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>Parceria Vital Assist</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{min-width:70%; max-width:900px; margin:0 auto; padding: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}
    label{font-size:15px; font-weight:500; margin-bottom:6px; display:block;}
    input, 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);
    }
    input:focus, select:focus, textarea:focus{
      border-color:var(--accent-2);
      box-shadow:0 0 0 3px var(--ring);
    }
    .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;
    }
    .option-buttons button.selected{
      background:var(--accent-2);
      color:#fff;
      border-color:var(--accent);
    }
    .btn{
      width:100%; padding:16px; font-size:16px; font-weight:700;
      border:0; border-radius:12px; cursor:pointer;
      color:#fff;
      background:linear-gradient(135deg, var(--accent), var(--accent-2));
    }
    .status{margin-top:12px;font-weight:600;text-align:center;}
    .status.error{color:var(--danger);}
    .status.ok{color:var(--ok);}
    .info-text{
      font-size:14px;
      color:var(--muted);
      line-height:1.5;
    }
  </style>
</head>

<body>
<main>
     <div style="padding-bottom: 30px; color: white;">
      <h1>Formulário de cadastro</h1>
      <div>Por favor preencha o formulario abaixo.</div>
    </div>

  
  <div class="card">
    <h2>Identificação Básica</h2>

    <label>Nome completo</label>
    <input id="name" type="text" placeholder="Seu nome completo" />

    <label>Telefone / WhatsApp</label>
    <input id="phone" type="tel" placeholder="DDD + número" />

    <label>E-mail</label>
    <input id="email" type="email" placeholder="email@exemplo.com" />

    <label>Estado</label>
    <select id="stateSelect">
      <option value="">Selecione um estado</option>
    </select>

    <label>Cidade</label>
    <select id="citySelect">
      <option value="">Selecione uma cidade</option>
    </select>
  </div>

  
  <div class="card">
    <h2>Perfil Profissional</h2>

    <label>Formação principal</label>
    <select id="education">
      <option value="">Selecione</option>
      <option value="1">Enfermagem</option>
      <option value="2">Fisioterapia</option>
      <option value="3">Medicina</option>
      <option value="4">Psicologia</option>
      <option value="5">Serviço Social</option>
      <option value="6">Administração / Gestão</option>
      <option value="99">Outra</option>
    </select>

    <label>Atuação atual</label>
    <input id="currentJobRole" type="text"
      placeholder="Ex.: enfermeiro autônomo, clínica, hospital..." />

    <label>Você já atuou com cuidados domiciliares?</label>
    <div class="option-buttons" data-key="homeCare">
      <button data-value="1">Sim</button>
      <button data-value="0">Não</button>
    </div>
  </div>

  
  <div class="card">
    <h2>Perfil Empreendedor</h2>

    <label>Você já gerenciou pessoas?</label>
    <div class="option-buttons" data-key="peopleManagement">
      <button data-value="1">Sim</button>
      <button data-value="0">Não</button>
    </div>

    <label>Você se considera uma pessoa com perfil empreendedor?</label>
    <div class="option-buttons" data-key="entrepreneurProfile">
      <button data-value="1">Sim</button>
      <button data-value="0">Não</button>
    </div>

    <label>Qual o seu interesse em atuar como gestor(a) da Vital Assist?</label>
    <textarea id="interest" rows="3"
      placeholder="Ex.: abrir operação local, complementar renda..."></textarea>
  </div>

  
  <div class="card">
    <h2>Disponibilidade e Visão</h2>

    <label>Tempo semanal disponível</label>
    <div class="option-buttons" data-key="availability">
      <button data-value="1">5h</button>
      <button data-value="2">10–20h</button>
      <button data-value="4">Integral</button>
    </div>

    <label>Você possui CNPJ ou teria interesse?</label>
    <div class="option-buttons" data-key="cnpj">
      <button data-value="2">Já possuo</button>
      <button data-value="1">Posso abrir</button>
    </div>
  </div>

  
  <div class="card">
    <p class="info-text">
      A Vital Assist entrará em contato para uma conversa inicial de alinhamento.
      O preenchimento deste formulário não garante aprovação ou parceria.
    </p>
  </div>

  <button class="btn" id="submit">Quero conversar sobre a parceria</button>
  <div class="status" id="status"></div>

</main>

<script>
const BASE = "https://api.vitalassisthomecare.com.br/lifeassist/v1";
const stateSelect = document.getElementById("stateSelect");
const citySelect = document.getElementById("citySelect");
const statusEl = document.getElementById("status");

const nameInput = document.getElementById("name");
const phoneInput = document.getElementById("phone");
const emailInput = document.getElementById("email");
const educationSelect = document.getElementById("education");
const currentJobRoleInput = document.getElementById("currentJobRole");
const interestTextarea = document.getElementById("interest");
const submitBtn = document.getElementById("submit");

document.querySelectorAll(".option-buttons").forEach(group => {
  group.querySelectorAll("button").forEach(btn => {
    btn.addEventListener("click", () => {
      group.querySelectorAll("button").forEach(b => b.classList.remove("selected"));
      btn.classList.add("selected");
    });
  });
});

const selectedValue = key => {
  const el = document.querySelector(`[data-key="${key}"] .selected`);
  return el ? parseInt(el.dataset.value, 10) : null;
};

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

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 o = document.createElement("option");
    o.value = c.id; o.textContent = c.name;
    citySelect.appendChild(o);
  });
}

stateSelect.addEventListener("change", () => {
  if (stateSelect.value) loadCities(stateSelect.value);
});

function showError(msg) {
  statusEl.textContent = msg;
  statusEl.className = "status error";
  window.scrollTo({ top: 0, behavior: "smooth" });
}

document.getElementById("submit").addEventListener("click", async () => {
  const payload = {
    name: nameInput.value.trim(),
    phone: phoneInput.value.replace(/\D/g, ""),
    email: emailInput.value.trim(),
    stateId: stateSelect.value,
    cityId: citySelect.value,
    education: educationSelect.value
      ? parseInt(educationSelect.value, 10)
      : null,
    currentJobRole: currentJobRoleInput.value.trim(),
    homeCareExperience: selectedValue("homeCare"),
    peopleManagement: selectedValue("peopleManagement"),
    entrepreneurProfile: selectedValue("entrepreneurProfile"),
    interest: interestTextarea.value.trim(),
    availability: selectedValue("availability"),
    cnpj: selectedValue("cnpj")
  };

    if (!payload.name) return showError("Informe seu nome.");
    if (!payload.phone) return showError("Informe seu telefone.");
    if (!payload.stateId) return showError("Selecione o estado.");
    if (!payload.cityId) return showError("Selecione a cidade.");

  if (payload.homeCareExperience === null) {
    return showError("Informe se já atuou com cuidados domiciliares.");
  }

  submitBtn.disabled = true;
  submitBtn.textContent = "Enviando...";
  try {
    const res = await fetch(BASE + "/sales/partners", {
      method: "POST",
      headers: { "Content-Type": "application/json" },
      body: JSON.stringify(payload)
    });

    if (!res.ok) throw new Error();

    window.location.href =
      "https://vitalassisthomecare.com.br/menagers/menager-form-completed";

  } catch {
    submitBtn.disabled = false;
    submitBtn.textContent = "Quero conversar sobre a parceria";
    showError("Não foi possível enviar agora. Tente novamente.");
  }
});

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.