" onsubmit=\"return validateForm()\">\r\n\r\n                    <input type=hidden name='captcha_settings' id=\"captcha_web_to_load\"\r\n                        value='{\"keyname\":\"TherapReCaptchaNM\",\"fallback\":\"true\",\"orgId\":\"00Di0000000GyrQ\",\"ts\":\"\"}'>\r\n\r\n                    <input type=hidden name=\"oid\" value=\"00Di0000000GyrQ\">\r\n                    <input type=hidden name=\"retURL\"\r\n                        value=\"https:\/\/www.therapservices.net\/thankyou\/landing-page-thank-you.php\">\r\n\r\n                    <!-- Referer -->\r\n                    <label for=\"00N0H00000K4t5R\" style=\"display:none\">Referrer:<\/label>\r\n                    <input id=\"00N0H00000K4t5R\" maxlength=\"255\" name=\"00N0H00000K4t5R\" size=\"20\" type=\"hidden\"\r\n                        value=\"\" \/>\r\n\r\n                    <label for=\"first_name\" style=\"display:none\">First Name<span class=\"required-star\">*<\/span><\/label>\r\n                    <input id=\"first_name\" maxlength=\"40\" name=\"first_name\" size=\"20\" type=\"hidden\" \/>\r\n                    <!-- START: Removed 'required' -->\r\n\r\n                    <label for=\"last_name\" style=\"display:none\">Last Name<span class=\"required-star\">*<\/span><\/label>\r\n                    <input id=\"last_name\" maxlength=\"80\" name=\"last_name\" size=\"20\" type=\"hidden\" \/>\r\n                    <!-- START: Removed 'required' -->\r\n\r\n                    <label for=\"title\" style=\"display:none\">Job Title<span class=\"required-star\">*<\/span><\/label>\r\n                    <input id=\"title\" maxlength=\"100\" name=\"title\" size=\"20\" type=\"hidden\" \/>\r\n                    <!-- START: Removed 'required' -->\r\n\r\n                    <label for=\"company\" style=\"display:none\">Company<span class=\"required-star\">*<\/span><\/label>\r\n                    <input id=\"company\" maxlength=\"80\" name=\"company\" size=\"20\" type=\"hidden\" \/>\r\n                    <!-- START: Removed 'required' -->\r\n\r\n                    <label for=\"email\" style=\"display:none\">Email<span class=\"required-star\">*<\/span><\/label>\r\n                    <input id=\"email\" maxlength=\"80\" name=\"email\" size=\"20\" type=\"hidden\" \/>\r\n                    <!-- START: Removed 'required' -->\r\n\r\n                    <label for=\"phone2\" style=\"display:none\">Phone<\/label>\r\n                    <input id=\"phone2\" maxlength=\"80\" name=\"phone\" size=\"20\" type=\"hidden\"\r\n                        placeholder=\"For example: xxxxxxxxxx or xxx-xxx-xxxx\" \/>\r\n                    <input id=\"00NVs00000JawpJ\" name=\"00NVs00000JawpJ\" size=\"20\" type=\"hidden\" value=\"\" \/>\r\n                    <fieldset style=\"padding:0px;margin-top:0px;margin-bottom:0px;border:none\">\r\n                        <span class=\"radio-label\" style=\"display: none;\">\r\n                            You are a:\r\n                            <span class=\"required-star\">*<\/span>\r\n                        <\/span>\r\n                        <label style=\"margin-top:0;margin-bottom: 5px; display: none;\" for=\"wl_radio_n_1\">\r\n                            <input class=\"radio-btn\" id=\"wl_radio_n_1\" name=\"00N0H00000K4t5W\" type=\"radio\"\r\n                                value=\"Therap User\" \/>\r\n                            <!-- START: Removed 'required' -->\r\n                            <span class=\"radio_text\">Existing Therap User<\/span>\r\n                        <\/label>\r\n                        <label style=\"margin-top:0;margin-bottom: 18px; display: none;\" for=\"wl_radio_n_2\">\r\n                            <input class=\"radio-btn\" id=\"wl_radio_n_2\" name=\"00N0H00000K4t5W\" type=\"radio\"\r\n                                value=\"Potential Therap User\" \/>\r\n                            <span class=\"radio_text\">Potential Therap Customer<\/span>\r\n                        <\/label>\r\n                    <\/fieldset>\r\n\r\n                    <input id=\"state\" maxlength=\"80\" name=\"state\" size=\"20\" type=\"hidden\" value=\"\" \/>\r\n\r\n                    <div id=\"zip_box\" style=\"display:none\">\r\n                        <label for=\"zip\" style=\"display:none\">Zip<span class=\"required-star\">*<\/span><\/label>\r\n                        <input id=\"zip\" maxlength=\"40\" name=\"zip\" size=\"20\" type=\"hidden\" \/>\r\n                    <\/div>\r\n\r\n                    <div id=\"county_box\" style=\"display:none\">\r\n                        <label for=\"00N6S00000KKVwo\" style=\"display:none\">County<span\r\n                                class=\"required-star\">*<\/span><\/label>\r\n                        <select id=\"00N6S00000KKVwo\" name=\"00N6S00000KKVwo\" style=\"width:100%\" title=\"County\">\r\n                            <option value=\"\">--None--<\/option>\r\n                            <option value=\"Alameda\">Alameda<\/option>\r\n                            <option value=\"Alpine\">Alpine<\/option>\r\n                            <option value=\"Amador\">Amador<\/option>\r\n                            <option value=\"Butte\">Butte<\/option>\r\n                            <option value=\"Calaveras\">Calaveras<\/option>\r\n                            <option value=\"Colusa\">Colusa<\/option>\r\n                            <option value=\"Contra Costa\">Contra Costa<\/option>\r\n                            <option value=\"Del Norte\">Del Norte<\/option>\r\n                            <option value=\"El Dorado\">El Dorado<\/option>\r\n                            <option value=\"Fresno\">Fresno<\/option>\r\n                            <option value=\"Glenn\">Glenn<\/option>\r\n                            <option value=\"Humboldt\">Humboldt<\/option>\r\n                            <option value=\"Imperial\">Imperial<\/option>\r\n                            <option value=\"Inyo\">Inyo<\/option>\r\n                            <option value=\"Kern\">Kern<\/option>\r\n                            <option value=\"Kings\">Kings<\/option>\r\n                            <option value=\"Lake\">Lake<\/option>\r\n                            <option value=\"Lassen\">Lassen<\/option>\r\n                            <option value=\"Los Angeles\">Los Angeles<\/option>\r\n                            <option value=\"Madera\">Madera<\/option>\r\n                            <option value=\"Marin\">Marin<\/option>\r\n                            <option value=\"Mariposa\">Mariposa<\/option>\r\n                            <option value=\"Mendocino\">Mendocino<\/option>\r\n                            <option value=\"Merced\">Merced<\/option>\r\n                            <option value=\"Modoc\">Modoc<\/option>\r\n                            <option value=\"Mono\">Mono<\/option>\r\n                            <option value=\"Monterey\">Monterey<\/option>\r\n                            <option value=\"Napa\">Napa<\/option>\r\n                            <option value=\"Nevada\">Nevada<\/option>\r\n                            <option value=\"Orange\">Orange<\/option>\r\n                            <option value=\"Placer\">Placer<\/option>\r\n                            <option value=\"Plumas\">Plumas<\/option>\r\n                            <option value=\"Riverside\">Riverside<\/option>\r\n                            <option value=\"Sacramento\">Sacramento<\/option>\r\n                            <option value=\"San Benito\">San Benito<\/option>\r\n                            <option value=\"San Bernardino\">San Bernardino<\/option>\r\n                            <option value=\"San Diego\">San Diego<\/option>\r\n                            <option value=\"San Francisco\">San Francisco<\/option>\r\n                            <option value=\"San Joaquin\">San Joaquin<\/option>\r\n                            <option value=\"San Luis Obispo\">San Luis Obispo<\/option>\r\n                            <option value=\"San Mateo\">San Mateo<\/option>\r\n                            <option value=\"Santa Barbara\">Santa Barbara<\/option>\r\n                            <option value=\"Santa Clara\">Santa Clara<\/option>\r\n                            <option value=\"Santa Cruz\">Santa Cruz<\/option>\r\n                            <option value=\"Shasta\">Shasta<\/option>\r\n                            <option value=\"Sierra\">Sierra<\/option>\r\n                            <option value=\"Siskiyou\">Siskiyou<\/option>\r\n                            <option value=\"Solano\">Solano<\/option>\r\n                            <option value=\"Sonoma\">Sonoma<\/option>\r\n                            <option value=\"Stanislaus\">Stanislaus<\/option>\r\n                            <option value=\"Sutter\">Sutter<\/option>\r\n                            <option value=\"Tehama\">Tehama<\/option>\r\n                            <option value=\"Trinity\">Trinity<\/option>\r\n                            <option value=\"Tulare\">Tulare<\/option>\r\n                            <option value=\"Tuolumne\">Tuolumne<\/option>\r\n                            <option value=\"Ventura\">Ventura<\/option>\r\n                            <option value=\"Yolo\">Yolo<\/option>\r\n                            <option value=\"Yuba\">Yuba<\/option>\r\n                        <\/select>\r\n                    <\/div>\r\n                    <input type=\"hidden\" name=\"description\"\r\n                        value='Please let us know what you are looking to learn more about.:' \/>\r\n                    <input id=\"lead_description\" name=\"description\" type=\"hidden\" \/>\r\n\r\n                    <!-- add hidden field for acknowledgement -->\r\n                    <input type=\"hidden\" id=\"lead-acknowledgement-label\" name=\"description\"\r\n                        value=\"I have read and acknowledged Therap's Privacy Policy.\" \/>\r\n                    <label for=\"lead-acknowledgement\" style=\"display: none;\">I have read and\r\n                        acknowledged Therap's\r\n                        Privacy Policy.<\/label>\r\n                    <input type=\"hidden\" id=\"lead-acknowledgement\" name=\"description\" value=\"\" \/>\r\n                    <!-- END: Added hidden field for acknowledgement -->\r\n                    <!-- START: ADDED hidden input for reCAPTCHA token -->\r\n                    <input type=\"hidden\" id=\"lead-recaptcha-response\" name=\"g-recaptcha-response\" value=\"\">\r\n                    <!-- END: ADDED hidden input -->\r\n\r\n                    <label for=\"g-recaptcha-response-1\" title=\"\" style=\"display:none\">label<\/label>\r\n                    <!-- REMOVED: Old reCAPTCHA div\r\n                    <div style=\"display: none;\" id=\"g-recaptcha-2\" class=\"g-recaptcha\"><\/div>\r\n                    -->\r\n\r\n                    <input id=\"submit-lead\" type=\"submit\" class=\"submit-btn submit-button\" value=\"Submit\"\r\n                        name=\"submitButtonLead\">\r\n                <\/form>\r\n            <\/div>\r\n\r\n            <!-- START: ADDED new visible reCAPTCHA widget holder -->\r\n            <div class=\"form-row\" id=\"recaptcha-widget\"\r\n                style=\"display: flex; justify-content: center; margin-top: 1.25rem;\">\r\n                <div id=\"visible-recaptcha-widget\"><\/div>\r\n            <\/div>\r\n            <div class=\"form-row\" style=\"text-align: center; margin-top: -1rem; margin-bottom: 1rem;\">\r\n                <span class=\"error-message\" id=\"error-recaptcha\"><\/span>\r\n            <\/div>\r\n            <!-- END: ADDED new visible reCAPTCHA widget holder -->\r\n\r\n            <div class=\"form-row submit-row\">\r\n                <!-- START: MODIFIED - Changed to type=\"button\" to prevent default submit -->\r\n                <button type=\"button\" id=\"main-submit-button\" class=\"submit-button\">\r\n                    <!-- END: MODIFIED -->\r\n                    Submit\r\n                <\/button>\r\n            <\/div>\r\n        <\/div> <!-- END: MODIFIED - Changed form back to div -->\r\n    <\/div>\r\n\r\n    <META HTTP-EQUIV=\"Content-type\" CONTENT=\"text\/html; charset=UTF-8\">\r\n\r\n<\/div>\r\n<!-- START: ADDED new JS for explicit reCAPTCHA rendering -->\r\n<script>\r\n    let recaptchaToken = ''; \/\/ Global variable to store the token\r\n    let recaptchaWidgetId; \/\/ To store the ID of the rendered widget\r\n    \/**\r\n     * This is called by the api.js script tag once it's loaded\r\n     *\/\r\n    function onRecaptchaLoad() {\r\n        \/\/ Render the new visible widget\r\n        if (document.getElementById('visible-recaptcha-widget')) {\r\n            recaptchaWidgetId = grecaptcha.render('visible-recaptcha-widget', {\r\n                'sitekey': '6LekGeIZAAAAAJXBg-y-JcCQPjFDXFJnXUQDZ17F', \/\/ Your sitekey\r\n                'callback': onRecaptchaSuccess\r\n            });\r\n        }\r\n    }\r\n    \/**\r\n     * This is called by reCAPTCHA when the user successfully solves it\r\n     *\/\r\n    function onRecaptchaSuccess(token) {\r\n        recaptchaToken = token;\r\n        \/\/ Automatically populate the hidden token fields in *both* forms\r\n        const caseResponse = document.getElementById('case-recaptcha-response');\r\n        if (caseResponse) {\r\n            caseResponse.value = token;\r\n        }\r\n        const leadResponse = document.getElementById('lead-recaptcha-response');\r\n        if (leadResponse) {\r\n            leadResponse.value = token;\r\n        }\r\n    }\r\n<\/script>\r\n<!-- END: ADDED new JS -->\r\n\r\n<!-- START: MODIFIED script tag to load reCAPTCHA explicitly -->\r\n<script src=\"https:\/\/www.google.com\/recaptcha\/api.js?onload=onRecaptchaLoad&render=explicit\" async defer><\/script>\r\n<!-- END: MODIFIED script tag -->\r\n\r\n<!-- START: REPLACED timestamp function -->\r\n<script>\r\n    \/**\r\n     * Updates timestamp on captcha_settings hidden inputs for both forms\r\n     * if the reCAPTCHA has not been solved.\r\n     *\/\r\n\r\n    const choicesInstances = {};\r\n    function timestamp() {\r\n        \/\/ Check our new global token variable\r\n        if (recaptchaToken.trim() == \"\") {\r\n            var captchaSettingsInputs = document.getElementsByName(\"captcha_settings\");\r\n            var newTime = JSON.stringify(new Date().getTime());\r\n            \/\/ Loop and update *both* captcha_settings inputs\r\n            captchaSettingsInputs.forEach(function (input) {\r\n                try {\r\n                    var elems = JSON.parse(input.value);\r\n                    elems[\"ts\"] = newTime;\r\n                    input.value = JSON.stringify(elems);\r\n                } catch (e) {\r\n                    \/\/ Silently fail to avoid console spam\r\n                }\r\n            });\r\n        }\r\n    }\r\n    setInterval(timestamp, 500);\r\n    \/\/ <!-- END: REPLACED timestamp function -->\r\n    \/\/ <!-- START: ADDED Validation Functions (Global Scope) -->\r\n    let notificationTimer;\r\n    \/**\r\n     * Shows a non-blocking notification message.\r\n     *\/\r\n    function showNotification(message) {\r\n        const notification = document.getElementById('custom-notification');\r\n        const messageEl = document.getElementById('custom-notification-message');\r\n        if (notification && messageEl) {\r\n            messageEl.textContent = message;\r\n            notification.style.display = 'block';\r\n            \/\/ Clear existing timer\r\n            if (notificationTimer) {\r\n                clearTimeout(notificationTimer);\r\n            }\r\n            \/\/ Hide after 3 seconds\r\n            notificationTimer = setTimeout(() => {\r\n                notification.style.display = 'none';\r\n            }, 3000);\r\n        } else {\r\n            \/\/ Fallback if modal isn't present\r\n            console.warn(message);\r\n        }\r\n    }\r\n    \/**\r\n     * Validates email format.\r\n     *\/\r\n    function validateEmail(email) {\r\n        var re = \/^[A-Z0-9._%-]+@[A-Z0-9.-]+\\.[A-Z]{2,4}$\/i;\r\n        return re.test(email);\r\n    }\r\n\r\n    function validateEmail2(email) {\r\n        var re = \/^[A-Z0-9._%-]+@[A-Z0-9.-]+\\.[A-Z]{2,4}$\/i;\r\n        return re.test(email);\r\n    }\r\n    \/**\r\n     * Validation for the hidden Web-to-Lead form.\r\n     *\/\r\n    function validateForm() {\r\n        var email = document.getElementById(\"email\").value;\r\n        if (email == \"hunterleap@yahoo.com\" || email == \"guthalsp@gmail.com\") {\r\n            \/\/ This will redirect, but the form won't submit to SF\r\n            window.location.href = \"https:\/\/www.therapservices.net\/thankyou\/landing-page-thank-you.php\";\r\n            return false;\r\n        }\r\n        if (email.length > 0) {\r\n            if (!validateEmail(email)) {\r\n                showNotification('Please fill in a valid value for all required fields: Email');\r\n                return false;\r\n            }\r\n        }\r\n        \/\/ Check our global reCAPTCHA token\r\n        if (recaptchaToken.length == 0) {\r\n            showNotification('Please Select : \"I\\'m not a robot\"');\r\n            return false;\r\n        }\r\n        var phone = document.getElementById(\"phone2\").value;\r\n        if (email == \"mhollins1@gmail.com\" || email == \"mhollins1@gamil.com\" || email ==\r\n            \"shawntae917@gmail.com\" || phone == \"(402) 429-2587\" || phone == \"(308) 999-0109\") {\r\n            showNotification('You have already submitted the form.');\r\n            return false;\r\n        }\r\n        \/\/ Phone regex check removed, as iti.js handles validation before syncing.\r\n        localStorage.setItem(\"gtag_user_email\", email);\r\n        return true;\r\n    }\r\n    \/**\r\n     * Validation for the hidden Web-to-Case form.\r\n     *\/\r\n    function validateForm2() {\r\n        var email = document.getElementById(\"wc-email\").value;\r\n        if (email == \"hunterleap@yahoo.com\") {\r\n            \/\/ This will redirect, but the form won't submit to SF\r\n            window.location.href = \"https:\/\/www.therapservices.net\/thankyou\/landing-page-thank-you.php\";\r\n            return false;\r\n        }\r\n        if (!validateEmail2(email)) {\r\n            showNotification('Please fill in a valid value for all required fields: Email');\r\n            return false;\r\n        }\r\n        \/\/ Check our global reCAPTCHA token\r\n        if (recaptchaToken.length == 0) {\r\n            showNotification('Please Select : \"I\\'m not a robot\"');\r\n            return false;\r\n        }\r\n        var phone = document.getElementById(\"phone\").value;\r\n        if (email == \"mhollins1@gmail.com\" || email == \"mhollins1@gamil.com\" || email ==\r\n            \"shawntae917@gmail.com\" || phone == \"(402) 429-2587\" || phone == \"(308) 999-0109\") {\r\n            showNotification('You have already submitted the form.');\r\n            return false;\r\n        }\r\n        \/\/ Phone regex check removed.\r\n        localStorage.setItem(\"gtag_user_email\", email);\r\n        return true;\r\n    }\r\n    \/\/ <!-- END: ADDED Validation Functions -->\r\n    \/\/ Initialize intl-tel-input\r\n    const phoneInput = document.querySelector(\"#init_phone\");\r\n    const iti = window.intlTelInput(phoneInput, {\r\n        utilsScript: \"https:\/\/therapservices.net\/jslib\/contact-form\/utils.js\",\r\n        initialCountry: \"us\",\r\n        separateDialCode: true,\r\n        placeholderNumberType: \"MOBILE\",\r\n        \/\/                             customPlaceholder: function (selectedCountryPlaceholder, selectedCountryData) {\r\n        \/\/ This function forces the placeholder to your desired format\r\n        \/\/                                 return \"01-555-012\";\r\n        \/\/ }\r\n    });\r\n    if (phoneInput) {\r\n        phoneInput.addEventListener('input', function (event) {\r\n            const currentValue = event.target.value;\r\n            \/\/ FIX: This regex now allows digits, plus signs, and hyphens\r\n            const allowedValue = currentValue.replace(\/[^0-9-]\/g, ''); \/\/ <-- CORRECT\r\n\r\n            if (currentValue !== allowedValue) {\r\n                event.target.value = allowedValue;\r\n            }\r\n        });\r\n    }\r\n    \/\/ START: MODIFIED - Added full form logic\r\n    const caseOnlyStates = ['AL', 'DE', 'GA', 'KY', 'NE', 'NV', 'NM', 'ND', 'RI', 'SC', 'SD', 'TN', 'PR']; \/\/ Added OK\r\n    \/**\r\n     * Syncs values from visible form to hidden forms\r\n     *\/\r\n    function syncFormFields() {\r\n        \/\/ Text inputs\r\n        const inputsToSync = [{\r\n            visible: 'init_firstName',\r\n            lead: 'first_name',\r\n            case: null\r\n        },\r\n        {\r\n            visible: 'init_lastName',\r\n            lead: 'last_name',\r\n            case: null\r\n        },\r\n        {\r\n            visible: 'init_email',\r\n            lead: 'email',\r\n            case: 'wc-email'\r\n        },\r\n        {\r\n            visible: 'init_company',\r\n            lead: 'company',\r\n            case: 'wc-company'\r\n        },\r\n        {\r\n            visible: 'init_jobTitle',\r\n            lead: 'title',\r\n            case: 'wc-title'\r\n        },\r\n        {\r\n            visible: 'init_message',\r\n            lead: 'lead_description',\r\n            case: 'comments'\r\n        },\r\n        {\r\n            visible: 'init_zip',\r\n            lead: 'zip',\r\n            case: null\r\n        } \/\/ Added Zip\r\n            , {\r\n            visible: 'privacy',\r\n            lead: 'lead-acknowledgement',\r\n            case: 'wc-privacy'\r\n        }\r\n        ];\r\n        inputsToSync.forEach(map => {\r\n            const visibleEl = document.getElementById(map.visible);\r\n            if (!visibleEl) return;\r\n            \/\/ Use 'input' event for more responsive syncing\r\n            visibleEl.addEventListener('input', (e) => {\r\n                const value = e.target.value;\r\n                if (map.lead) {\r\n                    const leadEl = document.getElementById(map.lead);\r\n                    if (leadEl) leadEl.value = value;\r\n                }\r\n                if (map.case) {\r\n                    const caseEl = document.getElementById(map.case);\r\n                    if (caseEl) caseEl.value = value;\r\n                }\r\n            });\r\n        });\r\n        \/\/ Full Name (Case only)\r\n        const syncFullName = () => {\r\n            const first = document.getElementById('init_firstName').value;\r\n            const last = document.getElementById('init_lastName').value;\r\n            const wcName = document.getElementById('wc-name');\r\n            if (wcName) {\r\n                wcName.value = `${first} ${last}`;\r\n            }\r\n        };\r\n        document.getElementById('init_firstName').addEventListener('input', syncFullName);\r\n        document.getElementById('init_lastName').addEventListener('input', syncFullName);\r\n        \/\/ Phone (Both forms)\r\n        const syncPhone = () => {\r\n            \/\/ Get the full international number from the 'iti' instance\r\n            const fullPhoneNumber = phoneInput.value; \/\/ <-- This gets the number with country code\r\n            \/\/ remove plus sign\r\n            const sanitizedPhoneNumber = fullPhoneNumber.replace(\/^\\+\/, '');\r\n            const leadPhone = document.getElementById('phone2');\r\n            const casePhone = document.getElementById('phone');\r\n\r\n            \/\/ Sync the full international number to the hidden forms\r\n            if (leadPhone) leadPhone.value = sanitizedPhoneNumber;\r\n            if (casePhone) casePhone.value = sanitizedPhoneNumber;\r\n        };\r\n        phoneInput.addEventListener('input', syncPhone);\r\n        phoneInput.addEventListener('countrychange', syncPhone);\r\n        \/\/ Selects\r\n        const selectsToSync = [{\r\n            visible: 'init_individuals',\r\n            lead: '00NVs00000JawpJ',\r\n            case: 'null'\r\n        },\r\n        \/\/ State is handled separately\r\n        {\r\n            visible: 'init_county',\r\n            lead: '00N6S00000KKVwo',\r\n            case: null\r\n        }\r\n        ];\r\n        selectsToSync.forEach(map => {\r\n            const visibleEl = document.getElementById(map.visible);\r\n            if (!visibleEl) return;\r\n            visibleEl.addEventListener('change', (e) => {\r\n                const value = e.target.value;\r\n                if (map.lead) {\r\n                    const leadEl = document.getElementById(map.lead);\r\n                    if (leadEl) leadEl.value = value;\r\n                }\r\n                if (map.case) {\r\n                    const caseEl = document.getElementById(map.case);\r\n                    if (caseEl) caseEl.value = value;\r\n                }\r\n            });\r\n        });\r\n        \/\/ State Select (Special handling)\r\n        \/\/ State Select (Special handling)\r\n        const initStateSelect = document.getElementById('init_state');\r\n        if (initStateSelect) {\r\n            initStateSelect.addEventListener('change', (e) => {\r\n                const value = e.target.value;\r\n\r\n                \/\/ Get the full state name (the visible text)\r\n                const fullStateName = e.target.options[e.target.selectedIndex].text;\r\n\r\n                \/\/ Sync the ABBREVIATION to the Lead form (Required for Lead field)\r\n                const leadState = document.getElementById('state');\r\n                if (leadState) leadState.value = value;\r\n\r\n                \/\/ Sync the FULL STATE NAME to the Case form (Your requested change)\r\n                const caseState = document.getElementById('00N0H00000JoJtw');\r\n                if (caseState) caseState.value = fullStateName; \/\/ <--- MODIFIED to use fullStateName\r\n\r\n                if (leadState.value == \"Guam\") {\r\n                    leadState.value = \"GU\";\r\n                }\r\n\r\n                \/\/ Trigger conditional field updates\r\n                updateConditionalFields();\r\n                updateMessageRequirement();\r\n                updateIndividualsFieldVisibility();\r\n                logSubmissionType();\r\n            });\r\n        }\r\n        \/\/ Therap User (Special handling for both forms)\r\n        const therapUserSelect = document.getElementById('init_therapUser');\r\n        const assistSelect = document.getElementById('init_assistance');\r\n        const initIndividuals = document.getElementById('init_individuals');\r\n        if (therapUserSelect) {\r\n            const troubleLoginInfo = document.getElementById('trouble-login-info'); \/\/ <-- ADD THIS LINE\r\n            const messageRow = document.getElementById('message-row'); \/\/ NEW LINE\r\n            const assistRow2 = document.getElementById('how-can-we-assist-you-row'); \/\/ NEW LINE\r\n            const privacyRow = document.getElementById('privacy-row'); \/\/ NEW LINE\r\n            const recaptchaRow = document.getElementById('recaptcha-widget'); \/\/ NEW LINE\r\n            const howCanAssistYou = document.getElementById('how-can-assist-you'); \/\/ NEW LINE\r\n\r\n            therapUserSelect.addEventListener('change', (e) => {\r\n                const value = e.target.value;\r\n                \/\/ 1. Sync to Lead form radios\r\n                const radioYes = document.getElementById('wl_radio_n_1');\r\n                const radioNo = document.getElementById('wl_radio_n_2');\r\n                var stateValue = document.getElementById('init_state').value;\r\n                howCanAssistYou.innerHTML = '';\r\n                mainSubmitButton.style.display = 'block';\r\n                troubleLoginInfo.style.display = 'none';\r\n                recaptchaRow.style.display = 'flex';\r\n                privacyRow.style.display = 'flex';\r\n                document.getElementById('county_row').style.display = 'none';\r\n                initIndividuals.selectedIndex = 0;\r\n                assistSelect.selectedIndex = 0;\r\n                if (stateValue === 'CA' && (assistSelect.selectedIndex != 2)) {\r\n                    document.getElementById('county_row').style.display = 'block';\r\n                    if (choicesInstances['init_county']) {\r\n                        choicesInstances['init_county'].enable();\r\n                        choicesInstances['init_county'].setChoiceByValue('', true);\r\n                    }\r\n                }\r\n                if (choicesInstances['init_assistance']) {\r\n                    choicesInstances['init_assistance'].enable();\r\n                    choicesInstances['init_assistance'].setChoiceByValue('', true);\r\n                }\r\n                if (choicesInstances['init_individuals']) {\r\n                    choicesInstances['init_individuals'].enable();\r\n                    choicesInstances['init_individuals'].setChoiceByValue('', true);\r\n                }\r\n                updateIndividualsFieldVisibility();\r\n                if (radioYes && radioNo) {\r\n                    if (value === 'Current Therap User') {\r\n                        radioYes.checked = true;\r\n                        assistRow2.style.display = 'block';\r\n                        messageRow.style.display = 'none'; \/\/ NEW LINE\t\t\t\t\t\t\r\n                    } else {\r\n                        radioNo.checked = true;\r\n                        assistRow2.style.display = 'none';\r\n                        messageRow.style.display = 'block'; \/\/ NEW LINE\r\n                    }\r\n                }\r\n                \/\/ 2. Sync to Case form hidden description (replaces showOptNew1)\r\n                const rn1Set = document.getElementById(\"rn1_set\");\r\n                if (rn1Set) {\r\n                    const descValue = (value === 'Current Therap User' ? 'Current Therap User' : 'Potential Therap User');\r\n                    rn1Set.innerHTML = '<input type=\"hidden\" value=\"' + descValue +\r\n                        '\" name=\"description\" \/>';\r\n                }\r\n                if (troubleLoginInfo) {\r\n                    \/\/ messageRow.style.display = 'block'; \/\/ NEW LINE\r\n                    if (value === 'Current Therap User') {\r\n                        \/\/ troubleLoginInfo.style.display = 'block';\r\n\r\n                    } else {\r\n                        \/\/ troubleLoginInfo.style.display = 'none';\r\n                    }\r\n\r\n                    if (value === \"\") {\r\n                        messageRow.style.display = 'none'; \/\/ NEW LINE\r\n                    }\r\n                }\r\n                updateMessageRequirement();\r\n                updateIndividualsFieldVisibility();\r\n                logSubmissionType();\r\n            });\r\n            assistSelect.addEventListener('change', (e) => {\r\n                const value = e.target.value;\r\n                var stateValue = document.getElementById('init_state').value;\r\n                if (assistSelect.selectedIndex == 0) {\r\n                    troubleLoginInfo.style.display = 'none';\r\n                    if (stateValue === 'CA') {\r\n                        document.getElementById('county_row').style.display = 'block';\r\n                    }\r\n                }\r\n                if (assistSelect.selectedIndex == 1) {\r\n\r\n                    if (stateValue === 'CA') {\r\n                        document.getElementById('county_row').style.display = 'none';\r\n                    }\r\n                }\r\n                \/\/ assistSelect.selectedIndex = 0;\r\n                \/\/ Sync to Case form hidden subject\r\n                if (value == \"Other\") {\r\n                    if (stateValue === 'CA') {\r\n                        document.getElementById('county_row').style.display = 'block';\r\n                    }\r\n                    messageRow.style.display = 'block'; \/\/ NEW LINE\r\n                    \/\/ main-submit-button hide\r\n                    mainSubmitButton.style.display = 'block';\r\n                    troubleLoginInfo.style.display = 'none';\r\n                    recaptchaRow.style.display = 'flex';\r\n                    privacyRow.style.display = 'flex';\r\n                    $(\"#message-row label[for='init_message']\").html(`Let us know how we can assist you. Please do NOT include any PHI data on this form. <span id=\"message-required-asterisk\" class=\"required-asterisk\">*<\/span>`);\r\n                    howCanAssistYou.innerHTML = '<input type=\"hidden\" value=\"How can we assist you?\"> <input type=\"hidden\" value=\"' + value +\r\n                        '\" name=\"description\" \/>';\r\n\r\n                } else {\r\n                    troubleLoginInfo.style.display = 'block';\r\n                    mainSubmitButton.style.display = 'none';\r\n                    messageRow.style.display = 'none'; \/\/ NEW LINE\r\n                    recaptchaRow.style.display = 'none';\r\n                    privacyRow.style.display = 'none';\r\n                    $(\"#message-row label[for='init_message']\").html(`Let us know how we can assist you. Please do NOT include any PHI data on this form. <span id=\"message-required-asterisk\" class=\"required-asterisk\">*<\/span>`);\r\n                    howCanAssistYou.innerHTML = '<input type=\"hidden\" value=\"How can we assist you?\"> <input type=\"hidden\" value=\"' + value +\r\n                        '\" name=\"description\" \/>';\r\n                    \/\/ messageRow label text will be Let us know how we can assist you. Please do NOT include any PHI data on this form.\r\n                    \/\/ messageRow.querySelector('label[for=\"init_message\"]').textContent = 'Let us know how we can assist you. Please do NOT include any PHI data on this form.';\r\n                    \/\/$(\"#message-row label[for='init_message']\").text('Let us know how we can assist you. Please do NOT include any PHI data on this form.');\r\n                    document.querySelectorAll(\".has-error\").forEach(e => e.classList.remove(\"has-error\"));\r\n                    document.querySelectorAll(\".error-message\").forEach(e => e.removeAttribute(\"style\"));\r\n                }\r\n                updateMessageRequirement();\r\n            });\r\n\r\n        }\r\n    }\r\n    \/**\r\n     * Updates visibility of County (CA) and Zip (NY) fields\r\n     *\/\r\n    function updateIndividualsFieldVisibility() {\r\n        const stateValue = document.getElementById('init_state').value;\r\n        const isTherapUser = document.getElementById('init_therapUser').value;\r\n        const individualsRow = document.getElementById('how-many-individuals-row');\r\n        const assistRow = document.getElementById('how-can-we-assist-you-row');\r\n        if (!individualsRow) return; \/\/ Safety check\r\n        if (!isTherapUser) return;\r\n\r\n        if (caseOnlyStates.includes(stateValue) || isTherapUser === 'Current Therap User') {\r\n            \/\/ This is a Web-to-Case submission, so HIDE it\r\n            individualsRow.style.display = 'none';\r\n        } else {\r\n            \/\/ This is a Web-to-Lead submission, so SHOW it\r\n            individualsRow.style.display = 'block';\r\n        }\r\n    }\r\n    function updateConditionalFields() {\r\n        const stateValue = document.getElementById('init_state').value;\r\n        const countyRow = document.getElementById('county_row');\r\n        const countySelect = document.getElementById('init_county');\r\n        const zipRow = document.getElementById('zip_row');\r\n        const zipInput = document.getElementById('init_zip');\r\n        \/\/ Handle County (CA)\r\n        if (stateValue === 'CA') {\r\n\r\n            if (document.getElementById(\"init_therapUser\").value == \"Current Therap User\") {\r\n                if (document.getElementById(\"init_assistance\").selectedIndex == 1) {\r\n                    countyRow.style.display = 'none';\r\n                    countySelect.required = false;\r\n                } else {\r\n                    countyRow.style.display = 'block';\r\n                    countySelect.required = true;\r\n                }\r\n            } else {\r\n                countyRow.style.display = 'block';\r\n                countySelect.required = true;\r\n            }\r\n        } else {\r\n            countyRow.style.display = 'none';\r\n            countySelect.required = false;\r\n        }\r\n        \/\/ Handle Zip (NY)\r\n        \/\/ if (stateValue === 'NY') {\r\n        \/\/     zipRow.style.display = 'block';\r\n        \/\/     zipInput.required = true;\r\n        \/\/ } else {\r\n        \/\/     zipRow.style.display = 'none';\r\n        \/\/     zipInput.required = false;\r\n        \/\/ }\r\n    }\r\n    \/**\r\n     * Updates 'required' status of Message field based on State\r\n     *\/\r\n    \/**\r\n     * Updates 'required' status AND label text of Message field based on State AND User Type\r\n     *\/\r\n    function updateMessageRequirement() {\r\n        const stateValue = document.getElementById('init_state').value;\r\n        const isTherapUser = document.getElementById('init_therapUser').value;\r\n        const messageTextarea = document.getElementById('init_message');\r\n        const messageAsterisk = document.getElementById('message-required-asterisk');\r\n        \/\/ --- START: Added lines ---\r\n        const messageLabel = document.querySelector('label[for=\"init_message\"]');\r\n        if (!messageLabel) return; \/\/ Exit if label isn't found\r\n        const labelTextNode = messageLabel.firstChild; \/\/ This gets the text part of the label\r\n        \/\/ --- END: Added lines ---\r\n        if (caseOnlyStates.includes(stateValue) || isTherapUser === 'Current Therap User') {\r\n            \/\/ REQUIRED STATE (Case Form Logic)\r\n            messageTextarea.required = true;\r\n            messageAsterisk.style.display = 'inline';\r\n            $(\"#message-row label[for='init_message']\").html(`Let us know how we can assist you. Please do NOT include any PHI data on this form. <span id=\"message-required-asterisk\" class=\"required-asterisk\">*<\/span>`);\r\n            \/\/labelTextNode.textContent = 'Let us know how we can assist you. Please do NOT include any PHI data on this form. '; \/\/ Set original text\r\n        } else {\r\n            \/\/ OPTIONAL STATE (Lead Form Logic)\r\n            messageTextarea.required = false;\r\n            messageAsterisk.style.display = 'none';\r\n            labelTextNode.textContent =\r\n                'Please let us know what you are looking to learn more about '; \/\/ Set new text\r\n        }\r\n    }\r\n    \/**\r\n     * Manually validates all required fields in the visible form.\r\n     *\/\r\n    \/**\r\n     * Manually validates all required fields in the visible form.\r\n     *\/\r\n    \/**\r\n     * Logs the submission type based on current selections.\r\n     *\/\r\n    function showError(fieldKey, message, elementId) {\r\n        const errorEl = document.getElementById('error-' + fieldKey);\r\n        if (errorEl) {\r\n            errorEl.textContent = message;\r\n            errorEl.style.display = 'block';\r\n        }\r\n\r\n        \/\/ Add 'has-error' class to the parent container\r\n        if (elementId) {\r\n            const inputEl = document.getElementById(elementId);\r\n            if (inputEl) {\r\n                \/\/ Find the closest container\r\n                const parentContainer = inputEl.closest('.form-row');\r\n                if (parentContainer) {\r\n                    parentContainer.classList.add('has-error');\r\n                }\r\n            }\r\n        }\r\n    }\r\n\r\n    \/**\r\n     * Hides a specific error message.\r\n     *\/\r\n    function clearError(fieldId) {\r\n        const errorEl = document.getElementById('error-' + fieldId);\r\n        if (errorEl) {\r\n            errorEl.textContent = '';\r\n            errorEl.style.display = 'none';\r\n        }\r\n    }\r\n\r\n    \/**\r\n     * Clears all visible error messages on the form.\r\n     *\/\r\n\r\n    function clearAllErrors() {\r\n        const errorMessages = document.querySelectorAll('.error-message');\r\n        errorMessages.forEach(el => {\r\n            el.textContent = '';\r\n            el.style.display = 'none';\r\n        });\r\n\r\n        \/\/ Remove all 'has-error' classes\r\n        const errorContainers = document.querySelectorAll('.has-error');\r\n        errorContainers.forEach(el => {\r\n            el.classList.remove('has-error');\r\n        });\r\n    }\r\n\r\n    function logSubmissionType() {\r\n        \/\/ We need to read the values *inside* the function so it gets the latest state\r\n        const isTherapUser = document.getElementById('init_therapUser').value;\r\n        const stateValue = document.getElementById('init_state').value;\r\n        \/\/ Check if both fields have a value before logging\r\n        if (stateValue && isTherapUser) {\r\n            if (caseOnlyStates.includes(stateValue)) {\r\n                console.log(\"Submission type will be: Web-to-Case (State rule)\");\r\n            } else if (isTherapUser === 'Current Therap User') {\r\n                console.log(\"Submission type will be: Web-to-Case (Existing user rule)\");\r\n            } else {\r\n                console.log(\"Submission type will be: Web-to-Lead\");\r\n            }\r\n        } else {\r\n            \/\/ This just prevents spamming the console before both are selected\r\n            console.log(\"Submission type: Waiting for both State and User Type selection.\");\r\n        }\r\n    }\r\n    \/**\r\n     * Manually validates all required fields in the visible form\r\n     * and shows inline error messages.\r\n     *\/\r\n    function manualCheckValidity(formElement) {\r\n        clearAllErrors(); \/\/ Start by clearing all errors\r\n        let isValid = true;\r\n        let firstInvalidElement = null;\r\n\r\n        \/\/ --- Define Validation Rules ---\r\n        \/\/ Note: The 'id' is the HTML element ID, 'key' is for the error span ID.\r\n        const fieldsToValidate = [\r\n            { id: 'init_firstName', key: 'firstName', msg: 'Please enter your First Name' },\r\n            { id: 'init_lastName', key: 'lastName', msg: 'Please enter your Last Name' },\r\n            { id: 'init_email', key: 'email', msg: 'Please enter your Work Email', emailMsg: 'Please enter a valid Work Email' },\r\n            { id: 'init_company', key: 'company', msg: 'Please enter your Company Name' },\r\n            { id: 'init_jobTitle', key: 'jobTitle', msg: 'Please enter your Job Title' },\r\n            { id: 'init_therapUser', key: 'therapUser', msg: 'Please select type of user' },\r\n            { id: 'init_state', key: 'state', msg: 'Please select your State\/Territory' },\r\n            { id: 'init_individuals', key: 'individuals', msg: 'Please select the number of Individuals' },\r\n            { id: 'init_county', key: 'county', msg: 'Please select your County' },\r\n            { id: 'init_assistance', key: 'assistance', msg: 'Please select how we can assist you' },\r\n            { id: 'init_message', key: 'message', msg: 'Please tell us how we can assist you' },\r\n            { id: 'privacy', key: 'privacy', msg: 'You must acknowledge the Privacy Policy' }\r\n        ];\r\n\r\n        fieldsToValidate.forEach(field => {\r\n            const el = document.getElementById(field.id);\r\n            if (!el) return; \/\/ Skip if element doesn't exist\r\n\r\n            \/\/ Check if element is required and visible\r\n            const parentContainer = el.closest('.form-row, .form-field, .privacy-row');\r\n            const isVisible = parentContainer && window.getComputedStyle(parentContainer).display !== 'none';\r\n            const isRequired = el.hasAttribute('required');\r\n\r\n            if (isRequired && isVisible) {\r\n                let fieldIsInvalid = false;\r\n\r\n                if (el.type === 'checkbox') {\r\n                    if (!el.checked) {\r\n                        fieldIsInvalid = true;\r\n                        \/\/ *** FIX: Pass field.id as 3rd argument ***\r\n                        showError(field.key, field.msg, field.id);\r\n                    }\r\n                } else {\r\n                    if (el.value.trim() === '') {\r\n                        fieldIsInvalid = true;\r\n                        \/\/ *** FIX: Pass field.id as 3rd argument ***\r\n                        showError(field.key, field.msg, field.id);\r\n                    }\r\n                }\r\n\r\n                \/\/ Special check for Email format\r\n                if (field.id === 'init_email' && !fieldIsInvalid && el.value.trim() !== '') {\r\n                    if (!validateEmail(el.value)) { \/\/ Uses your existing validateEmail function\r\n                        fieldIsInvalid = true;\r\n                        \/\/ *** FIX: Pass field.id as 3rd argument ***\r\n                        showError(field.key, field.emailMsg, field.id);\r\n                    }\r\n                }\r\n\r\n                if (fieldIsInvalid) {\r\n                    isValid = false;\r\n                    if (!firstInvalidElement) {\r\n                        firstInvalidElement = el; \/\/ Store first invalid element to focus\r\n                    }\r\n                }\r\n            }\r\n        });\r\n\r\n        \/\/ --- Phone Validation (Not required, but check format if filled) ---\r\n        const phoneVal = phoneInput.value.trim();\r\n        if (phoneVal !== '') {\r\n            \/\/ Regex: Allows only digits, or digits separated by a hyphen.\r\n            \/\/ ^\\d+    = Must start with one or more digits\r\n            \/\/ (-\\d+)* = Can be followed by zero or more groups of (hyphen + digits)\r\n            \/\/ $       = Must match until the end of the string\r\n            const phoneRegex = \/^\\d{3}-\\d{3}-\\d{4}$|^\\d{10}$\/;\r\n\r\n            if (!phoneRegex.test(phoneVal)) {\r\n                isValid = false;\r\n                \/\/ Updated error message to match the new rule\r\n                showError('phone', 'Please enter a valid phone number', 'init_phone');\r\n                if (!firstInvalidElement) {\r\n                    firstInvalidElement = phoneInput;\r\n                }\r\n            }\r\n        }\r\n\r\n        \/\/ --- reCAPTCHA Validation ---\r\n        if (recaptchaToken.length == 0) {\r\n            isValid = false;\r\n            \/\/ *** FIX: Pass null as 3rd argument ***\r\n            showError('recaptcha', 'Please Select : \"I\\'m not a robot\"', null);\r\n        }\r\n\r\n        \/\/ --- Focus first invalid element ---\r\n        if (firstInvalidElement) {\r\n            \/\/ Check if it's a Choices.js select\r\n            const choicesContainer = firstInvalidElement.closest('.form-field, .form-row')?.querySelector('.choices');\r\n            if (choicesContainer) {\r\n                choicesContainer.focus();\r\n            } else {\r\n                firstInvalidElement.focus();\r\n            }\r\n        }\r\n\r\n        return isValid; \/\/ All checks passed!\r\n    }\r\n    \/\/ Handle main submit button click\r\n    const mainSubmitButton = document.getElementById('main-submit-button');\r\n    if (mainSubmitButton) {\r\n        mainSubmitButton.addEventListener('click', function (e) {\r\n            const mainForm = document.getElementById('contactForm');\r\n            \/\/ Manually trigger validation\r\n            if (manualCheckValidity(mainForm)) {\r\n                const isTherapUser = document.getElementById('init_therapUser').value;\r\n                const stateValue = document.getElementById('init_state').value;\r\n                \/\/ --- SUBMISSION LOGIC ---\r\n                if (caseOnlyStates.includes(stateValue)) {\r\n                    console.log(\"Submitting 'Web to Case' form for specific state...\");\r\n                    document.getElementById('first-form-web-to-case').submit();\r\n                } else if (isTherapUser === 'Current Therap User') {\r\n                    console.log(\"Submitting 'Web to Case' form for existing user...\");\r\n                    document.getElementById('first-form-web-to-case').submit();\r\n                } else {\r\n                    console.log(\"Submitting 'Web to Lead' form for new user...\");\r\n                    document.getElementById('second-form-web-to-lead').submit();\r\n                }\r\n                \/\/ --- END OF SUBMISSION LOGIC ---\r\n            } else {\r\n                \/\/ Validation failed, manualCheckValidity already showed the error.\r\n                console.log('Form is invalid.');\r\n            }\r\n        });\r\n    }\r\n    document.addEventListener('DOMContentLoaded', function () {\r\n        \/\/ Set referrer for lead form\r\n        try {\r\n            document.getElementById(\"00N0H00000K4t5R\").value = document.URL;\r\n        } catch (e) { }\r\n        \/\/ Keep track of Choices instances\r\n        const selectsToStyle = document.querySelectorAll(\r\n            '#init_individuals, #init_therapUser, #init_state, #init_county, #init_assistance');\r\n        selectsToStyle.forEach(select => {\r\n            \/\/ Store the instance using the select's ID as the key\r\n            choicesInstances[select.id] = new Choices(select, {\r\n                searchEnabled: false,\r\n                itemSelectText: 'Select',\r\n                shouldSort: false,\r\n            });\r\n        });\r\n        \/\/ This jQuery-like selector ($) won't work without jQuery.\r\n        \/\/ Let's rewrite it in plain JavaScript.\r\n        try {\r\n            const initPhoneInput = document.getElementById(\"init_phone\");\r\n            if (initPhoneInput) {\r\n                \/\/ Get computed style\r\n                const style = window.getComputedStyle(initPhoneInput);\r\n                var padding = style.getPropertyValue('padding-left');\r\n                \/\/ Parse it to an integer and add 10\r\n                var newPadding = parseInt(padding, 10) + 10;\r\n                \/\/ Apply the new value\r\n                const phoneLabel = document.querySelector(\".custom-form .iti+.form-label\");\r\n                if (phoneLabel) {\r\n                    phoneLabel.style.left = newPadding + \"px\";\r\n                }\r\n            }\r\n        } catch (e) {\r\n            console.warn(\"Could not set phone label position:\", e);\r\n        }\r\n        \/\/ Add real-time validation listeners\r\n        const allFormFields = document.querySelectorAll(\r\n            '#init_firstName, #init_lastName, #init_email, #init_company, #init_jobTitle, #init_therapUser, #init_state, #init_individuals, #init_county, #init_assistance, #init_message, #privacy'\r\n        );\r\n\r\n        allFormFields.forEach(field => {\r\n            field.addEventListener(field.tagName === 'SELECT' ? 'change' : 'input', (e) => {\r\n                \/\/ Determine the most specific container to control the error style (form-field or form-row)\r\n                let container = e.target.closest('.form-field, .privacy-row');\r\n                if (!container && e.target.id === 'init_message') {\r\n                    container = e.target.closest('.form-row.message-row');\r\n                }\r\n\r\n                \/\/ 1. Clear the specific error message\r\n                const errorKey = e.target.id.replace('init_', ''); \/\/ e.g., 'init_firstName' -> 'firstName'\r\n                clearError(errorKey); \/\/ This function just hides the error message span\r\n\r\n                \/\/ 2. Re-run a detailed validation check for the current field only\r\n                let isFieldValid = true;\r\n\r\n                \/\/ Check if the element should be considered \"filled\"\r\n                const isFilled = e.target.value.trim() !== '' || (e.target.type === 'checkbox' && e.target.checked);\r\n\r\n                if (e.target.hasAttribute('required') && !isFilled) {\r\n                    isFieldValid = false;\r\n                }\r\n                \/\/ Special email format check\r\n                else if (e.target.id === 'init_email' && isFilled && !validateEmail(e.target.value)) {\r\n                    isFieldValid = false;\r\n                }\r\n\r\n                if (isFieldValid) {\r\n                    if (container) {\r\n                        \/\/ Only remove the error class from this field's immediate container\r\n                        container.classList.remove('has-error');\r\n                    }\r\n                } else {\r\n                    \/\/ If it's still invalid, show the error again and ensure the class stays on the container\r\n                    \/\/ Note: You would normally call showError here, but we only want to clear on input.\r\n                    \/\/ For now, let's focus on clearing the class correctly.\r\n                }\r\n            });\r\n        });\r\n        \/\/ Select all text inputs and textareas\r\n        const inputs = document.querySelectorAll(\r\n            '.form-input, .form-textarea'\r\n        );\r\n        inputs.forEach(input => {\r\n            \/\/ 1. Add blank placeholder.\r\n            input.placeholder = ' ';\r\n            \/\/ 2. Fallback for older browsers\r\n            function checkValue() {\r\n                if (input.value) {\r\n                    input.classList.add('has-value');\r\n                } else {\r\n                    input.classList.remove('has-value');\r\n                }\r\n            }\r\n            input.addEventListener('blur', checkValue);\r\n            \/\/ 3. Check on load in case of browser autofill\r\n            checkValue();\r\n        });\r\n        \/\/ Add change listener to selects for the same JS fallback (if needed)\r\n        const selects = document.querySelectorAll('.form-select');\r\n        const mainForm = document.getElementById('contactForm');\r\n        if (mainForm) {\r\n            mainForm.addEventListener('reset', function () {\r\n                \/\/ On reset, the :valid state might not update, so we force it\r\n                selects.forEach(select => {\r\n                    select.classList.remove('has-value');\r\n                    \/\/ Reset Choices.js instance\r\n                    const choice = choicesInstances[select.id];\r\n                    if (choice) {\r\n                        choice.setChoiceByValue('');\r\n                    }\r\n                });\r\n                \/\/ Also reset the reCAPTCHA\r\n                try {\r\n                    grecaptcha.reset(recaptchaWidgetId);\r\n           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Form\"\r\n                : \"Therap State - Request Form\";\r\n\r\n            \/\/ Get the hidden inputs for the Web-to-Case form (first-form-web-to-case)\r\n            const customField = document.getElementById('00N0H00000JoJtu');\r\n            const subjectField = document.getElementById('subject');\r\n\r\n            \/\/ Apply the determined value to both hidden fields\r\n            if (customField) {\r\n                customField.value = subjectValue;\r\n            }\r\n            if (subjectField) {\r\n                subjectField.value = subjectValue;\r\n            }\r\n\r\n            console.log(\"Salesforce Subject set to:\", subjectValue);\r\n        }\r\n\r\n        \/\/ Call the function once when the DOM content is fully loaded\r\n        updateSalesforceSubject(); \/\/ Call the function directly inside DOMContentLoaded\r\n        \/\/ END: ADDED\r\n        \/\/ remove br on 600px viewport and below\r\n        function removeBrOnSmallScreens() {\r\n            if ($(window).width() <= 600) {\r\n                $(\"div#trouble-login-info p\").html('If you are having issues logging in to your Therap account, please view the <a href=\"https:\/\/help.therapservices.net\/s\/article\/2035\" target=\"_blank\">Login\u00a0Troubleshooting\u00a0Guide<\/a>.');\r\n            } else {\r\n                $(\"div#trouble-login-info p\").html('If you are having issues logging in to your Therap account,<br>please view the <a href=\"https:\/\/help.therapservices.net\/s\/article\/2035\" target=\"_blank\">Login\u00a0Troubleshooting\u00a0Guide<\/a>.');\r\n            }\r\n        }\r\n        removeBrOnSmallScreens();\r\n        $(window).resize(function () {\r\n            removeBrOnSmallScreens();\r\n        });\r\n    });\r\n<\/script>\r\n<!-- SF FORM END --><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":226,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":""},"class_list":["post-12397","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v26.2 (Yoast SEO v26.2) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>New York State compliant EVV Software solution<\/title>\n<meta name=\"description\" content=\"Therap Scheduling &amp; EVV to address New York State compliance, communication, documentation, reporting, billing, and more service providers.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.therapservices.net\/products\/new-york-evv-compliance\/\" \/>\n<meta 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