RHSummit2015AutoClaimFormsApp.json

{
  "createdBy": "[email protected]",
  "description": "",
  "name": "Maggies Auto Accident Claim Form",
  "updatedBy": "[email protected]",
  "subscribers": [
    "[email protected]"
  ],
  "pageRules": [],
  "fieldRules": [],
  "pages": [
    {
      "name": "Driver Info",
      "fields": [
        {
          "fieldCode": "PolicyHolderName",
          "fieldOptions": {
            "validation": {
              "validateImmediately": true
            }
          },
          "name": "Policy Holder Name",
          "required": true,
          "type": "text",
          "adminOnly": false,
          "repeating": false
        },
        {
          "fieldCode": "PolicyHolderEmail",
          "fieldOptions": {
            "validation": {
              "validateImmediately": true
            }
          },
          "name": "Policy Holder Email",
          "required": true,
          "type": "emailAddress",
          "adminOnly": false,
          "repeating": false
        },
        {
          "fieldCode": "PolicyHolderPhone",
          "fieldOptions": {
            "validation": {
              "validateImmediately": true
            }
          },
          "name": "Policy Holder Phone Number",
          "required": true,
          "type": "text",
          "adminOnly": false,
          "repeating": false
        },
        {
          "fieldCode": "DriversLicenseNumber",
          "fieldOptions": {
            "validation": {
              "validateImmediately": true
            }
          },
          "name": "Driver's License Number",
          "required": true,
          "type": "text",
          "adminOnly": false,
          "repeating": false
        },
        {
          "fieldCode": "PolicyNumber",
          "fieldOptions": {
            "validation": {
              "validateImmediately": true
            }
          },
          "name": "Auto Insurance Policy Number",
          "required": true,
          "type": "text",
          "adminOnly": false,
          "repeating": false
        }
      ]
    },
    {
      "name": "Vehicle Info",
      "fields": [
        {
          "fieldCode": "VehicleYear",
          "fieldOptions": {
            "validation": {
              "validateImmediately": true
            }
          },
          "name": "Vehicle Year",
          "required": true,
          "type": "text",
          "adminOnly": false,
          "repeating": false
        },
        {
          "fieldCode": "VehicleMake",
          "fieldOptions": {
            "validation": {
              "validateImmediately": true
            }
          },
          "name": "Vehicle Make",
          "required": true,
          "type": "text",
          "adminOnly": false,
          "repeating": false
        },
        {
          "fieldCode": "VehicleModel",
          "fieldOptions": {
            "validation": {
              "validateImmediately": true
            }
          },
          "name": "Vehicle Model",
          "required": true,
          "type": "text",
          "adminOnly": false,
          "repeating": false
        },
        {
          "fieldCode": "VehicleColor",
          "fieldOptions": {
            "validation": {
              "validateImmediately": true
            }
          },
          "name": "Vehicle Color",
          "required": true,
          "type": "text",
          "adminOnly": false,
          "repeating": false
        },
        {
          "fieldCode": "VehicleLicensePlate",
          "fieldOptions": {
            "validation": {
              "validateImmediately": true
            }
          },
          "name": "Vehicle Licence Plate",
          "required": true,
          "type": "text",
          "adminOnly": false,
          "repeating": false
        }
      ]
    },
    {
      "name": "Accident Info",
      "fields": [
        {
          "fieldCode": "AccidentDate",
          "fieldOptions": {
            "validation": {
              "validateImmediately": true
            },
            "definition": {
              "datetimeUnit": "datetime"
            }
          },
          "name": "Accident Date",
          "required": true,
          "type": "dateTime",
          "adminOnly": false,
          "repeating": false
        },
        {
          "fieldCode": "AccidentLocation",
          "fieldOptions": {
            "validation": {
              "validateImmediately": true
            },
            "definition": {
              "locationUnit": "latlong"
            }
          },
          "name": "Accident Location",
          "required": false,
          "type": "location",
          "adminOnly": false,
          "repeating": false
        },
        {
          "fieldCode": "AccidentDescription",
          "fieldOptions": {
            "validation": {
              "validateImmediately": true
            }
          },
          "helpText": "Enter a more detailed description on the accident, i.e. Hit a bunch of clowns running the red light.",
          "name": "Accident Description",
          "required": true,
          "type": "textarea",
          "adminOnly": false,
          "repeating": false
        }
      ]
    }
  ],
  "lastUpdated": "2015-06-18T04:04:10.825Z",
  "dateCreated": "2015-06-10T21:33:45.728Z",
  "status": "ok",
  "statusCode": 200
}