document.write("    "+"\n");
document.write("    <style type=\"text/css\">"+"\n");
document.write("                    body {"+"\n");
document.write("                padding: 0;"+"\n");
document.write("                margin: 0;"+"\n");
document.write("            }"+"\n");
document.write("                    </style>"+"\n");
document.write("    <script type=\"text/javascript\">"+"\n");
document.write("        "+"\n");
document.write("    </script>"+"\n");
document.write("<div id=\"fsform-container-5066500\" class=\"fsform-container\" data-formid=\"5066500\"></div>"+"\n");
document.write("<script type=\"text/javascript\" src=\"https://static.formstack.com/forms/forms-renderer/builds/public/form_42b5f78573.js\"></script>"+"\n");
document.write("<script type=\"text/javascript\" nonce=\"a819431477efd0cb612de0095edfccfe8a3d277700d4ff35e63d4783c8f1d623\">"+"\n");
document.write("  FSForm.render({\"fullscreen\":false,\"id\":5066500,\"loggingConfig\":{\"disabled\":true,\"sessionSampleRate\":1},\"shouldAutofocusForm\":false,\"target\":\"fsform-container-5066500\",\"viewKey\":\"ULd7Pors0n\"},"+"\n");
document.write("    {"+"\n");
document.write("      formResponse: {\"error\":null,\"form\":{\"analytics\":{\"baseUrl\":\"https:\\/\\/abortiondefensenetwork.formstack.com\\/forms-analytics\",\"isEnabled\":true,\"viewMethod\":\"embedded\"},\"id\":\"5066500\",\"isEncrypted\":false,\"language\":\"en\",\"meta\":{\"ctaParams\":\"utm_source=formstack&utm_medium=product&utm_campaign=build+your+own\",\"ctaType\":\"s-prod-form\",\"extra\":{\"columns\":1,\"customIdentifier\":null,\"discountCode\":null,\"fileUploadsPerSubmission\":20,\"invisibleCaptcha\":false,\"invisibleCaptchaPublicKey\":\"\",\"kioskMode\":false,\"labelPosition\":\"top\",\"oneQuestion\":false,\"progressIndicator\":false,\"promptForLocation\":false,\"saveAndResume\":false,\"shareButtons\":null,\"showReferralBadge\":false,\"showSecurityLogo\":false,\"skipValidationBetweenPages\":false},\"fileUploadActionsDto\":{\"baseUrl\":\"https:\\/\\/abortiondefensenetwork.formstack.com\",\"getUploadUrlAction\":\"\\/live-form\\/fileUpload\\/getUploadUrls\"},\"hasEncryptionPassword\":false,\"hiddenSubmitFields\":[{\"key\":\"displayTime\",\"value\":\"2025-09-18T21:46:47-04:00\"}],\"isWorkflowForm\":false,\"isWorkspaceSubmission\":null,\"optimizeFormPerformance\":false,\"redirectUrl\":null,\"shouldTrackPartialSubmission\":null,\"stylesheets\":null,\"submitButtonTitle\":\"Submit Form\",\"timezone\":\"US\\/Eastern\",\"welcomeMessage\":null},\"name\":\"Abortion Defense Network Intake Form\",\"password\":null,\"paymentIntegrations\":[],\"plugins\":[],\"portal\":null,\"publicFileUrl\":\"https:\\/\\/static.formstack.com\\/forms\\/forms-renderer\",\"sections\":[{\"calculation\":null,\"defaultValue\":null,\"fieldTypeAttributes\":{\"dtoType\":\"FieldAttributesSectionDto\",\"content\":\"\",\"heading\":\"\",\"labelPosition\":\"\",\"languageFormat\":\"\",\"numColumns\":0,\"usePageBreak\":false},\"fields\":[{\"calculation\":{\"calculationAllowNegatives\":\"\",\"calculationCategory\":\"text\",\"calculationOperator\":\"\",\"calculationUnits\":\"\",\"fieldOneCalculation\":\"\",\"fieldTwoCalculation\":\"\",\"rules\":[]},\"defaultValue\":{\"dtoType\":\"DefaultValueStringDto\",\"confirmValue\":\"\",\"value\":\"\"},\"fieldTypeAttributes\":{\"dtoType\":\"FieldAttributesSelectDto\",\"defaultValue\":\"\",\"optionCount\":0,\"optionLayout\":\"vertical\",\"optionPartToStore\":\"value\",\"useLabelsAndValues\":false,\"useOtherOption\":false,\"useRandomOption\":false,\"useSearchableOptions\":null},\"fields\":null,\"general\":{\"autofill\":null,\"columnSpan\":\"1\",\"hidden\":false,\"hideLabel\":false,\"id\":\"134883276\",\"internalLabel\":null,\"isRootSection\":false,\"label\":\"Title\",\"language\":\"en\",\"options\":[{\"label\":\"\",\"value\":\"\"},{\"label\":\"Dr.\",\"value\":\"Dr.\",\"imageUrl\":null},{\"label\":\"Hon.\",\"value\":\"Hon.\",\"imageUrl\":null},{\"label\":\"Mr.\",\"value\":\"Mr.\",\"imageUrl\":null},{\"label\":\"Ms.\",\"value\":\"Ms.\",\"imageUrl\":\"\"},{\"label\":\"Mrs.\",\"value\":\"Mrs.\",\"imageUrl\":\"\"},{\"label\":\"Mx.\",\"value\":\"Mx.\",\"imageUrl\":\"\"},{\"label\":\"Something else (please specify)\",\"value\":\"Something else (please specify)\",\"imageUrl\":\"\"}],\"parentTableMetadata\":null,\"readOnly\":false,\"required\":true,\"searchConfig\":{\"canSearchOptions\":false,\"useRemoteSearch\":false},\"section\":\"0\",\"shouldForceSkipValidation\":false,\"supportingText\":\"Choose your title\",\"type\":\"select\",\"unique\":false,\"useCallout\":false},\"logic\":null,\"secureSettings\":null},{\"calculation\":{\"calculationAllowNegatives\":0,\"calculationCategory\":\"text\",\"calculationOperator\":\"\",\"calculationUnits\":\"\",\"fieldOneCalculation\":0,\"fieldTwoCalculation\":0,\"rules\":[]},\"defaultValue\":{\"dtoType\":\"DefaultValueStringDto\",\"confirmValue\":\"\",\"value\":\"\"},\"fieldTypeAttributes\":{\"dtoType\":\"FieldAttributesTextDto\",\"autocompleteOptions\":null,\"calculationAllowNegatives\":0,\"calculationCategory\":\"text\",\"calculationOperator\":\"\",\"calculationUnits\":\"\",\"charactersWide\":50,\"confirmationText\":\"\",\"defaultValue\":\"\",\"fieldOneCalculation\":0,\"fieldTwoCalculation\":0,\"maxLength\":0,\"minLength\":0,\"placeholderText\":\"Enter your title\"},\"fields\":null,\"general\":{\"autofill\":null,\"columnSpan\":\"1\",\"hidden\":false,\"hideLabel\":false,\"id\":\"134883277\",\"internalLabel\":null,\"isRootSection\":false,\"label\":\"Your title\",\"language\":\"en\",\"options\":[],\"parentTableMetadata\":null,\"readOnly\":false,\"required\":true,\"searchConfig\":{\"canSearchOptions\":false,\"useRemoteSearch\":false},\"section\":\"0\",\"shouldForceSkipValidation\":false,\"supportingText\":null,\"type\":\"text\",\"unique\":false,\"useCallout\":false},\"logic\":{\"action\":\"Show\",\"fields\":[{\"comparisonOperator\":\"==\",\"fieldId\":\"134883276\",\"value\":\"Something else (please specify)\"}],\"operator\":\"AND\",\"workflowSteps\":[]},\"secureSettings\":{\"hideInputCharacters\":false,\"removeDataFromEmailNotifications\":false,\"requireConfirmation\":false,\"restrictDataAccess\":false}},{\"calculation\":null,\"defaultValue\":{\"dtoType\":\"DefaultValueNameDto\",\"first\":\"\",\"initial\":\"\",\"last\":\"\",\"middle\":\"\",\"prefix\":\"\",\"suffix\":\"\"},\"fieldTypeAttributes\":{\"dtoType\":\"FieldAttributesNameDto\",\"charactersWide\":20,\"middleInitialRequired\":false,\"middleNameRequired\":true,\"prefixRequired\":true,\"suffixRequired\":false,\"useMiddleInitial\":true,\"useMiddleName\":false,\"usePrefix\":false,\"useSuffix\":true},\"fields\":null,\"general\":{\"autofill\":null,\"columnSpan\":\"1\",\"hidden\":false,\"hideLabel\":false,\"id\":\"134883278\",\"internalLabel\":null,\"isRootSection\":false,\"label\":\"Name\",\"language\":\"en\",\"options\":[],\"parentTableMetadata\":null,\"readOnly\":false,\"required\":true,\"searchConfig\":{\"canSearchOptions\":false,\"useRemoteSearch\":false},\"section\":\"0\",\"shouldForceSkipValidation\":false,\"supportingText\":null,\"type\":\"name\",\"unique\":false,\"useCallout\":false},\"logic\":null,\"secureSettings\":null},{\"calculation\":{\"calculationAllowNegatives\":0,\"calculationCategory\":\"text\",\"calculationOperator\":\"\",\"calculationUnits\":\"\",\"fieldOneCalculation\":0,\"fieldTwoCalculation\":0,\"rules\":[]},\"defaultValue\":{\"dtoType\":\"DefaultValueStringDto\",\"confirmValue\":\"\",\"value\":\"\"},\"fieldTypeAttributes\":{\"dtoType\":\"FieldAttributesTextDto\",\"autocompleteOptions\":null,\"calculationAllowNegatives\":0,\"calculationCategory\":\"text\",\"calculationOperator\":\"\",\"calculationUnits\":\"\",\"charactersWide\":50,\"confirmationText\":\"\",\"defaultValue\":\"\",\"fieldOneCalculation\":0,\"fieldTwoCalculation\":0,\"maxLength\":0,\"minLength\":0,\"placeholderText\":\"\"},\"fields\":null,\"general\":{\"autofill\":null,\"columnSpan\":\"1\",\"hidden\":false,\"hideLabel\":false,\"id\":\"179916742\",\"internalLabel\":null,\"isRootSection\":false,\"label\":\"Preferred Name\",\"language\":\"en\",\"options\":[],\"parentTableMetadata\":null,\"readOnly\":false,\"required\":false,\"searchConfig\":{\"canSearchOptions\":false,\"useRemoteSearch\":false},\"section\":\"0\",\"shouldForceSkipValidation\":false,\"supportingText\":null,\"type\":\"text\",\"unique\":false,\"useCallout\":false},\"logic\":null,\"secureSettings\":{\"hideInputCharacters\":false,\"removeDataFromEmailNotifications\":false,\"requireConfirmation\":false,\"restrictDataAccess\":false}},{\"calculation\":{\"calculationAllowNegatives\":\"\",\"calculationCategory\":\"text\",\"calculationOperator\":\"\",\"calculationUnits\":\"\",\"fieldOneCalculation\":\"\",\"fieldTwoCalculation\":\"\",\"rules\":[]},\"defaultValue\":{\"dtoType\":\"DefaultValueCheckboxDto\",\"otherValue\":null,\"useOtherValue\":false,\"value\":[]},\"fieldTypeAttributes\":{\"dtoType\":\"FieldAttributesCheckboxDto\",\"hideOptionButton\":true,\"imageDimensions\":\"customDimensions\",\"imageHeight\":100,\"imageLabelAlignment\":\"bottom\",\"imageWidth\":100,\"lockImageRatio\":true,\"lockImageRatioOption\":\"fitProportionally\",\"optionLayout\":\"horizontal\",\"optionPartToStore\":\"value\",\"useCheckAll\":false,\"useImages\":false,\"useLabelsAndValues\":false,\"useOtherOption\":false,\"useRandomOption\":false},\"fields\":null,\"general\":{\"autofill\":null,\"columnSpan\":\"2\",\"hidden\":false,\"hideLabel\":false,\"id\":\"134883279\",\"internalLabel\":null,\"isRootSection\":false,\"label\":\"Pronouns\",\"language\":\"en\",\"options\":[{\"label\":\"She\\/her\",\"value\":\"She\\/her\",\"imageUrl\":null},{\"label\":\"He\\/him\",\"value\":\"He\\/him\",\"imageUrl\":null},{\"label\":\"They\\/them\",\"value\":\"They\\/them\",\"imageUrl\":null},{\"label\":\"Something else (specify)\",\"value\":\"Something else (specify)\",\"imageUrl\":\"\"}],\"parentTableMetadata\":null,\"readOnly\":false,\"required\":true,\"searchConfig\":{\"canSearchOptions\":false,\"useRemoteSearch\":false},\"section\":\"0\",\"shouldForceSkipValidation\":false,\"supportingText\":null,\"type\":\"checkbox\",\"unique\":false,\"useCallout\":false},\"logic\":null,\"secureSettings\":null},{\"calculation\":{\"calculationAllowNegatives\":0,\"calculationCategory\":\"text\",\"calculationOperator\":\"\",\"calculationUnits\":\"\",\"fieldOneCalculation\":0,\"fieldTwoCalculation\":0,\"rules\":[]},\"defaultValue\":{\"dtoType\":\"DefaultValueStringDto\",\"confirmValue\":\"\",\"value\":\"\"},\"fieldTypeAttributes\":{\"dtoType\":\"FieldAttributesTextDto\",\"autocompleteOptions\":null,\"calculationAllowNegatives\":0,\"calculationCategory\":\"text\",\"calculationOperator\":\"\",\"calculationUnits\":\"\",\"charactersWide\":50,\"confirmationText\":\"\",\"defaultValue\":\"\",\"fieldOneCalculation\":0,\"fieldTwoCalculation\":0,\"maxLength\":0,\"minLength\":0,\"placeholderText\":\"\"},\"fields\":null,\"general\":{\"autofill\":null,\"columnSpan\":\"1\",\"hidden\":false,\"hideLabel\":false,\"id\":\"134883280\",\"internalLabel\":null,\"isRootSection\":false,\"label\":\"Pronouns\",\"language\":\"en\",\"options\":[],\"parentTableMetadata\":null,\"readOnly\":false,\"required\":false,\"searchConfig\":{\"canSearchOptions\":false,\"useRemoteSearch\":false},\"section\":\"0\",\"shouldForceSkipValidation\":false,\"supportingText\":\"Please tell us your preferred pronouns\",\"type\":\"text\",\"unique\":false,\"useCallout\":false},\"logic\":{\"action\":\"Show\",\"fields\":[{\"comparisonOperator\":\"==\",\"fieldId\":\"134883279\",\"value\":\"Something else (specify)\"}],\"operator\":\"OR\",\"workflowSteps\":[]},\"secureSettings\":{\"hideInputCharacters\":false,\"removeDataFromEmailNotifications\":false,\"requireConfirmation\":false,\"restrictDataAccess\":false}},{\"calculation\":null,\"defaultValue\":null,\"fieldTypeAttributes\":{\"dtoType\":\"FieldAttributesEmbedRichTextDto\",\"content\":\"<hr\\/>\\n\\n\",\"shouldProcessSubstitutionTokens\":false},\"fields\":null,\"general\":{\"autofill\":null,\"columnSpan\":\"1\",\"hidden\":false,\"hideLabel\":false,\"id\":\"134883281\",\"internalLabel\":null,\"isRootSection\":false,\"label\":\"\",\"language\":\"en\",\"options\":[],\"parentTableMetadata\":null,\"readOnly\":false,\"required\":false,\"searchConfig\":{\"canSearchOptions\":false,\"useRemoteSearch\":false},\"section\":\"0\",\"shouldForceSkipValidation\":false,\"supportingText\":null,\"type\":\"embed\",\"unique\":false,\"useCallout\":false},\"logic\":null,\"secureSettings\":null},{\"calculation\":null,\"defaultValue\":null,\"fieldTypeAttributes\":{\"dtoType\":\"FieldAttributesEmbedRichTextDto\",\"content\":\"<h2><span style=\\\"font-family: Arial, Helvetica, sans-serif; font-size: 24px; color: rgb(255, 255, 255);\\\">Contact information<\\/span><\\/h2>\",\"shouldProcessSubstitutionTokens\":false},\"fields\":null,\"general\":{\"autofill\":null,\"columnSpan\":\"1\",\"hidden\":false,\"hideLabel\":false,\"id\":\"134883282\",\"internalLabel\":null,\"isRootSection\":false,\"label\":\"\",\"language\":\"en\",\"options\":[],\"parentTableMetadata\":null,\"readOnly\":false,\"required\":false,\"searchConfig\":{\"canSearchOptions\":false,\"useRemoteSearch\":false},\"section\":\"0\",\"shouldForceSkipValidation\":false,\"supportingText\":null,\"type\":\"richtext\",\"unique\":false,\"useCallout\":false},\"logic\":null,\"secureSettings\":null},{\"calculation\":null,\"defaultValue\":{\"dtoType\":\"DefaultValueStringDto\",\"confirmValue\":\"\",\"value\":\"\"},\"fieldTypeAttributes\":{\"dtoType\":\"FieldAttributesEmailDto\",\"charactersWide\":50,\"confirmationText\":\"\",\"defaultValue\":\"\",\"maxLength\":0,\"placeholderText\":\"\",\"useConfirmation\":false},\"fields\":null,\"general\":{\"autofill\":null,\"columnSpan\":\"1\",\"hidden\":false,\"hideLabel\":false,\"id\":\"134883283\",\"internalLabel\":null,\"isRootSection\":false,\"label\":\"Email\",\"language\":\"en\",\"options\":[],\"parentTableMetadata\":null,\"readOnly\":false,\"required\":true,\"searchConfig\":{\"canSearchOptions\":false,\"useRemoteSearch\":false},\"section\":\"0\",\"shouldForceSkipValidation\":false,\"supportingText\":null,\"type\":\"email\",\"unique\":false,\"useCallout\":false},\"logic\":null,\"secureSettings\":null},{\"calculation\":{\"calculationAllowNegatives\":0,\"calculationCategory\":\"text\",\"calculationOperator\":\"\",\"calculationUnits\":\"\",\"fieldOneCalculation\":0,\"fieldTwoCalculation\":0,\"rules\":[]},\"defaultValue\":{\"dtoType\":\"DefaultValueStringDto\",\"confirmValue\":\"\",\"value\":\"\"},\"fieldTypeAttributes\":{\"dtoType\":\"FieldAttributesTextDto\",\"autocompleteOptions\":null,\"calculationAllowNegatives\":0,\"calculationCategory\":\"text\",\"calculationOperator\":\"\",\"calculationUnits\":\"\",\"charactersWide\":50,\"confirmationText\":\"\",\"defaultValue\":\"\",\"fieldOneCalculation\":0,\"fieldTwoCalculation\":0,\"maxLength\":0,\"minLength\":0,\"placeholderText\":\"\"},\"fields\":null,\"general\":{\"autofill\":null,\"columnSpan\":\"1\",\"hidden\":false,\"hideLabel\":false,\"id\":\"134883284\",\"internalLabel\":null,\"isRootSection\":false,\"label\":\"Best Phone Number\",\"language\":\"en\",\"options\":[],\"parentTableMetadata\":null,\"readOnly\":false,\"required\":false,\"searchConfig\":{\"canSearchOptions\":false,\"useRemoteSearch\":false},\"section\":\"0\",\"shouldForceSkipValidation\":false,\"supportingText\":null,\"type\":\"text\",\"unique\":false,\"useCallout\":false},\"logic\":null,\"secureSettings\":{\"hideInputCharacters\":false,\"removeDataFromEmailNotifications\":false,\"requireConfirmation\":false,\"restrictDataAccess\":false}},{\"calculation\":{\"calculationAllowNegatives\":\"\",\"calculationCategory\":\"text\",\"calculationOperator\":\"\",\"calculationUnits\":\"\",\"fieldOneCalculation\":\"\",\"fieldTwoCalculation\":\"\",\"rules\":[]},\"defaultValue\":{\"dtoType\":\"DefaultValueRadioDto\",\"otherValue\":\"\",\"value\":\"\"},\"fieldTypeAttributes\":{\"dtoType\":\"FieldAttributesRadioDto\",\"defaultValue\":\"\",\"hideRadioButtons\":false,\"imageDimensions\":\"customDimensions\",\"imageHeight\":100,\"imageLabelAlignment\":\"bottom\",\"imageWidth\":100,\"lockImageRatio\":true,\"lockImageRatioOption\":\"fitProportionally\",\"optionLayout\":\"horizontal\",\"optionPartToStore\":\"value\",\"useImages\":false,\"useLabelsAndValues\":false,\"useOtherOption\":false,\"useRandomOption\":false},\"fields\":null,\"general\":{\"autofill\":null,\"columnSpan\":\"1\",\"hidden\":false,\"hideLabel\":false,\"id\":\"134883285\",\"internalLabel\":null,\"isRootSection\":false,\"label\":\"Type of phone\",\"language\":\"en\",\"options\":[{\"label\":\"Mobile\",\"value\":\"Mobile\",\"imageUrl\":null},{\"label\":\"Landline\\u2014Home\",\"value\":\"Landline\\u2014Home\",\"imageUrl\":null},{\"label\":\"Landline\\u2014Work\",\"value\":\"Landline\\u2014Work\",\"imageUrl\":null},{\"label\":\"Something else (specify)\",\"value\":\"Something else (specify)\",\"imageUrl\":\"\"}],\"parentTableMetadata\":null,\"readOnly\":false,\"required\":false,\"searchConfig\":{\"canSearchOptions\":false,\"useRemoteSearch\":false},\"section\":\"0\",\"shouldForceSkipValidation\":false,\"supportingText\":null,\"type\":\"radio\",\"unique\":false,\"useCallout\":false},\"logic\":null,\"secureSettings\":null},{\"calculation\":{\"calculationAllowNegatives\":0,\"calculationCategory\":\"text\",\"calculationOperator\":\"\",\"calculationUnits\":\"\",\"fieldOneCalculation\":0,\"fieldTwoCalculation\":0,\"rules\":[]},\"defaultValue\":{\"dtoType\":\"DefaultValueStringDto\",\"confirmValue\":\"\",\"value\":\"\"},\"fieldTypeAttributes\":{\"dtoType\":\"FieldAttributesTextDto\",\"autocompleteOptions\":null,\"calculationAllowNegatives\":0,\"calculationCategory\":\"text\",\"calculationOperator\":\"\",\"calculationUnits\":\"\",\"charactersWide\":50,\"confirmationText\":\"\",\"defaultValue\":\"\",\"fieldOneCalculation\":0,\"fieldTwoCalculation\":0,\"maxLength\":0,\"minLength\":0,\"placeholderText\":\"\"},\"fields\":null,\"general\":{\"autofill\":null,\"columnSpan\":\"1\",\"hidden\":false,\"hideLabel\":false,\"id\":\"134883286\",\"internalLabel\":null,\"isRootSection\":false,\"label\":\"Tell us what type of phone you have:\",\"language\":\"en\",\"options\":[],\"parentTableMetadata\":null,\"readOnly\":false,\"required\":false,\"searchConfig\":{\"canSearchOptions\":false,\"useRemoteSearch\":false},\"section\":\"0\",\"shouldForceSkipValidation\":false,\"supportingText\":null,\"type\":\"text\",\"unique\":false,\"useCallout\":false},\"logic\":{\"action\":\"Show\",\"fields\":[{\"comparisonOperator\":\"==\",\"fieldId\":\"134883285\",\"value\":\"Something else (specify)\"}],\"operator\":\"OR\",\"workflowSteps\":[]},\"secureSettings\":{\"hideInputCharacters\":false,\"removeDataFromEmailNotifications\":false,\"requireConfirmation\":false,\"restrictDataAccess\":false}},{\"calculation\":{\"calculationAllowNegatives\":\"\",\"calculationCategory\":\"text\",\"calculationOperator\":\"\",\"calculationUnits\":\"\",\"fieldOneCalculation\":\"\",\"fieldTwoCalculation\":\"\",\"rules\":[]},\"defaultValue\":{\"dtoType\":\"DefaultValueStringDto\",\"confirmValue\":\"\",\"value\":\"\"},\"fieldTypeAttributes\":{\"dtoType\":\"FieldAttributesSelectDto\",\"defaultValue\":\"\",\"optionCount\":1,\"optionLayout\":\"vertical\",\"optionPartToStore\":\"value\",\"useLabelsAndValues\":false,\"useOtherOption\":false,\"useRandomOption\":false,\"useSearchableOptions\":null},\"fields\":null,\"general\":{\"autofill\":null,\"columnSpan\":\"1\",\"hidden\":false,\"hideLabel\":false,\"id\":\"134883287\",\"internalLabel\":null,\"isRootSection\":false,\"label\":\"I prefer to be contacted by:\",\"language\":\"en\",\"options\":[{\"label\":\"\",\"value\":\"\"},{\"label\":\"Phone Call\",\"value\":\"Phone Call\",\"imageUrl\":\"\"},{\"label\":\"Text Message\",\"value\":\"Text Message\",\"imageUrl\":\"\"},{\"label\":\"Email\",\"value\":\"Email\",\"imageUrl\":\"\"},{\"label\":\"Something else (specify)\",\"value\":\"Something else (specify)\",\"imageUrl\":\"\"}],\"parentTableMetadata\":null,\"readOnly\":false,\"required\":false,\"searchConfig\":{\"canSearchOptions\":false,\"useRemoteSearch\":false},\"section\":\"0\",\"shouldForceSkipValidation\":false,\"supportingText\":null,\"type\":\"select\",\"unique\":false,\"useCallout\":false},\"logic\":null,\"secureSettings\":null},{\"calculation\":{\"calculationAllowNegatives\":0,\"calculationCategory\":\"text\",\"calculationOperator\":\"\",\"calculationUnits\":\"\",\"fieldOneCalculation\":0,\"fieldTwoCalculation\":0,\"rules\":[]},\"defaultValue\":{\"dtoType\":\"DefaultValueStringDto\",\"confirmValue\":\"\",\"value\":\"\"},\"fieldTypeAttributes\":{\"dtoType\":\"FieldAttributesTextDto\",\"autocompleteOptions\":null,\"calculationAllowNegatives\":0,\"calculationCategory\":\"text\",\"calculationOperator\":\"\",\"calculationUnits\":\"\",\"charactersWide\":50,\"confirmationText\":\"\",\"defaultValue\":\"\",\"fieldOneCalculation\":0,\"fieldTwoCalculation\":0,\"maxLength\":0,\"minLength\":0,\"placeholderText\":\"\"},\"fields\":null,\"general\":{\"autofill\":null,\"columnSpan\":\"1\",\"hidden\":false,\"hideLabel\":false,\"id\":\"134883288\",\"internalLabel\":null,\"isRootSection\":false,\"label\":\"Tell us how you would prefer to be contacted\",\"language\":\"en\",\"options\":[],\"parentTableMetadata\":null,\"readOnly\":false,\"required\":false,\"searchConfig\":{\"canSearchOptions\":false,\"useRemoteSearch\":false},\"section\":\"0\",\"shouldForceSkipValidation\":false,\"supportingText\":null,\"type\":\"text\",\"unique\":false,\"useCallout\":false},\"logic\":{\"action\":\"Show\",\"fields\":[{\"comparisonOperator\":\"==\",\"fieldId\":\"134883287\",\"value\":\"Something else (specify)\"}],\"operator\":\"AND\",\"workflowSteps\":[]},\"secureSettings\":{\"hideInputCharacters\":false,\"removeDataFromEmailNotifications\":false,\"requireConfirmation\":false,\"restrictDataAccess\":false}},{\"calculation\":{\"calculationAllowNegatives\":\"\",\"calculationCategory\":\"text\",\"calculationOperator\":\"\",\"calculationUnits\":\"\",\"fieldOneCalculation\":\"\",\"fieldTwoCalculation\":\"\",\"rules\":[]},\"defaultValue\":{\"dtoType\":\"DefaultValueRadioDto\",\"otherValue\":\"\",\"value\":\"\"},\"fieldTypeAttributes\":{\"dtoType\":\"FieldAttributesRadioDto\",\"defaultValue\":\"\",\"hideRadioButtons\":false,\"imageDimensions\":\"customDimensions\",\"imageHeight\":100,\"imageLabelAlignment\":\"bottom\",\"imageWidth\":100,\"lockImageRatio\":true,\"lockImageRatioOption\":\"fitProportionally\",\"optionLayout\":\"horizontal\",\"optionPartToStore\":\"value\",\"useImages\":false,\"useLabelsAndValues\":false,\"useOtherOption\":false,\"useRandomOption\":false},\"fields\":null,\"general\":{\"autofill\":null,\"columnSpan\":\"1\",\"hidden\":false,\"hideLabel\":false,\"id\":\"134883289\",\"internalLabel\":null,\"isRootSection\":false,\"label\":\"If you prefer to be contacted by phone, is it safe for us to leave a message?\",\"language\":\"en\",\"options\":[{\"label\":\"Yes\",\"value\":\"Yes\",\"imageUrl\":null},{\"label\":\"No\",\"value\":\"No\",\"imageUrl\":null}],\"parentTableMetadata\":null,\"readOnly\":false,\"required\":false,\"searchConfig\":{\"canSearchOptions\":false,\"useRemoteSearch\":false},\"section\":\"0\",\"shouldForceSkipValidation\":false,\"supportingText\":null,\"type\":\"radio\",\"unique\":false,\"useCallout\":false},\"logic\":{\"action\":\"Show\",\"fields\":[{\"comparisonOperator\":\"==\",\"fieldId\":\"134883287\",\"value\":\"Phone Call\"}],\"operator\":\"AND\",\"workflowSteps\":[]},\"secureSettings\":null},{\"calculation\":null,\"defaultValue\":null,\"fieldTypeAttributes\":{\"dtoType\":\"FieldAttributesEmbedRichTextDto\",\"content\":\"<hr \\/>\\n\\n\",\"shouldProcessSubstitutionTokens\":false},\"fields\":null,\"general\":{\"autofill\":null,\"columnSpan\":\"1\",\"hidden\":false,\"hideLabel\":false,\"id\":\"134883290\",\"internalLabel\":null,\"isRootSection\":false,\"label\":\"\",\"language\":\"en\",\"options\":[],\"parentTableMetadata\":null,\"readOnly\":false,\"required\":false,\"searchConfig\":{\"canSearchOptions\":false,\"useRemoteSearch\":false},\"section\":\"0\",\"shouldForceSkipValidation\":false,\"supportingText\":null,\"type\":\"embed\",\"unique\":false,\"useCallout\":false},\"logic\":null,\"secureSettings\":null},{\"calculation\":null,\"defaultValue\":null,\"fieldTypeAttributes\":{\"dtoType\":\"FieldAttributesEmbedRichTextDto\",\"content\":\"<h2><span style=\\\"font-family: Arial, Helvetica, sans-serif; font-size: 24px; color: rgb(255, 255, 255);\\\">Assistance information:<\\/span><\\/h2>\",\"shouldProcessSubstitutionTokens\":false},\"fields\":null,\"general\":{\"autofill\":null,\"columnSpan\":\"1\",\"hidden\":false,\"hideLabel\":false,\"id\":\"134883291\",\"internalLabel\":null,\"isRootSection\":false,\"label\":\"\",\"language\":\"en\",\"options\":[],\"parentTableMetadata\":null,\"readOnly\":false,\"required\":false,\"searchConfig\":{\"canSearchOptions\":false,\"useRemoteSearch\":false},\"section\":\"0\",\"shouldForceSkipValidation\":false,\"supportingText\":null,\"type\":\"richtext\",\"unique\":false,\"useCallout\":false},\"logic\":null,\"secureSettings\":null},{\"calculation\":{\"calculationAllowNegatives\":\"\",\"calculationCategory\":\"text\",\"calculationOperator\":\"\",\"calculationUnits\":\"\",\"fieldOneCalculation\":\"\",\"fieldTwoCalculation\":\"\",\"rules\":[]},\"defaultValue\":{\"dtoType\":\"DefaultValueStringDto\",\"confirmValue\":\"\",\"value\":\"\"},\"fieldTypeAttributes\":{\"dtoType\":\"FieldAttributesSelectDto\",\"defaultValue\":\"\",\"optionCount\":1,\"optionLayout\":\"vertical\",\"optionPartToStore\":\"value\",\"useLabelsAndValues\":false,\"useOtherOption\":false,\"useRandomOption\":false,\"useSearchableOptions\":null},\"fields\":null,\"general\":{\"autofill\":null,\"columnSpan\":\"1\",\"hidden\":false,\"hideLabel\":false,\"id\":\"134883292\",\"internalLabel\":null,\"isRootSection\":false,\"label\":\"I am requesting help for:\",\"language\":\"en\",\"options\":[{\"label\":\"\",\"value\":\"\"},{\"label\":\"Myself\",\"value\":\"Myself\",\"imageUrl\":null},{\"label\":\"Another individual\",\"value\":\"Another individual\",\"imageUrl\":null},{\"label\":\"An organization\",\"value\":\"An organization\",\"imageUrl\":null}],\"parentTableMetadata\":null,\"readOnly\":false,\"required\":false,\"searchConfig\":{\"canSearchOptions\":false,\"useRemoteSearch\":false},\"section\":\"0\",\"shouldForceSkipValidation\":false,\"supportingText\":null,\"type\":\"select\",\"unique\":false,\"useCallout\":false},\"logic\":null,\"secureSettings\":null},{\"calculation\":{\"calculationAllowNegatives\":0,\"calculationCategory\":\"text\",\"calculationOperator\":\"\",\"calculationUnits\":\"\",\"fieldOneCalculation\":0,\"fieldTwoCalculation\":0,\"rules\":[]},\"defaultValue\":{\"dtoType\":\"DefaultValueStringDto\",\"confirmValue\":\"\",\"value\":\"\"},\"fieldTypeAttributes\":{\"dtoType\":\"FieldAttributesTextDto\",\"autocompleteOptions\":null,\"calculationAllowNegatives\":0,\"calculationCategory\":\"text\",\"calculationOperator\":\"\",\"calculationUnits\":\"\",\"charactersWide\":50,\"confirmationText\":\"\",\"defaultValue\":\"\",\"fieldOneCalculation\":0,\"fieldTwoCalculation\":0,\"maxLength\":0,\"minLength\":0,\"placeholderText\":\"\"},\"fields\":null,\"general\":{\"autofill\":null,\"columnSpan\":\"1\",\"hidden\":false,\"hideLabel\":false,\"id\":\"134883293\",\"internalLabel\":null,\"isRootSection\":false,\"label\":\"If you are requesting help for your organization<br \\/> what is the organization\\u2019s name?:\",\"language\":\"en\",\"options\":[],\"parentTableMetadata\":null,\"readOnly\":false,\"required\":false,\"searchConfig\":{\"canSearchOptions\":false,\"useRemoteSearch\":false},\"section\":\"0\",\"shouldForceSkipValidation\":false,\"supportingText\":null,\"type\":\"text\",\"unique\":false,\"useCallout\":false},\"logic\":{\"action\":\"Show\",\"fields\":[{\"comparisonOperator\":\"==\",\"fieldId\":\"134883292\",\"value\":\"An organization\"}],\"operator\":\"AND\",\"workflowSteps\":[]},\"secureSettings\":{\"hideInputCharacters\":false,\"removeDataFromEmailNotifications\":false,\"requireConfirmation\":false,\"restrictDataAccess\":false}},{\"calculation\":{\"calculationAllowNegatives\":0,\"calculationCategory\":\"text\",\"calculationOperator\":\"\",\"calculationUnits\":\"\",\"fieldOneCalculation\":0,\"fieldTwoCalculation\":0,\"rules\":[]},\"defaultValue\":{\"dtoType\":\"DefaultValueStringDto\",\"confirmValue\":\"\",\"value\":\"\"},\"fieldTypeAttributes\":{\"dtoType\":\"FieldAttributesTextDto\",\"autocompleteOptions\":null,\"calculationAllowNegatives\":0,\"calculationCategory\":\"text\",\"calculationOperator\":\"\",\"calculationUnits\":\"\",\"charactersWide\":50,\"confirmationText\":\"\",\"defaultValue\":\"\",\"fieldOneCalculation\":0,\"fieldTwoCalculation\":0,\"maxLength\":128,\"minLength\":0,\"placeholderText\":\"\"},\"fields\":null,\"general\":{\"autofill\":null,\"columnSpan\":\"1\",\"hidden\":false,\"hideLabel\":false,\"id\":\"134883294\",\"internalLabel\":null,\"isRootSection\":false,\"label\":\"What is your job title or role?\",\"language\":\"en\",\"options\":[],\"parentTableMetadata\":null,\"readOnly\":false,\"required\":false,\"searchConfig\":{\"canSearchOptions\":false,\"useRemoteSearch\":false},\"section\":\"0\",\"shouldForceSkipValidation\":false,\"supportingText\":null,\"type\":\"text\",\"unique\":false,\"useCallout\":false},\"logic\":{\"action\":\"Show\",\"fields\":[{\"comparisonOperator\":\"==\",\"fieldId\":\"134883292\",\"value\":\"An organization\"}],\"operator\":\"AND\",\"workflowSteps\":[]},\"secureSettings\":{\"hideInputCharacters\":false,\"removeDataFromEmailNotifications\":false,\"requireConfirmation\":false,\"restrictDataAccess\":false}},{\"calculation\":{\"calculationAllowNegatives\":\"\",\"calculationCategory\":\"text\",\"calculationOperator\":\"\",\"calculationUnits\":\"\",\"fieldOneCalculation\":\"\",\"fieldTwoCalculation\":\"\",\"rules\":[]},\"defaultValue\":{\"dtoType\":\"DefaultValueCheckboxDto\",\"otherValue\":null,\"useOtherValue\":false,\"value\":[]},\"fieldTypeAttributes\":{\"dtoType\":\"FieldAttributesCheckboxDto\",\"hideOptionButton\":true,\"imageDimensions\":\"customDimensions\",\"imageHeight\":100,\"imageLabelAlignment\":\"bottom\",\"imageWidth\":100,\"lockImageRatio\":true,\"lockImageRatioOption\":\"fitProportionally\",\"optionLayout\":\"vertical\",\"optionPartToStore\":\"value\",\"useCheckAll\":false,\"useImages\":false,\"useLabelsAndValues\":false,\"useOtherOption\":false,\"useRandomOption\":false},\"fields\":null,\"general\":{\"autofill\":null,\"columnSpan\":\"1\",\"hidden\":false,\"hideLabel\":true,\"id\":\"134896600\",\"internalLabel\":null,\"isRootSection\":false,\"label\":\"Law Enforcement Question\",\"language\":\"en\",\"options\":[{\"label\":\"If you are seeking criminal defense legal services because you or someone you know is being investigated, threatened with arrest or criminal charges, or charged with a crime related to abortion, please check here.\",\"value\":\"If you are seeking criminal defense legal services because you or someone you know is being investigated, threatened with arrest or criminal charges, or charged with a crime related to abortion, please check here.\",\"imageUrl\":null}],\"parentTableMetadata\":null,\"readOnly\":false,\"required\":false,\"searchConfig\":{\"canSearchOptions\":false,\"useRemoteSearch\":false},\"section\":\"0\",\"shouldForceSkipValidation\":false,\"supportingText\":null,\"type\":\"checkbox\",\"unique\":false,\"useCallout\":false},\"logic\":null,\"secureSettings\":null},{\"calculation\":{\"calculationAllowNegatives\":0,\"calculationCategory\":\"text\",\"calculationOperator\":\"\",\"calculationUnits\":\"\",\"fieldOneCalculation\":0,\"fieldTwoCalculation\":0,\"rules\":[]},\"defaultValue\":{\"dtoType\":\"DefaultValueStringDto\",\"confirmValue\":\"\",\"value\":\"\"},\"fieldTypeAttributes\":{\"dtoType\":\"FieldAttributesNumberDto\",\"calculationAllowNegatives\":0,\"calculationCategory\":\"text\",\"calculationOperator\":\"\",\"calculationUnits\":\"\",\"charactersWide\":5,\"currency\":null,\"currencyFormat\":\"\",\"defaultValue\":\"\",\"fieldOneCalculation\":0,\"fieldTwoCalculation\":0,\"maxValue\":4.1,\"minValue\":3.9,\"numberOfDecimals\":1,\"placeholderText\":\"\",\"useSlider\":false},\"fields\":null,\"general\":{\"autofill\":null,\"columnSpan\":\"1\",\"hidden\":false,\"hideLabel\":false,\"id\":\"156114461\",\"internalLabel\":null,\"isRootSection\":false,\"label\":\"What is 7 minus 3\",\"language\":\"en\",\"options\":[],\"parentTableMetadata\":null,\"readOnly\":false,\"required\":true,\"searchConfig\":{\"canSearchOptions\":false,\"useRemoteSearch\":false},\"section\":\"0\",\"shouldForceSkipValidation\":false,\"supportingText\":\"(To verify you are human)\",\"type\":\"number\",\"unique\":false,\"useCallout\":false},\"logic\":null,\"secureSettings\":null}],\"general\":{\"autofill\":null,\"columnSpan\":0,\"hidden\":false,\"hideLabel\":false,\"id\":\"0\",\"internalLabel\":null,\"isRootSection\":true,\"label\":\"\",\"language\":null,\"options\":[],\"parentTableMetadata\":null,\"readOnly\":false,\"required\":false,\"searchConfig\":null,\"section\":\"\",\"shouldForceSkipValidation\":null,\"supportingText\":null,\"type\":\"section\",\"unique\":false,\"useCallout\":null},\"logic\":null,\"secureSettings\":null}],\"shouldDisableSubmission\":null,\"submitUrl\":\"https:\\/\\/abortiondefensenetwork.formstack.com\\/forms\\/index.php\",\"theme\":{\"backgroundImage\":\"\",\"backgroundImageRepeat\":\"repeat\",\"bodyBgColor\":\"#4e1570\",\"buttonBgColor\":\"#ffda00\",\"buttonBorder\":\"0px\",\"buttonBorderColor\":\"transparent\",\"buttonColor\":\"#4e1570\",\"buttonFontSize\":\"20px\",\"buttonFontStyle\":\"normal\",\"buttonFontVariant\":\"\",\"buttonFontWeight\":\"700\",\"buttonPaddingLeftRight\":\"30px\",\"buttonPaddingTopBottom\":\"15px\",\"buttonRoundedCorners\":\"3px\",\"colorMain\":\"#ffffff\",\"customCss\":\"hr{\\n   \\n   border: none;\\n    height: 1px;\\n    \\/* Set the hr color *\\/\\n    color: #FFDA00; \\/* old IE *\\/\\n    background-color: #FFDA00; \\/* Modern Browsers *\\/\\n}\\n\\ninput, select{\\n     border-radius: 5px!important;\\n}\\n\\n.fsValidationError .fsLabel, .fsValidationError .fsRequiredLabel, .fsValidationError .fsRequiredMarker {\\n   \\/* font-weight:bold!important;*\\/\\n    color:#FF678B!important;\\n}\\n\\n.fsError{   -webkit-box-shadow: 0 0 0 calc(7.5px - 1px) #fae9e9, 0 0 0 7.5px #ce5f6d!important;\\nborder:none!important;\\n\\n}\\n\\ndiv.kmqLkQ {\\n      align-items: top!important; \\n    \\n}\",\"errorBackgroundColor\":\"#fae9e9\",\"errorColorPrimary\":\"#ff3C3C\",\"errorColorSecondary\":\"#15232b\",\"extraneousPrimaryColor\":\"#595d64\",\"extraneousSecondaryColor\":\"#d4d4d4\",\"extraneousTertiaryColor\":\"#eaeaea\",\"fieldBgColor\":\"#ffffff\",\"fieldBorder\":\"1px\",\"fieldBorderColor\":\"#cfd4d8\",\"fieldColor\":\"#595d64\",\"fieldFontStyle\":\"normal\",\"fieldFontVariant\":\"\",\"fieldFontWeight\":\"400\",\"fieldRequiredBgColor\":\"#ffffff\",\"fieldRequiredBorder\":\"1px\",\"fieldRequiredBorderColor\":\"#cfd4d8\",\"fieldRoundedCorners\":\"3px\",\"focusHighlightColor\":\"#72438e\",\"focusHighlightOpacity\":1,\"fontService\":\"google\",\"fontWeights\":\"700,400,600\",\"footerImageAlignment\":\"\",\"footerImageHeight\":\"\",\"footerImageUrl\":\"\",\"footerImageWidth\":\"\",\"formAlignment\":\"center\",\"formBgColor\":\"#4e1570\",\"formBgColorOpacity\":1,\"formBorder\":\"0px\",\"formBorderColor\":\"transparent\",\"formBorderRoundedCorners\":\"6px\",\"globalFont\":\"Open Sans\",\"globalFontSize\":1,\"globalRoundedCorners\":\"3px\",\"globalSpacing\":3,\"headerImageAlignment\":\"\",\"headerImageHeight\":\"\",\"headerImageUrl\":\"\",\"headerImageWidth\":\"\",\"inputFocusHighlightColor\":\"#0197EC\",\"isNoStyleStrict\":false,\"labelRequiredColor\":\"#ffda00\",\"labelRequiredFontSize\":\"16px\",\"matrixLabelColumnPosition\":\"center\",\"matrixLabelRowPosition\":\"right\",\"placeholderTextColor\":\"\",\"productPriceColor\":\"#595d64\",\"ratingIconColor\":\"#595d64\",\"ratingIconSize\":\"25px\",\"readOnlyFieldBgColor\":\"#edeff0\",\"saveAndResumeButtonBackgroundColor\":\"#eaeaea\",\"saveAndResumeButtonTextColor\":\"#595d64\",\"sectionBgColor\":\"#edeff0\",\"sectionColor\":\"#595d64\",\"sectionHeadingAlignment\":\"center\",\"sectionHeadingColor\":\"#595d64\",\"sectionHeadingFontStyle\":\"normal\",\"sectionHeadingFontVariant\":\"\",\"sectionHeadingFontWeight\":\"400\",\"sectionHeadingSize\":\"28px\",\"sectionRoundedCorners\":\"3px\",\"sizeField\":\"14px\",\"sizeLabel\":\"16px\",\"spacing\":\"15px\",\"successBackgroundColor\":\"#eefaf5\",\"successColorPrimary\":\"#21B573\",\"successColorSecondary\":\"#eefaf5\",\"supportingTextColor\":\"#ffffff\",\"supportingTextFontSize\":\"10px\",\"supportingTextFontStyle\":\"normal\",\"supportingTextFontVariant\":\"\",\"supportingTextFontWeight\":\"\",\"tableCellEvenBgColor\":\"#eaeaea33\",\"tableCellOddBgColor\":\"#d4d4d433\",\"transitionDuration\":\"0s\",\"transitionSpacingRightLeft\":\"15px\",\"transitionSpacingTopBottom\":\"15px\"},\"url\":\"https:\\/\\/abortiondefensenetwork.formstack.com\",\"version\":\"4\",\"viewKey\":\"ULd7Pors0n\",\"workflows\":null},\"isCached\":true,\"success\":true},"+"\n");
document.write("    }"+"\n");
document.write("  );"+"\n");
document.write("    (function(){"+"\n");
document.write("    var link = document.createElement(\'link\');"+"\n");
document.write("    link.rel = \'stylesheet\';"+"\n");
document.write("    link.href = \'https://fonts.googleapis.com/css?family=Open Sans:700,400,600\';"+"\n");
document.write("    document.querySelector(\'head\').appendChild(link);"+"\n");
document.write("  })();"+"\n");
document.write("  </script>"+"\n");
document.write(""+"\n");