{"full_forms":[{"form_id":"RQqWHx","live_form_versions":[{"form_id":"RQqWHx","form_version_id":24317625,"name":"Default Popup","form_type":"POPUP","channel_type":"WEB","form_type_direction":null,"update_timestamp":1772798397,"allocation":1.0,"id":24317625,"data":{"styling":{"preset_size":false,"input_styles":{"color":"#242424","focus_color":"#0064CD","border_radius":8,"height":40,"placeholder_color":"#70747D","border":{"default_color":"rgba(112,116,125,1)","active_color":"rgba(112,116,125,1)"},"font_family":"'GTAmerica', Helvetica, Arial, sans-serif","font_weight":400,"font_size":"14px","custom_company_font_id":null,"form_input_text_color":"#242424","letter_spacing":0},"size":320,"minimum_height":0,"dismiss_button_styles":{"size":32,"x_stroke":1.5,"xColor":"rgba(0,0,0)","border_color":"rgba(255,255,255,0)","background_color":"rgba(255,255,255,0)","margin":{"top":0,"left":0,"right":0,"bottom":0}},"margin":{"top":20,"bottom":20,"left":20,"right":20},"border_radius":0,"padding":{"top":30,"bottom":30,"left":15,"right":15},"is_max_width":true,"rich_text_styles":{"body":{"font_family":"'GTAmerica', Helvetica, Arial, sans-serif","font_weight":400,"font_size":"14px","custom_company_font_id":1605430}}},"independent_triggers":true,"banner_options":{"desktop_banner_position":"TOP_BANNER_POSITION","mobile_banner_position":"TOP_BANNER_POSITION","scroll_with_page":true},"show_close_button":true,"ignore_overlay_dismissal":{"desktop":false,"mobile":true}},"form_specialties":[],"views":[{"view_id":"01KHK3P6XMYG4JDABXJB2QWX7K","form_version_id":24317625,"position":0,"data":{"styling":{"preset_size":true,"input_styles":{"color":"#000000","focus_color":"#0064CD"},"size":"450"}},"name":"Survey","parent_view_id":null,"columns":[{"column_id":"01KHK3P70XJ4XZMPK44J3CY88J","view_id":"01KHK3P6XMYG4JDABXJB2QWX7K","position":0,"data":{},"rows":[{"row_id":"01KHK3P713S0YDA97YNQ20BYZA","column_id":"01KHK3P70XJ4XZMPK44J3CY88J","position":0,"data":{},"components":[{"component_id":"01KHK3P717HNZNP89Q4F49PPQ6","row_id":"01KHK3P713S0YDA97YNQ20BYZA","component_type":"TEXT","data":{"content":{"html":"<h1 style=\"text-align: center;\"><span style=\"font-family: FeatureDisplay, Arial, 'Helvetica Neue', Helvetica, sans-serif; font-weight: 300; font-style: normal; font-size: 32px;\">Connect with Us</span></h1>"},"styling":{"padding":{"left":0,"right":0,"top":0,"bottom":16}}},"action":null}]},{"row_id":"01KHK3P71BWAZJS3Z8XPEQ44N0","column_id":"01KHK3P70XJ4XZMPK44J3CY88J","position":1,"data":{},"components":[{"component_id":"01KHK3P71EVCMAQP6J9HFSB2T0","row_id":"01KHK3P71BWAZJS3Z8XPEQ44N0","component_type":"TEXT","data":{"styling":{"padding":{"top":0,"left":0,"right":0,"bottom":30}},"content":{"html":"<p style=\"text-align: center; font-size: 14px; font-family: Arial, 'Helvetica Neue', Helvetica, sans-serif; font-weight: 400; line-height: 144%;\">Fill out the request form below, and our team will follow up with you shortly.</p>"}},"action":null}]},{"row_id":"01KHK3P71MCWEN2KT0X10Z447R","column_id":"01KHK3P70XJ4XZMPK44J3CY88J","position":2,"data":{},"components":[{"component_id":"01KHK3P71RBWD6P6RM26HMFWMK","row_id":"01KHK3P71MCWEN2KT0X10Z447R","component_type":"TEXT","data":{"styling":{"padding":{"left":0,"right":0,"top":0,"bottom":16}},"content":{"html":"<h2 style=\"font-size: 14px; font-family: Arial, 'Helvetica Neue', Helvetica, sans-serif; font-weight: 400;\"><span style=\"font-size: 30px; font-family: FeatureDisplay, Arial, 'Helvetica Neue', Helvetica, sans-serif; font-weight: 300; font-style: normal; color: rgb(36, 36, 36);\">Your Information</span></h2>"}},"action":null}]},{"row_id":"01KHK3P71VTGG7HK7BVKKKN5R6","column_id":"01KHK3P70XJ4XZMPK44J3CY88J","position":3,"data":{},"components":[{"component_id":"01KHK3P71Z9AS8BH4HYTCY5AQM","row_id":"01KHK3P71VTGG7HK7BVKKKN5R6","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{},"padding":{"left":8,"right":8,"top":10,"bottom":10}},"field_id":"Practice Name","label":"Practice Name","placeholder":"Practice Name","required":true},"action":null}]},{"row_id":"01KHK3P7220R0JTEY67BTFD5DC","column_id":"01KHK3P70XJ4XZMPK44J3CY88J","position":4,"data":{},"components":[{"component_id":"01KHK3P7254NKRR6HTGJHY99WK","row_id":"01KHK3P7220R0JTEY67BTFD5DC","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{},"padding":{"left":6,"right":6,"top":10,"bottom":10}},"field_id":"Practice Address","label":"Practice Address","placeholder":"Your text here","required":false},"action":null}]},{"row_id":"01KHK3P7298K25N236JDR8BKRP","column_id":"01KHK3P70XJ4XZMPK44J3CY88J","position":5,"data":{},"components":[{"component_id":"01KHK3P72CVEN6045EM1QQ2TW4","row_id":"01KHK3P7298K25N236JDR8BKRP","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{},"padding":{"left":6,"right":6,"top":10,"bottom":10}},"field_id":"$region","label":"State","placeholder":"State","required":false},"action":null}]},{"row_id":"01KHK3P72FWC4029Z951XWPZEE","column_id":"01KHK3P70XJ4XZMPK44J3CY88J","position":6,"data":{},"components":[{"component_id":"01KHK3P72K3YS82XP740E6CKKH","row_id":"01KHK3P72FWC4029Z951XWPZEE","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{},"padding":{"left":6,"right":6,"top":10,"bottom":10}},"field_id":"$zip","label":"Zip Code","placeholder":"Zip Code","required":true},"action":null}]},{"row_id":"01KHK3P72PQ6D71EJTE66GW403","column_id":"01KHK3P70XJ4XZMPK44J3CY88J","position":7,"data":{},"components":[{"component_id":"01KHK3P72SFHG5PNH04G4TZW6R","row_id":"01KHK3P72PQ6D71EJTE66GW403","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{}},"field_id":"phone","label":"Phone","placeholder":"(XXX) XXX-XXXX","required":false},"action":null}]},{"row_id":"01KHK3P72X03AP9NW3JTYM2RPX","column_id":"01KHK3P70XJ4XZMPK44J3CY88J","position":8,"data":{},"components":[{"component_id":"01KHK3P730BA615FAMP71WQ2AG","row_id":"01KHK3P72X03AP9NW3JTYM2RPX","component_type":"EMAIL","data":{"styling":{"text_styles":{}},"field_id":"$email","required":true,"label":"Email","placeholder":"Email"},"action":null}]},{"row_id":"01KHK3P733D81AMNXB49J3FFAD","column_id":"01KHK3P70XJ4XZMPK44J3CY88J","position":9,"data":{},"components":[{"component_id":"01KHK3P73702RJEW0WZNE5S49X","row_id":"01KHK3P733D81AMNXB49J3FFAD","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{}},"field_id":"NPI Number","label":"NPI Number","placeholder":"NPI Number","required":false},"action":null}]},{"row_id":"01KHK3P73A4WN0D8KEY4FQ0W89","column_id":"01KHK3P70XJ4XZMPK44J3CY88J","position":10,"data":{},"components":[{"component_id":"01KHK3P73EMSRGGNNJ1VE5QVWQ","row_id":"01KHK3P73A4WN0D8KEY4FQ0W89","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{}},"field_id":"Physician Name","label":"Physician Name","placeholder":"Physician Name","required":false},"action":null}]},{"row_id":"01KHK3P73H2R9DB3T80136WZE9","column_id":"01KHK3P70XJ4XZMPK44J3CY88J","position":11,"data":{},"components":[{"component_id":"01KHK3P73N0ZB2DCH34A7G3EG2","row_id":"01KHK3P73H2R9DB3T80136WZE9","component_type":"MULTI_CHECKBOX","data":{"styling":{"text_styles":{},"arrangement":"vertical"},"field_id":"Clinic Specialties","required":false,"label":"Clinic Specialties (Select all that apply)","options":[{"label":"Dry Eye","value":"Dry Eye","key":"key_0"},{"label":"Retina","value":"Retina","key":"key_1"},{"label":"Myopia Control","value":"Myopia Control","key":"key_2_1769517520626"},{"label":"Cornea & Cataract","value":"Cornea & Cataract","key":"key_3_1769517529055"},{"label":"Glaucoma","value":"Glaucoma","key":"key_4_1769517538079"},{"label":"Pediatrics","value":"Pediatrics","key":"key_5_1769517546911"},{"label":"Oculoplastics/Aesthetics","value":"Oculoplastics/Aesthetics","key":"key_6_1769517557098"}]},"action":null}]},{"row_id":"01KHK3P73SFEDH965DVAJ44C10","column_id":"01KHK3P70XJ4XZMPK44J3CY88J","position":12,"data":{},"components":[{"component_id":"01KHK3P73W6CND7HV83XSGNHJJ","row_id":"01KHK3P73SFEDH965DVAJ44C10","component_type":"BUTTON","data":{"content":"Submit","meta_fields":[{"field_id":"$source","value":"Connect with Us Physician Form Mobile - EyePromise"}],"styling":{"specify_hover_background_color":true,"full_width":true,"text_styles":{"font_family":"GTAmerica, Helvetica, Arial, sans-serif","font_size":"16px","font_weight":400,"color":"rgba(255,255,255,1)","font_style":"normal","custom_company_font_id":1605430},"height":43,"padding_top":0,"padding_bottom":0,"border_style":"solid","border_width":1,"border_radius":100,"padding":{"left":0,"right":0,"top":24,"bottom":0},"background_color":"rgba(0,77,220,1)","alignment":"left","hover_text_color":"rgba(255,255,255,1)","border_color":"rgba(0,77,220,1)","hover_background_color":"rgba(0,77,220,1)"}},"action":{"action_id":"01KHK3P6Y9NYHBMFCY4H2TGBF0","action_type":"SUBMIT_TO_LIST_AND_TRANSITION_VIEW","data":{"to_phone_number":"+18449693268"},"view_id":"01KHK3P6Y171639R641W1K97AS","list_id":"RdQW8e"}}]}]}]},{"view_id":"01KHK3P6Y171639R641W1K97AS","form_version_id":24317625,"position":1,"data":{"styling":{"preset_size":true,"input_styles":{"color":"#000000","focus_color":"#0064CD"},"size":"450"}},"name":null,"parent_view_id":null,"columns":[{"column_id":"01KHK3P73ZW2010PDEHWSKYRN8","view_id":"01KHK3P6Y171639R641W1K97AS","position":0,"data":{},"rows":[{"row_id":"01KHK3P743V6BXM5FFB9WQ96PZ","column_id":"01KHK3P73ZW2010PDEHWSKYRN8","position":0,"data":{},"components":[{"component_id":"01KHK3P746M0CVH94NP0J0PQ1B","row_id":"01KHK3P743V6BXM5FFB9WQ96PZ","component_type":"IMAGE","data":{"styling":{"full_width":false,"alignment":"center","text_styles":{},"width":164,"padding":{"left":0,"right":0,"top":8,"bottom":8}},"image":{"name":"eyePromise-logo-color.1","url":"https://d3k81ch9hvuctc.cloudfront.net/company/TfQYVZ/images/996cb488-e7bf-4165-b73c-4d88e5057ff4.png","width":2484,"height":536,"format":"png","size":45288,"is_ai_generated":false,"cropped_asset_id":null,"cropping_aspect_ratio":null,"cropping_height":null,"cropping_width":null,"cropping_x":null,"cropping_y":null,"original_image_url":null,"alt_text":""},"alt_text":"logo"},"action":null}]},{"row_id":"01KHK3P7495VZT40K29VG2VD60","column_id":"01KHK3P73ZW2010PDEHWSKYRN8","position":1,"data":{},"components":[{"component_id":"01KHK3P74E2MGQ0K4VSHF4583V","row_id":"01KHK3P7495VZT40K29VG2VD60","component_type":"TEXT","data":{"content":{"html":"<h1 style=\"text-align: center; font-family: Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 14px;\"><span style=\"font-family: FeatureDisplay, Georgia, Times, &quot;Times New Roman&quot;, serif; font-size: 28px;\"><span style=\"font-weight: 300;\">THANK YOU FOR CONTACTING US</span></span></h1>"},"styling":{"padding":{"left":0,"right":0,"top":8,"bottom":8}}},"action":null}]},{"row_id":"01KHK3P74HR76Y24BWACE0BY4T","column_id":"01KHK3P73ZW2010PDEHWSKYRN8","position":2,"data":{},"components":[{"component_id":"01KHK3P74MTER9Z2030K0FQC8E","row_id":"01KHK3P74HR76Y24BWACE0BY4T","component_type":"TEXT","data":{"styling":{"padding":{"top":8,"left":0,"right":0,"bottom":8}},"content":{"html":"<p data-tagname=\"P\" style=\"text-align: center; font-family: Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 14px;\"><span style=\"font-family: GT-400, Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 16px;\">We have received your request and a team member will respond as soon as possible.</span></p>"}},"action":null}]}]}]}],"trigger_groups":[{"trigger_group_id":"01KHK3P74R5HA3P3TDE8PAMHBJ","form_version_id":24317625,"triggers":[{"trigger_id":"01KHK3P74VFQH3GPFZJ1KAWKSZ","trigger_group_id":"01KHK3P74R5HA3P3TDE8PAMHBJ","data":{"value":false},"trigger_type":"SUPPRESS_SUCCESS_FORM"},{"trigger_id":"01KHK3P755HWMSKYH9F4TEG2BG","trigger_group_id":"01KHK3P74R5HA3P3TDE8PAMHBJ","data":{"value":0},"trigger_type":"COOKIE_TIMEOUT"},{"trigger_id":"01KHK3P75J4PM5R38E000P2M6Z","trigger_group_id":"01KHK3P74R5HA3P3TDE8PAMHBJ","data":{"value":"MOBILE"},"trigger_type":"DESKTOP_MOBILE_TARGET"},{"trigger_id":"01KHK3P75ZDH9509R486M0P9XT","trigger_group_id":"01KHK3P74R5HA3P3TDE8PAMHBJ","data":{"value":true},"trigger_type":"EXIT_INTENT"},{"trigger_id":"01KHK3P762K5RAN3FKMAARP4YD","trigger_group_id":"01KHK3P74R5HA3P3TDE8PAMHBJ","data":{"value":true},"trigger_type":"JS_CUSTOM_TRIGGER"}],"SUPPRESS_SUCCESS_FORM":{"value":false},"COOKIE_TIMEOUT":{"value":0},"DESKTOP_MOBILE_TARGET":{"value":"MOBILE"},"EXIT_INTENT":{"value":true},"JS_CUSTOM_TRIGGER":{"value":true}}],"form_entity_form_view_dependencies":[]}],"name":"Connect with Us Physician Form Mobile - EyePromise","show_klaviyo_branding":false,"show_klaviyo_branding_fullpage_and_flyout_forms":false,"dismissed_alerts":[]},{"form_id":"TCVSer","live_form_versions":[{"form_id":"TCVSer","form_version_id":23918805,"name":"Default Popup","form_type":"POPUP","channel_type":"WEB","form_type_direction":null,"update_timestamp":1769148511,"allocation":1.0,"id":23918805,"data":{"styling":{"preset_size":false,"input_styles":{"color":"#152644","focus_color":"rgba(112,116,125)","border_radius":8,"height":56,"placeholder_color":"#70747D","font_family":"'GTAmerica', Helvetica, Arial, sans-serif","font_weight":400,"font_size":"18px","custom_company_font_id":1605430,"form_input_text_color":"#70747D","border":{"default_color":"rgba(112,116,125)","active_color":"rgba(112,116,125)"}},"size":588,"minimum_height":250,"dismiss_button_styles":{"size":32,"x_stroke":1,"xColor":"rgba(21,38,68)","border_color":"rgba(255,255,255,1)","background_color":"rgba(255,255,255,1)","margin":{"top":48,"left":48,"right":48,"bottom":48}},"margin":{"top":0,"bottom":0,"left":10,"right":10},"border_radius":0,"is_max_width":true,"rich_text_styles":{"body":{"text_color":"#000000","letter_spacing":0,"line_spacing":"1.0"}},"padding":{"top":48,"bottom":48,"left":48,"right":48},"border_style":"solid","border_width":1,"border_color":"rgba(112,116,125)"},"independent_triggers":true},"form_specialties":["BACK_IN_STOCK"],"views":[{"view_id":"01KFMQFWPMNMAM6T2ECZS65K0M","form_version_id":23918805,"position":0,"data":{"styling":{"preset_size":true,"input_styles":{"color":"#000000","focus_color":"#0064CD"},"size":"450"}},"name":"Email Opt-In","parent_view_id":null,"columns":[{"column_id":"01KFMQFWTKF1EPV0JHMZCHEJK4","view_id":"01KFMQFWPMNMAM6T2ECZS65K0M","position":0,"data":{},"rows":[{"row_id":"01KFMQFWTVJE62PWD9HGSBT760","column_id":"01KFMQFWTKF1EPV0JHMZCHEJK4","position":0,"data":{},"components":[{"component_id":"01KFMQFWV3MT2ZVA3BWCZETA9H","row_id":"01KFMQFWTVJE62PWD9HGSBT760","component_type":"TEXT","data":{"content":{"html":"<h1 style=\"font-size: 14px; font-family: Arial, 'Helvetica Neue', Helvetica, sans-serif; text-align: center;\"><span style=\"font-weight: 300; font-size: 56px; font-family: FeatureDisplay, Arial, 'Helvetica Neue', Helvetica, sans-serif; font-style: normal;\">Notify me when </span><span style=\"font-weight: 300; font-size: 56px; font-family: FeatureDisplay, Arial, 'Helvetica Neue', Helvetica, sans-serif; font-style: normal;\">back in stock</span></h1>"},"styling":{"padding":{"left":30,"right":30,"top":48,"bottom":0}}},"action":null}]},{"row_id":"01KFMQFWV834T5990TXEZMFBTC","column_id":"01KFMQFWTKF1EPV0JHMZCHEJK4","position":1,"data":{},"components":[{"component_id":"01KFMQFWVGG9JJZSD2YBHVQC3Z","row_id":"01KFMQFWV834T5990TXEZMFBTC","component_type":"TEXT","data":{"styling":{"padding":{"top":24,"left":0,"right":0,"bottom":48}},"content":{"html":"<div style=\"font-size: 14px; font-family: Arial, 'Helvetica Neue', Helvetica, sans-serif; text-align: center;\"><span style=\"font-weight: 400; font-size: 20px; font-family: GTAmerica, Helvetica, Arial, sans-serif; color: rgb(21, 38, 68); font-style: normal;\">We'll send you an email when this</span></div>\n<div style=\"font-size: 14px; font-family: Arial, 'Helvetica Neue', Helvetica, sans-serif; text-align: center;\"><span style=\"font-weight: 400; font-size: 20px; font-family: GTAmerica, Helvetica, Arial, sans-serif; color: rgb(21, 38, 68); font-style: normal;\">product is back in stock</span></div>"}},"action":null}]},{"row_id":"01KFMQFWVM3J10C432DJ25Z9QW","column_id":"01KFMQFWTKF1EPV0JHMZCHEJK4","position":2,"data":{},"components":[{"component_id":"01KFMQFWVW0HT6BE4SQ4TYT8TK","row_id":"01KFMQFWVM3J10C432DJ25Z9QW","component_type":"EMAIL","data":{"field_id":"$email","required":true,"placeholder":"Enter your email","styling":{"text_styles":{},"padding":{"bottom":0,"left":0,"right":0,"top":0}},"label":"Email","show_label":false},"action":null}]},{"row_id":"01KFMQFWW036DMJQWBBJQAEYCV","column_id":"01KFMQFWTKF1EPV0JHMZCHEJK4","position":3,"data":{},"components":[{"component_id":"01KFMQFWW8X6WFDSPDV5BKXZAN","row_id":"01KFMQFWW036DMJQWBBJQAEYCV","component_type":"BIS_PROMOTIONAL_EMAIL_CHECKBOX","data":{"label":"Also receive promotional marketing emails.","checkbox_label":"Also receive promotional marketing emails.","field_id":"opt_in_promotional_email","styling":{"padding":{"left":0,"right":0,"top":12,"bottom":40},"inner_alignment":"left"},"show_label":false},"action":null}]},{"row_id":"01KFMQFWWC661CAHZ7RK8WR22C","column_id":"01KFMQFWTKF1EPV0JHMZCHEJK4","position":4,"data":{},"components":[{"component_id":"01KFMQFWWQC7QSPMBTJ9TB26T6","row_id":"01KFMQFWWC661CAHZ7RK8WR22C","component_type":"BUTTON","data":{"content":"Notify Me!","meta_fields":[{"field_id":"$source","value":"Back in Stock Multi-step - EyePromise"}],"styling":{"specify_hover_background_color":false,"full_width":true,"text_styles":{"font_size":"18px","font_family":"GTAmerica, Helvetica, Arial, sans-serif","font_style":"normal","font_weight":400,"custom_company_font_id":1605430},"height":50,"padding_top":0,"padding_bottom":0,"border_style":"none","border_width":2,"border_radius":50,"background_color":"rgba(0,77,220)","padding":{"left":0,"right":0,"top":0,"bottom":0},"alignment":"left"}},"action":{"action_id":"01KFMQFWQCNSKPHBXT9WFSVC1N","action_type":"SUBMIT_BACK_IN_STOCK","data":{"to_phone_number":"+18449693268"},"view_id":"01KFMQFWPW8ZQVCVBA02199PSQ","list_id":"VufwDU"}}]}]}]},{"view_id":"01KFMQFWPW8ZQVCVBA02199PSQ","form_version_id":23918805,"position":1,"data":{"styling":{"preset_size":true,"input_styles":{"color":"#000000","focus_color":"#0064CD"},"size":"450"}},"name":null,"parent_view_id":null,"columns":[{"column_id":"01KFMQFWWZCS5FHPVKCPFGP2AH","view_id":"01KFMQFWPW8ZQVCVBA02199PSQ","position":0,"data":{},"rows":[{"row_id":"01KFMQFWX79DXGCNPZ0R9ZNJWE","column_id":"01KFMQFWWZCS5FHPVKCPFGP2AH","position":0,"data":{},"components":[{"component_id":"01KFMQFWXFWETMZTCMS6K26NS2","row_id":"01KFMQFWX79DXGCNPZ0R9ZNJWE","component_type":"TEXT","data":{"content":{"html":"<h1 style=\"font-size: 14px; font-family: Arial, 'Helvetica Neue', Helvetica, sans-serif; text-align: center;\"><span style=\"font-weight: 300; font-size: 44px; font-family: FeatureDisplay, Arial, 'Helvetica Neue', Helvetica, sans-serif; color: rgb(21, 38, 68); font-style: normal;\">YOU'RE ALL SET!</span></h1>"},"styling":{"padding":{"left":0,"right":0,"top":0,"bottom":16}}},"action":null}]},{"row_id":"01KFMQFWXMBMMA4514JFVC4963","column_id":"01KFMQFWWZCS5FHPVKCPFGP2AH","position":1,"data":{},"components":[{"component_id":"01KFMQFWXWQKX6BYMQ5RXE2RNW","row_id":"01KFMQFWXMBMMA4514JFVC4963","component_type":"TEXT","data":{"styling":{"padding":{"top":8,"left":0,"right":0,"bottom":8}},"content":{"html":"<div style=\"font-size: 14px; font-family: Arial, 'Helvetica Neue', Helvetica, sans-serif; text-align: center;\"><span style=\"font-weight: 400; font-size: 18px; font-family: GTAmerica, Helvetica, Arial, sans-serif; color: rgb(21, 38, 68); font-style: normal;\">Keep an eye out for a back-in-stock message.</span></div>"}},"action":null}]}]}]}],"trigger_groups":[{"trigger_group_id":"01KFMQFWY3045QPX6ZXCYYT89F","form_version_id":23918805,"triggers":[{"trigger_id":"01KFMQFX0E9XBGVHNRRA2PDX9A","trigger_group_id":"01KFMQFWY3045QPX6ZXCYYT89F","data":{"value":true},"trigger_type":"BACK_IN_STOCK"}],"BACK_IN_STOCK":{"value":true}}],"dynamic_buttons":[{"dynamic_button_id":"01KFMQFWT7AMZ8YVWC66PTH5Y0","type":"BACK_IN_STOCK_OPEN","form_version_id":23918805,"data":{"label":"Notify me","display":"NEXT_TO","text_styles":{"font_size":16,"font_color":"#FFFFFF","font_style":"normal","font_family":"'GT-400', Arial, 'Helvetica Neue', Helvetica, sans-serif","font_weight":400,"letter_spacing":0,"text_decoration":""},"button_styles":{"color":"#004DDC","width":"fullWidth","border":{"enabled":false},"height":50,"drop_shadow":{"enabled":false},"border_radius":50}}}],"form_entity_form_view_dependencies":[]}],"name":"Back in Stock Multi-step - EyePromise","show_klaviyo_branding":false,"show_klaviyo_branding_fullpage_and_flyout_forms":false,"dismissed_alerts":[]},{"form_id":"S2xcbi","live_form_versions":[{"form_id":"S2xcbi","form_version_id":24399969,"name":"Default Embed","form_type":"EMBED","channel_type":"WEB","form_type_direction":null,"update_timestamp":1771540004,"allocation":1.0,"id":24399969,"data":{"styling":{"padding":{"top":10,"right":5,"bottom":10,"left":5},"preset_size":true,"is_max_width":true,"background_color":"rgba(255,255,255,0)","input_styles":{"color":"#000000","focus_color":"#0064CD","border_radius":4,"height":50,"placeholder_color":"#767676","font_family":"Arial, 'Helvetica Neue', Helvetica, sans-serif","font_weight":400,"font_size":"18px","custom_company_font_id":null},"size":"600","minimum_height":120},"independent_triggers":true},"form_specialties":[],"views":[{"view_id":"01KHVZ8DJ42D457G3VTQ3EY26N","form_version_id":24399969,"position":0,"data":{"styling":{"padding":{"top":10,"right":5,"bottom":10,"left":5},"preset_size":false,"is_max_width":false,"background_color":"rgba(255,255,255,0)","input_styles":{"color":"#000000","focus_color":"#0064CD"},"size":"450"}},"name":"Sample Request Form","parent_view_id":null,"columns":[{"column_id":"01KHVZ8DKD8MB1FEACND8C4Z4Z","view_id":"01KHVZ8DJ42D457G3VTQ3EY26N","position":0,"data":{},"rows":[{"row_id":"01KHVZ8DKH0EAEZ3HCQKJ2VQF3","column_id":"01KHVZ8DKD8MB1FEACND8C4Z4Z","position":0,"data":{},"components":[{"component_id":"01KHVZ8DKP1CQ4KKXA39C5KFTK","row_id":"01KHVZ8DKH0EAEZ3HCQKJ2VQF3","component_type":"TEXT","data":{"content":{"html":"<h2 style=\"text-align: center; font-family: Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 14px;\"><span style=\"color: rgb(0, 0, 0); font-family: FeatureDisplay; font-size: 34px;\"><span style=\"font-weight: 300;\">I am interested in Heyedrate Clinical!</span></span></h2>"},"styling":{}},"action":null}]},{"row_id":"01KHVZ8DKTCBM0C7XRCCQPJHQJ","column_id":"01KHVZ8DKD8MB1FEACND8C4Z4Z","position":1,"data":{},"components":[{"component_id":"01KHVZ8DKZST34YXE0CG8X16N7","row_id":"01KHVZ8DKTCBM0C7XRCCQPJHQJ","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{}},"field_id":"$first_name","label":"First Name","placeholder":"First Name","required":true,"show_label":false},"action":null},{"component_id":"01KHVZ8DM23XC16CC9V3JX7YK6","row_id":"01KHVZ8DKTCBM0C7XRCCQPJHQJ","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{}},"field_id":"$last_name","label":"Last Name","placeholder":"Last Name","required":true,"show_label":false},"action":null}]},{"row_id":"01KHVZ8DM60SAA38Q7KYAY5ZBR","column_id":"01KHVZ8DKD8MB1FEACND8C4Z4Z","position":2,"data":{},"components":[{"component_id":"01KHVZ8DMAN7VZXTQK7S4V2ZAT","row_id":"01KHVZ8DM60SAA38Q7KYAY5ZBR","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{}},"field_id":"NPI Number","label":"NPI Number","placeholder":"NPI Number","required":true,"show_label":false},"action":null}]},{"row_id":"01KHVZ8DMDDBMR4968DW46BRCE","column_id":"01KHVZ8DKD8MB1FEACND8C4Z4Z","position":3,"data":{},"components":[{"component_id":"01KHVZ8DMHSJXG6X9K1Z3N2NXT","row_id":"01KHVZ8DMDDBMR4968DW46BRCE","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{}},"field_id":"$organization","label":"Practice","placeholder":"Name of Practice","required":true,"show_label":false},"action":null}]},{"row_id":"01KHVZ8DMNC80VCZEWA978VMHD","column_id":"01KHVZ8DKD8MB1FEACND8C4Z4Z","position":4,"data":{},"components":[{"component_id":"01KHVZ8DMRX5EFX8GS8SHCEHVW","row_id":"01KHVZ8DMNC80VCZEWA978VMHD","component_type":"EMAIL","data":{"placeholder":"Personal Email","required":true,"field_id":"$email","styling":{"text_styles":{}},"label":"Email","show_label":false},"action":null}]},{"row_id":"01KHVZ8DMXHQAXJP9GC5EDDH83","column_id":"01KHVZ8DKD8MB1FEACND8C4Z4Z","position":5,"data":{},"components":[{"component_id":"01KHVZ8DN1A56WZC3W48EA8X1T","row_id":"01KHVZ8DMXHQAXJP9GC5EDDH83","component_type":"TEXT","data":{"styling":{"block_background_color":"rgba(249,249,247,0)"},"content":{"html":"<p style=\"text-align: justify; font-family: Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 14px;\"><span data-color=\"rgb(255, 255, 255)\" style=\"text-align: justify; letter-spacing: normal; color: rgb(0, 0, 0); background-color: rgb(255, 255, 255); font-family: GTAmerica; font-size: 14.6667px;\">We\u2019ll be sending your honorarium via e-gift card. Please provide a valid personal email address to help avoid spam filters and ensure accurate and timely delivery.</span></p>"}},"action":null}]},{"row_id":"01KHVZ8DN5PCF2S4S6564APZ10","column_id":"01KHVZ8DKD8MB1FEACND8C4Z4Z","position":6,"data":{},"components":[{"component_id":"01KHVZ8DN8JDAYMECG25W5VS7R","row_id":"01KHVZ8DN5PCF2S4S6564APZ10","component_type":"PHONE_NUMBER","data":{"styling":{"text_styles":{}},"field_id":"$phone_number","required":true,"label":"Phone","placeholder":"Personal Phone Number","channel_settings":{"sms":{"consent_type":null},"whats_app":{"consent_type":null}},"sms_consent_type":"PHONE_NUMBER_ONLY","show_label":false},"action":null}]},{"row_id":"01KHVZ8DNC7DEZQ13BVY95AMY9","column_id":"01KHVZ8DKD8MB1FEACND8C4Z4Z","position":7,"data":{},"components":[{"component_id":"01KHVZ8DNGHM07FS8PZBZTVKCM","row_id":"01KHVZ8DNC7DEZQ13BVY95AMY9","component_type":"TEXT","data":{"styling":{"block_background_color":"rgba(249,249,247,0)"},"content":{"html":"<p style=\"text-align: justify; font-family: Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 14px;\"><span data-color=\"rgb(255, 255, 255)\" style=\"text-align: left; letter-spacing: normal; color: rgb(0, 0, 0); background-color: rgb(255, 255, 255); font-family: GTAmerica; font-size: 14.6667px;\">We may call you to confirm your shipping address for your free samples. Please provide a valid personal cell phone number to help ensure accurate and timely delivery.</span></p>"}},"action":null}]},{"row_id":"01KHVZ8DNKRCVDX5E8ZR52EQEB","column_id":"01KHVZ8DKD8MB1FEACND8C4Z4Z","position":8,"data":{},"components":[{"component_id":"01KHVZ8DNQMPK8Y5XNZ6B7V60J","row_id":"01KHVZ8DNKRCVDX5E8ZR52EQEB","component_type":"DROPDOWN","data":{"styling":{"text_styles":{}},"field_id":"$region","required":true,"label":"State","placeholder":"State","options":[{"label":"Alabama","value":"AL","key":"key_0"},{"label":"Alaska","value":"AK","key":"key_1"},{"label":"Arizona","value":"AZ","key":"key_2_1761229482544"},{"label":"Arkansas ","value":"AR","key":"key_3_1761229548038"},{"label":"California ","value":"CA","key":"key_4_1761229565959"},{"label":"Colorado ","value":"CO","key":"key_5_1761229582772"},{"label":"Connecticut ","value":"CT","key":"key_6_1761229595487"},{"label":"Delaware ","value":"DE","key":"key_7_1761229606511"},{"label":"Florida ","value":"FL","key":"key_8_1761229618786"},{"label":"Georgia ","value":"GA","key":"key_9_1761229629815"},{"label":"Hawaii ","value":"HI","key":"key_10_1761229640491"},{"label":"Idaho ","value":"ID","key":"key_11_1761229654563"},{"label":"Illinois ","value":"IL","key":"key_12_1761229666670"},{"label":"Indiana ","value":"IN","key":"key_13_1761229676067"},{"label":"Iowa ","value":"IA","key":"key_14_1761229685783"},{"label":"Kansas ","value":"KS","key":"key_15_1761229695975"},{"label":"Kentucky ","value":"KY","key":"key_16_1761229733381"},{"label":"Louisiana ","value":"LA","key":"key_17_1761229744589"},{"label":"Maine ","value":"ME","key":"key_18_1761229755370"},{"label":"Maryland ","value":"MD","key":"key_19_1761229764260"},{"label":"Massachusetts ","value":"MA","key":"key_20_1761229773552"},{"label":"Michigan ","value":"MI","key":"key_21_1761229785949"},{"label":"Minnesota ","value":"MN","key":"key_22_1761229792143"},{"label":"Mississippi ","value":"MS","key":"key_23_1761229907865"},{"label":"Missouri ","value":"MO","key":"key_24_1761229985177"},{"label":"Montana ","value":"MT","key":"key_25_1761230001112"},{"label":"Nebraska ","value":"NE","key":"key_26_1761230379506"},{"label":"Nevada ","value":"NV","key":"key_27_1761230389526"},{"label":"New Hampshire","value":"NH","key":"key_28_1761230410848"},{"label":"New Jersey","value":"NJ","key":"key_29_1761230426418"},{"label":"New Mexico","value":"NM","key":"key_30_1761230440232"},{"label":"New York","value":"NY","key":"key_31_1761230456625"},{"label":"North Carolina","value":"NC","key":"key_32_1761230474985"},{"label":"North Dakota","value":"ND","key":"key_33_1761230497516"},{"label":"Ohio","value":"OH","key":"key_34_1761230517054"},{"label":"Oklahoma ","value":"OK","key":"key_35_1761230529965"},{"label":"Oregon ","value":"OR","key":"key_36_1761230547623"},{"label":"Pennsylvania ","value":"PA","key":"key_37_1761230567303"},{"label":"Rhode Island","value":"RI","key":"key_38_1761230582598"},{"label":"South Carolina","value":"SC","key":"key_39_1761230596161"},{"label":"South Dakota","value":"SD","key":"key_40_1761230609828"},{"label":"Tennessee","value":"TN","key":"key_41_1761230624408"},{"label":"Texas ","value":"TX","key":"key_42_1761230634884"},{"label":"Utah ","value":"UT","key":"key_43_1761230645712"},{"label":"Vermont","value":"VT","key":"key_44_1761230665298"},{"label":"Virginia","value":"VA","key":"key_45_1761230672310"},{"label":"Washington","value":"WA","key":"key_46_1761230688044"},{"label":"West Virginia","value":"WV","key":"key_47_1761230703883"},{"label":"Wisconsin","value":"WI","key":"key_48_1761230717395"},{"label":"Wyoming","value":"WY","key":"key_49_1761230742136"}],"show_label":false},"action":null},{"component_id":"01KHVZ8DNVV1XM7F1E4G56Y76F","row_id":"01KHVZ8DNKRCVDX5E8ZR52EQEB","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{}},"field_id":"$zip","label":"Zip Code","placeholder":"Zip Code","required":true,"show_label":false},"action":null}]},{"row_id":"01KHVZ8DNYTAJV7HEMN7HR038J","column_id":"01KHVZ8DKD8MB1FEACND8C4Z4Z","position":9,"data":{},"components":[{"component_id":"01KHVZ8DP2M19J3K09PZ2DKDB2","row_id":"01KHVZ8DNYTAJV7HEMN7HR038J","component_type":"TEXT","data":{"styling":{"block_background_color":"rgba(249,249,247,0)"},"content":{"html":"<p style=\"text-align: left; font-family: Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 14px;\"><span style=\"text-align: left; letter-spacing: normal; color: rgb(0, 0, 0); font-family: GTAmerica; font-size: 20px;\"><span data-color=\"rgb(255, 255, 255)\" style=\"background-color: rgb(255, 255, 255);\">According to the webinar, what key ingredient differentiates Heyedrate Clinical from many other OTC artificial tears?&nbsp;</span></span></p>"}},"action":null}]},{"row_id":"01KHVZ8DP627F1WD2XBABJY5MD","column_id":"01KHVZ8DKD8MB1FEACND8C4Z4Z","position":10,"data":{},"components":[{"component_id":"01KHVZ8DP9VNB1F0WSENR84XN7","row_id":"01KHVZ8DP627F1WD2XBABJY5MD","component_type":"RADIO_BUTTONS","data":{"styling":{"text_styles":{},"arrangement":"vertical"},"field_id":"Question","required":true,"label":"Question","options":[{"label":"Added preservatives for longer shelf life","value":"Added preservatives for longer shelf life","key":"key_0"},{"label":"Low molecular weight hyaluronic acid ","value":"Low molecular weight hyaluronic acid ","key":"key_1"},{"label":"Highest molecular weight hyaluronic acid available in a tear","value":"Highest molecular weight hyaluronic acid available in a tear","key":"key_2_1771351568297"},{"label":"Lipid\u2011based emollients only","value":"Lipid\u2011based emollients only","key":"key_3_1771351569913"}],"show_label":false},"action":null}]},{"row_id":"01KHVZ8DPD6PB5NWP3BJ8RY9VZ","column_id":"01KHVZ8DKD8MB1FEACND8C4Z4Z","position":11,"data":{},"components":[{"component_id":"01KHVZ8DPH1PTSHYR01DV60G3G","row_id":"01KHVZ8DPD6PB5NWP3BJ8RY9VZ","component_type":"BUTTON","data":{"content":"SUBMIT","meta_fields":[{"field_id":"$source","value":"Heyedrate Sample Requests (Webinar)"}],"styling":{"specify_hover_background_color":false,"full_width":true,"text_styles":{"letter_spacing":2},"border_style":"none","border_width":2,"height":50,"padding_top":0,"padding_bottom":0,"border_radius":4,"background_color":"rgba(0,77,220,1)"}},"action":{"action_id":"01KHVZ8DJJ13GPBGTHQ9V3AT3H","action_type":"SUBMIT_TO_LIST_AND_TRANSITION_VIEW","data":{"to_phone_number":"+18449693268"},"view_id":"01KHVZ8DJB6GWDY3XEEJ0GAF0V","list_id":"UEsT6S"}}]},{"row_id":"01KHVZ8DPMDY45BSN8V5YKNYM4","column_id":"01KHVZ8DKD8MB1FEACND8C4Z4Z","position":12,"data":{},"components":[{"component_id":"01KHVZ8DPREVTMR87RPB1KB9H8","row_id":"01KHVZ8DPMDY45BSN8V5YKNYM4","component_type":"TEXT","data":{"styling":{"block_background_color":"rgba(249,249,247,0)"},"content":{"html":"<p style=\"text-align: justify; font-family: Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 14px;\"><span style=\"font-family: GTAmerica;\">Honorarium is for practicing doctors <em>only</em>. Office staff may attend for educational purposes only. Participants must watch a minimum of 75% of the content to qualify for the honorarium.</span></p>"}},"action":null}]}]}]},{"view_id":"01KHVZ8DJB6GWDY3XEEJ0GAF0V","form_version_id":24399969,"position":1,"data":{"styling":{"padding":{"top":10,"right":5,"bottom":10,"left":5},"preset_size":false,"is_max_width":false,"background_color":"rgba(255,255,255,0)","input_styles":{"color":"#000000","focus_color":"#0064CD"},"size":"450"}},"name":null,"parent_view_id":null,"columns":[{"column_id":"01KHVZ8DPWCZAZCKV62CY7Y4SM","view_id":"01KHVZ8DJB6GWDY3XEEJ0GAF0V","position":0,"data":{},"rows":[{"row_id":"01KHVZ8DPZG8D2TGRG7G3T7W89","column_id":"01KHVZ8DPWCZAZCKV62CY7Y4SM","position":0,"data":{},"components":[{"component_id":"01KHVZ8DQ3FV71EKTG5S89BDWN","row_id":"01KHVZ8DPZG8D2TGRG7G3T7W89","component_type":"TEXT","data":{"content":{"html":"<h2 style=\"text-align: center; font-family: Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 14px;\"><span style=\"font-family: FeatureDisplay; font-size: 32px;\"><span style=\"font-weight: 300;\">Your request has been received, thank you!</span></span></h2>"},"styling":{}},"action":null}]}]}]}],"trigger_groups":[{"trigger_group_id":"01KHVZ8DQ7Q6AFXQH0NJ8H88NX","form_version_id":24399969,"triggers":[]}],"form_entity_form_view_dependencies":[]}],"name":"Heyedrate Sample Requests (Webinar)","show_klaviyo_branding":false,"show_klaviyo_branding_fullpage_and_flyout_forms":false,"dismissed_alerts":[{"id":"94962e4e419a439285fd8f57b31b10f6","alert_id":"embed","dismissed":"2026-02-17T18:15:08.874232+00:00"}]},{"form_id":"YmsrZe","live_form_versions":[{"form_id":"YmsrZe","form_version_id":24136072,"name":"Default Popup","form_type":"POPUP","channel_type":"WEB","form_type_direction":null,"update_timestamp":1771241587,"allocation":1.0,"id":24136072,"data":{"styling":{"preset_size":false,"input_styles":{"color":"#242424","focus_color":"#0064CD","border_radius":8,"height":56,"placeholder_color":"#70747D","border":{"default_color":"rgba(112,116,125,1)","active_color":"rgba(112,116,125,1)"},"font_family":"'GTAmerica', Helvetica, Arial, sans-serif","font_weight":400,"font_size":"16px","custom_company_font_id":null,"form_input_text_color":"#242424","letter_spacing":0},"size":1232,"minimum_height":640,"dismiss_button_styles":{"size":32,"x_stroke":1.5,"xColor":"rgba(0,0,0)","border_color":"rgba(255,255,255,0)","background_color":"rgba(255,255,255,0)","margin":{"top":56,"left":80,"right":80,"bottom":56}},"margin":{"top":20,"bottom":20,"left":20,"right":20},"border_radius":0,"padding":{"top":80,"bottom":112,"left":137,"right":151},"is_max_width":true,"rich_text_styles":{"body":{"font_family":"'GTAmerica', Helvetica, Arial, sans-serif","font_weight":400,"font_size":"16px","custom_company_font_id":1605430}}},"independent_triggers":true,"banner_options":{"desktop_banner_position":"TOP_BANNER_POSITION","mobile_banner_position":"TOP_BANNER_POSITION","scroll_with_page":true},"show_close_button":true,"ignore_overlay_dismissal":{"desktop":true,"mobile":false}},"form_specialties":[],"views":[{"view_id":"01KGPW245KH9A8PRVW7QXJXVVA","form_version_id":24136072,"position":0,"data":{"styling":{"preset_size":true,"input_styles":{"color":"#000000","focus_color":"#0064CD"},"size":"450"}},"name":"Survey","parent_view_id":null,"columns":[{"column_id":"01KGPW249XH09NRQS996RYHWJS","view_id":"01KGPW245KH9A8PRVW7QXJXVVA","position":0,"data":{},"rows":[{"row_id":"01KGPW24A1VAZMSN5CMRFM0N9G","column_id":"01KGPW249XH09NRQS996RYHWJS","position":0,"data":{},"components":[{"component_id":"01KGPW24A5348WAW0SPCMFPKHM","row_id":"01KGPW24A1VAZMSN5CMRFM0N9G","component_type":"TEXT","data":{"content":{"html":"<h1 style=\"text-align: center;\"><span style=\"font-family: FeatureDisplay, Arial, 'Helvetica Neue', Helvetica, sans-serif; font-weight: 300; font-style: normal; font-size: 56px;\">Connect with Us</span></h1>"},"styling":{"padding":{"left":0,"right":0,"top":0,"bottom":16}}},"action":null}]},{"row_id":"01KGPW24AA9DJPCR2PJCAMCXNY","column_id":"01KGPW249XH09NRQS996RYHWJS","position":1,"data":{},"components":[{"component_id":"01KGPW24AEWD8SEVKJNTK7CA6N","row_id":"01KGPW24AA9DJPCR2PJCAMCXNY","component_type":"TEXT","data":{"styling":{"padding":{"top":0,"left":0,"right":0,"bottom":56}},"content":{"html":"<p style=\"text-align: center; font-size: 14px; font-family: Arial, 'Helvetica Neue', Helvetica, sans-serif; font-weight: 400; line-height: 144%;\"><span style=\"font-family: GT-400, Arial, 'Helvetica Neue', Helvetica, sans-serif; font-weight: 400; font-style: normal;\">Fill out the request form below, and our team will follow up with you shortly</span></p>"}},"action":null}]},{"row_id":"01KGPW24AJ84RDAKGMN72XEKD3","column_id":"01KGPW249XH09NRQS996RYHWJS","position":2,"data":{},"components":[{"component_id":"01KGPW24AQJCV8PBQQQH1MANV1","row_id":"01KGPW24AJ84RDAKGMN72XEKD3","component_type":"TEXT","data":{"styling":{"padding":{"left":0,"right":0,"top":0,"bottom":24}},"content":{"html":"<h2 style=\"font-size: 14px; font-family: Arial, 'Helvetica Neue', Helvetica, sans-serif; font-weight: 400;\"><span style=\"font-size: 34px; font-family: FeatureDisplay, Arial, 'Helvetica Neue', Helvetica, sans-serif; font-weight: 300; font-style: normal; color: rgb(36, 36, 36);\">Your Information</span></h2>"}},"action":null}]},{"row_id":"01KGPW24AV5MN9Y8MXVYNKAJQW","column_id":"01KGPW249XH09NRQS996RYHWJS","position":3,"data":{},"components":[{"component_id":"01KGPW24B1FGT35ZR2AHZG6504","row_id":"01KGPW24AV5MN9Y8MXVYNKAJQW","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{},"padding":{"left":8,"right":8,"top":10,"bottom":10}},"field_id":"Practice Name","label":"Practice Name","placeholder":"Practice Name","required":true},"action":null},{"component_id":"01KGPW24B5EBDVH1JGQMNNTBC0","row_id":"01KGPW24AV5MN9Y8MXVYNKAJQW","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{},"padding":{"left":6,"right":6,"top":10,"bottom":10}},"field_id":"Practice Address","label":"Practice Address","placeholder":"Your text here","required":false},"action":null}]},{"row_id":"01KHK3B24PYSJGWDR1W470RJH4","column_id":"01KGPW249XH09NRQS996RYHWJS","position":4,"data":{},"components":[{"component_id":"01KHK3B2632ZD41D5DTWYAT031","row_id":"01KHK3B24PYSJGWDR1W470RJH4","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{},"padding":{"left":8,"right":8,"top":10,"bottom":10}},"field_id":"$region","label":"State","placeholder":"State","required":false},"action":null},{"component_id":"01KHK3AXKZN67FVEA0ZBAXPDE1","row_id":"01KHK3B24PYSJGWDR1W470RJH4","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{},"padding":{"left":8,"right":8,"top":10,"bottom":10}},"field_id":"$zip","label":"Zip Code","placeholder":"Zip Code","required":true},"action":null}]},{"row_id":"01KGPW24B9M6FJT3NS01DN8W5H","column_id":"01KGPW249XH09NRQS996RYHWJS","position":5,"data":{},"components":[{"component_id":"01KGPW24BD4DMT940BG539DKAM","row_id":"01KGPW24B9M6FJT3NS01DN8W5H","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{}},"field_id":"phone","label":"Phone","placeholder":"(XXX) XXX-XXXX","required":false},"action":null},{"component_id":"01KGPW24BH7MAWE860P4B8JKTR","row_id":"01KGPW24B9M6FJT3NS01DN8W5H","component_type":"EMAIL","data":{"styling":{"text_styles":{}},"field_id":"$email","required":true,"label":"Email","placeholder":"Email"},"action":null}]},{"row_id":"01KGPW24BP402AKZQ8B5HK6BG9","column_id":"01KGPW249XH09NRQS996RYHWJS","position":6,"data":{},"components":[{"component_id":"01KGPW24BTDMMS5PWW3C8A0PB8","row_id":"01KGPW24BP402AKZQ8B5HK6BG9","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{}},"field_id":"NPI Number","label":"NPI Number","placeholder":"NPI Number","required":false},"action":null},{"component_id":"01KGPW24BYFGGHAPHRT1V0Z8M9","row_id":"01KGPW24BP402AKZQ8B5HK6BG9","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{}},"field_id":"Physician Name","label":"Physician Name","placeholder":"Physician Name","required":false},"action":null}]},{"row_id":"01KGPW24C20QZGVE1RKFZ43ZR1","column_id":"01KGPW249XH09NRQS996RYHWJS","position":7,"data":{},"components":[{"component_id":"01KGPW24C6N8GG6RMM32506STZ","row_id":"01KGPW24C20QZGVE1RKFZ43ZR1","component_type":"MULTI_CHECKBOX","data":{"styling":{"text_styles":{},"arrangement":"vertical"},"field_id":"Clinic Specialties","required":false,"label":"Clinic Specialties (Select all that apply)","options":[{"label":"Dry Eye","value":"Dry Eye","key":"key_0"},{"label":"Retina","value":"Retina","key":"key_1"},{"label":"Myopia Control","value":"Myopia Control","key":"key_2_1769516557949"},{"label":"Cornea & Cataract","value":"Cornea & Cataract","key":"key_3_1769516568199"},{"label":"Glaucoma","value":"Glaucoma","key":"key_4_1769516580407"},{"label":"Pediatrics","value":"Pediatrics","key":"key_5_1769516590680"},{"label":"Oculoplastics/Aesthetics","value":"Oculoplastics/Aesthetics","key":"key_6_1769516610664"}],"show_label":true},"action":null}]},{"row_id":"01KGPW24CBWWVYZ5GGQ4ZMC65T","column_id":"01KGPW249XH09NRQS996RYHWJS","position":8,"data":{},"components":[{"component_id":"01KGPW24CF701WB4AYH2VD6JCS","row_id":"01KGPW24CBWWVYZ5GGQ4ZMC65T","component_type":"BUTTON","data":{"content":"Submit","meta_fields":[{"field_id":"$source","value":"Connect with Us Physician Form Desktop - EyePromise"}],"styling":{"specify_hover_background_color":false,"full_width":true,"text_styles":{"font_family":"GTAmerica, Helvetica, Arial, sans-serif","font_size":"16px","font_weight":400,"color":"rgba(255,255,255,1)","font_style":"normal","custom_company_font_id":1605430},"height":44,"padding_top":0,"padding_bottom":0,"border_style":"none","border_width":1,"border_radius":100,"padding":{"left":0,"right":10,"top":24,"bottom":0},"background_color":"rgba(0,77,220,1)","alignment":"left","hover_text_color":"rgba(255,255,255,1)","border_color":"rgba(0,77,220,1)","hover_background_color":"rgba(0,77,220,1)"}},"action":{"action_id":"01KGPW246K2NN34B78D1B2MKKV","action_type":"SUBMIT_TO_LIST_AND_TRANSITION_VIEW","data":{"to_phone_number":"+18449693268"},"view_id":"01KGPW246BWN952EZ94BGWWZHP","list_id":"RdQW8e"}},{"component_id":"01KGPW24CM3YVAPF6A40CJ2XKG","row_id":"01KGPW24CBWWVYZ5GGQ4ZMC65T","component_type":"BUTTON","data":{"styling":{"full_width":true,"text_styles":{"font_weight":"400"},"specify_hover_background_color":false,"height":44,"padding_top":0,"padding_bottom":0,"border_radius":100,"padding":{"left":10,"right":0,"top":24,"bottom":0}},"content":"Cancel","meta_fields":[{"field_id":"$source","value":"Connect with Us Physician Form Desktop - EyePromise"}]},"action":{"action_id":"01KGPW2464DK9KBTD1SF60W6KC","action_type":"CLOSE_FORM","data":{"to_phone_number":"+18449693268"},"view_id":"01KGPW245KH9A8PRVW7QXJXVVA","list_id":null}}]}]}]},{"view_id":"01KGPW246BWN952EZ94BGWWZHP","form_version_id":24136072,"position":1,"data":{"styling":{"preset_size":true,"input_styles":{"color":"#000000","focus_color":"#0064CD"},"size":"450"}},"name":null,"parent_view_id":null,"columns":[{"column_id":"01KGPW24CR0AH9XD1DCVTKQDHY","view_id":"01KGPW246BWN952EZ94BGWWZHP","position":0,"data":{},"rows":[{"row_id":"01KGPW24CWG7VBQ8AG0XRJY0QP","column_id":"01KGPW24CR0AH9XD1DCVTKQDHY","position":0,"data":{},"components":[{"component_id":"01KGPW24D0QMDTM2W32D7NA1DE","row_id":"01KGPW24CWG7VBQ8AG0XRJY0QP","component_type":"IMAGE","data":{"styling":{"full_width":false,"alignment":"center","text_styles":{},"width":250,"padding":{"left":0,"right":0,"top":8,"bottom":8}},"image":{"name":"eyePromise-logo-color.1","url":"https://d3k81ch9hvuctc.cloudfront.net/company/TfQYVZ/images/996cb488-e7bf-4165-b73c-4d88e5057ff4.png","width":2484,"height":536,"format":"png","size":45288,"is_ai_generated":false,"cropped_asset_id":null,"cropping_aspect_ratio":null,"cropping_height":null,"cropping_width":null,"cropping_x":null,"cropping_y":null,"original_image_url":null,"alt_text":""},"alt_text":"logo"},"action":null}]},{"row_id":"01KGPW24D5G9J7D9FH4T2T1X2N","column_id":"01KGPW24CR0AH9XD1DCVTKQDHY","position":1,"data":{},"components":[{"component_id":"01KGPW24D9JZJZ9Q70STX2DYEM","row_id":"01KGPW24D5G9J7D9FH4T2T1X2N","component_type":"TEXT","data":{"content":{"html":"<h1 style=\"text-align: center; font-family: Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 14px;\"><span style=\"font-family: FeatureDisplay, Georgia, Times, &quot;Times New Roman&quot;, serif; font-size: 48px;\"><span style=\"font-weight: 300;\">THANK YOU FOR CONTACTING US</span></span></h1>"},"styling":{"padding":{"left":0,"right":0,"top":8,"bottom":8}}},"action":null}]},{"row_id":"01KGPW24DDTZ5Y68ZK4D2EQDGH","column_id":"01KGPW24CR0AH9XD1DCVTKQDHY","position":2,"data":{},"components":[{"component_id":"01KGPW24DH676Q4RYV3ZN5J360","row_id":"01KGPW24DDTZ5Y68ZK4D2EQDGH","component_type":"TEXT","data":{"styling":{"padding":{"top":8,"left":0,"right":0,"bottom":8}},"content":{"html":"<p data-tagname=\"P\" style=\"text-align: center; font-family: Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 14px;\"><span style=\"font-family: GT-400, Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 24px;\">We have received your request and a team member will respond as soon as possible.</span></p>"}},"action":null}]}]}]}],"trigger_groups":[{"trigger_group_id":"01KGPW24DPSMQXNRF7QMWXF9DW","form_version_id":24136072,"triggers":[{"trigger_id":"01KGPW24DTRSK8CE2GB24WEWXH","trigger_group_id":"01KGPW24DPSMQXNRF7QMWXF9DW","data":{"value":false},"trigger_type":"SUPPRESS_SUCCESS_FORM"},{"trigger_id":"01KGPW24E7HDMPG8JXYN78P1R8","trigger_group_id":"01KGPW24DPSMQXNRF7QMWXF9DW","data":{"value":0},"trigger_type":"COOKIE_TIMEOUT"},{"trigger_id":"01KGPW24ERNKBE2DT3T6D126D6","trigger_group_id":"01KGPW24DPSMQXNRF7QMWXF9DW","data":{"value":"DESKTOP"},"trigger_type":"DESKTOP_MOBILE_TARGET"},{"trigger_id":"01KGPW24F4BRG9X4HSEG17TVKE","trigger_group_id":"01KGPW24DPSMQXNRF7QMWXF9DW","data":{"value":true},"trigger_type":"EXIT_INTENT"},{"trigger_id":"01KGPW24F8M7GPWKHVXCHWCB11","trigger_group_id":"01KGPW24DPSMQXNRF7QMWXF9DW","data":{"value":true},"trigger_type":"JS_CUSTOM_TRIGGER"}],"SUPPRESS_SUCCESS_FORM":{"value":false},"COOKIE_TIMEOUT":{"value":0},"DESKTOP_MOBILE_TARGET":{"value":"DESKTOP"},"EXIT_INTENT":{"value":true},"JS_CUSTOM_TRIGGER":{"value":true}}],"form_entity_form_view_dependencies":[]}],"name":"Connect with Us Physician Form Desktop - EyePromise","show_klaviyo_branding":false,"show_klaviyo_branding_fullpage_and_flyout_forms":false,"dismissed_alerts":[]},{"form_id":"TPcd8q","live_form_versions":[{"form_id":"TPcd8q","form_version_id":22780050,"name":"Default Embed","form_type":"EMBED","channel_type":"WEB","form_type_direction":null,"update_timestamp":1775576195,"allocation":1.0,"id":22780050,"data":{"styling":{"padding":{"top":10,"right":5,"bottom":10,"left":5},"preset_size":true,"is_max_width":true,"background_color":"rgba(255,255,255,0)","input_styles":{"color":"#000000","focus_color":"#0064CD","border_radius":4,"height":50,"placeholder_color":"#767676","font_family":"Arial, 'Helvetica Neue', Helvetica, sans-serif","font_weight":400,"font_size":"18px","custom_company_font_id":null},"size":"600","minimum_height":120},"independent_triggers":true},"form_specialties":[],"views":[{"view_id":"01KACAT9HJXRFTV5XN7VJYWAN9","form_version_id":22780050,"position":0,"data":{"styling":{"padding":{"top":10,"right":5,"bottom":10,"left":5},"preset_size":false,"is_max_width":false,"background_color":"rgba(255,255,255,0)","input_styles":{"color":"#000000","focus_color":"#0064CD"},"size":"450"}},"name":"Sample Request Form","parent_view_id":null,"columns":[{"column_id":"01KACAT9JW9C8P7H0BHJC41ECZ","view_id":"01KACAT9HJXRFTV5XN7VJYWAN9","position":0,"data":{},"rows":[{"row_id":"01KACAT9K02A5TTHZJ1TB6BGD9","column_id":"01KACAT9JW9C8P7H0BHJC41ECZ","position":0,"data":{},"components":[{"component_id":"01KACAT9K3GB2AES0N3BRJZ2DF","row_id":"01KACAT9K02A5TTHZJ1TB6BGD9","component_type":"TEXT","data":{"content":{"html":"<h2 style=\"text-align: center; font-size: 14px; font-family: Arial, 'Helvetica Neue', Helvetica, sans-serif; font-weight: 400;\"><!--StartFragment--><span style=\"font-size: 22px; font-weight: 400;\" data-teams=\"true\">Yes, I'm interested in Heyedrate Clinical!</span><!--EndFragment--></h2>"},"styling":{}},"action":null}]},{"row_id":"01KACAT9K6N0XZ0JY1ZR9W4MT3","column_id":"01KACAT9JW9C8P7H0BHJC41ECZ","position":1,"data":{},"components":[{"component_id":"01KACAT9KAG3967GYZE4QZ2AMG","row_id":"01KACAT9K6N0XZ0JY1ZR9W4MT3","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{}},"field_id":"$first_name","label":"First Name","placeholder":"First Name","required":true,"show_label":false},"action":null},{"component_id":"01KACAT9KDAGAV6Q0G2CMH8TMK","row_id":"01KACAT9K6N0XZ0JY1ZR9W4MT3","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{}},"field_id":"$last_name","label":"Last Name","placeholder":"Last Name","required":true,"show_label":false},"action":null}]},{"row_id":"01KACAT9KG7W889FKJBQXRF85H","column_id":"01KACAT9JW9C8P7H0BHJC41ECZ","position":2,"data":{},"components":[{"component_id":"01KACAT9KKK5WM54X53GCXHKC2","row_id":"01KACAT9KG7W889FKJBQXRF85H","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{}},"field_id":"$organization","label":"Practice","placeholder":"Name of Practice","required":true,"show_label":false},"action":null}]},{"row_id":"01KACAT9KPSZX1533KYZVMK54Q","column_id":"01KACAT9JW9C8P7H0BHJC41ECZ","position":3,"data":{},"components":[{"component_id":"01KACAT9KSGFPHYGCJGK2RR4ZV","row_id":"01KACAT9KPSZX1533KYZVMK54Q","component_type":"EMAIL","data":{"placeholder":"Email","required":true,"field_id":"$email","styling":{"text_styles":{}},"label":"Email","show_label":false},"action":null}]},{"row_id":"01KNM95K109JSFE59SEDWVCX8R","column_id":"01KACAT9JW9C8P7H0BHJC41ECZ","position":4,"data":{},"components":[{"component_id":"01KNM95K990KWBWV6CPT2EEZX1","row_id":"01KNM95K109JSFE59SEDWVCX8R","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{}},"field_id":"$address1","label":"Street Address","placeholder":"Street Address","required":true,"show_label":false},"action":null}]},{"row_id":"01KNM99WZ0HBPWE2JTBFJJ2XEN","column_id":"01KACAT9JW9C8P7H0BHJC41ECZ","position":5,"data":{},"components":[{"component_id":"01KNM98KBJKQ599SEW8E4EE9HS","row_id":"01KNM99WZ0HBPWE2JTBFJJ2XEN","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{}},"field_id":"$city","label":"City","placeholder":"City","required":true,"show_label":false},"action":null},{"component_id":"01KACAT9M6J6Z4277M84V6NV9D","row_id":"01KNM99WZ0HBPWE2JTBFJJ2XEN","component_type":"DROPDOWN","data":{"styling":{"text_styles":{}},"field_id":"$region","required":true,"label":"State","placeholder":"State","options":[{"label":"Alabama","value":"AL","key":"key_0"},{"label":"Alaska","value":"AK","key":"key_1"},{"label":"Arizona","value":"AZ","key":"key_2_1761229482544"},{"label":"Arkansas ","value":"AR","key":"key_3_1761229548038"},{"label":"California ","value":"CA","key":"key_4_1761229565959"},{"label":"Colorado ","value":"CO","key":"key_5_1761229582772"},{"label":"Connecticut ","value":"CT","key":"key_6_1761229595487"},{"label":"Delaware ","value":"DE","key":"key_7_1761229606511"},{"label":"Florida ","value":"FL","key":"key_8_1761229618786"},{"label":"Georgia ","value":"GA","key":"key_9_1761229629815"},{"label":"Hawaii ","value":"HI","key":"key_10_1761229640491"},{"label":"Idaho ","value":"ID","key":"key_11_1761229654563"},{"label":"Illinois ","value":"IL","key":"key_12_1761229666670"},{"label":"Indiana ","value":"IN","key":"key_13_1761229676067"},{"label":"Iowa ","value":"IA","key":"key_14_1761229685783"},{"label":"Kansas ","value":"KS","key":"key_15_1761229695975"},{"label":"Kentucky ","value":"KY","key":"key_16_1761229733381"},{"label":"Louisiana ","value":"LA","key":"key_17_1761229744589"},{"label":"Maine ","value":"ME","key":"key_18_1761229755370"},{"label":"Maryland ","value":"MD","key":"key_19_1761229764260"},{"label":"Massachusetts ","value":"MA","key":"key_20_1761229773552"},{"label":"Michigan ","value":"MI","key":"key_21_1761229785949"},{"label":"Minnesota ","value":"MN","key":"key_22_1761229792143"},{"label":"Mississippi ","value":"MS","key":"key_23_1761229907865"},{"label":"Missouri ","value":"MO","key":"key_24_1761229985177"},{"label":"Montana ","value":"MT","key":"key_25_1761230001112"},{"label":"Nebraska ","value":"NE","key":"key_26_1761230379506"},{"label":"Nevada ","value":"NV","key":"key_27_1761230389526"},{"label":"New Hampshire","value":"NH","key":"key_28_1761230410848"},{"label":"New Jersey","value":"NJ","key":"key_29_1761230426418"},{"label":"New Mexico","value":"NM","key":"key_30_1761230440232"},{"label":"New York","value":"NY","key":"key_31_1761230456625"},{"label":"North Carolina","value":"NC","key":"key_32_1761230474985"},{"label":"North Dakota","value":"ND","key":"key_33_1761230497516"},{"label":"Ohio","value":"OH","key":"key_34_1761230517054"},{"label":"Oklahoma ","value":"OK","key":"key_35_1761230529965"},{"label":"Oregon ","value":"OR","key":"key_36_1761230547623"},{"label":"Pennsylvania ","value":"PA","key":"key_37_1761230567303"},{"label":"Rhode Island","value":"RI","key":"key_38_1761230582598"},{"label":"South Carolina","value":"SC","key":"key_39_1761230596161"},{"label":"South Dakota","value":"SD","key":"key_40_1761230609828"},{"label":"Tennessee","value":"TN","key":"key_41_1761230624408"},{"label":"Texas ","value":"TX","key":"key_42_1761230634884"},{"label":"Utah ","value":"UT","key":"key_43_1761230645712"},{"label":"Vermont","value":"VT","key":"key_44_1761230665298"},{"label":"Virginia","value":"VA","key":"key_45_1761230672310"},{"label":"Washington","value":"WA","key":"key_46_1761230688044"},{"label":"West Virginia","value":"WV","key":"key_47_1761230703883"},{"label":"Wisconsin","value":"WI","key":"key_48_1761230717395"},{"label":"Wyoming","value":"WY","key":"key_49_1761230742136"}],"show_label":false},"action":null}]},{"row_id":"01KACAT9M3YH3KH392JJA7JAXG","column_id":"01KACAT9JW9C8P7H0BHJC41ECZ","position":6,"data":{},"components":[{"component_id":"01KACAT9MANYJGQJH78AGVS71W","row_id":"01KACAT9M3YH3KH392JJA7JAXG","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{}},"field_id":"$zip","label":"Zip Code","placeholder":"Zip Code","required":true,"show_label":false},"action":null},{"component_id":"01KACAT9M0DKNRMHBQHC4HRDSJ","row_id":"01KACAT9M3YH3KH392JJA7JAXG","component_type":"PHONE_NUMBER","data":{"styling":{"text_styles":{}},"field_id":"$phone_number","required":true,"label":"Phone","placeholder":"Phone Number","channel_settings":{"sms":{"consent_type":null},"whats_app":{"consent_type":null}},"sms_consent_type":"PHONE_NUMBER_ONLY","show_label":false},"action":null}]},{"row_id":"01KNM9CGJGZCDB0PA6B430WABD","column_id":"01KACAT9JW9C8P7H0BHJC41ECZ","position":7,"data":{},"components":[{"component_id":"01KACAT9MM73NG14XE90ZQ70ZX","row_id":"01KNM9CGJGZCDB0PA6B430WABD","component_type":"MULTI_CHECKBOX","data":{"styling":{"text_styles":{},"arrangement":"vertical","padding":{"left":20,"right":0,"top":10,"bottom":10}},"field_id":"Opt-In Sales Contact - Heyedrate Samples","required":false,"label":"Opt-In Sales Contact - Heyedrate Samples","options":[{"label":"I would like to receive samples of Heyedrate Clinical.","value":"TRUE","key":"key_0"}],"show_label":false},"action":null}]},{"row_id":"01KNM9CCYJJMMVDMJAWYQW44H4","column_id":"01KACAT9JW9C8P7H0BHJC41ECZ","position":8,"data":{},"components":[{"component_id":"01KACAT9MD95G55QAGZTWZA5F8","row_id":"01KNM9CCYJJMMVDMJAWYQW44H4","component_type":"BUTTON","data":{"content":"SUBMIT","meta_fields":[{"field_id":"$source","value":"Heyedrate Sample Requests"}],"styling":{"specify_hover_background_color":false,"full_width":true,"text_styles":{"letter_spacing":2},"border_style":"none","border_width":2,"height":50,"padding_top":0,"padding_bottom":0,"border_radius":4,"background_color":"rgba(21,44,82)"}},"action":{"action_id":"01KACAT9J3G9PAJ35WDSW7X99Q","action_type":"SUBMIT_TO_LIST_AND_TRANSITION_VIEW","data":{"to_phone_number":"+18449693268"},"view_id":"01KACAT9HRK6C5ZNPC0SPCR8ZZ","list_id":"YuyNVv"}}]}]}]},{"view_id":"01KACAT9HRK6C5ZNPC0SPCR8ZZ","form_version_id":22780050,"position":1,"data":{"styling":{"padding":{"top":10,"right":5,"bottom":10,"left":5},"preset_size":false,"is_max_width":false,"background_color":"rgba(255,255,255,0)","input_styles":{"color":"#000000","focus_color":"#0064CD"},"size":"450"}},"name":null,"parent_view_id":null,"columns":[{"column_id":"01KACAT9MQ8F7F3NB8PNBG820W","view_id":"01KACAT9HRK6C5ZNPC0SPCR8ZZ","position":0,"data":{},"rows":[{"row_id":"01KACAT9MTFS1G1H2MJDMRJ520","column_id":"01KACAT9MQ8F7F3NB8PNBG820W","position":0,"data":{},"components":[{"component_id":"01KACAT9MXMSXTAYPVPPHFZGMK","row_id":"01KACAT9MTFS1G1H2MJDMRJ520","component_type":"TEXT","data":{"content":{"html":"<h2 style=\"text-align: center; font-size: 14px; font-family: Arial, 'Helvetica Neue', Helvetica, sans-serif; font-weight: 400;\"><span style=\"font-size: 24px; font-family: Arial, 'Helvetica Neue', Helvetica, sans-serif; font-weight: bold;\">Thank you for your interest!</span></h2>"},"styling":{}},"action":null}]},{"row_id":"01KACAT9N07XCB5BQZF4RE3BRF","column_id":"01KACAT9MQ8F7F3NB8PNBG820W","position":1,"data":{},"components":[{"component_id":"01KACAT9N3BZA58CKNY21B3RZ7","row_id":"01KACAT9N07XCB5BQZF4RE3BRF","component_type":"TEXT","data":{"styling":{},"content":{"html":"<p style=\"text-align:center;font-size:14px;font-family:Arial, 'Helvetica Neue', Helvetica, sans-serif;font-weight:400;\"><span style=\"font-size:16px;font-family:Arial, 'Helvetica Neue', Helvetica, sans-serif;font-weight:400;\">Check your email for a confirmation message.</span></p>"}},"action":null}]}]}]}],"trigger_groups":[{"trigger_group_id":"01KACAT9N66F7Q8FGZS2R1MTVM","form_version_id":22780050,"triggers":[]}],"form_entity_form_view_dependencies":[]}],"name":"Heyedrate Sample Requests","show_klaviyo_branding":false,"show_klaviyo_branding_fullpage_and_flyout_forms":false,"dismissed_alerts":[]},{"form_id":"XEwTRJ","live_form_versions":[{"form_id":"XEwTRJ","form_version_id":25732918,"name":"Default Embed","form_type":"EMBED","channel_type":"WEB","form_type_direction":null,"update_timestamp":1777378266,"allocation":1.0,"id":25732918,"data":{"styling":{"padding":{"top":10,"right":5,"bottom":10,"left":5},"preset_size":true,"is_max_width":true,"background_color":"rgba(255,255,255,0)","input_styles":{"color":"#000000","focus_color":"#0064CD","border_radius":4,"height":50,"placeholder_color":"#767676","font_family":"Arial, 'Helvetica Neue', Helvetica, sans-serif","font_weight":400,"font_size":"18px","custom_company_font_id":null},"size":"600","minimum_height":120},"independent_triggers":true},"form_specialties":[],"views":[{"view_id":"01KQ9ZT6BM9VG5WPTW3GFRZAPN","form_version_id":25732918,"position":0,"data":{"styling":{"padding":{"top":10,"right":5,"bottom":10,"left":5},"preset_size":false,"is_max_width":false,"background_color":"rgba(255,255,255,0)","input_styles":{"color":"#000000","focus_color":"#0064CD"},"size":"450"}},"name":"Sample Request Form","parent_view_id":null,"columns":[{"column_id":"01KQ9ZT6DC399Y1NHAVRAKC5J0","view_id":"01KQ9ZT6BM9VG5WPTW3GFRZAPN","position":0,"data":{},"rows":[{"row_id":"01KQ9ZT6DN6KNRMJF541W7762T","column_id":"01KQ9ZT6DC399Y1NHAVRAKC5J0","position":0,"data":{},"components":[{"component_id":"01KQ9ZT6DXCC7F1Y125E7638Y2","row_id":"01KQ9ZT6DN6KNRMJF541W7762T","component_type":"TEXT","data":{"content":{"html":"<h2 style=\"text-align: center; font-family: Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 14px;\"><span style=\"font-family: FeatureDisplay, Georgia, Times, &quot;Times New Roman&quot;, serif; font-size: 30px;\"><span style=\"font-weight: 300;\">Yes, I'm interested in Heyedrate Clinical!</span></span></h2>"},"styling":{}},"action":null}]},{"row_id":"01KQ9ZT6E2ZTEKR6YGMWY5SYVM","column_id":"01KQ9ZT6DC399Y1NHAVRAKC5J0","position":1,"data":{},"components":[{"component_id":"01KQ9ZT6EAEGB18RR76YDVQXAS","row_id":"01KQ9ZT6E2ZTEKR6YGMWY5SYVM","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{}},"field_id":"$first_name","label":"First Name","placeholder":"First Name","required":true,"show_label":false},"action":null},{"component_id":"01KQ9ZT6EE9HBNJPG3SGP2V147","row_id":"01KQ9ZT6E2ZTEKR6YGMWY5SYVM","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{}},"field_id":"$last_name","label":"Last Name","placeholder":"Last Name","required":true,"show_label":false},"action":null}]},{"row_id":"01KQ9ZT6EKDZC94DV89XDC35YT","column_id":"01KQ9ZT6DC399Y1NHAVRAKC5J0","position":2,"data":{},"components":[{"component_id":"01KQ9ZT6EVWYK38M22N6PAEXJV","row_id":"01KQ9ZT6EKDZC94DV89XDC35YT","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{}},"field_id":"$organization","label":"Practice","placeholder":"Name of Practice","required":true,"show_label":false},"action":null}]},{"row_id":"01KQ9ZT6EZFRXGA1VPQHBKRT4Y","column_id":"01KQ9ZT6DC399Y1NHAVRAKC5J0","position":3,"data":{},"components":[{"component_id":"01KQ9ZT6F7P937GPMYSTPTY44N","row_id":"01KQ9ZT6EZFRXGA1VPQHBKRT4Y","component_type":"EMAIL","data":{"placeholder":"Email","required":true,"field_id":"$email","styling":{"text_styles":{}},"label":"Email","show_label":false},"action":null}]},{"row_id":"01KQ9ZT6FB0V5A9MD8HH3Y8361","column_id":"01KQ9ZT6DC399Y1NHAVRAKC5J0","position":4,"data":{},"components":[{"component_id":"01KQ9ZT6FMTWNQEPN2TGB1ESGV","row_id":"01KQ9ZT6FB0V5A9MD8HH3Y8361","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{}},"field_id":"$address1","label":"Street Address","placeholder":"Street Address","required":true,"show_label":false},"action":null}]},{"row_id":"01KQ9ZT6FRMFA8PBH55ZEDHYDM","column_id":"01KQ9ZT6DC399Y1NHAVRAKC5J0","position":5,"data":{},"components":[{"component_id":"01KQ9ZT6G1JPBQAWPD8CJ2ZBYD","row_id":"01KQ9ZT6FRMFA8PBH55ZEDHYDM","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{}},"field_id":"$city","label":"City","placeholder":"City","required":true,"show_label":false},"action":null},{"component_id":"01KQ9ZT6G52BJWABXBDWMKTNKD","row_id":"01KQ9ZT6FRMFA8PBH55ZEDHYDM","component_type":"DROPDOWN","data":{"styling":{"text_styles":{}},"field_id":"$region","required":true,"label":"State","placeholder":"State","options":[{"label":"Alabama","value":"AL","key":"key_0"},{"label":"Alaska","value":"AK","key":"key_1"},{"label":"Arizona","value":"AZ","key":"key_2_1761229482544"},{"label":"Arkansas ","value":"AR","key":"key_3_1761229548038"},{"label":"California ","value":"CA","key":"key_4_1761229565959"},{"label":"Colorado ","value":"CO","key":"key_5_1761229582772"},{"label":"Connecticut ","value":"CT","key":"key_6_1761229595487"},{"label":"Delaware ","value":"DE","key":"key_7_1761229606511"},{"label":"Florida ","value":"FL","key":"key_8_1761229618786"},{"label":"Georgia ","value":"GA","key":"key_9_1761229629815"},{"label":"Hawaii ","value":"HI","key":"key_10_1761229640491"},{"label":"Idaho ","value":"ID","key":"key_11_1761229654563"},{"label":"Illinois ","value":"IL","key":"key_12_1761229666670"},{"label":"Indiana ","value":"IN","key":"key_13_1761229676067"},{"label":"Iowa ","value":"IA","key":"key_14_1761229685783"},{"label":"Kansas ","value":"KS","key":"key_15_1761229695975"},{"label":"Kentucky ","value":"KY","key":"key_16_1761229733381"},{"label":"Louisiana ","value":"LA","key":"key_17_1761229744589"},{"label":"Maine ","value":"ME","key":"key_18_1761229755370"},{"label":"Maryland ","value":"MD","key":"key_19_1761229764260"},{"label":"Massachusetts ","value":"MA","key":"key_20_1761229773552"},{"label":"Michigan ","value":"MI","key":"key_21_1761229785949"},{"label":"Minnesota ","value":"MN","key":"key_22_1761229792143"},{"label":"Mississippi ","value":"MS","key":"key_23_1761229907865"},{"label":"Missouri ","value":"MO","key":"key_24_1761229985177"},{"label":"Montana ","value":"MT","key":"key_25_1761230001112"},{"label":"Nebraska ","value":"NE","key":"key_26_1761230379506"},{"label":"Nevada ","value":"NV","key":"key_27_1761230389526"},{"label":"New Hampshire","value":"NH","key":"key_28_1761230410848"},{"label":"New Jersey","value":"NJ","key":"key_29_1761230426418"},{"label":"New Mexico","value":"NM","key":"key_30_1761230440232"},{"label":"New York","value":"NY","key":"key_31_1761230456625"},{"label":"North Carolina","value":"NC","key":"key_32_1761230474985"},{"label":"North Dakota","value":"ND","key":"key_33_1761230497516"},{"label":"Ohio","value":"OH","key":"key_34_1761230517054"},{"label":"Oklahoma ","value":"OK","key":"key_35_1761230529965"},{"label":"Oregon ","value":"OR","key":"key_36_1761230547623"},{"label":"Pennsylvania ","value":"PA","key":"key_37_1761230567303"},{"label":"Rhode Island","value":"RI","key":"key_38_1761230582598"},{"label":"South Carolina","value":"SC","key":"key_39_1761230596161"},{"label":"South Dakota","value":"SD","key":"key_40_1761230609828"},{"label":"Tennessee","value":"TN","key":"key_41_1761230624408"},{"label":"Texas ","value":"TX","key":"key_42_1761230634884"},{"label":"Utah ","value":"UT","key":"key_43_1761230645712"},{"label":"Vermont","value":"VT","key":"key_44_1761230665298"},{"label":"Virginia","value":"VA","key":"key_45_1761230672310"},{"label":"Washington","value":"WA","key":"key_46_1761230688044"},{"label":"West Virginia","value":"WV","key":"key_47_1761230703883"},{"label":"Wisconsin","value":"WI","key":"key_48_1761230717395"},{"label":"Wyoming","value":"WY","key":"key_49_1761230742136"}],"show_label":false},"action":null}]},{"row_id":"01KQ9ZT6G92DBB9AP9PXBSJ08Z","column_id":"01KQ9ZT6DC399Y1NHAVRAKC5J0","position":6,"data":{},"components":[{"component_id":"01KQ9ZT6GHXGK3NZQABX0PA2W7","row_id":"01KQ9ZT6G92DBB9AP9PXBSJ08Z","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{}},"field_id":"$zip","label":"Zip Code","placeholder":"Zip Code","required":true,"show_label":false},"action":null},{"component_id":"01KQ9ZT6GNHBJ8QY0BXXX46DWK","row_id":"01KQ9ZT6G92DBB9AP9PXBSJ08Z","component_type":"PHONE_NUMBER","data":{"styling":{"text_styles":{}},"field_id":"$phone_number","required":true,"label":"Phone","placeholder":"Phone Number","channel_settings":{"sms":{"consent_type":null},"whats_app":{"consent_type":null}},"sms_consent_type":"PHONE_NUMBER_ONLY","show_label":false},"action":null}]},{"row_id":"01KQ9ZT6H6J98DPN83Z3MEP1PE","column_id":"01KQ9ZT6DC399Y1NHAVRAKC5J0","position":7,"data":{},"components":[{"component_id":"01KQ9ZT6HJ99CDZTEAYCZXG2KB","row_id":"01KQ9ZT6H6J98DPN83Z3MEP1PE","component_type":"BUTTON","data":{"content":"SUBMIT","meta_fields":[{"field_id":"$source","value":"Heyedrate Sample Requests (VSE)"}],"styling":{"specify_hover_background_color":false,"full_width":true,"text_styles":{"letter_spacing":2,"font_family":"GTAmerica, Helvetica, Arial, sans-serif","font_size":"16px","font_weight":400,"font_style":"normal","text_decoration":"","custom_company_font_id":1794785},"border_style":"none","border_width":2,"height":50,"padding_top":0,"padding_bottom":0,"border_radius":4,"background_color":"rgba(0,77,220,1)"}},"action":{"action_id":"01KQ9ZT6C55JWCDRVWB5QWSF5F","action_type":"SUBMIT_TO_LIST_AND_TRANSITION_VIEW","data":{"to_phone_number":"+18449693268"},"view_id":"01KQ9ZT6BXW6G72CHFEKPKRF1V","list_id":"S2LefK"}}]}]}]},{"view_id":"01KQ9ZT6BXW6G72CHFEKPKRF1V","form_version_id":25732918,"position":1,"data":{"styling":{"padding":{"top":10,"right":5,"bottom":10,"left":5},"preset_size":false,"is_max_width":false,"background_color":"rgba(255,255,255,0)","input_styles":{"color":"#000000","focus_color":"#0064CD"},"size":"450"}},"name":null,"parent_view_id":null,"columns":[{"column_id":"01KQ9ZT6HT3H0FF0RVQS5NVB5J","view_id":"01KQ9ZT6BXW6G72CHFEKPKRF1V","position":0,"data":{},"rows":[{"row_id":"01KQ9ZT6J22ME1WVDSMB4XPPXQ","column_id":"01KQ9ZT6HT3H0FF0RVQS5NVB5J","position":0,"data":{},"components":[{"component_id":"01KQ9ZT6JB7SQ33HHPPDKB01WG","row_id":"01KQ9ZT6J22ME1WVDSMB4XPPXQ","component_type":"TEXT","data":{"content":{"html":"<h2 style=\"text-align: center; font-family: Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 14px;\"><span style=\"font-family: FeatureDisplay, Georgia, Times, &quot;Times New Roman&quot;, serif; font-size: 34px;\"><span style=\"font-weight: 300;\">Thank you for your interest!</span></span></h2>"},"styling":{}},"action":null}]},{"row_id":"01KQ9ZT6JFVDTK5BC7PG3VPC2A","column_id":"01KQ9ZT6HT3H0FF0RVQS5NVB5J","position":1,"data":{},"components":[{"component_id":"01KQ9ZT6JQJ4E4CSQH7JJ57833","row_id":"01KQ9ZT6JFVDTK5BC7PG3VPC2A","component_type":"TEXT","data":{"styling":{},"content":{"html":"<p style=\"text-align: center; font-family: Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 14px;\"><span style=\"font-family: GTAmerica, Helvetica, Arial, sans-serif; font-size: 20px;\">Check your email for a confirmation message.</span></p>"}},"action":null}]}]}]}],"trigger_groups":[{"trigger_group_id":"01KQ9ZT6JZY5R3B1W58HTMFA83","form_version_id":25732918,"triggers":[]}],"form_entity_form_view_dependencies":[]}],"name":"Heyedrate Sample Requests (VSE)","show_klaviyo_branding":false,"show_klaviyo_branding_fullpage_and_flyout_forms":false,"dismissed_alerts":[]},{"form_id":"UTwZxx","live_form_versions":[{"form_id":"UTwZxx","form_version_id":24156622,"name":"Default Embed","form_type":"EMBED","channel_type":"WEB","form_type_direction":null,"update_timestamp":1770379447,"allocation":1.0,"id":24156622,"data":{"styling":{"padding":{"top":10,"right":5,"bottom":10,"left":5},"preset_size":true,"is_max_width":true,"background_color":"rgba(255,255,255,1)","input_styles":{"color":"#FFFFFF","focus_color":"#0064CD","border_radius":4,"height":50,"placeholder_color":"#FFFFFF","form_input_text_color":"#FFFFFF","border":{"default_color":"rgba(255,255,255,1)","active_color":"rgba(255,255,255,1)"}},"size":450,"minimum_height":120,"is_full_page_embed":false},"independent_triggers":true},"form_specialties":[],"views":[{"view_id":"01KGSCP0SFYQ5A000658V80FMP","form_version_id":24156622,"position":0,"data":{"styling":{"padding":{"top":10,"right":5,"bottom":10,"left":5},"preset_size":false,"is_max_width":false,"background_color":"rgba(255,255,255,0)","input_styles":{"color":"#000000","focus_color":"#0064CD"},"size":"450"}},"name":null,"parent_view_id":null,"columns":[{"column_id":"01KGSCP0V8761QMX5AYPMCYJQM","view_id":"01KGSCP0SFYQ5A000658V80FMP","position":0,"data":{},"rows":[{"row_id":"01KGSCP0VD7TQW56CAM24T0RC4","column_id":"01KGSCP0V8761QMX5AYPMCYJQM","position":0,"data":{},"components":[{"component_id":"01KGSCP0VJHBKBGGKY6H154PTB","row_id":"01KGSCP0VD7TQW56CAM24T0RC4","component_type":"IMAGE","data":{"styling":{"full_width":false,"alignment":"center","text_styles":{},"width":200,"padding":{"left":6,"right":6,"top":50,"bottom":10}},"image":{"name":"eyePromise-logo-color bg","url":"https://d3k81ch9hvuctc.cloudfront.net/company/TfQYVZ/images/307c3f34-1fc1-49fd-b441-71de9eb9d95b.jpeg","width":1000,"height":217,"format":"jpeg","size":21241,"is_ai_generated":false,"cropped_asset_id":null,"cropping_aspect_ratio":null,"cropping_height":null,"cropping_width":null,"cropping_x":null,"cropping_y":null,"original_image_url":null,"alt_text":""},"alt_text":null},"action":null}]},{"row_id":"01KGSCP0VQV0QTWD38ZE45BMZF","column_id":"01KGSCP0V8761QMX5AYPMCYJQM","position":1,"data":{},"components":[{"component_id":"01KGSCP0VWCVVKGR691P8GQT8Z","row_id":"01KGSCP0VQV0QTWD38ZE45BMZF","component_type":"TEXT","data":{"content":{"html":"<p style=\"text-align: center; line-height: 1; letter-spacing: 0px; color: rgb(0, 0, 0); font-family: Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 16px;\"><span style=\"text-align: center; color: rgb(0, 77, 220); font-family: GTAmerica; font-size: 22px;\">Avenova is now EyePromise</span></p>"},"styling":{}},"action":null}]},{"row_id":"01KGSCP0W11B805NT0ZY5JCHZ6","column_id":"01KGSCP0V8761QMX5AYPMCYJQM","position":2,"data":{},"components":[{"component_id":"01KGSCP0W5FJQWBMTQT2Q6NY43","row_id":"01KGSCP0W11B805NT0ZY5JCHZ6","component_type":"TEXT","data":{"content":{"html":"<p style=\"text-align: center; line-height: 1; letter-spacing: 0px; color: rgb(0, 0, 0); font-family: Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 16px;\"><span style=\"text-align: center; color: rgb(0, 77, 220); font-family: GTAmerica; font-size: 22px;\">Stay subscribed for upcoming promotions and educational content.</span></p>"},"styling":{}},"action":null}]},{"row_id":"01KGSCP0WABK897HDAJJ3XPHXK","column_id":"01KGSCP0V8761QMX5AYPMCYJQM","position":3,"data":{},"components":[{"component_id":"01KGSCP0WFR205D13PA6WSEJK2","row_id":"01KGSCP0WABK897HDAJJ3XPHXK","component_type":"BUTTON","data":{"content":"Yes, I want to stay subscribed.","meta_fields":[{"field_id":"$source","value":"EA - Avenova re-Opt-in (embed)"}],"styling":{"specify_hover_background_color":false,"full_width":false,"text_styles":{"font_family":"GTAmerica, Helvetica, Arial, sans-serif","font_weight":400,"font_style":"normal","custom_company_font_id":1794785,"font_size":"22px"},"border_style":"none","border_width":2,"height":50,"padding_top":0,"padding_bottom":0,"border_radius":4,"background_color":"rgba(0,77,220,1)","padding":{"left":6,"right":6,"top":30,"bottom":400}}},"action":{"action_id":"01KGSCP0T286A0YXF77RE0GMZ2","action_type":"SUBMIT_TO_LIST_AND_TRANSITION_VIEW","data":{"to_phone_number":"+18449693268"},"view_id":"01KGSCP0SS0QW277M0KXX31CTT","list_id":"VSXfhK"}}]},{"row_id":"01KGSCP0WMJCCQ9XGXN4NXGW4E","column_id":"01KGSCP0V8761QMX5AYPMCYJQM","position":4,"data":{},"components":[{"component_id":"01KGSCP0WSMQT71TYJ3HP6K28D","row_id":"01KGSCP0WMJCCQ9XGXN4NXGW4E","component_type":"EMAIL","data":{"placeholder":"Email","required":true,"field_id":"$email","styling":{"text_styles":{}},"label":"Email","show_label":false},"action":null}]}]}]},{"view_id":"01KGSCP0SS0QW277M0KXX31CTT","form_version_id":24156622,"position":1,"data":{"styling":{"padding":{"top":10,"right":5,"bottom":10,"left":5},"preset_size":false,"is_max_width":false,"background_color":"rgba(255,255,255,0)","input_styles":{"color":"#000000","focus_color":"#0064CD"},"size":"450"}},"name":null,"parent_view_id":null,"columns":[{"column_id":"01KGSCP0WYMGKD9414B1NJFTBJ","view_id":"01KGSCP0SS0QW277M0KXX31CTT","position":0,"data":{},"rows":[{"row_id":"01KGSDBA7V0ZZ7GAH8AXT3820S","column_id":"01KGSCP0WYMGKD9414B1NJFTBJ","position":0,"data":{},"components":[{"component_id":"01KGSDBAEWKBWMRDEQR05JED6D","row_id":"01KGSDBA7V0ZZ7GAH8AXT3820S","component_type":"IMAGE","data":{"styling":{"full_width":false,"alignment":"center","text_styles":{},"width":200,"padding":{"left":6,"right":6,"top":50,"bottom":20}},"image":{"name":"eyePromise-logo-color.2","url":"https://d3k81ch9hvuctc.cloudfront.net/company/TfQYVZ/images/ed6e63a7-f9de-47d0-9dd5-f649cbb61ea1.jpeg","width":10291,"height":2230,"format":"jpeg","size":1078422,"is_ai_generated":false,"cropped_asset_id":null,"cropping_aspect_ratio":null,"cropping_height":null,"cropping_width":null,"cropping_x":null,"cropping_y":null,"original_image_url":null,"alt_text":""},"alt_text":null},"action":null}]},{"row_id":"01KGSCP0X3Q6JMNAMVPWFMF58C","column_id":"01KGSCP0WYMGKD9414B1NJFTBJ","position":1,"data":{},"components":[{"component_id":"01KGSCP0X7HYQMC1VD6E8E36EN","row_id":"01KGSCP0X3Q6JMNAMVPWFMF58C","component_type":"TEXT","data":{"content":{"html":"<p style=\"text-align: center; line-height: 1; letter-spacing: 0px; color: rgb(0, 0, 0); font-family: Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 16px;\"><span style=\"color: rgb(0, 77, 220); font-family: GTAmerica; font-size: 22px;\">Thank you! Your subscription has been confirmed.</span></p>"},"styling":{}},"action":null}]}]}]}],"trigger_groups":[{"trigger_group_id":"01KGSCP0XC6DV0GGJMDGWRQ4P5","form_version_id":24156622,"triggers":[]}],"form_entity_form_view_dependencies":[]}],"name":"EA - Avenova re-Opt-in (embed)","show_klaviyo_branding":false,"show_klaviyo_branding_fullpage_and_flyout_forms":false,"dismissed_alerts":[]},{"form_id":"U8gnht","live_form_versions":[{"form_id":"U8gnht","form_version_id":24003395,"name":"Win a free item - Mobile","form_type":"POPUP","channel_type":"WEB","form_type_direction":null,"update_timestamp":1769627905,"allocation":1.0,"id":24003395,"data":{"styling":{"preset_size":false,"padding":{"top":96,"right":48,"left":48,"bottom":48},"input_styles":{"color":"#000000","focus_color":"#0064CD","height":56,"font_size":"18px","font_family":"'GT-400', Arial, 'Helvetica Neue', Helvetica, sans-serif","custom_company_font_id":1642729,"border":{"default_color":"rgba(112,116,125,1)","active_color":"rgba(112,116,125,1)"},"font_weight":400,"border_radius":8,"placeholder_color":"#70747D"},"is_max_width":true,"size":588,"border_radius":8,"minimum_height":410,"border_style":"none","border_width":0,"margin":{"top":20,"bottom":20,"left":20,"right":20},"dismiss_button_styles":{"size":35,"x_stroke":1,"xColor":"rgba(36,36,36,1)","border_color":"rgba(255,255,255,0)","background_color":"rgba(180,187,195,0)","margin":{"top":48,"left":48,"right":48,"bottom":48}},"drop_shadow":{"enabled":true,"blur":30,"color":"rgba(0,0,0,0.15)"},"is_full_page_embed":false},"ignore_overlay_dismissal":{"mobile":true},"independent_triggers":true},"form_specialties":[],"views":[{"view_id":"01KG30P29END2Q34NS1ZT951DM","form_version_id":24003395,"position":0,"data":{"styling":{"preset_size":true,"padding":{"top":16,"right":16,"left":16},"input_styles":{"color":"#000000","focus_color":"#0064CD","height":51,"font_size":"18px","font_family":"'Nunito Sans', \"Helvetica Neue\", Helvetica, Arial, sans-serif","custom_company_font_id":26604,"border":{"default_color":"#606A72"},"font_weight":600},"is_max_width":true,"size":"450","border_radius":6}},"name":"Email Opt-in","parent_view_id":null,"columns":[{"column_id":"01KG30P2AKAY9RESMGM3DNTF58","view_id":"01KG30P29END2Q34NS1ZT951DM","position":0,"data":{},"rows":[{"row_id":"01KG30P2AP83D8T8HN3S78S0ZA","column_id":"01KG30P2AKAY9RESMGM3DNTF58","position":0,"data":{},"components":[{"component_id":"01KG30P2ATVXQK9PSGGZXN54DZ","row_id":"01KG30P2AP83D8T8HN3S78S0ZA","component_type":"TEXT","data":{"content":{"html":"<h1 style=\"text-align: center; line-height: 107%;\"><span style=\"color: rgb(55, 63, 71); font-family: FeatureDisplay, Georgia, Times, 'Times New Roman', serif; font-weight: 300; font-style: normal; font-size: 56px;\">&nbsp;<span style=\"color: rgb(21, 38, 68);\">Sign Up for Updates!</span></span></h1>"},"styling":{"padding":{"bottom":24,"left":0,"right":0,"top":0}},"violations":[]},"action":null}]},{"row_id":"01KG30P2AX29FEBMEF9MSC50XC","column_id":"01KG30P2AKAY9RESMGM3DNTF58","position":1,"data":{},"components":[{"component_id":"01KG30P2B1MFXB5FQMN4M18ME6","row_id":"01KG30P2AX29FEBMEF9MSC50XC","component_type":"TEXT","data":{"styling":{"padding":{"left":0,"right":0,"top":0,"bottom":48}},"content":{"html":"<p style=\"text-align: center; line-height: 120%;\"><span style=\"font-family: GT-400, Arial, 'Helvetica Neue', Helvetica, sans-serif; font-weight: 400; font-style: normal; font-size: 20px;\">Stay up to date with special offers, the latest news, and insights.</span></p>"},"violations":[]},"action":null}]},{"row_id":"01KG30P2B4XQ5WMRZVBJMHQXAH","column_id":"01KG30P2AKAY9RESMGM3DNTF58","position":2,"data":{},"components":[{"component_id":"01KG30P2B74Z1NPBE1GT0HJGQR","row_id":"01KG30P2B4XQ5WMRZVBJMHQXAH","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{},"padding":{"bottom":12,"top":0,"left":0,"right":6}},"field_id":"$first_name","label":"First Name","placeholder":"First Name","required":false,"violations":[{"a11y_identifier":"component:styles:30325342","id":"duplicate-id-active","impact":"serious","html":"<input id=\"first_name_30325342\" class=\"notranslate needsclick go4168726448 kl-private-reset-css-Xuajs1\" type=\"text\" autocomplete=\"given-name\" tabindex=\"-1\" placeholder=\"Name\" aria-label=\"Name\" aria-invalid=\"false\" options=\"[object Object]\" data-a11y-identifier=\"component:styles:30325342\" value=\"\" style=\"box-sizing: border-box; border-radius: 4px; padding: 0px 0px 0px 16px; height: 50px; text-align: left; color: rgb(0, 0, 0); font-family: &quot;Nunito Sans&quot;, &quot;Helvetica Neue&quot;, Helvetica, Arial, sans-serif; font-size: 18px; font-weight: 700; letter-spacing: 0px; background-color: rgb(255, 255, 255); border: 1px solid rgb(96, 106, 114);\">","reported_at":"Tue, 25 Apr 2023 22:09:03 GMT","related_nodes":[{"html":"<input id=\"first_name_30325342\" class=\"notranslate needsclick go4168726448 kl-private-reset-css-Xuajs1\" type=\"text\" autocomplete=\"given-name\" tabindex=\"-1\" placeholder=\"Name\" aria-label=\"Name\" aria-invalid=\"false\" options=\"[object Object]\" data-a11y-identifier=\"component:styles:30325342\" value=\"\" style=\"box-sizing: border-box; border-radius: 4px; padding: 0px 0px 0px 16px; height: 50px; text-align: left; color: rgb(0, 0, 0); font-family: &quot;Nunito Sans&quot;, &quot;Helvetica Neue&quot;, Helvetica, Arial, sans-serif; font-size: 18px; font-weight: 700; letter-spacing: 0px; background-color: rgb(255, 255, 255); border: 1px solid rgb(96, 106, 114);\">","a11y_identifier":"component:styles:30325342"}]}],"show_label":false},"action":null},{"component_id":"01KG30P2BB0KTWXKXTRZJXMDVJ","row_id":"01KG30P2B4XQ5WMRZVBJMHQXAH","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{},"padding":{"left":6,"right":0,"top":0,"bottom":12}},"field_id":"$last_name","label":"Last Name","placeholder":"Last Name","required":false,"show_label":false},"action":null}]},{"row_id":"01KG30P2BE5CSVBVBWWA8D9T2C","column_id":"01KG30P2AKAY9RESMGM3DNTF58","position":3,"data":{},"components":[{"component_id":"01KG30P2BJDYYBX4JS2BQ8SPQT","row_id":"01KG30P2BE5CSVBVBWWA8D9T2C","component_type":"EMAIL","data":{"field_id":"$email","required":true,"placeholder":"Enter your email","styling":{"padding":{"bottom":48,"top":0,"left":0,"right":0},"text_styles":{}},"label":"Email","violations":[{"a11y_identifier":"component:styles:30325343","id":"duplicate-id-active","impact":"serious","html":"<input id=\"email_30325343\" class=\"notranslate needsclick go4168726448 kl-private-reset-css-Xuajs1\" type=\"email\" autocomplete=\"email\" name=\"email\" tabindex=\"-1\" placeholder=\"Email\" aria-label=\"Email\" aria-invalid=\"false\" options=\"[object Object]\" data-a11y-identifier=\"component:styles:30325343\" value=\"\" style=\"box-sizing: border-box; border-radius: 4px; padding: 0px 0px 0px 16px; height: 50px; text-align: left; color: rgb(0, 0, 0); font-family: &quot;Nunito Sans&quot;, &quot;Helvetica Neue&quot;, Helvetica, Arial, sans-serif; font-size: 18px; font-weight: 700; letter-spacing: 0px; background-color: rgb(255, 255, 255); border: 1px solid rgb(96, 106, 114);\">","reported_at":"Tue, 25 Apr 2023 22:09:03 GMT","related_nodes":[{"html":"<input id=\"email_30325343\" class=\"notranslate needsclick go4168726448 kl-private-reset-css-Xuajs1\" type=\"email\" autocomplete=\"email\" name=\"email\" tabindex=\"-1\" placeholder=\"Email\" aria-label=\"Email\" aria-invalid=\"false\" options=\"[object Object]\" data-a11y-identifier=\"component:styles:30325343\" value=\"\" style=\"box-sizing: border-box; border-radius: 4px; padding: 0px 0px 0px 16px; height: 50px; text-align: left; color: rgb(0, 0, 0); font-family: &quot;Nunito Sans&quot;, &quot;Helvetica Neue&quot;, Helvetica, Arial, sans-serif; font-size: 18px; font-weight: 700; letter-spacing: 0px; background-color: rgb(255, 255, 255); border: 1px solid rgb(96, 106, 114);\">","a11y_identifier":"component:styles:30325343"}]}],"show_label":false},"action":null}]},{"row_id":"01KG30P2BNP7AMK2569N47WW60","column_id":"01KG30P2AKAY9RESMGM3DNTF58","position":4,"data":{},"components":[{"component_id":"01KG30P2BR07B9FZF77DDT1GK6","row_id":"01KG30P2BNP7AMK2569N47WW60","component_type":"BUTTON","data":{"content":"Subscribe","meta_fields":[{"field_id":"$source","value":"Newsletter Subscribe - EyePromise"}],"styling":{"border_style":"none","specify_hover_background_color":true,"full_width":true,"border_color":"#3D4BC7","hover_text_color":"rgba(255,255,255,1)","text_styles":{"color":"#FFFFFF","letter_spacing":0,"font_size":"18px","font_family":"GT-400, Arial, \"Helvetica Neue\", Helvetica, sans-serif","custom_company_font_id":1642729,"font_weight":400,"font_style":"normal"},"hover_background_color":"#303B43","border_width":2,"background_color":"rgba(0,77,220,1)","border_radius":50,"padding":{"top":0,"left":170,"right":170,"bottom":0},"height":50,"padding_top":0,"padding_bottom":0},"violations":[]},"action":{"action_id":"01KG30P2A2ESX1ET4DZ8MNQFXX","action_type":"SUBMIT_TO_LIST_AND_TRANSITION_VIEW","data":{"to_phone_number":"+18449693268"},"view_id":"01KG30P29V8SPBSM3R1NTMMPWH","list_id":"VSXfhK"}}]}]}]},{"view_id":"01KG30P29V8SPBSM3R1NTMMPWH","form_version_id":24003395,"position":1,"data":{"styling":{"preset_size":true,"padding":{"top":16,"right":16,"left":16},"input_styles":{"color":"#000000","focus_color":"#0064CD","height":51,"font_size":"18px","font_family":"'Nunito Sans', \"Helvetica Neue\", Helvetica, Arial, sans-serif","custom_company_font_id":26604,"border":{"default_color":"#606A72"},"font_weight":600},"is_max_width":true,"size":"450","border_radius":6}},"name":null,"parent_view_id":null,"columns":[{"column_id":"01KG30P2BWM4PS7CYSV2P6KJJW","view_id":"01KG30P29V8SPBSM3R1NTMMPWH","position":0,"data":{},"rows":[{"row_id":"01KG30P2BZC0DYMZ04QGJDFYVN","column_id":"01KG30P2BWM4PS7CYSV2P6KJJW","position":0,"data":{},"components":[{"component_id":"01KG30P2C22MQNCWEXX21MRX0V","row_id":"01KG30P2BZC0DYMZ04QGJDFYVN","component_type":"TEXT","data":{"styling":{"block_background_color":"#FFFFFF","padding":{"bottom":0,"top":10,"left":30,"right":30}},"content":{"html":"<h1 style=\"text-align: center; font-size: 14px; font-family: Arial, 'Helvetica Neue', Helvetica, sans-serif; font-weight: 400; line-height: 300%;\"><span class=\"ql-font-nunito-sans\" style=\"color: rgb(21, 38, 68); font-size: 56px; font-family: FeatureDisplay, Georgia, Times, 'Times New Roman', serif; font-weight: 300; font-style: normal;\">Thanks for subscribing!</span></h1>\n<p style=\"font-size: 14px; font-family: Arial, 'Helvetica Neue', Helvetica, sans-serif; font-weight: 400;\">&nbsp;</p>"},"violations":[]},"action":null}]}]}]}],"trigger_groups":[{"trigger_group_id":"01KG30P2C6SPXHGDVW49G2M0BE","form_version_id":24003395,"triggers":[{"trigger_id":"01KG30P2C9KKY17WKJDYT3HTST","trigger_group_id":"01KG30P2C6SPXHGDVW49G2M0BE","data":{"value":true},"trigger_type":"EXISTING_USER"},{"trigger_id":"01KG30P2CC408QMA5N8N36RAEB","trigger_group_id":"01KG30P2C6SPXHGDVW49G2M0BE","data":{"value":true},"trigger_type":"SUPPRESS_SUCCESS_FORM"},{"trigger_id":"01KG30P2CKP8FV2PKTZE162WKQ","trigger_group_id":"01KG30P2C6SPXHGDVW49G2M0BE","data":{"value":"BOTH"},"trigger_type":"DESKTOP_MOBILE_TARGET"},{"trigger_id":"01KG30P2CS3N4Q2PSC496Y3W01","trigger_group_id":"01KG30P2C6SPXHGDVW49G2M0BE","data":{"value":5},"trigger_type":"COOKIE_TIMEOUT"},{"trigger_id":"01KG30P2D3Q5NTZST28WRXNZCC","trigger_group_id":"01KG30P2C6SPXHGDVW49G2M0BE","data":{"value":true},"trigger_type":"JS_CUSTOM_TRIGGER"}],"EXISTING_USER":{"value":true},"SUPPRESS_SUCCESS_FORM":{"value":true},"DESKTOP_MOBILE_TARGET":{"value":"BOTH"},"COOKIE_TIMEOUT":{"value":5},"JS_CUSTOM_TRIGGER":{"value":true}}],"form_entity_form_view_dependencies":[]}],"name":"Newsletter Subscribe - EyePromise","show_klaviyo_branding":false,"show_klaviyo_branding_fullpage_and_flyout_forms":false,"dismissed_alerts":[]},{"form_id":"Xvj3B3","live_form_versions":[{"form_id":"Xvj3B3","form_version_id":25054565,"name":"Default Embed","form_type":"EMBED","channel_type":"WEB","form_type_direction":null,"update_timestamp":1774437931,"allocation":1.0,"id":25054565,"data":{"styling":{"padding":{"top":10,"right":5,"bottom":10,"left":5},"preset_size":true,"is_max_width":true,"background_color":"rgba(255,255,255,0)","input_styles":{"color":"#000000","focus_color":"#0064CD","border_radius":4,"height":50,"placeholder_color":"#767676","font_family":"'GTAmerica', Helvetica, Arial, sans-serif","font_weight":400,"font_size":"18px","custom_company_font_id":1794785,"letter_spacing":1},"size":"600","minimum_height":120,"rich_text_styles":{"body":{"font_family":"'GTAmerica', Helvetica, Arial, sans-serif","font_weight":400,"font_size":"18px","custom_company_font_id":1794785,"line_spacing":"1.1"}}},"independent_triggers":true},"form_specialties":[],"views":[{"view_id":"01KMJBQKS5JJNF0EQJVRZR5B3Q","form_version_id":25054565,"position":0,"data":{"styling":{"padding":{"top":10,"right":5,"bottom":10,"left":5},"preset_size":false,"is_max_width":false,"background_color":"rgba(255,255,255,0)","input_styles":{"color":"#000000","focus_color":"#0064CD"},"size":"450"}},"name":"Sample Request Form","parent_view_id":null,"columns":[{"column_id":"01KMJBQKT8H8YABREA8258SGBC","view_id":"01KMJBQKS5JJNF0EQJVRZR5B3Q","position":0,"data":{},"rows":[{"row_id":"01KMJBQKTBZMYCCJQK119XP03N","column_id":"01KMJBQKT8H8YABREA8258SGBC","position":0,"data":{},"components":[{"component_id":"01KMJBQKTEA88Z3GWM2KGE46BR","row_id":"01KMJBQKTBZMYCCJQK119XP03N","component_type":"TEXT","data":{"content":{"html":"<h2 style=\"text-align: center; font-family: Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 14px;\"><span style=\"color: rgb(0, 77, 220); font-family: FeatureDisplay, Georgia, Times, &quot;Times New Roman&quot;, serif; font-size: 32px;\"><span style=\"font-weight: 300;\">Yes</span><span style=\"font-weight: 300;\">, I would like to Reorder</span></span></h2>"},"styling":{}},"action":null}]},{"row_id":"01KMJBQKTJKZJQAA0WRKG3BBZS","column_id":"01KMJBQKT8H8YABREA8258SGBC","position":1,"data":{},"components":[{"component_id":"01KMJBQKTNZF1TZW4BTVNRWYE9","row_id":"01KMJBQKTJKZJQAA0WRKG3BBZS","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{}},"field_id":"$organization","label":"Practice","placeholder":"Name of Practice","required":true,"show_label":false},"action":null}]},{"row_id":"01KMJBQKTR5MF8ZJHR2WG53ZKF","column_id":"01KMJBQKT8H8YABREA8258SGBC","position":2,"data":{},"components":[{"component_id":"01KMJBQKTV2SPTQS631H7HD5R2","row_id":"01KMJBQKTR5MF8ZJHR2WG53ZKF","component_type":"EMAIL","data":{"placeholder":"Email","required":true,"field_id":"$email","styling":{"text_styles":{}},"label":"Email","show_label":false},"action":null}]},{"row_id":"01KMJBQKTYS5N6RVPDHCB4T25H","column_id":"01KMJBQKT8H8YABREA8258SGBC","position":3,"data":{},"components":[{"component_id":"01KMJBQKV1FP67BDX7WNMA38Q2","row_id":"01KMJBQKTYS5N6RVPDHCB4T25H","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{}},"field_id":"b2b_primary_product","label":"Product","placeholder":"Product","required":true},"action":null},{"component_id":"01KMJBQKV4XGR0Q9ETCNS3QHP7","row_id":"01KMJBQKTYS5N6RVPDHCB4T25H","component_type":"DROPDOWN","data":{"styling":{"text_styles":{}},"field_id":"b2b_reorder_qty","required":true,"label":"Qty (cases)","placeholder":"1 case","options":[{"label":"1 case","value":"1 case","key":"key_0"},{"label":"2 cases","value":"2 cases","key":"key_1_1774434587102"},{"label":"3 cases","value":"3 cases","key":"key_2_1774434601866"}]},"action":null}]},{"row_id":"01KMJBQKV7J1GT7XEPZG1HGCHK","column_id":"01KMJBQKT8H8YABREA8258SGBC","position":4,"data":{},"components":[{"component_id":"01KMJBQKVAS76DSR8MEJ6D7GA7","row_id":"01KMJBQKV7J1GT7XEPZG1HGCHK","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{},"padding":{"left":6,"right":6,"top":10,"bottom":10}},"field_id":"b2b_reorder_notes","label":"Order Notes","placeholder":"Anything else you'd like to share? ","required":false},"action":null}]},{"row_id":"01KMJBQKVDFFG2A7MER4DW07ME","column_id":"01KMJBQKT8H8YABREA8258SGBC","position":5,"data":{},"components":[{"component_id":"01KMJBQKVGGJWDV0WH0TKYJZB1","row_id":"01KMJBQKVDFFG2A7MER4DW07ME","component_type":"MULTI_CHECKBOX","data":{"styling":{"text_styles":{},"arrangement":"vertical"},"field_id":"b2b_order_consent","required":false,"label":"Ordering Consent","options":[{"label":"By checking this box I give consent for EyePromise to place an order on my behalf.","value":"TRUE","key":"key_0"}]},"action":null}]},{"row_id":"01KMJBQKVKP57WRYKBZ2NTXJ3E","column_id":"01KMJBQKT8H8YABREA8258SGBC","position":6,"data":{},"components":[{"component_id":"01KMJBQKVPGPY4EJ78KD68645P","row_id":"01KMJBQKVKP57WRYKBZ2NTXJ3E","component_type":"BUTTON","data":{"content":"SUBMIT MY ORDER","meta_fields":[{"field_id":"$source","value":"Notify My Sales Rep"}],"styling":{"specify_hover_background_color":false,"full_width":true,"text_styles":{"letter_spacing":2,"font_family":"GTAmerica, Helvetica, Arial, sans-serif","font_weight":400,"font_style":"normal","custom_company_font_id":1794785,"font_size":"18px"},"border_style":"none","border_width":2,"height":50,"padding_top":0,"padding_bottom":0,"border_radius":15,"background_color":"rgba(0,77,220,1)"}},"action":{"action_id":"01KMJBQKSJ53YXW5QZ0GQM540Y","action_type":"SUBMIT_TO_LIST_AND_TRANSITION_VIEW","data":{"to_phone_number":"+18449693268"},"view_id":"01KMJBQKSCFK1QGG71XRSXHK03","list_id":"RVhq9R"}}]}]}]},{"view_id":"01KMJBQKSCFK1QGG71XRSXHK03","form_version_id":25054565,"position":1,"data":{"styling":{"padding":{"top":10,"right":5,"bottom":10,"left":5},"preset_size":false,"is_max_width":false,"background_color":"rgba(255,255,255,0)","input_styles":{"color":"#000000","focus_color":"#0064CD"},"size":"450"}},"name":null,"parent_view_id":null,"columns":[{"column_id":"01KMJBQKVSV3C0D9G61PS01NSK","view_id":"01KMJBQKSCFK1QGG71XRSXHK03","position":0,"data":{},"rows":[{"row_id":"01KMJBQKVWEQ1B67K0RCFYBD4C","column_id":"01KMJBQKVSV3C0D9G61PS01NSK","position":0,"data":{},"components":[{"component_id":"01KMJBQKVZV0DFDSRQHSJHVQPW","row_id":"01KMJBQKVWEQ1B67K0RCFYBD4C","component_type":"TEXT","data":{"content":{"html":"<h2 style=\"text-align: center; font-family: Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 14px;\"><span style=\"color: rgb(0, 77, 220); font-family: FeatureDisplay, Georgia, Times, &quot;Times New Roman&quot;, serif; font-size: 40px;\"><span style=\"font-weight: 300;\">Thank You!</span></span></h2>"},"styling":{}},"action":null}]},{"row_id":"01KMJBQKW2C2QMWZPC1DQ98YA6","column_id":"01KMJBQKVSV3C0D9G61PS01NSK","position":1,"data":{},"components":[{"component_id":"01KMJBQKW5QKHA54NSK0QNK2DK","row_id":"01KMJBQKW2C2QMWZPC1DQ98YA6","component_type":"TEXT","data":{"styling":{},"content":{"html":"<p style=\"text-align: center; line-height: normal; letter-spacing: 1px; color: rgb(0, 0, 0); font-family: GTAmerica, Helvetica, Arial, sans-serif; font-size: 18px;\"><span style=\"text-align: center; line-height: normal; letter-spacing: 1px; font-size: 24px;\">Your sales rep has been notified and will follow up shortly.</span></p>"}},"action":null}]},{"row_id":"01KMJBQKW802GXEM6QKH5R0C9J","column_id":"01KMJBQKVSV3C0D9G61PS01NSK","position":2,"data":{},"components":[{"component_id":"01KMJBQKWBZRVA1MQ5HED1JY1E","row_id":"01KMJBQKW802GXEM6QKH5R0C9J","component_type":"TEXT","data":{"styling":{},"content":{"html":"<p style=\"text-align: center; font-family: Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 14px;\"><span style=\"font-family: GTAmerica, Helvetica, Arial, sans-serif; font-size: 16px;\">An email confirmation has been sent to your inbox.</span></p>"}},"action":null}]}]}]}],"trigger_groups":[{"trigger_group_id":"01KMJBQKWEQWQ64FANT5DZP7EZ","form_version_id":25054565,"triggers":[]}],"form_entity_form_view_dependencies":[]}],"name":"Notify My Sales Rep","show_klaviyo_branding":false,"show_klaviyo_branding_fullpage_and_flyout_forms":false,"dismissed_alerts":[]},{"form_id":"Uf9SNP","live_form_versions":[{"form_id":"Uf9SNP","form_version_id":23991632,"name":"Default Flyout","form_type":"EMBED","channel_type":"WEB","form_type_direction":null,"update_timestamp":1770253244,"allocation":1.0,"id":23991632,"data":{"styling":{"preset_size":false,"input_styles":{"color":"#242424","input_background_color":"rgba(255,255,255,0)","height":56,"font_family":"'GT-400', Arial, 'Helvetica Neue', Helvetica, sans-serif","custom_company_font_id":1642729,"font_weight":400,"form_input_text_color":"#242424","border":{"default_color":"rgba(112,116,125,1)","active_color":"rgba(0,0,0)"},"border_radius":8,"placeholder_color":"#70747D","font_size":"16px","letter_spacing":1},"size":672,"background_color":"#FFFFFF","is_max_width":true,"padding":{"top":0,"left":0,"right":0,"bottom":0},"background_image":null,"border_radius":24,"minimum_height":400,"dismiss_button_styles":{"size":30,"background_color":"rgba(255,255,255,0)","xColor":"#000","x_stroke":1,"border_color":"rgba(255,255,255,0)","margin":{"top":10,"bottom":10,"left":10,"right":10}},"margin":{"left":0,"right":0,"top":0,"bottom":0},"drop_shadow":{"enabled":true,"blur":30,"color":"rgba(0,0,0,0.15)"},"embed_alignment":"left","rich_text_styles":{"body":{"font_family":"'GT-400', Arial, 'Helvetica Neue', Helvetica, sans-serif","font_weight":400,"font_size":"16px","custom_company_font_id":1642729}},"border_style":"none","border_width":0,"border_color":"rgba(112,116,125,1)"},"independent_triggers":true},"form_specialties":[],"views":[{"view_id":"01KG1W5Z792TEARNZNPFH8YM8N","form_version_id":23991632,"position":0,"data":{"styling":{"preset_size":true,"input_styles":{"color":"#000000","focus_color":"#0064CD","input_background_color":"#FFFFFF","height":45,"font_family":"'Poppins', \"Helvetica Neue\", Helvetica, Arial, sans-serif","custom_company_font_id":26111,"font_weight":500,"form_input_text_color":"#000000"},"size":"450","background_color":"#FFFFFF","is_max_width":true,"padding":{"top":20,"left":15,"right":15},"background_image":{"name":"Frame 321","url":"https://d3k81ch9hvuctc.cloudfront.net/company/Pb3wug/images/30a378c3-497b-48e8-8da1-6b4c72f5a5be.png","width":450,"height":369,"format":"png","size":122123,"position":"cover","alignment":"center","custom_width":"450"},"border_radius":6}},"name":"Email Opt-In","parent_view_id":null,"columns":[{"column_id":"01KG1W5Z8FMZVPV6P72V09KAXR","view_id":"01KG1W5Z792TEARNZNPFH8YM8N","position":0,"data":{},"rows":[{"row_id":"01KG1W5Z8JADQBKWZ3HZ71DZB3","column_id":"01KG1W5Z8FMZVPV6P72V09KAXR","position":1,"data":{},"components":[{"component_id":"01KG1W5Z8N79AGA8AW2NY6AJMP","row_id":"01KG1W5Z8JADQBKWZ3HZ71DZB3","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{},"padding":{"left":0,"right":6,"top":0,"bottom":16}},"field_id":"$first_name","label":"First Name","placeholder":"First Name","required":true,"show_label":true},"action":null},{"component_id":"01KG1W5Z8R3W8VKFRGC124H1TR","row_id":"01KG1W5Z8JADQBKWZ3HZ71DZB3","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{},"padding":{"left":6,"right":0,"top":0,"bottom":16}},"field_id":"$last_name","label":"Last Name","placeholder":"Last Name","required":true,"show_label":true},"action":null}]},{"row_id":"01KG1W5Z8TK97VJXE6SZA94FYH","column_id":"01KG1W5Z8FMZVPV6P72V09KAXR","position":3,"data":{},"components":[{"component_id":"01KG1W5Z8XS37PWPCWQY4KHD1C","row_id":"01KG1W5Z8TK97VJXE6SZA94FYH","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{},"padding":{"left":0,"right":6,"top":0,"bottom":16}},"field_id":"Phone","label":"Phone ","placeholder":"(XXX) XXX-XXXX","required":false},"action":null},{"component_id":"01KG1W5Z90GR8GSWSDTX2RXC8J","row_id":"01KG1W5Z8TK97VJXE6SZA94FYH","component_type":"EMAIL","data":{"styling":{"text_styles":{},"padding":{"left":6,"right":0,"top":0,"bottom":16}},"field_id":"$email","required":true,"label":"Email","placeholder":"Email","violations":[{"a11y_identifier":"component:styles:76292545","id":"duplicate-id-active","impact":"serious","html":"<input id=\"email_76292545\" class=\"notranslate needsclick go2641114902 kl-private-reset-css-Xuajs1\" type=\"email\" autocomplete=\"email\" name=\"email\" tabindex=\"-1\" placeholder=\"Email\" aria-label=\"Email\" aria-invalid=\"false\" options=\"[object Object]\" data-a11y-identifier=\"component:styles:76292545\" value=\"\" style=\"box-sizing: border-box; border-radius: 0px; padding: 0px 0px 0px 16px; height: 40px; text-align: left; color: rgb(0, 0, 0); font-family: Helvetica, Arial, sans-serif; font-size: 16px; font-weight: 400; letter-spacing: 2px; background-color: rgba(255, 255, 255, 0); border: 1px solid rgba(255, 255, 255, 0);\">","reported_at":"Tue, 11 Jul 2023 20:43:12 GMT","related_nodes":[{"html":"<input id=\"email_76292545\" class=\"notranslate needsclick go2641114902 kl-private-reset-css-Xuajs1\" type=\"email\" autocomplete=\"email\" name=\"email\" tabindex=\"-1\" placeholder=\"Email\" aria-label=\"Email\" aria-invalid=\"false\" options=\"[object Object]\" data-a11y-identifier=\"component:styles:76292545\" value=\"\" style=\"box-sizing: border-box; border-radius: 0px; padding: 0px 0px 0px 16px; height: 40px; text-align: left; color: rgb(0, 0, 0); font-family: Helvetica, Arial, sans-serif; font-size: 16px; font-weight: 400; letter-spacing: 2px; background-color: rgba(255, 255, 255, 0); border: 1px solid rgba(255, 255, 255, 0);\">","a11y_identifier":"component:styles:76292545"}]}],"show_label":true},"action":null}]},{"row_id":"01KG1W5Z92BPS0E34N012DDHVH","column_id":"01KG1W5Z8FMZVPV6P72V09KAXR","position":4,"data":{},"components":[{"component_id":"01KG1W5Z953H9CW0C2D36MM3R4","row_id":"01KG1W5Z92BPS0E34N012DDHVH","component_type":"TEXT_INPUT","data":{"styling":{"text_styles":{},"padding":{"left":0,"right":0,"top":0,"bottom":16}},"field_id":"comment","label":"Comment","placeholder":"Add any additional notes here.","required":true},"action":null}]},{"row_id":"01KG1W5Z98PC3QRC8709YTYMNZ","column_id":"01KG1W5Z8FMZVPV6P72V09KAXR","position":5,"data":{},"components":[{"component_id":"01KG1W5Z9AA4JX7QYAKABR6ER4","row_id":"01KG1W5Z98PC3QRC8709YTYMNZ","component_type":"BUTTON","data":{"styling":{"full_width":true,"text_styles":{"font_family":"GT-400, Arial, \"Helvetica Neue\", Helvetica, sans-serif","custom_company_font_id":1642729,"color":"#FFFFFF","font_size":"16px","font_weight":400,"letter_spacing":2,"font_style":"normal"},"specify_hover_background_color":false,"block_background_color":"rgba(255,255,255,0)","background_color":"rgba(0,77,220,1)","padding":{"top":24,"bottom":0,"left":0,"right":0},"border_color":"#211D1C","border_style":"none","border_radius":50,"border_width":3,"height":50,"padding_top":0,"padding_bottom":0},"content":"Submit","meta_fields":[{"value":""}],"violations":[],"device_type":"ALL"},"action":{"action_id":"01KG1W5Z7TVTV6CGE6X0HS70AG","action_type":"SUBMIT_TO_LIST_AND_TRANSITION_VIEW","data":{"opt_in_keyword_id":null,"opt_in_message":"","to_phone_number":"+18449693268"},"view_id":"01KG1W5Z7P43F9F46M5KA5GWBF","list_id":"TAyS4Z"}}]},{"row_id":"01KG1W5Z9DBRDGCA3BHG7X9FEE","column_id":"01KG1W5Z8FMZVPV6P72V09KAXR","position":6,"data":{},"components":[]}]}]},{"view_id":"01KG1W5Z7P43F9F46M5KA5GWBF","form_version_id":23991632,"position":1,"data":{"styling":{"preset_size":true,"input_styles":{"color":"#000000","input_background_color":"#FFFFFF","height":45,"font_family":"'Poppins', \"Helvetica Neue\", Helvetica, Arial, sans-serif","custom_company_font_id":26111,"font_weight":500,"form_input_text_color":"#000000"},"size":"450","background_color":"#FFFFFF","is_max_width":true,"padding":{"top":20,"left":15,"right":15},"background_image":{"name":"Frame 321","url":"https://d3k81ch9hvuctc.cloudfront.net/company/Pb3wug/images/30a378c3-497b-48e8-8da1-6b4c72f5a5be.png","width":450,"height":369,"format":"png","size":122123,"position":"cover","alignment":"center","custom_width":"450"},"border_radius":6}},"name":null,"parent_view_id":null,"columns":[{"column_id":"01KG1W5Z9F9H8M0BP87T87T5BH","view_id":"01KG1W5Z7P43F9F46M5KA5GWBF","position":0,"data":{},"rows":[{"row_id":"01KG1W5Z9JBJGKCDP0DS8X8KDP","column_id":"01KG1W5Z9F9H8M0BP87T87T5BH","position":0,"data":{},"components":[{"component_id":"01KG1W5Z9MYA563ZTZ6AJZT0PH","row_id":"01KG1W5Z9JBJGKCDP0DS8X8KDP","component_type":"TEXT","data":{"styling":{"padding":{"bottom":10,"left":10,"right":10,"top":10}},"content":{"html":"<p style=\"text-align: center;\"><span style=\"font-family: FeatureDisplay, Georgia, Times, 'Times New Roman', serif; font-size: 28px; font-weight: 300; font-style: normal;\">THANKS FOR REACHING OUT!</span></p>"},"violations":[]},"action":null}]},{"row_id":"01KG1W5Z9QKNJ37KGMC7MQWBHX","column_id":"01KG1W5Z9F9H8M0BP87T87T5BH","position":1,"data":{},"components":[{"component_id":"01KG1W5Z9S9EBSA2CSA6CS1QM4","row_id":"01KG1W5Z9QKNJ37KGMC7MQWBHX","component_type":"TEXT","data":{"styling":{"padding":{"left":10,"right":10,"top":10,"bottom":10}},"content":{"html":"<p style=\"font-size: 14px; font-family: Arial, 'Helvetica Neue', Helvetica, sans-serif; font-weight: 400; text-align: center;\"><span style=\"font-family: GT-400, Arial, 'Helvetica Neue', Helvetica, sans-serif; font-weight: 400; font-size: 16px; font-style: normal;\">We have received your request and a team member will respond as soon as possible.</span></p>"},"violations":[]},"action":null}]}]}]}],"trigger_groups":[{"trigger_group_id":"01KG1W5Z9WH9JVG6XQDTMMMNJG","form_version_id":23991632,"triggers":[{"trigger_id":"01KG1W5Z9YJFE3V7C22V693Z46","trigger_group_id":"01KG1W5Z9WH9JVG6XQDTMMMNJG","data":{"value":true},"trigger_type":"SUPPRESS_SUCCESS_FORM"},{"trigger_id":"01KG1W5ZA1MKTTWZKQWCYVZQP4","trigger_group_id":"01KG1W5Z9WH9JVG6XQDTMMMNJG","data":{"value":3},"trigger_type":"COOKIE_TIMEOUT"},{"trigger_id":"01KG1W5ZA8DMW3K56QBYVY2VTW","trigger_group_id":"01KG1W5Z9WH9JVG6XQDTMMMNJG","data":{"value":5},"trigger_type":"TEASER_TIMEOUT"}],"SUPPRESS_SUCCESS_FORM":{"value":true},"COOKIE_TIMEOUT":{"value":3},"TEASER_TIMEOUT":{"value":5}}],"form_entity_form_view_dependencies":[]}],"name":"Contact Us - EyePromise","show_klaviyo_branding":false,"show_klaviyo_branding_fullpage_and_flyout_forms":false,"dismissed_alerts":[]},{"form_id":"VuqmfR","live_form_versions":[{"form_id":"VuqmfR","form_version_id":25763436,"name":"EA - Pop-Up Welcome Promo 2026 - OTP10","form_type":"POPUP","channel_type":"WEB","form_type_direction":null,"update_timestamp":1778789737,"allocation":1.0,"id":25763436,"data":{"styling":{"preset_size":false,"input_styles":{"color":"#000000","input_background_color":"#FFFFFF","height":50,"border":{"default_color":"#606A72"},"font_family":"'Kanit-Klaviyo-Hosted', Arial, 'Helvetica Neue', Helvetica, sans-serif","custom_company_font_id":983088,"border_radius":4,"placeholder_color":"#767676","font_weight":400,"font_size":"16px"},"size":940,"background_color":"rgba(255,255,255,1)","is_max_width":true,"padding":{"top":15,"left":40,"right":40,"bottom":15},"border_radius":6,"minimum_height":470,"dismiss_button_styles":{"size":35,"xColor":"#373F47","x_stroke":1,"background_color":"rgba(180,187,195,0)","border_color":"rgba(255,255,255,0)"},"margin":{"top":20,"bottom":20,"left":20,"right":20},"drop_shadow":{"enabled":true,"blur":30,"color":"rgba(0,0,0,0.15)"}},"side_image":{"data":{"styling":{"is_max_width":true,"preset_size":true,"size_multiplier":1},"device_type":"DESKTOP"},"position":0},"ignore_overlay_dismissal":{"mobile":false,"desktop":false},"independent_triggers":true,"user_toggled_shop_pay":false,"store_utm_params":true},"form_specialties":[],"views":[{"view_id":"01KQCXH45T394H2JFFC6K0BC9R","form_version_id":25763436,"position":0,"data":{"styling":{"preset_size":true,"input_styles":{"color":"#000000","focus_color":"#0064CD","input_background_color":"#FFFFFF","height":45},"size":"320","background_color":"#1873C7","is_max_width":true,"padding":{"top":20,"left":15,"right":15},"border_radius":6}},"name":null,"parent_view_id":null,"columns":[{"column_id":"01KQCXH47DF1H1SQKVGKNBEPH7","view_id":"01KQCXH45T394H2JFFC6K0BC9R","position":0,"data":{"styling":{"is_max_width":true,"preset_size":true,"size_multiplier":1,"background_image":{"name":"5 (compressed).1","url":"https://d3k81ch9hvuctc.cloudfront.net/company/TfQYVZ/images/e00a265d-5b04-4693-b64b-4f4baf18feea.png","width":728,"height":728,"format":"png","size":758057,"position":"cover","alignment":"center","is_ai_generated":false,"cropped_asset_id":null,"cropping_aspect_ratio":null,"cropping_height":null,"cropping_width":null,"cropping_x":null,"cropping_y":null,"original_image_url":null,"alt_text":"Close up image of a hand holding a golden pill with a text overlay that reads Unlock Your Exclusive Offer!","vertical_alignment":"center"}}},"rows":[]},{"column_id":"01KQCXH47HWHXWKFNJ3ASYCYE3","view_id":"01KQCXH45T394H2JFFC6K0BC9R","position":1,"data":{},"rows":[{"row_id":"01KQCXH47N1F4X8W35ZQE33H8Q","column_id":"01KQCXH47HWHXWKFNJ3ASYCYE3","position":0,"data":{},"components":[{"component_id":"01KQCXH47RX1EBJ8KGGWKTV9G3","row_id":"01KQCXH47N1F4X8W35ZQE33H8Q","component_type":"TEXT","data":{"content":{"html":"<p style=\"text-align: center; font-family: Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 14px;\"><span style=\"color: rgb(0, 77, 220); font-family: FeatureDisplay; font-size: 24px;\"><span style=\"font-weight: 300;\">UNLOCK</span></span></p><p style=\"text-align: center; font-family: Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 14px;\"><span style=\"color: rgb(0, 77, 220); font-family: FeatureDisplay; font-size: 46px;\"><span style=\"font-weight: 300;\">10% OFF</span></span></p><p style=\"text-align: center; font-family: Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 14px;\"><span style=\"color: rgb(0, 77, 220); font-family: FeatureDisplay; font-size: 24px;\"><span style=\"font-weight: 300;\">YOUR ORDER</span></span></p>"},"styling":{"padding":{"top":30}},"violations":[]},"action":null}]},{"row_id":"01KQCXH47WT7EP7T1QCJTVDAEQ","column_id":"01KQCXH47HWHXWKFNJ3ASYCYE3","position":1,"data":{},"components":[{"component_id":"01KQCXH47ZE442WS6DHM6XEP79","row_id":"01KQCXH47WT7EP7T1QCJTVDAEQ","component_type":"TEXT","data":{"styling":{"padding":{"top":0}},"content":{"html":"<p style=\"text-align: center; font-family: Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 14px;\"><span style=\"color: rgb(0, 77, 220); font-family: GTAmerica; font-size: 16px;\">Join the EyePromise Community to receive up to date science-based educational content, exclusive offers and updates from EyePromise.</span></p>"},"violations":[]},"action":null}]},{"row_id":"01KQCXH483YA8HKAAHYNBR54AJ","column_id":"01KQCXH47HWHXWKFNJ3ASYCYE3","position":2,"data":{},"components":[{"component_id":"01KQCXH487G0R0GMNPX8T9BYBR","row_id":"01KQCXH483YA8HKAAHYNBR54AJ","component_type":"EMAIL","data":{"placeholder":"Email","required":true,"field_id":"$email","styling":{"text_styles":{},"padding":{"top":20,"left":6,"right":6,"bottom":25}},"label":null,"violations":[{"a11y_identifier":"component:styles:68263833","id":"duplicate-id-active","impact":"serious","html":"<input id=\"email_68263833\" class=\"notranslate needsclick go386974734 kl-private-reset-css-Xuajs1\" type=\"email\" autocomplete=\"email\" name=\"email\" tabindex=\"-1\" placeholder=\"Email\" aria-label=\"Email\" aria-invalid=\"false\" options=\"[object Object]\" data-a11y-identifier=\"component:styles:68263833\" value=\"\" style=\"box-sizing: border-box; border-radius: 4px; padding: 0px 0px 0px 16px; height: 50px; text-align: left; color: rgb(0, 0, 0); font-family: Kanit-Klaviyo-Hosted, Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 16px; font-weight: 400; letter-spacing: 0px; background-color: rgb(255, 255, 255); border: 1px solid rgb(96, 106, 114);\">","reported_at":"Tue, 25 Apr 2023 20:48:54 GMT","related_nodes":[{"html":"<input id=\"email_68263833\" class=\"notranslate needsclick go386974734 kl-private-reset-css-Xuajs1\" type=\"email\" autocomplete=\"email\" name=\"email\" tabindex=\"-1\" placeholder=\"Email\" aria-label=\"Email\" aria-invalid=\"false\" options=\"[object Object]\" data-a11y-identifier=\"component:styles:68263833\" value=\"\" style=\"box-sizing: border-box; border-radius: 4px; padding: 0px 0px 0px 16px; height: 50px; text-align: left; color: rgb(0, 0, 0); font-family: Kanit-Klaviyo-Hosted, Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 16px; font-weight: 400; letter-spacing: 0px; background-color: rgb(255, 255, 255); border: 1px solid rgb(96, 106, 114);\">","a11y_identifier":"component:styles:68263833"}]}]},"action":null}]},{"row_id":"01KQCXH48A3RM3321RBVEFBYF3","column_id":"01KQCXH47HWHXWKFNJ3ASYCYE3","position":3,"data":{},"components":[{"component_id":"01KQCXH48EQZVDHKAHF38FSM6T","row_id":"01KQCXH48A3RM3321RBVEFBYF3","component_type":"BUTTON","data":{"content":"Unlock Offer","meta_fields":[{"field_id":"$source","value":"EA - Pop-Up Welcome Promo OTP10 vs SNS20"}],"styling":{"specify_hover_background_color":false,"full_width":true,"text_styles":{"font_family":"GTAmerica, Helvetica, Arial, sans-serif","custom_company_font_id":1794785,"font_size":"20px","font_weight":400,"font_style":"normal"},"border_width":2,"border_style":"none","border_color":"#157551","background_color":"rgba(0,77,220,1)","border_radius":15,"padding":{"top":0,"bottom":0},"height":54,"padding_top":0,"padding_bottom":0},"violations":[],"dismissed_alerts":["2bc8954c862246f285e10fabd9034088"]},"action":{"action_id":"01KQCXH46GX11Y2T0JPW2YCSPS","action_type":"SUBMIT_TO_LIST_AND_TRANSITION_VIEW","data":{"to_phone_number":"+18449693268"},"view_id":"01KQCXH469T8NH8BB4E89ERJJ8","list_id":"VSXfhK"}}]},{"row_id":"01KQCXH48HGZH8T39PQ2Q6YET1","column_id":"01KQCXH47HWHXWKFNJ3ASYCYE3","position":4,"data":{},"components":[{"component_id":"01KQCXH48M8H4JWPQ8FRYMPDYP","row_id":"01KQCXH48HGZH8T39PQ2Q6YET1","component_type":"TEXT","data":{"styling":{"padding":{"bottom":30,"left":15,"right":15,"top":10}},"content":{"html":"<p style=\"text-align: center; font-family: Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 14px;\"><span style=\"color: rgb(96, 106, 114); font-family: Kanit-Klaviyo-Hosted, Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 14px;\">By signing up, you agree to receive email marketing communications.  Offer is not valid for wholesale orders.</span></p>"},"violations":[]},"action":null}]}]}]},{"view_id":"01KQCXH469T8NH8BB4E89ERJJ8","form_version_id":25763436,"position":1,"data":{"styling":{"preset_size":true,"input_styles":{"color":"#000000","input_background_color":"#FFFFFF","height":45},"size":"320","background_color":"#1873C7","is_max_width":true,"padding":{"top":20,"left":15,"right":15},"border_radius":6}},"name":null,"parent_view_id":null,"columns":[{"column_id":"01KQCXH48R6AVW37ENC2R2AV24","view_id":"01KQCXH469T8NH8BB4E89ERJJ8","position":0,"data":{"styling":{"is_max_width":true,"preset_size":true,"size_multiplier":1,"background_image":{"name":"4 (compressed).1","url":"https://d3k81ch9hvuctc.cloudfront.net/company/TfQYVZ/images/36c1f477-7b14-442c-b5a1-fa3b3f5ba2df.png","width":728,"height":728,"format":"png","size":1124716,"position":"cover","alignment":"center","is_ai_generated":false,"cropped_asset_id":null,"cropping_aspect_ratio":null,"cropping_height":null,"cropping_width":null,"cropping_x":null,"cropping_y":null,"original_image_url":null,"alt_text":"","vertical_alignment":"center"}}},"rows":[]},{"column_id":"01KQCXH48VRBGQ2FANVKKYNFYZ","view_id":"01KQCXH469T8NH8BB4E89ERJJ8","position":1,"data":{},"rows":[{"row_id":"01KQCXH48ZWYJNKZY0C6TYWHWM","column_id":"01KQCXH48VRBGQ2FANVKKYNFYZ","position":0,"data":{},"components":[{"component_id":"01KQCXH492A3M19KH7TNM0ESG2","row_id":"01KQCXH48ZWYJNKZY0C6TYWHWM","component_type":"IMAGE","data":{"styling":{"full_width":false,"alignment":"center","text_styles":{},"width":200,"padding":{"left":6,"right":6,"top":0,"bottom":30}},"image":{"name":"eyePromise-logo-color bg","url":"https://d3k81ch9hvuctc.cloudfront.net/company/TfQYVZ/images/307c3f34-1fc1-49fd-b441-71de9eb9d95b.jpeg","width":1000,"height":217,"format":"jpeg","size":21241,"is_ai_generated":false,"cropped_asset_id":null,"cropping_aspect_ratio":null,"cropping_height":null,"cropping_width":null,"cropping_x":null,"cropping_y":null,"original_image_url":null,"alt_text":""},"alt_text":"EyePromise logo"},"action":null}]},{"row_id":"01KQCXH49634GKHBY539E34SJZ","column_id":"01KQCXH48VRBGQ2FANVKKYNFYZ","position":1,"data":{},"components":[{"component_id":"01KQCXH4992C3XZGD8GW497KPD","row_id":"01KQCXH49634GKHBY539E34SJZ","component_type":"TEXT","data":{"styling":{"padding":{"left":6,"right":6,"top":0,"bottom":20}},"content":{"html":"<p style=\"text-align: center; font-family: Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 14px;\"><span style=\"text-align: center; color: rgb(0, 77, 220); font-family: FeatureDisplay; font-size: 36px;\"><span style=\"font-weight: 300;\">Welcome to the EyePromise Community</span></span></p>"}},"action":null}]},{"row_id":"01KQCXH49CJKT41CZX6KNH4Z3D","column_id":"01KQCXH48VRBGQ2FANVKKYNFYZ","position":2,"data":{},"components":[{"component_id":"01KQCXH49GDV7QW8VZV079XW71","row_id":"01KQCXH49CJKT41CZX6KNH4Z3D","component_type":"TEXT","data":{"styling":{"padding":{"left":30,"right":30}},"content":{"html":"<p style=\"text-align: center; font-family: Arial, &quot;Helvetica Neue&quot;, Helvetica, sans-serif; font-size: 14px;\"><span style=\"color: rgb(0, 77, 220); font-family: GTAmerica; font-size: 20px;\">Keep an </span><span style=\"color: rgb(0, 77, 220); font-family: FeatureDisplay, Georgia, Times, &quot;Times New Roman&quot;, serif; font-size: 20px;\"><span style=\"font-weight: 300;\"><em>eye </em></span></span><span style=\"color: rgb(0, 77, 220); font-family: GTAmerica; font-size: 20px;\">on your email inbox for your secret code for 10% off of your next purchase!</span></p>"},"violations":[]},"action":null}]}]}]}],"trigger_groups":[{"trigger_group_id":"01KQCXH49KYSB3KS2SFGFCGRJQ","form_version_id":25763436,"triggers":[{"trigger_id":"01KQCXH49TZE528GA0247AV1JG","trigger_group_id":"01KQCXH49KYSB3KS2SFGFCGRJQ","data":{"value":true},"trigger_type":"EXISTING_USER"},{"trigger_id":"01KQCXH49X1Y40ANYJ9WTKKJF1","trigger_group_id":"01KQCXH49KYSB3KS2SFGFCGRJQ","data":{"value":true},"trigger_type":"SUPPRESS_SUCCESS_FORM"},{"trigger_id":"01KQCXH4A03JXJW6T1HP2X6B55","trigger_group_id":"01KQCXH49KYSB3KS2SFGFCGRJQ","data":{"value":5},"trigger_type":"COOKIE_TIMEOUT"},{"trigger_id":"01KQCXH4A44W9JAJBX6451E13T","trigger_group_id":"01KQCXH49KYSB3KS2SFGFCGRJQ","data":{"value":{"blacklist":["*/checkout*","*/account*","*/cart*","*portal*","https://eyepromise.com/collections/wholesale-products","https://eyepromise.com/pages/heyedrate-clinical-sample-requests","https://eyepromise.com/pages/vse-heyedrate-clinical-sample-requests","*company_location*"],"whitelist":["*"]}},"trigger_type":"URL_PATH_PATTERNS"},{"trigger_id":"01KQCXH4A7DR803JG6JPG9YJSJ","trigger_group_id":"01KQCXH49KYSB3KS2SFGFCGRJQ","data":{"value":{"whitelist":[]}},"trigger_type":"GEO_IP"}],"EXISTING_USER":{"value":true},"SUPPRESS_SUCCESS_FORM":{"value":true},"COOKIE_TIMEOUT":{"value":5},"URL_PATH_PATTERNS":{"value":{"blacklist":["*/checkout*","*/account*","*/cart*","*portal*","https://eyepromise.com/collections/wholesale-products","https://eyepromise.com/pages/heyedrate-clinical-sample-requests","https://eyepromise.com/pages/vse-heyedrate-clinical-sample-requests","*company_location*"],"whitelist":["*"]}},"GEO_IP":{"value":{"whitelist":[]}}}],"teasers":[{"teaser_id":"01KQCXH476Y560V8T4FSQZJNT8","type":"CIRCLE","direction":"BOTTOM_RIGHT","display_order":"DISPLAY_AFTER","form_version_id":25763436,"data":{"styling":{"margin":{"top":20,"left":20,"right":5,"bottom":0},"size":100,"background_color":"rgba(255,255,255,0)","background_image":{"name":"First order discount teaser","url":"https://d3k81ch9hvuctc.cloudfront.net/company/Pb3wug/images/0ed14cd8-c684-4921-9ce6-11220a3203a1.png","width":400,"height":400,"format":"png","size":37484,"position":"contain","alignment":"left","custom_width":200,"vertical_alignment":"bottom"},"preset_size":false,"drop_shadow":{"enabled":true,"blur":30,"color":"rgba(0,0,0,0.15)"},"dismiss_button_styles":{"margin":{"top":16,"left":16,"right":16,"bottom":16}}},"content":{"html":""},"show_dismiss_button":true}}],"form_entity_form_view_dependencies":[]}],"name":"EA - Pop-Up Welcome Promo 2026","show_klaviyo_branding":false,"show_klaviyo_branding_fullpage_and_flyout_forms":false,"dismissed_alerts":[]}],"form_settings":{"enabled":false,"shopify_visitor_api":{"sync_SMS_consent":true,"sync_email_consent":true}},"dynamic_info_config":{},"company_sender_settings":{"email_address":"noreply@eyepromise.com","email_settings":{}}}