function clearField(object)
{
    object.value = "";
}

function newWindow(mypage, myname, w, h, features)
{
    if( screen.width )
    {
        var winl = (screen.width-w) / 2;
        var wint = (screen.height-h) / 2;
    }
    else
    {
        winl = 0;
        wint = 0;
    }
    if( winl < 0 ) winl = 0;
    if( wint < 0 ) wint = 0;

    var settings = 'height=' + h + ',';
    settings += 'width=' + w + ',';
    settings += 'top=' + wint + ',';
    settings += 'left=' + winl + ',';
    settings += features;

    win = window.open(mypage, myname, settings);
    win.window.focus();
}

function selectField(object)
{
    object.select();
}

function validate()
{
    var words;
    var result = true;

    with( document.main )
    {
        words = textName.value.split(" ");
        if( result == true &&
            (textName.value == "") )
        {
            alert("Please enter your First name.");
            textName.focus();
            textName.select();
            result = false;
        }

		        if( result == true &&
            (textName1.value == "") )
        {
            alert("Please enter your Last name.");
            textName1.focus();
            textName1.select();
            result = false;
        }


        textEmail.value.replace(/ /, "");
        textPhone1.value.replace(/ /, "");
        textPhone2.value.replace(/ /, "");
        textPhone3.value.replace(/ /, "");
        if( result == true )
        {
			/*if( textEmail.value == "" &&
                (textPhone1.value == "" &&
                 textPhone2.value == "" &&
                 textPhone3.value == "") ) */
			
			if( textEmail.value == "")
			{
                alert("Please enter a valid email address");
                textEmail.focus();
                result = false;
            }
        }

        if( result == true )
        {
            if( textEmail.value != "" )
            {
                match = textEmail.value.match(/\b(^(\S+@).+((\.com)|(\.net)|(\.edu)|(\.mil)|(\.gov)|(\.org)|(\..{2,2}))$)\b/gi);
                if( match == null )
                {
                    alert("Please enter a valid email address.");
                    textEmail.focus();
                    textEmail.select();
                    result = false;
                }
            }
        }

        if( result == true && 
            (textEmail.value == "" || textPhone1.value != " " || textPhone2.value != " " || textPhone3.value != " ") )
        {
            if( textPhone1.value.match(/^[2-9][0-9][0-9]$/) == null )
            {
                alert("Please enter a valid area code.");
                textPhone1.focus();
                textPhone1.select();
                result = false;
            }

            if( result == true &&
                textPhone2.value.match(/^\d\d\d$/) == null )
            {
                alert("Please enter a valid phone number prefix.");
                textPhone2.focus();
                textPhone2.select();
                result = false;
            }

            if( result == true &&
                textPhone3.value.match(/^\d\d\d\d$/) == null )
            {
                alert("Please enter a valid phone number suffix.");
                textPhone3.focus();
                textPhone3.select();
                result = false;
            }
        }

		if( result == true && selectlocation.value == "Select Location" )
        {
            alert("Please Select Your Convenient Location.");
            selectlocation.focus();
            result = false;
        }
	  
		if( result == true && V1[0].checked != true && V1[1].checked != true   )
        {
            alert("Please Select New Patient Information.");
			V1[0].focus();
            result = false;
        }


		
		if( result == true && V1[0].checked == true  && hadd.value == "" )
        {
            alert("Please Enter Your Home Address");
            hadd.focus();
            result = false;
        }


		if( result == true && V1[0].checked == true && city.value == "" )
        {
            alert("Please Enter Your City");
            city.focus();
            result = false;
        }

		if( result == true && V1[0].checked == true && state.value == "Select a State" )
        {
            alert("Please Select Your State");
            state.focus();
            result = false;
        }

		if( result == true && V1[0].checked == true && zip.value == "" )
        {
            alert("Please Enter Your Zip Code");
            zip.focus();
            result = false;
        }

		if( result == true && V1[0].checked == true && phhome.value == "" )
        {
            alert("Please Enter Your Home Phone No.");
            phhome.focus();
            result = false;
        }

		if( result == true && V1[0].checked == true && agginfo.checked != true )
        {
            alert("Please Tick for information above is accurate.");
            agginfo.focus();
            result = false;
        }
	
		if( result == true && V1[0].checked == true && agginfo1.checked != true )
        {
            alert("Please Tick Notices.");
            agginfo1.focus();
            result = false;
        }
		
		if( result == true && V1[0].checked == true && tod1.value == "")
        {
            alert("Please select the month in todays date.");
            tod1.focus();
            result = false;
        }
		
		if( result == true && V1[0].checked == true && tod2.value == "")
        {
            alert("Please select  date in todays date.");
            tod2.focus();
            result = false;
        }
		
		if( result == true && V1[0].checked == true && tod3.value == "")
        {
            alert("Please select year in todays date.");
            tod3.focus();
            result = false;
        }
	

	
	
	
	}
    return result;
}