https://www.invisalign.eu/_next/static/chunks/3582.7e5676db86746a57.js

1(self.webpackChunk_N_E=self.webpackChunk_N_E||[]).push([[3582],{33582:function(e,a,t){"use strict";t.r(a),t.d(a,{ageValidator:function(){return Z},default:function(){return w}});var n=t(85893),l=t(67294),o=t(82175),s=t(7258),r=t(86202),i=t(10682),c=t(21608),d=t(31555),m=t(92991),u=t.n(m),h=t(50286),_=function(e){var a=e.successHeading,t=e.defaultSubHeading;e.name,e.hideSuccessImage,e.successPageImage;return(0,n.jsxs)("div",{className:"step-wrapper step-wrapper5 thankyouWrapper contact-us-thanks",children:[(0,n.jsxs)("h2",{className:"tile-heading",children:[a||"thanks "," "]}),(0,n.jsx)("h3",{dangerouslySetInnerHTML:{__html:"".concat(t)}}),!e.hideSuccessImage&&(0,n.jsx)("img",{alt:"AlignTech_Case_NoAligners_Green",src:e.successPageImage?e.successPageImage.url:"http://images.ctfassets.net/vh25xg5i1h5l/3jmWjw0QKfHum6oqkCoftr/7a7dab9abe246e3ce7890230caaa9a27/AlignTech_Case_NoAligners_Green_1.jpg"})]})},p=t(79730),g=t(62335),f=t(69495),b=t(93652),v=t(11163),x=t(76097),N=t(21269);function j(e,a,t){return a in e?Object.defineProperty(e,a,{value:t,enumerable:!0,configurable:!0,writable:!0}):e[a]=t,e}function y(e){for(var a=1;a<arguments.length;a++){var t=null!=arguments[a]?arguments[a]:{},n=Object.keys(t);"function"===typeof Object.getOwnPropertySymbols&&(n=n.concat(Object.getOwnPropertySymbols(t).filter((function(e){return Object.getOwnPropertyDescriptor(t,e).enumerable})))),n.forEach((function(a){j(e,a,t[a])}))}return e}var U=(0,r.ss)(u()),Z=function(e,a){return(Date.now()-new Date(e).getTime())/315576e5<a},w=function(e){var a=function(e){b.Z.gtmTrackNA(e)},t=(0,l.useState)("new"),m=t[0],w=t[1],k=(0,l.useState)(!0),P=k[0],C=k[1],S=(0,l.useState)(!0),T=S[0],D=S[1],M=(0,l.useState)(!0),q=M[0],E=M[1],L=(0,l.useState)(!1),I=L[0],O=L[1],F=(0,l.useState)(!1),H=F[0],A=F[1],Y=(0,l.useState)(!1),B=Y[0],X=Y[1],R=(0,v.useRouter)(),z=(0,l.useRef)(null),G=e.item,V=G.fields,W=V.caption,K=V.content,J=V.custom,Q=V.parentClass,$=(0,l.useContext)(x.Z).pageProps,ee=$.labelMap,ae=$.localeId,te="";if(ae){var ne=ae.split("-");ne[0]&&(te=ne[0])}var le=null!==J&&void 0!==J?J:{},oe=le.labelFirstName,se=void 0===oe?"":oe,re=le.labelLastName,ie=le.labelEmail,ce=le.labelAge,de=le.labelPhone,me=le.labelZip,ue=le.labelAlignernumber,he=le.alignerPatternRegex,_e=void 0===he?null:he,pe=le.submitBtnLabel,ge=le.termsAndConditions,fe=le.LeadSource,be=le.errorText,ve=void 0===be?"Something went wrong! Please try again later...":be,xe=le.optinStatus,Ne=le.zipUtility,je=void 0===Ne?{}:Ne,ye=le.phoneUtility,Ue=void 0===ye?{}:ye,Ze=le.dobUtility,we=void 0===Ze?{}:Ze,ke=le.countryCode,Pe=void 0===ke?"":ke,Ce=le.inputFieldEvents,Se=void 0===Ce?{}:Ce,Te=le.sendURLparamsToSFDC,De=le.showZipCodeField,Me=le.additional_language,qe=le.showInquiryDropdown,Ee=le.isOptinMandatory,Le=void 0!==Ee&&Ee,Ie=le.alignerNumberforPatient,Oe=le.alignerNumberModal,Fe=le.messageToDisplay,He=le.requiredLabel,Ae=le.cuFormNote,Ye=le.hidePhoneNumber,Be=le.ShowCityDropdown,Xe=void 0===Be?"":Be,Re=le.showPhoneNoWithPrefix,ze=le.showUserType,Ge=le.ageGroupButtons,Ve=void 0===Ge?"":Ge,We=le.hideZipField,Ke=void 0!==We&&We,Je=le.hideDOBField,Qe=void 0!==Je&&Je,$e=le.OptionalDOB,ea=void 0!==$e&&$e,aa=le.stepPatient,ta=void 0===aa?[]:aa,na=le.preferredTime,la=void 0===na?[]:na,oa=le.aligner_number,sa=void 0===oa?"":oa,ra=le.ageValidationMessage,ia=void 0===ra?"":ra,ca=le.thankyouSlug,da=void 0===ca?"/get-started/contact-us/thank-you#text":ca,ma=le.dropdownItemsWithLS,ua=le.hidePreferredTime,ha=void 0!==ua&&ua,_a=le.hideIsPatientField,pa=void 0!==_a&&_a,ga=le.enableAlignerNumber,fa=void 0===ga||ga,ba=le.disableFormLabel,va=void 0!==ba&&ba,xa=!1!==xe,Na=(null===je||void 0===je?void 0:je.inputType)?je.inputType:"tel",ja=(null===je||void 0===je?void 0:je.zipRegx)?je.zipRegx:"/d{5}",ya=(null===je||void 0===je?void 0:je.dataCharset)?je.dataCharset:"",Ua=(null===Ue||void 0===Ue?void 0:Ue.phonePattern)?Ue.phonePattern:"/d{3}-d{3}-d{4}",Za=we.dobPattern?we.dobPattern:"(1[0-2]|0[1-9])/(1[0-9]|0[1-9]|2[0-9]|3[0-1])/dddd",wa=new RegExp((null===je||void 0===je?void 0:je.zipRegx)?je.zipRegx:""),ka=new RegExp((null===Ue||void 0===Ue?void 0:Ue.phoneRegx)?Ue.phoneRegx:""),Pa=we.dobPlaceholder?we.dobPlaceholder:"MM/DD/YYYY",Ca=ia||"You must be 13 or more to continue",Sa=function(e,a,t){return U(j({"form-control":!0,"is-invalid":Boolean(a[e]&&t[e]),success:Boolean(!a[e]&&t[e])},e,!0))},Ta=(0,l.useState)(""),Da=(Ta[0],Ta[1]),Ma=(0,l.useState)(""),qa=(Ma[0],Ma[1]),Ea=(0,l.useRef)(ve),La=!1;(0,l.useEffect)((function(){var e=we.dobMaskedNumber?we.dobMaskedNumber:"XdDmMyY9";f.Z.init(e),void 0!=xe&&C(xe);var a=$&&p.Z.getCookie("submitted_form_".concat(g.Z.createIdFromLocaleAndSlug($))),t=a?JSON.parse(a):void 0;(null===t||void 0===t?void 0:t.submitted)&&R.push(da)}),[]),(0,l.useEffect)((function(){var e,a;void 0!==("undefined"===typeof document?"undefined":(a=document)&&"undefined"!==typeof Symbol&&a.constructor===Symbol?"symbol":typeof a)&&document.getElementById("message")&&(null===(e=document.getElementById("message"))||void 0===e||e.scrollIntoView({behavior:"smooth",block:"center"}))}),[H]);var Ia=function(){C(!P)},Oa=(0,l.useCallback)((function(e){Da(e.target.value)}),[]),Fa=(0,l.useCallback)((function(e){qa(e.target.value),"is invisalign patient"===e.target.value?(E(!0),D(!0)):(E(!1),D(!1))}),[]),Ha={className:r.ZP.getEntryClassesStrFromModuleCss(G,u(),"root",Q)},Aa={firstName:"",lastName:"",phone:"",email:"",zip:"",age:"",comment:"",contactEnquary:"",showInquiryDropdown:qe,optin:xa,showZip:De,alignernumber:"",alignerNumberforPatient:Ie,hidePhoneNumber:!Ye,optinMandatory:Le,cityDropdown:Xe?"":Xe,ShowCityDropdown:Xe,hideZip:Ke,hideDOB:Qe,OptionalDOB:ea,aligner_number:sa,ageGroup:"",ageGroupButtons:Ve||"",isPatient:"is invisalign patient",stepPatient:ta,preferredTime:"no preference",showUserType:ze};return(0,n.jsx)(n.Fragment,{children:(0,n.jsx)("div",y({},Ha,{children:(0,n.jsx)("div",{style:{width:"100%"},ref:z,children:(0,n.jsxs)("div",{children:["new"===m&&(0,n.jsx)(o.J9,{initialValues:Aa,validationSchema:s.Ry().shape({showZip:s.O7(),alignerNumberforPatient:s.O7(),aligner_number:s.Z_().test((function(){var e=arguments.length>0&&void 0!==arguments[0]?arguments[0]:"";return 0===e.length?(La=!1,!0):La&&!(null===e||void 0===e?void 0:e.match(_e))?(O(!0),!1):(La=!1,!0)})),optinMandatory:s.O7(),hidePhoneNumber:s.O7(),ShowCityDropdown:s.O7(),firstName:s.Z_().trim().required("First Name is required"),lastName:s.Z_().trim().required("Last Name is required"),phone:s.Z_().when("hidePhoneNumber",{is:!0,then:s.Z_().matches(ka,"Phone number is not val

1id").required("Phone number is required")}),email:s.Z_().email("Email is invalid").required("Email is required"),ageGroup:s.Z_().when("showUserType",{is:!0,then:s.Z_().required("agegroup is required")}),contactEnquary:s.Z_().when("showInquiryDropdown",{is:!0,then:s.Z_().required("Please select")}),zip:s.Z_().when("showZip",{is:!0,then:s.Z_().matches(wa,"Zip code is not valid").required("Zip is required")}),age:s.Z_().when(["hideDOB","OptionalDOB"],{is:function(e,a){return!e&&!a},then:s.Z_().test((function(e){if(e)if(e.length>=8){var a=e.split("/"),t=4==a[2].length?a[2]:a[0];if(3==a.length&&(4==a[2].length||4==a[0].length&&2==a[2].length)&&!isNaN(Number(a[0]))&&!isNaN(Number(a[1]))&&!isNaN(Number(a[2]))&&(0,h.cH)(new Date(t))>0)return!!new Date(a[0]+"-"+a[1]+"-"+a[2])}else if(e.length>=6&&e.length<8){var n=e.split("/"),l=4==n[1].length?n[1]:n[0];if(2==n.length&&(4==n[1].length||4==n[0].length&&2==n[1].length)&&!isNaN(Number(n[0]))&&!isNaN(Number(n[1]))&&(0,h.cH)(new Date(l))>0)return!!new Date(n[0]+"-"+n[1])}}))}),optin:s.Z_().when("optinMandatory",{is:!0,then:s.Z_().oneOf(["true"]).required()}),comment:s.Z_().when("isPatient",{is:"is invisalign patient",then:s.Z_().trim().required("Comment is required")})}),onSubmit:function(e){z.current&&g.Z.scrollTo(z.current,200),e.language=te;var a=null,t=null,n=null,l=null,o=null,s=(0,h.md)(e.age||"",Pa);if("A teen"===e.ageGroup&&Z(s,13))X(!0);else{if(Te){var r=g.Z.fetchUtmDataFromPageProps($)||p.Z.getUTMCookie(),i=p.Z.getGCLIDCookie();a=r&&r.utm_campaign?r.utm_campaign:null,t=r&&r.utm_medium?r.utm_medium:null,n=r&&r.utm_source?r.utm_source:null,l=r&&r.utm_term?r.utm_term:null,o=r&&r.utm_content?r.utm_content:null,i&&i.gclid?i.gclid:null,"","US"!=Pe&&"CA"!=Pe||"Top"}e.age=Qe?void 0:s,(e=y({},e,g.Z.heeetData(),{leadUrlCampaign:a,leadUrlMedium:t,leadUrlSource:n,leadUtmTerm:l,leadUtmContent:o})).country_code=Pe||"US",w((function(e){return"requested"})),"is invisalign patient"!==e.isPatient&&(e.comment=""),e.contactEnquary&&(e.comments=e.contactEnquary),(0,h.NK)(e,fe||"Contact Us","commonForm",void 0,{pageProps:$,cookieValue:{submitted:!0}},"true"===(null===ee||void 0===ee?void 0:ee.enableTicketOnContactUs)&&"is invisalign patient"===e.isPatient?"ticket":"lead").then((function(a){if("error"==a.data.name)Ea.current=a.data.msg||ve,w((function(e){return"error"}));else{var t,n,l=e.optin?"opt-in":"opt-out",o="is invisalign patient"===e.isPatient?"patient":"not a patient";!0===e.optin?b.Z.gtmTrackNA("inv_contact_us_opt_in_submit"):b.Z.gtmTrackNA("inv_contact_us_opt_out_submit"),pa||("is invisalign patient"===e.isPatient?b.Z.gtmTrackNA("inv_contact_us_patient_toggle"):b.Z.gtmTrackNA("inv_contact_us_not_inv_patient_toggle")),null===(t=window.dataLayer)||void 0===t||t.push({event:"inv_contact_us_thank_you_submit",ga_category:"contact us",ga_action:"contact us"}),R.push(da),b.Z.gtmTrackNA("page_load_get-started/contact-us/thank-you"),b.Z.gtmTrackNA("inv_home_landing_page"),null===(n=window.dataLayer)||void 0===n||n.push(y({event:"contact_us_completed"},!!ze&&{user_category:e.ageGroup},!pa&&{currently_have_invisalign:o},!ha&&{contact_time_preference:e.preferredTime},{contact_consent:l}))}})).catch((function(e){console.log(e),w((function(e){return"error"}))}))}},render:function(e){var t=e.errors,l=e.handleChange,s=e.handleBlur,r=e.touched,m=e.setFieldValue,h=e.setFieldTouched;return console.log("render iam: ",ze),(0,n.jsx)(i.Z,{className:U("request-appointment-wrapper-inner"),fluid:!0,children:H?!!Fe&&(0,n.jsx)("label",{id:"message",htmlFor:"message",dangerouslySetInnerHTML:{__html:Fe}}):(0,n.jsxs)(o.l0,{"data-id":g.Z.createIdFromLocaleAndSlug($),children:[(0,n.jsxs)(c.Z,{children:[(0,n.jsxs)(d.Z,{md:12,className:U("heading-css"),children:[!!W&&(0,n.jsx)("h2",{className:U("tile-heading"),dangerouslySetInnerHTML:{__html:W}}),!!K&&(0,n.jsx)("div",{dangerouslySetInnerHTML:{__html:K}})]}),(!!ze||!pa)&&(0,n.jsx)(d.Z,{md:12,children:(0,n.jsxs)(c.Z,{children:[(0,n.jsx)(d.Z,{md:6,children:!!ze&&(0,n.jsxs)(c.Z,{className:U("row-age-radio","age-group-class"),children:[(0,n.jsx)(d.Z,{md:12,className:U("am-field-css"),children:(0,n.jsx)("label",{children:Me.i_am?Me.i_am:"I am: "})}),(0,n.jsx)(d.Z,{md:12,children:(0,n.jsx)("div",{className:U("radio-wrap radio-btn-css radio-age-grp"),children:Ve.map((function(e,a){return(0,n.jsxs)("label",{className:U("radio-style radio-user-type"),children:[(0,n.jsx)(o.gN,{type:"radio",name:"ageGroup",value:"".concat(null===e||void 0===e?void 0:e.value),onChange:function(e){l(e),Oa(e)}}),(0,n.jsx)("span",{dangerouslySetInnerHTML:{__html:"".concat(null===e||void 0===e?void 0:e.label)},className:U(Sa("ageGroup",t,r))})]})}))})})]})}),(0,n.jsx)(d.Z,{md:6,children:!pa&&(0,n.jsxs)(c.Z,{className:U("row-age-radio patient-user-type"),children:[(0,n.jsx)(d.Z,{md:12,className:U("patient-field-css"),children:(0,n.jsx)("label",{children:(0,n.jsx)("span",{dangerouslySetInnerHTML:{__html:Me.invisalign_treatment?Me.invisalign_treatment:"Are you currently in Invisalign treatment?"}})})}),(0,n.jsx)(d.Z,{md:12,children:(0,n.jsx)("div",{className:U("radio-wrap error-radio-btn"),children:ta.ageGroupButtons.map((function(e,a){return(0,n.jsxs)("label",{className:U("radio-style"),children:[(0,n.jsx)(o.gN,{type:"radio",name:"isPatient",value:"".concat(null===e||void 0===e?void 0:e.value),className:Sa("isPatient",t,r),onChange:function(e){l(e),Fa(e),m("comment",""),h("comment",!1)}}),(0,n.jsx)("span",{dangerouslySetInnerHTML:{__html:"".concat(null===e||void 0===e?void 0:e.label)}})]})}))})})]})})]})}),!va&&(0,n.jsx)(d.Z,{md:12,className:U("info-text-css"),children:(0,n.jsx)("label",{children:Me.form_label?Me.form_label:"Your info "})}),(0,n.jsx)(d.Z,{md:12,children:(0,n.jsxs)(c.Z,{children:[(0,n.jsx)(d.Z,{md:6,children:(0,n.jsx)("div",{className:u()["form-group"],children:(0,n.jsxs)("label",{className:U("has-float-label form-field-label"),children:[(0,n.jsx)(o.gN,{name:"firstName",type:"text",placeholder:" ",onClick:function(){return a(Se.fnevent?Se.fnevent:"fnEvent")},className:Sa("firstName",t,r)}),(0,n.jsx)("span",{className:u().labelName,children:se||"Your first name"})]})})}),(0,n.jsx)(d.Z,{md:6,children:(0,n.jsx)("div",{className:u()["form-group"],children:(0,n.jsxs)("label",{className:U("has-float-label form-field-label"),children:[(0,n.jsx)(o.gN,{name:"lastName",type:"text",placeholder:" ",onClick:function(){return a(Se.lnevent?Se.lnevent:"lnEvent")},className:Sa("lastName",t,r)}),(0,n.jsx)("span",{className:u().labelName,children:re||"Your last name"})]})})}),!Qe&&(0,n.jsx)(d.Z,{md:6,children:(0,n.jsx)("div",{className:u()["form-group"],children:(0,n.jsxs)("label",{className:U("has-float-label form-field-label"),children:[(0,n.jsx)(o.gN,{id:"dob",name:"age",type:"tel",placeholder:" ",onClick:function(){return a(Se.ageEvent?Se.ageEvent:"ageEvent")},"form-placeholder":we.dobPlaceholder?we.dobPlaceholder:"MM/DD/YYYY",pattern:Za,"data-valid-example":we.dobDataValidExample?we.dobDataValidExample:"11/11/2018",className:"masked ".concat(Sa("age",t,r))}),(0,n.jsx)("span",{className:u().labelName,children:ce||"Age"}),(0,n.jsx)("span",{id:"dobMask",className:u().labelMask,"aria-hidden":"true"})]})})}),(0,n.jsx)(d.Z,{md:6,children:(0,n.jsx)("div",{className:u()["form-group"],children:(0,n.jsxs)("label",{className:U("has-float-label form-field-label"),children:[(0,n.jsx)(o.gN,{name:"email",type:"email",placeholder:" ",onClick:function(){return a(Se.emailVal?Se.emailVal:"emailVal")},className:Sa("email",t,r)}),(0,n.jsx)("span",{className:u().labelName,children:ie||"Your email"})]})})}),!Ye&&(0,n.jsx)(d.Z,{md:6,children:(0,n.jsx)("div",{className:u()["form-group"],children:Ue.formPlaceholder?(0,n.jsxs)("label",{className:U("has-float-label form-field-label"),children:[(0,n.jsx)(o.gN,{name:"phone",type:"tel",id:"phone",placeholder:" ",onClick:function(){return a(Se.phNumEvent?Se.phNumEvent:"phNumEvent")},pattern:Ua,"form-placeholder":Ue.formPlaceholder?Ue.formPlaceholder:"XXX-XXX-XXXX",className:"masked ".concat(Sa("phone",t,r))}),(0,n.jsx)("span",{className:u().labelName,children:de||"Your phone"})]}):(0,n.jsxs)("label",{className:"has-float-label  ".concat(Re?"phone-field-prefix":""),children:[(0,n.jsx)(o.gN,{name:"phone",type:"text",id:"phone",placeholder:" ",onClick:function(){return a(Se.phNumEvent?Se.phNumEvent:"phNumEvent")},className:Sa("phone",t,r)}),(0,n.jsx)("span",{className:u().labelName,children:de||"Your phone"})]})})}),!!De&&(0,n.jsx)(d.Z,{md:6,children:(0,n.jsx)("div",{className:u()["form-group"],children:(0,n.jsxs)("label",{className:U("has-float-label form-field-label"),children:[(0,n.jsx)(o.gN,{name:"zip",type:Na,id:"zip",placeholder:" ",onClick:function(){return a(Se.zipEvent?Se.zipEvent:"zipEvent")},"form-placeholder":je.zipPlaceholder?je.zipPlaceholder:"XXXXX",pattern:ja,"data-charset":ya,className:"masked ".concat(Sa("zip",t,r))}),(0,n.jsx)("span",{className:u().labelName,children:me||"Your ZIP"})]})})}),!!q&&fa&&(0,n.jsxs)(n.Fragment,{children:[(0,n.jsx)(d.Z,{md:6,children:(0,n.jsx)("div",{className:U("form-group aligner-field-css"),children:(0,n.jsxs)("label",{className:u()["has-float-label"],children:[(0,n.jsx)(o.gN,{name:"aligner_number",type:"tel",id:"alignernumber",placeholder:" ",maxLength:8,pattern:_e,className:Sa("aligner_number",t,r),onBlur:function(e){s(e),La=!0}}),(0,n.jsx)("span",{className:u().labelName,children:ue||"Your aligner number"}

1),(0,n.jsx)("span",{className:u().alignerinfo,children:(0,n.jsx)("span",{onClick:function(){return O(!0)},children:(0,n.jsx)("img",{alt:"infolink",className:u().infolink})})})]})})}),(0,n.jsx)(d.Z,{md:6,children:(0,n.jsxs)(N.default,{dialogClassName:U("custom-dialog  cls-btn-modal"),show:I,onHide:function(){return O(!1)},children:[(0,n.jsx)(N.default.Header,{closeButton:!0,children:" "}),(0,n.jsx)(N.default.Body,{children:!!Oe&&(0,n.jsx)("label",{htmlFor:"alignerNumberModal",dangerouslySetInnerHTML:{__html:Oe}})})]})})]}),!!qe&&(0,n.jsx)(d.Z,{md:12,children:(0,n.jsxs)("div",{className:u()["form-group"],children:[(0,n.jsx)("div",{className:u()["info-text-css"],children:(0,n.jsx)("label",{children:Me.inquaryDropdownLabel?Me.inquaryDropdownLabel:"What is your Invisalign treatment inquiry about?"})}),(0,n.jsx)("label",{className:"has-float-label shell",children:(0,n.jsxs)(o.gN,{component:"select",id:"contactEnquary",name:"contactEnquary",className:Sa("contactEnquary",t,r),onChange:function(e){l(e),function(e){var a=e.target.value,t=a.slice(0,a.indexOf("_"));"createTicket_patient"===a&&Ie?E(!0):"showMessage"===t?A(!0):q&&E(!1)}(e)},placeholder:"\x1cmake a selection",children:[(0,n.jsx)("option",{value:"",selected:!0,disabled:!0,children:Me.inquaryDropdown_default?Me.inquaryDropdown_default:"Make a selection"}),ma&&ma.map((function(e,a){return(0,n.jsx)("option",{value:e.value,children:e.fieldName},a)}))]})})]})}),!ha&&(0,n.jsxs)(d.Z,{md:12,className:U("prefrence-time-css"),children:[(0,n.jsx)("label",{className:U("prefrence-label-css"),children:Me.preferred_time?Me.preferred_time:"no preference: "}),(0,n.jsx)("div",{className:U("radio-wrap radio-prefernce-btn"),children:la.map((function(e,a){return(0,n.jsxs)("label",{className:U("radio-style"),children:[(0,n.jsx)(o.gN,{type:"radio",name:"preferredTime",value:"".concat(null===e||void 0===e?void 0:e.value),className:Sa("preferredTime",t,r)}),(0,n.jsx)("span",{dangerouslySetInnerHTML:{__html:"".concat(null===e||void 0===e?void 0:e.label)}})]})}))})]}),!!T&&(0,n.jsx)(n.Fragment,{children:(0,n.jsxs)(d.Z,{md:12,children:[(0,n.jsx)("span",{className:U("labelName comment-heading-css"),children:Me.comment_label?Me.comment_label:"Comment:"}),(0,n.jsx)("div",{className:U("form-group cu-comment-label comment-css"),children:(0,n.jsx)("label",{className:U("has-float-label comment-label-sec"),children:(0,n.jsx)(o.gN,{component:"textarea",rows:"4",cols:"20",id:"comments",className:Sa("comment",t,r),name:"comment",placeholder:" ","form-placeholder":Me.comment_placeholder?Me.comment_placeholder:"Please indicate the best dates and times to contact you. *",variant:"outlined",label:"PROJECT SHORT_DESCRIPTION"})})})]})}),(0,n.jsx)(d.Z,{md:12,children:(0,n.jsxs)("div",{className:U("form-group custom-checkbox contact-checkbox"),children:[(0,n.jsx)(o.gN,{id:"optin",name:"optin",type:"checkbox",checked:P,onClick:Ia,className:"custom-control-input "}),!!ge&&(0,n.jsx)("label",{className:u()["custom-control-label"],htmlFor:"optin",dangerouslySetInnerHTML:{__html:ge}})]})}),He&&(0,n.jsx)(d.Z,{md:12,children:(0,n.jsx)("label",{className:u()["cu-comment-label"],htmlFor:"commentLabel",dangerouslySetInnerHTML:{__html:He}})})]})})]}),(0,n.jsx)(c.Z,{className:U("contact-btn-submit"),children:(0,n.jsx)(d.Z,{children:(0,n.jsx)("div",{className:U("form-group get-start"),children:(0,n.jsx)("button",{type:"submit",className:U("btn-blue"),children:pe||"submit"})})})}),(0,n.jsx)(c.Z,{children:Ae&&(0,n.jsx)("label",{className:u()["cu-form-note-label"],htmlFor:"commentLabel",dangerouslySetInnerHTML:{__html:Ae}})}),!!Me.contactUsDisclaimer&&(0,n.jsx)(c.Z,{children:(0,n.jsx)("label",{className:u()["cu-form-discalimer"],htmlFor:"commentDiscalimer",dangerouslySetInnerHTML:{__html:Me.contactUsDisclaimer}})}),B&&(0,n.jsxs)(N.default,{show:B,onHide:function(){return X(!1)},children:[(0,n.jsx)(N.default.Header,{closeButton:!0}),(0,n.jsx)(N.default.Body,{children:(0,n.jsx)("div",{className:U("age-error-message"),children:Ca})})]})]})})}}),"requested"===m&&(0,n.jsx)("div",{className:U("loader-screen"),children:(0,n.jsx)("img",{alt:"loader",src:"https://d2i6vk5bmh3r0a.cloudfront.net/invisalign_next/loader_n.gif"})}),"thankYou"===m&&(0,n.jsx)("div",{children:(0,n.jsx)(_,{})}),"error"===m&&(0,n.jsx)("div",{className:U("error-msg"),children:(0,n.jsx)("h2",{className:U("error-form"),children:Ea.current})})]})})}))})}},92991:function(e){e.exports={root:"contactUs_root__PctQj","form-container":"contactUs_form-container__l5G5l","form-wrapper":"contactUs_form-wrapper__WWdZ9","homepage-form-wrapper":"contactUs_homepage-form-wrapper__aAKKN","tile-heading":"contactUs_tile-heading__asoPO","adult-form-section":"contactUs_adult-form-section__1knym","home-checkbox":"contactUs_home-checkbox__YWNhc","homepage-form-container":"contactUs_homepage-form-container__7WQCn","form-group":"contactUs_form-group__Oxrtr",success:"contactUs_success__niOk0","form-control":"contactUs_form-control__2DX7j","is-invalid":"contactUs_is-invalid__BiHU5","has-float-label":"contactUs_has-float-label__oWgCl",labelName:"contactUs_labelName__RGsgM",labelMask:"contactUs_labelMask__bpFl2","custom-checkbox":"contactUs_custom-checkbox__1ZzML","custom-control-label":"contactUs_custom-control-label__9Vbt2","custom-control-input":"contactUs_custom-control-input__iOYCP","tool-tip-error":"contactUs_tool-tip-error__QnDXv","tool-tip-arrow":"contactUs_tool-tip-arrow__WaPoy","get-start":"contactUs_get-start__WvlAE","homepage-form-button":"contactUs_homepage-form-button__lkbWg","parent-form-css":"contactUs_parent-form-css__MXCuM","custom-dialog":"contactUs_custom-dialog__lYc1A","custom-alignerinvalid-dialog":"contactUs_custom-alignerinvalid-dialog__1Z9Lu","custom-alignerloader-dialog":"contactUs_custom-alignerloader-dialog__iXvPA","modal

1-content":"contactUs_modal-content__qi3ar","modal-header":"contactUs_modal-header__Nr_dw","loader-screen":"contactUs_loader-screen__xYJvv",alignerinfo:"contactUs_alignerinfo__ciKnl","radio-wrap":"contactUs_radio-wrap__2nSzW","request-appointment-wrapper-inner":"contactUs_request-appointment-wrapper-inner__53Vlp","heading-css":"contactUs_heading-css__qU0Y4",infolink:"contactUs_infolink__u8_WC","cu-form-note-label":"contactUs_cu-form-note-label__UCc7t","am-field-css":"contactUs_am-field-css__x_YoB","patient-field-css":"contactUs_patient-field-css__gJQHo","prefrence-label-css":"contactUs_prefrence-label-css__VK2zH","contact-btn-submit":"contactUs_contact-btn-submit___RpZK","prefrence-time-css":"contactUs_prefrence-time-css__QnfOi",radioLabelcls:"contactUs_radioLabelcls__bIc4m","button-active":"contactUs_button-active__04Mrv",buttonCls:"contactUs_buttonCls___K_e6","cls-btn-modal":"contactUs_cls-btn-modal__lJuSm","aligner-field-css":"contactUs_aligner-field-css__OUDl8","radio-style":"contactUs_radio-style__QX440","comment-css":"contactUs_comment-css__rUnZ4","radio-btn-css":"contactUs_radio-btn-css__Vtwag","button-error":"contactUs_button-error__9etu6","radio-user-type":"contactUs_radio-user-type__VqKa3","radio-prefernce-btn":"contactUs_radio-prefernce-btn__3BlU6","comment-heading-css":"contactUs_comment-heading-css__FGyy6","age-group-class":"contactUs_age-group-class__uGytL","patient-user-type":"contactUs_patient-user-type__MHFw2","info-text-css":"contactUs_info-text-css__DdD6z","contact-us-thanks":"contactUs_contact-us-thanks__GlipU","radio-age-grp":"contactUs_radio-age-grp__VLXet",contactEnquary:"contactUs_contactEnquary__nglN8","form-field-label":"contactUs_form-field-label__J5A7i","comment-label-sec":"contactUs_comment-label-sec__MugHS","error-msg":"contactUs_error-msg__59rRA","error-form":"contactUs_error-form__eO8Le","heading-txt-contact":"contactUs_heading-txt-contact__kDCmx"}}}]);