[{"command":"settings","settings":{"pluralDelimiter":"\u0003","suppressDeprecationErrors":true,"ajaxPageState":{"libraries":"eJxLzEtJzU0qqoxPLi0uyc_Vz03NK8kvis_NT0nMAQCmrAt9","theme":"andembry","theme_token":null},"ajaxTrustedUrl":{"form_action_p_pvdeGsVG5zNF_XLGPTvYSKCf43t8qZYSwcfZl2uzM":true},"user":{"uid":0,"permissionsHash":"9eb9b9a5ebe679bcddcffecbf7fc36fad448d9587004f74b7ed975ed54dbf41d"}},"merge":true},{"command":"add_css","data":[{"rel":"stylesheet","media":"all","href":"\/core\/assets\/vendor\/jquery.ui\/themes\/base\/core.css?tmg1lg"},{"rel":"stylesheet","media":"all","href":"\/core\/assets\/vendor\/jquery.ui\/themes\/base\/controlgroup.css?tmg1lg"},{"rel":"stylesheet","media":"all","href":"\/core\/assets\/vendor\/jquery.ui\/themes\/base\/checkboxradio.css?tmg1lg"},{"rel":"stylesheet","media":"all","href":"\/core\/assets\/vendor\/jquery.ui\/themes\/base\/resizable.css?tmg1lg"},{"rel":"stylesheet","media":"all","href":"\/core\/assets\/vendor\/jquery.ui\/themes\/base\/button.css?tmg1lg"},{"rel":"stylesheet","media":"all","href":"\/core\/assets\/vendor\/jquery.ui\/themes\/base\/dialog.css?tmg1lg"},{"rel":"stylesheet","media":"all","href":"\/core\/themes\/stable9\/css\/core\/components\/progress.module.css?tmg1lg"},{"rel":"stylesheet","media":"all","href":"\/core\/themes\/stable9\/css\/core\/components\/ajax-progress.module.css?tmg1lg"},{"rel":"stylesheet","media":"all","href":"\/core\/modules\/ckeditor5\/css\/ckeditor5.dialog.fix.css?tmg1lg"},{"rel":"stylesheet","media":"all","href":"\/core\/assets\/vendor\/jquery.ui\/themes\/base\/theme.css?tmg1lg"},{"rel":"stylesheet","media":"all","href":"\/modules\/custom\/andembry_custom\/css\/mentor-modal.css?tmg1lg"},{"rel":"stylesheet","media":"all","href":"\/themes\/contrib\/bootstrap5\/css\/components\/progress.css?tmg1lg"},{"rel":"stylesheet","media":"all","href":"\/themes\/contrib\/bootstrap5\/css\/components\/dialog.css?tmg1lg"}]},{"command":"add_js","selector":"body","data":[{"src":"\/core\/assets\/vendor\/jquery\/jquery.min.js?v=4.0.0"},{"src":"\/core\/assets\/vendor\/once\/once.min.js?v=1.0.1"},{"src":"\/core\/misc\/drupalSettingsLoader.js?v=11.4.8"},{"src":"\/core\/misc\/drupal.js?v=11.4.8"},{"src":"\/core\/misc\/drupal.init.js?v=11.4.8"},{"src":"\/core\/misc\/debounce.js?v=11.4.8"},{"src":"\/core\/assets\/vendor\/jquery.ui\/ui\/version-min.js?v=11.4.8"},{"src":"\/core\/assets\/vendor\/jquery.ui\/ui\/data-min.js?v=11.4.8"},{"src":"\/core\/assets\/vendor\/jquery.ui\/ui\/disable-selection-min.js?v=11.4.8"},{"src":"\/core\/assets\/vendor\/jquery.ui\/ui\/jquery-patch-min.js?v=11.4.8"},{"src":"\/core\/assets\/vendor\/jquery.ui\/ui\/scroll-parent-min.js?v=11.4.8"},{"src":"\/core\/assets\/vendor\/jquery.ui\/ui\/unique-id-min.js?v=11.4.8"},{"src":"\/core\/assets\/vendor\/jquery.ui\/ui\/focusable-min.js?v=11.4.8"},{"src":"\/core\/assets\/vendor\/jquery.ui\/ui\/keycode-min.js?v=11.4.8"},{"src":"\/core\/assets\/vendor\/jquery.ui\/ui\/plugin-min.js?v=11.4.8"},{"src":"\/core\/assets\/vendor\/jquery.ui\/ui\/widget-min.js?v=11.4.8"},{"src":"\/core\/assets\/vendor\/jquery.ui\/ui\/labels-min.js?v=11.4.8"},{"src":"\/core\/assets\/vendor\/jquery.ui\/ui\/widgets\/controlgroup-min.js?v=11.4.8"},{"src":"\/core\/assets\/vendor\/jquery.ui\/ui\/form-reset-mixin-min.js?v=11.4.8"},{"src":"\/core\/assets\/vendor\/jquery.ui\/ui\/widgets\/mouse-min.js?v=11.4.8"},{"src":"\/core\/assets\/vendor\/jquery.ui\/ui\/widgets\/checkboxradio-min.js?v=11.4.8"},{"src":"\/core\/assets\/vendor\/jquery.ui\/ui\/widgets\/draggable-min.js?v=11.4.8"},{"src":"\/core\/assets\/vendor\/jquery.ui\/ui\/widgets\/resizable-min.js?v=11.4.8"},{"src":"\/core\/assets\/vendor\/jquery.ui\/ui\/widgets\/button-min.js?v=11.4.8"},{"src":"\/core\/assets\/vendor\/jquery.ui\/ui\/widgets\/dialog-min.js?v=11.4.8"},{"src":"\/core\/assets\/vendor\/tabbable\/index.umd.min.js?v=6.3.0"},{"src":"\/core\/assets\/vendor\/tua-body-scroll-lock\/tua-bsl.umd.min.js?v=11.4.8"},{"src":"\/core\/misc\/progress.js?v=11.4.8"},{"src":"\/core\/assets\/vendor\/loadjs\/loadjs.min.js?v=4.3.0"},{"src":"\/core\/misc\/announce.js?v=11.4.8"},{"src":"\/core\/misc\/message.js?v=11.4.8"},{"src":"\/core\/misc\/ajax.js?v=11.4.8"},{"src":"\/core\/misc\/displace.js?v=11.4.8"},{"src":"\/core\/misc\/position.js?v=11.4.8"},{"src":"\/core\/misc\/dialog\/dialog-deprecation.js?v=11.4.8"},{"src":"\/core\/misc\/dialog\/dialog.js?v=11.4.8"},{"src":"\/core\/misc\/dialog\/dialog.position.js?v=11.4.8"},{"src":"\/core\/misc\/dialog\/dialog.jquery-ui.js?v=11.4.8"},{"src":"\/core\/modules\/ckeditor5\/js\/ckeditor5.dialog.fix.js?v=11.4.8"},{"src":"\/core\/misc\/dialog\/dialog.ajax.js?v=11.4.8"},{"src":"\/modules\/custom\/andembry_custom\/js\/patient-mentor-modal.js?tmg1lg"}]},{"command":"openDialog","selector":"#drupal-modal","settings":null,"data":"\u003Cdiv id=\u0022patient-mentor-ajax-wrapper\u0022\u003E\u003Cform class=\u0022andembry_form patient_mentor_capture\u0022 id=\u0022patient_mentor_capture_form\u0022 data-drupal-selector=\u0022patient-mentor-capture\u0022 action=\u0022\/resources\/andembry-connect\/patient-mentor-modal\u0022 method=\u0022post\u0022 accept-charset=\u0022UTF-8\u0022\u003E\n  \n        \u003Cp\u003E\n          The ANDEMBRY Mentor Program is available for patients or caregivers to\n          connect with others who have personal experience with hereditary angioedema (HAE)\n          and ANDEMBRY\u00ae (garadacimab-gxii).\n        \u003C\/p\u003E\n        \u003Cp\u003E\n          Please enter the following information, which will be used as part of the\n          verification process for enrollment.\n        \u003C\/p\u003E\n  \u003Cinput id=\u0022invName\u0022 data-drupal-selector=\u0022edit-invname\u0022 type=\u0022hidden\u0022 name=\u0022invName\u0022 value=\u0022\u0022 \/\u003E\n\n\u003Cdiv class=\u0022name-wrapper\u0022\u003E\u003Cdiv class=\u0022field-wrapper\u0022 id=\u0022fname-wrapper\u0022\u003E\n\u003Cdiv class=\u0022js-form-item form-item js-form-type-textfield form-type-textfield js-form-item-firstname form-item-firstname\u0022\u003E\n      \u003Clabel for=\u0022edit-firstname\u0022 class=\u0022js-form-required form-required\u0022\u003EFirst Name \u003Cspan class=\u0022req\u0022\u003E(Required)\u003C\/span\u003E\u003C\/label\u003E\n          \n  \u003Cinput id=\u0022first_name\u0022 class=\u0022form-group form-text required form-control\u0022 data-drupal-selector=\u0022edit-firstname\u0022 type=\u0022text\u0022 name=\u0022firstName\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022128\u0022 required=\u0022required\u0022 \/\u003E\n\n\n        \u003C\/div\u003E\n\u003Cdiv id=\u0022fname-error\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022field-wrapper\u0022 id=\u0022lname-wrapper\u0022\u003E\n\u003Cdiv class=\u0022js-form-item form-item js-form-type-textfield form-type-textfield js-form-item-lastname form-item-lastname\u0022\u003E\n      \u003Clabel for=\u0022edit-lastname\u0022 class=\u0022js-form-required form-required\u0022\u003ELast Name \u003Cspan class=\u0022req\u0022\u003E(Required)\u003C\/span\u003E\u003C\/label\u003E\n          \n  \u003Cinput id=\u0022last_name\u0022 class=\u0022form-group form-text required form-control\u0022 data-drupal-selector=\u0022edit-lastname\u0022 type=\u0022text\u0022 name=\u0022lastName\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022128\u0022 required=\u0022required\u0022 \/\u003E\n\n\n        \u003C\/div\u003E\n\u003Cdiv id=\u0022lname-error\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022contact-wrapper\u0022\u003E\u003Cdiv class=\u0022field-wrapper\u0022 id=\u0022email-wrapper\u0022\u003E\n\u003Cdiv class=\u0022js-form-item form-item js-form-type-email form-type-email js-form-item-email form-item-email\u0022\u003E\n      \u003Clabel for=\u0022edit-email\u0022 class=\u0022js-form-required form-required\u0022\u003EEmail Address \u003Cspan class=\u0022req\u0022\u003E(Required)\u003C\/span\u003E\u003C\/label\u003E\n          \n  \u003Cinput id=\u0022email\u0022 class=\u0022form-group form-email required form-control\u0022 data-drupal-selector=\u0022edit-email\u0022 type=\u0022email\u0022 name=\u0022email\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022254\u0022 required=\u0022required\u0022 \/\u003E\n\n\n        \u003C\/div\u003E\n\u003Cdiv id=\u0022email-error\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022field-wrapper\u0022 id=\u0022phone-wrapper\u0022\u003E\n\u003Cdiv class=\u0022js-form-item form-item js-form-type-textfield form-type-textfield js-form-item-phonenumber form-item-phonenumber\u0022\u003E\n      \u003Clabel for=\u0022edit-phonenumber\u0022 class=\u0022js-form-required form-required\u0022\u003EPhone Number \u003Cspan class=\u0022req\u0022\u003E(Required)\u003C\/span\u003E\u003C\/label\u003E\n          \n  \u003Cinput id=\u0022phone_number\u0022 class=\u0022form-group form-text required form-control\u0022 data-drupal-selector=\u0022edit-phonenumber\u0022 type=\u0022text\u0022 name=\u0022phoneNumber\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022128\u0022 required=\u0022required\u0022 \/\u003E\n\n\n        \u003C\/div\u003E\n\u003Cdiv id=\u0022phone-error\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022field-wrapper\u0022 id=\u0022type-wrapper\u0022\u003E\u003Cdiv id=\u0022edit-type-of-person\u0022 class=\u0022form-radios\u0022\u003E\n\u003Cdiv class=\u0022form-check js-form-item form-item js-form-type-radio form-type-radio js-form-item-type-of-person form-item-type-of-person\u0022\u003E\n          \n  \u003Cinput id=\u0022patient\u0022 required data-drupal-selector=\u0022edit-type-of-person-patient\u0022 type=\u0022radio\u0022 name=\u0022type_of_person\u0022 value=\u0022patient\u0022 class=\u0022form-radio form-check-input\u0022 \/\u003E\n\n\n        \u003Clabel class=\u0022form-check-label option\u0022 for=\u0022edit-type-of-person-patient\u0022\u003EI\u0027m a person with HAE\u003C\/label\u003E\n      \u003C\/div\u003E\n\n\u003Cdiv class=\u0022form-check js-form-item form-item js-form-type-radio form-type-radio js-form-item-type-of-person form-item-type-of-person\u0022\u003E\n          \n  \u003Cinput id=\u0022caregiver\u0022 required data-drupal-selector=\u0022edit-type-of-person-caregiver\u0022 type=\u0022radio\u0022 name=\u0022type_of_person\u0022 value=\u0022caregiver\u0022 class=\u0022form-radio form-check-input\u0022 \/\u003E\n\n\n        \u003Clabel class=\u0022form-check-label option\u0022 for=\u0022edit-type-of-person-caregiver\u0022\u003EI\u0027m caring for someone with HAE\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003C\/div\u003E\n\u003Cdiv id=\u0022type-error\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv id=\u0022relationshipInput\u0022 style=\u0022display:none;\u0022 required data-drupal-selector=\u0022edit-relationship-wrapper\u0022 class=\u0022js-form-wrapper form-wrapper\u0022\u003E\n\u003Cdiv class=\u0022js-form-item form-item js-form-type-select form-type-select js-form-item-relationship form-item-relationship\u0022\u003E\n      \u003Clabel for=\u0022edit-relationship\u0022\u003ERelationship to Patient \u003Cspan class=\u0022req\u0022\u003E(Required)\u003C\/span\u003E\u003C\/label\u003E\n          \u003Cselect id=\u0022relationship\u0022 data-drupal-selector=\u0022edit-relationship\u0022 name=\u0022relationship\u0022 class=\u0022form-select\u0022\u003E\n            \u003Coption value=\u0022\u0022  selected=\u0022selected\u0022\u003ESelect One\u003C\/option\u003E\n                \u003Coption value=\u0022Child\u0022 \u003EChild\u003C\/option\u003E\n                \u003Coption value=\u0022Caregiver\u0022 \u003ECaregiver\u003C\/option\u003E\n                \u003Coption value=\u0022Parent\u0022 \u003EParent\u003C\/option\u003E\n                \u003Coption value=\u0022Spouse\u0022 \u003ESpouse\u003C\/option\u003E\n      \u003C\/select\u003E\n\n        \u003C\/div\u003E\n\u003Cdiv id=\u0022relationship-error\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003Cdiv class=\u0022field-wrapper\u0022 id=\u0022ageCheck-wrapper\u0022\u003E\n\u003Cdiv class=\u0022form-check js-form-item form-item js-form-type-checkbox form-type-checkbox js-form-item-agecheck form-item-agecheck\u0022\u003E\n          \n  \u003Cinput id=\u0022ageCheck\u0022 class=\u0022form-group form-checkbox required form-check-input\u0022 data-drupal-selector=\u0022edit-agecheck\u0022 type=\u0022checkbox\u0022 name=\u0022ageCheck\u0022 value=\u00221\u0022 required=\u0022required\u0022 \/\u003E\n\n\n        \u003Clabel class=\u0022form-check-label option js-form-required form-required\u0022 for=\u0022edit-agecheck\u0022\u003EI\u0027m 18 years of age or older \u003Cspan class=\u0027req\u0027\u003E(Required)\u003C\/span\u003E\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003Cdiv id=\u0022ageCheck-error\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Ch3\u003EPlease agree to the terms below.\u003C\/h3\u003E  \u003Cdiv class=\u0022form-legal\u0022\u003E\n    \u003Cp\u003E\n      CSL Behring respects your privacy. For an explanation of how CSL Behring will use\n      the information you are submitting, please view our Privacy Policy.\n      If you chose to provide information about your physician, CSL Behring will not contact\n      your physician regarding you or your treatment.\n    \u003C\/p\u003E\n\n    \u003Cp\u003E\n      By submitting this form, you are consenting to disclose any information provided,\n      including your name, email address, address, telephone number,\n      and any other information (collectively \u0022Personal Information\u0022) to\n      CSL Behring and its representatives, agents, and contractors, including\n      CSL Behring\u0027s support program(s) (collectively \u0022CSL Behring Entities\u0022) and\n      to receive communications with relevant information from CSL Behring Entities.\n      You may also receive relevant information, including marketing information, from\n      CSL Behring Entities by mail, email, telephone and\/or SMS\/text message in the future\n      to provide information or to offer enrollment in educational programs and programs\n      intended to benefit patients using or eligible to use CSL Behring therapies. You will\n      have the ability to opt out from receiving communications from CSL Behring Entities at\n      any time.\n    \u003C\/p\u003E\n  \u003C\/div\u003E\u003Cdiv class=\u0022field-wrapper\u0022 id=\u0022termsCheck-wrapper\u0022\u003E\n\u003Cdiv class=\u0022form-check js-form-item form-item js-form-type-checkbox form-type-checkbox js-form-item-termscheck form-item-termscheck\u0022\u003E\n          \n  \u003Cinput id=\u0022termsCheck\u0022 class=\u0022form-group form-checkbox required form-check-input\u0022 data-drupal-selector=\u0022edit-termscheck\u0022 type=\u0022checkbox\u0022 name=\u0022termsCheck\u0022 value=\u00221\u0022 required=\u0022required\u0022 \/\u003E\n\n\n        \u003Clabel class=\u0022form-check-label option js-form-required form-required\u0022 for=\u0022edit-termscheck\u0022\u003EBy checking this box, you are consenting to the above agreement.\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003Cdiv id=\u0022termsCheck-error\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022field-wrapper\u0022 id=\u0022privacyCheck-wrapper\u0022\u003E\n\u003Cdiv class=\u0022form-check js-form-item form-item js-form-type-checkbox form-type-checkbox js-form-item-privacycheck form-item-privacycheck\u0022\u003E\n          \n  \u003Cinput id=\u0022privacyCheck\u0022 class=\u0022form-group form-checkbox required form-check-input\u0022 data-drupal-selector=\u0022edit-privacycheck\u0022 type=\u0022checkbox\u0022 name=\u0022privacyCheck\u0022 value=\u00221\u0022 required=\u0022required\u0022 \/\u003E\n\n\n        \u003Clabel class=\u0022form-check-label option js-form-required form-required\u0022 for=\u0022edit-privacycheck\u0022\u003EI agree to the \u003Ca href=\u0022https:\/\/www.csl.com\/terms-of-use\u0022 target=\u0022_blank\u0022\u003ETerms of Use\u003C\/a\u003E and\n        \u003Ca href=\u0022https:\/\/privacy.csl.com\/\u0022 target=\u0022_blank\u0022\u003EPrivacy Policy\u003C\/a\u003E.\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003Cdiv id=\u0022privacyCheck-error\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\n    \u003Cinput class=\u0022mentor-submit button js-form-submit form-submit btn btn-secondary\u0022 data-drupal-selector=\u0022edit-submit\u0022 type=\u0022submit\u0022 id=\u0022edit-submit\u0022 name=\u0022op\u0022 value=\u0022SUBMIT\u0022 \/\u003E\n\n  \u003Cdiv class=\u0022form-legal\u0022\u003E\n    \u003Cp\u003EFor any questions about the ANDEMBRY Mentor program or to register by phone,\n      please call us at \u003Ca href=\u0022tel:18883831896\u0022\u003E1-888-383-1896\u003C\/a\u003E.\u003Cbr\u003E\n      If you would like to contact ANDEMBRY Connect\u003Csup\u003ESM\u003C\/sup\u003E, please call \n      \u003Ca href=\u0022tel:1-844-423-4273\u0022\u003E1-844-423-4273\u003C\/a\u003E Monday through Friday from 8:00 AM \n      to 8:00 PM ET.\n    \u003C\/p\u003E\n  \u003C\/div\u003E\n  \u003Cinput autocomplete=\u0022off\u0022 data-drupal-selector=\u0022form-jr3rottgc-yjgnejzrugu1nljyyd-ubeipdimnwp-80\u0022 type=\u0022hidden\u0022 name=\u0022form_build_id\u0022 value=\u0022form-jr3ROtTgc-YJgNejZrUgu1NLJyyD-UbEiPdiMNWP_80\u0022 \/\u003E\n\n\n  \u003Cinput data-drupal-selector=\u0022edit-patient-mentor-capture\u0022 type=\u0022hidden\u0022 name=\u0022form_id\u0022 value=\u0022patient_mentor_capture\u0022 \/\u003E\n\n\n\u003C\/form\u003E\n\u003C\/div\u003E","dialogOptions":{"width":"1200","modal":true,"closeOnEscape":true,"height":"auto","title":"Sign Up For The ANDEMBRY Mentor Program","classes":{"ui-dialog":"andembry-mentor-modal"}}}]