/* growform client2 bundle.url: https://assets.growform.co/7ce1dc50-mu2jbvpp/form.bundle.js resolve.source: memory resolve.at: 2026-10-23T09:00:19.433Z form.source: api cache.age_ms: 8909 fallback_used: false */ ;(function () { var EMBED_TYPE = "iFrame"; var FORM_ID = "6850a11dbd68c4000c90cfd6"; var FORM_BUNDLE_URL = "https://assets.growform.co/7ce1dc50-mu2jbvpp/form.bundle.js"; // injected by worker (KV/memory/fallback) var FORM_DATA = {"data":{"form":{"_id":"6850a11dbd68c4000c90cfd6","steps":[{"id":"a88dd57159b5ef86f6fef424","name":"Name","sortOrder":1},{"id":"e13ac5cbc8eedf7607b5bc63","name":"Date of birth","sortOrder":2,"copyOf":"8d2309d21d8fe8e0bc1f81da"},{"id":"2a56cacfe5d0119477734d04","name":"Gender","sortOrder":3},{"id":"de59b18bbd02c0eef8e91b2c","name":"Residence","sortOrder":4},{"id":"60c2d61a66a74bcb70ce6e49","name":"Smoking status","sortOrder":5,"copyOf":"acd45227cac332d443c4e1db"},{"id":"8d2309d21d8fe8e0bc1f81da","name":"Coverage amount","sortOrder":6},{"id":"343876c9bd9bf4993e506844","name":"Term Length","sortOrder":7,"copyOf":"8d2309d21d8fe8e0bc1f81da"},{"id":"ad14c979f73daa25aa94c795","name":"Health Classification","sortOrder":8,"copyOf":"343876c9bd9bf4993e506844"},{"id":"ff4727c9498ef9c0a6c989d9","name":"Contact info","sortOrder":9}],"isActive":true,"formName":"Term Life Quote","fields":{"Decorative Header_52363373085874":{"type":"Decorative Header","value":"Success!","width":12,"step":"complete","sortOrder":1,"fieldStyle":{"fontSize":{"value":27,"unit":"px"},"fontWeight":"Bold"},"margins":{"marginTop":20},"stepId":"complete"},"Decorative Header_576559560634956":{"type":"Decorative Header","value":"How shall we contact you about your quotes?","width":12,"step":5,"sortOrder":1,"fieldStyle":{"fontSize":{"value":19,"unit":"px"},"fontWeight":"Bold"},"stepId":"ff4727c9498ef9c0a6c989d9","margins":{"marginBottom":5}},"email_907058157108782":{"type":"Email","label":"Your email address","width":12,"margins":{"marginBottom":0},"step":5,"sortOrder":2,"stepId":"ff4727c9498ef9c0a6c989d9"},"phone_589083232390193":{"type":"Phone","label":"Your phone number","width":12,"margins":{"marginBottom":0},"step":5,"sortOrder":3,"helperText":"","stepId":"ff4727c9498ef9c0a6c989d9"},"Decorative_Paragraph_194067845817258":{"type":"Decorative Paragraph","value":"Thank you!\n\n\nWe will contact you with tailored life insurance quotes by phone and email momentarily.","width":12,"step":"complete","sortOrder":2,"margins":{"marginBottom":60},"stepId":"complete","fieldStyle":{"fontSize":{"value":34,"unit":"px"}}},"decorative_header_892646863007116":{"type":"Decorative Header","value":"Do you smoke?","width":12,"step":2,"sortOrder":1,"fieldStyle":{"fontSize":{"value":24,"unit":"px"},"fontWeight":"Bold"},"stepId":"60c2d61a66a74bcb70ce6e49","margins":{"marginBottom":6,"marginTop":6}},"buttons_88398974892131":{"type":"Buttons","validationRules":{"required":true},"label":"Smoking status","width":12,"multiple":false,"buttonStyle":{"rt_buttonsPerRow":2,"rt_buttonsPerRowMobile":1,"buttonsType":"Square","spacing":20,"showControls":"Yes","rt_compactLayoutOnMobile":"Yes","sq_buttonsPerRow":"2"},"options":[{"text":"Yes","id":"a87008aa386b54a352fd7fa0","image":"https://res.cloudinary.com/dqnjggegp/image/upload/v1689071914/uploads/fqldvovu2elcuf2qkq0q.png"},{"text":"No","id":"4ebf4a36fbb49f6efba3c325","image":"https://res.cloudinary.com/dqnjggegp/image/upload/v1689071918/uploads/ou1njca82d5jmzpljsl8.png"}],"stepId":"60c2d61a66a74bcb70ce6e49","sortOrder":2,"hideLabel":true,"imageStyles":{"rt_borderRadius":0,"size":"50%"},"margins":{"marginLeft":0,"marginRight":0}},"decorative_header_59270480717140":{"type":"Decorative Header","value":"How much life insurance coverage is needed?","width":12,"sortOrder":1,"stepId":"8d2309d21d8fe8e0bc1f81da","fieldStyle":{"fontSize":{"value":24,"unit":"px"}},"margins":{"marginBottom":5}},"number_529584757854804":{"type":"Number","label":"Amount","currencySymbol":"$","width":12,"stepId":"8d2309d21d8fe8e0bc1f81da","sortOrder":2,"wholeNumbersOnly":true,"validationRules":{"required":true}},"decorative_header_155835293514018":{"type":"Decorative Header","value":"What is your date of birth?","width":12,"sortOrder":1,"stepId":"e13ac5cbc8eedf7607b5bc63","fieldStyle":{"fontSize":{"value":24,"unit":"px"}},"margins":{"marginBottom":5}},"dob_385139492655202":{"type":"DOB","label":"Date of Birth","width":12,"stepId":"e13ac5cbc8eedf7607b5bc63","sortOrder":2,"hideLabel":false,"validationRules":{"required":true}},"toscheckbox_518177952850574":{"type":"TOSCheckbox","label":"By clicking “Submit,” I expressly authorize **Lifeworth Insurance** and its licensed agents to call, text, or email me at the number and email address I provided—even if my number is on a federal, state, or corporate Do-Not-Call registry—using an automatic telephone dialing system or prerecorded/artificial voice to discuss life-insurance products and services. ","width":12,"stepId":"ff4727c9498ef9c0a6c989d9","sortOrder":4},"name_656366904050696":{"type":"Name","label":"What is your name?","width":12,"hideLabel":true,"options":{"Firstname":{"value":null,"errorText":null},"Lastname":{"value":null,"errorText":null},"Prefix":{"value":null,"errorText":null}},"stepId":"a88dd57159b5ef86f6fef424","sortOrder":2},"decorative_header_394241076933514":{"type":"Decorative Header","value":"Get Your Life Insurance Quote","width":12,"stepId":"a88dd57159b5ef86f6fef424","sortOrder":1,"fieldStyle":{"fontSize":{"value":35,"unit":"px"}}},"decorative_header_494514603970181":{"type":"Decorative Header","value":"Your Gender","width":12,"stepId":"2a56cacfe5d0119477734d04","sortOrder":1,"fieldStyle":{"fontSize":{"value":24,"unit":"px"}}},"radio_buttons_457794459416565":{"type":"Radio Buttons","label":"Gender","width":"12","options":[{"text":"Female","id":"91fa4d2c45782d033635b06a"},{"text":"Male","id":"eadc9487448a6c0ae902d136"},{"text":"Other","id":"a26fb026479b195ed1ba3bc0"}],"stepId":"2a56cacfe5d0119477734d04","sortOrder":2,"hideLabel":true},"decorative_header_96375366602429":{"type":"Decorative Header","value":"State of Residence","width":12,"stepId":"de59b18bbd02c0eef8e91b2c","sortOrder":1},"single_select_239457842743626":{"type":"Single Select","width":12,"label":"State","options":[{"text":"Alabama","id":"61829875d5171f20b29420cc"},{"text":"Alaska","id":"6c24bc5fe9f433876d08fd7f"},{"text":"Arizona","id":"e4229a0da8daa1f39280629f"},{"text":"Arkansas","image":null,"id":"4aefc5cae424545070f4c838"},{"text":"California","image":null,"id":"2277929c68eb4124743f5985"},{"text":"Colorado","image":null,"id":"fffa0a9551da4d212be13c8b"},{"text":"Connecticut","image":null,"id":"e1aa0410b6767260ec3744bd"},{"text":"Delaware","image":null,"id":"c29757a0e0f490a358097d22"},{"text":"Florida","image":null,"id":"57d2892fd105d35763debc1e"},{"text":"Georgia","image":null,"id":"0ec644ca67debc469b24d88c"},{"text":"Hawaii","image":null,"id":"515df8fa6d235aba5a323d85"},{"text":"Idaho","image":null,"id":"d596bac175952efd46a4854b"},{"text":"Illinois","image":null,"id":"42a46892c91253b221eef6a3"},{"text":"Indiana","image":null,"id":"0763f4017c61bea872f7b4c6"},{"text":"Iowa","image":null,"id":"349f8bcca30975f6ec67c3f5"},{"text":"Kansas","image":null,"id":"b48600fb5695f0c539a33f72"},{"text":"Kentucky","image":null,"id":"572550f2b9feb1bf4a540421"},{"text":"Louisiana","image":null,"id":"2bd59d4e93283ff6ae95a075"},{"text":"Maine","image":null,"id":"641bcb555f75a306fc34accf"},{"text":"Maryland","image":null,"id":"1929508cbeadd0ec34f9b091"},{"text":"Massachusetts","image":null,"id":"35d064da3ad9d6ffa7cbd93c"},{"text":"Michigan","image":null,"id":"6e9e4df5f697795287f81da6"},{"text":"Minnesota","image":null,"id":"3457187dad60f93307e21237"},{"text":"Mississippi","image":null,"id":"a7f78af80faf8f984f8b9d9c"},{"text":"Missouri","image":null,"id":"d21037ec4ff368c73e6d2184"},{"text":"Montana","image":null,"id":"bc7dd1b9e59bd1913be44002"},{"text":"Nebraska","image":null,"id":"58d625c5da742eed043c84e0"},{"text":"Nevada","image":null,"id":"75b912578250b4b4fb21d2ec"},{"text":"New Hampshire","image":null,"id":"91a50edc3683d9166b5309b8"},{"text":"New Jersey","image":null,"id":"7b6e2164b5dbaa650a2b0882"},{"text":"New Mexico","image":null,"id":"839f46f4fcdbb197a58c4bb1"},{"text":"New York","image":null,"id":"9470401fe2f3f830abfb4565"},{"text":"North Carolina","image":null,"id":"f0a27cbfe93cb3e95d1213ae"},{"text":"North Dakota","image":null,"id":"d48f743448180566d54f52a4"},{"text":"Ohio","image":null,"id":"07f984253195708fede5dc36"},{"text":"Oklahoma","image":null,"id":"f841ebceef6df9425c77dffd"},{"text":"Oregon","image":null,"id":"85dee37a61d45f3ef002555d"},{"text":"Pennsylvania","image":null,"id":"4be69d564582ceb5ca6e4407"},{"text":"Rhode Island","image":null,"id":"b6a204095473d62ad664e1ac"},{"text":"South Carolina","image":null,"id":"425af74713fc1bd0e1c55fd7"},{"text":"South Dakota","image":null,"id":"18d588abf69777bd92fb375a"},{"text":"Tennessee","image":null,"id":"b961ef83659cbeec0698ad15"},{"text":"Texas","image":null,"id":"9a8ee6539c2d3cd4747fd2f3"},{"text":"Utah","image":null,"id":"037695962f80c3bbb6ccb255"},{"text":"Vermont","image":null,"id":"1ec6bf682bc92720d13e621e"},{"text":"Virginia","image":null,"id":"f30c0e89f0dbb5528f93a470"},{"text":"Washington","image":null,"id":"ffe0b88e538e458a4d22a832"},{"text":"West Virginia","image":null,"id":"74376b5e0ec25fbaccc0eac8"},{"text":"Wisconsin","image":null,"id":"7859d6b86c4effbc0d78aefd"},{"text":"Wyoming","image":null,"id":"e6e739dcf85a3df112ae30bb"}],"helperText":null,"stepId":"de59b18bbd02c0eef8e91b2c","sortOrder":2,"hideLabel":false,"validationRules":{"required":true}},"zipcode_12399766785319":{"type":"Zipcode","label":"Zip Code","zipcodeFieldFormat":"zipcode_usa","width":12,"stepId":"de59b18bbd02c0eef8e91b2c","sortOrder":3,"conditionalLogic":{"action":"show","ruleBlocks":[{"sortOrder":0,"rules":[{"observedField":"single_select_239457842743626","operator":"is_filled","criteria":""}]}]}},"decorative_header_947275717835413":{"type":"Decorative Header","value":"Term Length","width":12,"sortOrder":1,"stepId":"343876c9bd9bf4993e506844","fieldStyle":{"fontSize":{"value":24,"unit":"px"}},"margins":{"marginBottom":5}},"decorative_paragraph_238768356997381":{"type":"Decorative Paragraph","value":"What length of time would you need to be covered? ","width":12,"stepId":"343876c9bd9bf4993e506844","sortOrder":2,"fieldStyle":{"fontSize":{"value":16,"unit":"px"},"fontFamily":"Inter","fontStyle":"normal","fontWeight":"bold"}},"single_select_693752241588159":{"type":"Single Select","width":12,"label":"Policy Duration","options":[{"text":"10 Years","id":"61829875d5171f20b29420cc"},{"text":"15 Years","id":"6c24bc5fe9f433876d08fd7f"},{"text":"20 Years","id":"e4229a0da8daa1f39280629f"},{"text":"25 Years","image":null,"id":"91d27968dea1247729e8b2d9"},{"text":"30 Years","image":null,"id":"990236794264967f77f9f1b3"}],"helperText":null,"stepId":"343876c9bd9bf4993e506844","sortOrder":3,"validationRules":{"required":true}},"decorative_header_254112407016597":{"type":"Decorative Header","value":"Health Classification","width":12,"sortOrder":1,"stepId":"ad14c979f73daa25aa94c795","fieldStyle":{"fontSize":{"value":24,"unit":"px"}},"margins":{"marginBottom":5}},"single_select_210437084037685":{"type":"Single Select","width":12,"label":"Health Classification","options":[{"text":"Excellent","id":"61829875d5171f20b29420cc"},{"text":"Good","id":"6c24bc5fe9f433876d08fd7f"},{"text":"Average","id":"e4229a0da8daa1f39280629f"},{"text":"Below Average","image":null,"id":"91d27968dea1247729e8b2d9"}],"helperText":null,"stepId":"ad14c979f73daa25aa94c795","sortOrder":2,"validationRules":{"required":true},"hideLabel":true}},"options":{"numberOfSteps":5,"dateFormat":"DD/MM/YYYY","progressBar":{"enable":true},"continueButton":{"continueText":"Next","submitText":"Get my quotes","backText":"Back"},"customStyles":{"width":{"unit":"px","value":580},"parentContainerMinHeight":{"value":0,"unit":"px"},"parentBackgroundImage":{"imageInitialHeight":1362,"imageInitialWidth":2066,"imageHeight":1362,"imageWidth":2066,"imageUrl":"https://res.cloudinary.com/dqnjggegp/image/upload/v1597337140/uploads/qmsfk98ank3wfp1ehvyg.jpg"},"headerMarginTop":30,"parentBackgroundColor":"#ffffff","innerFormBackgroundColor":"#ffffff","innerFormBackgroundTransparency":"","primaryColor":"#3e67c6","bodyTextColor":"#343434","parentContainerBackgroundType":"color","innerFormBackgroundType":"none","buttonBorderColor":"#ff7500","buttonColorSelected":"#ffa659","buttonBorderColorSelected":"#ff7500","footerMarginBottom":70,"errorColor":"#ff4e4e","buttonColor":"#ff7500","buttonTextColor":"#ffffff","inputLabelColor":"#a3a3a3","inputTextColor":"#000000","defaultFont":"Mulish","sq_buttonFont":"Poppins","sq_buttonFontSize":15,"showShadows":"Yes","sq_buttonTextColor":"#343434","sq_buttonColor":"#FFFFFF","sq_buttonColorSelected":"#FFFFFF","sq_buttonBorderColor":"#DADADA","sq_buttonBorderColorSelected":"primary","sq_buttonBannerColor":"#FFFFFF","rt_buttonFont":"Poppins","rt_buttonFontSize":15,"rt_buttonColor":"#FFFFFF","rt_buttonColorSelected":"#FFFFFF","rt_buttonTextColor":"#343434","rt_buttonBorderColor":"#DADADA","rt_buttonBorderColorSelected":"primary","inputLabelFont":"Poppins","inputFontSize":16,"continueSubmitButtonFontSize":15,"fullModeBackgroundColor":"#ECF0F9","canvasSetup":"full"},"localization":{"dateFormat":"MM/DD/YYYY"},"exportTransparentBackground":false,"customScript":"","logo":{"value":"https://res.cloudinary.com/dqnjggegp/image/upload/v1750114835/uploads/h19jzmrchxwqd7t17abc.png","linkUrl":"","imageWidth":122,"imageHeight":40,"imageInitialWidth":1024,"imageInitialHeight":334},"footer":{"component":"decorativeParagraph","decorativeParagraph":{"value":"© Lifeworth Insurance 2025"}},"endings":[{"id":"complete","name":"Thank you (default)","type":"inFormEnding","sortOrder":1,"conditionalLogic":null}]},"ownedByUser":"62e1f0f36001a600a8b9adde","personalisation":{"form_related_to":"Life insurance"}},"accountIsActive":true,"accountIsFreeTrial":false}}; // ---- Utils ---- function safeJSONStringify(obj) { return JSON.stringify(obj) .replace(/<\/(script|style)/gi, '<\\/$1') .replace(//g, '--\\>') .replace(/\u2028/g, '\\u2028') .replace(/\u2029/g, '\\u2029'); } function preloadScript(href) { try { if (!href) return; if (document.querySelector('link[rel="preload"][href="' + href + '"]')) return; var l = document.createElement("link"); l.rel = "preload"; l.as = "script"; l.href = href; l.crossOrigin = ""; // allow cache reuse in iframe document.head.appendChild(l); } catch (_) {} } function parseQuery() { var out = {}; try { if (!window.location.search) return out; var usp = new URLSearchParams(window.location.search); usp.forEach(function (v, k) { out[k] = v; }); } catch (_) {} return out; } function getCookie(name) { try { var match = document.cookie.match(new RegExp('(^| )' + name + '=([^;]+)')); return match ? decodeURIComponent(match[2]) : ''; } catch (_) { return ''; } } function buildIframeHTML(opts) { var html = '\n' + '\n' + '\n' + ' \n' + ' \n' + ' \n' + '\n' + '\n' + ' \n' + '
\n' + '