<?php include 'header.php';?>


  <main class="main">

    <!-- Hero Section -->
    <section id="hero" class="hero section">

      <div class="container" data-aos="fade-up" data-aos-delay="100">

        <div class="row align-items-center">
          <div class="col-lg-12">
            <div class="hero-content" data-aos="fade-up" data-aos-delay="200">
       


              <h1 class="mb-4 text-center">
                              Thank You!
<br>
             
              </h1>

              <p class="mb-4 mb-md-5">
         <h4 style="color: #343f52; font-size: 1rem; font-weight:600" class="text-center">Your request has been successfully submitted.  A licensed agent will be in touch very soon!</h4>
              <h1 style="font-style: italic; font-size: 1rem;" class="text-center">If you are in need of immediate assistance you can call us directly at <span><a style="color: #0052D4 !important; text-decoration: none;" href="tel:+18882998146">Call Now: +1 (888) 299-8146</a></span></h4>            
              </p>

             
            </div>
          </div>

         

      </div>

    </section><!-- /Hero Section -->

  
       

            </div>
          </div>

        </div>

      </div>

    </section><!-- /Contact Section -->

  </main>

  <footer id="footer" class="footer">

  

    <div class="container copyright text-center">
      © 2025 by The Advocacy Service Center. <a href="/privacy.php">Privacy Policy</a> | <a href="/terms.php">Terms and Conditions</a>
  
    </div>

  </footer>

  <!-- Scroll Top -->
  <a href="/" id="scroll-top" class="scroll-top d-flex align-items-center justify-content-center"><i class="bi bi-arrow-up-short"></i></a>

  <!-- Vendor JS Files -->
  <script src="assets/vendor/bootstrap/js/bootstrap.bundle.min.js"></script>
  <script src="assets/vendor/php-email-form/validate.js"></script>
  <script src="assets/vendor/aos/aos.js"></script>
  <script src="assets/vendor/glightbox/js/glightbox.min.js"></script>
  <script src="assets/vendor/swiper/swiper-bundle.min.js"></script>
  <script src="assets/vendor/purecounter/purecounter_vanilla.js"></script>

  <!-- Main JS File -->
  <script src="assets/js/main.js"></script>


<script>

function submitForm()
{
$('#submitButton').prop('disabled', true);
$.ajax({
type: 'post',
dataType:'jsonp',
url: 'https://ushaleads.healthinsuranceguide.org/api/LeadAPI',
data: $('form').serialize(),
success: function () {
console.log('success');
window.location.href = "form-success.php";
},
error:function(){
console.log('Error');
window.location.href = "form-success.php";
}

})
};


$(document).ready(function(){
$('input:checkbox').click(function() {
$('input:checkbox').not(this).prop('checked', false);
});
});

/*-----------------------------------------------------------------------*/
/*----------------------- Phone Number Input Mask -----------------------*/
/*-----------------------------------------------------------------------*/

$(document).ready(function(){
$('#phone').mask('0000000000');
});

/*-----------------------------------------------------------------------*/
/*---------------------------- Zip Code Lookup --------------------------*/
/*-----------------------------------------------------------------------*/


$('#zipCode').on("input",function(){
var zipCode = $('#zipCode').val();
if(zipCode.length == 5)
{
$.ajax({
type: 'GET',
url:'https://ziplookup.visualyzers.com/Ziplookup?zipcode=' + zipCode,
success:function(results){
$('#city').val(results.city);
$('#state').val(results.state);
}

})
}
});

/*-------------------------------------------------------------------------*/
/*---------------------------- Validation Lookup --------------------------*/
/*-------------------------------------------------------------------------*/

$("#valForm").submit(function(e) {
e.preventDefault();
}).validate({

rules:{
phone:{
required:true,
minlength:10,
maxlength:10
},
firstname:{
required:true
},
lastname:{
required:true
},
dateofbirth:{
required:true,
date:true,
},
typeofplan:{
required: true
},
email:{
required:true,
email:true
},

city:{
required:true
},

state:{
required:true
},

zipCode:{
required:true,
minlength:5,
maxlength:5
}
},
messages: {
phone: {
required: "Please enter a valid phone number"
},

},

submitHandler: function(event)
{

submitForm();
}
});


$(function() {
$( "#datepicker" ).datepicker({
dateFormat : 'mm/dd/yy',
changeMonth : true,
changeYear : true,
yearRange: '-100y:c+nn',
maxDate: '-1d'
});
});




/*-----------------------------------------------------------------------*/
/*--------------------------- Date of Birth  ----------------------------*/
/*-----------------------------------------------------------------------*/

$(document).ready(function() {
$.getJSON('https://api.ipify.org?format=jsonp&callback=?', function(data) {
$('#IpAddress').val(data.ip);
});

$.dobPicker({
daySelector: '#dobday',
/* Required */
monthSelector: '#dobmonth',
/* Required */
yearSelector: '#dobyear',
/* Required */
dayDefault: 'Day',
/* Optional */
monthDefault: 'Month',
/* Optional */
yearDefault: 'Year',
/* Optional */
minimumAge: 18,
/* Optional */
maximumAge: 100 /* Optional */
});
});




window.dataLayer = window.dataLayer || [];
$.dataLayer.push({
'event':'ec_formsubmit',
'enhanced_conversion_data': {
first_name: $('#firstname').val(),
last_name: $('#lastname').val(),
phone_number: $('#phone').val(),
email_address: $('#email').val(),
street: $('#street').val(),
city: $('#city').val(),
postal_code: $('#zip').val(),
dobday: $('#dobday').val(),
dobmonth: $('#dobmonth').val(),
dobyear: $('#dobyear').val(),     
date_of_birth: $('#dob').val(),  
plan_condition: $('.planConditions').val(),        
plan_option: $('.planOption').val(),       
}
})



</script>
</body>

</html>