www.culligan.com
Open in
urlscan Pro
192.0.66.104
Public Scan
URL:
https://www.culligan.com/scheduler
Submission: On July 10 via api from FI — Scanned from FI
Submission: On July 10 via api from FI — Scanned from FI
Form analysis 5 forms found in the DOM
<form class="relative sm:w-auto w-full pl-0 xl:pl-3 1xl:p-0 2xl:p-0">
<div class="flex items-center rounded-[5px] border-white border"><input type="text" aria-label="search field" placeholder="Search Culligan.com"
class="w-full py-2 px-3 2xl:px-4 rounded-[5px] bg-transparent text-white placeholder:text-white text-12px" value="">
<div class="hidden"></div><button aria-label="trigger search" type="button"
class="cursor-pointer relative h-10 font-bold text-sm px-3 transition-colors duration-200 ease-in flex flex-nowrap items-center justify-center leading-base border-orange bg-orange text-white hover:bg-orange-light hover:border-orange-light text-sm leading-sm border rounded h-7 rounded-l-none hover:bg-blue-darker border-none px-1.5 bg-transparent"><svg
stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 24 24" class="h-4 w-4 text-white" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg">
<path
d="M19.023 16.977a35.13 35.13 0 0 1-1.367-1.384c-.372-.378-.596-.653-.596-.653l-2.8-1.337A6.962 6.962 0 0 0 16 9c0-3.859-3.14-7-7-7S2 5.141 2 9s3.14 7 7 7c1.763 0 3.37-.66 4.603-1.739l1.337 2.8s.275.224.653.596c.387.363.896.854 1.384 1.367l1.358 1.392.604.646 2.121-2.121-.646-.604c-.379-.372-.885-.866-1.391-1.36zM9 14c-2.757 0-5-2.243-5-5s2.243-5 5-5 5 2.243 5 5-2.243 5-5 5z">
</path>
</svg></button>
</div>
</form>#
<form action="#" novalidate="" class="grid grid-cols-12 gap-x-5 md:gap-x-5">
<div class="flex flex-col transform-gpu transition-all duration-300 lg:duration-500 overflow-hidden max-h-[250px] ease-in col-span-12 md:col-span-12">
<div class="flex flex-col">
<div class="flex flex-row items-center relative"><input type="zipcode" name="top_zipcode" value="" id="form0-top_zipcode"
class="text-gray-dark text-sm rounded w-full placeholder:text-gray-dark border-gray-light pr-3 h-input pl-3 h-input !h-[40px]" placeholder="Zip/Postal Code"><svg stroke="currentColor" fill="currentColor" stroke-width="0"
viewBox="0 0 512 512" class="text-red h-6 w-6 absolute right-1.5 transition-all duration-150 ease-in opacity-0 invisible top-[calc(theme(spacing.1))] undefined" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg">
<path
d="M449.07 399.08L278.64 82.58c-12.08-22.44-44.26-22.44-56.35 0L51.87 399.08A32 32 0 0080 446.25h340.89a32 32 0 0028.18-47.17zm-198.6-1.83a20 20 0 1120-20 20 20 0 01-20 20zm21.72-201.15l-5.74 122a16 16 0 01-32 0l-5.74-121.95a21.73 21.73 0 0121.5-22.69h.21a21.74 21.74 0 0121.73 22.7z">
</path>
</svg></div>
</div>
<div
class="relative px-1 mx-1 text-xs text-red transform-gpu transition-all duration-150 ease-in mt-0.5 mb-1 flex items-baseline leading-tight font-bold whitespace-pre-wrap opacity-0 invisible !text-white bg-red px-3 rounded py-1 mt-[-3px] after:border-y-[11px] after:border-r-[11px] after:border-r-indigo-600 after:border-y-transparent after:rotate-90 after:absolute after:right-[calc(theme(spacing.1)+4.5px)] after:-top-2.5 after:text-red undefined"
style="height:19px">
<p class="undefined" data-testid="formfield-error"> </p>
</div>
</div>
<div class="flex flex-col transform-gpu transition-all duration-300 lg:duration-500 overflow-hidden max-h-[250px] ease-in col-span-12 md:col-span-12">
<div class="flex flex-col">
<div class="flex flex-row items-center relative"><select data-component="select" class="bg-white text-gray-dark text-sm transition-all duration-100 cursor-pointer rounded pl-3 pr-2 w-full border border-gray-light h-input !h-[40px] border-0 "
name="InterestSupport">
<option selected="" value="" disabled="">Select Area of Interest</option>
<option value="{"label":"Water Softening","value":"HH"}">Water Softening</option>
<option value="{"label":"Water Delivery/Water Coolers","value":"BW"}">Water Delivery/Water Coolers</option>
<option value="{"label":"Water Filtration","value":"HH"}">Water Filtration</option>
<option value="{"label":"Other","value":"HH"}">Other</option>
</select><svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 512 512" class="text-red h-6 w-6 absolute right-1.5 transition-all duration-150 ease-in opacity-0 invisible top-[calc(theme(spacing.1))]" height="1em"
width="1em" xmlns="http://www.w3.org/2000/svg">
<path
d="M449.07 399.08L278.64 82.58c-12.08-22.44-44.26-22.44-56.35 0L51.87 399.08A32 32 0 0080 446.25h340.89a32 32 0 0028.18-47.17zm-198.6-1.83a20 20 0 1120-20 20 20 0 01-20 20zm21.72-201.15l-5.74 122a16 16 0 01-32 0l-5.74-121.95a21.73 21.73 0 0121.5-22.69h.21a21.74 21.74 0 0121.73 22.7z">
</path>
</svg></div>
</div>
<div
class="relative px-1 mx-1 text-xs text-red transform-gpu transition-all duration-150 ease-in mt-0.5 mb-1 flex items-baseline leading-tight font-bold whitespace-pre-wrap opacity-0 invisible !text-white bg-red px-3 rounded py-1 mt-[-3px] after:border-y-[11px] after:border-r-[11px] after:border-r-indigo-600 after:border-y-transparent after:rotate-90 after:absolute after:right-[calc(theme(spacing.1)+4.5px)] after:-top-2.5 after:text-red undefined"
style="height:19px">
<p class="undefined" data-testid="formfield-error"> </p>
</div>
</div><button aria-label="SUBMIT" type="submit"
class="cursor-pointer relative h-10 font-bold text-sm px-3 transition-colors duration-200 ease-in flex flex-nowrap items-center justify-center leading-base border-orange bg-transparent hover:bg-orange-light hover:border-orange-light text-sm leading-sm rounded col-span-12 text-white w-full border-2 border-white text-lg leading-6 rounded-[5px] h-[40px] !px-0">SUBMIT</button>
</form><form class="relative sm:w-auto w-full pl-0 xl:pl-3 1xl:p-0 2xl:p-0">
<div class="flex items-center rounded-[5px] border-gray-light border"><input type="text" aria-label="search field" placeholder="Search Culligan.com"
class="w-full py-2 px-3 2xl:px-4 rounded-[5px] bg-transparent text-gray-dark placeholder:text-gray-dark text-12px" value="">
<div class="hidden"></div><button aria-label="trigger search" type="button"
class="cursor-pointer relative h-10 font-bold text-sm px-3 transition-colors duration-200 ease-in flex flex-nowrap items-center justify-center leading-base border-orange bg-orange text-white hover:bg-orange-light hover:border-orange-light text-sm leading-sm border rounded h-7 rounded-l-none hover:bg-blue-darker border-none px-1.5 bg-transparent"><svg
stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 24 24" class="h-5 w-5 text-gray-dark" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg">
<path
d="M19.023 16.977a35.13 35.13 0 0 1-1.367-1.384c-.372-.378-.596-.653-.596-.653l-2.8-1.337A6.962 6.962 0 0 0 16 9c0-3.859-3.14-7-7-7S2 5.141 2 9s3.14 7 7 7c1.763 0 3.37-.66 4.603-1.739l1.337 2.8s.275.224.653.596c.387.363.896.854 1.384 1.367l1.358 1.392.604.646 2.121-2.121-.646-.604c-.379-.372-.885-.866-1.391-1.36zM9 14c-2.757 0-5-2.243-5-5s2.243-5 5-5 5 2.243 5 5-2.243 5-5 5z">
</path>
</svg></button>
</div>
</form>#
<form action="#" class="grid grid-cols-12 gap-x-5">
<div class="flex flex-col transform-gpu transition-all duration-300 lg:duration-500 overflow-hidden max-h-[250px] ease-in col-span-6 md:col-span-6">
<div class="flex flex-col"><label for="personal-infoFirstName" class="leading-4 text-sm font-bold items-center mb-1.5 w-full relative text-gray-dark"><span class="flex flex-row">
<div>First Name<!-- -->*</div>
</span></label>
<div class="flex flex-row items-center relative"><input name="FirstName" value="" id="personal-infoFirstName" class="text-gray-dark text-sm rounded w-full placeholder:text-gray-dark border border-gray-light pr-3 h-input pl-3 h-input undefined"
placeholder=""><svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 512 512" class="text-red h-6 w-6 absolute right-1.5 transition-all duration-150 ease-in opacity-0 invisible undefined" height="1em" width="1em"
xmlns="http://www.w3.org/2000/svg">
<path
d="M449.07 399.08L278.64 82.58c-12.08-22.44-44.26-22.44-56.35 0L51.87 399.08A32 32 0 0080 446.25h340.89a32 32 0 0028.18-47.17zm-198.6-1.83a20 20 0 1120-20 20 20 0 01-20 20zm21.72-201.15l-5.74 122a16 16 0 01-32 0l-5.74-121.95a21.73 21.73 0 0121.5-22.69h.21a21.74 21.74 0 0121.73 22.7z">
</path>
</svg></div>
</div>
<div class="relative max-w-max text-xs text-red transform-gpu transition-all duration-150 ease-in mt-0.5 mb-1 flex items-baseline leading-tight font-bold whitespace-pre-wrap opacity-0 invisible undefined" style="height:19px">
<p class="undefined" data-testid="formfield-error"> First Name is required</p>
</div>
</div>
<div class="flex flex-col transform-gpu transition-all duration-300 lg:duration-500 overflow-hidden max-h-[250px] ease-in col-span-6 md:col-span-6">
<div class="flex flex-col"><label for="personal-infoLastName" class="leading-4 text-sm font-bold items-center mb-1.5 w-full relative text-gray-dark"><span class="flex flex-row">
<div>Last Name<!-- -->*</div>
</span></label>
<div class="flex flex-row items-center relative"><input name="LastName" value="" id="personal-infoLastName" class="text-gray-dark text-sm rounded w-full placeholder:text-gray-dark border border-gray-light pr-3 h-input pl-3 h-input undefined"
placeholder=""><svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 512 512" class="text-red h-6 w-6 absolute right-1.5 transition-all duration-150 ease-in opacity-0 invisible undefined" height="1em" width="1em"
xmlns="http://www.w3.org/2000/svg">
<path
d="M449.07 399.08L278.64 82.58c-12.08-22.44-44.26-22.44-56.35 0L51.87 399.08A32 32 0 0080 446.25h340.89a32 32 0 0028.18-47.17zm-198.6-1.83a20 20 0 1120-20 20 20 0 01-20 20zm21.72-201.15l-5.74 122a16 16 0 01-32 0l-5.74-121.95a21.73 21.73 0 0121.5-22.69h.21a21.74 21.74 0 0121.73 22.7z">
</path>
</svg></div>
</div>
<div class="relative max-w-max text-xs text-red transform-gpu transition-all duration-150 ease-in mt-0.5 mb-1 flex items-baseline leading-tight font-bold whitespace-pre-wrap opacity-0 invisible undefined" style="height:19px">
<p class="undefined" data-testid="formfield-error"> Last Name is required</p>
</div>
</div>
<div class="flex flex-col transform-gpu transition-all duration-300 lg:duration-500 overflow-hidden max-h-[250px] ease-in col-span-12 md:col-span-6">
<div class="flex flex-col"><label for="personal-infoAddress-1" class="leading-4 text-sm font-bold items-center mb-1.5 w-full relative text-gray-dark"><span class="flex flex-row">
<div>Address<!-- -->*</div>
</span></label>
<div class="flex flex-row items-center relative"><input name="Address-1" value="" id="personal-infoAddress-1"
class="text-gray-dark text-sm rounded w-full placeholder:text-gray-dark border border-gray-light pr-3 h-input pl-3 undefined pac-target-input" placeholder="" autocomplete="address-line1"><svg stroke="currentColor" fill="currentColor"
stroke-width="0" viewBox="0 0 512 512" class="text-red h-6 w-6 absolute right-1.5 transition-all duration-150 ease-in opacity-0 invisible undefined" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg">
<path
d="M449.07 399.08L278.64 82.58c-12.08-22.44-44.26-22.44-56.35 0L51.87 399.08A32 32 0 0080 446.25h340.89a32 32 0 0028.18-47.17zm-198.6-1.83a20 20 0 1120-20 20 20 0 01-20 20zm21.72-201.15l-5.74 122a16 16 0 01-32 0l-5.74-121.95a21.73 21.73 0 0121.5-22.69h.21a21.74 21.74 0 0121.73 22.7z">
</path>
</svg></div>
</div>
<div class="relative max-w-max text-xs text-red transform-gpu transition-all duration-150 ease-in mt-0.5 mb-1 flex items-baseline leading-tight font-bold whitespace-pre-wrap opacity-0 invisible undefined" style="height:19px">
<p class="undefined" data-testid="formfield-error"> Address is required</p>
</div>
</div>
<div class="flex flex-col transform-gpu transition-all duration-300 lg:duration-500 overflow-hidden max-h-[250px] ease-in col-span-12 md:col-span-6">
<div class="flex flex-col"><label for="personal-infoCity" class="leading-4 text-sm font-bold items-center mb-1.5 w-full relative text-gray-dark"><span class="flex flex-row">
<div>City<!-- -->*</div>
</span></label>
<div class="flex flex-row items-center relative"><input name="City" value="" id="personal-infoCity" class="text-gray-dark text-sm rounded w-full placeholder:text-gray-dark border border-gray-light pr-3 h-input pl-3 h-input undefined"
placeholder=""><svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 512 512" class="text-red h-6 w-6 absolute right-1.5 transition-all duration-150 ease-in opacity-0 invisible undefined" height="1em" width="1em"
xmlns="http://www.w3.org/2000/svg">
<path
d="M449.07 399.08L278.64 82.58c-12.08-22.44-44.26-22.44-56.35 0L51.87 399.08A32 32 0 0080 446.25h340.89a32 32 0 0028.18-47.17zm-198.6-1.83a20 20 0 1120-20 20 20 0 01-20 20zm21.72-201.15l-5.74 122a16 16 0 01-32 0l-5.74-121.95a21.73 21.73 0 0121.5-22.69h.21a21.74 21.74 0 0121.73 22.7z">
</path>
</svg></div>
</div>
<div class="relative max-w-max text-xs text-red transform-gpu transition-all duration-150 ease-in mt-0.5 mb-1 flex items-baseline leading-tight font-bold whitespace-pre-wrap opacity-0 invisible undefined" style="height:19px">
<p class="undefined" data-testid="formfield-error"> City is required</p>
</div>
</div>
<div class="flex flex-col transform-gpu transition-all duration-300 lg:duration-500 overflow-hidden max-h-[250px] ease-in col-span-6 md:col-span-3">
<div class="flex flex-col"><label for="personal-infoState" class="leading-4 text-sm font-bold items-center mb-1.5 w-full relative text-gray-dark"><span class="flex flex-row">
<div>State/Province<!-- -->*</div>
</span></label>
<div class="flex flex-row items-center relative"><input name="State" value="" id="personal-infoState" class="text-gray-dark text-sm rounded w-full placeholder:text-gray-dark border border-gray-light pr-3 h-input pl-3 h-input undefined"
placeholder=""><svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 512 512" class="text-red h-6 w-6 absolute right-1.5 transition-all duration-150 ease-in opacity-0 invisible undefined" height="1em" width="1em"
xmlns="http://www.w3.org/2000/svg">
<path
d="M449.07 399.08L278.64 82.58c-12.08-22.44-44.26-22.44-56.35 0L51.87 399.08A32 32 0 0080 446.25h340.89a32 32 0 0028.18-47.17zm-198.6-1.83a20 20 0 1120-20 20 20 0 01-20 20zm21.72-201.15l-5.74 122a16 16 0 01-32 0l-5.74-121.95a21.73 21.73 0 0121.5-22.69h.21a21.74 21.74 0 0121.73 22.7z">
</path>
</svg></div>
</div>
<div class="relative max-w-max text-xs text-red transform-gpu transition-all duration-150 ease-in mt-0.5 mb-1 flex items-baseline leading-tight font-bold whitespace-pre-wrap opacity-0 invisible undefined" style="height:19px">
<p class="undefined" data-testid="formfield-error"> State is required</p>
</div>
</div>
<div class="flex flex-col transform-gpu transition-all duration-300 lg:duration-500 overflow-hidden max-h-[250px] ease-in col-span-6 md:col-span-3">
<div class="flex flex-col"><label for="personal-infoPostalCode" class="leading-4 text-sm font-bold items-center mb-1.5 w-full relative text-gray-dark"><span class="flex flex-row">
<div>Zip/Postal Code<!-- -->*</div>
</span></label>
<div class="flex flex-row items-center relative"><input type="zipcode" name="PostalCode" value="" id="personal-infoPostalCode"
class="text-gray-dark text-sm rounded w-full placeholder:text-gray-dark border border-gray-light pr-3 h-input pl-3 h-input undefined" placeholder=""><svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 512 512"
class="text-red h-6 w-6 absolute right-1.5 transition-all duration-150 ease-in opacity-0 invisible undefined" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg">
<path
d="M449.07 399.08L278.64 82.58c-12.08-22.44-44.26-22.44-56.35 0L51.87 399.08A32 32 0 0080 446.25h340.89a32 32 0 0028.18-47.17zm-198.6-1.83a20 20 0 1120-20 20 20 0 01-20 20zm21.72-201.15l-5.74 122a16 16 0 01-32 0l-5.74-121.95a21.73 21.73 0 0121.5-22.69h.21a21.74 21.74 0 0121.73 22.7z">
</path>
</svg></div>
</div>
<div class="relative max-w-max text-xs text-red transform-gpu transition-all duration-150 ease-in mt-0.5 mb-1 flex items-baseline leading-tight font-bold whitespace-pre-wrap opacity-0 invisible undefined" style="height:19px">
<p class="undefined" data-testid="formfield-error"> Zip/Postal Code is required</p>
</div>
</div>
<div class="flex flex-col transform-gpu transition-all duration-300 lg:duration-500 overflow-hidden max-h-[250px] ease-in col-span-12 md:col-span-6">
<div class="flex flex-col"><label for="personal-infoEmailAddress" class="leading-4 text-sm font-bold items-center mb-1.5 w-full relative text-gray-dark"><span class="flex flex-row">
<div>Email Address<!-- -->*</div>
</span></label>
<div class="flex flex-row items-center relative"><input type="email" name="EmailAddress" value="" id="personal-infoEmailAddress"
class="text-gray-dark text-sm rounded w-full placeholder:text-gray-dark border border-gray-light pr-3 h-input pl-3 h-input undefined" placeholder=""><svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 512 512"
class="text-red h-6 w-6 absolute right-1.5 transition-all duration-150 ease-in opacity-0 invisible undefined" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg">
<path
d="M449.07 399.08L278.64 82.58c-12.08-22.44-44.26-22.44-56.35 0L51.87 399.08A32 32 0 0080 446.25h340.89a32 32 0 0028.18-47.17zm-198.6-1.83a20 20 0 1120-20 20 20 0 01-20 20zm21.72-201.15l-5.74 122a16 16 0 01-32 0l-5.74-121.95a21.73 21.73 0 0121.5-22.69h.21a21.74 21.74 0 0121.73 22.7z">
</path>
</svg></div>
</div>
<div class="relative max-w-max text-xs text-red transform-gpu transition-all duration-150 ease-in mt-0.5 mb-1 flex items-baseline leading-tight font-bold whitespace-pre-wrap opacity-0 invisible undefined" style="height:19px">
<p class="undefined" data-testid="formfield-error"> Email Address is required</p>
</div>
</div>
<div class="flex flex-col transform-gpu transition-all duration-300 lg:duration-500 overflow-visible max-h-[250px] ease-in col-span-12 md:col-span-6">
<div class="flex flex-col"><label for="personal-infoPhone" class="leading-4 text-sm font-bold items-center mb-1.5 w-full relative text-gray-dark"><span class="flex flex-row">
<div>Phone #<!-- -->*<div class="block absolute right-0 top-0">
<div data-testid="tooltip" class="flex text-blue-light"><span><svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 512 512" data-testid="tooltip-icon" class="mt-1" height="17" width="17"
xmlns="http://www.w3.org/2000/svg">
<path
d="M256 8C119.043 8 8 119.083 8 256c0 136.997 111.043 248 248 248s248-111.003 248-248C504 119.083 392.957 8 256 8zm0 448c-110.532 0-200-89.431-200-200 0-110.495 89.472-200 200-200 110.491 0 200 89.471 200 200 0 110.53-89.431 200-200 200zm107.244-255.2c0 67.052-72.421 68.084-72.421 92.863V300c0 6.627-5.373 12-12 12h-45.647c-6.627 0-12-5.373-12-12v-8.659c0-35.745 27.1-50.034 47.579-61.516 17.561-9.845 28.324-16.541 28.324-29.579 0-17.246-21.999-28.693-39.784-28.693-23.189 0-33.894 10.977-48.942 29.969-4.057 5.12-11.46 6.071-16.666 2.124l-27.824-21.098c-5.107-3.872-6.251-11.066-2.644-16.363C184.846 131.491 214.94 112 261.794 112c49.071 0 101.45 38.304 101.45 88.8zM298 368c0 23.159-18.841 42-42 42s-42-18.841-42-42 18.841-42 42-42 42 18.841 42 42z">
</path>
</svg></span></div>
</div>
</div>
</span></label>
<div class="flex flex-row items-center relative"><input type="tel" name="Phone" value="" id="personal-infoPhone"
class="text-gray-dark text-sm rounded w-full placeholder:text-gray-dark border border-gray-light pr-3 h-input pl-3 h-input undefined" placeholder=""><svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 512 512"
class="text-red h-6 w-6 absolute right-1.5 transition-all duration-150 ease-in opacity-0 invisible undefined" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg">
<path
d="M449.07 399.08L278.64 82.58c-12.08-22.44-44.26-22.44-56.35 0L51.87 399.08A32 32 0 0080 446.25h340.89a32 32 0 0028.18-47.17zm-198.6-1.83a20 20 0 1120-20 20 20 0 01-20 20zm21.72-201.15l-5.74 122a16 16 0 01-32 0l-5.74-121.95a21.73 21.73 0 0121.5-22.69h.21a21.74 21.74 0 0121.73 22.7z">
</path>
</svg></div>
</div>
<div class="relative max-w-max text-xs text-red transform-gpu transition-all duration-150 ease-in mt-0.5 mb-1 flex items-baseline leading-tight font-bold whitespace-pre-wrap opacity-0 invisible undefined" style="height:19px">
<p class="undefined" data-testid="formfield-error"> Phone # is required</p>
</div>
</div>
<div class="flex flex-col transform-gpu transition-all duration-300 lg:duration-500 overflow-hidden max-h-[250px] ease-in col-span-12 md:col-span-6">
<div class="flex flex-col"><label for="personal-infoPhone_Type__c" class="leading-4 text-sm font-bold items-center mb-1.5 w-full relative text-gray-dark"><span class="flex flex-row">
<div>Phone Type<!-- -->*</div>
</span></label>
<ul class="grid grid-cols-2 md:grid-cols-3 undefined">
<li class="flex items-center relative"><label class="w-full h-input text-sm text-gray-dark flex items-center cursor-pointer" for="Mobile personal-infoPhone_Type__c"><span
class="w-5 h-5 flex items-center justify-center border border-gray rounded-full mr-2"><span class="w-3 h-3 inline-block bg-gray-dark transition-opacity duration-200 ease-in rounded-full opacity-100"></span></span>Mobile
Phone</label><input type="radio" name="Phone_Type__c" value="Mobile" id="Mobile personal-infoPhone_Type__c" class="hidden"></li>
<li class="flex items-center relative"><label class="w-full h-input text-sm text-gray-dark flex items-center cursor-pointer" for="Home personal-infoPhone_Type__c"><span
class="w-5 h-5 flex items-center justify-center border border-gray rounded-full mr-2"><span class="w-3 h-3 inline-block bg-gray-dark transition-opacity duration-200 ease-in rounded-full opacity-0"></span></span>Home Phone</label><input
type="radio" name="Phone_Type__c" value="Home" id="Home personal-infoPhone_Type__c" class="hidden"></li>
</ul>
</div>
<div class="relative max-w-max text-xs text-red transform-gpu transition-all duration-150 ease-in mt-0.5 mb-1 flex items-baseline leading-tight font-bold whitespace-pre-wrap opacity-0 invisible undefined" style="height:19px">
<p class="undefined" data-testid="formfield-error"> </p>
</div>
</div>
<div class="flex flex-col transform-gpu transition-all duration-300 lg:duration-500 overflow-hidden max-h-[250px] ease-in col-span-12 md:col-span-12">
<div class="flex flex-row-reverse max-w-max items-start"><label for="personal-infoMobile_SMS_Opt_In__c" class="leading-4 text-sm font-bold items-center mb-1.5 w-full relative text-gray-dark"><span class="flex flex-row">
<div>Opt-In to Receive SMS Alerts from Culligan<span class="font-normal"> <!-- --> (Optional)</span></div>
</span></label>
<ul class="flex mb-1.5 mr-2">
<li><input type="checkbox" name="Mobile_SMS_Opt_In__c" value="false" class="hidden">
<p class="border border-gray bg-white rounded w-5 h-5 flex items-center justify-center cursor-pointer"><span class="w-5 h-5 bg-orange rounded transition-all duration-200 border-orange opacity-0 invisible"><svg stroke="currentColor"
fill="currentColor" stroke-width="0" viewBox="0 0 512 512" color="white" class="mx-auto mt-1" style="color:white" height="13" width="13" xmlns="http://www.w3.org/2000/svg">
<path
d="M173.898 439.404l-166.4-166.4c-9.997-9.997-9.997-26.206 0-36.204l36.203-36.204c9.997-9.998 26.207-9.998 36.204 0L192 312.69 432.095 72.596c9.997-9.997 26.207-9.997 36.204 0l36.203 36.204c9.997 9.997 9.997 26.206 0 36.204l-294.4 294.401c-9.998 9.997-26.207 9.997-36.204-.001z">
</path>
</svg></span></p>
</li>
</ul>
</div>
<div class="relative max-w-max text-xs text-red transform-gpu transition-all duration-150 ease-in mt-0.5 mb-1 flex items-baseline leading-tight font-bold whitespace-pre-wrap opacity-0 invisible undefined" style="height:19px">
<p class="undefined" data-testid="formfield-error"> </p>
</div>
<div class="ml-0 md:ml-7 mt-0 md:-mt-4 mt-1">
<p class="text-xs text-gray-dark mb-4 md:mb-0">By opting in, you are agreeing to receive SMS messages from Culligan. Alerts at the phone number listed above. 4 msgs/month. If you have questions, text HELP to 73777 or contact Customer Service at
1-855-558-1684 or customerservice@culligan.com. You can opt-out of the subscription anytime by texting STOP to 73777. Msg&data rates may apply. You can view the Terms and Conditions<!-- -->
<a class="text-gray-dark hover:text-orange-dark2 underline font-bold decoration-orange" href="https://cloud.em.culligan.com/sms-terms-and-conditions">here</a> <!-- -->and Privacy Policy<!-- -->
<a class="text-gray-dark hover:text-orange-dark2 underline font-bold decoration-orange" href="/privacy-policy-2">here</a>.</p>
</div>
</div>
<div class="md:mb-10"></div>
<div class="flex justify-between flex-col items-start md:gap-y-0 w-full" style="grid-column:auto / span 12">
<div class="flex justify-between flex-col-reverse items-start md:gap-y-0 w-full"><span></span><button data-testid="scheduler-next-button" aria-label="Next" type="submit"
class="cursor-pointer relative h-10 font-bold text-sm px-3 transition-colors duration-200 ease-in flex flex-nowrap items-center justify-center leading-base border-orange bg-transparent hover:bg-orange-light hover:border-orange-light text-sm leading-sm rounded min-w-full md:w-64 md:min-w-max border-orange bg-transparent text-orange border-2 hover:text-white uppercase">Next:
choose date & time</button></div>
</div>
</form><form action="" onsubmit="LO.submit_chat(); return false;">
<div id="lo_chat_input" style="position:relative; width: 100%; ">
<div class="lo-fx-hr" style="height:0px; margin-bottom:0px; margin-top:0px; width:100%; border-top:1px solid #000000;border-bottom:1px solid #4f4f4f"></div>
<div style="padding:10px;"><label for="lo_chat_textarea" style="display:none">Chat Input Box</label><textarea id="lo_chat_textarea" disabled="disabled" rows="2"
style="color: black; background-color: rgb(255, 255, 255); border-radius: 5px; padding: 7px; height: auto; width: 100%; font-family: sans-serif; text-transform: none; resize: none;" dir="null" data-last-scroll-height="0"></textarea></div>
<div id="lo_chat_sound_holder" style="position:absolute; right:0px; top:-25px; width:100%;">
<div style="cursor: pointer; float:right; opacity:0.6; padding-right:10px; height:16px;" id="lo_chat_sound"><img alt="Click to mute chat sounds" src="https://d10lpsik1i8c69.cloudfront.net/graphics/sound-on-white.png"></div>
<div id="lo_chat_status" style="padding-left:10px; font-size:11px; color:#6d6d6d"></div>
<div style="clear:both;"></div>
</div>
</div>
</form>Text Content
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