<!-- End Google Tag Manager (noscript) --> <!-- Header --> <div id="header"></div> <!-- Header --> <section id="assessment-section-1"> <div class="container"> <div class="back_div"> <a href="/" class="back">❮ Back</a> </div> <input type="radio" name="slide1" id="ctr_slide1" value="1" checked> <input type="radio" name="slide1" id="ctr_slide2" value="2"> <input type="radio" name="slide1" id="ctr_slide3" value="3"> <input type="radio" name="slide1" id="ctr_slide4" value="4"> <input type="radio" name="slide1" id="ctr_slide5" value="5"> <input type="radio" name="slide1" id="ctr_slide6" value="6"> <input type="radio" name="slide1" id="ctr_slide7" value="7"> <input type="radio" name="slide1" id="ctr_slide8" value="8"> <div class="bullets"> <label for="ctr_slide1"></label> <label for="ctr_slide2"></label> <label for="ctr_slide3"></label> <label for="ctr_slide4"></label> <label for="ctr_slide5"></label> <label for="ctr_slide6"></label> <label for="ctr_slide7"></label> <label for="ctr_slide8"></label> </div> <div class="inner_div"> <form id="assessment_form"> <div class="slider_div"> <div class="first_div"> <div class="img_div"> <img src="/assets/images/assessment/assessment_icon.png"> </div> <div class="content_div"> <h4>To see if invisible aligners are right for you, our orthodontists have a few questions</h4> </div> <div class="button_div"> <button type="button" id="get_started">LET'S GET STARTED</button> </div> </div> <div class="single_div"> <div class="title_div"> <h4>Why are you thinking about straightening your teeth?</h4> </div> <div class="option_div"> <label><input type="radio" name="why_thinking" value="I have not been wearing my retainers and my teeth have shifted"> <span>I have not been wearing my retainers and my teeth have shifted</span> </label> <label><input type="radio" name="why_thinking" value="I want to increase my confidence"> <span>I want to increase my confidence</span> </label> <label><input type="radio" name="why_thinking" value="I feel it will help my career"> <span>I feel it will help my career</span> </label> <label><input type="radio" name="why_thinking" value="For an upcoming event"> <span>For an upcoming event</span> </label> </div> </div> <div class="single_div"> <div class="title_div"> <h4>Have you ever worn braces or invisible aligners in the past?</h4> </div> <div class="option_div"> <label><input type="radio" name="worn_past" value="yes"> <span>Yes</span> </label> <label><input type="radio" name="worn_past" value="no"> <span>No</span> </label> </div> </div> <div class="single_div"> <div class="title_div"> <h4>Choose the option that best describes your current teeth alignment concern</h4> </div> <div class="option_div teeth_option"> <label> <input type="radio" name="biggest_concern" value="General straighter teeth"> <span><img src="/assets/images/assessment/general.png"><br>General straighter teeth</span> </label> <label><input type="radio" name="biggest_concern" value="Crowding"> <span><img src="/assets/images/assessment/crowding.png"><br>Crowding</span> </label> <label><input type="radio" name="biggest_concern" value="Spacing"> <span><img src="/assets/images/assessment/spacing.png"><br>Spacing</span> </label> <label><input type="radio" name="biggest_concern" value="Gaps"> <span><img src="/assets/images/assessment/gaps.png"><br>Gaps</span> </label> </div> </div> <div class="single_div"> <div class="title_div"> <h4>Where would you like us to send your results?</h4> <p>We will only share useful information and promotions related to Dr. Wondersmile clear aligner treatment and products to your email.</p> </div> <div class="option_div"> <input class="email" type="text" id="email" placeholder="Email"> <label class="agree_information"><input type="checkbox" id="agree_information"> <span>I agree to receive information on special offers, discounts and promotions from Dr. Wondersmile.</span> </label> </div> <div class="button_div"> <button type="button" id="email_continue">CONTINUE</button> </div> </div> <div class="single_div"> <div class="title_div"> <h4>Do any of the following apply to you?<br>You can choose more than one.</h4> </div> <div class="option_div"> <label><input type="checkbox" name="any_following_apply" value="Currently or will be pregnant when undergoing clear aligner treatment"> <span>Currently or will be pregnant when undergoing clear aligner treatment</span> </label> <label><input type="checkbox" name="any_following_apply" value="Still have my baby teeth"> <span>Still have my baby teeth</span> </label> <label><input type="checkbox" name="any_following_apply" value="Under the age of 12"> <span>Under the age of 12</span> </label> <label><input type="checkbox" name="any_following_apply" value="None of these apply to me"> <span>None of these apply to me</span> </label> </div> <div class="button_div"> <button type="button" id="any_following_apply_continue">CONTINUE</button> </div> </div> <div class="single_div"> <div class="title_div"> <h4>Which aligner treatment are you interested in?</h4> </div> <div class="option_div"> <label><input type="radio" name="interested_plan" value="Daytime Aligners (22 hours daily wear time)"> <span>Daytime Aligners (22 hours daily wear time)</span> </label> <label><input type="radio" name="interested_plan" value="Nighttime Aligners (10 hours daily wear at night)"> <span>Nighttime Aligners (10 hours daily wear at night)</span> </label> <label><input type="radio" name="interested_plan" value="No preference"> <span>No preference</span> </label> </div> </div> <div class="single_div"> <div class="title_div"> <h4>Your assessment is complete!</h4> <h5>We can tailor your solution better with a few more details below.</h5> <p>We will only share useful information and promotions related to Dr. Wondersmile clear aligner treatment and products to your email.</p> </div> <div class="option_div client_information"> <label> <input type="text" placeholder="First Name" id="first_name" required> </label> <label> <input type="text" placeholder="Postcode" id="postcode" required> </label> <label> <select id="gender" required> <option selected disabled>Gender</option> <option>Male</option> <option>Female</option> </select> </label> <label> <input type="text" placeholder="Mobile" id="phone_number" required> </label> </div> <div class="button_div"> <button type="submit" id="form_submit_btn">GET YOUR RESULTS</button> </div> </div> </div> </form> </div> </div> </section> <!-- Footer --> <div id="footer"></div> <!-- Footer --> <script type='text/javascript' src="/assets/js/jquery.js "></script> <!-- required --> <script type="text/javascript "> // Load header & footer $('#header').load('/header'); $(document).ready(function() { $('#footer').load('/footer'); }); </script> <!-- required --> <script> $(document).ready(function() { get_started(); why_thinking_on_click(); worn_past_on_click(); biggest_concern_on_click(); email_continue(); any_following_apply_continue(); interested_plan_on_click(); cancel_when_press_enter_sumbit_form(); submit_form(); }) function get_started() { $('#get_started').on('click', function() { $('.bullets').css('display', 'block'); $('#ctr_slide2').prop('disabled', false); $('#ctr_slide2').prop('checked', true); }) } function why_thinking_on_click() { let why_thinking = $('input[type=radio][name=why_thinking]'); why_thinking.on('click', function() { $('#ctr_slide3').prop('disabled', false); $('#ctr_slide3').prop('checked', true); }) } function worn_past_on_click() { let worn_past = $('input[type=radio][name=worn_past]'); worn_past.on('click', function() { $('#ctr_slide4').prop('disabled', false); $('#ctr_slide4').prop('checked', true); }) } function biggest_concern_on_click() { let biggest_concern = $('input[type=radio][name=biggest_concern]'); biggest_concern.on('click', function() { $('#ctr_slide5').prop('disabled', false); $('#ctr_slide5').prop('checked', true); }) } function email_continue() { $('#email_continue').on('click', function() { if (!($('#email').val() == '')) { $('#ctr_slide6').prop('disabled', false); $('#ctr_slide6').prop('checked', true); } else { alert('Please fill in email!'); } }) } function any_following_apply_continue() { $('#any_following_apply_continue').css('display', 'none'); let any_following_apply = $('input[type=checkbox][name=any_following_apply]'); any_following_apply.on('click', function() { let check = 0; for (i = 0; i < any_following_apply.length; i++) { if (any_following_apply[i].checked) { check = 1; } } if (check == 0) { $('#any_following_apply_continue').css('display', 'none'); } else { $('#any_following_apply_continue').css('display', 'block'); } }) $('#any_following_apply_continue').on('click', function() { $('#ctr_slide7').prop('disabled', false); $('#ctr_slide7').prop('checked', true); }) } function interested_plan_on_click() { let interested_plan = $('input[type=radio][name=interested_plan]'); interested_plan.on('click', function() { $('#ctr_slide8').prop('disabled', false); $('#ctr_slide8').prop('checked', true); }) } function cancel_when_press_enter_sumbit_form() { $('#assessment_form').keypress(function(e) { if (e.keyCode == 13) { e.preventDefault(); return; } }) } //check string if it begins with '=' or '+' and replace it with "" function checkinput(str) { c = str.charAt(0) while (c == '=' || c == '+') { str = str.replace(str.charAt(0), "") c = str.charAt(0) } return str } function submit_form() { $('#assessment_form').submit(function(e) { e.preventDefault(); let why_thinking = $('input[type=radio][name=why_thinking]:checked').val(); let worn_past = $('input[type=radio][name=worn_past]:checked').val(); let biggest_concern = $('input[type=radio][name=biggest_concern]:checked').val(); let email = $('#email').val(); let agree_information = $('#agree_information')[0].checked; let any_following_apply = document.querySelectorAll('input[type=checkbox][name=any_following_apply]:checked'); let following_apply = []; for (i = 0; i < any_following_apply.length; i++) { following_apply.push(any_following_apply[i].value); } let interested_plan = $('input[type=radio][name=interested_plan]:checked').val(); let first_name = $('#first_name').val(); let postcode = $('#postcode').val(); let gender = $('#gender').val(); let phone_number = $('#phone_number').val(); let lang = 'en' first_name = checkinput(first_name) postcode = checkinput(postcode) phone_number = checkinput(phone_number) if (!why_thinking) { alert('Please select the options !'); $('#ctr_slide2').prop('checked', true); return; } if (!worn_past) { alert('Please select the options !'); $('#ctr_slide3').prop('checked', true); return; } if (!biggest_concern) { alert('Please select the options !'); $('#ctr_slide4').prop('checked', true); return; } if (!email) { alert('Please fille in the email !'); $('#ctr_slide5').prop('checked', true); return; } if (following_apply == '') { alert('Please select the options !'); $('#ctr_slide6').prop('checked', true); return; } if (!interested_plan) { alert('Please select the options !'); $('#ctr_slide7').prop('checked', true); return; } if (gender == null) { alert('Please select gender !'); $('#ctr_slide8').prop('checked', true); return; } $('#form_submit_btn').attr('disabled', 'disabled'); $.ajax({ url: '/v1/booking_assessment', type: 'POST', data: { why_thinking, worn_past, biggest_concern, email, agree_information, following_apply, interested_plan, first_name, postcode, gender, phone_number, lang } }).done((res) => { window.location = '/smile-quiz/thank-you/'; }).fail((res) => { // alert(res.responseText); // location.reload(); window.location = '/smile-quiz/thank-you/'; }) }) } </script> </body> </html>