Do BOTOX® Treatments Hurt?

Select Your City... Birmingham Arrowhead - AZ *Coming Soon* Avondale *NEW* Chandler Gilbert - San Tan Village Phoenix - Arcadia Scottsdale Surprise Tucson Sacramento - Fair Oaks *Coming Soon* Brentwood Burlingame Castro Concord Corte Madera Dublin Emeryville Fremont Fresno Fresno - Clovis Los Gatos Milpitas Mountain View Novato Oakland Palo Alto San Carlos San Francisco - The Marina San Francisco - Union Square San Jose San Ramon Santa Rosa *Coming Soon* Tracy Walnut Creek Corona Hills Eastvale Rancho Cucamonga Bakersfield Beverly Hills Chino Hills *NEW* Downtown Los Angeles Glendale Hermosa Beach Long Beach Los Feliz Marina del Rey Oxnard Pasadena Porter Ranch Santa Monica Sherman Oaks Thousand Oaks Valencia West Hollywood Woodland Hills Anaheim Hills Brea Cerritos Costa Mesa Fullerton Huntington Beach Lake Forest Mission Viejo Newport Beach Orange Tustin Davis *Coming Soon* East Sacramento Elk Grove Folsom Roseville Sacramento - Midtown 4S Ranch Carlsbad Chula Vista Del Mar *Coming Soon* Escondido Hillcrest La Jolla - UTC La Mesa Santa Barbara *Coming Soon* Temecula Boulder Belmar Centennial - Park Meadows Denver Denver - Berkeley Stamford Aventura *Coming Soon* Fort Lauderdale Jacksonville Kendall Miami - Coral Gables Miami - South Beach Orlando *NEW* Palm Beach *Coming Soon* Pembroke Pines St Petersburg *NEW* Tampa Atlanta - Buckhead Atlanta - Midtown Peachtree *NEW* Honolulu Boise Chicago - Bucktown Chicago - Deer Park *Coming Soon* Chicago - Elmhurst Chicago - Lincoln Park Chicago - River North Chicago - West Loop Evanston Naperville Northbrook Indianapolis Kansas City Wichita Lexington *Coming Soon* Baltimore *NEW* North Bethesda Boston - Fenway Somerville Wellesley Woburn Detroit-Birmingham *NEW* Edina St Louis Omaha *NEW* Henderson Las Vegas - Town Square Reno *Coming Soon* Summerlin Clifton Edgewater Englewood Hoboken Summit *Coming Soon* Albuquerque Scarsdale Brooklyn - Brooklyn Heights Brooklyn - Park Slope Brooklyn - Williamsburg Long Island - Garden City Long Island - Manhasset *Coming Soon* Long Island - Woodbury Manhattan - Flatiron Manhattan - Meatpacking Manhattan - Morningside Heights Manhattan - TriBeCa Manhattan - Upper East Side Manhattan - Upper West Side Queens - Astoria Charlotte Charlotte-Ballantyne Raleigh Cincinnati *Coming Soon* Cleveland-Pinecrest *NEW* Columbus Oklahoma City Beaverton Portland - Tigard Portland-Cascade Station *Coming Soon* Philadelphia - Jenkintown *Coming Soon* Philadelphia - Main Line Philadelphia - Rittenhouse Nashville Dallas-Addison *Coming Soon* Austin - East Side Austin - The Domain Arlington - TX Dallas Fort Worth Fort Worth - Alliance Town Center *NEW* Frisco Prosper Rockwall Southlake El Paso Friendswood Houston Houston - Houston Heights Sugar Land The Woodlands San Antonio - Alamo Ranch San Antonio - La Cantera Station Park *Coming Soon* Riverton *Coming Soon* Salt Lake City - Downtown Salt Lake City - Murray Alexandria Arlington - VA Ashburn Reston Richmond Tysons Kirkland Seattle Washington DC - Cathedral Heights Washington DC - The Yards Madison

{ "settings": { "formType": "standard", "useServiceHiddenField": false, "showStepsIndicator": true, "showAccolades": true, "fullWidthFormStep": true, "showLegalConsentText": true, "backButton": true }, "steps": [ { "id": "services", "type": "button-selection", "question": "Which one are you interested in?", "dynamicTarget": true, "nextButtonText": "Next", "firstStep": true, "target": "form-name", "answers": [ { "text": "BOTOX & XEOMIN", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/botox-1.png", "value": "Botox", "target": "botox-services" }, { "text": "CLEAR & BRILLIANT", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/clearbrilliant.png", "value": "Clear + Brilliant", "target": "clear+brilliant-services" }, { "text": "COOLSCULPTING", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/coolsculpting-1.png", "value": "CoolSculpting", "target": "coolsculpting-services" }, { "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", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/laserskinrejuvenation.png", "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", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/thermage.png", "value": "Thermage", "target": "thermage-services" }, { "text": "HYDRAFACIAL", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2023/10/hyfrafacial-1-1.png", "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", "value": "RF Microneedling", "target": "potenza-rf-microneedling-services" } ] }, { "id": "botox-services", "type": "button-selection", "question": "What do you want to treat with Botox?", "target": "treatment-count", "canSelectMultiple": false, "answers": [ { "text": "CROW'S FEET", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/crowsfeet-severe.png", "value": "crows-feet" }, { "text": "FROWN LINES", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/frownlines-moderate.png", "value": "frown-lines" }, { "text": "PREVENTION", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/other.png", "value": "prevention" }, { "text": "FOREHEAD LINES", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_1_00000048492736188866793050000017805665106656178851_.png", "value": "forehead-lines" }, { "text": "FINE LINES & WRINKLES", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2023/09/bunnylines_tgr9ce.png", "value": "fine-lines-wrinkles-lines" }, { "text": "CHIN DIMPLES", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2023/09/chinupperlip-acne_1_p00x6j.png", "value": "chin-dimples" }, { "text": "LIP FLIP", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2021/08/fullerlips-1.png", "value": "lip-flip" }, { "text": "LIP LINES", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2021/08/definedlips-1.png", "value": "lip-lines" }, { "text": "NECK-BANDS", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2021/08/neck-1.png", "value": "neck-bands" } ] }, { "id": "clear+brilliant-services", "type": "button-selection", "question": "Why do you want Clear + Brilliant?", "canSelectMultiple": false, "target": "treatment-count", "answers": [ { "text": "ACNE SCARS", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_1.png", "value": "acne-scars" }, { "text": "AGE SPOTS", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/agespots.png", "value": "age-spots" }, { "text": "DULLNESS", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_1_00000023275290920588681870000015240469521700868541_.png", "value": "dullness" }, { "text": "FINE LINES", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/ReplenishLostVolume.png", "value": "fine-lines" }, { "text": "HYPERPIGMENTATION", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_1_00000031200112466972895190000009647119818480900755_.png", "value": "hyperpigmentation" }, { "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", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_1_00000166671424757127320120000014177169169813912715_.png", "value": "sun-damage" }, { "text": "TEXTURE", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_1_00000096766009607905930770000004577942716063408298_.png", "value": "texture" } ] }, { "id": "coolsculpting-services", "type": "button-selection", "question": "Where would you like CoolSculpting?", "canSelectMultiple": false, "target": "treatment-count", "answers": [ { "text": "BACK", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/back-4.png", "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" }, { "text": "OUTER THIGH", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/outterthigh.png", "value": "outer-thigh" }, { "text": "ABDOMEN", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_3.png", "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" } ] }, { "id": "ipl-services", "type": "button-selection", "question": "What would you like to address?", "canSelectMultiple": false, "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", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_1_00000153694541318718417730000004868358805772514723_.png", "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" }, { "text": "HYPERPIGMENTATION", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_1_00000031200112466972895190000009647119818480900755_-1.png", "value": "HYPERPIGMENTATION" }, { "text": "MELASMA", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_1_00000058556429863106026800000016594759179205353877_-1.png", "value": "MELASMA" }, { "text": "PORES", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_1_00000044885345945937442190000000246289599014143411_-1.png", "value": "PORES" }, { "text": "SUN DAMAGE", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_1_00000147217862669713079450000014903675268305941659_.png", "value": "SUN-DAMAGE" }, { "text": "ROSACEA", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_1_00000166671424757127320120000014177169169813912715_-1.png", "value": "ROSACEA" } ] }, { "id": "dermal-fillers-services", "type": "button-selection", "question": "Where do you want dermal fillers?", "canSelectMultiple": false, "target": "treatment-count", "answers": [ { "text": "CHEEKS", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/chinupperlip.png", "value": "CHEEKS" }, { "text": "LIPS", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/poutylip.png", "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", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/icon-chest.png", "value": "CHEST" }, { "text": "CHIN / LIPS", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/icon-lips.png", "value": "CHIN-/ LIPS" }, { "text": "FACE", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/icon-face.png", "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", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/icon-underarms.png", "value": "UNDERARMS" } ] }, { "id": "skin-rejuvenation-services", "type": "button-selection", "question": "What would you like to address?", "canSelectMultiple": false, "target": "treatment-count", "answers": [ { "text": "ACNE SCARS", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/agespots-2.png", "value": "ACNE-SCARS" }, { "text": "AGE SPOTS", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_1-1.png", "value": "AGE-SPOTS" }, { "text": "COLLAGEN LEVEL", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_1_00000153694541318718417730000004868358805772514723_.png", "value": "COLLAGEN-LEVEL" }, { "text": "DULLNESS", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_1_00000023275290920588681870000015240469521700868541_-1.png", "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", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_1_00000031200112466972895190000009647119818480900755_-2.png", "value": "HYPERPIGMENTATION" }, { "text": "MELASMA", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_1_00000058556429863106026800000016594759179205353877_-2.png", "value": "MELASMA" }, { "text": "PORES", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_1_00000044885345945937442190000000246289599014143411_-2.png", "value": "PORES" }, { "text": "SUN DAMAGE", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_1_00000166671424757127320120000014177169169813912715_-2.png", "value": "SUN-DAMAGE" }, { "text": "TEXTURE", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_1_00000096766009607905930770000004577942716063408298_-1.png", "value": "TEXTURE" } ] }, { "id": "tattoo-services", "type": "button-selection", "question": "Where are your tattoos located?", "canSelectMultiple": false, "target": "treatment-count", "answers": [ { "text": "ARM", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/arms.png", "value": "arm" }, { "text": "BACK", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/back-2.png", "value": "back" }, { "text": "CHEST", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/chest.png", "value": "chest" }, { "text": "FOOT", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/feet-1.png", "value": "foot" }, { "text": "HAND", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/other-hand.png", "value": "hand" }, { "text": "LEG", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/legs.png", "value": "leg" }, { "text": "NECK", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/neck.png", "value": "neck" }, { "text": "OTHER", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/other-butt-1.png", "value": "other" } ] }, { "id": "thermage-services", "type": "button-selection", "question": "Which area(s) would you like to target?", "canSelectMultiple": false, "target": "treatment-count", "answers": [ { "text": "ARMS", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/arms.png", "value": "ARMS" }, { "text": "CHEST", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/chest.png", "value": "chest" }, { "text": "FACE", "icon": "https://storage.googleapis.com/images-la/sites/www/wp-content/uploads/2022/12/Layer_1_00000023275290920588681870000015240469521700868541_-2.png", "value": "face" }, { "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", "commonStep": true, "target": "age-group" }, { "id": "age-group", "commonStep": true, "target": "form-zipcode" }, { "id": "form-zipcode", "question": "What is the Zip Code of your preferred location?", "target": "your-city", "type": "input", "layoutClasses": "grid grid-cols-1 xs:flex xs:flex-wrap", "inputs": [ { "name": "zipcode", "type": "zipcode", "validation": { "onChange": true, "rules": { "required": "Please provide your zip code", "regex": { "value": "^\\d{5}(?:[-]\\d{4})?$", "message": "Zip code must have either 5 or 9 digits (plus hyphen)" }, "zipcode": "Please make sure you enter a valid zipcode" } } } ] }, { "id": "your-city", "question": "Choose your nearest location.", "target": "form-name", "type": "nearest-locations", "layoutClasses": "grid grid-cols-1 xs:flex xs:flex-wrap" }, { "id": "form-name", "commonStep": true, "target": "form-email" }, { "id": "form-email", "commonStep": true, "target": "form-phone" }, { "id": "form-phone", "commonStep": true, "lastStep": true } ] }

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.