Schedule a Catalog Demo

require([ 'jquery', 'Amasty_Customform/js/google-map-loader', 'Amasty_Customform/js/form-render', 'Amasty_Customform/js/form-filler', 'Amasty_Customform/js/am-google-map', 'Amasty_Customform/js/form-init' ], function ($, googleMapLoader) { function renderForm () { var renderedFormContainer = $('#amform-form-6 .insert-container'), renderedForm; $('body').addClass('amform-body'); renderedFormContainer.formRender( 6, {"dataType":"json","formData":"[[{\"type\":\"textinput\",\"name\":\"textinput-1682422008769\",\"entity_id\":\"\",\"label\":\"Name\",\"className\":\"form-control\",\"style\":\"\",\"placeholder\":\"\",\"required\":\"1\",\"description\":\"\",\"validation\":\"\",\"regexp\":\"\",\"errorMessage\":\"\",\"value\":\"\",\"maxlength\":\"\",\"layout\":\"one\",\"parentType\":\"input\",\"dependency\":[],\"validation_fields\":{\"required\":\"1\"}},{\"type\":\"textinput\",\"name\":\"textinput-1682422032361\",\"entity_id\":\"\",\"label\":\"Email\",\"className\":\"form-control\",\"style\":\"default\",\"placeholder\":\"\",\"required\":\"1\",\"description\":\"\",\"validation\":\"\",\"regexp\":\"\",\"errorMessage\":\"\",\"value\":\"\",\"maxlength\":\"\",\"layout\":\"one\",\"parentType\":\"input\",\"dependency\":[],\"validation_fields\":{\"required\":\"1\"}},{\"type\":\"textinput\",\"name\":\"textinput-1682422045413\",\"entity_id\":\"\",\"label\":\"Phone Number\",\"className\":\"form-control\",\"style\":\"default\",\"placeholder\":\"\",\"required\":\"1\",\"description\":\"\",\"validation\":\"\",\"regexp\":\"\",\"errorMessage\":\"\",\"value\":\"\",\"maxlength\":\"\",\"layout\":\"one\",\"parentType\":\"input\",\"dependency\":[],\"validation_fields\":{\"required\":\"1\"}},{\"type\":\"dropdown\",\"name\":\"dropdown-1682422082200\",\"entity_id\":\"\",\"label\":\"Do you prefer we reach out via phone or email to schedule?\",\"className\":\"form-control\",\"style\":\"\",\"placeholder\":\"\",\"description\":\"\",\"layout\":\"one\",\"parentType\":\"options\",\"values\":[{\"label\":\"Phone\",\"value\":\"option-1\"},{\"label\":\"Email\",\"value\":\"option-2\",\"selected\":\"1\"}],\"dependency\":[],\"validation_fields\":[]},{\"type\":\"textinput\",\"name\":\"textinput-1682422172529\",\"entity_id\":\"\",\"label\":\"Facility Name\",\"className\":\"form-control\",\"style\":\"\",\"placeholder\":\"\",\"required\":\"1\",\"description\":\"\",\"validation\":\"\",\"regexp\":\"\",\"errorMessage\":\"\",\"value\":\"\",\"maxlength\":\"\",\"layout\":\"one\",\"parentType\":\"input\",\"dependency\":[],\"validation_fields\":{\"required\":\"1\"}}]]","src_image_progress":"https:\/\/shop.tccpharma.com\/pub\/static\/frontend\/Codazon\/fastest_drug_pharmacy\/en_US\/Amasty_Customform\/images\/loading.gif","ajax_submit":0,"pageTitles":"[\"Schedule a Demo\"]","submitButtonTitle":"Submit","dateFormat":"mm\/dd\/yy","placeholder":"mm\/dd\/yyyy"}, 0, function () { renderedForm = $('[data-amcform-js="multi-page"]'); if (renderedForm.length) { renderedForm.amFormInit(); renderedForm.amFormFill({ 'formParams' : {"urlSession":"https:\/\/shop.tccpharma.com\/amasty_customform\/form\/sessiondata\/","formId":6} }); renderedForm.trigger('contentUpdated'); } $(document).on('amcform-init-multipage', function (e, form) { var $form = form.find('[data-amcform-js="multi-page"]'); if ($form.length) { $form.amFormFill({ 'formParams' : {"urlSession":"https:\/\/shop.tccpharma.com\/amasty_customform\/form\/sessiondata\/","formId":6} }); } }); } ); } renderForm(); });