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Form Capture /
Household Repeater
Household Repeater
Allows applicants to add, edit, and remove household members as part of a
benefits application. Each member includes name, date of birth,
relationship, and optional SSN information.
Usage Notes
When to use
Use this pattern when an application requires information about people
living in the same household. Common in benefits, healthcare, and social
services applications where eligibility depends on household composition.
Accessibility considerations
Each add, edit, and remove action is announced via a live region.
The remove action requires confirmation through a modal dialog.
Focus is managed to move users to the form when adding or editing,
and back to the list when cancelling. All form fields use proper
labels and required indicators.
NYSDS components used
nys-textinput, nys-select,
nys-button, nys-modal
Customization points
Agencies can adjust the maximum number of household members, modify the
list of relationship options, add or remove fields (e.g., gender,
citizenship status), and customize validation rules. The repeater
component is generic and can be configured for any list of structured
items.