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{
"settings": {
"useServiceHiddenField": false
},
"steps": [
{
"id": "services",
"type": "button-selection",
"question": "Which one are you interested in?",
"dynamicTarget": true,
"nextButtonText": "Get Pricing",
"firstStep": true,
"target": "form-name",
"answers": [
{
"text": "BOTOX & XEOMIN",
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"target": "botox-services"
},
{
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{
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"value": "CoolSculpting",
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},
{
"text": "IPL PHOTOFACIALS",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/BottomNav-Light-IPL-1.png",
"value": "IPL Photofacial",
"target": "ipl-services"
},
{
"text": "DERMAL FILLERS",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/dermalfillers.png",
"value": "Dermal Fillers",
"target": "dermal-fillers-services"
},
{
"text": "LASER HAIR REMOVAL",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/laserhairremoval.png",
"value": "Hair Removal",
"target": "hair-removal-services"
},
{
"text": "SKIN REJUVENATION",
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"value": "Skin Rejuvenation",
"target": "skin-rejuvenation-services"
},
{
"text": "TATTOO REMOVAL",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/tattooremoval.png",
"value": "Tattoo Removal",
"target": "tattoo-services"
},
{
"text": "THERMAGE",
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},
{
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"value": "Hydrafacial",
"target": "hydrafacial-services"
},
{
"text": "POTENZA RF MICRONEEDLING",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2023/12/RFmicroneedling.svg",
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"text": "CROW'S FEET",
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},
{
"text": "FROWN LINES",
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{
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{
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{
"text": "DULLNESS",
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{
"text": "FINE LINES",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/ReplenishLostVolume.png",
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{
"text": "HYPERPIGMENTATION",
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"value": "hyperpigmentation"
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{
"text": "MELASMA",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_1_00000058556429863106026800000016594759179205353877_.png",
"value": "melasma"
},
{
"text": "PORES",
"icon": "https://storage.googleapis.com/laseraway-dev.appspot.com/2021/08/c187f1f4-pores.svg",
"value": "pores"
},
{
"text": "SUN DAMAGE",
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"value": "sun-damage"
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{
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"target": "treatment-count",
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{
"text": "BACK",
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"value": "back"
},
{
"text": "BELLOW BUTT",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/other-butt.png",
"value": "bellow-butt"
},
{
"text": "INNER THIGH",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/innerthigh.png",
"value": "inner-thigh"
},
{
"text": "LOVE HANDLES",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_3-1.png",
"value": "love-handles"
},
{
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"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/outterthigh.png",
"value": "outer-thigh"
},
{
"text": "ABDOMEN",
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"value": "abdomen"
},
{
"text": "UNDER CHIN",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/neck.png",
"value": "under-chin"
},
{
"text": "UPPER ARM",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/upperarms-3.png",
"value": "upper-arm"
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{
"id": "ipl-services",
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"question": "What would you like to address?",
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"target": "treatment-count",
"answers": [
{
"text": "AGE SPOTS",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/agespots.png",
"value": "AGE-SPOTS"
},
{
"text": "BROKEN CAPILLARIES",
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"value": "BROKEN-CAPILLARIES"
},
{
"text": "COLLAGEN LEVEL",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_1.png",
"value": "COLLAGEN-LEVEL"
},
{
"text": "FINE LINES",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/ReplenishLostVolume-1.png",
"value": "FINE-LINES"
},
{
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"value": "HYPERPIGMENTATION"
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{
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"value": "MELASMA"
},
{
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"value": "PORES"
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{
"text": "SUN DAMAGE",
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"value": "SUN-DAMAGE"
},
{
"text": "ROSACEA",
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"value": "ROSACEA"
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},
{
"id": "dermal-fillers-services",
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"question": "Where do you want dermal fillers?",
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"target": "treatment-count",
"answers": [
{
"text": "CHEEKS",
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"value": "CHEEKS"
},
{
"text": "LIPS",
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"value": "LIPS"
},
{
"text": "MARIONETTE LINES",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/marionette.png",
"value": "MARIONETTE-LINES"
},
{
"text": "SMILE LINES",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/laughlines.png",
"value": "SMILE-LINES"
},
{
"text": "NASOLABIAL FOLDS",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/nasolabial.png",
"value": "NASOLABIAL-FOLDS"
},
{
"text": "OTHER",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/ReplenishLostVolume-2.png",
"value": "OTHER"
}
]
},
{
"id": "hair-removal-services",
"type": "button-selection",
"question": "Which areas need hair removal?",
"canSelectMultiple": false,
"target": "treatment-count",
"answers": [
{
"text": "BACK",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/icon-back.png",
"value": "BACK"
},
{
"text": "BIKINI",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/icon-bikini.png",
"value": "BIKINI"
},
{
"text": "BRAZILIAN",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/icon-brazilian.png",
"value": "BRAZILIAN"
},
{
"text": "CHEST",
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"value": "CHEST"
},
{
"text": "CHIN / LIPS",
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"value": "CHIN-/ LIPS"
},
{
"text": "FACE",
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"value": "FACE"
},
{
"text": "LEGS",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/icon-legs.png",
"value": "LEGS"
},
{
"text": "OTHER",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/icon-other.png",
"value": "OTHER"
},
{
"text": "UNDERARMS",
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"value": "UNDERARMS"
}
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},
{
"id": "skin-rejuvenation-services",
"type": "button-selection",
"question": "What would you like to address?",
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"target": "treatment-count",
"answers": [
{
"text": "ACNE SCARS",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/agespots-2.png",
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},
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"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_1-1.png",
"value": "AGE-SPOTS"
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{
"text": "COLLAGEN LEVEL",
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"value": "COLLAGEN-LEVEL"
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{
"text": "DULLNESS",
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"value": "DULLNESS"
},
{
"text": "FINE LINES",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/ReplenishLostVolume-3.png",
"value": "FINE-LINES"
},
{
"text": "HYPERPIGMENTATION",
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"value": "HYPERPIGMENTATION"
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{
"text": "MELASMA",
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"value": "MELASMA"
},
{
"text": "PORES",
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"text": "SUN DAMAGE",
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{
"id": "tattoo-services",
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"question": "Where are your tattoos located?",
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"target": "treatment-count",
"answers": [
{
"text": "ARM",
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"value": "arm"
},
{
"text": "BACK",
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},
{
"text": "CHEST",
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},
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"text": "FOOT",
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{
"text": "LEG",
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},
{
"text": "NECK",
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"value": "neck"
},
{
"text": "OTHER",
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{
"id": "thermage-services",
"type": "button-selection",
"question": "Which area(s) would you like to target?",
"canSelectMultiple": false,
"target": "treatment-count",
"answers": [
{
"text": "ARMS",
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},
{
"text": "CHEST",
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"value": "chest"
},
{
"text": "FACE",
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},
{
"text": "HANDS",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/other-hand.png",
"value": "hands"
},
{
"text": "THIGHS",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/legs.png",
"value": "THIGHS"
},
{
"text": "NECK",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/neck.png",
"value": "neck"
},
{
"text": "BUTT",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/other-butt-1.png",
"value": "BUTT"
},
{
"text": "ABDOMEN",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_3.png",
"value": "ABDOMEN"
}
]
},
{
"id": "hydrafacial-services",
"type": "button-selection",
"question": "What do you want to treat with Hydrafacial?",
"canSelectMultiple": false,
"target": "treatment-count",
"answers": [
{
"text": "FINE LINES",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2023/09/ReplenishLostVolume_wmh2tw.png",
"value": "FINE-LINES"
},
{
"text": "ELASTICITY",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2023/10/cheeklines-1.png",
"value": "ELASTICITY"
},
{
"text": "DULLNESS",
"icon": "https://storage.googleapis.com/laseraway-dev.appspot.com/2021/08/9c9c2ad2-dullness.svg",
"value": "DULLNESS"
},
{
"text": "AGE SPOTS",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2023/09/agespots_ul67hi.png",
"value": "AGE-SPOTS"
},
{
"text": "HYPERPIGMENTATION",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2023/09/hyperpigmentation_dtopoi.png",
"value": "HYPERPIGMENTATION"
},
{
"text": "PORES",
"icon": "https://storage.googleapis.com/laseraway-dev.appspot.com/2021/08/c187f1f4-pores.svg",
"value": "PORES"
},
{
"text": "MELASMA",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2023/10/melasma.png",
"value": "MELASMA"
},
{
"text": "CONGESTION",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_1-1.png",
"value": "CONGESTION"
},
{
"text": "TEXTURE",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2023/10/texture.png",
"value": "TEXTURE"
}
]
},
{
"id": "potenza-rf-microneedling-services",
"type": "button-selection",
"question": "What best describes your main concern?",
"canSelectMultiple": false,
"target": "treatment-count",
"answers": [
{
"text": "FINE LINES",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2023/09/ReplenishLostVolume_wmh2tw.png",
"value": "FINE-LINES"
},
{
"text": "COLLAGEN LEVEL",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2021/08/collagen-level.png",
"value": "COLLAGEN-LEVEL"
},
{
"text": "PORES",
"icon": "https://storage.googleapis.com/laseraway-dev.appspot.com/2021/08/c187f1f4-pores.svg",
"value": "PORES"
},
{
"text": "TEXTURE",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2023/10/texture.png",
"value": "TEXTURE"
},
{
"text": "LOOSE SKIN",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2023/12/loose_skin_icon.svg",
"value": "LOOSE-SKIN"
},
{
"text": "OTHER",
"icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2023/12/other_face_icon.svg",
"value": "OTHER"
}
]
},
{
"id": "treatment-count",
"question": "How many times have you had this treatment?",
"type": "button-selection",
"target": "age-group",
"answers": [
{
"text": "0",
"value": "0"
},
{
"text": "1-2",
"value": "1-2"
},
{
"text": "3-4",
"value": "3-4"
},
{
"text": "5-6",
"value": "5-6"
},
{
"text": "7-8",
"value": "7-8"
},
{
"text": "9+",
"value": "9+"
}
]
},
{
"id": "age-group",
"question": "What age group are you in?",
"type": "button-selection",
"target": "form-name",
"answers": [
{
"text": "18-24",
"value": "18-24"
},
{
"text": "25-34",
"value": "25-34"
},
{
"text": "35-44",
"value": "35-44"
},
{
"text": "45-54",
"value": "45-54"
},
{
"text": "55-64",
"value": "55-64"
},
{
"text": "65+",
"value": "65+"
}
]
},
{
"id": "form-name",
"question": "What is your name",
"type": "input",
"target": "form-email",
"inputs": [
{
"name": "name",
"type": "text",
"placeholder": "Name",
"validation": {
"onChange": true,
"rules": {
"required": "Please provide your name",
"minLength": {
"value": 4,
"message": "Name should containt at least 4 characters"
}
}
}
}
]
},
{
"id": "form-email",
"question": "What is your e-mail?",
"type": "input",
"target": "form-phone",
"inputs": [
{
"name": "email",
"type": "text",
"placeholder": "E-mail",
"validation": {
"onChange": true,
"rules": {
"required": "Please provide your e-mail",
"regex": {
"value": "(?:[a-z0-9!#$%&'*+\/=?^_`{|}~-]+(?:\\.[a-z0-9!#$%&'*+\/=?^_`{|}~-]+)*|\"(?:[\\x01-\\x08\\x0b\\x0c\\x0e-\\x1f\\x21\\x23-\\x5b\\x5d-\\x7f]|\\\\[\\x01-\\x09\\x0b\\x0c\\x0e-\\x7f])*\")@(?:(?:[a-z0-9](?:[a-z0-9-]*[a-z0-9])?\\.)+[a-z0-9](?:[a-z0-9-]*[a-z0-9])?|\\[(?:(?:25[0-5]|2[0-4][0-9]|[01]?[0-9][0-9]?)\\.){3}(?:25[0-5]|2[0-4][0-9]|[01]?[0-9][0-9]?|[a-z0-9-]*[a-z0-9]:(?:[\\x01-\\x08\\x0b\\x0c\\x0e-\\x1f\\x21-\\x5a\\x53-\\x7f]|\\\\[\\x01-\\x09\\x0b\\x0c\\x0e-\\x7f])+)\\])",
"message": "E-mail should be valid"
}
}
}
}
]
},
{
"id": "form-phone",
"question": "What is your phone number?",
"type": "input",
"target": "form-location",
"inputs": [
{
"name": "telephone",
"type": "text",
"placeholder": "Phone",
"validation": {
"onChange": true,
"rules": {
"required": "Please provide your phone number",
"regex": {
"value": "^(?:\\+?1[-. ]?)?\\(?(?:[2-9][0-8][0-9])\\)?[-. ]?(?:[2-9][0-9]{2})[-. ]?(?:\\d{4})$",
"message": "Please enter a valid 10-digit phone number."
}
}
}
}
]
},
{
"id": "form-location",
"question": "What LaserAway location works best for you?",
"type": "input",
"lastStep": true,
"inputs": [
{
"name": "your-city",
"type": "select",
"validation": {
"onChange": true,
"rules": {
"required": "Please select a location"
}
},
"mode": "dom",
"querySelector": "#location-container"
}
]
}
]
}
