document.write('<!--LP_FORM_START-->');
document.write('		<div class="c-wrap__inner">');
document.write('			<form method="post" name="sfm-form" id="sfm-form" action="//denki-mikata.com/apply/confirm.html">');
document.write('				<div class="p-form__inner">');
document.write('					<div class="input-area required-input">');
document.write('						<p><span class="required">必須</span> お名前</p>');
document.write('						<input class="text" type="text" name="name_s" id="name" size="30" placeholder="例）山田太郎" value="" required/>');
document.write('						<p class="ERR" ></p>');
document.write('					</div>');
document.write('					<div class="input-area required-input">');
document.write('						<p><span class="required">必須</span> 電話番号</p>');
document.write('						<input type="tel" name="tel_s" id="tel" placeholder="例）09012345678 ※ハイフン不要" value="" required/>');
document.write('						<p class="ERR" ></p>');
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document.write('					</div>');
document.write('					<div class="input-area">');
document.write('						<p><span class="not-required">任意</span>メールアドレス</p>');
document.write('						<input type="email" name="mail" id="email" placeholder="例）example@denki-mikata.com" class="half-width" value=""/>');
document.write('					</div>');
document.write('					<div class="input-area required-input">');
document.write('						<p><span class="not-required">任意</span> お問い合わせ内容</p>');
document.write('						<textarea type="text" rows="7" name="message" id="message" placeholder="お困りの内容や希望日時などをご記入ください"></textarea>');
document.write('					</div>');
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document.write('					<input type="hidden" name="subject" value="【電気のミカタ_夜間_Google_SP】お問い合わせフォーム" />');
document.write('					<!-- 注文番号の振り分け -->');
document.write('					<input type="hidden" name="orderid" id="orderid" value="20250523231844" />');
document.write('					<input type="hidden" name="action" value="conf" />');
document.write('					<input type="hidden" name="action" value="conf" />');
document.write('					<input class="button c-btn submit" id="btn_submit_top" type="submit" name="submit" value="無料お見積り依頼" onclick="window.onbeforeunload=null" />');
document.write('				</div>');
document.write('			</form>');
document.write('		</div>');
document.write('		<script>');
document.write('			document.getElementById(\'sfm-form\').addEventListener(\'submit\', function(){');
document.write('				sessionStorage.setItem(\'name\', document.getElementById(\'name\').value);');
document.write('				sessionStorage.setItem(\'tel\', document.getElementById(\'tel\').value);');
document.write('				sessionStorage.setItem(\'mail\', document.getElementById(\'email\').value);');
document.write('				sessionStorage.setItem(\'message\', document.getElementById(\'message\').value); }');
document.write('			);');
document.write('		</script>');
document.write('		');
document.write('<script>');
document.write('var lpQuery = location.search;');
document.write('var element = document.forms[0]; ');
document.write('element.action = element.getAttribute(\'action\')+lpQuery;');
document.write('</script>');