{"id":3085,"date":"2019-08-01T13:21:48","date_gmt":"2019-08-01T13:21:48","guid":{"rendered":"https:\/\/www.stormsmart.com\/?page_id=3085"},"modified":"2024-12-02T16:57:38","modified_gmt":"2024-12-02T21:57:38","slug":"service-request-form","status":"publish","type":"page","link":"https:\/\/www.stormsmart.com\/service-request-form\/","title":{"rendered":"Service Request Form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"3085\" class=\"elementor elementor-3085\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-18b19140 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"18b19140\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-656a90a\" data-id=\"656a90a\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-21cf59ed elementor-widget elementor-widget-text-editor\" data-id=\"21cf59ed\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h1>Service Request Form<\/h1><p>Fill out the form below and one of our team members will contact you to schedule a service appointment.<\/p><p>\n        <script src=\"https:\/\/www.google.com\/recaptcha\/api.js\"><\/script>\n        <script>\n        function timestamp() { var response = document.getElementById(\"g-recaptcha-response\"); if (response == null || response.value.trim() == \"\") {var elems = JSON.parse(document.getElementsByName(\"captcha_settings\")[0].value);elems[\"ts\"] = JSON.stringify(new Date().getTime());document.getElementsByName(\"captcha_settings\")[0].value = JSON.stringify(elems); } } setInterval(timestamp, 500); \n        <\/script>\n\n<!--  ----------------------------------------------------------------------  -->\n        <!--  NOTE: Please add the following <META> element to your page <HEAD>.      -->\n        <!--  If necessary, please modify the charset parameter to specify the        -->\n        <!--  character set of your HTML page.                                        -->\n        <!--  ----------------------------------------------------------------------  -->\n\n        <META HTTP-EQUIV=\"Content-type\" CONTENT=\"text\/html; charset=UTF-8\">\n        <script src=\"https:\/\/www.google.com\/recaptcha\/api.js\"><\/script>\n        <script>\n        function timestamp() { var response = document.getElementById(\"g-recaptcha-response\"); if (response == null || response.value.trim() == \"\") {var elems = JSON.parse(document.getElementsByName(\"captcha_settings\")[0].value);elems[\"ts\"] = JSON.stringify(new Date().getTime());document.getElementsByName(\"captcha_settings\")[0].value = JSON.stringify(elems); } } setInterval(timestamp, 500); \n        <\/script>\n        <script type=\"text\/javascript\">\n            $(function() {\n                $(\"#email\").change(function () {\n                    localStorage.setItem('client_email', this.value);\n                });\n            });\n        <\/script>\n\n        <div id=\"service-request-wrap\">\n        <!--  ----------------------------------------------------------------------  -->\n        <!--  NOTE: Please add the following <FORM> element to your page.             -->\n        <!--  ----------------------------------------------------------------------  -->\n\n        <form id=\"web-to-case\" action=\"https:\/\/webto.salesforce.com\/servlet\/servlet.WebToCase?encoding=UTF-8\" method=\"POST\">\n\n\n        <!--  ----------------------------------------------------------------------  -->\n        <!--  NOTE: These fields are optional debugging elements. Please uncomment    -->\n        <!--  these lines if you wish to test in debug mode.                          -->\n        <!--  <input type=\"hidden\" name=\"debug\" value=1>                              -->\n        <!--  <input type=\"hidden\" name=\"debugEmail\"                                  -->\n        <!--  value=\"chelseaspedale@gmail.com\">                                       -->\n        <!--  ----------------------------------------------------------------------  -->\n\n        <div class=\"field-wraps\">\n            <label for=\"name\">Contact Name <span class=\"form-required\">*<\/span><\/label>\n            <input id=\"name\" maxlength=\"80\" name=\"name\" size=\"20\" type=\"text\" required \/>\n        <\/div>\n        <div class=\"form-row w-100\">\n            <div class=\"field-wraps col-md-6\">\n                <label for=\"email\">Email <span class=\"form-required\">*<\/span><\/label>\n                <input id=\"email\" style=\"margin-right: 20px;\" maxlength=\"80\" name=\"email\" size=\"20\" type=\"text\" required \/>\n            <\/div>\n            <div class=\"field-wraps col-md-6\">\n                <label for=\"phone\">Phone <span class=\"form-required\">*<\/span><\/label>\n                <input id=\"phone\" maxlength=\"40\" name=\"phone\" size=\"20\" type=\"text\" required \/>\n            <\/div>\n        <\/div>\n        <div class=\"form-row w-100\">\n            <div class=\"field-wraps col-md-6\">\n                <label for=\"street\">Street <span class=\"form-required\">*<\/span><\/label>\n                <input id=\"street\" style=\"margin-right: 20px;\" maxlength=\"255\" name=\"00N1U00000Tyz1Q\" size=\"20\" type=\"text\" required \/>\n            <\/div>\n            <div class=\"field-wraps col-md-6\">\n                <label for=\"city\">City <span class=\"form-required\">*<\/span><\/label>\n                <input id=\"city\" maxlength=\"80\" name=\"00N1U00000Tyz1V\" size=\"20\" type=\"text\" required \/>\n            <\/div>\n        <\/div>\n        <div class=\"form-row w-100\">\n            <div class=\"field-wraps col-md-6 field-select\">\n                <label for=\"state\">State <span class=\"form-required\">*<\/span><\/label>\n                <select id=\"state\" name=\"00N1U00000Tyz1a\" style=\"margin-right: 20px;\" required>\n                    <option value=\"\">Select a State<\/option>\n                    <option value=\"AL\">Alabama<\/option>\n                    <option value=\"AK\">Alaska<\/option>\n                    <option value=\"AZ\">Arizona<\/option>\n                    <option value=\"AR\">Arkansas<\/option>\n                    <option value=\"CA\">California<\/option>\n                    <option value=\"CO\">Colorado<\/option>\n                    <option value=\"CT\">Connecticut<\/option>\n                    <option value=\"DE\">Delaware<\/option>\n                    <option value=\"DC\">District Of Columbia<\/option>\n                    <option value=\"FL\">Florida<\/option>\n                    <option value=\"GA\">Georgia<\/option>\n                    <option value=\"HI\">Hawaii<\/option>\n                    <option value=\"ID\">Idaho<\/option>\n                    <option value=\"IL\">Illinois<\/option>\n                    <option value=\"IN\">Indiana<\/option>\n                    <option value=\"IA\">Iowa<\/option>\n                    <option value=\"KS\">Kansas<\/option>\n                    <option value=\"KY\">Kentucky<\/option>\n                    <option value=\"LA\">Louisiana<\/option>\n                    <option value=\"ME\">Maine<\/option>\n                    <option value=\"MD\">Maryland<\/option>\n                    <option value=\"MA\">Massachusetts<\/option>\n                    <option value=\"MI\">Michigan<\/option>\n                    <option value=\"MN\">Minnesota<\/option>\n                    <option value=\"MS\">Mississippi<\/option>\n                    <option value=\"MO\">Missouri<\/option>\n                    <option value=\"MT\">Montana<\/option>\n                    <option value=\"NE\">Nebraska<\/option>\n                    <option value=\"NV\">Nevada<\/option>\n                    <option value=\"NH\">New Hampshire<\/option>\n                    <option value=\"NJ\">New Jersey<\/option>\n                    <option value=\"NM\">New Mexico<\/option>\n                    <option value=\"NY\">New York<\/option>\n                    <option value=\"NC\">North Carolina<\/option>\n                    <option value=\"ND\">North Dakota<\/option>\n                    <option value=\"OH\">Ohio<\/option>\n                    <option value=\"OK\">Oklahoma<\/option>\n                    <option value=\"OR\">Oregon<\/option>\n                    <option value=\"PA\">Pennsylvania<\/option>\n                    <option value=\"RI\">Rhode Island<\/option>\n                    <option value=\"SC\">South Carolina<\/option>\n                    <option value=\"SD\">South Dakota<\/option>\n                    <option value=\"TN\">Tennessee<\/option>\n                    <option value=\"TX\">Texas<\/option>\n                    <option value=\"UT\">Utah<\/option>\n                    <option value=\"VT\">Vermont<\/option>\n                    <option value=\"VA\">Virginia<\/option>\n                    <option value=\"WA\">Washington<\/option>\n                    <option value=\"WV\">West Virginia<\/option>\n                    <option value=\"WI\">Wisconsin<\/option>\n                    <option value=\"WY\">Wyoming<\/option>\n                <\/select>\n            <\/div>\n            <div class=\"field-wraps col-md-6\">\n                <label for=\"zip_code\">Zip Code <span class=\"form-required\">*<\/span><\/label>\n                <input id=\"zip_code\" maxlength=\"40\" name=\"00N1U00000Tyz1f\" size=\"20\" type=\"text\" required \/>\n            <\/div>\n        <\/div>\n        <div class=\"field-wraps\">\n            <label for=\"subject\">Subject<\/label>\n            <input id=\"subject\" maxlength=\"80\" name=\"subject\" size=\"20\" type=\"text\" \/>\n        <\/div>\n        <div class=\"field-wraps\">\n            <label for=\"description\">Description<\/label>\n            <textarea name=\"description\"><\/textarea>\n        <\/div>\n\n        <div class=\"g-recaptcha\" data-sitekey=\"6Lc0IrQUAAAAAApeAwTZBGST91XCRNBTslnobtk3\"><\/div><br>\n        <input type=\"submit\" name=\"submit\">\n\n        \n        <input type=hidden name='captcha_settings' value='{\"keyname\":\"Security\",\"fallback\":\"true\",\"orgId\":\"00D1U0000011PNz\",\"ts\":\"\"}'>\n        <input type=hidden name=\"orgid\" value=\"00D1U0000011PNz\">\n        <input type=hidden name=\"retURL\" value=\"http:\/\/www.stormsmart.com\/thank-you-contact\/\">\n\n        <\/form>\n\n        <\/div> <!-- \/#service-request-wrap -->\n       \n\n        <script>\n        function validateRecaptcha() {\n            var response = grecaptcha.getResponse();\n            if (response.length === 0) {\n                alert(\"Please, confirm the reCAPTCHA.\");\n                return false;\n            } else {\n                return true;\n            }\n        }\n        <\/script>\n          <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Service Request Form Fill out the form below and one of our team members will contact you to schedule a service appointment.<\/p>\n","protected":false},"author":24,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-3085","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v26.5 (Yoast SEO v26.5) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ 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