/* growform client2 bundle.url: https://assets.growform.co/7cd213d-mkcup4o2/form.bundle.js resolve.source: kv resolve.at: 2026-01-16T00:50:16.933Z form.source: kv cache.age_ms: 0 kv.value_present: true fallback_used: false */ ;(function () { var EMBED_TYPE = "iFrame"; var FORM_ID = "692fb86582be3547c94469f0"; var FORM_BUNDLE_URL = "https://assets.growform.co/7cd213d-mkcup4o2/form.bundle.js"; // injected by worker (KV/memory/fallback) var FORM_DATA = {"data":{"form":{"_id":"692fb86582be3547c94469f0","options":{"numberOfSteps":5,"dateFormat":"DD/MM/YYYY","progressBar":{"enable":true,"line_showPercent":"Yes","variant":"bars"},"continueButton":{"continueText":"GET QUOTE","submitText":"Submit","backText":"Back"},"customStyles":{"width":{"unit":"px","value":700},"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":15,"parentBackgroundColor":"#ffffff","innerFormBackgroundColor":"#ffffff","innerFormBackgroundTransparency":"","primaryColor":"#000000","bodyTextColor":"#343434","parentContainerBackgroundType":"none","innerFormBackgroundType":"none","buttonBorderColor":"#ff7500","buttonColorSelected":"#ffa659","buttonBorderColorSelected":"#ff7500","footerMarginBottom":15,"errorColor":"#ff4e4e","buttonColor":"#ff7500","buttonTextColor":"#ffffff","inputLabelColor":"#949393","inputTextColor":"#000000","defaultFont":"Open Sans","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":"#e5f1f5","rt_buttonColorSelected":"#FFFFFF","rt_buttonTextColor":"#343434","rt_buttonBorderColor":"#DADADA","rt_buttonBorderColorSelected":"primary","inputLabelFont":"Poppins","inputFontSize":16,"continueSubmitButtonFontSize":15,"fullModeBackgroundColor":"#ffffff","canvasSetup":"minimal","continueButtonColor":"#2fb3c4","progressColor":"#78f8ff","inputBackgroundColor":"#effffd","formMarginSide":null},"localization":{"dateFormat":"MM/DD/YYYY"},"exportTransparentBackground":false,"customScript":"","customRedirectUrls":[{"url":"https://totalchoicehealth.com/book-a-call?name={name}&email={email}&a1={a1}&a2={a2}&a3={a3}&a4={a4}&a5={a5}&a6={a6}&a7={a7}&a8={a8}&a9={a9}","conditionalLogic":{"ruleBlocks":[{"sortOrder":0,"rules":[{"observedField":"buttons_72190667710778","operator":"selected_option","criteria":"d3d89c8c3c80779f4b834e99"},{"observedField":"buttons_72190667710778","operator":"selected_option","criteria":"8c1bcb558a24e09200a7d6fe"},{"observedField":"buttons_72190667710778","operator":"selected_option","criteria":"a4fc47f75474a4529e1201d5"}]},{"sortOrder":4,"rules":[{"observedField":"dob_241505933425026","operator":"is_younger_than","criteria":"60"}]},{"sortOrder":5,"rules":[{"observedField":"buttons_160861410246195","operator":"selected_option","criteria":"f04cffb940169c2787f47db6"}]},{"sortOrder":4,"rules":[{"observedField":"buttons_681876813694708","operator":"selected_option","criteria":"c24753f070a6cc5a1835835a"},{"observedField":"buttons_681876813694708","operator":"selected_option","criteria":"f04cffb940169c2787f47db6"},{"observedField":"buttons_681876813694708","operator":"selected_option","criteria":"50198843f8658c3f49ea283e"},{"observedField":"buttons_681876813694708","operator":"selected_option","criteria":"d3d89c8c3c80779f4b834e99"},{"observedField":"buttons_681876813694708","operator":"selected_option","criteria":"27319a3d7dffa90661a9f19f"},{"observedField":"buttons_681876813694708","operator":"selected_option","criteria":"18d2b6e4517cc6b8cef61c1b"}]},{"sortOrder":5,"rules":[{"observedField":"buttons_109446974978914","operator":"selected_option","criteria":"192368f189795a7f9199624d"}]}]}},{"url":"https://totalchoicehealth.com/book-a-call?name={name}&email={email}&a1={a1}&a2={a2}&a3={a3}&a4={a4}&a5={a5}&a6={a6}&a7={a7}&a8={a8}&a9={a9}","conditionalLogic":{"ruleBlocks":[{"sortOrder":0,"rules":[{"observedField":"buttons_681876813694708","operator":"selected_option","criteria":"f04cffb940169c2787f47db6"},{"observedField":"buttons_681876813694708","operator":"selected_option","criteria":"50198843f8658c3f49ea283e"},{"observedField":"buttons_681876813694708","operator":"selected_option","criteria":"d3d89c8c3c80779f4b834e99"},{"observedField":"buttons_681876813694708","operator":"selected_option","criteria":"27319a3d7dffa90661a9f19f"},{"observedField":"buttons_681876813694708","operator":"selected_option","criteria":"18d2b6e4517cc6b8cef61c1b"}]},{"sortOrder":2,"rules":[{"observedField":"buttons_72190667710778","operator":"selected_option","criteria":"8c1bcb558a24e09200a7d6fe"},{"observedField":"buttons_72190667710778","operator":"selected_option","criteria":"a4fc47f75474a4529e1201d5"}]},{"sortOrder":3,"rules":[{"observedField":"dob_241505933425026","operator":"is_younger_than","criteria":"60"}]},{"sortOrder":4,"rules":[{"observedField":"buttons_160861410246195","operator":"selected_option","criteria":"f04cffb940169c2787f47db6"}]},{"sortOrder":5,"rules":[{"observedField":"buttons_109446974978914","operator":"selected_option","criteria":"5be94772672205ea06fa1c3c"}]}]}},{"url":"https://totalchoicehealth.com/youve-been-matched-with-an-agent","conditionalLogic":null}],"logo":null,"additionalInfo":null,"actionOnSubmit":"redirect","sendCustomRedirectQueryParams":true},"fields":{"Decorative Header_797442086161467":{"type":"Decorative Header","value":"Get a Free Quote Now:","width":12,"step":2,"sortOrder":1,"fieldStyle":{"fontSize":{"value":18,"unit":"px"},"fontWeight":"Bold"},"stepId":"acd45227cac332d443c4e1db","margins":{"marginBottom":0}},"Decorative Header_576559560634956":{"type":"Decorative Header","value":"Select Your Gender","width":12,"step":5,"sortOrder":1,"fieldStyle":{"fontSize":{"value":18,"unit":"px"},"fontWeight":"Bold"},"stepId":"ff4727c9498ef9c0a6c989d9","margins":{"marginBottom":0}},"buttons_109446974978914":{"type":"Buttons","validationRules":{"required":true},"label":"Who Are You Searching For?","width":12,"multiple":false,"buttonStyle":{"rt_buttonsPerRow":2,"rt_buttonsPerRowMobile":1,"buttonsType":"Rectangle","spacing":20,"showControls":"Yes","rt_compactLayoutOnMobile":"Yes"},"options":[{"text":"MY FAMILY","id":"5be94772672205ea06fa1c3c"},{"text":"MYSELF","id":"192368f189795a7f9199624d"}],"stepId":"acd45227cac332d443c4e1db","sortOrder":2,"hideLabel":false,"customQueryParamName":"a8"},"decorative_header_656897462625682":{"type":"Decorative Header","value":"Great Job, You're Almost Done!","width":12,"step":2,"sortOrder":1,"fieldStyle":{"fontSize":{"value":18,"unit":"px"},"fontWeight":"Bold"},"stepId":"e69a42007f1d4180f08d3e66","margins":{"marginBottom":0}},"buttons_8792293396332":{"type":"Buttons","validationRules":{"required":false},"label":"Gender","width":12,"multiple":false,"buttonStyle":{"rt_buttonsPerRow":2,"rt_buttonsPerRowMobile":1,"buttonsType":"Rectangle","spacing":20,"showControls":"Yes","rt_compactLayoutOnMobile":"Yes"},"imageStyles":{},"options":[{"text":"Male","id":"6ccbdc909d9fdf901f8a6294"},{"text":"Female","id":"dbda969c009f3113aec18fbd"}],"stepId":"ff4727c9498ef9c0a6c989d9","sortOrder":2,"hideLabel":true,"customQueryParamName":"a5"},"decorative_header_674375862052895":{"type":"Decorative Header","value":"Enter Your Date of Birth","width":12,"step":5,"sortOrder":1,"fieldStyle":{"fontSize":{"value":18,"unit":"px"},"fontWeight":"Bold"},"stepId":"d9da87b2ff5e89642ed0b305","margins":{"marginBottom":0}},"decorative_header_978354463212314":{"type":"Decorative Header","value":"
How Many People Live in Your Household?
","width":12,"v":2,"sortOrder":1,"stepId":"b7eef3f9f2f9d21eb2cbc273"},"buttons_681876813694708":{"type":"Buttons","validationRules":{"required":false},"label":"HH Size","width":12,"multiple":false,"buttonStyle":{"rt_buttonsPerRow":2,"rt_buttonsPerRowMobile":1,"buttonsType":"Rectangle","spacing":20,"showControls":"Yes","rt_compactLayoutOnMobile":"Yes"},"imageStyles":{},"options":[{"text":"1","id":"c24753f070a6cc5a1835835a"},{"text":"2","id":"f04cffb940169c2787f47db6"},{"text":"3","id":"50198843f8658c3f49ea283e"},{"text":"4","id":"d3d89c8c3c80779f4b834e99"},{"text":"5","image":null,"id":"27319a3d7dffa90661a9f19f"},{"text":"6 +","image":null,"id":"18d2b6e4517cc6b8cef61c1b"}],"stepId":"b7eef3f9f2f9d21eb2cbc273","sortOrder":2,"hideLabel":true,"customQueryParamName":"a7"},"decorative_header_291122287368880":{"type":"Decorative Header","value":"Great Job! You're Almost Done!
","width":12,"v":2,"sortOrder":1,"stepId":"25d06dd4f325502eeb37b32d"},"decorative_header_712344742576987":{"type":"Decorative Header","value":"Annual Pre-Tax Income? (Household Total)
","width":12,"v":2,"sortOrder":1,"stepId":"7738897b10954c8bb9f2c7b0"},"buttons_72190667710778":{"type":"Buttons","validationRules":{"required":false},"label":"Income","width":12,"multiple":false,"buttonStyle":{"rt_buttonsPerRow":2,"rt_buttonsPerRowMobile":1,"buttonsType":"Rectangle","spacing":20,"showControls":"Yes","rt_compactLayoutOnMobile":"Yes"},"imageStyles":{},"options":[{"text":"$0 - $19,999","id":"c24753f070a6cc5a1835835a"},{"text":"$20,000 - $29,999","id":"f04cffb940169c2787f47db6"},{"text":"$30,000 - $49,999","id":"50198843f8658c3f49ea283e"},{"text":"$50,000 - $69,999","id":"d3d89c8c3c80779f4b834e99"},{"text":"$70,000 - $89,999","image":null,"id":"8c1bcb558a24e09200a7d6fe"},{"text":"$90,000 - $100,000 +","image":null,"id":"a4fc47f75474a4529e1201d5"}],"stepId":"7738897b10954c8bb9f2c7b0","sortOrder":2,"hideLabel":true,"customQueryParamName":"a3"},"decorative_header_56825507332958":{"type":"Decorative Header","value":"Do You Have Any Pre Existing Medical Conditions?
","width":12,"v":2,"sortOrder":1,"stepId":"d5ce4207dda11b05326d947f"},"decorative_text_421625560308459":{"type":"Decorative Text","value":"Examples of pre-existing conditions include: Cancer, AIDS/HIV, Heart Disease, Pregnancy, Diabetes, and Transplant History
","fieldStyle":{"fontSize":{"value":16,"unit":"px"}},"width":12,"v":2,"stepId":"d5ce4207dda11b05326d947f","sortOrder":3},"buttons_160861410246195":{"type":"Buttons","validationRules":{"required":false},"label":"Pre Existing","width":12,"multiple":false,"buttonStyle":{"rt_buttonsPerRow":2,"rt_buttonsPerRowMobile":1,"buttonsType":"Rectangle","spacing":20,"showControls":"Yes","rt_compactLayoutOnMobile":"Yes"},"imageStyles":{},"options":[{"text":"Yes","id":"c24753f070a6cc5a1835835a"},{"text":"No","id":"f04cffb940169c2787f47db6"}],"stepId":"d5ce4207dda11b05326d947f","sortOrder":2,"hideLabel":true,"customQueryParamName":"a4"},"dob_241505933425026":{"type":"DOB","label":"Birthday","width":12,"stepId":"d9da87b2ff5e89642ed0b305","sortOrder":2,"customQueryParamName":"a2"},"address_778767022454389":{"type":"Address","label":"Address","width":12,"stepId":"e69a42007f1d4180f08d3e66","sortOrder":2,"customQueryParamName":"a9"},"phone_972768218543606":{"type":"Phone","label":"Phone","width":12,"stepId":"e69a42007f1d4180f08d3e66","sortOrder":4,"customQueryParamName":"a1","showCountryCode":true},"name_609089810440844":{"type":"Name","label":"Name","width":12,"hideLabel":true,"options":{"Firstname":{"value":null,"errorText":null},"Lastname":{"value":null,"errorText":null},"Prefix":{"value":null,"errorText":null}},"stepId":"25d06dd4f325502eeb37b32d","sortOrder":2,"hidePrefix":true,"customQueryParamName":"name"},"email_345071693065667":{"type":"Email","label":"Email","width":12,"stepId":"25d06dd4f325502eeb37b32d","sortOrder":3,"customQueryParamName":"email"},"decorative_image_806372428067079":{"type":"Decorative Image","value":"https://res.cloudinary.com/dqnjggegp/image/upload/v1765164056/uploads/adbjwzra1xstozupwwsn.png","width":12,"imageWidth":450,"imageHeight":150,"imageInitialHeight":500,"imageInitialWidth":1500,"stepId":"e69a42007f1d4180f08d3e66","sortOrder":5},"decorative_text_572306395145404":{"type":"Decorative Text","value":"By clicking “GET QUOTE,” I hereby provide my express written consent, indicated by my electronic signature, to receive communications regarding my request for information. Such communications may include telephone calls, text messages, emails, live-agent outreach, and direct messages through social media platforms, using the contact information I have provided (including mobile numbers), even if my number is listed on any state, local, or national Do Not Call registry. Communications may be delivered by an automatic telephone dialing system or by a live representative. My consent is not a condition of any purchase. Message and data rates may apply. Message frequency may vary. I may text “STOP” or “HELP” to 419-750-0242, or call the same number with any questions or to revoke consent.
I acknowledge that I have reviewed and agree to the Privacy Policy and Terms of Use, and that I may withdraw my consent at any time. I understand that this website may collect personal information, including but not limited to my phone number, email address, first and last name, physical address, date of birth, income information, and zip code, for the purpose of providing insurance-related information and services.
I further understand and agree that my information may be used for follow-up communication, and may also be used to create or supplement advertising audiences—including, but not limited to, Custom Audiences—on platforms such as Facebook and other social media networks, for the purpose of delivering relevant advertisements as permitted by applicable law. I acknowledge that such data may be hashed or otherwise processed prior to being shared with advertising platforms in accordance with their privacy and data-use policies. I may opt out of such advertising by contacting 419-750-0242 or following the instructions in the Privacy Policy.
","fieldStyle":{"fontSize":{"value":9,"unit":"px"}},"width":12,"v":2,"stepId":"e69a42007f1d4180f08d3e66","sortOrder":6},"decorative_image_759240985306338":{"type":"Decorative Image","value":"https://res.cloudinary.com/dqnjggegp/image/upload/v1765152533/uploads/petmgki85aqnj1exny4u.png","width":12,"imageWidth":4000,"imageHeight":5000,"imageInitialHeight":1350,"imageInitialWidth":1080,"stepId":"complete","sortOrder":1},"zipcode_43968246339770":{"type":"Zipcode","label":"What is your zip code?","zipcodeFieldFormat":"zipcode_usa","width":12,"stepId":"e69a42007f1d4180f08d3e66","sortOrder":3,"customQueryParamName":"a6"}},"ownedByUser":"692fb84682be3547c94469bd","formName":"Get a Free Health Insurance Quote","personalisation":{"form_related_to":"(None - start with a blank slate)"},"created":"2025-12-03T04:11:17.621Z","steps":[{"id":"acd45227cac332d443c4e1db","name":"Who Are You Searching For","sortOrder":1},{"id":"b7eef3f9f2f9d21eb2cbc273","name":"HH Size","sortOrder":2},{"id":"7738897b10954c8bb9f2c7b0","name":"Annual Pre-Tax Income? (Household Total)","sortOrder":3},{"id":"d5ce4207dda11b05326d947f","name":"Pre Existing Conditions","sortOrder":4},{"id":"ff4727c9498ef9c0a6c989d9","name":"Gender","sortOrder":5},{"id":"d9da87b2ff5e89642ed0b305","name":"Birthday","sortOrder":6,"copyOf":"ff4727c9498ef9c0a6c989d9"},{"id":"e69a42007f1d4180f08d3e66","name":"Address / Phone Number","sortOrder":7,"copyOf":"acd45227cac332d443c4e1db"},{"id":"25d06dd4f325502eeb37b32d","name":"First Name / Email","sortOrder":8}],"screenshotUrl":"https://res.cloudinary.com/dqnjggegp/image/upload/v1766255754/growform-production/form-screenshots/692fb86582be3547c94469f0.png","isActive":true,"reportedSpam":null,"__v":0,"lastEdited":"2025-12-28T17:25:22.929Z","leadsCount":101,"spamOcr":"O MY FAMILY\nGet a Free Quote Now:\nWho Are You Searching For?\nMYSELF O MY FAMILY Get a Free Quote Now : Who Are You Searching For ? MYSELF"},"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 buildIframeHTML(opts) { var html = '\n' + '\n' + '\n' + ' \n' + ' \n' + ' \n' + '\n' + '\n' + ' \n' + ' \n' + '