function validateField(f) {
	if(f==null || f=="") {
		alert("You must complete all fields.");
		return 1;
	}
	else {
		return 0;
	}
}

function validateRadio(r) {
	selected=0;
	for(i=0;i<r.length;i++) {
		if (r[i].checked) selected++;
	}
	if (selected==0) {
		alert("Please indicate whether generic is requested.");
		return 1;
	}
	else {
		return 0;
	}
}		

function processRefillRequest() {

	errors=0;
	
	fieldCheck = validateField(document.refillRequest.name.value);
	if (fieldCheck>0) {
		document.refillRequest.name.focus();
		return false;
	} 
	fieldCheck = validateField(document.refillRequest.ss.value);
	if (fieldCheck>0) {
		document.refillRequest.ss.focus();
		return false;
	} 
	fieldCheck = validateField(document.refillRequest.email.value);
	if (fieldCheck>0) {
		document.refillRequest.email.focus();
		return false;
	} 
	fieldCheck = validateField(document.refillRequest.telephone.value);
	if (fieldCheck>0) {
		document.refillRequest.telephone.focus();
		return false;
	} 
	fieldCheck = validateField(document.refillRequest.physician.value);
	if (fieldCheck>0) {
		document.refillRequest.physician.focus();
		return false;
	} 
	fieldCheck = validateField(document.refillRequest.medication.value);
	if (fieldCheck>0) {
		document.refillRequest.medication.focus();
		return false;
	} 
	fieldCheck = validateField(document.refillRequest.dosage.value);
	if (fieldCheck>0) {
		document.refillRequest.dosage.focus();
		return false;
	} 
	fieldCheck = validateRadio(document.refillRequest.generic);
	if (fieldCheck>0) {
		return false;
	} 
	fieldCheck = validateField(document.refillRequest.pharmacy.value);
	if (fieldCheck>0) {
		document.refillRequest.pharmacy.focus();
		return false;
	} 
	fieldCheck = validateField(document.refillRequest.pharmacyTelephone.value);
	if (fieldCheck>0) {
		document.refillRequest.pharmacyTelephone.focus();
		return false;
	} 
	
	ssNo = document.refillRequest.ss.value;
	ssOK = false;

	if (ssNo.length == 11) {
		ssNum = ssNo.substring(0,3) + ssNo.substring(4,6) + ssNo.substring(7);
		if (!isNaN(ssNum) && ssNo.charAt(3) == "-" && ssNo.charAt(6) == "-") {
			ssOK = true;
		}
	}

	if (ssNo.length == 9 &&	!isNaN(ssNo)) {
			ssNoFormatted = ssNo.substring(0,3) + "-" + ssNo.substring(4,6) + "-" + ssNo.substring(7);
			ssNo = ssNoFormatted;
			ssOK = true;
	}			

	if (ssOK==false) {
		alert("Invalid Social Security Number. Please re-enter.");
		document.refillRequest.ss.focus();
		return false;
	}

	phn = "";
	for (i=0;i<document.refillRequest.telephone.value.length;i++) {
		if (isNumeric(document.refillRequest.telephone.value.charAt(i))) {
			phn = phn + document.refillRequest.telephone.value.charAt(i);
		}
	}

	if (phn.length==10) {
		phnNo = phn.substring(0,3) + "-" + phn.substring(3,6) + "-" + phn.substring(6);
	}
	else {
		alert("Invalid Telephone Number. Please re-enter, beginning with your area code.");
		document.refillRequest.telephone.focus();
		return false;
	}

	phn = ""
	for (i=0;i<document.refillRequest.pharmacyTelephone.value.length;i++) {
		if (isNumeric(document.refillRequest.pharmacyTelephone.value.charAt(i))) {
			phn = phn + document.refillRequest.pharmacyTelephone.value.charAt(i);
		}
	}

	if (phn.length==10) {
		pPhnNo = phn.substring(0,3) + "-" + phn.substring(3,6) + "-" + phn.substring(6);
	}
	else {
		alert("Invalid Telephone Number. Please re-enter, beginning with your area code.");
		document.refillRequest.pharmacyTelephone.focus();
		return false;
	}

	nameOK = true;
	if (document.refillRequest.name.value.length<4) {
		nameOK = false;
	}

	firstSpace = -1;
	for (i=0;i<document.refillRequest.name.value.length;i++) {
		if (document.refillRequest.name.value.charAt(i) == " " && firstSpace == -1) {
			firstSpace = i;
		}
	}
	if (firstSpace < 1 || firstSpace == (document.refillRequest.name.value.length-1)) {
		nameOK = false;
	}

	if (nameOK==false) {
		alert("Please enter your full name, separated by spaces.");
		document.refillRequest.name.focus();
		return false;
	}

	charCount=0;
	for (i=0;i<document.refillRequest.dosage.value.length;i++) {
		if (isNumeric(document.refillRequest.dosage.value.charAt(i))) {
			charCount++;
		}
		if (isAlpha(document.refillRequest.dosage.value.charAt(i))) {
			charCount++;
		}
	}
	
	if (charCount<4) {
		alert("Please enter the complete dosage instructions for your medication.");
		return false;
	}


//* passed all edits--processing form

	document.submitRequest.Patient.value=document.refillRequest.name.value;
	document.submitRequest.realname.value=document.refillRequest.name.value;
	document.submitRequest.SSno.value=ssNo;
	document.submitRequest.email.value=document.refillRequest.email.value;
	document.submitRequest.Patient_Email.value=document.refillRequest.email.value;
	document.submitRequest.Telephone.value=phnNo;
	document.submitRequest.Physician.value=document.refillRequest.physician.value;
	document.submitRequest.Medication.value=document.refillRequest.medication.value;
	document.submitRequest.Dosage.value=document.refillRequest.dosage.value;
	
	for (i=0;i<document.refillRequest.generic.length;i++) {
		if (document.refillRequest.generic[i].checked) myIndex=i;
	}
	document.submitRequest.Generic.value=document.refillRequest.generic[myIndex].value;

	document.submitRequest.Pharmacy.value=document.refillRequest.pharmacy.value;
	document.submitRequest.Pharmacy_Telephone.value=pPhnNo;
	document.submitRequest.Comments.value=document.refillRequest.comments.value;


	document.submitRequest.submit();
	return false;
}