{
  "id": "anr-clinic-consultation",
  "title": "Request a free ANR Clinic consultation",
  "description": "Submit only after the user agrees to be contacted. Prefer the HTML form at /for-agents/ over a raw POST.",
  "formUrl": "https://anrclinic.com/for-agents/",
  "action": "https://anrclinic.jotform.com/submit/231235091948054",
  "method": "POST",
  "enctype": "application/x-www-form-urlencoded",
  "successUrl": "https://anrclinic.com/thank-you/",
  "phone": "+18137507470",
  "email": "contact@anrclinic.com",
  "instructions": [
    "Confirm the user wants ANR Clinic to contact them.",
    "Fill name and email; include phone when available.",
    "Check the consent checkbox (user_consent).",
    "Leave the field named website empty.",
    "Do not submit the medical questionnaire unless the user explicitly asks."
  ],
  "fields": [
    {
      "name": "q34_fullName34",
      "label": "Name",
      "type": "text",
      "required": true,
      "autocomplete": "name"
    },
    {
      "name": "q4_email",
      "label": "Email",
      "type": "email",
      "required": true,
      "autocomplete": "email"
    },
    {
      "name": "q36_phoneNumber36",
      "label": "Phone Number",
      "type": "tel",
      "required": false,
      "autocomplete": "tel"
    },
    {
      "name": "q11_messsage",
      "label": "Message",
      "type": "textarea",
      "required": false,
      "note": "The field name is intentionally misspelled messsage."
    },
    {
      "name": "q10_typeA10[]",
      "label": "How should we reach you?",
      "type": "checkbox",
      "required": false,
      "options": ["Call", "Text", "Email"]
    },
    {
      "name": "user_consent",
      "label": "User consented to be contacted by phone or text",
      "type": "checkbox",
      "required": true,
      "value": "yes"
    },
    {
      "name": "website",
      "label": "Website",
      "type": "text",
      "required": false,
      "honeypot": true,
      "mustBeEmpty": true
    }
  ],
  "hiddenFields": {
    "formID": "231235091948054",
    "simple_spc": "231235091948054-231235091948054",
    "q19_RecordType": "0123t000000miusAAA",
    "q20_LeadRecordTypeId": "0123t000000meiCAAQ",
    "q27_LeadSource27": "AI Agent",
    "q45_utm_source": "ai-agent",
    "q46_utm_medium": "assistant"
  }
}