// Validations for Medical Quote Form

function checkMedicalFrm()
{
	var regxForName=/^[a-zA-Z-'.,& ]+[\sa-zA-Z-'.,& ]+$/;
	var regxForNameNum=/^[a-zA-Z0-9-'.,& ]+[\sa-zA-Z0-9-'.,& ]+$/;
	var regxForPName=/^[a-zA-Z-.']+[\sa-zA-Z-.']+$/;
	var regexForNumber=/^[0-9.]+$/;
	var regxForEMail=/^[_a-z0-9-]+(\.[_a-z0-9-]+)*@[a-z0-9-]+(\.[a-z0-9-]+)*(\.[a-z]{2,3})$/;
	var regexForRsNumber=/^[0-9.]+$/;
	var regxForspecialchar=/^[a-zA-Z!@$%*:;<>\?|'.,&#\/()-]+[\sa-zA-Z!@$%*:;<>\?|'.,&#\/()-]+$/;
	
	/*if(document.getElementById('physicianname').value=="")
	{
		alert('Please enter Physician Name.');
		document.getElementById('physicianname').focus();
		return false;
	}
	if(regxForPName.test(document.getElementById('physicianname').value)==false)
	{	
		alert('Please enter a valid Physician Name.');
		document.getElementById('physicianname').focus();
		return false
	}
	if(document.getElementById('partnershipname').value=="")
	{
		alert('Please enter Corporation/Partnership Name.');
		document.getElementById('partnershipname').focus();
		return false;
	}
	if(regxForName.test(document.getElementById('partnershipname').value)==false)
	{	
		alert('Please enter a valid Corporation/Partnership Name.');
		document.getElementById('partnershipname').focus();
		return false
	}*/
	if(document.getElementById('city').value!="")
	{
		if(regxForName.test(document.getElementById('city').value)==false)
		{	
			alert('Please enter a valid City.');
			document.getElementById('city').focus();
			return false
		}
	}
	if(document.getElementById('zip').value!="")
	{
		if(regxForspecialchar.test(document.getElementById('zip').value)==true)
			{	
				alert('Please enter valid zip code.');
				document.getElementById('zip').focus();
				return false
			}
	}
	if((document.getElementById('phone1').value=="")||(document.getElementById('phone2').value=="")||(document.getElementById('phone3').value==""))
			{
				alert('Please enter Phone Number.');
				document.getElementById('phone1').focus();
				return false
			}
	if((regexForNumber.test(document.getElementById('phone1').value)==false)||(regexForNumber.test(document.getElementById('phone2').value)==false)||(regexForNumber.test(document.getElementById('phone3').value)==false))
			{	
				alert('Please enter a valid Phone Number.');
				document.getElementById('phone1').focus();
				return false
			}
	if((document.getElementById('fax1').value!="")||(document.getElementById('fax2').value!="")||(document.getElementById('fax3').value!=""))
	{
	if((regexForNumber.test(document.getElementById('fax1').value)==false)||(regexForNumber.test(document.getElementById('fax2').value)==false)||(regexForNumber.test(document.getElementById('fax3').value)==false))
			{	
				alert('Please enter a valid Fax Number.');
				document.getElementById('fax1').focus();
				return false
			}
	}
	if(document.getElementById('email').value=="")
	{
		alert('Please enter Email Address.');
		document.getElementById('email').focus();
		return false
	}
	if(regxForEMail.test(document.getElementById('email').value)==false)
	{	
		alert('Please enter valid EMail Address.');
		document.getElementById('email').focus();
		return false
	}
	
	if((document.getElementById('dateofbirth1').value!="")||(document.getElementById('dateofbirth2').value!="")||(document.getElementById('dateofbirth3').value!=""))
	{
			if((regexForNumber.test(document.getElementById('dateofbirth1').value)==false)||(regexForNumber.test(document.getElementById('dateofbirth2').value)==false)||(regexForNumber.test(document.getElementById('dateofbirth3').value)==false))
			{	
				alert('Please enter valid Date of Birth.');
				document.getElementById('dateofbirth1').focus();
				return false
			}
if((document.getElementById('dateofbirth1').value<=0)||(document.getElementById('dateofbirth1').value>31))
			{
				alert('Please enter a valid Date of Birth between 1-31.');
				document.getElementById('dateofbirth1').focus();
				return false
			}
	if((document.getElementById('dateofbirth2').value<=0)||(document.getElementById('dateofbirth2').value>12))
			{
				alert('Please enter a valid Month of Birth between 1-12.');
				document.getElementById('dateofbirth2').focus();
				return false
			}
	if((document.getElementById('dateofbirth3').value<1900)||(document.getElementById('dateofbirth3').value>2200))
			{
				alert('Please enter a valid Year of Birth between 1900-2200.');
				document.getElementById('dateofbirth3').focus();
				return false
			}			
	}
	if(document.getElementById('licensenumber').value!="")
	{
		if(regxForNameNum.test(document.getElementById('licensenumber').value)==false)
		{	
			alert('Please enter a valid License Number.');
			document.getElementById('licensenumber').focus();
			return false
		}
	}
	if(document.getElementById('speciality').value!="")
	{
		if(regxForName.test(document.getElementById('speciality').value)==false)
		{	
			alert('Please enter a valid Speciality.');
			document.getElementById('speciality').focus();
			return false
		}
	}
	if(document.getElementById('boardcertificate').value!="")
	{
		if(regxForNameNum.test(document.getElementById('boardcertificate').value)==false)
		{	
			alert('Please enter a valid Board Certification.');
			document.getElementById('boardcertificate').focus();
			return false
		}
	}
	if((document.getElementById('reDate1').value!="")||(document.getElementById('reDate2').value!="")||(document.getElementById('reDate3').value!=""))
	{
			if((regexForNumber.test(document.getElementById('reDate1').value)==false)||(regexForNumber.test(document.getElementById('reDate2').value)==false)||(regexForNumber.test(document.getElementById('reDate3').value)==false))
			{	
				alert('Please enter valid Request Effective Date.');
				document.getElementById('reDate1').focus();
				return false
			}
if((document.getElementById('reDate1').value<=0)||(document.getElementById('reDate1').value>31))
			{
				alert('Please enter a valid Request Effective Date between 1-31.');
				document.getElementById('reDate1').focus();
				return false
			}
	if((document.getElementById('reDate2').value<=0)||(document.getElementById('reDate2').value>12))
			{
				alert('Please enter a valid Request Effective Month between 1-12.');
				document.getElementById('reDate2').focus();
				return false
			}
	if((document.getElementById('reDate3').value<1900)||(document.getElementById('reDate3').value>2200))
			{
				alert('Please enter a valid Request Effective Year between 1900-2200.');
				document.getElementById('reDate3').focus();
				return false
			}			
	}
	if(document.getElementById('liabilitylimit').value!="")
	{
		if(regxForName.test(document.getElementById('liabilitylimit').value)==false)
		{	
			alert('Please enter a valid Limits of Liability in Coverage Options.');
			document.getElementById('liabilitylimit').focus();
			return false
		}
	}
		
	if(document.getElementById('coveragetype3').checked==true)
	{
	
	if(document.getElementById('coveragetype3').value=="1")
	{
	if((document.getElementById('retroDate1').value=="")||(document.getElementById('retroDate2').value=="")||(document.getElementById('retroDate3').value==""))
	{
		alert('Please enter Retro Date.');
				document.getElementById('retroDate1').focus();
				return false
	}
			if((regexForNumber.test(document.getElementById('retroDate1').value)==false)||(regexForNumber.test(document.getElementById('retroDate2').value)==false)||(regexForNumber.test(document.getElementById('retroDate3').value)==false))
			{	
				alert('Please enter valid Retro Date.');
				document.getElementById('retroDate1').focus();
				return false
			}
if((document.getElementById('retroDate1').value<=0)||(document.getElementById('retroDate1').value>31))
			{
				alert('Please enter a valid Retro Date between 1-31.');
				document.getElementById('retroDate1').focus();
				return false
			}
	if((document.getElementById('retroDate2').value<=0)||(document.getElementById('retroDate2').value>12))
			{
				alert('Please enter a valid Retro Month between 1-12.');
				document.getElementById('retroDate2').focus();
				return false
			}
	if((document.getElementById('retroDate3').value<1900)||(document.getElementById('retroDate3').value>2200))
			{
				alert('Please enter a valid Retro Year between 1900-2200.');
				document.getElementById('retroDate3').focus();
				return false
			}			
	}
	}
	if(document.getElementById('parttime').checked==true)
	{
	if(document.getElementById('parttime').value=="1")
	{
		if(document.getElementById('hPweek').value=="")
		{	
			alert('Please enter Hrs. Per Week.');
			document.getElementById('hPweek').focus();
			return false
		}
		if(regexForRsNumber.test(document.getElementById('hPweek').value)==false)
		{	
			alert('Please enter valid Hrs. Per Week.');
			document.getElementById('hPweek').focus();
			return false
		}
	}
	}
	if((document.getElementById('iDate1').value!="")||(document.getElementById('iDate2').value!="")||(document.getElementById('iDate3').value!=""))
	{
			if((regexForNumber.test(document.getElementById('iDate1').value)==false)||(regexForNumber.test(document.getElementById('iDate2').value)==false)||(regexForNumber.test(document.getElementById('iDate3').value)==false))
			{	
				alert('Please enter valid Incident Date.');
				document.getElementById('iDate1').focus();
				return false
			}
if((document.getElementById('iDate1').value<=0)||(document.getElementById('iDate1').value>31))
			{
				alert('Please enter a valid Incident Date between 1-31.');
				document.getElementById('iDate1').focus();
				return false
			}
	if((document.getElementById('iDate2').value<=0)||(document.getElementById('iDate2').value>12))
			{
				alert('Please enter a valid Incident Month between 1-12.');
				document.getElementById('iDate2').focus();
				return false
			}
	if((document.getElementById('iDate3').value<1900)||(document.getElementById('iDate3').value>2200))
			{
				alert('Please enter a valid Incident Year between 1900-2200.');
				document.getElementById('iDate3').focus();
				return false
			}			
	}
	if((document.getElementById('rDate1').value!="")||(document.getElementById('rDate2').value!="")||(document.getElementById('rDate3').value!=""))
	{
			if((regexForNumber.test(document.getElementById('rDate1').value)==false)||(regexForNumber.test(document.getElementById('rDate2').value)==false)||(regexForNumber.test(document.getElementById('rDate3').value)==false))
			{	
				alert('Please enter valid Report Date.');
				document.getElementById('rDate1').focus();
				return false
			}
if((document.getElementById('rDate1').value<=0)||(document.getElementById('rDate1').value>31))
			{
				alert('Please enter a valid Report Date between 1-31.');
				document.getElementById('rDate1').focus();
				return false
			}
	if((document.getElementById('rDate2').value<=0)||(document.getElementById('rDate2').value>12))
			{
				alert('Please enter a valid Report Month between 1-12.');
				document.getElementById('rDate2').focus();
				return false
			}
	if((document.getElementById('rDate3').value<1900)||(document.getElementById('rDate3').value>2200))
			{
				alert('Please enter a valid Report Year between 1900-2200.');
				document.getElementById('rDate3').focus();
				return false
			}			
	}
	if((document.getElementById('cDate1').value!="")||(document.getElementById('cDate2').value!="")||(document.getElementById('cDate3').value!=""))
	{
			if((regexForNumber.test(document.getElementById('cDate1').value)==false)||(regexForNumber.test(document.getElementById('cDate2').value)==false)||(regexForNumber.test(document.getElementById('cDate3').value)==false))
			{	
				alert('Please enter valid Closed Date.');
				document.getElementById('cDate1').focus();
				return false
			}
if((document.getElementById('cDate1').value<=0)||(document.getElementById('cDate1').value>31))
			{
				alert('Please enter a valid Closed Date between 1-31.');
				document.getElementById('cDate1').focus();
				return false
			}
	if((document.getElementById('cDate2').value<=0)||(document.getElementById('cDate2').value>12))
			{
				alert('Please enter a valid Closed Month between 1-12.');
				document.getElementById('cDate2').focus();
				return false
			}
	if((document.getElementById('cDate3').value<1900)||(document.getElementById('cDate3').value>2200))
			{
				alert('Please enter a valid Closed Year between 1900-2200.');
				document.getElementById('cDate3').focus();
				return false
			}			
	}
	if(document.getElementById('amountPaid1').value!="")
	{
		if(regexForRsNumber.test(document.getElementById('amountPaid1').value)==false)
		{	
			alert('Please enter a valid Amount.');
			document.getElementById('amountPaid1').focus();
			return false
		}
	}
	if(document.getElementById('insuranceComp').value!="")
	{
		if(regxForNameNum.test(document.getElementById('insuranceComp').value)==false)
		{	
			alert('Please enter a valid Insurance Company.');
			document.getElementById('insuranceComp').focus();
			return false
		}
	}
	if((document.getElementById('expirationDate1').value!="")||(document.getElementById('expirationDate2').value!="")||(document.getElementById('expirationDate3').value!=""))
	{
			if((regexForNumber.test(document.getElementById('expirationDate1').value)==false)||(regexForNumber.test(document.getElementById('expirationDate2').value)==false)||(regexForNumber.test(document.getElementById('expirationDate3').value)==false))
			{	
				alert('Please enter valid Expiration Date.');
				document.getElementById('expirationDate1').focus();
				return false
			}
if((document.getElementById('expirationDate1').value<=0)||(document.getElementById('expirationDate1').value>31))
			{
				alert('Please enter a valid Expiration Date between 1-31.');
				document.getElementById('expirationDate1').focus();
				return false
			}
	if((document.getElementById('expirationDate2').value<=0)||(document.getElementById('expirationDate2').value>12))
			{
				alert('Please enter a valid Expiration Month between 1-12.');
				document.getElementById('expirationDate2').focus();
				return false
			}
	if((document.getElementById('expirationDate3').value<1900)||(document.getElementById('expirationDate3').value>2200))
			{
				alert('Please enter a valid Expiration Year between 1900-2200.');
				document.getElementById('expirationDate3').focus();
				return false
			}			
	}
	if(document.getElementById('insurancelimit').value!="")
	{
		if(regxForName.test(document.getElementById('insurancelimit').value)==false)
		{	
			alert('Please enter a valid Limits of Liability in Current Insurance Company.');
			document.getElementById('insurancelimit').focus();
			return false
		}
	}
	if(document.getElementById('currentpremium').value!="")
	{
		if(regexForRsNumber.test(document.getElementById('currentpremium').value)==false)
		{	
			alert('Please enter a valid Current Premium.');
			document.getElementById('currentpremium').focus();
			return false
		}
	}
	//return true;
	document.frm_medical_quote.submit();
	
}

function Show()
{
		window.location="index.php";
}
function ShowPartTime(id)
{
		var obj=document.getElementById('divPartTime');
		if(id==1)
		{
			obj.style.display="none";
		}
		else if(id==2)
		{
			obj.style.display="";
		}
}

function checkDate(id)
{
	if(id==1)
	{
		var dt=document.getElementById('dateofbirth1').value;
	}
	else if(id==2)
	{
		var dt=document.getElementById('reDate1').value;
	}
	else if(id==3)
	{
		var dt=document.getElementById('retroDate1').value;
	}
	else if(id==4)
	{
		var dt=document.getElementById('iDate1').value;
	}
	else if(id==5)
	{
		var dt=document.getElementById('rDate1').value;
	}
	else if(id==6)
	{
		var dt=document.getElementById('cDate1').value;
	}
	else if(id==7)
	{
		var dt=document.getElementById('expirationDate1').value;
	}
	if((dt<0)||(dt>31))
	{
		alert('Please enter a valid Date between 1-31');
	}
}
function checkMonth(id)
{
	if(id==1)
	{
		var dt=document.getElementById('dateofbirth2').value
	}
	else if(id==2)
	{
		var dt=document.getElementById('reDate2').value
	}
	else if(id==3)
	{
		var dt=document.getElementById('retroDate2').value
	}
	else if(id==4)
	{
		var dt=document.getElementById('iDate2').value;
	}
	else if(id==5)
	{
		var dt=document.getElementById('rDate2').value;
	}
	else if(id==6)
	{
		var dt=document.getElementById('cDate2').value;
	}
	else if(id==7)
	{
		var dt=document.getElementById('expirationDate2').value;
	}
	if((dt<0)||(dt>12))
	{
		alert('Please enter a valid Month between 1-12')
	}
}
function checkYear(id)
{
	if(id==1)
	{
		var dt=document.getElementById('dateofbirth3').value
	}
	else if(id==2)
	{
		var dt=document.getElementById('reDate3').value
	}
	else if(id==3)
	{
		var dt=document.getElementById('retroDate3').value
	}
	else if(id==4)
	{
		var dt=document.getElementById('iDate3').value;
	}
	else if(id==5)
	{
		var dt=document.getElementById('rDate3').value;
	}
	else if(id==6)
	{
		var dt=document.getElementById('cDate3').value;
	}
	else if(id==7)
	{
		var dt=document.getElementById('expirationDate3').value;
	}
	if((parseInt(dt)<1900)||(parseInt(dt)>2200))
	{
		//alert(dt);
		
		alert('Please enter a valid Year between 1900-2200')
	}
	
 	
}