1jQuery(document).ready(function() { 2 $("#providers").on('change', function() { 3 var jsondata = this.value; 4 if (jsondata != "") { 5 var objJson = JSON.parse(jsondata); 6 $("#drfirstName").val(objJson.first_name); 7 $("#drlastName").val(objJson.last_name); 8 $("#practiceName").val(objJson.provider_name); 9 $("#drAddress").val(objJson.address_1); 10 $("#drCity").val(objJson.city); 11 $("#drState").val(objJson.state); 12 $("#drState").select2().trigger('change'); 13 $("#drZip").val(objJson.zip); 14 $("#drPhone").val(objJson.phone_number); 15 $("#drFax").val(objJson.fax_number); 16 $("#drNpi").val(objJson.physician_npi); 17 $("#drZip").mask("99999"); 18 $("#drPhone").mask("999-999-9999"); 19 $("#drFax").mask("999-999-9999"); 20 } else { 21 $('.doctor_form_patient').trigger("reset"); 22 } 23 }); 24 25 $('.plus').click(function(event) { 26 $('.search-box').css('display', 'block'); 27 $('.plus').css('display', 'none'); 28 $('.close-search').css('display', 'block'); 29 $('.search-title').addClass('active-search'); 30 }); 31 $('.close-search').click(function(event) { 32 $('.search-box').css('display', 'none'); 33 $('.plus').css('display', 'block'); 34 $('.close-search').css('display', 'none'); 35 $('.search-title').removeClass('active-search'); 36 }); 37 38 $('#chooseFile').bind('change', function() { 39 var filename = $("#chooseFile").val(); 40 if (/^\s*$/.test(filename)) { 41 $(".file-upload").removeClass('active'); 42 $("#noFile").text("No file chosen"); 43 } else { 44 $(".file-upload").addClass('active'); 45 $("#noFile").text(filename.replace("C:\\fakepath\\", "")); 46 } 47 }); 48 49 jQuery('input[name="pcontact-email"]').change(function() { 50 if (jQuery(this).is(':checked')) 51 jQuery('p.email-address').removeClass('hide'); 52 else 53 jQuery('p.email-address').addClass('hide'); 54 }); 55 56 jQuery('.form-validate-eft').submit(function(event) { 57 var errorField2 = '<div class="inner">Please complete or correct the fields marked in red and click Continue.</div>'; 58 jQuery('.prompt-error').remove(); 59 var fields = jQuery('p.field.required-field.text', this); 60 61 var valid = true; 62 fields.each(function(index) { 63 var obj = jQuery(this); 64 obj.removeClass("red"); 65 66 var errorField = '<span class="prompt-error error">This field is required.</span>'; 67 68 if (obj.hasClass('ignore') && obj.hasClass('hide')) 69 return; 70 71 var inputVal = jQuery('input', obj).val(); 72 if (inputVal != '') 73 return; 74 obj.addClass("red"); 75 obj.append(errorField); 76 valid = false; 77 }); 78 var dropdowns = jQuery('.required-field.dropdown'); 79 dropdowns.each(function(index) { 80 var obj = jQuery(this); 81 obj.removeClass("red"); 82 var select = jQuery('select :selected', obj).val(); 83 if (select !== '') 84 return; 85 var errorField3 = '<span class="prompt-error error">Please select account type.</span>'; 86 obj.addClass("red"); 87 obj.append(errorField3); 88 89 valid = false; 90 }); 91 var b1 = jQuery('#bank1').val(); 92 var b2 = jQuery('#bank2').val(); 93 if (b1 != b2) { 94 var obj = jQuery('p.confirm-bank'); 95 var errorField4 = '<span class="prompt-error error">Confirm Bank ABA routing number must match Bank ABA routing number.</span>'; 96 obj.addClass("red"); 97 obj.append(errorField4); 98 99 valid = false; 100 } 101 102 var a1 = jQuery('#account1').val(); 103 var a2 = jQuery('#account2').val(); 104 if (a1 != a2) { 105 var obj = jQuery('p.confirm-number'); 106 var errorField5 = '<span class="prompt-error error">Confirm Account Number must match Account Number.</span>'; 107 obj.addClass("red"); 108 obj.append(errorField5); 109 110 valid = false; 111 } 112 113 var radios = jQuery('.required-field.radio'); 114 var errorFieldradio = '<span class="prompt-error error">This field is required.</span>'; 115 radios.each(function(index) { 116 117 var obj = jQuery(this); 118
119 var checked = jQuery('input:checked', obj); 120 121 122 if (checked.length > 0) 123 return; 124 125 jQuery('p.error', obj).append(errorFieldradio); 126 valid = false; 127 }); 128 129 130 if (valid == false) jQuery('.error-form').html(errorField2); 131 132 if (!valid) 133 event.preventDefault(); 134 }); 135 jQuery('.patient_form').submit(function(event) { 136 137 var errorField = '<div class="inner">Please complete or correct the fields marked in red and click Continue. </div>'; 138 var emailRegex = /^([a-zA-Z0-9_.+-])+\@(([a-zA-Z0-9-])+\.)+([a-zA-Z0-9]{2,4})+$/; 139 140 var fields = jQuery('p.field.required-field', this); 141 142 var valid = true; 143 144 captcha = $('#captcha'); 145 if (grecaptcha.getResponse() == '') { 146 valid = false;; 147 148 $(captcha).css({ 149 "border": "2px solid #e30000", 150 }); 151 // $(captcha).after(errorCaptcha); 152 } else { 153 $(captcha).css({ 154 "border": "", 155 }); 156 $(captcha).after(""); 157 } 158 159 var st = $("#state").val(); 160 161 if ($("#state").val() === "") { 162 $("#state").after(''); 163 $(".state .select2-selection").css({ 164 "border": "2px solid #e30000", 165 }); 166 valid = false; 167 } else { 168 $(".state .select2-selection").css({ 169 "border": "", 170 }); 171 } 172 173 if ($("#pmc").val() === "") 174 { 175 $("#pmc").after(''); 176 $(".pmc .select2-selection").css({ 177 "border": "2px solid #e30000", 178 }); 179 valid = false; 180 } else 181 { 182 $(".pmc .select2-selection").css({ 183 "border": "", 184 }); 185 } 186 187 if ($("#code").val() === "") { 188 $("#code").after(''); 189 $(".select-code .select2-selection").css({ 190 "border": "2px solid #e30000", 191 }); 192 valid = false; 193 } else { 194 $(".select-code .select2-selection").css({ 195 "border": "", 196 }); 197 } 198 199 if ($("input[name='enrolled_by']:checked").val() == 'PATIENT') { 200 if ($("#indication").val() === "") { 201 $("#indication").after(''); 202 $(".indication .select2-selection").css({ 203 "border": "2px solid #e30000", 204 }); 205 valid = false; 206 } else { 207 $(".indication .select2-selection").css({ 208 "border": "", 209 }); 210 } 211 } 212 213 214 215 216 if ($("#d1").val() === "") { 217 $("#d1").after(''); 218 $(".date-1 .select2-selection").css({ 219 "border": "2px solid #e30000", 220 }); 221 valid = false; 222 } else { 223 $(".date-1 .select2-selection").css({ 224 "border": "", 225 }); 226 } 227 if ($("#d2").val() === "") { 228 $("#d2").after(''); 229 $(".date-2 .select2-selection").css({ 230 "border": "2px solid #e30000", 231 }); 232 valid = false; 233 } else { 234 $(".date-2 .select2-selection").css({ 235 "border": "", 236 }); 237 } 238 if ($("#d3").val() === "") { 239 $("#d3").after(''); 240 $(".date-3 .select2-selection").css({ 241 "border": "2px solid #e30000", 242 }); 243 valid = false; 244 } else { 245 $(".date-3 .select2-selection").css({ 246 "border": "", 247 }); 248 } 249 250 if (!$("input[name='gender']:checked").val()) { 251 $('input[name="gender"] + label span', this).css({ 252 "border": "2px solid #e30000", 253 }); 254 255 valid = false; 256 } else { 257 $('input[name="gender"] + label span', this).css({ 258 "border": "2px solid #c5c5c5", 259 }); 260 } 261 262 if (!$("input[name='enrolled_by']:checked").val()) { 263 $('input[name="enrolled_by"] + label span', this).css({ 264 "border": "2px solid #e30000", 265 }); 266 267 valid = false; 268 } else { 269 $('input[name="enrolled_by"] + label span', this).css({ 270 "border": "2px solid #c5c5c5", 271 }); 272 } 273 274 if (!$("input[name='prescription_insurance_type']:checked").val()) { 275 $('input[name="prescription_insurance_type"] + label span', this).css({ 276 "border": "2px solid #e30000", 277 }); 278 279 valid = false; 280 } else { 281 $('input[name="prescription_insurance_type"] + label span', this).css({ 282 "border": "2px solid #c5c5c5", 283 }); 284 285 if ($("input[name='prescription_insurance_type']:checked").val() == 'PrescriptionInsurance') { 286 if ($("#prescription_insurance_name").val() === "") { 287 288 $("#prescription_insurance_name").after(''); 289 $("#prescription_insurance_name").css({ 290 "border": "2px solid #e30000", 291 }); 292 valid = false; 293 } else { 294 $("#prescription_insurance_name").css({ 295 "border": "", 296 }); 297 } 298 299 if ($("#prescription_bin").val() === "") { 300 301 $("#prescription_bin").after(''); 302 $("#prescription_bin").css({ 303 "border": "2px solid #e30000", 304 }); 305 valid = false; 306 } else { 307 $("#prescription_bin").css({ 308 "border": "", 309 }); 310 } 311 312 if ($("#prescription_group_number").val() === "" && $("#prescription_pcn").val() === "") { 313 314 $("#prescription_group_number").after(''); 315 $("#prescription_group_number").css({ 316 "border": "2px solid #e30000", 317 }); 318 $("#prescription_pcn").after(''); 319 $("#prescription_pcn").css({ 320 "border": "2px solid #e30000", 321 }); 322 valid = false; 323 } else { 324 $("#prescription_pcn").next('img').remove(); 325 $("#prescription_group_number").next('img').remove(); 326 $("#prescription_pcn").css({ 327 "border": "", 328 }); 329 $("#prescription_group_number").css({ 330 "border": "", 331 }); 332 } 333 } else { 334 if ($("#medical_insurance_name").val() === "") { 335 336 $("#medical_insurance_name").after(''); 337 $("#medical_insurance_name").css({ 338 "border": "2px solid #e30000", 339 }); 340 valid = false; 341 } else { 342 $("#medical_insurance_name").css({ 343 "border": "", 344 }); 345 } 346 347 if ($("#medical_insurance_member_id").val() === "") { 348 349 $("#medical_insurance_member_id").after(''); 350 $("#medical_insurance_member_id").css({ 351 "border": "2px solid #e30000", 352 }); 353 valid = false; 354 } else { 355 $("#medical_insurance_member_id").css({ 356 "border": "", 357 }); 358 } 359 } 360 } 361 362 if ($("#d1").val() !== "" && $("#d2").val() !== "" && $("#d3").val() !== "") { 363 const birthDate = $("#d1").val() + "/" + $("#d2").val() + "/" + $("#d3").val(); 364 365 var currentDate = new Date(); 366 var date = new Date(birthDate); 367 368 //check future dates 369 if (date > currentDate) { 370 $("#d1").after(''); 371 $(".date-1 .select2-selection").css({ 372 "border": "2px solid #e30000", 373 }); 374 $("#d2").after(''); 375 $(".date-2 .select2-selection").css({ 376 "border": "2px solid #e30000", 377 }); 378 $("#d3").after(''); 379 $(".date-3 .select2-selection").css({ 380 "border": "2px solid #e30000", 381 }); 382 valid = false; 383 } else { 384 $(".date-1 .select2-selection").css({ 385 "border": "", 386 }); 387 $(".date-2 .select2-selection").css({ 388 "border": "", 389 }); 390 $(".date-3 .select2-selection").css({ 391 "border": "", 392 }); 393 } 394 395 const patAge = Math.floor((new Date() - new Date(birthDate).getTime()) / 3.15576e+10); 396 397 if (patAge < 18) { 398 //cg_first_name 399 if ($("#cg_first_name").val() === "") { 400 $("#cg_first_name").after(''); 401 $("#cg_first_name").css({ 402 "border": "2px solid #e30000", 403 }); 404 valid = false; 405 } else { 406 $("#cg_first_name").css({ 407 "border": "", 408 }); 409 } 410 //cg_last_name 411 if ($("#cg_last_name").val() === "") { 412 $("#cg_last_name").after(''); 413 $("#cg_last_name").css({ 414 "border": "2px solid #e30000", 415 }); 416 valid = false; 417 } else { 418 $("#cg_last_name").css({ 419 "border": "", 420 }); 421 } 422 423 //address 424 if ($("#cg_address").val() === "") { 425 $("#cg_address").after(''); 426 $("#cg_address").css({ 427 "border": "2px solid #e30000", 428 }); 429 valid = false; 430 } else { 431 $("#cg_address").css({ 432 "border": "", 433 }); 434 } 435 //city 436 if ($("#cg_city").val() === "") { 437 $("#cg_city").after(''); 438 $("#cg_city").css({ 439 "border": "2px solid #e30000", 440 }); 441 valid = false; 442 } else { 443 $("#cg_city").css({ 444 "border": "", 445 }); 446 } 447 //state 448 if ($("#cg_state").val() === "") { 449 $("#cg_state").after(''); 450 $(".cgstate .select2-selection").css({ 451 "border": "2px solid #e30000", 452 }); 453 valid = false; 454 } else { 455 $(".cgstate .select2-selection").css({ 456 "border": "", 457 }); 458 } 459 //zip 460 if ($("#cg_zip").val() === "") { 461 $("#cg_zip").css({ 462 "border": "2px solid #e30000", 463 }); 464 valid = false; 465 } else { 466 $("#cg_zip").css({ 467 "border": "", 468 }); 469 } 470 //date day month 471 472 if ($("#cg_d1").val() === "") { 473 $("#cg_d1").after(''); 474 $(".cgdate-1 .select2-selection").css({ 475 "border": "2px solid #e30000", 476 }); 477 valid = false; 478 } else { 479 $(".cgdate-1 .select2-selection").css({ 480 "border": "", 481 }); 482 } 483 if ($("#cg_d1").val() === "") { 484 $("#cg_d1").after(''); 485 $(".cgdate-2 .select2-selection").css({ 486 "border": "2px solid #e30000", 487 }); 488 valid = false; 489 } else { 490 $(".cgdate-2 .select2-selection").css({ 491 "border": "", 492 }); 493 } 494 if ($("#cg_d1").val() === "") { 495 $("#cg_d1").after(''); 496 $(".cgdate-3 .select2-selection").css({ 497 "border": "2px solid #e30000", 498 }); 499 valid = false; 500 } else { 501 $(".cgdate-3 .select2-selection").css({ 502 "border": "", 503 }); 504 } 505 506 //cd dob validation 507 if ($("#cg_d1").val() !== "" && $("#cg_d2").val() !== "" && $("#cg_d1").val() !== "") { 508 const cgBirthDate = $("#cg_d1").val() + "/" + $("#cg_d2").val() + "/" + $("#cg_d3").val(); 509 const cgAge = Math.floor((new Date() - new Date(cgBirthDate).getTime()) / 3.15576e+10); 510 511 var cgCurrentDate = new Date(); 512 var cdDate = new Date(cgBirthDate); 513 //check future dates 514 515 if (cgAge < 18 || cdDate > cgCurrentDate) { 516 $("#cg_d1").after(''); 517 $(".cgdate-1 .select2-selection").css({ 518 "border": "2px solid #e30000", 519 }); 520 521 $("#cg_d2").after(''); 522 $(".cgdate-2 .select2-selection").css({ 523 "border": "2px solid #e30000", 524 }); 525 526 $("#cg_d3").after(''); 527 $(".cgdate-3 .select2-selection").css({ 528 "border": "2px solid #e30000", 529 }); 530 531 valid = false; 532 } else { 533 $(".cgdate-1 .select2-selection").css({ 534 "border": "", 535 }); 536 537 $(".cgdate-1 .select2-selection").css({ 538 "border": "", 539 }); 540 541 $(".cgdate-3 .select2-selection").css({ 542 "border": "", 543 }); 544 } 545 546 547 } 548 549 } 550 551 } 552 553 var email = $("#email_address").val(); 554 555 if (!emailRegex.test(email)) { 556 $("#email_address").after(''); 557 $("#email_address").css({ 558 "border": "2px solid #e30000", 559 }); 560 valid = false; 561 } else { 562 $("#email_address").css({ 563 "border": "", 564 }); 565 } 566 567 $('p.required-field input[type="text"]').each(function() { 568 $(this).next('img').remove(); 569 if ($.trim($(this).val()) == '') { 570 $(this).after(''); 571 $(this).css({ 572 "border": "2px solid #e30000", 573 }); 574 valid = false;; 575 } else { 576 $(this).next('img').remove(); 577 $(this).css({ 578 "border": "", 579 }); 580 } 581 }); 582 583 if ($("#pmc").val() === "SMS" 584 && !$("#patient_smsConsent").is(":checked") 585 && $("input[name='enrolled_by']:checked").val() == 'PATIENT') 586 { 587 $("#patientSmsConsent").after(''); 588 $("#patientSmsConsent .consent").css({ 589 "border": "2px solid #e30000", 590
590 }); 591 valid = false; 592 } 593 else 594 { 595 $("#patientSmsConsent .consent").css({ 596 "border": "", 597 }); 598 } 599 600 if ($("#pmc").val() === "SMS" && !$("#hcp_sp_smsConsent").is(":checked") 601 && $("input[name='enrolled_by']:checked").val() != 'PATIENT') 602 { 603 $("#smsConsent").after(''); 604 $("#smsConsent .consent").css({ 605 "border": "2px solid #e30000", 606 }); 607 valid = false; 608 } 609 else 610 { 611 $("#smsConsent .consent").css({ 612 "border": "", 613 }); 614 } 615 616 if (valid == false) jQuery('#error-form').html(errorField); 617 618 if (!valid) 619 event.preventDefault(); 620 }); 621 622 jQuery('.provider_form').on('submit', function(event) { 623 var errorField = '<div class="inner">Please complete or correct the fields marked in red and click Continue. </div>'; 624 625 var valid = true; 626 627 if ($(".required-field #drstate").val() === "") { 628 isValid = false; 629 $("#drstate").after(''); 630 $(".required-field .select2-selection").css({ 631 "border": "2px solid #e30000", 632 }); 633 valid = false; 634 } else { 635 636 $(".required-field .select2-selection").css({ 637 "border": "", 638 }); 639 } 640 $('p.required-field input[type="text"]').each(function() { 641 $(this).next('img').remove(); 642 if ($.trim($(this).val()) == '') { 643 isValid = false; 644 $(this).after(''); 645 $(this).css({ 646 "border": "2px solid #e30000", 647 }); 648 valid = false; 649 650 } else { 651 652 $(this).next('img').remove(); 653 $(this).css({ 654 "border": "", 655 }); 656 657 } 658 659 }); 660 if (valid == false) jQuery('.error-form').html(errorField); 661 662 if (!valid) 663 event.preventDefault(); 664 }); 665 666 jQuery('.enroll_form').submit(function(event) { 667 668 var errorField = '<div class="inner">Please complete or correct the fields marked in red and click Submit. </div>'; 669 670 var fields = jQuery('p.field.required-field', this); 671 672 var valid = true; 673 674 if ($("#state").val() === "") { 675 $("#state").after(''); 676 $(".state .select2-selection").css({ 677 "border": "2px solid #e30000", 678 }); 679 valid = false; 680 } else { 681 682 $(".state .select2-selection").css({ 683 "border": "", 684 }); 685 } 686 687 $('p.required-field input[type="text"]').each(function() { 688 $(this).next('img').remove(); 689 if ($.trim($(this).val()) == '') { 690 $(this).after(''); 691 $(this).css({ 692 "border": "2px solid #e30000", 693 }); 694 valid = false; 695 } else { 696 $(this).next('img').remove(); 697 $(this).css({ 698 "border": "", 699 }); 700 } 701 }); 702 if (valid == false) jQuery('.error-form').html(errorField); 703 704 if (!valid) 705 event.preventDefault(); 706 }); 707 708 jQuery('.form-card-information').submit(function(event) { 709 710 var errorField = '<div class="inner">Please complete or correct the fields marked in red and click Continue.</div>'; 711 712 713 var fields = jQuery('p.field.required-field', this); 714 715 var valid = true; 716 $('p.required-field input[type="text"]').each(function() { 717 $(this).next('img').remove(); 718 if ($.trim($(this).val()) == '') { 719 720 isValid = false; 721 $(this).after(''); 722 $(this).css({ 723 724 "border": "2px solid #e30000", 725 726 727 }); 728 valid = false;; 729 730 } else { 731 732 $(this).next('img').remove(); 733 $(this).css({ 734 735 "border": "", 736 737 738 }); 739 740 } 741 }); 742 if (valid == false) jQuery('.error-form').html(errorField); 743 744 if (!valid) 745 event.preventDefault(); 746 });
747 jQuery('.form-card-information-popup').submit(function(event) { 748 749 var errorField = '<div class="inner">Please complete or correct the fields marked in red and click Continue.</div>'; 750 751 752 var fields = jQuery('p.field.popup-required.required-field', this); 753 754 var valid = true; 755 $('p.popup-required input[type="text"]').each(function() { 756 $(this).next('img').remove(); 757 if ($.trim($(this).val()) == '') { 758 759 isValid = false; 760 $(this).after(''); 761 $(this).css({ 762 763 "border": "2px solid #e30000", 764 765 766 }); 767 valid = false;; 768 769 } else { 770 771 $(this).next('img').remove(); 772 $(this).css({ 773 774 "border": "", 775 776 777 }); 778 779 } 780 781 782 783 784 785 if (valid == false) { jQuery('#err').html(errorField); } else { 786 jQuery('.eligibility-agreement').css('display', 'none'); 787 jQuery('.eligibility-agreement-step2').css('display', 'block'); 788 } 789 if (valid == true) event.preventDefault(); 790 if (!valid) 791 event.preventDefault(); 792 }); 793 794 795 }); 796 jQuery('.form-validate-password').submit(function(event) { 797 798 var errorField = '<div class="inner">Please complete or correct the fields marked in red and click Password Reset. </div>'; 799 800 801 var fields = jQuery('p.field.required-field', this); 802 803 var valid = true; 804 $('.form-validate-password p.required-field input[type="text"]').each(function() { 805 $(this).next('img').remove(); 806 if ($.trim($(this).val()) == '') { 807 808 isValid = false; 809 $(this).after(''); 810 $(this).css({ 811 812 "border": "2px solid #e30000", 813 814 815 }); 816 valid = false;; 817 818 } else { 819 $(this).next('img').remove(); 820 $(this).css({ 821 822 "border": "", 823 824 825 }); 826 827 } 828 }); 829 if (valid == false) jQuery('.error-form2.pass').html(errorField); 830 831 if (!valid) 832 event.preventDefault(); 833 834 }); 835 836 jQuery('.form-validation-continue').submit(function(event) { 837 838 var errorField = '<div class="inner">Please complete or correct the fields marked in red and click Continue.</div>'; 839 840 841 var fields = jQuery('p.field.required-field', this); 842 843 var valid = true; 844 $('p.required-field input[type="text"]').each(function() { 845 846 if ($.trim($(this).val()) == '') { 847 848 isValid = false; 849 $(this).after(''); 850 $(this).css({ 851 852 "border": "2px solid #e30000", 853 854 855 }); 856 valid = false;; 857 858 } else { 859 860 $(this).next('img').remove(); 861 $(this).css({ 862 863 "border": "", 864 865 866 }); 867 868 } 869 }); 870 if (valid == false) jQuery('.error-form').html(errorField); 871 872 if (!valid) 873 event.preventDefault(); 874 }); 875 876 877 jQuery('.form-card-information-hcp').submit(function(event) { 878 879 var errorField2 = '<div class="inner">There is an error with the EVENITY<sup>™</sup> Co-pay Card Information you entered. Please delete the EVENITY<sup>™</sup> Co-pay Card Member ID and last 4 digits of the 16-digit card number and click Continue to proceed. A new EVENITY<sup>™</sup> Co-pay Card will be registered and mailed to the patient.</div>'; 880 var errorField = '<div class="inner">Please complete or correct the fields marked in red and click Continue.</div>'; 881 882 883 var fields = jQuery('p.field.required-field', this); 884 885 var valid = true; 886 $('p.required-field input[type="text"]').each(function() { 887 $(this).next('img').remove(); 888 if ($.trim($(this).val()) == '') { 889 890 isValid = false; 891 $(this).after(''); 892 $(this).css({ 893 894 "border": "2px solid #e30000", 895 896 897 }); 898 valid = false;; 899 900 } else { 901 902 $(this).next('img').remove(); 903 $(this).css({ 904 905 "border": "", 906 907 908 }); 909 910 } 911 912 913 914 915 916 if (valid == false) jQuery('.error-form').html(errorField); 917 918 if (!valid) 919 event.preventDefault(); 920 }); 921 922 923 });
924 jQuery('.update-doctor-form').submit(function(event) { 925 926 var errorField = '<div class="inner">Please complete or correct the fields marked in red and click Save Profile Updates.</div>'; 927 928 $("#state").next('img').remove(); 929 if ($("#state").val() === "") { 930 isValid = false; 931 $("#state").after(''); 932 $("#state").css({ 933 934 "border": "2px solid #e30000", 935 936 937 }); 938 valid = false;; 939 } else { 940 941 $("#state").next('img').remove(); 942 $("#state").css({ 943 944 "border": "", 945 946 947 }); 948 949 } 950 var fields = jQuery('p.field.required-field', this); 951 952 953 $('p.required-field input').each(function() { 954 $(this).next('img').remove(); 955 if ($.trim($(this).val()) == '') { 956 957 isValid = false; 958 $(this).after(''); 959 $(this).css({ 960 961 "border": "2px solid #e30000", 962 963 964 }); 965 valid = false;; 966 967 } else { 968 969 $(this).next('img').remove(); 970 $(this).css({ 971 972 "border": "", 973 974 975 }); 976 977 978 } 979 }); 980 if (valid == false) jQuery('.error-form').html(errorField); 981 982 if (!valid) 983 event.preventDefault(); 984 985 }); 986 jQuery('.form-validate-re-enroll').submit(function(event) { 987 988 var errorField = '<div class="inner">Please complete or correct the fields marked in red and click Re-enroll.</div>'; 989 990 991 var fields = jQuery('p.field.required-field', this); 992 993 var valid = true; 994 $('p.required-field input').each(function() { 995 $(this).next('img').remove(); 996 if ($.trim($(this).val()) == '') { 997 998 isValid = false; 999 $(this).after(''); 1000 $(this).css({ 1001 1002 "border": "2px solid #e30000", 1003 1004 1005 }); 1006 valid = false;; 1007 1008 } else { 1009 1010 $(this).next('img').remove(); 1011 $(this).css({ 1012 1013 "border": "", 1014 1015 1016 }); 1017 1018 1019 } 1020 }); 1021 if (valid == false) jQuery('.error-form2').html(errorField); 1022 1023 if (!valid) 1024 event.preventDefault(); 1025 }); 1026 jQuery('.profile_form_1').submit(function(event) { 1027 1028 var errorField = '<div class="inner">Please complete or correct the fields marked in red and click Submit.</div>'; 1029 1030 1031 var fields = jQuery('p.field.required-field', this); 1032 1033 var valid = true; 1034 $("#state").next('img').remove(); 1035 if ($("#state").val() === "") { 1036 isValid = false; 1037 $("#state").after(''); 1038 $("#state").css({ 1039 1040 "border": "2px solid #e30000", 1041 1042 1043 }); 1044 valid = false;; 1045 } else { 1046 1047 $("#state").next('img').remove(); 1048 $("#state").css({ 1049 1050 "border": "", 1051 1052 1053 }); 1054 1055 } 1056 $('.profile_form_1 p.required-field input').each(function() { 1057 $(this).next('img').remove(); 1058 if ($.trim($(this).val()) == '') { 1059 1060 isValid = false; 1061 $(this).after(''); 1062 $(this).css({ 1063 1064 "border": "2px solid #e30000", 1065 1066 1067 }); 1068 valid = false;; 1069 1070 } else { 1071 1072 $(this).next('img').remove(); 1073 $(this).css({ 1074 1075 "border": "", 1076 1077 1078 }); 1079 1080 1081 } 1082 if ($("#need-password").val() !== "") { 1083 $(".confirm-password").addClass('required-field'); 1084 if ($("#confirm-password").val() === "") { 1085 valid = false; 1086 $("#confirm-password").css({ "border": "2px solid #e30000" });
1087 } else { 1088 $("#confirm-password").css({ "border": "2px solid #c5c5c5" }); 1089 valid = true; 1090 } 1091 1092 } else { 1093 $(".confirm-password").removeClass('required-field'); 1094 $("#confirm-password").css({ "border": "2px solid #c5c5c5" }); 1095 } 1096 1097 if ($("#confirm-password").val() !== "") { 1098 $(".need-password").addClass('required-field'); 1099 if ($("#need-password").val() === "") { 1100 valid = false; 1101 $("#need-password").css({ "border": "2px solid #e30000" }); 1102 } else { 1103 $("#confirm-password").css({ "border": "2px solid #c5c5c5" }); 1104 valid = true; 1105 } 1106 1107 } else { 1108 $(".need-password").removeClass('required-field'); 1109 $("#need-password").css({ "border": "2px solid #c5c5c5" }); 1110 } 1111 }); 1112 if (valid == false) jQuery('.error-form.er1').html(errorField); 1113 1114 if (!valid) 1115 event.preventDefault(); 1116 1117 1118 }); 1119 jQuery('.profile_form_2').submit(function(event) { 1120 1121 var errorField = '<div class="inner">Please complete or correct the fields marked in red and click Submit.</div>'; 1122 1123 1124 var fields = jQuery('p.field.required-field', this); 1125 1126 var valid = true; 1127 $('.profile_form_2 p.required-field input').each(function() { 1128 $(this).next('img').remove(); 1129 if ($.trim($(this).val()) == '') { 1130 1131 isValid = false; 1132 $(this).after(''); 1133 $(this).css({ 1134 1135 "border": "2px solid #e30000", 1136 1137 1138 }); 1139 valid = false;; 1140 1141 } else { 1142 1143 $(this).next('img').remove(); 1144 $(this).css({ 1145 1146 "border": "", 1147 1148 1149 }); 1150 1151 1152 } 1153 }); 1154 if (valid == false) jQuery('.error-form.er2').html(errorField); 1155 1156 if (!valid) 1157 event.preventDefault(); 1158 1159 1160 }); 1161 jQuery('.form-validate-update').submit(function(event) { 1162 1163 var errorField = '<div class="inner">Please complete or correct the fields marked in red and click Continue. </div>'; 1164 jQuery('.prompt-error').remove(); 1165 var valid2 = true; 1166 1167 var dropdowns = jQuery('p.field.required-field.dropdown'); 1168 dropdowns.each(function(index) { 1169 1170 var obj = jQuery(this); 1171 var drop = jQuery('select', obj); 1172 $(drop).next('img').remove(); 1173 $(drop).css({ 1174 1175 "border": "1px solid #424242", 1176 1177 1178 }); 1179 var select = jQuery('select :selected', obj).val(); 1180 if (select !== '') 1181 1182 return; 1183 1184 //obj.append(errorField); 1185 if (select === '') { 1186 1187 $(drop).after(''); 1188 $(drop).css({ 1189 1190 "border": "2px solid #e30000", 1191 1192 1193 }); 1194 valid2 = false; 1195 event.preventDefault(); 1196 } else { 1197 var valid2 = true; 1198 $('#state').next('img').remove(); 1199 $('#state').css({ 1200 1201 "border": "", 1202 1203 1204 }); 1205 var valid2 = true; 1206 1207 } 1208 1209 }); 1210 1211 var radios = jQuery('p.field.required-field.radio'); 1212 radios.each(function(index) { 1213 var obj = jQuery(this); 1214 var checked = jQuery('input:checked', obj); 1215 1216 if (checked.length > 0) 1217 return; 1218 1219 obj.append(errorField); 1220 valid = false; 1221 }); 1222 1223 1224 1225 1226 if (!valid2) { 1227 event.preventDefault(); 1228 } 1229 1230 1231 }); 1232 jQuery('.form-validate').submit(function(event) { 1233 1234 var errorField = '<div class="inner">Please complete or correct the fields marked in red and click Sign In.</div>'; 1235 1236 1237 //var fields = jQuery('p.field.required-field', this); 1238
1239 var valid = true; 1240 $('.form-validate p.required-field input').each(function() { 1241 $(this).next('img').remove(); 1242 if ($.trim($(this).val()) == '') { 1243 1244 isValid = false; 1245 $(this).after(''); 1246 $(this).css({ 1247 1248 "border": "2px solid #e30000", 1249 1250 1251 }); 1252 valid = false; 1253 1254 } else { 1255 1256 $(this).next('img').remove(); 1257 $(this).css({ 1258 1259 "border": "", 1260 1261 1262 }); 1263 1264 1265 } 1266 }); 1267 if (valid == false) { 1268 jQuery('.error-form').html(errorField); 1269 event.preventDefault(); 1270 } 1271 1272 }); 1273 jQuery('.form-validate-hcp').submit(function(event) { 1274 1275 var errorField = '<div class="inner">Please complete or correct the fields marked in red and click Submit.</div>'; 1276 1277 1278 //var fields = jQuery('p.field.required-field', this); 1279 1280 var valid = true; 1281 $('.form-validate-hcp p.required-field input').each(function() { 1282 $(this).next('img').remove(); 1283 if ($.trim($(this).val()) == '') { 1284 1285 isValid = false; 1286 $(this).after(''); 1287 $(this).css({ 1288 1289 "border": "2px solid #e30000", 1290 1291 1292 }); 1293 valid = false; 1294 1295 } else { 1296 $(this).next('img').remove(); 1297 $(this).css({ 1298 1299 "border": "", 1300 }); 1301 } 1302 }); 1303 if (valid == false) { 1304 jQuery('.error-form').html(errorField); 1305 event.preventDefault(); 1306 } 1307 }); 1308 1309 jQuery('#sign-in').click(function(event) { 1310 event.preventDefault(); 1311 jQuery('.submenu ul').toggle('slide', { 1312 direction: 'right' 1313 }, 100) 1314 1315 }); 1316 1317 jQuery('.doctor_form_hcp').submit(function(event) { 1318 1319 1320 var errorField = '<div class="inner">Please complete or correct the fields marked in red and click one of the enroll buttons.</div>'; 1321 1322 1323 var fields = jQuery('p.field.required-field', this); 1324 1325 var valid = true; 1326 isValid = true; 1327 1328 $('p.required-field input').each(function() { 1329 1330 $(this).next('img').remove(); 1331 if ($.trim($(this).val()) == '') { 1332 valid = false; 1333 1334 isValid = false; 1335 $(this).after(''); 1336 $(this).css({ 1337 1338 "border": "2px solid #e30000", 1339 1340 1341 }); 1342 1343 1344 1345 } 1346 if ($.trim($(this).val()) != '') { 1347 1348 $(this).next('img').remove(); 1349 $(this).css({ 1350 1351 "border": "", 1352 1353 1354 }); 1355 } 1356 1357 1358 }); 1359 //alert(isValid); 1360 //alert(valid); 1361 1362 if ((valid == false) || (isValid == false)) { 1363 jQuery('.error-form').html(errorField); 1364 event.preventDefault(); 1365 } 1366 1367 1368 1369 1370 1371 1372 1373 1374 1375 }); 1376 1377 jQuery('.doctor_form').submit(function(event) { 1378 1379 1380 var errorField = '<div class="inner">Please complete or correct the fields marked in red and click an "Enroll patient" button to continue.</div>'; 1381 1382 1383 var fields = jQuery('p.field.required-field', this); 1384 1385 var valid = true; 1386 isValid = true; 1387 1388 $('p.required-field input').each(function() { 1389 1390 $(this).next('img').remove(); 1391 if ($.trim($(this).val()) == '') { 1392 valid = false; 1393 1394 isValid = false; 1395 $(this).after(''); 1396 $(this).css({ 1397 1398 "border": "2px solid #e30000", 1399 1400 1401 }); 1402 1403 1404 1405 } 1406 if ($.trim($(this).val()) != '') { 1407 1408 $(this).next('img').remove(); 1409 $(this).css({ 1410 1411 "border": "", 1412 1413 1414 }); 1415 } 1416 1417 1418 }); 1419 //alert(isValid); 1420 //alert(valid); 1421 1422 if ((valid == false) || (isValid == false)) { 1423 jQuery('.error-form').html(errorField); 1424 event.preventDefault(); 1425 } 1426 1427 1428 1429 1430 1431 1432 1433 1434 1435 });
1436 jQuery('.doctor_find_form').submit(function(event) { 1437 1438 1439 var errorField = '<div class="inner">Please complete or correct the fields marked in red and click the "Find" button to continue.</div>'; 1440 1441 1442 var fields = jQuery('p.field.required-field', this); 1443 1444 var valid = true; 1445 isValid = true; 1446 1447 $('p.required-field input').each(function() { 1448 1449 $(this).next('img').remove(); 1450 if ($.trim($(this).val()) == '') { 1451 valid = false; 1452 1453 isValid = false; 1454 $(this).after(''); 1455 $(this).css({ 1456 1457 "border": "2px solid #e30000", 1458 1459 1460 }); 1461 1462 1463 1464 } 1465 if ($.trim($(this).val()) != '') { 1466 1467 $(this).next('img').remove(); 1468 $(this).css({ 1469 1470 "border": "", 1471 1472 1473 }); 1474 } 1475 1476 1477 }); 1478 //alert(isValid); 1479 //alert(valid); 1480 1481 if ((valid == false) || (isValid == false)) { 1482 jQuery('.error-form2').html(errorField); 1483 event.preventDefault(); 1484 } 1485 1486 1487 1488 1489 1490 1491 1492 1493 1494 }); 1495 jQuery('.doctor_form_patient').submit(function(event) { 1496 1497 1498 var errorField = '<div class="inner">Please complete or correct the fields marked in red and click an "Enroll" button to continue.</div>'; 1499 1500 1501 var fields = jQuery('p.field.required-field', this); 1502 1503 var valid = true; 1504 isValid = true; 1505 1506 $('p.required-field input').each(function() { 1507 1508 $(this).next('img').remove(); 1509 if ($.trim($(this).val()) == '') { 1510 valid = false; 1511 1512 isValid = false; 1513 $(this).after(''); 1514 $(this).css({ 1515 1516 "border": "2px solid #e30000", 1517 1518 1519 }); 1520 1521 1522 1523 } 1524 if ($.trim($(this).val()) != '') { 1525 1526 $(this).next('img').remove(); 1527 $(this).css({ 1528 1529 "border": "", 1530 1531 1532 }); 1533 } 1534 1535 1536 }); 1537 //alert(isValid); 1538 //alert(valid); 1539 1540 if ((valid == false) || (isValid == false)) { 1541 jQuery('.error-form').html(errorField); 1542 event.preventDefault(); 1543 } 1544 1545 1546 1547 1548 1549 1550 1551 1552 1553 }); 1554 jQuery('.consent_form_patient').submit(function(event) { 1555 1556 1557 var errorField = '<div class="inner">Please complete or correct the fields marked in red and click an "Enroll" button to continue.</div>'; 1558 1559 var errorField1 = '<span class="red-error error">Digital Signature is required</span>'; 1560 var errorField2 = '<span class="red-error error">Please provide</span>'; 1561 //var errorCaptcha = '<p><span class="red-error error">Captcha is required</span></p>'; 1562 var fields = jQuery('p.field.required-field', this); 1563 1564 var valid = true; 1565 isValid = true; 1566 1567 captcha = $('#captcha'); 1568 if (grecaptcha.getResponse() == '') { 1569 valid = false;; 1570 1571 isValid = false; 1572 1573 $(captcha).css({ 1574 "border": "2px solid #e30000", 1575 }); 1576 // $(captcha).after(errorCaptcha); 1577 } else { 1578 $(captcha).css({ 1579 "border": "", 1580 }); 1581 $(captcha).after(""); 1582 } 1583 1584 if ($("#relationship_to_patient").val() === "") { 1585 $("#relationship_to_patient").after(''); 1586 $(".relationship .select2-selection").css({ 1587 "border": "2px solid #e30000", 1588 }); 1589 $("#spnRelError").css("display", "block"); 1590 valid = false; 1591 } else { 1592 $(".relationship .select2-selection").css({ 1593 "border": "", 1594 }); 1595 1596 $(this).after(""); 1597 $("#spnRelError").css("display", "none"); 1598 } 1599 1600 $('p.required-field input').each(function() { 1601 $(this).next('.error').remove(); 1602 1603 if ($.trim($(this).val()) == '') { 1604 valid = false; 1605 1606 isValid = false; 1607 1608 $(this).css({ 1609 1610 "border": "2px solid #e30000", 1611 1612 1613 }); 1614 $(this).after(errorField1); 1615 1616 //alert(label2); 1617 1618 1619 } 1620 if ($.trim($(this).val()) != '') { 1621 1622 $(this).next('img').remove(); 1623 $(this).css({ 1624 1625 "border": "", 1626 1627 1628 }); 1629 $(this).after(""); 1630 } 1631 1632 1633 }); 1634 //alert(isValid); 1635 //alert(valid); 1636 1637 if ((valid == false) || (isValid == false)) { 1638 jQuery('.error-form').html(errorField); 1639 event.preventDefault(); 1640 } else { 1641 $("#btnAuthBack").prop("disabled", true); 1642 $('#btnAuthBack').click(function () { return false; }); 1643 $("#submit").prop("disabled", true); 1644 1645 } 1646 1647 1648 1649 1650 1651 1652 1653 1654 1655 });
1656 1657 $(".submit-form-hcp").click(function() { 1658 1659 1660 var errorField = '<div class="inner">Please complete or correct the fields marked in red and click on "Submit" button to continue.</div>'; 1661 1662 1663 var fields = jQuery('p.field.required-field', this); 1664 1665 var valid = true; 1666 1667 if ($("#state").val() === "") { 1668 isValid = false; 1669 $("#state").after(''); 1670 $("#state").css({ 1671 1672 "border": "2px solid #e30000", 1673 1674 1675 }); 1676 valid = false;; 1677 } else { 1678 isValid = true; 1679 1680 $("#state").next('img').remove(); 1681 $("#state").css({ 1682 1683 "border": "", 1684 1685 1686 }); 1687 1688 } 1689 1690 1691 1692 if ($("#checkbox-required").is(':checked')) { 1693 1694 isValid = true; 1695 $("#checkbox-required").css({ 1696 1697 "border": "", 1698 1699 1700 }); 1701 } else { 1702 isValid = false; 1703 1704 $("#checkbox-required").css({ 1705 1706 "border": "2px solid #e30000", 1707 1708 1709 }); 1710 $(".required-text").css('color', 'red'); 1711 valid = false;; 1712 } 1713 $('p.required-field input').each(function() { 1714 1715 $(this).next('img').remove(); 1716 if ($.trim($(this).val()) == '') { 1717 valid = false; 1718 1719 isValid = false; 1720 $(this).after(''); 1721 $(this).css({ 1722 1723 "border": "2px solid #e30000", 1724 1725 1726 }); 1727 1728 1729 1730 } 1731 if ($.trim($(this).val()) != '') { 1732 1733 $(this).next('img').remove(); 1734 $(this).css({ 1735 1736 "border": "", 1737 1738 1739 }); 1740 } 1741 1742 1743 }); 1744 //alert(isValid); 1745 //alert(valid); 1746 1747 if ((valid == false) || (isValid == false)) { 1748 jQuery('.error-form').html(errorField); 1749 event.preventDefault(); 1750 } else { 1751 $(".doctor_form_hcp").submit(); 1752 } 1753 1754 1755 1756 1757 1758 1759 1760 1761 }); 1762 1763 1764 1765 1766 1767}); 1768 1769 1770function ValidateDate(input) { 1771 var regex = /^\d{1,2}\/\d{1,2}\/\d{4}$/; 1772 return regex.test(input); 1773} 1774$(document).ready(function() { 1775 $('input[name="gender"]').change(function() { 1776 $('+label span', this).css({ 1777 1778 "border": "2px solid c5c5c5", 1779 }); 1780 }); 1781 1782}); 1783$(function() { 1784 $.datepicker.setDefaults({ 1785 minDate: '-100y', 1786 maxDate: '+0y' 1787 }); 1788 $("#birth-date").datepicker(); 1789 $("#end-date").datepicker(); 1790 $("#start-date").datepicker(); 1791}); 1792 1793function goBack() { 1794 window.history.back(); 1795} 1796jQuery(function($) { 1797 $.mask.definitions['~'] = '[+-]'; 1798 $(".zipMask").mask("99999"); 1799 $(".phoneMask").mask("(999) 999-9999"); 1800 $(".dateMask").mask("99/99/9999"); 1801}); 1802/** Date field validation */ 1803Date.prototype.isValid = function() { 1804 // If the date object is invalid it 1805 // will return 'NaN' on getTime() 1806 // and NaN is never equal to itself. 1807 return this.getTime() === this.getTime(); 1808}; 1809 1810function isDateCheck(txtDate) { 1811 currVal = txtDate; 1812 1813 if (currVal == '') 1814 return true; 1815 1816 var currVal = new Date(txtDate); 1817 1818 return currVal.isValid(); 1819} 1820 1821function updateToDate() { 1822 var startDate = $("#start-date").val(); 1823 var dateCheck = isDateCheck(startDate); 1824 if (startDate == '' || !dateCheck) { 1825 var currentdate = new Date(); 1826 $("#end-date").datepicker('setDate', currentdate); 1827 currentdate.setDate(currentdate.getDate() - 7); 1828 $("#start-date").datepicker('setDate', currentdate); 1829 } else { 1830 var date = $("#start-date").datepicker("getDate"); 1831 date.setDate(date.getDate() + 7); 1832 var dateMsg = (date.getMonth() + 1) + '/' + date.getDate() + '/' + date.getFullYear(); 1833 $("#end-date").datepicker('setDate', dateMsg); 1834 } 1835} 1836 1837function updateFromDate() { 1838 var endDate = $("#end-date").val(); 1839 var dateCheck = isDateCheck(endDate); 1840 if (endDate == '' || !dateCheck) { 1841 var currentdate = new Date(); 1842 $("#end-date").datepicker('setDate', currentdate); 1843 currentdate.setDate(currentdate.getDate() - 7);
1844 $("#start-date").datepicker('setDate', currentdate); 1845 } else { 1846 var date = $("#end-date").datepicker("getDate"); 1847 date.setDate(date.getDate() - 7); 1848 var dateMsg = (date.getMonth() + 1) + '/' + date.getDate() + '/' + date.getFullYear(); 1849 $("#start-date").datepicker('setDate', dateMsg); 1850 } 1851}
Line numbers count LF bytes from the start of the resource, as the search results do. Vendor segments are library code the classifier recognised; they are stored but not indexed. Bytes are shown as Latin1 characters, one per byte.