/* growform client2 bundle.url: https://assets.growform.co/cee2d99-mhw6hzfz/form.bundle.js resolve.source: memory resolve.at: 2026-01-01T20:54:23.766Z form.source: api cache.age_ms: 8425 fallback_used: false */ ;(function () { var EMBED_TYPE = "iFrame"; var FORM_ID = "693f4ea8e8f53aa5f822fa60"; var FORM_BUNDLE_URL = "https://assets.growform.co/cee2d99-mhw6hzfz/form.bundle.js"; // injected by worker (KV/memory/fallback) var FORM_DATA = {"data":{"form":{"_id":"693f4ea8e8f53aa5f822fa60","options":{"numberOfSteps":5,"dateFormat":"DD/MM/YYYY","progressBar":{"enable":true},"continueButton":{"continueText":"Continue","submitText":"Agree & Continue","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":40,"parentBackgroundColor":"#ffffff","innerFormBackgroundColor":"#ffffff","innerFormBackgroundTransparency":"","primaryColor":"#681994","bodyTextColor":"#343434","parentContainerBackgroundType":"none","innerFormBackgroundType":"none","buttonBorderColor":"#ff7500","buttonColorSelected":"#ffa659","buttonBorderColorSelected":"#ff7500","footerMarginBottom":70,"errorColor":"#ff4e4e","buttonColor":"#ff7500","buttonTextColor":"#ffffff","inputLabelColor":"#a3a3a3","inputTextColor":"#000000","defaultFont":"Poppins","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":"#E7F3FA","canvasSetup":"minimal","progressColor":"#681994"},"localization":{"dateFormat":"MM/DD/YYYY"},"exportTransparentBackground":false,"customScript":"","customRedirectUrls":[{"url":"https://help.survivorsrights.com/rideshare/thank-you"}],"logo":null,"actionOnSubmit":"redirect","customCss":"/* Force Growform to display desktop layout on all devices */\n.gf-container,\n.growform,\n.gf-page,\n.gf-outer-container {\n min-width: 768px !important; /* Desktop breakpoint */\n}\n\n/* Prevent overflow issues on small screens */\nbody, html {\n overflow-x: auto !important;\n}","analyticsSettings":{"trustedForm":{"enabled":true}},"captureSystemDetails":true},"fields":{"Decorative Header_52363373085874":{"type":"Decorative Header","value":"Thanks for your enquiry!","width":12,"step":"complete","sortOrder":1,"fieldStyle":{"fontSize":{"value":19,"unit":"px"},"fontWeight":"Bold"},"margins":{"marginTop":20},"stepId":"complete"},"Decorative Header_797442086161467":{"type":"Decorative Header","value":"Did you or a loved one experience any of the following in an UBER or LYFT?","width":12,"step":2,"sortOrder":1,"fieldStyle":{"fontSize":{"value":17,"unit":"px"},"fontWeight":"Bold"},"stepId":"acd45227cac332d443c4e1db","margins":{"marginBottom":0}},"Decorative Header_576559560634956":{"type":"Decorative Header","value":"

It appears you may be eligible and qualify for legal representation. Complete the form below to be contacted by a representative. There are absolutely NO costs or commitments incurred by submitting this form.

","width":12,"step":5,"sortOrder":1,"fieldStyle":{"fontSize":{"value":15,"unit":"px"},"fontWeight":null},"stepId":"ff4727c9498ef9c0a6c989d9","margins":{"marginBottom":0},"v":2},"email_907058157108782":{"type":"Email","label":"Your email address","width":12,"margins":{"marginBottom":0},"step":5,"sortOrder":5,"stepId":"ff4727c9498ef9c0a6c989d9"},"Decorative_Paragraph_194067845817258":{"type":"Decorative Paragraph","value":"Thanks for getting in touch. We'll be in contact soon.","width":12,"step":"complete","sortOrder":2,"margins":{"marginBottom":60},"stepId":"complete"},"buttons_109446974978914":{"type":"Buttons","validationRules":{"required":true},"label":"Buttons 1","width":12,"multiple":false,"buttonStyle":{"rt_buttonsPerRow":"1","rt_buttonsPerRowMobile":1,"buttonsType":"Rectangle","spacing":15,"showControls":"Yes","rt_compactLayoutOnMobile":"No"},"options":[{"text":"Verbal Harassment or Threats","id":"5be94772672205ea06fa1c3c"},{"text":"Sexual Assault","id":"192368f189795a7f9199624d"},{"text":"Unwanted Sexual Contact (e.g., kissing, touching)","id":"cd688d984891cf9918f17913"},{"text":"Confinement or Entrapment","id":"4aa2d0676e2b31322c5ba7d6"},{"text":"None of the Above","image":null,"id":"bd6d031190927bd04ee5b6a1"}],"stepId":"acd45227cac332d443c4e1db","sortOrder":2,"hideLabel":true},"decorative_header_620956436989809":{"type":"Decorative Header","value":"

It appears you may be eligible and qualify for legal representation. Complete the form below to be contacted by a representative. There are absolutely NO costs or commitments incurred by submitting this form.

","width":12,"step":5,"sortOrder":1,"fieldStyle":{"fontSize":{"value":15,"unit":"px"},"fontWeight":null},"stepId":"dec4f4f2c15b76ed75e27e71","margins":{"marginBottom":0},"v":2},"text_912034547896810":{"type":"Text","label":"Please briefly describe what happened:","width":12,"stepId":"dec4f4f2c15b76ed75e27e71","sortOrder":2,"multiline":true,"rows":2,"validationRules":{"required":true}},"single_select_43346140476747":{"type":"Single Select","width":12,"label":"State of Incident","options":[{"text":"AL","id":"319221681d4da7db3eb04eed"},{"text":"AK","id":"e0c906626f989aa063a8a3ef"},{"text":"AZ","id":"a2100713cc9463abe69cc810"},{"text":"AR","image":null,"id":"a441af835c114bbb8538b389"},{"text":"CA","image":null,"id":"f1a8a1eade88a5a6e858a9a3"},{"text":"CO","image":null,"id":"446deffa34d30954131b884f"},{"text":"CT","image":null,"id":"301057848efc711d0ef0b564"},{"text":"DE","image":null,"id":"23f406d27c53e3785e3c0efe"},{"text":"FL","image":null,"id":"cd2277a515d4a2c549911671"},{"text":"GA","image":null,"id":"c2f23e3f6e43cc7505f0c1d2"},{"text":"HI","image":null,"id":"e3158e58daed26a9f982ddc6"},{"text":"ID","image":null,"id":"d9d3216971acdace2c871107"},{"text":"IL","image":null,"id":"07ada8ee55394c31e8cf3c18"},{"text":"IN","image":null,"id":"935a4f272635c6b85595de11"},{"text":"IA","image":null,"id":"b4474b1a74e163ff5e834b44"},{"text":"KS","image":null,"id":"db68099253296fd65c996440"},{"text":"KY","image":null,"id":"c2b078eaf52ff96e98395500"},{"text":"LA","image":null,"id":"1428506a7950470a71244a63"},{"text":"ME","image":null,"id":"8bb89c9de3d7094d59cfbe37"},{"text":"MD","image":null,"id":"bfa668adbeec7594c6e7a222"},{"text":"MA","image":null,"id":"19b93f560739d5b20eb24239"},{"text":"MI","image":null,"id":"7d9230da405f54b0cd9af17a"},{"text":"MN","image":null,"id":"8163c1acbad544ffa5169cdb"},{"text":"MS","image":null,"id":"28bb9c2f5e58c4649c129f2a"},{"text":"MO","image":null,"id":"e8d1669b08167c3d42ac3bdf"},{"text":"MT","image":null,"id":"fbd4f21c03d8e10a06bd9ef7"},{"text":"NE","image":null,"id":"844bc84077cf9f3940960222"},{"text":"NV","image":null,"id":"4525b65aa5fd7980159f53ac"},{"text":"NH","image":null,"id":"ea05b38923f4c35e57846d9e"},{"text":"NJ","image":null,"id":"b9cfb2cff3b4a1752cf358bc"},{"text":"NM","image":null,"id":"c8acbf74860b53d37528f7cb"},{"text":"NY","image":null,"id":"82629eb6ed7fa798463a172f"},{"text":"NC","image":null,"id":"67c90f5993541053394c4dd4"},{"text":"ND","image":null,"id":"62b7f9ebdd8019ab8616a2ab"},{"text":"OH","image":null,"id":"e32cccc29455be7371946799"},{"text":"OK","image":null,"id":"164cb41b38704b77cecf7e48"},{"text":"OR","image":null,"id":"f9cc0f1f49e267b8c6a9af05"},{"text":"PA","image":null,"id":"a31b3782f694c83c858435d6"},{"text":"RI","image":null,"id":"3adf3a0cac14e7e99a539df1"},{"text":"SC","image":null,"id":"63a8a7ae9cac161a3ab3cda5"},{"text":"SD","image":null,"id":"c4f318bdf73996540eaa1303"},{"text":"TN","image":null,"id":"04b5b4d31f876797a7564887"},{"text":"TX","image":null,"id":"fde9e80591b939824722618f"},{"text":"UT","image":null,"id":"fa270615b107df8c16f807d3"},{"text":"VT","image":null,"id":"13f02b8829c1dc36a006e04d"},{"text":"VA","image":null,"id":"386d16a64fa3517e2912d99f"},{"text":"WA","image":null,"id":"50732f596c09b278deb2f56a"},{"text":"WV","image":null,"id":"b23c766fc61386b47405db40"},{"text":"WI","image":null,"id":"ccd9106bb42fce3b3158aafb"},{"text":"WY","image":null,"id":"9c1b08663357a298480ad5a8"}],"helperText":null,"stepId":"dec4f4f2c15b76ed75e27e71","sortOrder":3,"validationRules":{"required":true}},"single_select_807755365894035":{"type":"Single Select","width":12,"label":"Year of Incident","options":[{"text":"2025","id":"319221681d4da7db3eb04eed"},{"text":"2024","id":"e0c906626f989aa063a8a3ef"},{"text":"2023","id":"a2100713cc9463abe69cc810"},{"text":"2022","image":null,"id":"8fc2150153d117d3db8bf536"},{"text":"2021","image":null,"id":"7cfa707cf89d683a105e2265"},{"text":"2020","image":null,"id":"8e95e0713d73b370fdc63579"},{"text":"2019","image":null,"id":"0104b6303296e63f62a43ff5"},{"text":"2018","image":null,"id":"bdccb9060f2aa76471bc0ea1"},{"text":"2017","image":null,"id":"2118382c98986a3ae6af97c7"},{"text":"2016","image":null,"id":"2b636e3d5903f19e070d3298"},{"text":"2015","image":null,"id":"3c3ffa05c70b4c8964c7fae3"},{"text":"2014","image":null,"id":"13dd6f87f0811b7426f9cd3e"},{"text":"2013","image":null,"id":"ff14327bff197c535031f77a"},{"text":"2012","image":null,"id":"3d490223ccb1074f4df2f724"},{"text":"2011","image":null,"id":"72ea2c2c56206b24d25e3855"},{"text":"2010","image":null,"id":"7a7ead8a138d87e333579cb7"},{"text":"2009","image":null,"id":"44b8fdbcc714b107e2a227b3"}],"helperText":null,"stepId":"dec4f4f2c15b76ed75e27e71","sortOrder":4,"validationRules":{"required":true}},"single_select_311475908987543":{"type":"Single Select","width":12,"label":"Rideshare Platform","options":[{"text":"Uber","id":"319221681d4da7db3eb04eed"},{"text":"Lyft","id":"e0c906626f989aa063a8a3ef"},{"text":"Do Not Remember","id":"a2100713cc9463abe69cc810"}],"helperText":null,"stepId":"dec4f4f2c15b76ed75e27e71","sortOrder":5,"validationRules":{"required":true}},"single_select_708094046404770":{"type":"Single Select","width":12,"label":"Did you file a police report?","options":[{"text":"Yes","id":"319221681d4da7db3eb04eed"},{"text":"No","id":"e0c906626f989aa063a8a3ef"}],"helperText":null,"stepId":"dec4f4f2c15b76ed75e27e71","sortOrder":6,"validationRules":{"required":true}},"text_213034261418052":{"type":"Text","label":"First Name","width":6,"stepId":"ff4727c9498ef9c0a6c989d9","sortOrder":2,"validationRules":{"required":true}},"text_159130358457098":{"type":"Text","label":"Last Name","width":6,"stepId":"ff4727c9498ef9c0a6c989d9","sortOrder":3,"validationRules":{"required":true}},"phone_404470339144260":{"type":"Phone","label":"Phone Number","width":12,"stepId":"ff4727c9498ef9c0a6c989d9","sortOrder":4},"decorative_text_501576937538109":{"type":"Decorative Text","value":"

We may record your interactions with this website. I agree to receive marketing. By clicking Agree and Continue, you provide your electronic signature, express written consent and binding agreement to our Terms, Privacy Policy, and for Select Justice and our law firm partners to email, call and text you at the email address and telephone number you provided above, including possibly using an automatic telephone dialing system, prerecorded messages and artificial/A.I. voices, with case evaluations, legal marketing offers and other information, including outside of normal calling windows. Normal rates apply and consent is not a condition of purchase as you can always receive information by emailing us at support@intaketeam.com.

","fieldStyle":{"fontSize":{"value":10,"unit":"px"}},"width":12,"v":2,"stepId":"ff4727c9498ef9c0a6c989d9","sortOrder":6},"hidden_879452951809521":{"type":"Hidden","hiddenFieldName":"cid","width":12,"stepId":"ff4727c9498ef9c0a6c989d9","sortOrder":7,"defaultValue":"1529"},"hidden_709164653024307":{"type":"Hidden","hiddenFieldName":"afid","width":12,"stepId":"ff4727c9498ef9c0a6c989d9","sortOrder":8,"defaultValue":"67"},"hidden_367269406557216":{"type":"Hidden","hiddenFieldName":"usid","width":12,"stepId":"ff4727c9498ef9c0a6c989d9","sortOrder":9},"hidden_178051288445271":{"type":"Hidden","hiddenFieldName":"sid","width":12,"stepId":"ff4727c9498ef9c0a6c989d9","sortOrder":10},"hidden_407042280947713":{"type":"Hidden","hiddenFieldName":"msid","width":12,"stepId":"ff4727c9498ef9c0a6c989d9","sortOrder":11,"defaultValue":"lo"}},"ownedByUser":"69389b7410acc0a2c0a0061e","formName":"Survivors Rights - Rideshare","personalisation":{"form_related_to":"(None - start with a blank slate)"},"created":"2025-12-14T23:56:24.154Z","steps":[{"id":"acd45227cac332d443c4e1db","name":"Initial Question","sortOrder":1},{"id":"dec4f4f2c15b76ed75e27e71","name":"Incident Details","sortOrder":2,"copyOf":"ff4727c9498ef9c0a6c989d9"},{"id":"ff4727c9498ef9c0a6c989d9","name":"Contact Details","sortOrder":3}],"screenshotUrl":"https://res.cloudinary.com/dqnjggegp/image/upload/v1765799677/growform-production/form-screenshots/693f4ea8e8f53aa5f822fa60.png","isActive":true,"reportedSpam":null,"__v":0,"lastEdited":"2025-12-15T11:54:31.864Z","spamOcr":"Did you or a loved one experience any of the following in an\nUBER or LYFT?\n○ Verbal Harassment or Threats\n○ Sexual Assault\n○ Unwanted Sexual Contact (e.g., kissing, touching)\n○ Confinement or Entrapment\nNone of the Above Did you or a loved one experience any of the following in an UBER or LYFT ? ○ Verbal Harassment or Threats ○ Sexual Assault ○ Unwanted Sexual Contact ( e.g. , kissing , touching ) ○ Confinement or Entrapment None of the Above","leadsCount":4},"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' + '