“use client” import type React from “react” import { useState } from “react” import { useRouter } from “next/navigation” import { Button } from “@/components/ui/button” import { Input } from “@/components/ui/input” import { Label } from “@/components/ui/label” import { RadioGroup, RadioGroupItem } from “@/components/ui/radio-group” import { Select, SelectContent, SelectItem, SelectTrigger, SelectValue } from “@/components/ui/select” import { ArrowLeft, ArrowRight } from “lucide-react” import { Progress } from “@/components/ui/progress” export default function QuestionnairePage() { const router = useRouter() const [step, setStep] = useState(1) const [formData, setFormData] = useState({ fullName: “”, dateOfBirth: “”, phoneNumber: “”, email: “”, bestTimeToContact: “”, reasonForInsurance: “”, urgency: “”, }) const totalSteps = 7 const progress = (step / totalSteps) * 100 const handleInputChange = (e: React.ChangeEvent) => { const { name, value } = e.target setFormData((prev) => ({ …prev, [name]: value })) } const handleSelectChange = (name: string, value: string) => { setFormData((prev) => ({ …prev, [name]: value })) } const handleRadioChange = (name: string, value: string) => { setFormData((prev) => ({ …prev, [name]: value })) } const handleNext = () => { if (step < totalSteps) { setStep(step + 1) } else { // Submit form and navigate to results router.push("/results") } } const handleBack = () => { if (step > 1) { setStep(step – 1) } } return (
JRD Insurance Life Coverage
Step {step} of {totalSteps}
{step === 1 && (

What's your full name?

)} {step === 2 && (

What's your date of birth?

)} {step === 3 && (

What's your phone number?

We'll only call if necessary.

)} {step === 4 && (

What's your email address?

For your quote.

)} {step === 5 && (

When is the best time to contact you?

)} {step === 6 && (

Why are you looking for life insurance?

handleRadioChange(“reasonForInsurance”, value)} value={formData.reasonForInsurance} >
)} {step === 7 && (

How soon do you need coverage?

handleRadioChange(“urgency”, value)} value={formData.urgency}>
)}
) }