<!--
	var PATH = 'http://www.drchampion.com/';
	
	function quickContact2() {
		var quick_name = $('quick_name2').value;
		var quick_eail = $('quick_eail2').value;
		var quick_message = $('quick_message2').value;

		if ( (quick_name=="") && (quick_eail=="") && (quick_message=="") ) {
			alert("Please fill out the entire form.");
			$('quick_name').focus();
			return false;
		}
		else if (quick_name=="") {
			alert("Please fill in your name properly");
			$('quick_name').focus();
			return false;
		}
		else if (quick_eail=="") {
			alert("Please enter your email address");
			$('quick_eail').focus();
			return false;
		}
		else if(quick_message=="") {
			alert("Please enter in a message");
			$('quick_message').focus();
			return false;
		}

		var url = PATH+"formssubmit/quickContact.php";

		var pars = "quick_name="+quick_name+'&quick_eail='+quick_eail+'&quick_message='+quick_message;
		
		var myAjax = new Ajax.Request(
				url,
				{
					method: 'get',
					parameters: pars,
					onFailure: reportError,
					onComplete:  showResultContact2	
				});	
	}
	
	function showResultContact2(request)
	{
		var response = request.responseText;
		var quickContact = $('quickContact2');
		
		if (response.indexOf('Error') == -1) {
			quickContact.innerHTML = "<p align=center><strong>Thank you for contacting us. Your request was successfully delivered.<br>- Dr. Champion</strong></p>";
		} else {
			if (response.indexOf('name') != -1) {
				alert("Please fill in your name properly");
				$('quick_name').focus();
			}
			if (response.indexOf('email') != -1) {
				alert("Please enter a valid email address");
				$('quick_eail').focus();
			}
			if (response.indexOf('message') != -1) {
				alert("Please enter in a message");
				$('quick_message').focus();
			}
			if (response.indexOf('directly') != -1) {
				quickContact.innerHTML = "<p align=center><strong>There was an error in submitting your form. Please contact us directly.</strong></p>";
			}
		}
	}

	function quickContact() {
		var quick_name = $('quick_name').value;
		var quick_eail = $('quick_eail').value;
		var quick_message = $('quick_message').value;

		if ( (quick_name=="") && (quick_eail=="") && (quick_message=="") ) {
			alert("Please fill out the entire form.");
			$('quick_name').focus();
			return false;
		}
		else if (quick_name=="") {
			alert("Please fill in your name properly");
			$('quick_name').focus();
			return false;
		}
		else if (quick_eail=="") {
			alert("Please enter your email address");
			$('quick_eail').focus();
			return false;
		}
		else if(quick_message=="") {
			alert("Please enter in a message");
			$('quick_message').focus();
			return false;
		}

		var url = PATH+"formssubmit/quickContact.php";

		var pars = "quick_name="+quick_name+'&quick_eail='+quick_eail+'&quick_message='+quick_message;
		
		var myAjax = new Ajax.Request(
				url,
				{
					method: 'get',
					parameters: pars,
					onFailure: reportError,
					onComplete:  showResultContact		
				});	
	}
	
	function reportError(request)
	{
		alert('Sorry. There was an error in processing your form.');
	}
	
	function showResultContact(request)
	{
		var response = request.responseText;
		var quickContact = $('quickContact');
		
		if (response.indexOf('Error') == -1) {
			quickContact.innerHTML = "<p align=center><strong>Thank you for contacting us. Your request was successfully delivered.<br>- Dr. Champion</strong></p>";
		} else {
			if (response.indexOf('name') != -1) {
				alert("Please fill in your name properly");
				$('quick_name').focus();
			}
			if (response.indexOf('email') != -1) {
				alert("Please enter a valid email address");
				$('quick_eail').focus();
			}
			if (response.indexOf('message') != -1) {
				alert("Please enter in a message");
				$('quick_message').focus();
			}
			if (response.indexOf('directly') != -1) {
				quickContact.innerHTML = "<p align=center><strong>There was an error in submitting your form. Please contact us directly.</strong></p>";
			}
		}
	}
	
	function infoRequest() {
		var d = document;
		var req_name = $('req_name').value;
		var req_email = $('req_email').value;
		var req_street = $('req_street').value;
		var req_city = $('req_city').value;
		var req_state = $('req_state').value;
		var req_zip = $('req_zip').value;
		var req_phone = $('req_phone').value;
		var req_country = $('req_country').value;
		
		var requesting_info = $('requesting_info');		// checkboxes
		var requesting_info_other = $('requesting_info_other').value;
		
		var info_for = $('info_for');	// radio buttons
		
		var find_us = $('find_us');		// checkboxes
		var find_us_text = $('find_us_text').value; 	// find_us[2] checked
		
		var mag_find_us = $('mag_find_us');		// radio buttons
		
		var web_address = $('web_address').value;
		
		var packet_location = $('packet_location');		// radio buttons
		
		
		var url = PATH+"formssubmit/infoRequest.php";

		var pars = 'req_name='+req_name+'&req_email='+req_email+'&req_street='+req_street;
			pars += '&req_city='+req_city+'&req_state='+req_state+'&req_zip='+req_zip;
			pars += '&req_phone='+req_phone+'&req_country='+req_country;
		
		for(i=0; i<document.infoRequestForm.requesting_info.length; i++) {
			if (document.infoRequestForm.requesting_info[i].checked)
				pars += '&requesting_info'+i+'='+document.infoRequestForm.requesting_info[i].value;
		}
			pars += '&requesting_info_other='+requesting_info_other;
		
		for(i=0; i<document.infoRequestForm.info_for.length; i++) {
			//alert(document.infoRequestForm.info_for[i].value+': '+document.infoRequestForm.info_for[i].checked);
			if (document.infoRequestForm.info_for[i].checked)
				pars += '&info_for='+document.infoRequestForm.info_for[i].value;
		}
		
		for(i=0; i<document.infoRequestForm.find_us.length; i++) {
			if (document.infoRequestForm.find_us[i].checked)
				pars += '&find_us'+i+'='+document.infoRequestForm.find_us[i].value;
		}
		if (document.infoRequestForm.find_us[2].checked)
				pars += '&find_us_text='+find_us_text;
		
		for(i=0; i<document.infoRequestForm.mag_find_us.length; i++) {
			if (document.infoRequestForm.mag_find_us[i].checked)
				pars += '&mag_find_us='+document.infoRequestForm.mag_find_us[i].value;
		}
		
			pars += '&web_address='+web_address;
		
		for(i=0; i<document.infoRequestForm.packet_location.length; i++) {
			if (document.infoRequestForm.packet_location[i].checked)
				pars += '&packet_location='+document.infoRequestForm.packet_location[i].value;
		}

		var myAjax = new Ajax.Request(
				url,
				{
					method: 'get',
					parameters: pars,
					onFailure: reportError,
					onComplete:  showInfoRequest		
				});	
	}
	
	function showInfoRequest(request)
	{
		var errBG = "#FFCCCC";
		$('t_name').style.backgroundColor = "#FFFFFF";
		$('t_email').style.backgroundColor = "#FFFFFF";
		$('t_street').style.backgroundColor = "#FFFFFF";
		$('t_city').style.backgroundColor = "#FFFFFF";
		$('t_state').style.backgroundColor = "#FFFFFF";
		$('t_zip').style.backgroundColor = "#FFFFFF";
		$('t_phone').style.backgroundColor = "#FFFFFF";
		
		var response = request.responseText;
		if (response.indexOf('Error') == -1) {
			$('err').innerHTML = "";
			var resText;
			if (document.infoRequestForm.packet_location[0].checked) {
				resText = "<p align=\"center\" style=\"width: 65%; margin: 0 auto 0 auto; padding: 10px; border: 1px solid #000000;\">Thank you!<br />";
				resText += "Your request was successfully delivered!<br />";
				resText += "A link to the Bariatric Package you requested was sent to <strong><u>"+$('req_email').value+"</u></strong><br /><br />";
				resText += "<strong>Please remember to periodcally check both your inbox and your junk mail, as your email client may filter our email which contains the Bariatric Form you requested.</strong><br /><br />";
				resText += "Note: You must have Adobe Reader installed to view this document. You can download Adobe Reader <a href=\"http://www.adobe.com/products/acrobat/readstep2.html\" target=\"_blank\">here</a> if you do not have it installed.";
				resText += "Please print out the document, fill it out, and either mail or fax it to:<br /><br />";
				resText += "Videoscopic Institute of Atlanta, PC<br>";
				resText += "140 Vann Street, Suite 350<br>";
				resText += "Marietta, Georgia 30060<br><br>";
				resText += "Phone: 770-425-5525 Ext: 4<br>";
				resText += "Fax:   770-425-5868<br><br>";
				resText += "If you do not receive your packet, please email us at <a href=\"mailto:drchampion@drchampion.com\">drchampion@drchampion.com</a>.<br />";
				resText += "Thank you for visiting Dr. Champion.com!</p><p>&nbsp;</p>";
			} else {
				resText = "<p align=\"center\" style=\"width: 65%; margin: 0 auto 0 auto; padding: 10px; border: 1px solid #000000;\">Thank you!<br />";
				resText += "Your request was successfully delivered!<br />";
				resText += "When you receive your Bariatric Package, please either mail or fax it to:<br /><br />";
				resText += "Videoscopic Institute of Atlanta, PC<br>";
				resText += "140 Vann Street, Suite 350<br>";
				resText += "Marietta, Georgia 30060<br><br>";
				resText += "Phone: 770-425-5525 Ext: 4<br>";
				resText += "Fax:   770-425-5868<br><br>";
				resText += "Thank you for visiting Dr. Champion.com!</p><p>&nbsp;</p>";
			}
			resText += '<!-- Google Code for lead Conversion Page --><script language="JavaScript" type="text/javascript"><!--var google_conversion_id = 1070946493;var google_conversion_language = "en_US";var google_conversion_format = "1";var google_conversion_color = "FFFFFF";if (1) {  var google_conversion_value = 1;}var google_conversion_label = "lead";//--></script><script language="JavaScript" src="http://www.googleadservices.com/pagead/conversion.js"></script><noscript><img height=1 width=1 border=0 src="http://www.googleadservices.com/pagead/conversion/1070946493/imp.gif?value=1&label=lead&script=0"></noscript>';
			$('contform').innerHTML = resText;
		} else {
			if (response.indexOf('name') != -1) {
				$('t_name').style.backgroundColor = errBG;
				$('req_name').focus();
			}
			if (response.indexOf('email') != -1) {
				$('t_email').style.backgroundColor = errBG;
				$('req_email').focus();
			}
			if (response.indexOf('street') != -1) {
				$('t_street').style.backgroundColor = errBG;
				$('req_street').focus();
			}
			if (response.indexOf('city') != -1) {
				$('t_city').style.backgroundColor = errBG;
				$('req_city').focus();
			}
			if (response.indexOf('state') != -1) {
				$('t_state').style.backgroundColor = errBG;
				$('req_state').focus();
			}
			if (response.indexOf('zip') != -1) {
				$('t_zip').style.backgroundColor = errBG;
				$('req_zip').focus();
			}
			if (response.indexOf('phone') != -1) {
				$('t_phone').style.backgroundColor = errBG;
				$('req_phone').focus();
			}

			$('err').innerHTML = "<img src=\"images/warning_icon.gif\" align=\"left\"> <strong class=\"red\">"+response+"</strong>";
		}
	}
//-->
