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698<script type="text/javascript"> 699 700$(document).ready(function() { 701 702 703 $('.submit-bttn'+6).click(function(e){ 704 705 $('.submit-bttn'+6).hide(); 706 $('.wait-contactform-contact'+6).show(); 707 // Declare the function variables: 708 // Parent form, form URL, email regex and the error HTML 709 710 var $formId = $(this).parents('form'); 711 var formAction = $formId.attr('action'); 712 var emailReg = /^([\w-\.]+@([\w-]+\.)+[\w-]{2,4})?$/; 713 var phoneReg = /^\(?(\d{3})\)?[- ]?(\d{3})[- ]?(\d{4})$/; 714 var $error = $('<span class="error"></span>'); 715 716 717 // Prepare the form for validation - remove previous errors 718 //$('li',$formId).removeClass('error'); 719 $('span.error').remove(); 720 $('.input-holder').removeClass('error'); 721 $('#msg6').hide(); 722 $('#msg6').removeClass('newerror'); 723 $("#msg6").html(""); 724 725 726 // Validate all inputs with the class "required" 727 //$('.required',$formId).each(function(){ 728 $($formId).find('input, select, textarea').each(function(){ 729 730 var inputVal = $.trim($(this).val()); 731 var $parentTag = $(this).parent(); 732 733 var class_name=""; 734 class_name = $(this).attr('class'); 735 var fieldtitle = $(this).attr("title"); 736 737 if(typeof(class_name) != "undefined"){ 738 class_name=class_name.split(' '); 739 class_name=class_name[0]; 740 } 741 if(class_name=="required"){ 742 if(inputVal == ''){ 743 $parentTag.addClass('error').append($error.clone().text(fieldtitle)); 744 $(this).focus(); 745 $('.submit-bttn'+6).show(); 746 $('.wait-contactform-contact'+6).hide(); 747 return false; 748 } 749 750 } 751 752 if($(this).attr('type')=="email"){ 753 if(!emailReg.test(inputVal)){ 754 $parentTag.addClass('error').append($error.clone().text('Sorry, you have entered an invalid Email Address')); 755 $(this).focus();$(this).select(); 756 $('.submit-bttn'+6).show(); 757 $('.wait-contactform-contact'+6).hide(); 758 return false; 759 } 760 } 761 762 if(jQuery(this).attr('type')=="checkbox"){ 763 jQuery('.check-box').click(function(e){ 764 jQuery(this).attr('checked', 'checked'); 765 }); 766 if(class_name=="required"){ 767 if(jQuery('.check-box').is(":checked")){ 768 $parentTag.removeClass('error'); 769 } 770 else if(jQuery('.check-box').is(":not(:checked)")){ 771 $parentTag.addClass('error').append($error.clone().text(fieldtitle)); 772 jQuery(this).focus(); 773 jQuery('.submit-bttn'+6).show(); 774 jQuery('.wait-contactform-contact'+6).hide(); 775 return false; 776 } 777 } 778 } 779 780 781 if($(this).val()!=""){ 782 if($(this).attr('type')=="tel"){ 783 if(!phoneReg.test(inputVal)){ 784 $parentTag.addClass('error').append($error.clone().text('Phone number seems invalid')); 785 $(this).focus();$(this).select(); 786 $('.submit-bttn'+6).show(); 787 $('.wait-contactform-contact'+6).hide(); 788 return false; 789 } 790 if( ( inputVal.indexOf("123456") > -1 ) || ( inputVal.indexOf("142536") > -1 ) ){ 791 $parentTag.addClass('error').append($error.clone().text('Please enter a valid Phone number')); 792 $(this).focus();$(this).select(); 793 $('.submit-bttn'+6).show(); 794 $('.wait-contactform-contact'+6).hide(); 795 return false; 796 } 797 798 799 800 } 801 } 802 803 804 }); 805 806 807 808 809 // All validation complete - Check if any errors exist 810 // If has errors 811 if ($('span.error').length > 0) { 812 813 $('span.error').each(function(){ 814 815 // Set the distance for the error animation 816 var distance = 5; 817 818 // Get the error dimensions 819 var width = $(this).outerWidth(); 820 821 // Calculate starting position 822 var start = width + distance; 823 824 // Set the initial CSS 825 $(this).show().css({ 826 display: 'block', 827 opacity: 0 828 }) 829 // Animate the error message 830 .animate({ 831 opacity: 1 832 }, 'slow'); 833 834 }); 835 836 }else { 837 //$formId.submit(); 838 //alert("success form going to be submit."); 839 840 var captcha_field = $(".captcha_field_6").val(); 841 validateCaptchaContact(6, $('#captcha_hid_contact_6').val(),captcha_field); 842 843 } 844 // Prevent form submission 845 e.preventDefault(); 846 }); 847 848 // Fade out error message when input field gains focus 849 $('.required').keypress(function(){ 850 var $parent = $(this).parent(); 851 $parent.removeClass('error'); 852 $('span.error',$parent).fadeOut(); 853 }); 854 855 $('.captcha-image-contact').focus(function(){ 856 var $parent = $(this).parent(); 857 $parent.removeClass('error'); 858 $('span.error',$parent).fadeOut(); 859 }); 860 861 jQuery('#captcha_div_contact_6').on('click','a.captcha-image-contact',function(){ 862 var $parent = $(this).parent(); 863 $parent.removeClass('error'); 864 $('span.error',$parent).fadeOut(); 865 }); 866 867 868 869}); 870 871</script>
871 872 873 874 875<form name="formcontact_6" id="formcontact_6" action="https://www.cognitivebehaviourtherapytoronto.com/wp-content/plugins/techwyse-form/forms/mails/mail.php" method="post"> 876 877 878 879 880 881 <div class="contact-form cf"> 882 <div class="cwrap cf"> 883 <div class="input-holder"> 884 <input tabindex="61" type="text" required="yes" name="cname" id="cname" class="required" title="Please enter your Name." placeholder="Name*" > 885 </div> 886 </div> 887 <div class="cwrap cf"> 888 <div class="input-holder"> 889 <input tabindex="62" type="tel" required="yes" name="cphone" id="cphone" class="required" title="Please enter your Phone." placeholder="Phone*" > 890 </div> 891 </div> 892 <div class="cwrap cf"> 893 <div class="input-holder"> 894 <input tabindex="63" type="email" required="yes" name="cemail" id="cemail" class="required" title="Please enter your Email." placeholder="Email*" > 895 </div> 896 </div> 897 <div class="cwrap cf"> 898 <div class="input-holder"> 899<label class="checkbox-label">Preferred Contact Method* : </label><br/><label class="chk-container">Email<input name="cresponse[]" id="Email" value="Email" type="checkbox" required="yes" name="cresponse" id="cresponse" class="required check-box" title="Please select one or more for Preferred Contact Method" placeholder="Preferred Contact Method* : " options="Email:Email|Text:Text|Call:Call|No Preference:No Preference" ><span class="checkmark"></span></label id="Email"><label class="chk-container">Text<input name="cresponse[]" id="Text" value="Text" type="checkbox" required="yes" name="cresponse" id="cresponse" class="required check-box" title="Please select one or more for Preferred Contact Method" placeholder="Preferred Contact Method* : " options="Email:Email|Text:Text|Call:Call|No Preference:No Preference" ><span class="checkmark"></span></label id="Text"><label class="chk-container">Call<input name="cresponse[]" id="Call" value="Call" type="checkbox" required="yes" name="cresponse" id="cresponse" class="required check-box" title="Please select one or more for Preferred Contact Method" placeholder="Preferred Contact Method* : " options="Email:Email|Text:Text|Call:Call|No Preference:No Preference" ><span class="checkmark"></span></label id="Call"><label class="chk-container">No Preference<input name="cresponse[]" id="No Preference" value="No Preference" type="checkbox" required="yes" name="cresponse" id="cresponse" class="required check-box" title="Please select one or more for Preferred Contact Method" placeholder="Preferred Contact Method* : " options="Email:Email|Text:Text|Call:Call|No Preference:No Preference" ><span class="checkmark"></span></label id="No Preference"> 900 </div> 901 </div> 902 903 <div class="cwrap cf"> 904 <div class="input-holder"> 905 <select tabindex="65" required="yes" name="mpref" id="mpref" class="required" title="Please Select Meeting Preference" placeholder="Please Select Meeting Preference" options="Virtual|In-Person|No Preference" ><option value="">Please Select Meeting Preference*</option><option value="Virtual">Virtual</option><option value="In-Person">In-Person</option><option value="No Preference">No Preference</option></select> 906 </div> 907 </div> 908 909<div class="cwrap cf"> 910<div class="input-holder"> 911 <select tabindex="66" required="yes" name="cresponse_time" id="cresponse_time" class="required" title="Please Select Preferred Appointment Type" placeholder="Preferred Appointment Type" options="15-minute c
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1070 <div class="dvdr"></div> 1071 <div class="hom-map-otr"> 1072 <span> 1073 <span> 1074 <h2 class="span-spn-h4">Cognitive Behaviour Therapy Toronto</h2> 1075 <p>3080 Yonge Street, Suite #5042, </p> 1076 <p><span>Toronto</span>, <span>Ontario</span>, <span>M4N 3N1</span>, <span>Canada</span></p> 1077 <p><a class="f-tel" href="tel:416-817-8925">416-817-8925</a></p> 1078 </span></span> 1079 <div class="cf"></div> 1080 <div class="hom-map maps"> 1081<iframe style="" src="https://www.google.com/maps/embed?pb=!1m18!1m12!1m3!1d2883.2773572177466!2d-79.40509518443288!3d43.72556477911891!2m3!1f0!2f0!3f0!3m2!1i1024!2i768!4f13.1!3m3!1m2!1s0x882b32e78a0d5355%3A0x185818296b1a0648!2sCognitive+Behaviour+Therapy+Toronto!5e0!3m2!1sen!2sin!4v1497521964891" width="100%" height="280" frameborder="0" style="border:0" allowfullscreen></iframe> 1082<div style="display: none;"> 1083<span>43.725146</span> 1084<span>-79.402155</span> 1085</div> 1086 </div> 1087 1088 </div> 1089 1090<div class="con-hou"> 1091<p class="span-spn-h4">Cognitive Behaviour Therapy Toronto</p> 1092<ul> 1093 <li>Monday : 8AMâ8PM</li> 1094 <li>Tuesday : 8AMâ8PM</li> 1095 <li>Wednesday : 8AMâ8PM</li> 1096 <li>Thursday : 8AMâ8PM</li> 1097 <li>Friday : 8AMâ8PM</li> 1098 <li>Saturday : 8AMâ8PM</li> 1099 <li>Sunday : 8AMâ8PM</li> 1100 </ul> 1101 1102 1103</div> 1104 1105 1106 <!-- <div class="contact-form cf"> 1107 <div class="cwrap cf"> 1108 <div class="input-holder"> 1109 <input type="text" placeholder="Name*" title="Name"> 1110 </div> 1111 </div> 1112 <div class="cwrap cf"> 1113 <div class="input-holder"> 1114 <input type="tel" placeholder="Phone*" title="Phone*"> 1115 </div> 1116 </div> 1117 <div class="cwrap cf"> 1118 <div class="input-holder"> 1119 <input type="email" placeholder="Email*" title="Email*"> 1120 </div> 1121 </div> 1122 <div class="cwrap cf"> 1123 <div class="input-holder"> 1124 <textarea placeholder="Questions/Comments" title="Questions/Comments" rows="5" cols="30"></textarea> 1125 </div> 1126 <label class="tarea"></label> 1127 </div> 1128 1129 <div class="cap-box cf"> 1130 <p>Please select the <span>Circle</span> and click the Submit button</p> 1131 1132 <input type="submit" class="cont-submit" value="Submit"> 1133 </div> 1134 </div> 1135 --> 1136 1137 1138 <a href="javascript:history.go(-1)" class="back-bttn">Back</a> 1139 1140 1141 1142 </div> 1143 </div> 1144 1145 1146 1147 <div class="col-md-4 col-md-pull-8"> 1148 <div class="inner-sidebar cf"> 1149 <div class="side-box cf"> 1150 <p class="span-spn-h2"><a >Areas of Specialty</a></p> 1151 <ul> 1152 1153 <li><a href="https://www.cognitivebehaviourtherapytoronto.com/areas-of-specialty/anxiety-disorders/">Anxiety Disorders</a></li> 1154 1155 <li><a href="https://www.cognitivebehaviourtherapytoronto.com/areas-of-specialty/obsessive-compulsive-disorder/">Obsessive-compulsive Disorder (OCD)</a></li> 1156 <li><a href="https://www.cognitivebehaviourtherapytoronto.com/areas-of-specialty/couples-therapy/">Marriage Counselling / Couples Therapy</a></li> 1157 <li><a href="https://www.cognitivebehaviourtherapytoronto.com/areas-of-specialty/skin-picking-disorder-treatment-toronto/">Skin picking treatment </a></li> 1158 <li><a href="https://www.cognitivebehaviourtherapytoronto.com/areas-of-specialty/hair-pulling-disorder-treatment-toronto/">Hair pulling treatment</a></li> 1159 <li><a href="https://www.cognitivebehaviourtherapytoronto.com/areas-of-specialty/body-dysmorphic-disorder/">Body Image and Body Dysmorphic Disorder</a></li> 1160 1161 <li><a href="https://www.cognitivebehaviourtherapytoronto.com/areas-of-specialty/depression/">Depression</a></li> 1162 1163 <li><a href="https://www.cognitivebehaviourtherapytoronto.com/areas-of-specialty/post-traumatic-stress-disorder/">Post Traumatic Stress Disorder (PTSD)</a></li> 1164 1165 </ul> 1166 1167 </div> 1168 <!-- <div class="side-box cf"> 1169 1170 <h2><a href="https://www.cognitivebehaviourtherapytoronto.com/blog/" title="">Recent blog posts</a></h2> 1171 1172 <p>Oneâs mental health is an essential factor in leading a productive life. In person therapy is the most conventional way to receive mental health care from a counsellor.</p> 1173 <h5><a href="https://www.cognitivebehaviourtherapytoronto.com/blog/author/sue-sonshine/" title="Posts by Sue Sonshine" rel="author">Sue Sonshine</a></h5> 1174 <a href="https://www.cognitivebehaviourtherapytoronto.com/blog/" class="vew-btn">View All</a> 1175 1176 1177 </div> 1178 --> 1179 </div> 1180</div> 1181</div> 1182</div> 1183 1184</div> 1185 1186 1187<footer class="footer-out"> 1188 <div class="container"> 1189 <div class="footer-wrp"> 1190 <p id="back-top"> 1191<a href="#top" title="">Top</a> 1192</p> 1193 <div class="row no-gutters"> 1194 1195 <div class="col-md-2 col-sm-12 ft-bdr"> 1196 <div class="foot-box01"> 1197 <div class="footer-nav"> 1198 <!-- <ul> 1199 <li><a href="">HOME</a></li> 1200 <li><a href="">About</a></li> 1201 <li><a href="">Procedures</a></li> 1202 <li><a href="">FAQ</a></li> 1203 <li><a href="">Photo Gallery</a></li> 1204 <li><a href="">Video 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href="tel:416-817-8925">416-817-8925</a></p> 1275 <div class="map"><a rel="nofollow" target="_blank" href="https://www.google.co.in/maps/place/Cognitive+Behaviour+Therapy+Toronto/@43.7255648,-79.4050952,17z/data=!3m1!4b1!4m5!3m4!1s0x882b32e78a0d5355:0x185818296b1a0648!8m2!3d43.7255648!4d-79.4029065">VIEW MAP</a></div> 1276 1277 <div class="cancel-notice">If you are unable to attend your scheduled appointment please make sure you reach out to cancel or reschedule your appointment at least 48 hours beforehand to avoid being charged the full fee for your missed session.</div> 1278 </div> 1279 </div> 1280 <!-- <div class="col-md-6 col-sm-6"> 1281 <div class="foot-box02"> 1282 <h2>Newsletter Signup</h2> 1283 <small>Subscribe to our newsletter and be date with news</small> 1284 1285 <div class="subscrb-wrp"> 1286 1287 <form id="news_letter" name="news_letter" method="post" action="/mails/newsletter-mail.php"> 1288 <div class="input-holder"> 1289 <input class="required email" tabindex="116" 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1419<script type="text/javascript"> 1420 1421$(document).ready(function() { 1422 1423 1424 $('.submit-bttn'+3).click(function(e){ 1425 1426 $('.submit-bttn'+3).hide(); 1427 $('.wait-contactform-contact'+3).show(); 1428 // Declare the function variables: 1429 // Parent form, form URL, email regex and the error HTML 1430 1431 var $formId = $(this).parents('form'); 1432 var formAction = $formId.attr('action'); 1433 var emailReg = /^([\w-\.]+@([\w-]+\.)+[\w-]{2,4})?$/; 1434 var phoneReg = /^\(?(\d{3})\)?[- ]?(\d{3})[- ]?(\d{4})$/; 1435 var $error = $('<span class="error"></span>'); 1436 1437 1438 // Prepare the form for validation - remove previous errors 1439 //$('li',$formId).removeClass('error'); 1440 $('span.error').remove(); 1441 $('.input-holder').removeClass('error'); 1442 $('#msg3').hide(); 1443 $('#msg3').removeClass('newerror'); 1444 $("#msg3").html(""); 1445 1446 1447 // Validate all inputs with the class "required" 1448 //$('.required',$formId).each(function(){ 1449 $($formId).find('input, select, textarea').each(function(){ 1450 1451 var inputVal = $.trim($(this).val()); 1452 var $parentTag = $(this).parent(); 1453 1454 var class_name=""; 1455 class_name = $(this).attr('class'); 1456 var fieldtitle = $(this).attr("title"); 1457 1458 if(typeof(class_name) != "undefined"){ 1459 class_name=class_name.split(' '); 1460 class_name=class_name[0]; 1461 } 1462 if(class_name=="required"){ 1463 if(inputVal == ''){ 1464 $parentTag.addClass('error').append($error.clone().text(fieldtitle)); 1465 $(this).focus(); 1466 $('.submit-bttn'+3).show(); 1467 $('.wait-contactform-contact'+3).hide(); 1468 return false; 1469 } 1470 1471 } 1472 1473 if($(this).attr('type')=="email"){ 1474 if(!emailReg.test(inputVal)){ 1475 $parentTag.addClass('error').append($error.clone().text('Sorry, you have entered an invalid Email Address')); 1476 $(this).focus();$(this).select(); 1477 $('.submit-bttn'+3).show(); 1478 $('.wait-contactform-contact'+3).hide(); 1479 return false; 1480 } 1481 } 1482 1483 if(jQuery(this).attr('type')=="checkbox"){ 1484 jQuery('.check-box').click(function(e){ 1485 jQuery(this).attr('checked', 'checked'); 1486 }); 1487 if(class_name=="required"){ 1488 if(jQuery('.check-box').is(":checked")){ 1489 $parentTag.removeClass('error'); 1490 } 1491 else if(jQuery('.check-box').is(":not(:checked)")){ 1492 $parentTag.addClass('error').append($error.clone().text(fieldtitle)); 1493 jQuery(this).focus(); 1494 jQuery('.submit-bttn'+3).show(); 1495 jQuery('.wait-contactform-contact'+3).hide(); 1496 return false; 1497 } 1498 } 1499 } 1500 1501 1502 if($(this).val()!=""){ 1503 if($(this).attr('type')=="tel"){ 1504 if(!phoneReg.test(inputVal)){ 1505 $parentTag.addClass('error').append($error.clone().text('Phone number seems invalid')); 1506 $(this).focus();$(this).select(); 1507 $('.submit-bttn'+3).show(); 1508 $('.wait-contactform-contact'+3).hide(); 1509 return false; 1510 } 1511 if( ( inputVal.indexOf("123456") > -1 ) || ( inputVal.indexOf("142536") > -1 ) ){ 1512 $parentTag.addClass('error').append($error.clone().text('Please enter a valid Phone number')); 1513 $(this).focus();$(this).select(); 1514 $('.submit-bttn'+3).show(); 1515 $('.wait-contactform-contact'+3).hide(); 1516 return false; 1517 } 1518 1519 1520 1521 } 1522 } 1523 1524 1525 }); 1526 1527 1528 1529 1530 // All validation complete - Check if any errors exist 1531 // If has errors 1532 if ($('span.error').length > 0) { 1533 1534 $('span.error').each(function(){ 1535 1536 // Set the distance for the error animation 1537 var distance = 5; 1538 1539 // Get the error dimensions 1540 var width = $(this).outerWidth(); 1541 1542 // Calculate starting position 1543 var start = width + distance; 1544 1545 // Set the initial CSS 1546 $(this).show().css({ 1547 display: 'block', 1548 opacity: 0 1549 }) 1550 // Animate the error message 1551 .animate({ 1552 opacity: 1 1553 }, 'slow'); 1554 1555 }); 1556 1557 }else { 1558 //$formId.submit(); 1559 //alert("success form going to be submit."); 1560 1561 var captcha_field = $(".captcha_field_3").val(); 1562 validateCaptchaContact(3, $('#captcha_hid_contact_3').val(),captcha_field); 1563 1564 } 1565 // Prevent form submission 1566 e.preventDefault(); 1567 }); 1568 1569 // Fade out error message when input field gains focus 1570 $('.required').keypress(function(){ 1571 var $parent = $(this).parent(); 1572 $parent.removeClass('error'); 1573 $('span.error',$parent).fadeOut(); 1574 }); 1575 1576 $('.captcha-image-contact').focus(function(){ 1577 var $parent = $(this).parent(); 1578 $parent.removeClass('error'); 1579 $('span.error',$parent).fadeOut(); 1580 }); 1581 1582 jQuery('#captcha_div_contact_3').on('click','a.captcha-image-contact',function(){ 1583 var $parent = $(this).parent(); 1584 $parent.removeClass('error'); 1585 $('span.error',$parent).fadeOut(); 1586 }); 1587 1588 1589 1590}); 1591 1592</script>
1592 1593 1594 1595<form name="formcontact_3" id="formcontact_3" action="https://www.cognitivebehaviourtherapytoronto.com/wp-content/plugins/techwyse-form/forms/mails/mail.php" method="post"> 1596 1597 1598 1599 1600 1601 <div class="input-holder"> 1602 <input tabindex="31" type="text" required="yes" name="pname" id="pname" class="required" title="Please enter your Name." placeholder="Name*" > 1603 </div> 1604 1605 <div class="input-holder"> 1606 <input tabindex="32" type="tel" required="yes" name="pphone" id="pphone" class="required" title="Please enter your Phone." placeholder="Phone*" > 1607 </div> 1608 1609 1610 <div class="input-holder"> 1611 <input tabindex="33" type="email" required="yes" name="pemail" id="pemail" class="required" title="Please enter your Email." placeholder="Email*" > 1612 </div> 1613 1614<div class="input-holder"> 1615<label class="checkbox-label">Preferred Contact Method* : </label><br/><label class="chk-container">Email<input name="presponse[]" id="Email" value="Email" type="checkbox" required="yes" name="presponse" id="presponse" class="required check-box" title="Please select one or more for Preferred Contact Method" placeholder="Preferred Contact Method* : " options="Email:Email|Text:Text|Call:Call|No Preference:No Preference" ><span class="checkmark"></span></label id="Email"><label class="chk-container">Text<input name="presponse[]" id="Text" value="Text" type="checkbox" required="yes" name="presponse" id="presponse" class="required check-box" title="Please select one or more for Preferred Contact Method" placeholder="Preferred Contact Method* : " options="Email:Email|Text:Text|Call:Call|No Preference:No Preference" ><span class="checkmark"></span></label id="Text"><label class="chk-container">Call<input name="presponse[]" id="Call" value="Call" type="checkbox" required="yes" name="presponse" id="presponse" class="required check-box" title="Please select one or more for Preferred Contact Method" placeholder="Preferred Contact Method* : " options="Email:Email|Text:Text|Call:Call|No Preference:No Preference" ><span class="checkmark"></span></label id="Call"><label class="chk-container">No Preference<input name="presponse[]" id="No Preference" value="No Preference" type="checkbox" required="yes" name="presponse" id="presponse" class="required check-box" title="Please select one or more for Preferred Contact Method" placeholder="Preferred Contact Method* : " options="Email:Email|Text:Text|Call:Call|No Preference:No Preference" ><span class="checkmark"></span></label id="No Preference"> 1616 </div> 1617 1618 1619<div class="cwrap cf"> 1620 <div class="input-holder"> 1621 <select tabindex="35" required="yes" name="mpref" id="mpref" class="required" title="Please Select Meeting Preference" placeholder="Please Select Meeting Preference" options="Virtual|In-Person|No Preference" ><option value="">Please Select Meeting Preference*</option><option value="Virtual">Virtual</option><option value="In-Person">In-Person</option><option value="No Preference">No Preference</option></select> 1622 </div> 1623 </div> 1624 1625 1626 1627 1628<div class="input-holder"> 1629 <select tabindex="36" required="yes" name="presponse_time" id="presponse_time" class="required" title="Please Select Preferred Appointment Type" placeholder="Preferred Appointment Type" options="15-minute consultation|1-hour session" ><option value="">Preferred Appointment Type*</option><option value="15-minute consultation">15-minute consultation</option><option value="1-hour session">1-hour session</option></select> 1630 </div> 1631 1632 <div class="input-holder"> 1633 <textarea tabindex="37" required="no" name="pcomments" id="pcomments" title="Please enter your Questions/Comments." placeholder="Questions/Comments regarding your needs and availability" ></textarea> 1634 </div> 1635 <div class="pop-catcha-otr"> 1636 <div class="input-holder"> 1637 <span class="errors" id="msg3"></span> 1638 <div id="captcha_div_contact_3" class="captcha-wrap" ><p>Please select the <span>TRIANGLE</span> and click the SUBMIT button</p> 1639<div class="btn-grp cf"><a class="ref-img" href="javascript:void();" onClick="refreshCapchaContact(3);return false;" alt="Refresh" title="Refresh"><svg tabindex="38" class="ref-img" style="width:20px; height:20px;" viewBox="0 0 28.265 28.265"> 1640<path d="M14.133,28.265c-7.061,0-12.805-5.75-12.805-12.809c0-7.06,5.744-12.807,12.8
164005-12.807c0.469,0,0.943,0.027,1.414,0.08 1641v-2.07c0-0.266,0.164-0.508,0.406-0.611c0.252-0.098,0.531-0.043,0.723,0.148l4.537,4.547c0.258,0.258,0.258,0.67,0,0.932 1642l-4.535,4.557c-0.193,0.188-0.473,0.246-0.725,0.143c-0.242-0.104-0.406-0.344-0.406-0.609V7.47 1643c-0.469-0.086-0.941-0.125-1.414-0.125c-4.473,0-8.113,3.639-8.113,8.111c0,4.471,3.641,8.113,8.113,8.113s8.111-3.643,8.111-8.113 1644c0-0.363,0.295-0.66,0.662-0.66h3.369c0.365,0,0.662,0.297,0.662,0.66C26.937,22.515,21.189,28.265,14.133,28.265z"/> 1645</g> 1646 1647</svg></a><a href="javascript:void(0)" class="captcha-image-contact captcha_inactive" data-ran="522921017" ><svg class="shapes-cap" id="STAR" viewBox="0 0 112 112" > 1648<g class="shape-color" > 1649 <path d="M81.564,69.924l9.043,39.336L56,88.496l-34.607,20.768l9.047-39.336L0,43.421l40.203-3.542L56,2.736l15.797,37.143 1650 L112,43.421L81.564,69.924z"/> 1651</g> 1652</svg></a><a href="javascript:void(0)" class="captcha-image-contact captcha_inactive" data-ran="1340491353" ><svg class="shapes-cap" id="SQUARE" viewBox="0 0 360.72 360.72" > 1653 <g class="shape-color"> 1654 <path d="M360.72,352.99c0,4.269-3.459,7.727-7.728,7.727H7.722c-4.263,0-7.722-3.458-7.722-7.727V7.724 1655 c0-4.263,3.459-7.721,7.722-7.721h345.271c4.259,0,7.716,3.458,7.716,7.721V352.99H360.72z"/> 1656 </g> 1657 1658</svg></a><a href="javascript:void(0)" class="captcha-image-contact captcha_inactive" data-ran="1222873317" ><svg class="shapes-cap" id="DIAMOND" viewBox="0 0 40.731 40.731" > 1659 <g class="shape-color"> 1660 <path d="M37.761,19.833c0.114,0.164,0.184,0.363,0.184,0.578c0,0.431-0.271,0.797-0.653,0.938 1661 c-1.546,1.096-9.82,7.307-16.016,18.733c-0.122,0.304-0.378,0.548-0.7,0.621c-0.084,0.021-0.168,0.027-0.252,0.027 1662 c-0.339,0-0.656-0.156-0.832-0.453c-0.047-0.07-0.084-0.146-0.112-0.228c-0.804-1.56-6.132-11.422-15.984-18.756 1663 c-0.358-0.152-0.608-0.507-0.608-0.921c0-0.008,0-0.016,0-0.022c-0.004-0.19,0.045-0.381,0.149-0.549 1664 c0.118-0.19,0.295-0.333,0.499-0.41c1.279-0.894,9.649-7.022,15.965-18.612C19.499,0.334,19.899,0,20.376,0 1665 c0.196,0,0.379,0.057,0.533,0.154c0.213,0.12,0.376,0.316,0.455,0.553c0.613,1.209,5.938,11.318,16.04,18.802 1666 C37.548,19.587,37.672,19.698,37.761,19.833z"/> 1667</g> 1668</svg></a><a href="javascript:void(0)" class="captcha-image-contact captcha_inactive" data-ran="1722578493" ><svg class="shapes-cap" id="TRIANGLE" viewBox="0 0 488.84 488.84" > 1669<g class="shape-color"> 1670 <path d="M244.42,33.42L0,455.42h488.84L244.42,33.42L244.42,33.42z"/> 1671</g> 1672</svg></a><a href="javascript:void(0)" class="captcha-image-contact captcha_inactive" data-ran="1393126750" ><svg class="shapes-cap" id="CIRCLE" viewBox="0 0 510 510" > 1673 <g class="shape-color" style="color:#C3C3C3;"> 1674 <path d="M255,0C114.75,0,0,114.75,0,255s114.75,255,255,255s255-114.75,255-255S395.25,0,255,0z"/> 1675 </g> 1676 1677</svg></a><input type="hidden" name="captcha_hid_contact_3" id="captcha_hid_contact_3" value="" /> 1678<input type="hidden" name="captcha_field_3" class="captcha_field_3" value="1722578493"> 1679</div></div></div> 1680 <div id="wait_contactform_3" class="wait-contactform-contact wait-contactform-contact3" style="display:none"> 1681 <div class="pls-wait-img-contact"><img src="https://www.cognitivebehaviourtherapytoronto.com/wp-content/plugins/techwyse-form/forms/template/img/wait.gif" align="left" border="0" class="loader-img"/></div> 1682 <div class="pls-wait-text-contact">Please wait...</div> 1683 </div><input type="submit" tabindex="39" alt="Submit" value="Submit" id="submit_contactform_3" class="btn submit-bttn3 submit-bttn shutter" /></div> 1684 1685 1686 1687 1688<div class="input-holder"> 1689 <input type="hidden" name="form_id" id="form_id" value="3" /> 1690 <input name="field_name" autocomplete="off" type="text" placeholder="Name*" style="display:none"> 1691<input name="field_email" autocomplete="off" type="email" placeholder="Email*" style="display:none"> 1692<input name="field_phone" autocomplete="off" type="text" placeholder="Phone*" style="display:none"> 1693 1694 </div> 1695</form> 1696
1697<script> 1698// $(".mulsel").attr("multiple",""); 1699// $(".mulsel").attr("size","1"); 1700jQuery('#captcha_div_contact_3').on('click','a.captcha-image-contact',function(){ 1701 jQuery('.captcha-image-contact').removeClass('captcha_active'); 1702 jQuery(this).addClass('captcha_active'); 1703 jQuery("#msg3").hide(); 1704 1705jQuery("#captcha_hid_contact_3").val(jQuery(this).data('ran')); 1706}) 1707 1708jQuery('#aname').on('focus',function(){ 1709 refreshCapchaContact(3,8); 1710}) 1711jQuery('#cname').on('focus',function(){ 1712 refreshCapchaContact(3,8); 1713}) 1714jQuery('#bname').on('focus',function(){ 1715 refreshCapchaContact(3,8); 1716}) 1717jQuery('#pname').on('focus',function(){ 1718 refreshCapchaContact(3,8); 1719}) 1720jQuery('#fname').on('focus',function(){ 1721 refreshCapchaContact(3,8); 1722}) 1723jQuery('#hname').on('focus',function(){ 1724 refreshCapchaContact(3,8); 1725}) 1726 1727</script>
1727 1728 1729 1730 1731 </div> 1732 <div class="modal-footer"> 1733 1734 </div> 1735 </div> 1736 </div> 1737</div> 1738 1739<div class="modal fade" id="myModalb" tabindex="-1" role="dialog" aria-labelledby="myModalLabel" aria-hidden="true"> 1740 <div class="modal-dialog"> 1741 <div class="modal-content"> 1742 <div class="modal-header"> 1743 <p class="modal-title span-spn-h4" id="myModalLabel">Request an Appointment</p> 1744 <!-- <p style="margin:15px 10px;">To determine if I am the right fit for your needs, please let me know when & how to contact you to schedule a free 15 minute consultation.</p> --> 1745 <button title="Close" type="button" class="close" data-dismiss="modal" aria-label="Close"><span aria-hidden="true">x</span></button> 1746 </div> 1747 <div class="modal-body"> 1748 1749 1750
1750<script type="text/javascript"> 1751 1752$(document).ready(function() { 1753 1754 1755 $('.submit-bttn'+4).click(function(e){ 1756 1757 $('.submit-bttn'+4).hide(); 1758 $('.wait-contactform-contact'+4).show(); 1759 // Declare the function variables: 1760 // Parent form, form URL, email regex and the error HTML 1761 1762 var $formId = $(this).parents('form'); 1763 var formAction = $formId.attr('action'); 1764 var emailReg = /^([\w-\.]+@([\w-]+\.)+[\w-]{2,4})?$/; 1765 var phoneReg = /^\(?(\d{3})\)?[- ]?(\d{3})[- ]?(\d{4})$/; 1766 var $error = $('<span class="error"></span>'); 1767 1768 1769 // Prepare the form for validation - remove previous errors 1770 //$('li',$formId).removeClass('error'); 1771 $('span.error').remove(); 1772 $('.input-holder').removeClass('error'); 1773 $('#msg4').hide(); 1774 $('#msg4').removeClass('newerror'); 1775 $("#msg4").html(""); 1776 1777 1778 // Validate all inputs with the class "required" 1779 //$('.required',$formId).each(function(){ 1780 $($formId).find('input, select, textarea').each(function(){ 1781 1782 var inputVal = $.trim($(this).val()); 1783 var $parentTag = $(this).parent(); 1784 1785 var class_name=""; 1786 class_name = $(this).attr('class'); 1787 var fieldtitle = $(this).attr("title"); 1788 1789 if(typeof(class_name) != "undefined"){ 1790 class_name=class_name.split(' '); 1791 class_name=class_name[0]; 1792 } 1793 if(class_name=="required"){ 1794 if(inputVal == ''){ 1795 $parentTag.addClass('error').append($error.clone().text(fieldtitle)); 1796 $(this).focus(); 1797 $('.submit-bttn'+4).show(); 1798 $('.wait-contactform-contact'+4).hide(); 1799 return false; 1800 } 1801 1802 } 1803 1804 if($(this).attr('type')=="email"){ 1805 if(!emailReg.test(inputVal)){ 1806 $parentTag.addClass('error').append($error.clone().text('Sorry, you have entered an invalid Email Address')); 1807 $(this).focus();$(this).select(); 1808 $('.submit-bttn'+4).show(); 1809 $('.wait-contactform-contact'+4).hide(); 1810 return false; 1811 } 1812 } 1813 1814 if(jQuery(this).attr('type')=="checkbox"){ 1815 jQuery('.check-box').click(function(e){ 1816 jQuery(this).attr('checked', 'checked'); 1817 }); 1818 if(class_name=="required"){ 1819 if(jQuery('.check-box').is(":checked")){ 1820 $parentTag.removeClass('error'); 1821 } 1822 else if(jQuery('.check-box').is(":not(:checked)")){ 1823 $parentTag.addClass('error').append($error.clone().text(fieldtitle)); 1824 jQuery(this).focus(); 1825 jQuery('.submit-bttn'+4).show(); 1826 jQuery('.wait-contactform-contact'+4).hide(); 1827 return false; 1828 } 1829 } 1830 } 1831 1832 1833 if($(this).val()!=""){ 1834 if($(this).attr('type')=="tel"){ 1835 if(!phoneReg.test(inputVal)){ 1836 $parentTag.addClass('error').append($error.clone().text('Phone number seems invalid')); 1837 $(this).focus();$(this).select(); 1838 $('.submit-bttn'+4).show(); 1839 $('.wait-contactform-contact'+4).hide(); 1840 return false; 1841 } 1842 if( ( inputVal.indexOf("123456") > -1 ) || ( inputVal.indexOf("142536") > -1 ) ){ 1843 $parentTag.addClass('error').append($error.clone().text('Please enter a valid Phone number')); 1844 $(this).focus();$(this).select(); 1845 $('.submit-bttn'+4).show(); 1846 $('.wait-contactform-contact'+4).hide(); 1847 return false; 1848 } 1849 1850 1851 1852 } 1853 } 1854 1855 1856 }); 1857 1858 1859 1860 1861 // All validation complete - Check if any errors exist 1862 // If has errors 1863 if ($('span.error').length > 0) { 1864 1865 $('span.error').each(function(){ 1866 1867 // Set the distance for the error animation 1868 var distance = 5; 1869 1870 // Get the error dimensions 1871 var width = $(this).outerWidth(); 1872 1873 // Calculate starting position 1874 var start = width + distance; 1875 1876 // Set the initial CSS 1877 $(this).show().css({ 1878 display: 'block', 1879 opacity: 0 1880 }) 1881 // Animate the error message 1882 .animate({ 1883 opacity: 1 1884 }, 'slow'); 1885 1886 }); 1887 1888 }else { 1889 //$formId.submit(); 1890 //alert("success form going to be submit."); 1891 1892 var captcha_field = $(".captcha_field_4").val(); 1893 validateCaptchaContact(4, $('#captcha_hid_contact_4').val(),captcha_field); 1894 1895 } 1896 // Prevent form submission 1897 e.preventDefault(); 1898 }); 1899 1900 // Fade out error message when input field gains focus 1901 $('.required').keypress(function(){ 1902 var $parent = $(this).parent(); 1903 $parent.removeClass('error'); 1904 $('span.error',$parent).fadeOut(); 1905 }); 1906 1907 $('.captcha-image-contact').focus(function(){ 1908 var $parent = $(this).parent(); 1909 $parent.removeClass('error'); 1910 $('span.error',$parent).fadeOut(); 1911 }); 1912 1913 jQuery('#captcha_div_contact_4').on('click','a.captcha-image-contact',function(){ 1914 var $parent = $(this).parent(); 1915 $parent.removeClass('error'); 1916 $('span.error',$parent).fadeOut(); 1917 }); 1918 1919 1920 1921}); 1922 1923</script>
1923 1924 1925 1926<form name="formcontact_4" id="formcontact_4" action="https://www.cognitivebehaviourtherapytoronto.com/wp-content/plugins/techwyse-form/forms/mails/mail.php" method="post"> 1927 1928 1929 1930 1931 1932 <div class="input-holder"> 1933 <input tabindex="41" type="text" required="yes" name="bname" id="bname" class="required" title="Please enter your Name." placeholder="Name*" > 1934 </div> 1935 1936 <div class="input-holder"> 1937 <input tabindex="42" type="tel" required="yes" name="bphone" id="bphone" class="required" title="Please enter your Phone." placeholder="Phone*" > 1938 </div> 1939 1940 1941 <div class="input-holder"> 1942 <input tabindex="43" type="email" required="yes" name="bemail" id="bemail" class="required" title="Please enter your Email." placeholder="Email*" > 1943 </div> 1944 1945<div class="input-holder"> 1946<label class="checkbox-label">Preferred Contact Method* : </label><br/><label class="chk-container">Email<input name="bresponse[]" id="Email" value="Email" type="checkbox" required="yes" name="bresponse" id="bresponse" class="required check-box" title="Please select one or more for Preferred Contact Method" placeholder="Preferred Contact Method* : " options="Email:Email|Text:Text|Call:Call|No Preference:No Preference" ><span class="checkmark"></span></label id="Email"><label class="chk-container">Text<input name="bresponse[]" id="Text" value="Text" type="checkbox" required="yes" name="bresponse" id="bresponse" class="required check-box" title="Please select one or more for Preferred Contact Method" placeholder="Preferred Contact Method* : " options="Email:Email|Text:Text|Call:Call|No Preference:No Preference" ><span class="checkmark"></span></label id="Text"><label class="chk-container">Call<input name="bresponse[]" id="Call" value="Call" type="checkbox" required="yes" name="bresponse" id="bresponse" class="required check-box" title="Please select one or more for Preferred Contact Method" placeholder="Preferred Contact Method* : " options="Email:Email|Text:Text|Call:Call|No Preference:No Preference" ><span class="checkmark"></span></label id="Call"><label class="chk-container">No Preference<input name="bresponse[]" id="No Preference" value="No Preference" type="checkbox" required="yes" name="bresponse" id="bresponse" class="required check-box" title="Please select one or more for Preferred Contact Method" placeholder="Preferred Contact Method* : " options="Email:Email|Text:Text|Call:Call|No Preference:No Preference" ><span class="checkmark"></span></label id="No Preference"> 1947 </div> 1948 1949 1950 1951 1952<div class="cwrap cf"> 1953 <div class="input-holder"> 1954 <select tabindex="45" required="yes" name="mpref" id="mpref" class="required" title="Please Select Meeting Preference" placeholder="Please Select Meeting Preference" options="Virtual|In-Person|No Preference" ><option value="">Please Select Meeting Preference*</option><option value="Virtual">Virtual</option><option value="In-Person">In-Person</option><option value="No Preference">No Preference</option></select> 1955 </div> 1956 </div> 1957 1958 1959 1960 1961<div class="input-holder"> 1962 <select tabindex="46" required="yes" name="bresponse_time" id="bresponse_time" class="required" title="Please Select Preferred Appointment Type" placeholder="Preferred Appointment Type" options="15-minute consultation|1-hour session" ><option value="">Preferred Appointment Type*</option><option value="15-minute consultation">15-minute consultation</option><option value="1-hour session">1-hour session</option></select> 1963 </div> 1964 1965 1966 <div class="input-holder"> 1967 <textarea tabindex="47" required="no" name="bcomments" id="bcomments" title="Please enter your Questions/Comments." placeholder="Questions/Comments regarding your needs and availability" ></textarea> 1968 </div> 1969 1970 <div class="pop-catcha-otr"> <div class="input-holder"> 1971 <span class="errors" id="msg4"></span> 1972 <div id="captcha_div_contact_4" class="captcha-wrap" ><p>Please select the <span>TRIANGLE</span> and click the SUBMIT button</p> 1973<div class="btn-grp cf"><a class="ref-img" href="javascript:void();" onClick="refreshCapchaContact(4);return false;" alt="Refresh" title="Refresh"><svg tabindex="48" class="ref-img" style="width:20px; height:20px;" viewBox="0 0 28.265 28.265"> 1974<path d="M14.133,28.265c-7.061,0-12.805-5.75-12.805-12.809c0-7.06,5.744-12.807,12.8
197405-12.807c0.469,0,0.943,0.027,1.414,0.08 1975v-2.07c0-0.266,0.164-0.508,0.406-0.611c0.252-0.098,0.531-0.043,0.723,0.148l4.537,4.547c0.258,0.258,0.258,0.67,0,0.932 1976l-4.535,4.557c-0.193,0.188-0.473,0.246-0.725,0.143c-0.242-0.104-0.406-0.344-0.406-0.609V7.47 1977c-0.469-0.086-0.941-0.125-1.414-0.125c-4.473,0-8.113,3.639-8.113,8.111c0,4.471,3.641,8.113,8.113,8.113s8.111-3.643,8.111-8.113 1978c0-0.363,0.295-0.66,0.662-0.66h3.369c0.365,0,0.662,0.297,0.662,0.66C26.937,22.515,21.189,28.265,14.133,28.265z"/> 1979</g> 1980 1981</svg></a><a href="javascript:void(0)" class="captcha-image-contact captcha_inactive" data-ran="793454006" ><svg class="shapes-cap" id="CIRCLE" viewBox="0 0 510 510" > 1982 <g class="shape-color" style="color:#C3C3C3;"> 1983 <path d="M255,0C114.75,0,0,114.75,0,255s114.75,255,255,255s255-114.75,255-255S395.25,0,255,0z"/> 1984 </g> 1985 1986</svg></a><a href="javascript:void(0)" class="captcha-image-contact captcha_inactive" data-ran="795263172" ><svg class="shapes-cap" id="DIAMOND" viewBox="0 0 40.731 40.731" > 1987 <g class="shape-color"> 1988 <path d="M37.761,19.833c0.114,0.164,0.184,0.363,0.184,0.578c0,0.431-0.271,0.797-0.653,0.938 1989 c-1.546,1.096-9.82,7.307-16.016,18.733c-0.122,0.304-0.378,0.548-0.7,0.621c-0.084,0.021-0.168,0.027-0.252,0.027 1990 c-0.339,0-0.656-0.156-0.832-0.453c-0.047-0.07-0.084-0.146-0.112-0.228c-0.804-1.56-6.132-11.422-15.984-18.756 1991 c-0.358-0.152-0.608-0.507-0.608-0.921c0-0.008,0-0.016,0-0.022c-0.004-0.19,0.045-0.381,0.149-0.549 1992 c0.118-0.19,0.295-0.333,0.499-0.41c1.279-0.894,9.649-7.022,15.965-18.612C19.499,0.334,19.899,0,20.376,0 1993 c0.196,0,0.379,0.057,0.533,0.154c0.213,0.12,0.376,0.316,0.455,0.553c0.613,1.209,5.938,11.318,16.04,18.802 1994 C37.548,19.587,37.672,19.698,37.761,19.833z"/> 1995</g> 1996</svg></a><a href="javascript:void(0)" class="captcha-image-contact captcha_inactive" data-ran="1875830154" ><svg class="shapes-cap" id="STAR" viewBox="0 0 112 112" > 1997<g class="shape-color" > 1998 <path d="M81.564,69.924l9.043,39.336L56,88.496l-34.607,20.768l9.047-39.336L0,43.421l40.203-3.542L56,2.736l15.797,37.143 1999 L112,43.421L81.564,69.924z"/> 2000</g> 2001</svg></a><a href="javascript:void(0)" class="captcha-image-contact captcha_inactive" data-ran="1606509059" >
2001<svg class="shapes-cap" id="SQUARE" viewBox="0 0 360.72 360.72" > 2002 <g class="shape-color"> 2003 <path d="M360.72,352.99c0,4.269-3.459,7.727-7.728,7.727H7.722c-4.263,0-7.722-3.458-7.722-7.727V7.724 2004 c0-4.263,3.459-7.721,7.722-7.721h345.271c4.259,0,7.716,3.458,7.716,7.721V352.99H360.72z"/> 2005 </g> 2006 2007</svg></a><a href="javascript:void(0)" class="captcha-image-contact captcha_inactive" data-ran="1481818936" ><svg class="shapes-cap" id="TRIANGLE" viewBox="0 0 488.84 488.84" > 2008<g class="shape-color"> 2009 <path d="M244.42,33.42L0,455.42h488.84L244.42,33.42L244.42,33.42z"/> 2010</g> 2011</svg></a><input type="hidden" name="captcha_hid_contact_4" id="captcha_hid_contact_4" value="" /> 2012<input type="hidden" name="captcha_field_4" class="captcha_field_4" value="1481818936"> 2013</div></div></div> 2014 <div id="wait_contactform_4" class="wait-contactform-contact wait-contactform-contact4" style="display:none"> 2015 <div class="pls-wait-img-contact"><img src="https://www.cognitivebehaviourtherapytoronto.com/wp-content/plugins/techwyse-form/forms/template/img/wait.gif" align="left" border="0" class="loader-img"/></div> 2016 <div class="pls-wait-text-contact">Please wait...</div> 2017 </div><input type="submit" tabindex="49" alt="Submit" value="Submit" id="submit_contactform_4" class="btn submit-bttn4 submit-bttn shutter" /> </div> 2018 2019 2020 2021 2022<div class="input-holder"> 2023 <input type="hidden" name="form_id" id="form_id" value="4" /> 2024 <input name="field_name" autocomplete="off" type="text" placeholder="Name*" style="display:none"> 2025<input name="field_email" autocomplete="off" type="email" placeholder="Email*" style="display:none"> 2026<input name="field_phone" autocomplete="off" type="text" placeholder="Phone*" style="display:none"> 2027 2028 </div> 2029</form> 2030
2031<script> 2032// $(".mulsel").attr("multiple",""); 2033// $(".mulsel").attr("size","1"); 2034jQuery('#captcha_div_contact_4').on('click','a.captcha-image-contact',function(){ 2035 jQuery('.captcha-image-contact').removeClass('captcha_active'); 2036 jQuery(this).addClass('captcha_active'); 2037 jQuery("#msg4").hide(); 2038 2039jQuery("#captcha_hid_contact_4").val(jQuery(this).data('ran')); 2040}) 2041 2042jQuery('#aname').on('focus',function(){ 2043 refreshCapchaContact(4,8); 2044}) 2045jQuery('#cname').on('focus',function(){ 2046 refreshCapchaContact(4,8); 2047}) 2048jQuery('#bname').on('focus',function(){ 2049 refreshCapchaContact(4,8); 2050}) 2051jQuery('#pname').on('focus',function(){ 2052 refreshCapchaContact(4,8); 2053}) 2054jQuery('#fname').on('focus',function(){ 2055 refreshCapchaContact(4,8); 2056}) 2057jQuery('#hname').on('focus',function(){ 2058 refreshCapchaContact(4,8); 2059}) 2060 2061</script>
2061 2062 2063 2064 2065 </div> 2066 <div class="modal-footer"> 2067 2068 </div> 2069 </div> 2070 </div> 2071</div>
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