diff --git a/src/constants/error-messages.js b/src/constants/error-messages.js
index 6899c2aec..b5cbde3fa 100644
--- a/src/constants/error-messages.js
+++ b/src/constants/error-messages.js
@@ -44,6 +44,10 @@ const errorMessages = {
     DAMAGE_TYPES_REQUIRED: "How damage occurred is required",
     ZIP_CODE_REQUIRED: "Please enter your ZIP code",
     ZIP_CODE_FORMAT: "Zip must be 5 digits",
+    DATE_OF_BIRTH_REQUIRED: "Please enter your date of birth",
+    LOSS_TIME_REQUIRED: "Please enter your loss time",
+    LOSS_LOCATION_REQUIRED: "Please select your loss location",
+    SUBROGATION_REQUIRED: "Please make a selection",
 };
 
 export { errorMessages };
diff --git a/src/digital-components/date-picker-popup/date-picker-popup.vue b/src/digital-components/date-picker-popup/date-picker-popup.vue
index 7f3e109ac..ea24197bc 100644
--- a/src/digital-components/date-picker-popup/date-picker-popup.vue
+++ b/src/digital-components/date-picker-popup/date-picker-popup.vue
@@ -26,7 +26,8 @@
                 :min-date="minDate"
                 :max-date="maxDate"
                 :auto-apply="autoApply"
-                :text-input="textInput"
+                :text-input="resolvedTextInput"
+                :hide-input-icon="textInputOnly"
                 :prevent-min-max-navigation="preventMinMaxNavigation"
                 :teleport="true"
                 :aria-labels="{ input: questionText }"
@@ -107,6 +108,12 @@ export default {
             type: Boolean,
             default: false,
         },
+        // Force manual entry: text input enabled, calendar popup never opens
+        // and the calendar icon is hidden.
+        textInputOnly: {
+            type: Boolean,
+            default: false,
+        },
         preventMinMaxNavigation: {
             type: Boolean,
             default: false,
@@ -155,7 +162,7 @@ export default {
         questionText() {
             if (!this.cmsWidgetName) return "";
             const text = this.getCmsContent
-                ? this.getCmsContent(this.cmsWidgetName, "BodyText")
+                ? this.getCmsContent(this.cmsWidgetName, "QuestionText")
                 : "";
             return this.addOptionalText ? `${text} (optional)` : text;
         },
@@ -193,6 +200,15 @@ export default {
                 clearable: this.clearable,
             };
         },
+        // Forwarded to VueDatePicker's `text-input` prop. When `textInputOnly`
+        // is set, force text input on AND tell the picker never to open its
+        // menu (so focus/click on the input is a no-op visually).
+        resolvedTextInput() {
+            if (this.textInputOnly) {
+                return { enabled: true, openMenu: false };
+            }
+            return this.textInput;
+        },
     },
     methods: {
         onDateChange(newValue) {
diff --git a/src/layouts/policy-info/policy-info.vue b/src/layouts/policy-info/policy-info.vue
index bb860ee5e..f89e5db09 100644
--- a/src/layouts/policy-info/policy-info.vue
+++ b/src/layouts/policy-info/policy-info.vue
@@ -28,6 +28,40 @@
                         inputId="policyNumber"
                         validationRules="policy-number-required" />
 
+                    <datePickerPopup
+                        v-if="displayDateOfBirth"
+                        isRequired
+                        class="mb-4"
+                        cmsWidgetName="DateOfBirthWidget"
+                        v-model="dateOfBirth"
+                        customInputId="dateOfBirth"
+                        placeholderText="MM/DD/YYYY"
+                        validationRules="date-of-birth-required"
+                        format="MM/dd/yyyy"
+                        modelType="MM/dd/yyyy"
+                        :enableTimePicker="false"
+                        :textInputOnly="true"
+                        :maxDate="today"
+                        :preventMinMaxNavigation="true" />
+
+                    <textboxQuestion
+                        v-if="displayLastName"
+                        isRequired
+                        class="mb-4"
+                        cmsWidgetName="LastNameWidget"
+                        v-model="lastName"
+                        inputId="lastName"
+                        validationRules="last-name-required" />
+
+                    <textboxQuestion
+                        v-if="displayStreetAddress"
+                        isRequired
+                        class="mb-4"
+                        cmsWidgetName="StreetAddressWidget"
+                        v-model="streetAddress"
+                        inputId="streetAddress"
+                        validationRules="street-address-required" />
+
                     <textboxQuestion
                         isRequired
                         class="mb-4"
@@ -72,6 +106,18 @@
                         :maxDate="today"
                         :preventMinMaxNavigation="true" />
 
+                    <dropdownQuestion
+                        isRequired
+                        :questionText="timeOfLossQuestionText"
+                        class="mb-4"
+                        v-model="lossTime"
+                        cmsWidgetName="TimeOfLossWidget"
+                        customDropdownId="lossTime"
+                        :options="lossTimeOptions"
+                        :valueAsKey="true"
+                        validationRules="loss-time-required"
+                        :labelBold="true" />
+
                     <dropdownQuestion
                         isRequired
                         :questionText="damageTypesQuestionText"
@@ -84,7 +130,19 @@
                         validationRules="damage-types-required"
                         :labelBold="true" />
 
+                    <buttonQuestion
+                        v-if="displaySubrogation"
+                        :questionText="subrogationQuestionText"
+                        :answers="subrogationAnswers"
+                        class="mb-4"
+                        groupName="SubrogationQuestion"
+                        buttonTypeString="listButton"
+                        isRequired
+                        validationRules="subrogation-required"
+                        v-model="subrogationSelectedValue" />
+                    
                     <dropdownQuestion
+                        v-if="displayLossState"
                         class="mb-4"
                         customDropdownId="policyState"
                         cmsWidgetName="StateQuestionWidget"
@@ -96,7 +154,20 @@
                         placeHolderText="Select State"
                         :labelBold="true" />
 
+                    <dropdownQuestion
+                        v-if="displayLossLocation"
+                        :questionText="lossLocationQuestionText"
+                        class="mb-4"
+                        v-model="lossLocation"
+                        cmsWidgetName="LossLocationQuestionWidget"
+                        customDropdownId="lossLocation"
+                        :options="lossLocationOptions"
+                        :valueAsKey="true"
+                        validationRules="loss-location-required"
+                        :labelBold="true" />
+
                     <textboxQuestion
+                        v-if="displayLossCity"
                         isRequired
                         class="mb-4"
                         cmsWidgetName="CityWidget"
@@ -133,6 +204,7 @@ import textboxQuestion from "@/digital-components/textbox-question/textbox-quest
 import datePickerPopup from "@/digital-components/date-picker-popup/date-picker-popup";
 import dropdownQuestion from "@/digital-components/dropdown-question/dropdown-question";
 import morePolicyQuestions from "@/layouts/policy-info/more-policy-questions/more-policy-questions";
+import buttonQuestion from "@/digital-components/button-question/button-question";
 import { stateOptions } from "@/constants/state-options";
 import { Form, defineRule } from "vee-validate";
 import { required } from "@/helpers/validation-rules";
@@ -142,6 +214,7 @@ import { regex } from "@/helpers/validation-rules";
 import { fetchCmsContentForPage } from "@/helpers/cms-content-helper";
 import { settleAllPromises } from "@/helpers/layout-helper";
 import store from "@/store";
+import { debugLog } from "@/helpers/debug-log-helper";
 
 defineRule("policy-number-required", required(errorMessages.POLICY_NUMBER_REQUIRED));
 defineRule("zip-code-required", required(errorMessages.ZIP_REQUIRED));
@@ -151,6 +224,12 @@ defineRule("date-of-loss-required", required(errorMessages.DATE_OF_LOSS_REQUIRED
 defineRule("damage-types-required", required(errorMessages.DAMAGE_TYPES_REQUIRED));
 defineRule("state-required", required(errorMessages.STATE_REQUIRED));
 defineRule("city-required", required(errorMessages.CITY_REQUIRED));
+defineRule("date-of-birth-required", required(errorMessages.DATE_OF_BIRTH_REQUIRED));
+defineRule("last-name-required", required(errorMessages.LAST_NAME_REQUIRED));
+defineRule("street-address-required", required(errorMessages.STREET_ADDRESS_REQUIRED));
+defineRule("loss-time-required", required(errorMessages.LOSS_TIME_REQUIRED));
+defineRule("loss-location-required", required(errorMessages.LOSS_LOCATION_REQUIRED));
+defineRule("subrogation-required", required(errorMessages.SUBROGATION_REQUIRED));
 
 export default {
     name: "policy-info",
@@ -163,10 +242,16 @@ export default {
             phoneNumber: this.getPhoneNumberFromStore(),
             phoneExtension: this.getPhoneExtensionFromStore(),
             dateOfLoss: this.getDateOfLossFromStore(),
+            lastName: this.getLastNameFromStore(),
+            streetAddress: this.getStreetAddressFromStore(),
             damageCause: this.getDamageCauseFromStore(),
             policyState: this.getPolicyStateFromStore(),
             city: this.getCityFromStore(),
-            morePolicyQuestions: [],
+            dateOfBirth: this.getDateOfBirthFromStore(),
+            lossTime: this.getLossTimeFromStore(),
+            morePolicyQuestions: this.getMorePolicyQuestionsFromStore(),
+            subrogationSelectedValue: this.getSubrogationSelectedValueFromStore(),
+            lossLocation: this.getLossLocationFromStore(),
         };
     },
     components: {
@@ -179,6 +264,7 @@ export default {
         datePickerPopup,
         dropdownQuestion,
         morePolicyQuestions,
+        buttonQuestion,
     },
     computed: {
         stateOptions() {
@@ -206,6 +292,72 @@ export default {
 
             return options;
         },
+        lossTimeOptions() {
+            const options = {};
+
+            const answers = this.getCmsContent("TimeOfLossWidget", "Answers");
+            for (const answer of answers) {
+                options[answer.Name] = answer.Text;
+            }
+
+            return options;
+        },
+        timeOfLossQuestionText() {
+            return this.getCmsContent("TimeOfLossWidget", "QuestionText");
+        },
+        lossLocationOptions() {
+            const options = {};
+
+            const answers = this.getCmsContent("LossLocationQuestionWidget", "Answers");
+            for (const answer of answers) {
+                options[answer.Name] = answer.Text;
+            }
+            
+            return options;
+        },
+        parsedClientConfig() {
+            const raw = this.clientConfig?.ConfigWidget?.Text;
+            if (!raw) return {};
+            try {
+                return JSON.parse(raw);
+            } catch (err) {
+                console.warn("Failed to parse clientConfig.ConfigWidget.Text", err);
+                return {};
+            }
+        },
+        displayLossState() {
+            return this.parsedClientConfig.displayLossState ?? false;
+        },
+        displayLossCity() {
+            return this.parsedClientConfig.displayLossCity ?? false;
+        },
+        displayLossLocation() {
+            return this.parsedClientConfig.displayLossLocation ?? false;
+        },
+        displaySubrogation() {
+            return this.parsedClientConfig.displaySubrogation ?? false;
+        },
+        displayStreetAddress() {
+            return this.parsedClientConfig.displayStreetAddress ?? false;
+        },
+        displayDateOfBirth() {
+            return this.parsedClientConfig.displayDateOfBirth ?? false;
+        },
+        displayLastName() {
+            return this.parsedClientConfig.displayLastName ?? false;
+        },
+        displayLossTime() {
+            return this.parsedClientConfig.displayLossTime ?? false;
+        },
+        subrogationQuestionText() {
+            return this.getCmsContent("SubrogationQuestionWidget", "QuestionText");
+        },
+        subrogationAnswers() {
+            return this.getCmsContent("SubrogationQuestionWidget", "Answers");
+        },
+        lossLocationQuestionText() {
+            return this.getCmsContent("LossLocationQuestionWidget", "QuestionText");
+        },
     },
     // Ensure CMS content is fetched during route navigation without depending on `to`/`from`
     async beforeRouteEnter(to, from, next) {
@@ -228,6 +380,7 @@ export default {
         next((vm) => {
             vm.setCmsContent(resultMap.cmsContent);
             vm.clientConfig = resultMap.clientConfig;
+            debugLog(`clientConfig::${clientConfigPageName}`, JSON.stringify(vm.clientConfig));
         });
     },
 
@@ -256,6 +409,27 @@ export default {
         getCityFromStore() {
             return store.getters.order.policy.city;
         },
+        getDateOfBirthFromStore() {
+            return store.getters.order.policy.dateOfBirth;
+        },
+        getLastNameFromStore() {
+            return store.getters.order.policy.lastName;
+        },
+        getStreetAddressFromStore() {
+            return store.getters.order.policy.streetAddress;
+        },
+        getLossTimeFromStore() {
+            return store.getters.order.policy.lossTime;
+        },
+        getSubrogationSelectedValueFromStore() {
+            return store.getters.order.policy.subrogation;
+        },
+        getMorePolicyQuestionsFromStore() {
+            return store.getters.order.policy.morePolicyQuestions ?? [];
+        },
+        getLossLocationFromStore() {
+            return store.getters.order.policy.lossLocation;
+        },
         backButtonAction() {
             this.$router.navigateWithoutSaving(
                 this.navigationScenarios.CLICKED_BACK,
@@ -273,6 +447,12 @@ export default {
                     state: this.policyState,
                     city: this.city,
                     morePolicyQuestions: this.morePolicyQuestions,
+                    lossLocation: this.lossLocation,
+                    lossTime: this.lossTime,
+                    lastName: this.lastName,
+                    dateOfBirth: this.dateOfBirth,
+                    subrogation: this.subrogationSelectedValue,
+                    streetAddress: this.streetAddress,
                 },
                 false
             );
diff --git a/src/store/index.js b/src/store/index.js
index a794d702d..9f06b76cc 100644
--- a/src/store/index.js
+++ b/src/store/index.js
@@ -182,6 +182,11 @@ const getDefaultState = () => {
                 city: null,
                 state: null,
                 zipCode: null,
+                dateOfBirth: null,
+                lossTime: null,
+                lossLocation: null,
+                lastName: null,
+                subrogation: null,
             },
             schedule: {
                 date: null,
@@ -559,6 +564,12 @@ export const mutations = {
             state.order.policy.phoneNumber = insuranceDetails.phoneNumber;
             state.order.policy.phoneExtension = insuranceDetails.phoneExtension;
             state.order.policy.morePolicyQuestions = insuranceDetails.morePolicyQuestions;
+            state.order.policy.dateOfBirth = insuranceDetails.dateOfBirth;
+            state.order.policy.lossTime = insuranceDetails.lossTime;
+            state.order.policy.lastName = insuranceDetails.lastName;
+            state.order.policy.lossLocation = insuranceDetails.lossLocation;
+            state.order.policy.subrogation = insuranceDetails.subrogation;
+            state.order.policy.streetAddress = insuranceDetails.streetAddress;
         }
     },
     updateDamageDetails(state, damageDetails) {