Text

<h2 style="white-space:pre-line">Vamos conversar</h2>
<p>Encontraremos o cuidador ideal para o seu perfil.💚</p>

Embed

<!DOCTYPE html>
<html lang="pt-BR">
<head>
  <meta charset="UTF-8" />
  <meta name="viewport"
        content="width=device-width, initial-scale=1, maximum-scale=3, user-scalable=yes, viewport-fit=cover">
  <title>Formulário do Paciente</title>
  <style>
    :root {
      --bg:#F1F8F4; --card:#ffffff; --muted:#6b7368; --text:#3F473C;
      --accent:#567861; --accent-2:#619B75; --danger:#c14254; --ok:#2e8053;
      --ink-weak:#3F473C22; --ring:#619B7533;
    }
    *{box-sizing:border-box; margin:0; padding:0}
    body{
      font-family: ui-sans-serif, system-ui, -apple-system, Segoe UI, Roboto, Helvetica, Arial;
      color:var(--text);
      background:var(--bg);
    }
    main{width:70%; max-width: 900px; margin:0 auto; padding:20px;}
    @media (max-width: 768px){
      main{width:100%; max-width:none;}
    }
    h1{text-align:center; margin-bottom:20px}
    .card{
      background:var(--card);
      border:1px solid var(--ink-weak);
      border-radius:16px;
      padding:20px;
      margin-bottom:20px;
      box-shadow:0 6px 22px rgba(63,71,60,.08);
    }
    .card h2{font-size:18px; margin-bottom:12px}
    .option-buttons{display:flex; flex-wrap:wrap; gap:12px; margin-bottom:12px;}
    .option-buttons button{flex:1; padding:10px; font-size:14px; font-weight:600; border-radius:12px; border:1px solid var(--ink-weak); background:#fff; cursor:pointer; transition:all .2s ease; text-align:center;}
    .option-buttons button.selected{background:var(--accent-2); color:#fff; border-color:var(--accent);}
    input[type="tel"], input[type="text"], input[type="number"], input[type="email"], input[type="date"], select {
      width:100%; padding:12px; font-size:15px; margin-top:6px; margin-bottom:12px;
      border:1px solid var(--ink-weak); border-radius:12px; background:#fff; color:var(--text);
    }
    input:focus, select:focus {border-color:var(--accent-2); box-shadow:0 0 0 3px var(--ring)}
.greenCheck{color:rgb(95,148,113)!important; accent-color: var(--ok);}
    label{font-size:15px; font-weight:500; margin-bottom:6px; display:block;}
    .check-group label{margin:10px 0; display: flex; align-items: center; gap: 8px;}
    .btn{width:100%; padding:14px; font-size:16px; font-weight:700; border:0; border-radius:12px; cursor:pointer; color:#fff; background:linear-gradient(135deg, var(--accent), var(--accent-2)); margin-top:10px;}
    .hidden{display:none;}
    .combo {margin-top: 5px;margin-bottom: 10px;}
    .status{margin-top:10px;font-size:15px;font-weight:600;text-align:center;}
    .status.error{color:var(--danger);} .status.ok{color:var(--ok);}
    input[type="tel"], input[type="text"], input[type="number"], input[type="email"], input[type="date"], select, textarea {
  width:100%;
  padding:12px;
  font-size:15px;
  margin-top:6px;
  margin-bottom:12px;
  border:1px solid var(--ink-weak);
  border-radius:12px;
  background:#fff;
  color:var(--text);
}
textarea:focus {
  border-color:var(--accent-2);
  box-shadow:0 0 0 3px var(--ring);
}
  </style>
</head>
<body>
<main>
  <div class="card">
    <label>Seu nome</label>
    <input type="text" id="contactName" placeholder="Ex.: João Silva" />
    <label>Telefone</label>
    <input type="tel" id="whatsapp" placeholder="27999998888" />
      <label>Estado</label>
    <select id="stateSelect" class="combo">
      <option value="">Selecione um estado</option>
    </select>
    <label>Cidade</label>
    <select id="citySelect" class="combo">
      <option value="">Selecione uma cidade</option>
    </select>
  </div>
  <button class="btn" id="submitForm">Iniciar conversa</button>
  <div class="status" id="statusMsg"></div>
</main>

<script>
const BASE = "https://api.vitalassisthomecare.com.br/lifeassist/v1";
const LEAD_URL = BASE + "/sales/lead";

function getTrackingFromStorage() {
  return {
    gclid: localStorage.getItem("gclid"),
    utmSource: localStorage.getItem("utm_source"),
    utmCampaign: localStorage.getItem("utm_campaign"),
    utmMedium: localStorage.getItem("utm_medium"),
    utmTerm: localStorage.getItem("utm_term"),
    utmContent: localStorage.getItem("utm_content")
  };
}

document.addEventListener("DOMContentLoaded", () => {
  const stateSelect = document.getElementById("stateSelect");
  const citySelect = document.getElementById("citySelect");
  const statusMsg = document.getElementById("statusMsg");
  const submitBtn = document.getElementById("submitForm");

  let referralCode = null;

  const showError = msg => {
    statusMsg.textContent = msg;
    statusMsg.className = "status error";
  };

  const showSuccess = msg => {
    statusMsg.textContent = msg;
    statusMsg.className = "status ok";
  };

  async function loadStates() {
    const res = await fetch(BASE + "/domain/states");
    const data = await res.json();
    stateSelect.innerHTML = '<option value="">Selecione um estado</option>';
    data.forEach(s => {
      const opt = document.createElement("option");
      opt.value = s.id;
      opt.textContent = s.name;
      stateSelect.appendChild(opt);
    });
  }

  async function loadCities(stateId) {
    const res = await fetch(BASE + "/domain/cities/" + stateId);
    const data = await res.json();
    citySelect.innerHTML = '<option value="">Selecione uma cidade</option>';
    data.forEach(c => {
      const opt = document.createElement("option");
      opt.value = c.id;
      opt.textContent = c.name;
      citySelect.appendChild(opt);
    });
  }

  stateSelect.addEventListener("change", () => {
    if (stateSelect.value) loadCities(stateSelect.value);
    citySelect.innerHTML = '<option value="">Selecione uma cidade</option>';
  });

  // URL params
  const params = new URLSearchParams(window.location.search);
  if (params.has("phone")) {
    document.getElementById("whatsapp").value =
      params.get("phone").replace(/\D/g, "");
  }
  if (params.has("code")) {
    referralCode = params.get("code");
  }

  submitBtn.addEventListener("click", async () => {
    const contactName = document.getElementById("contactName").value.trim();
    const whatsapp = document.getElementById("whatsapp").value.trim();

    if (!contactName) return showError("Informe seu nome.");
    if (!whatsapp) return showError("Informe seu WhatsApp.");
    if (!stateSelect.value) return showError("Selecione o estado.");
    if (!citySelect.value) return showError("Selecione a cidade.");

    const tracking = getTrackingFromStorage();

    const payload = {
        name: contactName,
        phone: whatsapp,
        stateId: stateSelect.value,
        cityId: citySelect.value,

        gclid: tracking.gclid,
        utmSource: tracking.utmSource,
        utmCampaign: tracking.utmCampaign,
        utmMedium: tracking.utmMedium,
        utmTerm: tracking.utmTerm,
        utmContent: tracking.utmContent
    };

    if (referralCode) payload.code = referralCode;

    submitBtn.disabled = true;
    submitBtn.textContent = "Iniciando...";
    showSuccess("Iniciando...");

    try {
        const res = await fetch(LEAD_URL, {
            method: "POST",
            headers: { "Content-Type": "application/json" },
            body: JSON.stringify(payload)
        });

        if (!res.ok) throw new Error();
        const data = await res.json();
        /* 🔥 AVISO AO GOOGLE ADS: LEAD REAL */
        window.dataLayer = window.dataLayer || [];
        window.dataLayer.push({
            event: "lead_submitted",
            lead_source: "customer_form",
            utm_campaign: tracking.utmCampaign,
            utm_source: tracking.utmSource,
            utm_medium: tracking.utmMedium
        });

        if (!data.phone) {
            throw new Error("Telefone não retornado pelo servidor.");
        }
        window.location.href = "https://vitalassisthomecare.com.br/whatsRedirect?phone=" + encodeURIComponent(data.phone);
    } catch {
      showError("Erro ao Iniciar conversa. Tente novamente.");
    } finally {
      submitBtn.disabled = false;
      submitBtn.textContent = "Iniciar conversa";
    }
  });

  loadStates();
});
</script>
</body>
</html>

Vital Assist - Home Care

We offer a new standard in care: we find, train, and empower the best caregivers, supported by a system that records all tasks in real time and generates transparent reports.

All to provide comfort, care, and safety for those receiving care—and peace of mind for those accompanying care.