var field = new Array();

function fielditem(FieldName, Required, ValidationFunc,  ExtractFunc) 
{

	this.FieldName      = FieldName;
	this.Required       = Required;
//	this.ValidationFunc = ValidationFunc;
//	this.ExtactFunc     = ExtractFunc;

}

function InitData()
{
	var fi = 0;

//====== Requestor Contact Information

	field[fi++] = new fielditem("HWA1",  1); // First Name
	field[fi++] = new fielditem("HWA2",  1); // Last Name      
	field[fi++] = new fielditem("HWA3",  1); // Address1     
	field[fi++] = new fielditem("HWA4",  0); // Address2     
	field[fi++] = new fielditem("HWA5",  1); // City     
	field[fi++] = new fielditem("HWA6",  1); // State     
	field[fi++] = new fielditem("HWA7",  1); // Zip     
	field[fi++] = new fielditem("HWA8",  1); // Email     
	field[fi++] = new fielditem("HWA9",  1); // Phone     
	field[fi++] = new fielditem("HWA10", 0); // Cell     
	field[fi++] = new fielditem("HWA11", 0); // Fax     
	field[fi++] = new fielditem("HWA12", 1); // Consultation is for     

//======= Client Contact information	

	field[fi++] = new fielditem("HWB1",  0); // First Name
	field[fi++] = new fielditem("HWB2",  0); // Last Name     
	field[fi++] = new fielditem("HWB3",  0); // Address1
	field[fi++] = new fielditem("HWB4",  0); // Address2     
	field[fi++] = new fielditem("HWB5",  0); // City     
	field[fi++] = new fielditem("HWB6",  0); // State     
	field[fi++] = new fielditem("HWB7",  0); // Zip     
	field[fi++] = new fielditem("HWB8",  0); // Email     
	field[fi++] = new fielditem("HWB9",  0); // Phone     
	field[fi++] = new fielditem("HWB10", 0); // Cell     
	field[fi++] = new fielditem("HWB11", 0); // Fax     

//======= Client Information

	field[fi++] = new fielditem("HWC1",  0); // Month
	field[fi++] = new fielditem("HWC2",  0); // Day     
	field[fi++] = new fielditem("HWC3",  0); // Year     
	field[fi++] = new fielditem("HWC4",  0); // Height     
	field[fi++] = new fielditem("HWC5",  0); // Weight     
	field[fi++] = new fielditem("HWC6",  0); // Health Goals     
	field[fi++] = new fielditem("HWC7",  0); // Marital Status     
	field[fi++] = new fielditem("HWC8",  0); // Have Children     
	field[fi++] = new fielditem("HWC9",  0); //    How many     
	field[fi++] = new fielditem("HWC10", 0); //    Ages     

//======= Medical Information	

	field[fi++] = new fielditem("HWD1", 0); // Medical history
	field[fi++] = new fielditem("HWD2", 0); // Last see Physician     
	field[fi++] = new fielditem("HWD3", 0); // For what reason     
	field[fi++] = new fielditem("HWD4", 0); // Treated for     
	field[fi++] = new fielditem("HWD5", 0); // List medicines     
	field[fi++] = new fielditem("HWD6", 0); // List minerals, herb, etc.     

	field[fi++] = new fielditem("HWD7", 0); // []Indigestion
	field[fi++] = new fielditem("HWD8", 0); // []Gas
	field[fi++] = new fielditem("HWD9", 0); // []Bloating

	field[fi++] = new fielditem("HWD10", 0); // What foods cause indigestion
	field[fi++] = new fielditem("HWD11", 0); // Daily bowel movements     
	field[fi++] = new fielditem("HWD12", 0); // How often do you go     
	field[fi++] = new fielditem("HWD13", 0); // Suffer with diarrhea     
	field[fi++] = new fielditem("HWD14", 0); // Constipation     
	field[fi++] = new fielditem("HWD15", 0); // low energy or fatigue     

	field[fi++] = new fielditem("HWD16", 0); // []Alcoholism
	field[fi++] = new fielditem("HWD17", 0); // []Digestive disorders
	field[fi++] = new fielditem("HWD18", 0); // []Memory Lapses

	field[fi++] = new fielditem("HWD19", 0); // []Allergies
	field[fi++] = new fielditem("HWD20", 0); // []Eczema
	field[fi++] = new fielditem("HWD21", 0); // []Nervousness

	field[fi++] = new fielditem("HWD22", 0); // []Anemia
	field[fi++] = new fielditem("HWD23", 0); // []Emphysema
	field[fi++] = new fielditem("HWD24", 0); // []P.M.S.

	field[fi++] = new fielditem("HWD25", 0); // []Anxiety issues
	field[fi++] = new fielditem("HWD26", 0); // []Gallstones	
	field[fi++] = new fielditem("HWD27", 0); // []Respiratory problems

	field[fi++] = new fielditem("HWD28", 0); // []Appendicitis
	field[fi++] = new fielditem("HWD29", 0); // []Hay Fever
	field[fi++] = new fielditem("HWD30", 0); // []Stress

	field[fi++] = new fielditem("HWD31", 0); // []Arthritis
	field[fi++] = new fielditem("HWD32", 0); // []Headaches
	field[fi++] = new fielditem("HWD33", 0); // []Sinusitus

	field[fi++] = new fielditem("HWD34", 0); // []Asthma
	field[fi++] = new fielditem("HWD35", 0); // []Heart disease
	field[fi++] = new fielditem("HWD36", 0); // []Tuberculosis

	field[fi++] = new fielditem("HWD37", 0); // []Cancer
	field[fi++] = new fielditem("HWD38", 0); // []Inability to focus
	field[fi++] = new fielditem("HWD39", 0); // []Tumors

	field[fi++] = new fielditem("HWD40", 0); // []Chills
	field[fi++] = new fielditem("HWD41", 0); // []Kidney stones
	field[fi++] = new fielditem("HWD42", 0); // []Ulcers

	field[fi++] = new fielditem("HWD43", 0); // []Depression
	field[fi++] = new fielditem("HWD44", 0); // []Libido issues
	field[fi++] = new fielditem("HWD45", 0); // []Sexual disorders

	field[fi++] = new fielditem("HWD46", 0); // []Diabetes
	field[fi++] = new fielditem("HWD47", 0); // []mental disorders
	field[fi++] = new fielditem("HWD48", 0); // []HIV

	field[fi++] = new fielditem("HWD49", 0); // Explain ailments     
	field[fi++] = new fielditem("HWD51", 0); // List allergies     



//======= Eating Habits

	field[fi++] = new fielditem("HWE1",  0); // Snack before bedtime
	field[fi++] = new fielditem("HWE2",  0); // Midnight snack     
	field[fi++] = new fielditem("HWE3",  0); //     Eat what     
	field[fi++] = new fielditem("HWE4",  0); // Over Eat     
	field[fi++] = new fielditem("HWE5",  0); // Feel stuff     
	field[fi++] = new fielditem("HWE6",  0); // Eat between meals     
	field[fi++] = new fielditem("HWE7",  0); //     Explain     
	field[fi++] = new fielditem("HWE8",  0); // Drink with meals    
 

	field[fi++] = new fielditem("HWE10", 0); // Wear dentures     
	field[fi++] = new fielditem("HWE11", 0); // Eat fast     

	field[fi++] = new fielditem("HWE13", 0); // Peaceful when eating     
	field[fi++] = new fielditem("HWE14", 0); // following a diet     
	field[fi++] = new fielditem("HWE15", 0); // have set meal times     
	field[fi++] = new fielditem("HWE16", 0); //      Explain
	field[fi++] = new fielditem("HWE17", 0); // Eat animal products     

//======= Life Style
	
	field[fi++] = new fielditem("HWF1", 0); // Healh of spouse
	field[fi++] = new fielditem("HWF2", 0); // Hours of TV watching per week     
	field[fi++] = new fielditem("HWF3", 0); // Bed time     
	field[fi++] = new fielditem("HWF4", 0); // Wake up time     
	field[fi++] = new fielditem("HWF5", 0); // Feel rested?     
	field[fi++] = new fielditem("HWF6", 0); // How often exercise     
	field[fi++] = new fielditem("HWF7", 0); // Describe exercise     
	field[fi++] = new fielditem("HWF8", 0); // Feel after excercise     

//======= Tobacco Use
	
	field[fi++] = new fielditem("HWG1", 0); // Do you smoke
	field[fi++] = new fielditem("HWG2", 0); //    which
	field[fi++] = new fielditem("HWG3", 0); //    how may years
	field[fi++] = new fielditem("HWG4", 0); // Used in pass
	field[fi++] = new fielditem("HWG5", 0); //    how many year  
	field[fi++] = new fielditem("HWG6", 0); //    when stop  

//======= Alcohol Consumption

	field[fi++] = new fielditem("HWH1", 0); // drink alcohol
	field[fi++] = new fielditem("HWH2", 0); //     what kind
	field[fi++] = new fielditem("HWH3", 0); //     how many years 
	field[fi++] = new fielditem("HWH4", 0); // drink alcohol in past     
	field[fi++] = new fielditem("HWH5", 0); //     how many years 
	field[fi++] = new fielditem("HWH6", 0); //     when stop 

//======= Food

	field[fi++] = new fielditem("HWJ1",  0); // water amt per day

	field[fi++] = new fielditem("HWJ3",  0); // []Soda    
	field[fi++] = new fielditem("HWJ4",  0); //   bottle per day  
	field[fi++] = new fielditem("HWJ5",  0); // []Coffee     
	field[fi++] = new fielditem("HWJ6",  0); //   cups per day   
	field[fi++] = new fielditem("HWJ7",  0); // []Tea     
	field[fi++] = new fielditem("HWJ8",  0); //   cups per day  
	field[fi++] = new fielditem("HWJ9",  0); // []Fruit juice     
	field[fi++] = new fielditem("HWJ10", 0); //   type and amt per day  
	field[fi++] = new fielditem("HWJ11", 0); // []Beer     
	field[fi++] = new fielditem("HWJ12", 0); //   type and amt per day  
	field[fi++] = new fielditem("HWJ13", 0); // []Milk     
	field[fi++] = new fielditem("HWJ14", 0); //   amt per day   
	field[fi++] = new fielditem("HWJ15", 0); // []Other     
	field[fi++] = new fielditem("HWJ16", 0); //   type and mount per day   
	field[fi++] = new fielditem("HWJ17", 0); // Dairy products     
	field[fi++] = new fielditem("HWJ18", 0); // Eat desserts   


	field[fi++] = new fielditem("HWJ20", 0); // breakfast time     
	field[fi++] = new fielditem("HWJ21", 0); //   usual breakfast     
	field[fi++] = new fielditem("HWJ22", 0); // lunch time     
	field[fi++] = new fielditem("HWJ23", 0); //   usual lunch   
	field[fi++] = new fielditem("HWJ24", 0); // supper time     
	field[fi++] = new fielditem("HWJ25", 0); //   usual supper   

//======= Working
	
	field[fi++] = new fielditem("HWK1",  0); // Occupation
	field[fi++] = new fielditem("HWK2",  0); // Hours worked daily    
	field[fi++] = new fielditem("HWK3",  0); // Overwork
	field[fi++] = new fielditem("HWK4",  0); // worry a lot
	field[fi++] = new fielditem("HWK5",  0); // feel stressed
	field[fi++] = new fielditem("HWK6",  0); //    how often
	field[fi++] = new fielditem("HWK7",  0); // []Financial concerns
	field[fi++] = new fielditem("HWK8",  0); // []Job related
	field[fi++] = new fielditem("HWK9",  0); // []Getting along with people     
	field[fi++] = new fielditem("HWK10", 0); // []Family     
	field[fi++] = new fielditem("HWK11", 0); // []Not happy with self
	field[fi++] = new fielditem("HWK12", 0); // 1-10 scale    
	field[fi++] = new fielditem("HWK13", 0); // enjoy work you do     
	field[fi++] = new fielditem("HWK14", 0); //    explain     
	field[fi++] = new fielditem("HWK15", 0); // elaborate more

//======= Consulting Expectations

	field[fi++] = new fielditem("HWL1", 0); // Consulting Expectations

//======= Disclaimer

	field[fi++] = new fielditem("HWM1", 0); // Disclaimer

}

//=============================================================================
//=============================================================================
//=============================================================================

function LogData (item)
{
	var obj;

	obj = document.getElementById("testarea");
	obj.innerHTML += item + "<br>";
}

//=============================================================================

function GetRadio(obj)
{
	var value="";

	for (var i=0; i<obj.length; i++)
	{
		if(obj[i].checked)
		{
			return(obj[i].value);
		}
	}

	return(value);
}

//=============================================================================
function GetChecked(obj)
{
	var value="";

	for (var i=0; i<obj.length; i++)
	{
		if(obj[i].checked)
		{
			return("CHECKED");
		}
	}

	return(value);
}

//=============================================================================
function GetTextarea(obj)
{
	var pos      = 0;
	var startpos = 0;
	var string   = new String();
        var endpos   = obj[0].cols;
	
	string = obj[0].value;

	while ( pos != (-1) && (pos < string.length) )
	{	
		pos = string.indexOf("\r\n",startpos);
		if (pos < endpos)
		{
			startpos = pos + 2;
			endpos   = pos + 2 + obj[0].cols;
			continue;
		}
		pos = endpos - 1;
		string = string.substring(0,pos) + "\r\n" + string.substring(pos);		
		pos += 2;
		startpos = pos;
		endpos   = pos + obj[0].cols;
	}
	return(string);
}

//=============================================================================

var HWQhasData =  false;

function ShowCSOrder()
{
	var item = "";

	item += "<table border=1 style='border: ridge gold 6; background: white; ;'>"; 
	item += "<tr><td colspan=4 align=center><font size=+1>Your Order is</font></td></tr>";
	item += "<tr style='background-color: wheat;'><th  width=400>Item</th>";
	item += "<th>Unit Price</th><th>Qty</th><th>Total</th></tr>"; 
	item += "<tr><td nowrap><b>" + CSitem; 
	item += "</b></td><td align=right><b>" + num2money(CSuprice) ; 
	item += "</b></td><td align=center><b>" + CSquantity; 
	item += "</b></td><td align=right><b>" + num2money(CStprice); 
	item += "</b></td></tr></table>"; 

	obj = document.getElementById("CSorder");
	obj.innerHTML = item ;

	HWpage = true;

	window.onbeforeunload = LeavingSite;

}


//=============================================================================
var CSno;
var CSitem;
var CSuprice;
var CSquantity;
var CStprice;

var CSTableItem = 0;


function ProcessCS(TableItem)
{
	var obj;
	var item;


	CSTableItem = TableItem;

	switch(TableItem)
	{

		case 1:
			CSitem        = "";

			obj = document.getElementsByName("CSR1");
			item = GetRadio(obj);
			if (item.length == 0)
			{
				alert("You must select the male or female kit before we can process it.");
				return;
			}
			if ( item == "male")    CSitem = "Male Salvia test kit";
			if ( item == "female") CSitem = "Female Salvia test kit";

			CSno           = 1;
			CSuprice    =  275.00;
			CSquantity = 1;
			CStprice      =  275.00;

			LoadPageLocation("HWQuestionnaire.txt", "#MOHtop");
			break;

		case 2:
			CSno           = 2;
			CSitem        = "Initial in-person or Telephone Consultation";
			CSuprice    = 60.00;
			CSquantity = 1;
			CStprice      = 60.00;

			LoadPageLocation("HWQuestionnaire.txt", "#MOHtop");
			break;

		case 3:
			CSno           = 3;
			CSitem        = "Personalized Bodybuilding/Figure Competition Weight Lost  Program";
			CSuprice    = 100.00;
			CSquantity = 1;
			CStprice      = 100.00;

			LoadPageLocation("HWQuestionnaire.txt", "#MOHtop");
			break;

		case 4:
			break;
		case 5:
			break;

		case 6:
			CSno           = 6;
			CSitem        = "Individual Email Consultaion (1 email)";
			CSuprice    = 30.00;
			CSquantity = 1;
			CStprice      = 30.00;

			LoadPageLocation("HWQuestionnaire.txt", "#MOHtop");
			break;
		case 7:
			alert(" deleted ");
			break;

		case 8:
			break;

		case 9:
			alert(" gift certificate ");
			break;

		case 10:
			CSno           = 10;
			CSitem        = "Female Comprehensive Saliva test kit";
			CSuprice    = 350.00;
			CSquantity =  1;
			CStprice      = 350.00;

			LoadPageLocation("HWQuestionnaire.txt", "#MOHtop");
			break;


		default:
			break;
	}
	

}

//=============================================================================

function MissingHWdata()
{
	var results = false;
	var obj;
	for (i=0; i<field.length; i++)
	{
		if (field[i].Required)
		{

			obj = document.getElementsByName(field[i].FieldName);
			if (obj[0].value.trim().length == 0) 
			{
				//alert(field[i].FieldName);
				results = true;
			}
		}
	}

	if (results) alert ("You must fill out all the Required fields." );
	return results ;
}

//=============================================================================

function ProcessHW()
{
	var el;
	var item;
	var obj;
	var i;
	var param = ""; 
	var sep = "";



	if (field.length == 0) InitData();

	if ( (CSTableItem == 1) || (CSTableItem == 10) )
	{
		var Sstate = document.getElementById("HWB6");
		var Bstate = document.getElementById("HWA6");

		if ( (Sstate.value.length > 0) && (Sstate.value == "NY") )
		{
			alert("Sorry, we cannot sell or ship Sabre Saliva Test kits to the state of New York.");
			return false;
		}
		if ( (Bstate.value.length > 0) && (Bstate.value == "NY") )
		{
			alert("Sorry, we cannot sell or ship Sabre Saliva Test kits to the state of New York.");
			return false;
		}
	}


	obj = document.getElementsByName("HWM1"); 
	if (GetRadio(obj) != "YES")
	{
		alert("You must agree to the Disclaimer above the order form inorder for the Messenger of Health can process your request.");
		return false;
	}

	if ( MissingHWdata() ) return false;

	for (i=0; i<field.length; i++)
	{
		obj = document.getElementsByName(field[i].FieldName); 		
		if (obj[0] == null)
		{
			//LogData("-----UnknownXXX-----:" + field[i].FieldName);
			continue;
		}
		switch(obj[0].type)
		{

			case "text":
				//LogData(field[i].FieldName + " ==> text value: " + obj[0].value);
				param += sep + field[i].FieldName + "=" + encodeURI(obj[0].value);
				break;

			case "textarea":
				//LogData(field[i].FieldName + " ==> textarea value: " + obj[0].value);
				param += sep + field[i].FieldName + "=" + encodeURI(GetTextarea(obj));
				break;

			case "checkbox":
				//LogData(field[i].FieldName + " ==> checkbox value: " + obj[0].value);
				param += sep + field[i].FieldName + "=" + encodeURI(GetChecked(obj));
				break;

			case "select-one":
				//LogData(field[i].FieldName + " ==> select-one value: " + obj[0].value);
				param += sep + field[i].FieldName + "=" + encodeURI(obj[0].value);
				break;

			case "radio":
				//LogData(field[i].FieldName + " ==> radio value: " + obj[0].value);
				param += sep + field[i].FieldName + "=" + encodeURI(GetRadio(obj));
				break;

			default:
				//LogData("-----Unknown-----:" + field[i].FieldName + "value: " + obj[0].value);
				param += sep + field[i].FieldName + "=" + encodeURI(obj[0].value);
				break;
		}
		sep = "&";
	}

	param += sep + "CSno="            + encodeURI( CSno );
	param += sep + "CSitem="         + encodeURI( CSitem );
	param += sep + "CSuprice="     + encodeURI( num2money(CSuprice) );
	param += sep + "CSquantity="  + encodeURI( CSquantity );
	param += sep + "CStprice="       + encodeURI(  num2money(CStprice)  );



	var url;
	url = document.location.href;
	if (url.indexOf("localhost", 0) != (-1) ) 
	{
		GetServerData("http://messengerofhealth.com/HWEmail.php", param, StoreDataResults, "TEXT");
	}
	else
	{
		GetServerData("HWEmail.php", param, StoreDataResults, "TEXT");
	}	


	el = document.getElementById("HWform");

	item = document.createElement("input"); 
	item.type  = "hidden";
	item.name  = "item_name_1";
	item.value = CSitem;
	el.appendChild(item);

	item = document.createElement("input"); 
	item.type  = "hidden";
	item.name  = "amount_1";
	item.value = CSuprice;
	el.appendChild(item);

	item = document.createElement("input"); 
	item.type  = "hidden";
	item.name  = "quantity_1";
	item.value = CSquantity;
	el.appendChild(item);

	HWpage = false;

	if (OrderSubtotal == 0) window.onbeforeunload = null;

	return true;

}

//=============================================================================