// JavaScript Document

function validate_required(field,alerttxt){
	with (field){
	  if (value==null||value==""){
		  alert(alerttxt);return false;
	  } else{
	  return true;
	  }
	}
}

function validate_admission(thisform){
	with (thisform){
		//PATIENT INFORMATION
		if (validate_required(fullname,"Patient Name is required")==false){
			fullname.focus();
			fullname.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(birthmonth,"Please enter patient's birth month")==false){
			birthmonth.focus();
			birthmonth.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(birthday,"Please enter patient's birth date")==false){
			birthday.focus();
			birthday.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(birthyear,"Please enter patient's birth year")==false){
			birthyear.focus();
			birthyear.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(areacode,"Please enter patient's phone number")==false){
			areacode.focus();
			areacode.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(phone1,"Please enter patient's phone number")==false){
			phone1.focus();
			phone1.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(phone2,"Please enter patient's phone number")==false){
			phone2.focus();
			phone2.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(address,"Please enter patient's street address")==false){
			address.focus();
			address.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(city,"Please enter patient's city")==false){
			city.focus();
			city.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(state,"Please enter patient's state")==false){
			state.focus();
			state.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(zip,"Please enter patient's zip code")==false){
			zip.focus();
			zip.style.background='#CCCCCC';
			return false;
		}
		//REFERRER'S INFORMATION
		if (validate_required(refname,"Please enter name of referrer")==false){
			refname.focus();
			refname.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(jobtitle,"Please enter referrer's job title")==false){
			jobtitle.focus();
			jobtitle.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(agency,"Please enter referral agency")==false){
			agency.focus();
			agency.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(agencyaddress,"Please enter referral agency's address")==false){
			agencyaddress.focus();
			agencyaddress.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(agencycity,"Please enter referral agency's city")==false){
			agencycity.focus();
			agencycity.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(agencystate,"Please enter referral agency's state")==false){
			agencystate.focus();
			agencystate.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(agencyzip,"Please enter referral agency's zip")==false){
			agencyzip.focus();
			agencyzip.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(agencyareacode,"Please enter referral agency's phone number")==false){
			agencyareacode.focus();
			agencyareacode.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(agencyphone1,"Please enter referral agency's phone number")==false){
			agencyphone1.focus();
			agencyphone1.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(agencyphone2,"Please enter referral agency's phone number")==false){
			agencyphone2.focus();
			agencyphone2.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(refemail,"Please enter referrer's e-mail address")==false){
			refemail.focus();
			refemail.style.background='#CCCCCC';
			return false;
		}
		//LEGAL GUARDIAN
		if (validate_required(guardname,"Please enter name of legal guardian")==false){
			guardname.focus();
			guardname.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(guardrelation,"Please enter legal guardian's relationship to patient")==false){
			guardrelation.focus();
			guardrelation.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(guardaddress,"Please enter legal guardian's address")==false){
			guardaddress.focus();
			guardaddress.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(guardcity,"Please enter legal guardian's city")==false){
			guardcity.focus();
			guardcity.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(guardstate,"Please enter legal guardian's state")==false){
			guardstate.focus();
			guardstate.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(guardzip,"Please enter legal guardian's zip")==false){
			guardzip.focus();
			guardzip.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(guardareacode,"Please enter legal guardian's phone number")==false){
			guardareacode.focus();
			guardareacode.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(guardphone1,"Please enter legal guardian's phone number")==false){
			guardphone1.focus();
			guardphone1.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(guardphone2,"Please enter legal guardian's phone number")==false){
			guardphone2.focus();
			guardphone2.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(guardemail,"Please enter legal guardian's e-mail address")==false){
			guardemail.focus();
			guardemail.style.background='#CCCCCC';
			return false;
		}
		//FUNDING SOURCE
		if (validate_required(fundsource,"Please enter funding source")==false){
			fundsource.focus();
			fundsource.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(policynum,"Please enter a ID/Policy #")==false){
			policynum.focus();
			policynum.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(guarantor,"Please enter guarantor's name")==false){
			guarantor.focus();
			guarantor.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(guaranssn1,"Please enter guarantor's Social Security Number")==false){
			guaranssn1.focus();
			guaranssn1.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(guaranssn2,"Please enter guarantor's Social Security Number")==false){
			guaranssn2.focus();
			guaranssn2.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(guaranssn3,"Please enter guarantor's Social Security Number")==false){
			guaranssn3.focus();
			guaranssn3.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(guaranaddress,"Please enter guarantor's address")==false){
			guaranaddress.focus();
			guaranaddress.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(guarancity,"Please enter guarantor's address")==false){
			guarancity.focus();
			guarancity.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(guaranstate,"Please enter guarantor's state")==false){
			guaranstate.focus();
			guaranstate.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(guaranzip,"Please enter guarantor's zip code")==false){
			guaranzip.focus();
			guaranzip.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(guaranareacode,"Please enter guarantor's phone number")==false){
			guaranareacode.focus();
			guaranareacode.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(guaranphone1,"Please enter guarantor's phone number")==false){
			guaranphone1.focus();
			guaranphone1.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(guaranphone2,"Please enter guarantor's phone number")==false){
			guaranphone2.focus();
			guaranphone2.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(guaranemail,"Please enter guarantor's e-mail address")==false){
			guaranemail.focus();
			guaranemail.style.background='#CCCCCC';
			return false;
		}
		//FINAL INFORMATION		
		if (validate_required(completedby,"Please enter your name")==false){
			completedby.focus();
			completedby.style.background='#CCCCCC';
			return false;
		}
		if (validate_required(completedbyrelation,"Please enter your relationship to patient")==false){
			completedbyrelation.focus();
			completedbyrelation.style.background='#CCCCCC';
			return false;
		}
	}
}